Overview. Overview. Chapter 30. Injuries to the Head and Spine 9/11/2012. Review of the Nervous and Skeletal Systems. Devices for Immobilization

Size: px
Start display at page:

Download "Overview. Overview. Chapter 30. Injuries to the Head and Spine 9/11/2012. Review of the Nervous and Skeletal Systems. Devices for Immobilization"

Transcription

1 Chapter 30 Injuries to the Head and Spine Slide 1 Overview Review of the Nervous and Skeletal Systems The Nervous System The Skeletal System Devices for Immobilization Cervical Spine Short Backboards Long Backboards (Full-Body Spinal Immobilization Devices) Slide 2 Overview Injuries to the Spine Mechanism of Injury Assessment Complications Emergency Medical Care of the Spine-Injured Patient Injuries to the Brain and Skull Head and Skull Injuries Emergency Medical Care of the Head-Injured Patient Slide 3 1

2 Overview Special Considerations Rapid Extrication Helmet Removal Infants and Children Geriatric Patients Slide 4 The Nervous System Slide 5 The Nervous System Function Controls the voluntary and involuntary activity of the body Slide 6 2

3 The Nervous System Central nervous system Brain Spinal cord Central Nervous System Brain Spinal cord Peripheral Nervous System Cranial nerves (12) Spinal nerves cervical (8) thoraic (12) lumbar (5) sacral (5) coccyx (1) Slide 7 The Nervous System Peripheral nervous system Sensory Impulses carry information from the body to the brain and spinal cord Motor Impulses carry information from the brain and spinal cord to the body Central Nervous System Brain Spinal cord Peripheral Nervous System Cranial nerves (12) Spinal nerves cervical (8) thoraic (12) lumbar (5) sacral (5) coccyx (1) Slide 8 The Skeletal System The skeletal system is the scaffolding of the body Gives the body shape and rigidity Protects the vital internal organs Enables movement Slide 9 3

4 The Skull Skull Houses and protects the brain Orbit Nasal bone Maxilla Mandible Zygomatic bone Slide 10 Spinal Column Cervical (neck) 7 vertebrae Thoracic (upper back) 12 vertebrae Lumbar (lower back) 5 vertebrae Sacral (back wall of the pelvis) 5 vertebrae Coccyx (tailbone) 4 vertebrae Slide 11 Devices for Immobilization Cervical spine Indications Any suspected injury to the spine based on mechanism of injury, history, or signs and symptoms Use in conjunction with short and long backboards Slide 12 4

5 Devices for Immobilization Slide 13 Devices for Immobilization Sizing Sizing is based on the specific design of the device An improperly sized immobilization device has a potential for further injury Do not obstruct the airway with the placement of a cervical immobilization device An improperly fit device will do more harm than good Slide 14 Devices for Immobilization Rolled blankets or towels may be used to stabilize the patient s head Slide 15 5

6 Devices for Immobilization When the cervical collar is properly sized and placed, it will help to immobilize the head in a neutral position Slide 16 Devices for Immobilization Technique for sizing Slide 17 Devices for Immobilization Precautions Cervical immobilization devices alone do not provide adequate in-line immobilization Manual immobilization must always be used with a cervical immobilization device until the head is secured to a board Slide 18 6

7 Devices for Immobilization Short backboards Several different types of short board immobilization devices exist Vest-type devices Rigid short board Provides stabilization and immobilization to the head, neck, and torso Used to immobilize noncritical sitting patients with suspected spinal injuries Slide 19 Devices for Immobilization Slide 20 Devices for Immobilization Long backboards (full-body spinal immobilization devices) Several different types of long board immobilization devices exist Provide stabilization and immobilization to the head, neck and torso, pelvis, and extremities Used to immobilize patients found in a lying, standing, or sitting position Sometimes used in conjunction with short backboards Slide 21 7

8 Injuries to the Spine Mechanism of injury Compression Falls Diving accidents Motor vehicle accidents Excessive flexion, extension, rotation Lateral bending Distraction Pulling apart of the spine Hangings Slide 22 Injuries to the Spine Slide 23 Injuries to the Spine Maintain a high index of suspicion Motor vehicle crashes Pedestrian-vehicle collisions Falls Blunt trauma Penetrating trauma to head, neck, or torso Motorcycle crashes Hangings Diving accidents Unconscious trauma victims Slide 24 8

9 Injuries to the Spine Mechanism of injury may lead you to suspect spine injury Slide 25 Signs and symptoms Assessment Tenderness in the area of injury Pain associated with moving Do not ask the patient to move to try to elicit a pain response Do not move the patient to test for a pain response Ability to walk, move extremities, or feel sensation or the lack of pain to spinal column does not rule out the possibility of spinal column or cord damage. Slide 26 Signs and symptoms Assessment Pain independent of movement or palpation Along spinal column Lower legs May be intermittent Slide 27 9

10 Signs and symptoms Assessment Obvious deformity of the spine on palpation Soft tissue injuries associated with trauma Head and neck to cervical spine Shoulders, back, or abdomen thoracic, lumbar Lower extremities lumbar, sacral Slide 28 Signs and symptoms Assessment Numbness, weakness, or tingling in the extremities Loss of sensation or paralysis below the suspected level of injury Loss of sensation or paralysis in the upper or lower extremities Incontinence Slide 29 Assessment Considerations in the responsive patient Mechanism of injury Questions to ask Does your neck or back hurt? What happened? Where does it hurt? Can you move your hands and feet? Can you feel me touching your fingers? Can you feel me touching your toes? Slide 30 10

11 Assessment Considerations in the responsive patient Inspect for contusions, deformities, lacerations, punctures, penetrations, swelling Palpate for areas of tenderness or deformity Assess equality of strength of extremities Hand grip Gently push feet against hands Slide 31 Assessment Considerations for the unresponsive patient Mechanism of injury Initial assessment Inspect for: Contusions Deformities Lacerations Punctures/penetrations Swelling Palpate for areas of tenderness or deformity Slide 32 Assessment Considerations for the unresponsive patient Obtain information from others at the scene to determine information relevant to mechanism of injury or patient mental status prior to the EMT- Basic s arrival Slide 33 11

12 Complications of Spine Injury Inadequate breathing effort Paralysis Slide 34 Emergency Care of Spine Injury Body substance isolation Establish and maintain in-line immobilization Place the head in a neutral in-line position Maintain constant manual in-line immobilization until the patient is properly secured to a backboard with the head immobilized Slide 35 Video Clip: In-line Cervical Spinal Immobilization Slide 36 12

