INTRODUCTION
This essay focuses on Pathophysiology and symptoms of compartment Syndrome, which has occurred in Leigh Richards due to a car accident. He is 39 years married male with three children. Currently, he is working as an irrigation consultant in Murray Bridge. While taking part in car rally where he was a restrained passenger, he was involved in a car accident. As a result, he was trapped inside the car by cabin intrusion which pinned his leg. To remove his leg, the car was separated. The driver of the car who was his brother immediately called emergency services.
During the accident, the pressure on his leg was increased resulting in fluid leakage outside the capillary wall which compress intracellular space. Consequently, Leigh was suffered from compartment syndrome. Firstly, this essay will describe the pathophysiology of Acute Compartment Syndrome by considering patient situation, collecting cues and data and processing information. Then, signs and symptoms of CS will be discussed which is relevant to the given scenario.
PATHOPHYSIOLOGY
While discussing about compartment syndrome; it is a condition which occurs when the pressure inside muscles increases and leads to poor blood supply, resulting in lack of oxygen and nourishment of nerve and muscle cells.
There are two types of compartment syndrome, they are Acute compartment syndrome and chronic compartment syndrome. The Acute compartment syndrome occurs when a person suffers from severe injury. It is a medical emergency which can lead to everlasting muscle damage and even amputation.
Chronic compartment syndrome, is a recurrent syndrome and usually not a medical emergency often caused due to athletic exertion and repetitive action. It can be controlled and relieved by stopping the exercise.
As Leigh recently got injured in a car accident, so in this condition he is suffering from Acute Compartment Syndrome.
In context of pathophysiology; in our body, muscles are divided by connective tissue. Within connective tissue there are thin, fibrous layer which is called fascia which border the muscle and bind veins, arteries, nerves, ligaments and tendons together into functional groups. To flow blood from artery to vein pressure requires within the compartment. As fascia does not stretch which cause pressure to increase inside a muscle compartment. Therefore, when the tissue pressure within the closed muscle compartment exceeds the perfusion pressure it results in muscle and nerve ischemia. This sequence of event result in lack of oxygenated blood flow from artery to vein and collection of waste product results in pain and decreased peripheral sensation. It characteristically occurs following to a traumatic event, most commonly after fracture as stated in the given scenario.
Similarly, in this case Leigh is suffering from acute compartment syndrome as he got injured in a car accident. During accident, he was stuck in the car by a cabin intrusion as a result his leg was pinned which causes increase of pressure in limb muscle compartment. Leigh suffered from left lower leg fracture and humeral shaft fracture.
After accident, the tissue pressure of his left hand and leg was increased and lead to poor circulation of blood and nutrition from artery to vein. As a result, there was lack of blood supply in his limbs, nerve vessels and tissue. Reduce in venous drainage results in fluid collection in capillary wall which consequences edema in his left upper arm. Through all these process Leigh has suffered from compartment syndrome.
Similarly, patient with compartment syndrome need to assess 6P’s as a physical assessment. These six signs are often seen in patient with compartment syndrome.They are pain, paresthesia, pallor, paralysis, pulsenes and poikilothermia. Among all these signs, two sign that has seen in Leigh are pain and paresthesia.
Sign and Symptoms:
•Pain: After accident, when Leigh reached hospital his left upper arm was swollen and painful to touch and on movement. Pain is one of the most common symptom of compartment syndrome as in this condition person’s body compartment got injured. Likewise in this case Leigh’s left hand and leg got injured during whivh the tissue of that area was damaged. As in our body, after tissue injury pain receptors of skin are activated. After that peripheral nerve got signal which travels to the spinal cord.Then, spinal cord releases different neurotransmitters which helps to activate the nerves that passes these signals directly to brain and pain sensation occurs. Therefore, stimulation of different chemical messenger and sensory nerves in the skin caused pain in Leigh’s left hand and left leg.
•Paresthesia: During neurovascular observation of Leigh, it is found thet his finger was slight tingling.As paresthesia refers to tingling or prickling sensation which is usually felt in hand, feet or may occur in other parts of our body. Due to tissue ischemia the nerve conduction of his legs and hands became slow which affects sensory actions of his limbs.As this decreases the neurosensory action of limbs and results change in peripheral nervous system.Thereafter change in his peripheral nervous system releases clinical features in his body like tingling sensation which is also known as paresthesia.
Conclusion
This study presents a detail view of pathophysiology and sign and symptoms of compartment syndrome which has affected the limbs of Leigh Mark Richard due to car accident.It specifies that compartment syndrome occurs when a person suffers from severe injury or due to repetitive motions. In this case Leigh is suffering from acute compartment syndrome due to severe injury related to car accident. As this incident affected his limbs and the pressure inside the muscle compartment of his limbs was increased which results in tissue ischemia and nerve damage of his humeral shaft and tibia and fibula of his limbs.Moreover, two sign and symptoms which has manifested in leigh are pain and paresthesia.Therefore, acute compartment syndrome is most commom in peple having severe injury and trauma.
