The concept of trauma. Classification and characteristics of injuries

The concept of trauma. Classification and characteristics of injuries.

Injury are the factors external environment that cause tissue damage or functional impairment in the body without visible morphological changes in them.

Damage is a violation of the integrity or functional state of the tissue resulting from exposure to some kind of injury. The body responds to damage with an appropriate protective and adaptive reaction.

Classification

1. Mechanical injury- the effect of mechanical force on the body. Injuries causing mechanical injuries are divided into operational, accidental, generic, wartime. They can be open and closed. Both are non-/direct, multiple and single.

Closed mechanical damage characterized by the preservation of the anatomical integrity of the skin and mucous membranes. These include bruises or contusions, sprains, ruptures of soft tissues and parenchymal organs, dislocations of the joints, violation of the integrity of the bones. Due to the peculiarities of the anatomical and histological structure of the skin, it has great elasticity and strength. Therefore, its anatomical continuity can be preserved even with severe injuries, when the organs and tissues lying under it are in a state of stretching, tearing, crushing, crushing, fracture, and even crushing.

Open mechanical damage Wounds are characterized by separation of the skin, mucous membranes and underlying soft tissues, internal organs and bones. They are more than closed ones are subject to repeated traumatic effects of the external environment, as well as pollution, contamination by various microorganisms. These include wounds of various types and nature, open fractures and dislocations. Direct mechanical damage occurs at the site of application of traumatic mechanical force. Indirect - appear at a certain distance from the place of application of the traumatic effect.

2. thermal injury It is less common than mechanical and is associated with exposure of the skin of animals to high (burns) or low (frostbite) temperatures.

3. electrical injury associated with passage through the body electric current or lightning.

4. radiation injury associated with more or less prolonged exposure to radiant energy or ionizing radiation. This type of injury does not cause immediate defensive reaction and is not recognized immediately after its application.

5. chemical injury is a consequence of exposure to tissues of acids, alkalis, salts of heavy metals, chemical warfare agents and some chemicals used to treat animals. Some chemicals cause mainly local damage, while others, being absorbed through the skin and mucous membranes, act toxically on the entire body.

7. mental trauma occurs with fright caused by the perception of external phenomena by the visual and auditory analyzer, as well as by the rough influence of a person, causing fear in animals. This injury is more often observed in animals with increased excitability and a predominance of excitatory processes over inhibitory ones. Each of the above injuries can be acute and chronic. Under the influence of acute injuries in the body, tissue damage, functional disorders, and acute reactive processes immediately occur; at chronic injuries these phenomena appear after prolonged or repeated exposure to it.

A combined injury is also distinguished, when the effect on the tissues of one of the injuries, for example mechanical, is combined with the damaging effect of a chemical or other injury on them. Then in the body there are more heavy damage often ending in the death of the animal.

Immediately after the application of heavy trams, and sometimes at the time of their application, there is a danger of developing collapse, shock, paresis, paralysis, loss of individual tissues, organs, body parts, it is possible sudden death. Mechanical injuries, especially wounds, are accompanied by bleeding, often life threatening. Damage to the integument contributes to the penetration of the infection into the tissues of the internal environment of the body and creates the risk of developing a general or local infection.

With extensive, especially closed, traumatic toxicosis often develops due to the absorption of enzymatic decay products of dead tissues. Under the influence of injuries, trophic disorders often develop that worsen or completely inhibit regeneration. In case of large tissue damage and necrosis, even after favorable healing, extensive scars develop at the site of injury, making it difficult or completely shutting down an organ or even entire parts of the body from function.

The outcomes of injuries of the same strength and duration of exposure depend on the anatomical and physiological characteristics of damaged tissues and organs, their vital importance, the presence of previous pathological changes in them, as well as on the functional state of the nervous system at the time of injury and the species reactivity of injured animals.

2. The concept of trauma. Classification and principles of injury prevention.

Trauma refers to a combination of various factors causing damage organism.

Currently, the following types of animal injuries are distinguished:

1. agricultural;

2. operational;

3. sports;

4. transport;

5. random;

7. stern, with its causal and damaging features.

1. Agricultural injuries arises as a result of a violation of zoohygienic conditions and rules for keeping animals (drafts, poorly arranged floors and fluid drains, dampness, poor ventilation, malfunctioning of premises and equipment, insufficient walking areas and exercise, improper organization of large-group keeping), as well as in case of improper and careless use means of mechanization, automation and electrification (violation of safety regulations).

2. Operational injuries observed in the case of improper and excessive exploitation of animals.

3. Sports injuries, being a kind of operational, is observed mainly in horses. Most often, it is due to improper training, inept management and underestimation of the physiological capabilities of the animal, as well as the conditions of the competition, terrain, etc.

4. Transport injuries occurs in animals during their transportation by rail, road, water and air transport. It is characterized by the relative mass character and originality of the defeat of the static-dynamic apparatus of animals (stretching of the tendon-ligamentous apparatus, myositis, myopathosis, arthritis, pododermatitis, etc.).

5. Accidental injury is predominantly mechanical, thermal, chemical, electrical, radiation in nature. Often it is associated with meteorological and natural disasters. It is more difficult to foresee and prevent than other types of injuries.

6. Military injuries- a set of mechanical, thermal, chemical, electrical and radiation damage caused to animals during the war.

7. Feed injuries associated with feeding, fodder preparation, forage quality, as well as with the state of pasture lands (contamination with metal objects, poisonous herbs, etc.).

Clinical signs

For treatment, etiotropic therapy is used, aimed at eliminating the cause of shock and symptomatic, which includes the use of adrenaline, long-term (more than 5-6 hours) infusion therapy, oxygen therapy, as well as the introduction of drugs - antibiotics, diuretics to stop pulmonary edema, steroid hormones, analgesics and others, depending on the severity of the condition and the dynamics of the course of the disease.

Clinical signs

The erectile phase of shock develops at the time of injury and lasts from a few seconds to several minutes. Clinically, it is manifested by a sharp, violent excitement: the animal makes strong sounds (screeching, growling, etc.), beats, strives to free itself from fixation. Eyes wide open, pupils and nostrils dilated, breathing quickened; pulse is frequent, strong filling, blood pressure increased. There may be increased sweating.

At mild form erectile shock and the cessation of strong pain stimuli, the animal comes out of state of shock. In cases of moderate and especially severe forms, the erectile phase passes into the torpid phase of shock.

The torpid phase of shock is characterized by a sharp depression, a decrease in reflexes while maintaining "consciousness"; lack of response to newly applied pain; a decrease in all body functions, as a result of which the muscles become sluggish, the animal lies down or falls, lies motionless, poorly reacting to auditory stimuli.