13 Emergency Care of Spine Injury Perform initial assessment Whenever possible, airway control must be done with in-line immobilization Whenever possible, artificial ventilation must be done with in-line immobilization Assess pulse, motor, and sensation in all extremities Assess the cervical region and neck Slide 37 Emergency Care of Spine Injury Apply a rigid, cervical immobilization device Properly size the cervical immobilization device Spinal immobilization Slide 38 Video Clip: Application of a Cervical Spinal Immobilization Device Slide 39 13

14 Emergency Care of Spine Injury Spinal immobilization Stabilize the head Log-roll patient onto the board Immobilize torso to the board Immobilize the patient s head to the board Secure the legs to the board Reassess pulses, motor, and sensation and record Slide 40 Emergency Care of Spine Injury Spinal immobilization Pad voids between the patient and the board Adult Under the head Voids under torso. Be careful of extra movement Infant and child Pad under the shoulders to the toes to establish a neutral position Slide 41 Emergency Care of Spine Injury Log-roll the patient Slide 42 14

15 Emergency Care of Spine Injury Immobilize the torso Slide 43 Emergency Care of Spine Injury Immobilize the head Slide 44 Video Clip: Immobilization of a Lying Patient on a Long Back Board Slide 45 15

16 Emergency Care of the Spine-Injured Patient Seated patient Immobilize with a short spine immobilization device Exception If the patient must be removed urgently Use rapid extrication Slide 46 Emergency Care of the Spine-Injured Patient Seated patient Position device behind the patient Secure the device to the patient s torso Evaluate torso fixation and adjust as necessary without excessive movement of the patient Secure the patient s legs to the device Evaluate and pad behind the patient s head as necessary to maintain neutral in-line immobilization Secure the patient s head to the device Reassess pulses, motor, and sensory in all extremities and record Slide 47 Emergency Care of the Spine-Injured Patient Seated patient Maintain manual stabilization of the spine Slide 48 16

17 Emergency Care of the Spine-Injured Patient Seated patient Position the device Slide 49 Emergency Care of the Spine-Injured Patient Seated patient Secure the device to the patient s torso Slide 50 Emergency Care of the Spine-Injured Patient Seated patient Secure the patient s legs Slide 51 17

18 Emergency Care of the Spine-Injured Patient Seated patient Secure the patient s head to the device Slide 52 Emergency Care of the Spine-Injured Patient Seated patient Transfer the patient to a long spine board Slide 53 Emergency Care of the Spine-Injured Patient Seated patient Secure the patient to a long spine board Slide 54 18

19 Video Clip: Immobilization of the Seated Patient with a Short Rigid Back Board Slide 55 Video Clip: Immobilization of the Seated Patient to the Kendrick Extrication Device (KED) Slide 56 Emergency Care of the Spine-Injured Patient Standing position Immobilize the patient to a long spine board Slide 57 19

20 Emergency Care of the Spine-Injured Patient If the patient is critically injured, perform a rapid extrication Transport the patient immediately Bring body into alignment Transfer to long board without short spine board Slide 58 Video Clip: Immobilization of a Standing Patient Slide 59 Injuries to the Brain and Skull Injuries to the scalp Very vascular, may bleed more than expected Control bleeding with direct pressure Slide 60 20

21 Injuries to the Brain and Skull Injury of brain tissue or bleeding into the skull will cause an increase of pressure in the skull Slide 61 Injuries to the Brain and Skull Signs and symptoms Altered or decreasing mental status is the best indicator of a brain injury Confusion, disorientation, or repetitive questioning Conscious deteriorating mental status Unresponsive Irregular breathing pattern Slide 62 Injuries to the Brain and Skull Signs and symptoms Mechanism of injury Deformity of helmet Starred windshield Deformity to the skull Slide 63 21

22 Injuries to the Brain and Skull Signs and symptoms Blood or fluid (cerebrospinal fluid) leakage from the ears or nose Bruising (discoloration) around the eyes Bruising (discoloration) behind the ears (mastoid process) Neurologic disability Nausea and/or vomiting Unequal pupil size with altered mental status Seizure activity may be seen Slide 64 Injuries to the Brain and Skull Slide 65 Injuries to the Brain and Skull Additional signs of open head trauma Contusions, lacerations, hematomas, bruises to the scalp Penetrating injury Do not remove impaled objects in the skull Exposed brain tissue if open Bleeding from the open bone injury Slide 66 22

23 Injuries to the Brain and Skull Related nontraumatic conditions Nontraumatic injuries to the brain may occur due to clots or hemorrhaging Nontraumatic brain injuries can be a cause of altered mental status Signs and symptoms parallel those of traumatic injuries with the exception of evidence of trauma and a lack of mechanism of injury Slide 67 Emergency Care for Head Injuries Body substance isolation Maintain airway/artificial ventilation/oxygenation Initial assessment with spinal immobilization should be done on scene with a complete detailed physical exam en route With any head injury, the EMT-Basic must suspect spinal injury; immobilize the spine Slide 68 Emergency Care for Head Injuries Closely monitor the airway, breathing, pulse, and mental status for deterioration Control bleeding Do not apply pressure to an open or depressed skull injury Dress and bandage open wound as indicated in the treatment of soft tissue injuries Slide 69 23

24 Emergency Care for Head Injuries If a medical injury or nontraumatic injury exists, place patient on the left side Be prepared for changes in patient condition Immediately transport the patient Slide 70 Special Considerations Rapid extrication Indications Unsafe scene Unstable patient condition warrants immediate movement and transport Patient blocks the EMT-Basic s access to another, more seriously injured patient Rapid extrication is based on time and the patient, not the EMT-Basic s preference. Slide 71 Special Considerations Helmet removal Special assessment needs for patients wearing helmets Airway and breathing Fit of the helmet and patient s movement within the helmet Ability to gain access to airway and breathing Slide 72 24

25 Special Considerations Types of helmets Sports Typically open anteriorly Easier access to airway Motorcycle Full-face Shield Other Slide 73 Special Considerations Indications for leaving the helmet in place Good fit with little or no movement of the patient s head within the helmet No impending airway or breathing problems Removal would cause further injury to the patient Proper spinal immobilization could be performed with helmet in place No interference with ability to assess and reassess airway and breathing Slide 74 Special Considerations Indications for removing the helmet Inability to assess and/or reassess airway and breathing Restriction of adequate management of the airway or breathing Improperly fitted helmet allowing for excessive patient head movement within the helmet Proper spinal immobilization cannot be performed due to helmet Cardiac arrest Slide 75 25

