may be internal or external. injuries of the external ear are typically lacerations of the cartilage or the formation of a hematoma. injuries of the middle and internal ear may include a perforated eardrum or trauma caused by extreme pressure changes. the ear is also highly sensitive to blast injury. the bones of the ear are connected to facial nerves, and ear injuries can cause paralysis of the face. trauma to the ear can cause hearing loss. eye injuries often take place in the cornea, and they have the potential to permanently damage vision. corneal abrasions are a common injury caused by contact with foreign objects. the eye can also be injured by a foreign object remaining in the cornea. radiation damage can be caused by exposure to excessive light, often caused by welding without eye protection or being exposed to excessive ultraviolet radiation, such as sunlight. exposure to corrosive chemicals can permanently damage the eyes, causing blindness if not sufficiently irrigated. the eye is protected from most blunt injuries by the infraorbital margin, but in some cases blunt force may cause an eye to hemorrhage or tear. overuse of the eyes can cause eye strain, particularly when looking at brightly lit screens for an extended period. heart cardiac injuries affect the heart and blood vessels. blunt cardiac injury in a common injury caused by blunt trauma to the heart. it can be difficult to diagnose, and it can have many effects on the heart, including contusions, ruptures, acute valvular disorders, arrhythmia, or heart failure. penetrative trauma to the heart is typically caused by stab wounds or gunshot wounds. accidental cardiac penetration can also occur in rare cases from a fractured sternum or rib. stab wounds to the heart are typically survivable with medical attention, though gunshot wounds to the heart are not. the right ventricle is most susceptible to injury due to its prominent location. the two primary consequences of traumatic injury to the heart are severe hemorrhaging and fluid buildup around the heart. musculoskeletal types of bone fracture musculoskeletal injuries affect the skeleton and the muscular system. soft tissue injuries affect the skeletal muscles, ligaments, and tendons. ligament and tendon injuries account for half of all musculoskeletal injuries. ligament sprains and tendon strains are common injuries that do not require intervention, but the healing process is slow. physical therapy can be used to assist reconstruction and use of injured ligaments and tendons. torn ligaments or tendons typically require surgery. skeletal muscles are abundant in the body and commonly injured when engaging in athletic activity. muscle injuries trigger an inflammatory response to facilitate healing. blunt trauma to the muscles can cause contusions and hematomas. excessive tensile strength can overstretch a muscle, causing a strain. strains may present with torn muscle fibers, hemorrhaging, or fluid in the muscles. severe muscle injuries in which a tear extends across the muscle can cause total loss of function. penetrative trauma can cause laceration to muscles, which may take an extended time to heal. unlike contusions and strains, lacerations are uncommon in sports injuries. traumatic injury may cause various bone fractures depending on the amount of force, direction of the force, and width of the area affected. pathologic fractures occur when a previous condition weakens the bone until it can be easily fractured. stress fractures occur when the bone is overused or suffers under excessive or traumatic pressure, often during athletic activity. hematomas occur immediately following a bone fracture, and the healing process often takes from six weeks to three months to complete, though continued use of the fractured bone will prevent healing. articular cartilage damage may also affect function of the skeletal system, and it can cause posttraumatic osteoarthritis. unlike most bodily structures, cartilage cannot be healed once it is damaged. nervous system ct scan of a brain hemorrhage (bottom arrow) and the surrounding edema (top arrow) injuries to the nervous system include brain injury, spinal cord injury, and nerve injury. trauma to the brain causes traumatic brain injury (tbi), causing "long-term physical, emotional, behavioral, and cognitive consequences". mild tbi, including concussion, often occurs during athletic activity, military service, or as a result of untreated epilepsy, and its effects are typically short-term. more severe injuries to the brain cause moderate tbi, which may cause confusion or lethargy, or severe tbi, which may result in a coma or a secondary brain injury. tbi is a leading cause of mortality. approximately half of all trauma-related deaths involve