Breathing becomes shallow, irregular and rare, mucous membranes are pale; the pulse is weak, frequent, barely perceptible, the blood pressure progressively falls; there is a glassy sheen of the cornea, the pupils are dilated, sluggishly react to light; body temperature decreases by 1-2°C; observed involuntary separation of feces and urine.

The blood gradually thickens; the amount of plasma decreases, as a result of which the number of red blood cells in the blood volume is increased; hemodynamics worsens, cardiac activity weakens; metabolism is disturbed; kidney function decreases, oliguria and even anuria occur; the functional state of other organs and systems changes.

With a favorable course and timely treatment, the torpid phase of shock ends in recovery, in other cases it passes into a paralytic phase due to exhaustion. nerve centers and central paralysis. During this phase, body temperature drops by 2°C and even 3°C, blood pressure becomes very low. The pulse is barely perceptible, reflexes and other reactions to external stimuli are absent.

Treatment. Rational Therapy traumatic shock should be comprehensive, as early as possible, aimed at correcting all disturbed vegetative processes and restoring functional disorders of the body.
The main principles of treatment for shock are:
1) urgent cessation (blocking) of the flow of pain impulses from the area of injury to the cerebral cortex;
2) elimination of the cause (source) of pain irritation (trauma, surgery, etc.) and normalization of the function of the nervous system;
3) restoration of hemodynamics and elevation blood pressure;
4) termination of toxemia and restoration of impaired metabolism.
Blocking of pain impulses is achieved by the urgent use of novocaine blockades, the type of which is determined by the type and location of the damage that caused traumatic shock. With open organ injuries chest cavity(pneumothorax) apply cervical vagosympathetic blockade, and in the abdominal and pelvic - suprapleural novocaine blockade of the celiac nerves and borderline sympathetic trunks (according to V.V. Mosin). A positive effect can be obtained from the intravenous administration of novocaine (0.25% solution at a dose of 1 ml / kg). Vitamins C, Bj, B6, B12 are urgently prescribed. To relieve shock during operations and injuries, bone fractures, immediately carry out local anesthesia(infiltration, conduction, epidural) depending on the location of the damage, after which the consequences of the injury are eliminated. Penetrating wounds into the thoracic and abdominal cavities after careful antiseptic treatment closed with sutures, in cases of prolapse of the intestine, it is set into the abdominal cavity. To prevent and relieve pain irritation in case of bone fractures, a 2-3% solution of novocaine at 30% is injected into the fracture zone. ethyl alcohol, when the nerve trunk is infringed, it is released from bone fragments and an immobilizing bandage is applied.
After turning off the pain reflexes, the treatment is directed to the restoration of impaired body functions. The animal is given absolute rest.

In the treatment of traumatic shock blood substitutes and anti-shock fluids may be used. Protein-containing liquids are used as blood substitutes - colloidal infusin, aminopeptide, aminoblood, gelatinol, etc. From synthetic means polyglucin (dextran), polyvinol, polyvinylpyrralidone are recommended. The dose of the infused blood substitute depends on the severity of the traumatic shock, the characteristics of the injury and its complications - on average, it ranges from 3-4 to 5-6 liters.
It must be remembered that any one transfusion agent should be administered, since they are mostly antagonistic.
Note that the recommended in some textbooks general surgery in traumatic shock, the prescriptions of anti-shock liquids by E. A. Asratyan and I. Popov are not harmless to the animal organism due to the overestimated dose of sodium chloride in them. In the liquid of E. A. Asratyan, its dose exceeds the therapeutic dose by 8-10 times, and in the liquid of I. Popov - 3-4 times. In this regard, noteworthy is the "camphor serum" prescribed by M. V. Plakhotin, which provides a high therapeutic effect. It consists of the following items: camphor - 3 g, glucose - 100 g, calcium chloride - 20 g, physiological sodium chloride solution - 2000 ml. It is administered intravenously to large animals at a dose of 1500-2000 ml, to small animals - 150-200 ml. This liquid is also effective in secondary shock, etiological factor which is intoxication and infection. For these purposes, a 40% solution of hexamethylenetetramine is also used at a dose of 40-50 ml (large animals) with the addition of 10% calcium chloride and a dose of caffeine (intravenously). Both last resort provide detoxification, remove toxins from the body, reduce capillary permeability and cell membranes. However, it should be remembered that in all cases of treatment for traumatic shock, it is necessary to carry out complete or partial excision of dead tissues and thorough drainage.

Prevention of traumatic shock is based on ensuring optimal zoohygienic conditions in the maintenance, feeding and exploitation of animals, excluding mechanical and other types of injuries. During surgical operations, in order to prevent operational shock, anesthesia, local anesthesia and special novocaine blockades are used. So, for the prevention of shock before abdominal operations, suprapleural novocaine blockade is performed (according to V.V. Mosin). To prevent pleuropulmonary shock in penetrating wounds and operations on the organs of the chest cavity, vagosympathetic blockade is performed, and a glucocorticoid is administered before surgery, which helps to increase the body's resistance to the development of postoperative shock.

Etiology of inflammation

Phases of inflammation

First phase inflammation is characterized by the phenomena of hydration (swelling), it occurs in the focus of inflammation as a result of active hyperemia, exudation, acidosis, local metabolic disorders, redox processes and acid-base balance. In the future, hydration is enhanced as a result of impaired blood and lymph circulation and activation of enzymatic processes, accumulation of physiologically active substances and increased oncotic and osmotic pressure.

The main processes unfolding in the first phase are as follows: in the center of the inflammation focus, conditions are created for interstitial digestion of dead tissues and infection, and along the periphery, on the border with healthy tissues, processes of localization and restriction (barrierization) of the damage zone and the initial introduction of the infection occur. . Initially, a cellular barrier is formed, which gradually turns into a granulation one.

In the process of enzymatic cleavage of dead tissues, toxic products of tissue destruction (aseptic inflammation) or microbial toxins (with infectious inflammation) accumulate in the focus of inflammation. At the same time, tissue cells are additionally necrotic, leukocytes are damaged and die. As a result of fermentolysis and phagocytosis in the central part of the focus of infectious inflammation, dead tissues liquefy, purulent exudate accumulates, and an abscess cavity gradually forms, delimited from neighboring intact tissues by a granulation barrier. This barrier prevents the generalization of the infection and the spread of necrosis to damaged tissues. Complete delimitation of the purulent cavity by the granulation barrier indicates the maturation of the abscess. As it matures, the inflammatory phenomena begin to subside, and the inflammation passes into the second phase.

