Qualification - Certificate in Health Support

HEALTH SUPPORT DISTANCE LEARNING COURSE 

Modules

Note that each module in the Qualification - Certificate in Health Support is a short course in its own right, and may be studied separately.

WHAT CAN GO WRONG WITH BONES AND JOINTS

These may include any of the following:

Sprains occur when the ligaments (connective tissues that connect two anatomical structures) have been suddenly stretched or even torn. A sprain is indicated by pain and swelling at a joint and temporary, localised lameness. These symptoms can be associated with other injuries (eg. Broken bone), so if symptoms are more severe, pain severe or a deformity obvious an examination by a doctor is advised. It is best to take caution and seek a professional opinion and x-ray as the localised swelling can mask deformity and cause further damage. Delaying treatment of a fracture can seriously affect healing. For a sprain the best treatment is rest. Ice packs can also help reduce swelling. Serious sprain injuries (such as sprained knee ligaments) may require prolonged rest, perhaps for as long as six months. Repeat ligament strains can require surgery. Anti inflammatory medications may be required to reduce swelling. Some more severe sprains may also be treated with a cast, to immobilize the affected tissue.

Bones may be broken as a result of a significant force, such as a car accident, fight or fall. Internal injuries caused by the same event, perhaps resulting in internal bleeding are not uncommon. The victim may also often suffer shock when a bone is broken. Pain and bleeding from the bones is common as they are very well vascularised and innervated. Bones in children are less brittle and may crack more often, and break less. Bones in older people, being more brittle are more often likely to break. There are several types of fractures:

o        Open or Compound

o        Broken bones penetrate through the skin

o        Comminuted

o        Splintering, shattering, crushing or smashing of a bone into several pieces

o        Compression

o        The bone is broken due to antiparallel forces on opposite ends, common in the vertebrae

o        Greenstick

o        An incomplete fracture, where one edge of the bone shaft is broken and the other is bent toward the fracture. Most common in young children

o        Salter-Harris

o        Fracture of the epiphysial plates (area of new bone formation, seal when a person stops growing in early adulthood)

o        Spiral/Torsion

o        A fracture due to a severe twisting force along the length of the bone

o        Transverse

o        A fracture that runs at right angles to the long axis of the bone

A compound fracture is most likely to damage associated musculature and connective tissues structures and to cause infection. Infection of the bone itself is particularly serious. Complications from fractures can be penetrating injuries to the organs and deep blood vessels.

These are most likely to occur when the skin has been punctured. Symptoms might include swelling, limping, pain and fever. Bone infection can occur in the absence of an obvious injury and is also a symptom of some degenerative diseases. Bone infections must be confirmed using an x ray and often a biopsy. Antibiotics and surgery may be needed and recovery can take a long time. The bone marrow is often affected, compromising the immune system.

Bones may be dislodged from their normal position in a joint as a result of a significant force such as a car accident, fight or fall. Internal injuries caused by the same event, perhaps resulting in internal bleeding are not uncommon. Dislocation causes pain, and obviously, the person may be unable to weight bear on the dislocated bond. Often there will be an apparent deformity superficial to the dislocation. A doctor will need to verify suspected dislocation and replace the bone in the joint by a physical manipulation. You should not attempt to correct a dislocation yourself! It can be extremely painful when done incorrectly (in some cases an anaesthetic or analgesic will be given prior to manipulation), some dislocations require surgical correction, and you will most likely cause greater damage (pinch nerves or tendons, damage muscle or joint tissues etc). Simply support and immobilise the joint and seek professional assessment and treatment. Applying ice compresses (wrapped in cloth, never directly onto the skin) can also reduce swelling and pain.

DISORDERS OF THE MUSCULOSKELETAL SYSTEM

The muscles need to be healthy and functioning properly for the body to move normally. Often, muscles, bursas, and tendons that are injured due to trauma, overuse, infection, and occasionally disease can be temporarily or permanently damaged. Damage can cause pain, limit control over movement, and reduce the normal range of motion. In some cases, the neurological control of the muscle is lost. This is the case with spinal injuries, and can also occur with deep laceration injuries where the nerve is severed closer to the muscle it controls. 

Common muscle disorders include:

Cramp
A sudden, brief and painful tetanic contraction of a muscle or group of muscles. Cramps are believed to be caused mainly by hyperexcitability of the nerves controlling the muscle/s. They may also be due to muscle fatigue, dehydration, low blood concentrations of calcium, magnesium or potassium or depletion of ATP.

Sprains and strains
Sprains and strains are not the same thing! A sprain is an injury to a ligament, while a strain is an injury to muscle or tendon. The extent of the injury (complete or partial tear, hyperextension, torsion) will determine the severity of the symptoms, which will include some localised pain, inflammation and loss of mobility. In severe cases a tendon or muscle can be partially or completely torn from the bone insertion or origin.

Muscular Dystrophy
A group of related genetic diseases that are characterised by the progressive weakening of the skeletal and smooth muscles. Some types result in a rapid degeneration and premature death, others are much slower and do not alter life expectancy too greatly. 

Fibromyalgia
A group of disorders that are characterised by pain and stiffness in the soft tissues (including muscles, tendons and ligaments)

The smooth muscles can also be affected by disorders. Examples include irritable bowel syndrome, varicose veins and conditions where arterial tone is compromised. 

ELECTIVES