Nomenclature, Terminology and Evaluation

Injury Nomenclature

standardized terminology used to describe the type, severity, location, and mechanism of an injury.

Anatomical References Positions

Supine

• Prone

• Anterior/ventral/Palmar

• Posterior/dorsal

• Superior/Cranial/Cephalic

• Inferior/Caudal

• Medial

• Lateral

• Proximal

• Distal

• Visceral

• Parietal

Anatomical References Planes

Transverse

• Sagittal

• Coronal/Frontal

Injury Classification Sign

Finding the observable: can be observed or measured by a healthcare provider.

• Objectively measured Can be seen, felt, heard, or measured.

• Examples? Swelling, bruising (contusion), bleeding, deformity, redness, warmth, limited range of motion, abnormal vital signs.

Injury Classification Signs definition

Objective (what the examiner observes or measures).

Injury Classification Symptoms

Subjective complaint: experienced and reported by the patient.

• Cannot directly be observed.

• Examples? Pain, tenderness, dizziness, numbness, tingling, weakness, stiffness, nausea.

Injury Classification Symptoms definition

Subjective (what the patient feels and reports).

Injury Classification Acute

Sudden onset

• Short duration

• Single traumatic event or mechanism

• Exact time and cause of injury are usually known

Injury Classification Acute Characteristics

• Occurs suddenly after a specific event

• Immediate pain and swelling are common

• Usually caused by trauma

Acute injury ex.

• Ankle sprain

• Bone fracture

• Shoulder dislocation

• Muscle strain

  • Ligament tear

Injury Classification Acute injury

Sudden injury from one traumatic event.

Injury Classification Chronic

Gradual onset

• Prolonged duration

• Exact mechanism or time of injury is unknown (insidious)

• Develops from repetitive stress or overuse

Exact time or mechanism is often unknown (insidious onset)

Injury Classification Chronic Characteristics:

• Develops slowly over time

• Results from repeated stress or overuse

  • Symptoms may worsen gradually

Injury Classification Chronic Examples::

• Tendinitis

• Stress fracture

• Tennis elbow

• Shin splints

  • Runner's knee

Injury Classification Chronic injury

• Gradual injury caused by repetitive stress or overuse over time.

Injury Classification can be either

acute or chronic

Closed Injuries can either be

contusions, strain, closed fracture, sprain, Epiphyseal Injuries, Dislocation/ Subluxation.

Closed Injuries Contusions

Degrees

• 1st: Mild pain and tenderness. Minimal swelling. Slight discoloration (bruising).

• 2nd: Moderate pain. Noticeable swelling and bruising. Reduced movement of the affected area

• 3rd: Severe pain. Extensive bleeding and swelling. Significant loss of function; may involve muscle damage

A contusion is a

closed injury caused by a direct blow, resulting in bleeding under the skin.

Closed injuries

occur without a break in the skin. The damage is beneath the skin and may involve muscles, ligaments, tendons, bones, or joints.

Closed Injuries Sprain

Ligament or capsule

• Degrees

• 1st: Ligament is stretched but not torn. Mild pain and swelling. Joint remains stable

• 2nd: Partial tear of the ligament. Moderate pain, swelling, and bruising. Some joint instability and difficulty using the joint

• 3rd: Complete tear of the ligament. Severe swelling and instability. Loss of joint function; may require surgery

A sprain is an

injury to a ligament or joint capsule caused by overstretching or tearing.

Closed Injuries Strains

Affects Tendons/muscles

• Degrees

• 1st: Muscle or tendon is overstretched. Mild pain and tenderness. Little or no loss of strength or movement

• 2nd: Partial tear of the muscle or tendon. Moderate pain, swelling, and bruising. Decreased strength and limited movement

• 3rd: Complete tear (rupture) of the muscle or tendon. Severe pain (may lessen after rupture). Significant loss of function and strength. Often requires surgical repair.