Following the impact of the damaging agent, a reflex spasm of small blood vessels occurs in the damage zone; soon they expand, active hyperemia develops, blood flow accelerates, blood pressure and local metabolism increase. At the same time, histamine, acetylcholine, leukotaxin are released, and potassium ions and other tissue decay products are released from damaged cells. By acting on the walls of blood vessels, these substances further increase blood flow, increase local blood pressure, increase capillary permeability and exudation of the liquid part of the blood. Initially, small molecular proteins - albumins, later proteins-globulins and, finally, fibrinogen penetrate into the tissues along with the exudate. At the same time, leukocytes migrate from the vessels and accumulate in the tissues of the damaged area (especially in large numbers with purulent inflammation).

The accumulation of leukocytes in the inflammatory focus is accompanied by the development of phagocytosis and enzymatic effects on the harmful agent.

Violation fat metabolism leads to the accumulation of fat and fatty acids in the exudate due to the decay and degeneration of cells. Incomplete oxidation of fats occurs, a large amount of under-oxidized products accumulate in the focus of inflammation.

The breakdown of proteins is carried out by enzymes of mesenchymal cells and proteolytic enzymes secreted by neutrophilic leukocytes. Under their influence, large molecules of polypeptides and amino acids are formed in the focus of inflammation. The accumulation of underoxidized products of carbohydrate, fat and protein metabolism and associated carbon dioxide is accompanied by an increase in the concentration of hydrogen ions and the development of acidosis. Initially, acidosis is compensated, as acidic products are neutralized by alkaline tissue reserves (compensated acidosis). In the future, when blood and lymph circulation becomes difficult or completely stops in the focus of inflammation, the concentration of hydrogen ions increases even more, and the alkaline reserves of tissues are depleted, decompensated acidosis occurs.

Due to the death and decay of cells in the exudate, the amount of potassium ions increases. The more intense the inflammation, the more potassium accumulates in the exudate. Their accumulation contributes to an increase in vascular permeability, increased pain, the development of neurodystrophic phenomena and necrosis of tissues with reduced viability.

The disintegration of tissue elements is accompanied by the splitting of large molecules into small ones, which leads to an increase in molecular and ionic concentrations. As a result, the osmotic pressure increases, and this leads to further disruption of blood and lamp circulation and adversely affects the functional state of the cells. Along with this, oncotic pressure also increases, i.e., the dispersion of tissue colloids, their ability to attract and retain water, increases. Towards the periphery of the inflammation focus, oncotic pressure, as well as the concentration of hydrogen ions and potassium, gradually decreases. The described bio-physico-chemical shifts that develop in the focus of inflammation contribute to hydration phenomena, i.e., swelling, primarily of damaged tissues, as well as increased proteolysis and active phagocytosis.

In the first phase of inflammation in horses and dogs, serous (aseptic inflammation) or serous-purulent ( infectious inflammation) exudation and pronounced proteolysis (melting) of the dead substrate, while in cattle and pigs there is serous-fibrinous or purulent-fibrinous exudation with sequestration phenomena, proteolysis is weakly expressed. As a result, dead tissues in these animals linger in the focus of inflammation for a longer time. Their rejection occurs due to the developing purulent-demarcation inflammation. The sequestration process is accompanied by the formation of a granulation barrier with a relatively small accumulation of pus between it and the sequestering dead tissues. In the process of sequestration, the dead substrate is also subjected to enzymatic melting. open injuries(wounds, burns) is rejected into the external environment.

Second phase inflammation is characterized by a decrease in all signs of inflammation and a gradual normalization of bio-physico-chemical disorders that occurred in the first phase. This contributes to the development of dehydration phenomena (swelling) in the focus of inflammation. Against the background of which compensatory and regenerative processes prevail in the inflammatory focus, accompanied by compaction of colloids of connective tissue, cell membranes and a decrease in capillary permeability. At the same time, the barrierization (localization) of the inflammation focus by the emerging granulation tissue comes to an end. In the future, it can turn into a connective tissue capsule, as a result of which a more perfect isolation (encapsulation) of the inflammation occurs. If in this phase exudative processes predominate over proliferative ones, then self-purification of the body from tissue decay products and microorganisms occurs by removing the contents, for example, an abscess, into the external environment.

Following this, regeneration becomes the main process in the focus of inflammation. Due to this, the tissue defect that has arisen as a result of alterative (destructive) phenomena of the first phase of inflammation is replaced mainly by connective tissue elements, which then turn into a scar. This occurs against the background of a gradual normalization of trophism and metabolism. In this regard, in the area of inflammation, the amount of potassium and underoxidized products decreases, oncotic and osmotic pressure and acidosis decrease, exudation decreases significantly, leukocyte emigration and their phagocytic reaction decrease. At the same time, the number of histiocytic elements increases, the macrophage reaction increases, and regeneration processes unfold more fully than in the first phase. Recovery is coming.

Outcome of inflammation

Distinguish complete resolution of the inflammatory process and incomplete resolution of the inflammatory process.

The complete resolution of the inflammatory process is such an outcome, when the damaged tissue is restored at the site of the inflammatory focus and their function is restored. Usually this outcome is observed often on the mucous membranes of the gastrointestinal tract, respiratory tract, and also with minor injuries.

Incomplete resolution of the inflammatory process is such an outcome when connective tissue grows in place of the dead tissue. This process is usually observed in cases of significant damage to organs or tissues. The function of the organs is reduced.

6. Stages of development of the inflammatory process.

7. Clinical manifestation serous manifestation.

8. Clinical manifestation of serous-fibrinous inflammation.

9. Clinical manifestation of fibrinous inflammation.

10. Principles of treatment of aseptic inflammation.

Etiology and pathogenesis

Most often, purulent processes are caused by various types of staphylococci; a large number of them are on the objects surrounding the animal, on itself, which creates the conditions for infection of any accidental wound.

Their pathogenic effect is associated with the release of toxins that destroy blood cells and enzymes that coagulate and destroy proteins. Their virulence in pus rises sharply, which explains the special danger of infection with purulent discharge of wounds.

Purulent processes can be caused by Escherichia coli, which is always present in large quantities in the intestinal contents and on the contaminated surface of the animal's body. The process caused by Escherichia coli is characterized by putrefactive fusion of tissues, especially great importance it has with purulent processes in the abdominal cavity. In case of violation of the barrier function of the mucous membrane of the gastrointestinal tract, Escherichia coli can penetrate into the general bloodstream and cause intoxication and even sepsis.

Pneumococcus causes an inflammatory process that is fibrinous in nature, the localization of such processes can be different.

Fibrinous - purulent inflammation develops when infected with Pseudomonas aeruginosa, which saprophytes on the skin, in places rich in sweat glands. Its development significantly inhibits tissue regeneration in the wound.