26 Special Considerations General rules for removal of a helmet The technique depends on the type of helmet Remove eyeglasses before removal of the helmet Slide 76 Special Considerations Helmet removal Manually stabilize the helmet and the spine Cut or remove the strap Slide 77 Special Considerations Helmet removal Stabilize the spine Slide the helmet halfway off the head Slide 78 26

27 Special Considerations Helmet removal Reposition hands to maintain spinal immobilization Slide 79 Special Considerations Helmet removal The helmet is removed completely Slide 80 Video Clip: Removal of a Motorcycle Helmet Slide 81 27

28 Video Clip: Alternative Method for Removal of a Helmet Slide 82 Special Considerations Infants and children Immobilize the infant or child on a rigid board appropriate for size (short, long, or padded splint) Special considerations: Pad from the shoulders to the heels of the infant or child, if necessary to maintain neutral immobilization Properly size the cervical immobilization device If it doesn t fit, use a rolled towel and tape to the board and manually support head Slide 83 Special Considerations Child with padding Child without padding Slide 84 28

29 Special Considerations Geriatric patients Immobilize geriatric patients on a rigid board Special considerations Arthritis Osteoporosis Abnormal curvature Pad as necessary to maintain neutral immobilization Properly size the cervical immobilization device If it doesn t fit, use a rolled towel and tape to the board and manually support head Slide 85 Summary Review of the Nervous and Skeletal Systems The Nervous System The Skeletal System Devices for Immobilization Cervical Spine Short Backboards Long Backboards (Full-Body Spinal Immobilization Devices) Slide 86 Summary Injuries to the Spine Mechanism of Injury Assessment Complications Emergency Medical Care of the Spine-Injured Patient Injuries to the Brain and Skull Head and Skull Injuries Emergency Medical Care of the Head-Injured Patient Slide 87 29

30 Summary Special Considerations Rapid Extrication Helmet Removal Infants and Children Geriatric Patients Slide 88 30

Shenandoah Co. Fire & Rescue. Injuries to. and Spine. December EMS Training Bill Streett Training Section Chief

Shenandoah Co. Fire & Rescue. Injuries to. and Spine. December EMS Training Bill Streett Training Section Chief Shenandoah Co. Fire & Rescue Injuries to the Head and Spine December EMS Training Bill Streett Training Section Chief C.E. Card Information BLS Providers 2 Cards / Provider Category 1 Course # Blank Topic#

More information

Injuries to the Head and Spine

Injuries to the Head and Spine Injuries to the Head and Spine Anatomy Review Skull Protects the brain Made up of several bones with seam like sutures Regions of the scalp-frontal, occipital, parietal, temporal Bones of face Orbits Mandible

More information

Introduction to Emergency Medical Care 1

Introduction to Emergency Medical Care 1 Introduction to Emergency Medical Care 1 OBJECTIVES 31.1 Define key terms introduced in this chapter. Slides 13 15, 17, 19, 28 31.2 Describe the components and function of the nervous system and the anatomy

More information

Chapter 32. Objectives. Objectives 01/09/2013. Spinal Column and Spinal Cord Trauma

Chapter 32. Objectives. Objectives 01/09/2013. Spinal Column and Spinal Cord Trauma Chapter 32 Spinal Column and Spinal Cord Trauma Prehospital Emergency Care, Ninth Edition Joseph J. Mistovich Keith J. Karren Copyright 2010 by Pearson Education, Inc. All rights reserved. Objectives 1.

More information

Chapter 26 Head and Spine Trauma The Nervous System The nervous system controls virtually all of our body activities including reflex, voluntary and

Chapter 26 Head and Spine Trauma The Nervous System The nervous system controls virtually all of our body activities including reflex, voluntary and 1 2 3 4 5 Chapter 26 Head and Spine Trauma The Nervous System The nervous system controls virtually all of our body activities including reflex, voluntary and involuntary activities Voluntary activities

More information

Injuries to the Head and Spine From Bradys Emergency Care 10 th Edition

Injuries to the Head and Spine From Bradys Emergency Care 10 th Edition Injuries to the Head and Spine From Bradys Emergency Care 10 th Edition 1. When performing the four-rescuer log roll, which responder pulls the board into position? A.) Head B.) Waist C.) Knee D.) Shoulder

More information

SPINAL IMMOBILIZATION

SPINAL IMMOBILIZATION Spinal Immobilization Decision Assessment Recent studies have shown an increase in mortality for patients with isolated penetrating trauma who are spinally immobilized. Therefore spinal immobilization

More information

Chapter 32. Injuries to the Spine by Pearson Education, Inc. Upper Saddle River, New Jersey

Chapter 32. Injuries to the Spine by Pearson Education, Inc. Upper Saddle River, New Jersey Chapter Injuries to the Spine Topics Anatomy and physiology of the spine Spinal injuries Guidelines for immobilization Special considerations Enrichment Introduction Injuries to the spine are among the

More information

Chapter 8 Trauma Patient Assessment The Patient Assessment Process The Primary Assessment ABCDE s Airway, Breathing, Circulation while securing

Chapter 8 Trauma Patient Assessment The Patient Assessment Process The Primary Assessment ABCDE s Airway, Breathing, Circulation while securing 1 2 3 4 5 6 Chapter 8 Trauma Patient Assessment The Patient Assessment Process The Primary Assessment ABCDE s Airway, Breathing, Circulation while securing D-Disability Chief complaint and/or Mechanism

More information

Selective Spine Assessment & Spinal Motion Restriction

Selective Spine Assessment & Spinal Motion Restriction Selective Spine Assessment & Spinal Motion Restriction Supersedes: 02-09-15 Effective: 10-20-15 Spinal cord injury may be the result of direct blunt and/or penetrating trauma, compression forces (axial

More information

Assessment of the Trauma Patient

Assessment of the Trauma Patient CHAPTER 10 Assessment of the Trauma Patient Overall Assessment Scheme Scene Size-Up Initial Assessment Trauma Physical Exam Vital Signs & SAMPLE History Medical SAMPLE History Physical Exam & Vital Signs