A strain is an

injury to a muscle or tendon caused by overstretching or tearing.

Closed Injuries Closed Fractures

Affects the bone

Stress fractures

Traumatic fractures

• Various types

Types of Closed Fractures: Stress Fracture

• Small crack in the bone caused by repetitive stress or overuse

• Common in athletes and runners

• Gradual onset of pain

Types of Closed Fractures: Traumatic Fracture

• Caused by a single forceful injury, such as a fall, collision, or direct blow

• Sudden pain and loss of function

Common Types of Traumatic Fractures

• Transverse –

• Oblique –

• Spiral –

• Comminuted –

• Impacted –

• Greenstick –

• Compression –

Common Types of Traumatic Fractures: Transverse

Straight break across the bone

Common Types of Traumatic Fractures: Oblique

Diagonal break

Common Types of Traumatic Fractures: Spiral

Twisting fracture

Common Types of Traumatic Fractures: Comminuted

Bone breaks into several pieces

Common Types of Traumatic Fractures: Impacted

One bone fragment is driven into another

Common Types of Traumatic Fractures: Greenstick

Incomplete fracture, common in children

Common Types of Traumatic Fractures: Compression

Bone is crushed, often in the spine

A closed fracture (simple fracture) is a

broken bone in which the skin remains intact.

Stress Fracture

affects the bone, Small crack caused by repetitive stress.

Traumatic Fracture

affects bone. break caused by a sudden traumatic force.

Closed Injuries: Epiphyseal Injuries

Disruption of epiphyseal plates Occurs in children/adolescents; classified by

• Salter-Harris classifications:

• Type I: Fracture through the growth plate only.

• Type II: Fracture through the growth plate and metaphysis (most common).

• Type III: Fracture through the growth plate and epiphysis.

• Type IV: Fracture through the metaphysis, growth plate, and epiphysis.

• Type V: Crush injury to the growth plate (least common but has the highest risk of growth disturbance).

Salter-Harris classifications:

• Type I: Fracture through the growth plate only.

• Type II: Fracture through the growth plate and metaphysis (most common).

• Type III: Fracture through the growth plate and epiphysis.

• Type IV: Fracture through the metaphysis, growth plate, and epiphysis.

• Type V: Crush injury to the growth plate (least common but has the highest risk of growth disturbance).

Closed Injuries: Epiphyseal Injuries definition

are injuries involving the epiphyseal (growth) plate of a bone. They occur mainly in children and adolescents because their growth plates have not yet closed.

Closed Injuries Dislocation/ Subluxation

Disassociation of joint surfaces

Closed Injuries Dislocation/ Subluxation defintion

These injuries involve the disassociation (separation) of joint surfaces.

Dislocation (Luxation)

• Complete displacement/seperation of the bones forming a joint.

• Joint surfaces lose all contact.

• Causes severe pain, deformity, swelling, and inability to move the joint.

Subluxation

• Partial displacement/seperation of a joint.

• Joint surfaces remain in partial contact.

• Causes pain, swelling, and some joint instability, but is less severe than a complete dislocation.

Nerve Injuries Classified based on extent of nerve

disruption:

- Neuropraxia

• Axonotmesis

• Neurotmesis

- Neuralgia

• Neuroma

Nerve Injuries 1. Neuropraxia (Mildest)

• Temporary interruption of nerve conduction.

• No structural damage to the nerve (axon remains intact).

• Caused by compression or a mild stretch injury.

• Symptoms: Numbness, tingling, temporary weakness.

  • Recovery: Usually complete within days to weeks.

Nerve Injuries 2. Axonotmesis (Moderate)

• Axon is damaged, but the connective tissue around the nerve remains intact.

• Caused by more severe crush or stretch injuries.

• Results in loss of motor and sensory function.

• Recovery: Possible because the nerve can regenerate, but it may take weeks to months.

Nerve Injuries 3. Neurotmesis (Most Severe)

• Complete disruption of the nerve and its supporting structures.