In the development of the purulent process, the ways of introducing and spreading pathogens are important. Undamaged skin and mucous membranes serve as a reliable barrier through which pyogenic microorganisms cannot penetrate. Damage to this barrier can result from mechanical trauma, thermal lesions, chemicals and other traumatic factors. In this case, the size of the damage is not critical for the penetration of microbes. Through a defect in the integument, microbes enter the intercellular gaps, lymphatic vessels and, with the lymph flow, are carried into deeper tissues: skin, subcutaneous tissue, muscles and The lymph nodes. The further spread and development of the purulent process depends on the number and virulence of the microbes that have entered and the immunobiological forces of the organism itself.

A purulent infection meets considerable resistance in areas of the body with a good blood supply.

Moments that favor the development of pyogenic microbes when they penetrate through a defect are:

1. the presence in the injury zone of a nutrient medium for them (hemorrhages, dead tissues):

2. Simultaneous penetration of several types of microbes - polyinfection

3. penetration of microbes with increased virulence.

The reaction of the body to a purulent infection has local and general manifestations.

Sepsis

Sepsis is a severe infectious disease caused by various pathogens and their toxins, manifested by a peculiar reaction of the body with the same type of clinical picture, despite the difference in pathogens.

Classification

1. By the time of manifestation clinical signs distinguish between: primary and secondary sepsis

Primary (cryptogenic)-hidden, associated with autoinfection, when it is not possible to find the primary focus of inflammation.

Secondary- develops against the background of the existence of a purulent focus in the body.

2. According to the localization of the primary focus: surgical, umbilical, gynecological.

3. By type of pathogen: coccal, colibacillary, anaerobic.

4. By source: wound, postoperative, inflammatory

5. By the time of development: early (up to 10-14 days from the moment of damage) and late (after 2 weeks or more from the moment of damage).

6. By type clinical course:

Fulminant-characterized by rapid generalization of the inflammatory process. The duration of the course is 5-7 days, and most often a fatal outcome.

Spicy- characterized by a more favorable course. The duration of the course is 2-4 weeks.

subacute- lasts 6-12 weeks with a favorable outcome

Chronic if it is not possible to eliminate acute sepsis, then it passes into the chronic stage, which lasts for years with periodic exacerbations and remissions.

7. According to clinical and anatomical signs: septicemia (without metastases), septicemia and pyemia (with secondary metastotic purulent foci).

Pathogenesis

In the mechanism of development of sepsis, 3 factors are important:

1. Microbial - the number, type and virulence of microbes.

2. Type of entrance gate (the nature of tissue destruction or the size of the purulent focus, its location, the state of blood circulation in this area).

3. The reactivity of the body, that is, the state of immunity and nonspecific resistance organism.

The development of sepsis is due not so much to the properties of the pathogen as to an acute disorder of local immunobiological mechanisms, which the body cannot suppress by creating a protective barrier at the level of the entrance gate for infection.

Microbes and their toxins, having entered the bloodstream, in many cases can no longer be destroyed due to a breakdown in the biological defense system.

Clinical picture determined by the form of sepsis.

Septicemia

Septicemia is a toxic form of sepsis. It proceeds acutely or with lightning speed, more often with a fatal outcome.

A massive intake of toxins into the blood with severe general intoxication is characteristic. At the same time, bacteria are also found in the blood.

The entry of toxins and tissue decay products into the blood leads to severe over-irritation of the peripheral nerves, spinal cord and brain.

In this regard, septicemia occurs with early suppression of protective and adaptive and immunobiological reactions. As a result, the ability to localize the inflammatory focus is suppressed in the body and acute anaerobic processes occur.

Septicemia is characterized by severe depression, refusal of water and food, cachexia, fever, persistent fever.

Immediately develop hemodynamic disorders: tachycardia, increased heart rate. BP drops, heart sounds become muffled. Respiration becomes more frequent, cyanosis of the mucous membranes and skin areas without hair appears.

Periodically, the animals appear excited, accompanied by a convulsive state. Excitation is replaced by lethargy, the skin and sclera are icteric (erythrocyte hemolysis).

Sometimes you can palpate an enlarged spleen, which is accompanied by a pain reaction on the part of the animal. Sometimes subcutaneous hemorrhages are noted.

In dogs, taste perversion, nausea and vomiting, and profuse diarrhea all lead to dehydration.

In sick animals, due to severe trophic disorders, bedsores appear, the number of erythrocytes and the percentage of hemoglobin sharply decrease. The amount of billy ruby increases in the blood.

In the primary focus, purulent-necrotic, putrefactive or gangrenous tissue decay is found.

Pyemia

It is characterized by bacteremia and purulent metastases in various organs.

In this process, microbes, coming from the primary focus into the bloodstream, are transported to the capillaries of various organs, where they settle, creating purulent foci.

Sometimes secondary infected thrombi can form here, entering other organs, where secondary purulent metastases develop.

Septicopyemia

With septicopyemia, protective-adaptive, immunobiological reactions are not completely suppressed. Therefore, septicopyemia has a more favorable course. It flows sharply and subacutely.

In cattle and pigs, microbial metastasis occurs more frequently in the lymphatics; in dogs and horses, the hematogenous route of metastasis.

Ulcers are localized in various organs and tissues, and are single or multiple. Settling of microbes in tissues contributes to slow blood flow. It depends on the structure of capillaries, weakening of cardiac activity, general weakness, sensitization of the body and other reasons.

General changes in metastasizing forms of sepsis, they are characterized by a severe general condition, refusal of food and water. It is also characterized by high body temperature, but with periodic remissions. Daily fluctuations in body temperature 2-4 0С. and with a decrease in temperature - strong sweating.

Remittent fever is combined with intermittent. This type of fever with a temporary decrease in temperature indicates a periodic decrease in the supply of microbes and their toxins in the blood. This is usually associated with the moment of maturation and the formation of a granulation barrier around the abscess.

A new rise in temperature indicates a secondary breakthrough of the infection beyond the metastatic focus.

Local changes in the primary focus are characterized by progressive edema, necrosis, delayed formation of the granulation barrier, muscle and joint pain.

As a result of prolonged or massive toxic-microbial effects, thermoregulation is disturbed:

In a severe general condition, an arrhythmic pulse of weak filling and a decrease in blood pressure, the temperature is slightly increased.

You can get injured almost anywhere and anytime. In this article, it is about injuries and types of injuries that I want to talk in more detail.

Basic terminology

This article will use two main terms:

Injury. This is the impact of the environment or external factors on organs, tissues or the human body as a whole. As a result of these actions, various kinds of anatomical and physiological changes occur, which can be accompanied by both local and general reactions of the body.
Traumatism is a set of injuries that are repeated under certain circumstances for the same population groups and for the same length of time.

