Soft-tissue Injury: From 1 Different Sources
Damage to the tissues (see ligament; tendon; muscle) that surround bones and joints.
Sometimes called ?brous tissue, this is one of the most abundant tissues in the body, holding together the body’s many di?erent structures. Connective tissue comprises a matrix of substances called mucopolysaccharides in which are embedded various specialist tissues and cells. These include elastic (yellow), collagenous (white) and reticular ?bres as well as macrophages (see MACROPHAGE) and MAST CELLS. Assembled in di?ering proportions, this provides structures with varying functions: bone, cartilage, tendons, ligaments and fatty and elastic tissues. Collagenous connective tissue binds the muscles together and provides the substance of skin. It is also laid down in wound repair, forming the scar tissue. Contracting with time, connective tissue becomes denser, causing the puckering that is typical in serious wounds or burns. (See ADHESION; SCAR; WOUNDS.)... connective tissue
Adipose tissue, or fat, is a loose variety of ?brous tissue in the meshes of which lie cells, each of which is distended by several small drops, or one large drop, of fat. This tissue replaces ?brous tissue when the amount of food taken is in excess of the bodily requirements. Adipose tissue occurs as a layer beneath the skin and also around several internal organs. (See DIET; FAT; OBESITY.)... adipose tissue
A collection of cells similar in structure or function.... tissue
The essential procedure for matching the tissue of a recipient in need of transplanted tissue or organ to that of a potential donor. Unless there is a reasonable match, the recipient’s immune system (see IMMUNITY) will reject the donor’s organ. The main factors that are relevant to an individual’s reaction to donor tissue are called histocompatability antigens (see ANTIGEN). These are mostly human leucocyte antigens (HLAs – see HLA SYSTEM) present on the surface of cells. HLAs are inherited and, like ?ngerprints, unique to an individual, although identical twins have identical HLAs and hence are perfect matches for TRANSPLANTATION procedures.... tissue typing
An injury to the neck region caused by the neck being forcibly bent backwards and forwards (or the other way around). Car accidents are a common cause, when a driver or passenger is suddenly decelerated. The injury usually affects the ligaments, spinal joints and soft tissues of the neck. Subluxation (partial dislocation) of a cervical joint sometimes occurs and cervical vertebra may occasionally be fractured if the forces are severe. Pain and sti?ness of the neck result and these may worsen after a day or so. Treatment includes immobilisation of the neck in a collar, and analgesic and muscle-relaxing drugs. PHYSIOTHERAPY may be necessary. The patient usually recovers fully but may take several weeks to do so.... whiplash injury
CONNECTIVE TISSUE which contains a profusion of yellow elastic ?bres. Long, slender and branching, these ?bres (made up of elastin, an albumin-like PROTEIN) ensure that the elastic tissue is ?exible and stretchable. The dermis layer of the skin, arterial walls and the alveolar walls in the LUNGS all contain elastic tissue.... elastic tissue
Tissue involved in the formation of LYMPH, lymphocytes (see LYMPHOCYTE), and ANTIBODIES. It consists of the LYMPH NODES, THYMUS GLAND, TONSILS and SPLEEN.... lymphoid tissue
Accidental perforation of the skin by an injection needle, commonly of the hand or ?nger and usually by a nurse or doctor administering a therapeutic injection. The term also refers to accidental injuries from injection needles discarded by drug abusers. Dangerous infections such as viral HEPATITIS or HIV may be acquired from needle-stick injuries, and there are strict procedures about the disposal of used syringes and needles in medical settings.... needle-stick injury
See child abuse.... nonaccidental injury
(RSI) An overuse injury that affects keyboard workers and musicians, causing weakness and pain in the wrists and fingers.... repetitive strain injury
A group of generalised in?ammatory diseases that affect CONNECTIVE TISSUE in almost any system in the body. The term does not include those disorders of genetic origin. RHEUMATIC FEVER and RHEUMATOID ARTHRITIS were traditionally classi?ed in this group, as were those diseases classed under the outdated heading COLLAGEN DISEASES.... connective tissue disorders
See CONNECTIVE TISSUE.... fibrous tissue
A surgical dressing composed of a thick layer of cotton-wool between two layers of absorbent gauze, introduced by the Birmingham surgeon, Sampson Gamgee (1828–1886). Gamgee tissue has been a registered trademark since 1911.... gamgee tissue
Negative effect resulting from a medical treatment.... iatrogenic illness (or injury)