More information

Injuries to the head and spine

Injuries to the head and spine Injuries to the head and spine Aaron J. Katz, AEMT-P, CIC www.es26medic.net 2013 Nervous System Two sub-systems Central Nervous System ( CNS ) Brain and spinal cord Peripheral Nervous System 12 cranial

More information

MEDICAL CONTROL POLICY STATEMENT/ADVISORY. Re: Spinal Injury Assessment & Spinal Precautions Procedure

MEDICAL CONTROL POLICY STATEMENT/ADVISORY. Re: Spinal Injury Assessment & Spinal Precautions Procedure MEDICAL CONTROL POLICY STATEMENT/ADVISORY No. 2015-01 Date: January 20, 2015 Re: Spinal Injury Assessment & Spinal Precautions Procedure Office of the Medical Director Noel Wagner, MD, NREMT-P 1000 Houghton

More information

Hatfield & McCoy Mine Safety Competition First-Aid Contest JULY 15, Page 1

Hatfield & McCoy Mine Safety Competition First-Aid Contest JULY 15, Page 1 Hatfield & McCoy Mine Safety Competition First-Aid Contest JULY 15, 2014 Page 1 PROBLEM Billy is a maintenance person that has been conducting clean-up and service duties on the number one conveyor belt

More information

Patient Assessment. Chapter 8

Patient Assessment. Chapter 8 Patient Assessment Chapter 8 Patient Assessment Scene size-up Initial assessment Focused history and physical exam Vital signs History Detailed physical exam Ongoing assessment Patient Assessment Process

More information

XXX Spinal Motion Restriction

XXX Spinal Motion Restriction Nor-Cal EMS Policy & Procedure Manual NAME OF MODULE XXX Purpose: The purpose of this protocol is to protect patients with signs and symptoms of spinal injuries and those who have the potential for spinal

More information

Focused History and Physical Examination of the

Focused History and Physical Examination of the Henry: EMT Prehospital Care, Revised 3 rd Edition Lecture Notes Chapter 10: Focused History and Physical Examination of Trauma Patients Chapter 10 Focused History and Physical Examination of the Trauma

More information

Chapter 12. Learning Objectives. Learning Objectives 9/11/2012. Musculoskeletal Injuries

Chapter 12. Learning Objectives. Learning Objectives 9/11/2012. Musculoskeletal Injuries Chapter 12 Musculoskeletal Injuries Learning Objectives Describe the anatomy and function of the musculoskeletal system Demonstrate the assessment and management of a patient with a suspected musculoskeletal

More information

Chapter 24 Spinal Trauma Introduction to Spinal Injuries (1 of 2) Annually 15,000 permanent spinal cord injuries Commonly men years old

Chapter 24 Spinal Trauma Introduction to Spinal Injuries (1 of 2) Annually 15,000 permanent spinal cord injuries Commonly men years old 1 2 3 4 5 6 7 Chapter 24 Spinal Trauma Introduction to Spinal Injuries (1 of 2) Annually 15,000 permanent spinal cord injuries Commonly men 16-30 years old Mechanism of Injury: Vehicle crashes: 48% : 21%

More information

Caring for Muscle and Bone Injuries From Brady s First Responder (8 th Edition) 54 Questions

Caring for Muscle and Bone Injuries From Brady s First Responder (8 th Edition) 54 Questions Caring for Muscle and Bone Injuries From Brady s First Responder (8 th Edition) 54 Questions 1. What is caused by overexerting or tearing of a muscle? p. 375 A.) Dislocation B.) Sprain C.) Fracture *D.)

More information

MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH OFFICE OF EMERGENCY MEDICAL SERVICES Basic EMT Practical Examination Cardiac Arrest Management

MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH OFFICE OF EMERGENCY MEDICAL SERVICES Basic EMT Practical Examination Cardiac Arrest Management Basic EMT Practical Examination 6.0 - Cardiac Arrest Management Station 1 RESUSCITATION & DEFIBRILLATION No Point WHILE FUNCTIONING AS FIRST RESCUER: Point 1. Verbalizes or takes body substance isolation

More information

Caring for Muscle and Bone Injuries From Brady s First Responder (8 th Edition) 54 Questions

Caring for Muscle and Bone Injuries From Brady s First Responder (8 th Edition) 54 Questions Caring for Muscle and Bone Injuries From Brady s First Responder (8 th Edition) 54 Questions 1. What do injuries to the shoulder often produce? p. 393 *A.) Anterior dislocation B.) Superior dislocation

More information

Musculoskeletal Trauma. Lesson Goal. Lesson Objectives 9/10/2012. Recognize and manage patients with musculoskeletal trauma

Musculoskeletal Trauma. Lesson Goal. Lesson Objectives 9/10/2012. Recognize and manage patients with musculoskeletal trauma Musculoskeletal Trauma Lesson Goal Recognize and manage patients with musculoskeletal trauma Lesson Objectives Describe function of muscular system Describe composition of muscular system Describe, compare,

More information

Every day thousands of people become the accidental victims of trauma.

Every day thousands of people become the accidental victims of trauma. Aurora Health Care South Region EMS 2010 2 nd Quarter CE Packet Spinal Cord Trauma Every day thousands of people become the accidental victims of trauma. Approximately 43,000 people die in motor vehicle

More information

Chapter 30 Putting It All Together for the Trauma Patient

Chapter 30 Putting It All Together for the Trauma Patient Chapter 30 Putting It All Together for the Trauma Patient Putting It All Together Balance need for prompt transport vs. treatment on scene. Select critical interventions to implement at scene of multipletrauma

More information

To protect patients exhibiting signs and symptoms of spinal injuries and those who have the potential for spinal injuries.