Option 1. Integrity of the skin

At the very beginning, you need to say that there is great amount various kinds injuries. They are classified according to various characteristics. So, injuries are:

Closed. When damage does not violate the integrity of the skin.
Open. In this case, the integrity of the skin is violated. There is also a rupture of the mucous membranes, which increases the possibility of infection of damaged tissues (and this, in turn, leads to various complications). Most often, such injuries occur when it comes to a broken bone.

Option 2. By severity

What other types of injuries exist? So, they can be distinguished by such an indicator as the degree of severity.

Minor injury. It does not cause serious disturbances or loss of working capacity in the human body. Such injuries include abrasions, scratches, light bruises, abrasions, sprains of mild degrees. However, with such injuries, a person also requires medical assistance. In some cases, the patient may be placed on ambulatory treatment. Moderate exercise is also allowed.
Moderate injury. These are injuries that lead to pronounced changes in the body. In this case, you can’t do without doctoral help (you need to contact a traumatologist). The patient will receive leave (sick leave) for a period of 10 days to 1 month. Physical activity during this period is undesirable.
Severe injuries. They cause serious and pronounced changes in the body. Lead to loss of working capacity for a period of more than 1 month. The victims are hospitalized at the very beginning, then outpatient treatment is possible.

Depending on the degree of injury, the treatment and physical activity of the patient differ. However, in any case, you need to seek medical help. After all, ignoring the problem can lead to serious problems in the body.

Option 3. Impact

There are two types of injuries, both acute and chronic. In the first case, they arise as a result of a sudden impact of a traumatic factor. If we are talking about chronic injuries, then it is customary to talk about the periodic impact of a traumatic factor on a certain area of \u200b\u200bthe human body.

Option 3. Sports

Another classification of injuries is related to physical exercises (we are talking about such if we talk about athletes or people involved in sports):

Tendinitis. This is what is called inflammation of the tendons. This problem characterized by an inflammatory process in the tendon, as well as pain.
Sprains of ligaments and tendons. Most often it occurs due to improper warm-up before training. Also, the cause may be untreated injuries or insufficient rehabilitation period.
Bursitis. This is an inflammation of the joint capsule, which contains synovial fluid. The most common bursitis of the shoulder, knee and elbow joints.
Articular mice (or dissecting osteochondritis). This problem occurs when bones collide frequently, causing small pieces of bone or cartilage to separate. The so-called articular mouse is formed, which disrupts the functioning of the joint.
Fracture. Occurs when a sharp load on the bone. Accompanied most often by rupture of internal tissues. The most common cause of a fracture is an incorrect fall, or rather, an incorrect landing during a fall.
The following types of injuries are bruises. They appear as a result of sudden hard hit on muscle tissues. Accompanying symptoms: swelling at the site of impact, bruising and possible subsequent bruising. The most painful is a bruised joint.

Some statistics

What physical injuries are most common in athletes and people who are actively involved in sports?

Most sports are characterized by injury upper limbs. For example, this is gymnastics (70% of all injuries).
May also be damaged lower limbs. For example, it can be when doing athletics (66%).

For boxers, damage to the face and head is typical (this occurs in more than 65% of cases). Basketball and volleyball players often injure their fingers (80%). In tennis players, the elbow joint suffers (in 70% of cases), in football players - knee-joint(48% of cases).

Option 4. Localization of damage

The next classification of injuries is according to the location of the damage. In this case, it is customary to talk about the following damage:

Isolated. In this case, one organ or segment of the musculoskeletal system is damaged.
Multiple. Several of the same damage occurs.
Combined. In this case, several damaged areas are combined. For example, the head, chest and pelvic region may be injured. These injuries are also called polytraumas. If the patient has more than five areas of damage, traumatic shock often occurs.
Combined injuries. These are lesions that are applied sequentially or simultaneously. However, the mechanical factor is combined with a different agent (chemical, thermal injury). The clinical picture in this case is very severe, and the mortality of patients is high.

Option 5. By penetration depth

There is another classification of injuries. They are distinguished by the depth of penetration.

Superficial injury. Only the skin or skin vessels are damaged. As a result, hematomas or abrasions may occur.
Subcutaneous injuries. In this case, tendons, ligaments, muscles, joints, bones are damaged.
The most severe variety in this classification is abdominal trauma. It is characterized by complex damage to the internal organs, which are located in the natural cavities of the body.

Spinal injury

Separately, I also want to consider various injuries of the spine. The reasons for their occurrence are most often the following:

Falling from height.
Car crashes.
Power sports.

It is worth saying that you can get a spinal injury even if the weight is lifted incorrectly. What are the types of injuries in this case? Depending on the cause, they can be:

Compression. In this case, compression or fracture of the vertebral bodies occurs. This also includes cracks in them. With compression injuries, not only one vertebra can be affected, but several.
Injuries can occur due to excessive flexion-extension of the spine. The cause is often not only car accidents, but also non-compliance with safety regulations.
The cause may be a spinal injury. Serious problems can arise if the necessary assistance was not provided to the spine in a timely manner after the bruise.
Well gunshot wound can also lead to spinal injury.

There are spinal injuries depending on their location. In this case, it is customary to talk about:

Injuries of the cervical spine.
Injuries of the thoracic spine (less common).
Injuries of the lumbosacral spine (most common).
And also about coccyx injuries.

And spinal injuries are distinguished by the nature of the injury. In this case, we are talking about:

Closed and open injuries.
Injuries with and without spinal cord injury.

Muscle injuries

There are also various muscle injuries. What can be discussed in this case?

Contracture. It's a raise muscle tone which causes spasm. In this case, pain is felt. There is no clear localization.
Krepatura. it irreversible changes occurring in the muscle. Cause overload. muscle tissue.
Stretching. In this case, damage to some muscle fibers occurs. However, connective tissues in this case are not affected.
Rupture of some muscle fibers. The connective tissue is minimally affected.
Muscle rupture. Not only muscle, but also connective tissue suffers. Symptoms: pain syndrome and loss of motor muscle function.
Complete rupture or detachment of the muscle. In this classification, the most serious injury. The muscle is torn into separate parts transversely.

Joints and bones

Separately, you also need to consider injuries to the joints and bones. What are they?

bruises.
Injury to intraarticular formations.
Fractures.
Dislocations and subluxations.
Intra-articular fractures.

Also, traumatic injuries of the joints can be open (intra-articular fractures and wounds) and closed.

Causes of injury

What are the most common causes of injury? Why do people get hurt so often?

Carelessness. A person may simply not see and hit something.
Carelessness and overestimation of one's capabilities often also lead to injuries.
Lack of knowledge of safety. This is especially true for athletes who train on their own, or people working in production.
Untreated injuries. Previously untreated injuries can lead to new injuries.
When it comes to athletes, improperly selected exercises for training can also cause injuries.

There are many reasons why various injuries, bruises can occur. But they are always associated with wrong human activity.