(See also CHILD ABUSE). Though NAI has traditionally been seen as abuse against children – and they are still the main victims – such injuries can also be in?icted on vulnerable adults. Adults with learning diffculties, dementias or physical disabilities su?ciently serious as to require institutional care (or who make heavy demands on relatives) are sometimes the victims of NAI. Health professionals, social workers and relatives should bear this possibility in mind when discovering unusual, severe or repeated bruising or fractures in vulnerable adults, even in circumstances where NAI may seem unlikely. (See also MUNCHAUSEN’S SYNDROME; PAEDOPHILIA.)... non-accidental injury (nai)
See UPPER LIMB DISORDERS.... repetitive strain injury (rsi)
A natural PROTEIN that occurs in the body. It has the property of breaking down a THROMBUS in a blood vessel (see THROMBOLYSIS). It is e?ective only in the presence of FIBRIN and activates plasminogen, which occurs normally on the surface of the ?brin. TPA is an important thrombolytic treatment immediately after a myocardial infarction (see HEART, DISEASES OF).... tissue plasminogen activator (tpa, tpa)
Trauma Injury to the urethra is often the result of severe trauma to the pelvis – for example, in a car accident or as the result of a fall. Trauma can also result from catheter insertion (see CATHETERS) or the insertion of foreign bodies into the urethra. The signs are the inability to pass urine, and blood at the exit of the urethra. The major complication of trauma is the development of a urethral stricture (see below).
Urethritis is in?ammation of the urethra from infection.
Causes The sexually transmitted disease GONORRHOEA affects the urethra, mainly in men, and causes severe in?ammation and urethritis. Non-speci?c urethritis (NSU) is an in?ammation of the urethra caused by one of many di?erent micro-organisms including BACTERIA, YEAST and CHLAMYDIA.
Symptoms The classic signs and symptoms are a urethral discharge associated with urethral pain, particularly on micturition (passing urine), and DYSURIA.
Treatment This involves taking urethral swabs, culturing the causative organism and treating it with the appropriate antibiotic. The complications of urethritis include stricture formation.
Stricture This is an abrupt narrowing of the urethra at one or more places. Strictures can be a result of trauma or infection or a congenital abnormality from birth. Rarely, tumours can cause strictures.
Symptoms The usual presenting complaint is one of a slow urinary stream. Other symptoms include hesitancy of micturition, variable stream and terminal dribbling. Measurement of the urine ?ow rate may help in the diagnosis, but often strictures are detected during cystoscopy (see CYSTOSCOPE).
Treatment The traditional treatment was the periodic dilation of the strictures with ‘sounds’
– solid metal rods passed into the urethra. However, a more permanent solution is achieved by cutting the stricture with an endoscopic knife (optical urethrotomy). For more complicated long or multiple strictures, an open operation (urethroplasty) is required.... urethra, diseases of and injury to
Damage sustained during birth. Minor injuries, such as bruising and swelling of the scalp during a vaginal delivery (see cephalhaematoma) are common. More serious injury can occur, particularly if the baby is excessively large and has difficulty in passing through the birth canal. A breech delivery may result in injury to nerves in the shoulder, causing temporary paralysis in the arm. The face may be paralysed temporarily if the facial nerve is traumatized by forceps. Fractured bones are another hazard of difficult deliveries, but the bones usually heal easily. (See also birth defects; brain damage.)... birth injury
Types of autoimmune disorders that often affect blood vessels and produce secondary connective tissue damage. They include rheumatoid arthritis, systemic lupus erythematosus, polyarteritis nodosa, scleroderma, and dermatomyositis.... connective tissue diseases
A mass of red, moist, granular tissue that develops on the surface of an ulcer or open wound during the process of healing.... granulation tissue
Accidental puncture of the skin by a contaminated hypodermic needle. Hospital staff are most likely to be at risk. Needlestick injuries carry the risk of serious infections, such as HIV and hepatitis, and need immediate attention. The wound should be cleaned thoroughly; blood tests may be needed to determine whether infection has been transmitted.... needlestick injury
The watery liquid present in the tiny gaps between body cells, also known as interstitial fluid.... tissue fluid