To protect patients exhibiting signs and symptoms of spinal injuries and those who have the potential for spinal injuries. POLICY T1 SPINAL MOTION RESTRICTION Effective Date: January 1, 2017 Last Review Date: January 1, 2017 New Policy Next Review Date: January 2019 Purpose: To protect patients exhibiting signs and symptoms

More information

10O SPLINTING OF INJURIES ADULT & PEDIATRIC. 10Oa: Axial/Spine with Selective Spinal Motion Restriction Adult & Pediatric:

10O SPLINTING OF INJURIES ADULT & PEDIATRIC. 10Oa: Axial/Spine with Selective Spinal Motion Restriction Adult & Pediatric: 10O SPLINTING OF INJURIES ADULT & PEDIATRIC EMERGENCY MEDICAL RESPONDER EMT EMT-INTERMEDIATE 85 ADVANCED EMT PARAMEDIC 10Oa: Axial/Spine with Selective Spinal Motion Restriction Adult & Pediatric: Many

More information

Trauma Life Support Pre-Hospital (TLS-P) Preparatory Materials

Trauma Life Support Pre-Hospital (TLS-P) Preparatory Materials Trauma Life Support Pre-Hospital (TLS-P) Preparatory Materials 1 1. A high-risk bodily fluid for spreading infection is blood. 2. Items that can reduce the spread of infection include masks, gloves, and

More information

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. EPC Ch 24 Quiz w-key Name MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 1) Which of the following best explains the presentation and prognosis of

More information

4 inch laceration traversing down the front of forearm. Fracture of lower leg midway between knee and ankle

4 inch laceration traversing down the front of forearm. Fracture of lower leg midway between knee and ankle 2 inch wound on forehead 3 inch wound on top of shoulder islocated elbow in flexed position 4 inch laceration traversing down the front of forearm 3 inch wound on inner thigh Fracture of lower leg midway

More information

Musculoskeletal System

Musculoskeletal System CHAPTER 28 Musculoskeletal Injuries Musculoskeletal System Anatomy & Physiology Bones provide framework. Joints allow for bending. Muscles allow for movement. Cartilage provides flexibility. Tendons connect

More information

CHAPTER 28 Musculoskeletal Injuries

CHAPTER 28 Musculoskeletal Injuries CHAPTER 28 Musculoskeletal Injuries Musculoskeletal System Anatomy & Physiology Bones provide framework. Joints allow for bending. Muscles allow for movement. Cartilage provides flexibility. Tendons connect

More information

EMS Spinal Assessment and Precautions

EMS Spinal Assessment and Precautions EMS Spinal Assessment and Precautions Adapted from a presentation prepared by Chelsea C. White IV, MD, NREMT-P Medical Director, Bernalillo County Fire Department Robert M. Domeier, MD, EMS Medical Director,

More information

Fractures of the Thoracic and Lumbar Spine

Fractures of the Thoracic and Lumbar Spine A spinal fracture is a serious injury. Nader M. Hebela, MD Fellow of the American Academy of Orthopaedic Surgeons http://orthodoc.aaos.org/hebela Cleveland Clinic Abu Dhabi Cleveland Clinic Abu Dhabi Neurological

More information

CHANHASSEN FIRE DEPARTMENT MEDICAL / RESCUE SKILLS

CHANHASSEN FIRE DEPARTMENT MEDICAL / RESCUE SKILLS CHANHASSEN FIRE DEPARTMENT MEDICAL / RESCUE SKILLS PRACTICAL STATIONS CHANHASSEN FIRE DEPARTMENT MEDICAL / RESCUE SKILLS 1. CARDIAC ARREST MANAGEMENT 2. AIRWAY & RESPIRATORY MANAGEMENT 3. SPINAL IMMOBILIZATION

More information

oriented evaluation of your patient and establishing priorities of care based on existing and

oriented evaluation of your patient and establishing priorities of care based on existing and 1 Chapter 12: Patient Assessment in the Field 2 Patient assessment means conducting a - oriented evaluation of your patient and establishing priorities of care based on existing and potential threats to

More information

Chapter 28 - Head and Spine Injuries

Chapter 28 - Head and Spine Injuries 1 2 3 4 National EMS Education Standard Competencies (1 of 4) Trauma Applies fundamental knowledge to provide basic emergency care and transportation based on assessment findings for an acutely injured

More information

Face and Throat Injuries. Chapter 26

Face and Throat Injuries. Chapter 26 Face and Throat Injuries Chapter 26 Anatomy of the Head Landmarks of the Neck Injuries to the Face Injuries around the face can lead to upper airway obstructions. Bleeding from the face can be profuse.

More information

the back book Your Guide to a Healthy Back

the back book Your Guide to a Healthy Back the back book Your Guide to a Healthy Back anatomy Your spine s job is to: Support your upper body and neck Increase flexibility of your spine Protect your spinal cord There are 6 primary components of

More information

Chapter 30 - Musculoskeletal_Trauma

Chapter 30 - Musculoskeletal_Trauma Introduction to Emergency Medical Care 1 OBJECTIVES 30.1 Define key terms introduced in this chapter. Slides 11 12, 19 20, 22 23, 37 30.2 Describe the anatomy of elements of the musculoskeletal system.

More information

IRECA BLS Challenge 2015 Scenario 1

IRECA BLS Challenge 2015 Scenario 1 Scenario 1 Team Name Team Number Captain Name Judge 1 # Judge 2 # JUDGE S SHEET Overview: This scenario challenges the competitors to use basic triage techniques and then to do the most good for the most

More information

Chapter 24. Learning Objectives. Learning Objectives 9/18/2012. Injuries to the Head and Spine

Chapter 24. Learning Objectives. Learning Objectives 9/18/2012. Injuries to the Head and Spine Chapter 24 Injuries to the Head and Spine Learning Objectives State components of the nervous system List functions of the central nervous system Define structure of the skeletal system as it relates to

More information

Abdomen and Genitalia Injuries. Chapter 28

Abdomen and Genitalia Injuries. Chapter 28 Abdomen and Genitalia Injuries Chapter 28 Hollow Organs in the Abdominal Cavity Signs of Peritonitis Abdominal pain Tenderness Muscle spasm Diminished bowel sounds Nausea/vomiting Distention Solid Organs

More information

68W COMBAT MEDIC POCKET GUIDE

68W COMBAT MEDIC POCKET GUIDE GTA 08-05-058 68W COMBAT MEDIC POCKET GUIDE PART I: TRAUMA TREATMENT This publication contains technical information that is for official Government use only. Distribution is limited to U.S. Government

More information

Chapter 7 EMERGENCY PLAN AND INITIAL INJURY EVALUATION

Chapter 7 EMERGENCY PLAN AND INITIAL INJURY EVALUATION Chapter 7 EMERGENCY PLAN AND INITIAL INJURY EVALUATION Major Concepts. Proper planning of an emergency response is essential for appropriate first aid management of an injury. Anything that can be done

More information

Restore adequate respiratory and circulatory conditions. Reduce pain

Restore adequate respiratory and circulatory conditions. Reduce pain Pre-hospital management of the trauma patient is best performed by an integrated team focused on minimizing the time from injury to definitive care at an appropriate trauma center. Dispatchers, first responders,

More information

SEMINOLE COUNTY EMS PROVISIONAL EMT SKILLS VERIFICATION

SEMINOLE COUNTY EMS PROVISIONAL EMT SKILLS VERIFICATION The following individual has completed the Seminole County EMS Provisional EMT Skills Verification check in the following areas: Oxygen, Airway and Ventilation Skills ALS Assistance Trauma Management Medical

More information

Lesson Plans and Objectives: Review material for article Prep work for article Picture recovery Review for placement on-line.