Everyone has been injured at least once in their life. Whether it was minor or extensive - there are many variations. Electric shock, fractures or just sprains, small cuts and large lacerations - in such situations, you should definitely seek medical help.

The classification of injuries is extensive, with any division highly dependent on a large number factors. In case of injury, there may be a violation of the integrity of all tissues in the human body: soft, bone, connective. The skin will also suffer. The cause of injury is usually an external influence.

Various injuries literally accompany a person, as if nature itself reminds that no one is perfect. Common violations are, first of all, mechanical injuries, after them - electrical and psychological. By all indications, radiation injury is recognized as the most difficult: the effect of radiation on the body is almost impossible to reverse.

Even food or any other poisoning is considered an injury. AT modern world not to find a person who has not been injured at least once in his life. It is very important to diagnose the type of injury and provide appropriate emergency care, because the life of the victim may depend on it.

Common terminology consists of only two parts:

trauma - damage to the integrity of the human body (organs, skin, tissues), resulting in changes in human anatomy and physiology. Such shocks are accompanied by the reaction of the body, in other words, by the symptoms;
traumatism - a complex of repetitive or entailing injuries. Characteristically: the same conditions, causes and time.

Types of classification

You can classify the main types of injuries according to various symptoms, types, etc. Many of the characteristics are confirmed by the medical practice of trauma doctors.

Type of damage

As already mentioned, injuries have multiple confirmed classifications. That is why the classification according to the type of injury comes first.

The type of damage characterizes the integrity of the skin. The following injuries are diagnosed immediately:

closed - the skin is not damaged;
open - the skin is damaged. As a result of internal pressure, in response to external influences, the skin begins to break down.

The first "victims" open type there will be mucous membranes. As a result of mucosal ruptures, cracks can occur, into which it is easy to infect the infection. This will lead to many complications. Open-type injuries occur with bone fractures, a different manifestation is a rather rare occurrence.

Severity

The severity is a very important criterion for assessing any violation. Damage is evaluated from top to bottom - from simple to complex.

Light type.

There are no significant disturbances in the human body. Signs, such as fighting, are immediately obvious - abrasions, scratches, bruises and minor sprains. There is no incapacitation.

Medical assistance is still needed to process even the slightest scratches. It is recommended to reduce physical activity during treatment and rehabilitation.

Medium type.

Injuries cause pronounced problems to the body - serious bruises, cuts, open wounds, dislocations, etc. The victim begins outpatient treatment, in some cases hospitalization is required. Sick leave lasts from 2 weeks to 1 calendar month. Physical overvoltage is contraindicated, but performance is partially preserved.

Heavy type.

Serious injuries that entail cardinal changes in the body of the victim - most often, these are various fractures, internal bleeding, breaks, etc. The victim is urgently hospitalized, the period of treatment and rehabilitation starts from 1 calendar month.

The degree of injury affects the order of clinical treatment, the physical activity of the victim. Seeking medical help is necessary - a bruise, for example, can be much deeper than it seems, and besides, accompany more serious damage. Lack of attention to the symptoms manifested can cause serious consequences for the body in the future.

Impact on the body

There is a well-established characteristic of injuries by type of impact - acute and chronic. Acute injuries arise from the sudden appearance of a damaging factor. Chronic exposure characterized the periodic nature of the injury factor on a certain part of the body or body.

Sports

For people who are professionally involved in sports, separate category injuries: sports. They are all characterized by the fact that injury occurs at the time of active sports.

Constant physical activity can lead to the following changes in the body:

injury statistics

Physical injuries of the sports type are common among professional athletes, as well as people who are actively involved in sports.

In most cases, gymnastics is characterized by a violation of the upper body, hands are often injured - 70-75%. Injury to the lower body during athletics accounts for 66% of injuries in this sport. Boxers suffer face and head injuries in 65% of cases. Athletes who often handle the ball often injure their hands - 80%, and those involved in tennis - the elbow in 70% of cases. Those involved in football, respectively, knee - 47-50%.

Damage localization

Classification according to the location of the injury:

isolated - one of the organs or part of the motor apparatus is injured;
multiple - characterized by many identical injuries;
combined - violations occur in several areas, intersecting with each other. Another name - polytrauma, occurs most often in car accidents. In the case of more than 5 areas of injury, a traumatic shock develops, leading to death;
combined - violations that appear with a certain sequence or at one moment. The nature of the appearance - mechanical, chemical and thermal - interact with each other, combining into one injury.

Penetration depth

Another principle to characterize various injuries lies in the depth of the lesion:

superficial - only the skin and small blood vessels are affected, small cuts, bruises, abrasions, etc. occur;
subcutaneous - connective tissues (tendons, ligaments), muscle tissues, joints and bones are injured;
abdominal - a severe type of damage, characterized by extensive lesions of internal organs.

Certain types of injuries

Remove from the general classification should be the most dangerous species injuries, entailing complete deprivation of legal capacity in some cases.

Spine

Spinal injuries often result from falls from great heights, traffic accidents, and power sports. However, you can get hurt just by lifting a weight.

The number of such cases led to the creation of a separate classification according to the type of damage.

Compression - the spinal column is damaged as a result of pressure or fracture of the vertebral bodies. The cause can be cracks, violations, often multiple: several vertebrae are damaged at once.
The actual one is due to the frequent flexion and extension of the column, which entails an increased load on all parts of the spine. It is typical for accidents, often occurs when safety is not observed when playing sports or in professional activities related to the transfer of heavy loads.
Ridge bruise - characterized by deep tissue damage, however, it is often mistaken for a simple bruise and proper treatment assistance is not provided. Growing edema, internal bleeding affect the spine, starting to squeeze the vertebrae together, and this leads to a compression type of injury.
A gunshot wound, rare for a layman, immediately damages both tissues and bones of the spine.

In addition, there is a distinctive feature of spinal injury - at the location. In the case of the spine, this various departments- cervical, thoracic, lumbosacral and coccyx. It is characteristic that shocks of the thoracic region are rare, while the lumbosacral spine is injured more often.

And, of course, there is a classification by type - open and closed injury. A separate type of spinal cord injury or its absence is distinguished.

Muscle

Muscle injury occurs, perhaps, most often and is characterized by completely different symptoms.

Contracture is characteristic of increased muscle tone, resulting in a spasm - severe pain is felt and radiates to the entire area of \u200b\u200bthe muscle, while there is no specific localization for pain. Krepatura also belongs to this type - as a result of overload, irreversible consequences occur.

Muscle strain - some fibers of muscle tissue are damaged. Connective tissues (tendons and ligaments) remain intact. This also includes the rupture of part of the fibers, only in this case the surrounding connective tissue also suffers.