A substance produced by body tissues that prevents abnormal blood clotting. Also called , it is produced by the inner lining of blood vessels. can be prepared artificially for use as a thrombolytic drug, which is called alteplase. This is used in the treatment of myocardial infarction, severe angina pectoris, and arterial embolism, including pulmonary embolism. Possible side effects include bleeding or the formation of a haematoma at the injection site and an allergic reaction. (See also fibrinolysis.)... tissue-plasminogen activator
a quick method for determining the severity of a case of serious trauma. It can be used for purposes of *triage and *clinical audit.... abbreviated injury scale
see AKI.... acute kidney injury
loose *connective tissue consisting of a meshwork of collagen, elastic tissue, and reticular fibres interspersed with numerous connective tissue cells. It binds the skin to underlying muscles and forms a link between organs while allowing a high degree of relative movement.... areolar tissue
a collection of specialized cells that transmits electricity within the heart. It may be normal (e.g. the *sinoatrial node) or abnormal (e.g. an *accessory pathway).... conducting tissue
any one of a group of diseases that are characterized by inflammatory changes in connective tissue and can affect virtually any body system. Formerly known as collagen diseases (connective-tissue disease has been the preferred term since 1978), they include *dermatomyositis, systemic and discoid *lupus erythematosus, *morphoea, *polyarteritis nodosa, and *rheumatoid arthritis.... connective-tissue disease
the UK government agency, established by the Human Tissue Act 2004, that regulates the removal, use, and storage of human organs and tissue from both the living and the deceased for certain purposes as defined by the statute. These purposes include clinical research, clinical audit, and medical education. Anyone handling such material for those purposes should have a licence issued by the authority. Membership of the authority comprises clinical, scientific, academic, and lay representatives.... human tissue authority
(injury severity scale, ISS) a system used, particularly in *triage, for grading the severity of an injury. See also abbreviated injury scale.... injury scoring system
a disease with features in common with systemic *lupus erythematosus, *polymyositis, and *scleroderma. It is characterized by high levels of antibodies to ribonucleoprotein and most commonly affects women between 20 and 40 years of age.... mixed connective tissue disease
a tissue in the *bone marrow in which the various classes of blood cells are produced. See also haemopoiesis.... myeloid tissue
(OASIS) a spectrum of injuries that encompasses both third- and fourth-degree *perineal tears. Injury to the anal sphincter mechanism during childbirth may arise secondarily to direct disruption of the sphincter muscles and/or traction of the pudendal nerves. Disruption of the anal sphincter muscles is best assessed by anal ultrasound examination. This is usually performed using a high-frequency (10 MHz) endoanal probe. In selected cases with complex injury and/or suspected rectovaginal *fistula, magnetic resonance imaging (MRI) may also be employed.... obstetric anal sphincter injury
a penetrating injury by a ski stick.... ski-stick injury
(chancroid) a sexually transmitted disease caused by the bacterium Haemophilus ducreyi, resulting in enlargement and ulceration of lymph nodes in the groin. Treatment with sulphonamides is effective.... soft sore
any injury related to the practice of a sport, often resulting from the overuse and stretching of muscles, tendons, and ligaments.... sports injury
the culture of living tissues, removed from the body, in a suitable medium supplied with nutrients and oxygen. Tissue engineering, in which skin, cartilage, and other connective-tissue cells are cultured on a *fibronectin ‘mat’ to create new tissues, is being explored for use in tissue grafting for patients with burns, sports injuries, etc.... tissue culture
(tPA, TPA) a natural protein, found in the body and able to be manufactured by genetic engineering, that can break up a thrombus (see thrombolysis). It requires the presence of *fibrin as a cofactor and is able to activate *plasminogen on the fibrin surface, which distinguishes it from the other plasminogen activators, *streptokinase and *urokinase. tPAs include reteplase and tenecteplase, given to treat acute myocardial infarction, and *alteplase.... tissue-type plasminogen activator
(TBI) injury to the brain due to external force, such as occurs following falls, road traffic accidents, and violence. It is a major cause of death and chronic disability worldwide, especially in young males.... traumatic brain injury
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