Lecture Notes: Musculoskeletal System and Soft Tissue Injuries

Introduction

• Importance of understanding soft tissue injuries in the musculoskeletal system.
• Prepare for patient care, not just exams.
• Engage actively in learning and relate content to personal experience.
• Review content and assess understanding regularly.

Key Components of the Musculoskeletal System

• Muscles, Tendons, and Ligaments
  • Tendon: Connects muscle to bone; fibrous tissue.
  • Ligament: Connects bone to bone; fibrous tissue.
  • Involved in movement, positioning, and joint mobility.

Types of Soft Tissue Injuries

Contusions

• Definition: Injury by blunt force causing small blood vessel rupture, leading to bruising.
• Characteristics:
  • Local bleeding, pain, edema.
  • Can range from minor to severe.
  • Impact joint range of motion and cause muscle weakness/stiffness.
  • Healing time: 1-2 weeks for minor, longer for severe.

Strains

• Definition: Injury to muscle or tendon from overuse, overstretching, or stress.
• Characteristics:
  • Known as a "pulled muscle."
  • Affects tendons in foot, leg, back.
  • Acute or chronic based on severity and symptoms.

Sprains

• Definition: Injury to ligaments around a joint from twisting or hyperextension.
• Characteristics:
  • Causes stretching/weakening of fibrous tissues.
  • Common in ankles, knees, wrists.
  • Severity graded based on ligament damage.

Dislocations

• Definition: Articular surfaces of bones forming a joint are misaligned.
• Characteristics:
  • Complete dislocation vs. subluxation (partial dislocation).
  • Impact on surrounding structures causing pain and potential nerve/vessel damage.
  • Can lead to avascular necrosis if untreated.

Compartment Syndrome

• Definition: Increased pressure within muscle compartment, compromising blood flow.
• Characteristics:
  • Can lead to tissue necrosis and permanent dysfunction.
  • Often arises from fractures, especially tibial.
  • Requires timely surgical intervention.

Assessments and Diagnosis

• Neurovascular Assessments: Focus on the "six P's": Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Poikilothermia.
• Diagnosis Process:
  • Identify symptoms and severity.
  • Formulate nursing problem statements with evidence.

Nursing Interventions

• Symptom Management: Immobilization, protection, pain management.
• Intervention Principles:
  • Use of PRICE acronym: Protect, Rest, Ice, Compress, Elevate.
  • Ensure interventions are safe and backed by understanding.

Medical Management

• Dislocation Management: Prompt reduction and stabilization.
• Compartment Syndrome: Fasciotomy to relieve pressure.

Patient Education and Discharge Planning

• Key Areas:
  • Pain and mobility management at home.
  • Importance of follow-up care and therapy.
  • Recognizing signs of complications.

Self-Care for Nurses

• Nurses face high risk of musculoskeletal disorders.
• Important to balance patient care with self-care to avoid injury.

Review and Mastery

• Regular review of content and notes.
• Self-testing for gaps in knowledge.
• Achieving learning objectives through continuous study and application.