Rupture of muscles is the most serious injury, since muscle tissue also comes off, touching the connective tissues. The pain is pronounced, it is impossible to strain the muscle - it is torn. In particularly difficult cases, muscle detachment occurs.

Joints and bones

Slight damage to the articular and bone tissues occurs often even in everyday life. It includes a variety of bruises, disorders within the joints, dislocations and subluxations, intra-articular fractures and simply fractures.

They are divided by type: open (intra-articular fractures and wounds) and closed.

Risk Factors for Damage

There are many reasons that can result in any type of injury:

Lack of attention when moving - a person may fall, stumble, or hit something static;
Careless movement, exaggerated assessment of possibilities. A common reason for young people doing parkour, skateboarding, etc.;
Non-observance or ignoring of safety regulations. It is typical for athletes involved in self-study, as well as for people employed in heavy production;
Untreated injuries lead to repeated damage to the weakened area;
Lack of warm-up, improper exercise during sports.

There are a huge number of reasons, but they are all related to the human factor. With the exception of injuries during natural disaster, at this moment a person is injured, because nothing can oppose nature.

Types of injuries

Injuries are injuries of the same nature in similar conditions. Since any damage to the anatomical integrity of tissues and organs due to external factors is considered traumatism, there are types of traumatism.

Mechanical injuries are grouped according to the nature of their occurrence.. Injury is inflicted at rest or during movement - when falling.

There are different types of injuries:

production - arise in industry and agriculture;
transport - additionally divided into road, rail, aviation, shipping, etc.;
street - as a result of a fall in an open space;
domestic - injuries occurring at home due to aggregate common causes or intentionally caused;
military - injuries that appear during military operations;
sports.

Each type has features having a direct connection with the character, as well as with the reasons for obtaining. With production types, for example, open wounds occur more often, and on the street - fractures and dislocations. Sports are characterized by bruises and stretching of tissues. All types are treated by doctors in an ordinary hospital, except for the military. The military falls within the competence of military hospitals.

Mechanical damage can be caused by cold weapons, tools of labor and production, and household damage can be caused by various objects, tools. Instruments of damage are divided into blunt and sharp.

Diagnosis of injuries

Any damage needs to be diagnosed in a timely manner to begin with. proper treatment and prevention of consequences. First of all, after the appeal is carried out initial inspection: the victim is examined, the causes of the injury are found out. This helps to eliminate internal damage and order further investigations.

The main types of diagnostic studies are as follows:

x-ray - gives an idea of the state of the skeleton;
computed tomography (CT) - allows you to assess the condition of bone tissues and joints;
ultrasound examination (ultrasound) - is necessary to determine the damage to internal organs and soft tissues: cartilage, tendons, etc.;
magnetic resonance imaging (MRI) - assesses the condition of the periarticular tissue, connective and intervertebral discs;
endoscopy - is used only with a combination of tissue injury to accurately assess the injury and the presence of a tumor.

Diagnosis is very important in case of injuries, because only according to its results, treatment and rehabilitation of a person can begin.

Traumatology is a clinical field of medicine that deals with the development of methods for diagnosing and medical procedures recovery functional systems, musculoskeletal system and internal organs that have been damaged due to various types of injuries. In the direction of research and clinical practice traumatology has a very close connection with various branches of surgery: orthopedics, neurosurgery, cardiology, sports medicine and prosthetics.

Today, every traumatologist daily faces a number of common household, childhood and professional injuries. Main types of injuries today there are violations of the musculoskeletal system, but often there are cases with complex combined injuries. The most common cause of complex injuries are traffic accidents, non-compliance with safety regulations at home and at work.

Types and classification of injuries

An injury is a complex of injuries that are caused by a traumatic environmental factor. The action of a damaging factor can be strong and short-term, causing an acute injury, as well as weak, but long-term and repeated, which can also provoke an injury.

All types of injuries can be divided into several categories depending on the nature of the damage and the factor that caused them:

Mechanical injuries are the result of a blow or fall, in which soft and hard tissue organism. Mechanical force can act through direct and indirect impact, compression, squeezing, twisting, bending, in which there are violations of the integrity of the bones, dislocations of the joints, bruises, hematomas and hemorrhages from damaged blood vessels. In traumatology, open and closed mechanical injuries are distinguished, that is, with the preservation or violation of the anatomical integrity of the skin and the muscular frame of the body.
Physical injury can be received from negative impact various physical factors- actions of high or low temperatures(burns or frostbite), electric current, harmful radiation, etc.
Biological injuries arise from the influence of bacteria, viruses or other pathogenic microorganisms harmful to the human body, as well as toxic biological poisons and allergens.
Chemical injuries most often occur from contact with acids or alkalis on the skin, which cause damage to the outer skin of the skin and sometimes even to the deep subcutaneous layers of fiber, muscle tissue and internal organs. Some chemicals, for example, salts of heavy metals, have the ability to be absorbed through the skin or mucous tissues, poisoning the body from the inside.

In addition to the above types of injuries, which are distributed according to the type of factors that caused damage, there is a classification according to the result and degree of damage to various tissues:

An isolated injury is a malfunction or damage to one organ or one segment of the skeleton, for example, a bruise, dislocation or fracture of one bone.
Multiple - these are several injuries of the same type, in a number of which one main dominant injury stands out, on which the doctor's attention is concentrated when the patient is in serious condition.
Combined - this is damage to several parts of the human body at the same time by the same factor. This type includes fractures, which are also accompanied by damage to internal organs or the brain, as happens in traffic accidents or a fall from a great height.
Combined - this is the most complex type of injury, since with this type of injury, the injured person simultaneously has violations of a different nature - mechanical injuries with thermal or chemical burns.

Injury examination and diagnosis

For any injury essential role timely and accurate diagnostics carried out by an experienced specialist plays. After an accident, the doctor conducts an initial examination in order to find out the main signs and symptoms:

examination of the victim by external signs and determination of the type of traumatic injuries and the mechanism for their receipt, at least in in general terms. Such information helps to suggest the nature of internal violations;
Determining the degree of damage and their main localization;
Identification of violations of the main vital functions of the body - the rhythm of cardiac activity, the ability to breathe independently, etc.;
Assessing the viability of the injured person and identifying impairments that may be life threatening.

Even with very severe injuries and injuries, the initial examination is a very important point, which makes it possible to evaluate such important factors, how:

degree of blood loss
Possible disorders of the brain and internal organs,
The state of human consciousness.

This procedure is very important for providing rational assistance in case of serious damage to the vital functions of the body. Only after evaluation general condition of the injured person and the exclusion of violations that threaten the viability of the patient, the traumatologist proceeds to a more detailed examination and diagnostic procedures.