Lesson Plans and Objectives: Review material for article Prep work for article Picture recovery Review for placement on-line. Lesson Plans and Objectives: Review material for article Prep work for article Picture recovery Review for placement on-line. After reading the article, the staff will be able to: Define facial trauma

More information

Basic Assessment and Treatment of Trauma

Basic Assessment and Treatment of Trauma Basic Assessment and Treatment of Trauma Final Exam Version 1 1. In which of the following scenarios would the potential for serious injury or death be the GREATEST? A. 77-kg (170-lb) man who falls 1.2

More information

Spinal Cord Injury. The nerves that go from the spinal cord to the arms, legs, chest, and abdomen are called peripheral nerves.

Spinal Cord Injury. The nerves that go from the spinal cord to the arms, legs, chest, and abdomen are called peripheral nerves. Spinal Cord Injury Introduction Spinal cord injuries can be very devastating. More than 10,000 Americans experience spinal cord injuries each year, mainly due to auto or falling accidents. More than 200,000

More information

55-year-old male with 2nd and 3rd degree burns to face, chest, and arms on 25% of the body Respirations: 34 Pulse: 120 Mental Status: moans to painful stimulus Mucous membranes charred Stridor 10 cm scalp

More information

Ears. Mouth. Jowls 6 Major Bones of the Face Nasal bone Two

Ears. Mouth. Jowls 6 Major Bones of the Face Nasal bone Two 1 2 3 4 5 Chapter 25 Injuries to the Face, Neck, and Eyes Injuries to the Face and Neck Face and neck are to injury Relatively unprotected positions on body Some injuries are life-threatening. trauma to

More information

Hockey New South Wales Head Injury Guidelines Effective November

Hockey New South Wales Head Injury Guidelines Effective November Hockey New South Wales Effective November 2011 1 Table of Contents Part 1: Guidelines Statement 3 Head Injuries 3 Two Types of Head Injuries 3 Symptoms of Head Injuries 3 Head Injury Notifications 3 Important

More information

Indications for cervical spine immobilisation: -

Indications for cervical spine immobilisation: - Paediatric Trauma Cervical Spine Guidelines UHW Traumatic injuries of the cervical spine (C-spine) are uncommon in children. However, it is safer assume there is a cervical spine injury until examination

More information

Evaluation and Stabilization of the Athlete with Possible Spine Injury

Evaluation and Stabilization of the Athlete with Possible Spine Injury Evaluation and Stabilization of the Athlete with Possible Spine Injury Jeffrey H. Bohmer, MD, FACEP Emergency Physician Northwestern Medicine Central DuPage Hospital June 12, 2015 Introduction Goals: 1.

More information

EMS Update Spinal Motion Restriction Training

EMS Update Spinal Motion Restriction Training EMS Update Spinal Motion Restriction Training 700-M11 Spinal Motion Restriction Spinal Motion Restriction, also called SMR Formally known as Spinal Immobilization or C-Spine Effective February 9, 2016

More information

Spinal injury. Structure of the spine

Spinal injury. Structure of the spine Spinal injury Structure of the spine Some understanding of the structure of the spine (spinal column) and the spinal cord is important as it helps your Neurosurgeon explain about the part of the spine

More information

Airway Adjuncts and Suction

Airway Adjuncts and Suction Airway Adjuncts and Suction Oropharyngeal Airway Selects appropriately sized airway. Measures airway. Inserts airway without pushing the tongue posteriorly. Examiner States: patient is gagging and becoming

More information

Aviation Rescue Swimmer Course

Aviation Rescue Swimmer Course Aviation Rescue Swimmer Course Primary Survey LT 5.4 December 2003 1 Objectives List the procedures used in a primary survey. Demonstrate primary survey procedures used in a mock trauma (moulage) scenario

More information

Cervical Spine Precautions A quick review. By Joseph Lewis, M.D. Medical Director, Honolulu EMS Board Certified in Emergency Medicine

Cervical Spine Precautions A quick review. By Joseph Lewis, M.D. Medical Director, Honolulu EMS Board Certified in Emergency Medicine Cervical Spine Precautions A quick review By Joseph Lewis, M.D. Medical Director, Honolulu EMS Board Certified in Emergency Medicine 1 Goals of this Cervical Spine Immobilization In-service Learn Objectives:

More information

OUTLINE SHEET 5.4 PRIMARY SURVEY

OUTLINE SHEET 5.4 PRIMARY SURVEY ENABLING OBJECTIVES: 4.7 List the procedures used in a primary survey. 4.8 Demonstrate primary survey procedures used in a mock trauma (moulage) scenario without injury to personnel or damage to equipment.

More information

Head Injury Guidelines POL 5700

Head Injury Guidelines POL 5700 Issued by: WHS Effective Date: 1 st Oct 13 Rev: A Page 1 of 5 1. PURPOSE Concussion - Important information What is a concussion? A concussion is an injury to the brain. A blow to the head usually causes

More information

TRAUMA PATIENT ASSESSMENT

TRAUMA PATIENT ASSESSMENT SECTION: Adult Trauma Emergencies PROTOCOL TITLE: Injury General Trauma Management REVISED: 06/2015 OVERVIEW Each year, one out of three Americans sustains a traumatic injury. Trauma is a major cause of

More information

Patient Assessment From Brady s First Responder (8th Edition) 83 Questions

Patient Assessment From Brady s First Responder (8th Edition) 83 Questions Patient Assessment From Brady s First Responder (8th Edition) 83 Questions 1. Which question is important if your patient may be a candidate for surgery? p. 183 *A.) When did you last eat? B.) What is