• Caused by severe trauma or laceration.

• Complete loss of nerve function below the injury.

  • Recovery: Does not occur spontaneously; usually requires surgical repair.

Nerve Injuries Neuralgia

• Definition: Pain along the course of a nerve.

• Characteristics: Sharp, burning, stabbing, or shooting pain.

  • Examples: Trigeminal neuralgia, sciatic neuralgia.

Nerve Injuries Neuroma

• Definition: A benign growth or thickened mass of nerve tissue, often formed after a nerve injury.

• Characteristics: Painful lump, tenderness, tingling, or abnormal sensations.

• Can develop when a damaged nerve heals abnormally.

Open Wounds/Injuries

Blister

• Abrasion

• Incision

• Laceration

• Puncture

• Avulsion

• Compound Fracture/dislocation

Open Wounds/Injuries Blister

• A fluid-filled sac that forms beneath the skin.

• Usually caused by friction, burns, or irritation.

Open Wounds/Injuries: Abrasion

• A superficial scrape of the skin.

• Caused by friction against a rough surface.

• Minimal bleeding but can be painful.

Open Wounds/Injuries: Incision

• A clean, straight cut made by a sharp object (e.g., knife or glass).

• Edges are smooth and regular.

Open Wounds/Injuries: Laceration

• A tear or jagged cut in the skin and soft tissue.

• Caused by blunt trauma or sharp objects.

• Edges are irregular and bleeding may be significant.

Open Wounds/Injuries: Puncture

• A deep, narrow wound caused by a pointed object (e.g., nail or needle).

• Small surface opening but deeper tissue may be injured.

• Higher risk of infection.

Open Wounds/Injuries: Avulsion

• A forcible tearing away of skin or soft tissue from its normal attachment.

• May expose muscle, tendon, or bone.

• Often associated with severe bleeding.

Open Wounds/Injuries: Compound (Open) Fracture

A broken bone that pierces the skin or has an open wound communicating with the fracture.

Open Wounds/Injuries: Open Dislocation:

A dislocated joint with an associated open wound, exposing the joint.

Open Wounds/Injuries: Compound Fracture/dislocation

Both injuries are medical emergencies because of the high risk of infection and tissue damage.

Chronic Injuries

Apophysitis

• Exostosis

• Bursitis

• Capsulitis

• Myositis

• Neuritis

• Periostitis

• Tendinitis

• Tendinosis

• Tenosynovitis

• Osteochondritis

Chronic Injuries: Apophysitis

Inflammation of an apophysis (growth plate where a tendon attaches to bone), still growth occurring, irritates bone which causes this. also seen in Achilles. common in growing children and adolescents.

Chronic Injuries: Exostosis

Abnormal bony growth (bone spur) that develops due to chronic stress or irritation.

Chronic Injuries: Bursitis

Inflammation of a bursa, the fluid-filled sac that reduces friction around joints.

Chronic Injuries: Capsulitis

Inflammation of the joint capsule, causing pain and stiffness.

Chronic Injuries: Myositis

Inflammation of a muscle.

Chronic Injuries: Neuritis

Inflammation of a nerve, causing pain, numbness, or tingling.

Chronic Injuries: Periostitis

Inflammation of the periosteum (outer covering of bone), often due to repetitive stress (e.g., shin splints).

Chronic Injuries: Tendinitis

Acute inflammation of a tendon, usually caused by overuse.

Chronic Injuries: Tendinosis

Chronic degeneration of a tendon without significant inflammation, resulting from long-term overuse.

Chronic Injuries: Tenosynovitis

Inflammation of the tendon sheath surrounding a tendon.

Chronic Injuries: Osteochondritis

Inflammation or injury involving bone and cartilage, which may lead to pain and joint dysfunction.

Chronic injuries develop

gradually over time, usually due to repetitive stress, overuse, or prolonged irritation.