In traumatology, instrumental research methods are most often used to determine the nature and degree of damage. The main diagnostic methods include:

Radiography is one of the most common and proven methods and informative, which gives a clear picture of the state of damage. bone structure. Modern digital x-ray machines make it possible to display images on a computer monitor, to increase them many times. As a result, the resulting images have high accuracy and multidimensionality.
Computed tomography is the most accurate and most informative method, which is also based on the principle of x-rays, but its accuracy and high resolution allow us to assess not only structural bone disorders, but also assess the condition of bone and articular tissues.
Ultrasound examination is performed to examine and diagnose damage to internal organs and soft tissues of the body, cartilage, tendons and semi-solid components of the joints.
Magnetic resonance imaging - is able to give a picture of damage to the soft periarticular tissues, ligaments and intervertebral discs.
Endoscopic research methods are carried out for complex combined injuries, when it is necessary to establish the exact size of the damage or assess the presence of a tumor process in the area of injury.

Diagnosis of injuries is one of the most important stages, which provides information to specialists to determine the type, nature and extent of injuries, and also in the future allows you to track the dynamics and effectiveness of treatment. Our clinic employs the best traumatologists who are able to quickly identify damage of any type, diagnose and assess the degree of threat to life and health, and prescribe a set of therapeutic measures in a timely manner.

There are different classifications of injuries. This division depends on many factors. After all, with an injury, the integrity of tissues and their physiological functions are violated. This is facilitated by various external influences. The most common are mechanical, electrical, psychological. More complex is radiation injury. Poisoning of the body is referred to as these injuries. AT modern conditions residence injuries happen every day. Their number according to the results of statistics is huge. In order to provide first aid to the victim and not be mistaken in its correctness, it is necessary to determine exactly what type of injury this or that is attributed to.

This is the largest and most widespread group according to statistical calculations. A mechanical injury occurs when a person falls on an immovable object or, conversely, when an object is suddenly struck by an object, and the person is at rest at that time. This type of violation of the integrity of tissues is often found: directly at the place of work and during various sports. Therefore, they are classified as industrial.

result mechanical damage tissues are:

dislocation;
bruise;
abrasion;
fracture;
rupture of organs;
sprain and bruise;
squeezing.

Timely provision of first aid is of great importance for the life of the victim. For bruises and sprains, apply cold compress, secure with an elastic bandage. A dislocation that causes pain shock is anesthetized with any available pharmacological agents, and the patient is immediately taken to a medical institution. Crushing of tissues as a result of prolonged compression, rupture of internal organs is among the most dangerous mechanical injuries that require immediate transportation to a medical institution.

The category of mechanical damage to the ENT organs also includes injuries of the paranasal sinuses. They are characterized by bruises, fractures with displacement of bone fragments and without displacement. In severe cases, a fracture of the anterior sinuses is combined with a fracture of the orbit. The clinical picture of this pathology is manifested in profuse nosebleeds. Due to the collapse of the wall frontal sinus as a result of a fracture, the nasolabial canal is blocked. If there is damage to the ethmoid bone, then there is a rupture of the mucous membrane of the cell and subcutaneous emphysema.

If the anterior wall of the maxillary sinus is injured, then damage to the eyeball, zygomatic bone and lattice labyrinth. The patient must be urgently taken to the hospital for qualified assistance.

Mine blast injury

This class of damage is characterized by the influence of many damaging factors. Indeed, during an explosion, a blast wave, a gas-flame jet is formed, multiple fragments appear, various toxins are thrown out. Each of the factors affects the victim in its own way. The nature of the damage depends on the location of the fighter at the time of the explosion.

If we are talking about an armored car or a tank, then the condition can be complicated by multiple burns. An explosion that caught a fighter on the ground can lead to shell shock. They are very heavy toxic poisoning upper respiratory tract. Gases CO 2 , CO, NO, HCN only increase the chemical effect on the victim.

These severe injuries are characterized by large blood loss, and the heart, open and closed fractures limbs. Therefore, the main diagnostic task is to identify the main lesion, on which the life of the victim depends, and to provide him with first aid. In the future, appropriate treatment is prescribed.

Urologists believe that the characteristics of this type of injury depends on their location and severity. If the outer skin of the penis, testicles, urethra is damaged, then the injuries are open, and in case of damage to the kidneys, Bladder, ureter — closed. All of the above damage is very dangerous for human health. Therefore, if there is blood in the urine, persistent pain in the scrotum and groin, lower rib fractures and pelvic bone(secondary injury), you must immediately contact a medical institution. After all, chronic urological disease can just begin due to damage to the organs of the genitourinary system.

These damages occur due to. In this case, contusion and rupture of the kidney, damage to the vascular bundle most often occurs. Household, street, transport injury, gunshot or stab wounds cause disturbances in the functioning of the organs of the genitourinary system. In such cases, it is necessary to immediately hospitalize the patient in the intensive care, trauma or surgical department. Only there they will be able to determine the severity of the injury and plan treatment.

Craniocervical injuries

Falls from a height, car accidents, blows with blunt heavy objects provoke craniocerebral injuries. If this violates the integrity of the upper cervical spinal department, then craniocervical damage occurs, which is accompanied by blocking of the ligamentous-articular apparatus. This area of the human body is in close connection with many structures of neurovascular significance.

Therefore, the manifestations of this type of injury can be varied. The doctor's task is to timely determine the severity of the injury. But practice shows the opposite. Often in medical institutions they cannot immediately determine the consequences of an injury, which leads to a deterioration in the health of the patient.

Injuries received at home

In every home there are traumatic places and objects. After all, inept handling, which in some cases is accompanied by a state of intoxication, can lead to irreversible consequences. Young children are at risk if left unattended by their parents.

All household items can both benefit and be dangerous if you do not follow the rules of operation. A large number of injuries at home are divided into several groups. Their species are diverse in structure and location. These include cut, stab, electrical injuries, bruises and falls, thermal and chemical burns, poisoning. Causes of injuries and cause their symptoms. Bruises and sprains are accompanied by acute pain and swelling. Therefore, first aid consists in applying cold and obligatory consultation of a specialist. Physical injury of moderate severity, which includes dislocations and fractures of the fingers, should be eliminated only in medical institutions. Any measures to reduce the bone can only aggravate the clinical picture.

Injuries from a fall from a height (stairs, attic, tree) are dangerous for spinal injuries and fractures of limbs. Therefore, it is necessary to transport the patient with such injuries on a hard surface in the supine position.

Frequent quarrels, stress, psychological overload arising from family quarrels and scandals are classified as emotional trauma. This disorder of the central nervous system can be corrected by taking sedative fees and drugs, but it is best to eliminate the psychological irritant and protect yourself from its subsequent effects, so as not to end up in a clinic for serious treatment.

Everyone should know the classification of injuries experienced doctor in order to correctly determine the damage and prescribe competent and effective treatment.