More information

Skill Evaluation Sheets

Skill Evaluation Sheets Skill Evaluation Sheets Skill Drill 2-: How to Remove Gloves Skill Drill 4-: Primary Check: RAP-CAB Skill Drill 4-2: Perform a Secondary Check Skill Drill 5-: Adult CPR Skill Drill 5-2: Child CPR Skill

More information

CBT/OTEP 445 Head, Spine and Chest Trauma

CBT/OTEP 445 Head, Spine and Chest Trauma Seattle-King County EMS Seattle-King County Emergency Medical Services Division Public Health - Seattle/King County 401 5th Avenue, Suite 1200 Seattle, WA 98104 (206) 296-4693 January 2009 CBT/OTEP 445

More information

Commonwealth Health Corporation NEXT

Commonwealth Health Corporation NEXT Commonwealth Health Corporation This computer-based learning (CBL) module details important aspects of musculoskeletal disorders, body mechanics and ergonomics in the workplace. It examines: what causes

More information

Acting in an emergency. Dr. Samer Sara

Acting in an emergency. Dr. Samer Sara Acting in an emergency Dr. Samer Sara 1 Acting in an emergency basic steps to follow: 1. Recognize the emergency. 2. Check the scene. 3. Call 110. 4. Check the victim. 5. Give first aid. 2 Dr. Samer Sara

More information

Competency Log Professional Responder Courses

Competency Log Professional Responder Courses Competency Log Professional Responder Courses Check off each competency once successfully demonstrated. This log may be used as a support tool when teaching a Professional Responder course. Refer to the

More information

Emergency First Response (EFR) Assessment Sheets September 2011

Emergency First Response (EFR) Assessment Sheets September 2011 Emergency First Response () Assessment Sheets September 2011 Airway Management & Ventilation Current Version: Version 2 (Sep 2011) Airway Management & Ventilation TRAUMA JAW THRUST 1 Hand position 2 Perform

More information

CERVICAL STRAIN AND SPRAIN

CERVICAL STRAIN AND SPRAIN CERVICAL STRAIN AND SPRAIN Description Cervical strain/sprain is an injury to the neck caused when it is forcefully whipped or forced backward or forward. The structures involved are the muscles, ligaments,

More information

CERVICAL STRAIN AND SPRAIN (Whiplash)

CERVICAL STRAIN AND SPRAIN (Whiplash) CERVICAL STRAIN AND SPRAIN (Whiplash) Description time and using proper technique decrease the frequency of Whiplash is an injury to the neck caused when it is forcefully whipped or forced backward or

More information

Oral and Maxillofacial Surgeons and the seriously injured patient. Barts and The London NHS Trust

Oral and Maxillofacial Surgeons and the seriously injured patient. Barts and The London NHS Trust Oral and Maxillofacial Surgeons and the seriously injured patient Barts and The London NHS Trust How do you assess this? Primary Survey A B C D E Airway & Cervical Spine Breathing & Ventilation Circulation

More information

Module Summaries: The emergency plan is a crucial part of the total sports program.

Module Summaries: The emergency plan is a crucial part of the total sports program. Module Summaries: Summary - The Emergency Plan The emergency plan is a crucial part of the total sports program. Prior to each season and game, those individuals responsible for the program and athletes

More information

Chapter 31. Objectives. Objectives 01/09/2013. Head Trauma

Chapter 31. Objectives. Objectives 01/09/2013. Head Trauma Chapter 31 Head Trauma Prehospital Emergency Care, Ninth Edition Joseph J. Mistovich Keith J. Karren Copyright 2010 by Pearson Education, Inc. All rights reserved. Objectives 1. Define key terms introduced

More information

Injuries to Muscles, Bones and Joints. Emergency Medical Response

Injuries to Muscles, Bones and Joints. Emergency Medical Response Injuries to Muscles, Bones and Joints Lesson 33: Injuries to Muscles, Bones and Joints You Are the Emergency Medical Responder You are patrolling the state park where you are the emergency medical responder

More information

ITLS Pediatric Provider Course Basic Pre-Test

ITLS Pediatric Provider Course Basic Pre-Test ITLS Pediatric Provider Course Basic Pre-Test 1. You arrive at the scene of a motor vehicle collision and are directed to evaluate a child who was in one of the vehicles. The patient appears to be a child

More information

MEMORANDUM Date: To: From: Subject:

MEMORANDUM Date: To: From: Subject: COUNTY OF EL DORADO HEALTH & HUMAN SERVICES BOARD OF SUPERVISORS Director Chris Weston Program Manager II 931 Spring Street Placerville, CA 95667 530-621-6100 Phone / 530-295-2501 Fax 1360 Johnson Boulevard,

More information

Lifting and Moving Patients

Lifting and Moving Patients 1. Which of the following factors should be considered before lifting any patient? a. The weight of the patient b. Your physical limitations c. Communications 2. When lifting a patient, a basic principle

More information

Emergency First Response (EFR) Skills Assessment Sheets V4 June 2017

Emergency First Response (EFR) Skills Assessment Sheets V4 June 2017 Emergency First Response () Skills Assessment Sheets V4 June 2017 Airway management & ventilation Airway management & ventilation Trauma jaw thrust 1 Hand positions 2 Perform jaw thrust / mouth open 3

More information

ITLS Pediatric Provider Course Advanced Pre-Test

ITLS Pediatric Provider Course Advanced Pre-Test ITLS Pediatric Provider Course Advanced Pre-Test 1. You arrive at the scene of a motor vehicle crash and are directed to evaluate a child who was in one of the vehicles. The patient appears to be a child

More information

NOTE If it is necessary to perform abdominal thrusts, expose the abdominal area prior to pressing on the abdomen.

NOTE If it is necessary to perform abdominal thrusts, expose the abdominal area prior to pressing on the abdomen. ENABLING OBJECTIVES: 4.7 List the procedures used in a primary survey. 4.8 Demonstrate primary survey procedures used in a mock trauma (moulage) scenario without injury to personnel or damage to equipment.

More information

Skin is the largest, most important organ % of total body weight Functions: - -Sensation - Regulation AKA: System

Skin is the largest, most important organ % of total body weight Functions: - -Sensation - Regulation AKA: System 1 Chapter 20 Soft-Tissue Injury 2 Introduction to Soft-Tissue Injury Skin is the largest, most important organ % of total body weight Functions: - -Sensation - Regulation AKA: System 3 Epidemiology Most

More information

Pre-hospital Trauma Life Support. Rattiya Banjungam Emergency Physician, Khon Kaen Hospital

Pre-hospital Trauma Life Support. Rattiya Banjungam Emergency Physician, Khon Kaen Hospital Pre-hospital Trauma Life Support Rattiya Banjungam Emergency Physician, Khon Kaen Hospital Golden principles of Prehospital Trauma Care Golden Hour There is a golden hour if you are critically injured,

More information

Chapter 28. Objectives. Objectives 01/09/2013. Bleeding and Soft-Tissue Trauma

Chapter 28. Objectives. Objectives 01/09/2013. Bleeding and Soft-Tissue Trauma Chapter 28 Bleeding and Soft-Tissue Trauma Prehospital Emergency Care, Ninth Edition Joseph J. Mistovich Keith J. Karren Copyright 2010 by Pearson Education, Inc. All rights reserved. Objectives 1. Define

More information

Emergency Care Progress Log

Emergency Care Progress Log Emergency Care Progress Log For further details on the National Occupational Competencies for EMRs, please visit www.paramedic.ca. Check off each skill once successfully demonstrated the Instructor. All

More information

You Are the Emergency Medical Responder

You Are the Emergency Medical Responder Lesson 32: Injuries to the Chest, Abdomen and Genitalia You Are the Emergency Medical Responder Your police unit responds to a call in a part of town plagued by violence. When you arrive, you find the

More information

Heidi Lako-Adamson, MD, NRP, FAEMS FM Ambulance and Sanford EMS Education Medical Director

Heidi Lako-Adamson, MD, NRP, FAEMS FM Ambulance and Sanford EMS Education Medical Director Heidi Lako-Adamson, MD, NRP, FAEMS FM Ambulance and Sanford EMS Education Medical Director Spinal cord injury statistics. Definition of spinal motion restriction. Difference between spinal motion restriction

More information

International Trauma Life Support for Prehospital Care Providers Sixth Edition Patricia M. Hicks, MS, NREMTP Roy Alson, PhD, MD, FACEP Donna Hastings, EMT-P John Emory Campbell, MD, FACEP and Alabama Chapter,

More information

Pre-hospital Spinal Motion Restriction Standard update. Presented by: Dr. Tatiana Jevremovic CCFP (EM)(SEM), Dip.

Pre-hospital Spinal Motion Restriction Standard update. Presented by: Dr. Tatiana Jevremovic CCFP (EM)(SEM), Dip. Pre-hospital Spinal Motion Restriction Standard update Presented by: Dr. Tatiana Jevremovic CCFP (EM)(SEM), Dip. Sport Med (CASEM) Dr. Thomas J. Pashby What is happening Pre-hospital Spinal Motion Restriction

More information

3. D Objective: Chapter 4, Objective 4 Page: 79 Rationale: A carbon dioxide level below 35 mmhg indicates hyperventilation.

3. D Objective: Chapter 4, Objective 4 Page: 79 Rationale: A carbon dioxide level below 35 mmhg indicates hyperventilation. 1. A Objective: Chapter 1, Objective 3 Page: 14 Rationale: The sudden increase in acceleration produces posterior displacement of the occupants and possible hyperextension of the cervical spine if the

More information

Trauma Overview. Chapter 22

Trauma Overview. Chapter 22 Trauma Overview Chapter 22 Kinematics of Trauma Injuries are the leading cause of death among children and young adults. Kinematics introduces the basic physical concepts that dictate how injuries occur

More information

4/19/2017. Prehospital Spinal Care: Then. Prehospital Spinal Care: Then. Prehospital Spinal Care: Then. Prehospital Spinal Care: Then. Why Immobilize?

4/19/2017. Prehospital Spinal Care: Then. Prehospital Spinal Care: Then. Prehospital Spinal Care: Then. Prehospital Spinal Care: Then. Why Immobilize? Management of Cervical Spine Injuries and Athletic Equipment Removal Gianluca Del Rossi, PhD, ATC Prehospital Spinal Care: Then While the exact origins of backboards in EMS are unclear, noted trauma surgeon

More information

Injuries to the Extremities

Injuries to the Extremities Injuries to the Extremities KNOWLEDGE OBJECTIVES 1. List seven signs and symptoms that suggest a serious extremity injury. 2. Describe how to care for injuries to the shoulder, upper arm, and elbow. 3.

More information

PRE-HOSPITAL PATIENT CARE PROTOCOLS BASIC LIFE SUPPORT/ADVANCED LIFE SUPPORT

PRE-HOSPITAL PATIENT CARE PROTOCOLS BASIC LIFE SUPPORT/ADVANCED LIFE SUPPORT PRE-HOSPITAL PATIENT CARE PROTOCOLS BASIC LIFE SUPPORT/ADVANCED LIFE SUPPORT Board Approved June 2007 Revised December 2009 Revised July 2011 Revised June 2015 435 Hunter Street Fredericksburg, VA 22401

More information

Extremity Injuries and Splinting

Extremity Injuries and Splinting CHAPTER 15 Extremity Injuries and Splinting Lesson Objectives 1. Describe the 3 general types of splints and how to improvise splints with common materials. 2. List the general guidelines for splinting

More information

Chapter 5. Learning Objectives. Learning Objectives 9/18/2012. Lifting and Moving Patients. Define body mechanics

Chapter 5. Learning Objectives. Learning Objectives 9/18/2012. Lifting and Moving Patients. Define body mechanics Chapter 5 Lifting and Moving Patients Learning Objectives Define body mechanics Discuss guidelines/safety precautions to follow when lifting patient Explain rationale for properly lifting/moving patients

More information

Disaster Medical Operations-Part 2

Disaster Medical Operations-Part 2 Disaster Medical Operations-Part 2 Community Emergency Response Team Disaster Medical Operations Part 1 Review The killers Airway obstruction Excessive bleeding Shock All immediate receive airway control,

More information

1 Chapter 29 Orthopaedic Injuries Principles of Splinting 2 Types of Muscles. Striated Skeletal. Smooth

1 Chapter 29 Orthopaedic Injuries Principles of Splinting 2 Types of Muscles. Striated Skeletal. Smooth 1 Chapter 29 Orthopaedic Injuries Principles of Splinting 2 Types of Muscles Striated Skeletal Smooth 3 Anatomy and Physiology of the Musculoskeletal System 4 Skeletal System 5 Skeletal System Functions

More information