tbi. non-traumatic injuries to the brain cause acquired brain injury (abi). this can be caused by stroke, a brain tumor, poison, infection, cerebral hypoxia, drug use, or the secondary effect of a tbi. injury to the spinal cord is not immediately terminal, but it is associated with concomitant injuries, lifelong medical complications, and reduction in life expectancy. it may result in complications in several major organ systems and a significant reduction in mobility or paralysis. spinal shock causes temporary paralysis and loss of reflexes. unlike most other injuries, damage to the peripheral nerves is not healed through cellular proliferation. following nerve injury, the nerves undergo degeneration before regenerating, and other pathways can be strengthened or reprogrammed to make up for lost function. the most common form of peripheral nerve injury is stretching, due to their inherent elasticity. nerve injuries may also be caused by laceration or compression. pelvis injuries to the pelvic area include injuries to the bladder, rectum, colon, and reproductive organs. traumatic injury to the bladder is rare and often occurs with other injuries to the abdomen and pelvis. the bladder is protected by the peritoneum, and most cases of bladder injury are concurrent with a fracture of the pelvis. bladder trauma typically causes hematuria, or blood in the urine. ingestion of alcohol may cause distension of the bladder, increasing the risk of injury. a catheter may be used to extract blood from the bladder in the case of hemorrhaging, though injuries that break the peritoneum typically require surgery. the colon is rarely injured by blunt trauma, with most cases occurring from penetrative trauma through the abdomen. rectal injury is less common than injury to the colon, though the rectum is more susceptible to injury following blunt force trauma to the pelvis. injuries to the male reproductive system are rarely fatal and typically treatable through grafts and reconstruction. the elastic nature of the scrotum makes it resistant to injury, accounting for 1% of traumatic injuries. trauma to the scrotum may cause damage to the testis or the spermatic cord. trauma to the penis can cause penile fracture, typically as a result of vigorous intercourse. injuries to the female reproductive system are often a result of pregnancy and childbirth or sexual activity. they are rarely fatal, but they can produce a variety of complications, such as chronic discomfort, dyspareunia, infertility, or the formation of fistulas. age can greatly affect the nature of genital injuries in women due to changes in hormone composition. childbirth is the most common cause of genital injury to women of reproductive age. many cultures practice female genital mutilation, which is estimated to affect over 125 million women and girls worldwide as of 2018. tears and abrasions to the vagina are common during sexual intercourse, and these may be exacerbated in instances of non-consensual sexual activity. respiratory tract injuries to the respiratory tract affect the lungs, diaphragm, trachea, bronchus, pharynx, or larynx. tracheobronchial injuries are rare and often associated with other injuries. bronchoscopy is necessary for an accurate diagnosis of tracheobronchial injury. the neck, including the pharynx and larynx, is highly vulnerable to injury due to its complex, compacted anatomy. injuries to this area can cause airway obstruction. ingestion of corrosive chemicals can cause chemical burns to the larynx. inhalation of toxic materials can also cause serious injury to the respiratory tract. severe trauma to the chest can cause damage to the lungs, including pulmonary contusions, accumulation of blood, or a collapsed lung. the inflammation response to a lung injury can cause acute respiratory distress syndrome. injuries to the lungs may cause symptoms ranging from shortness of breath to terminal respiratory failure. injuries to the lungs are often fatal, and survivors often have a reduced quality of life. injuries to the diaphragm are uncommon and rarely serious, but blunt trauma to the diaphragm can result in the formation of a hernia over time. injuries to the diaphragm may present in many ways, including abnormal blood pressure, cardiac arrest, gastroinetestinal obstruction, and respiratory insufficiency. injuries to the diaphragm are often associated with other injuries in the chest or abdomen, and its position between two major cavities of the human body may complicate diagnosis. skin most injuries to the skin are minor and do not require specialist treatment. lacerations of the skin are typically repaired with sutures, staples, or adhesives. the skin is susceptible to burns, and burns to the skin often cause blistering. abrasive trauma scrapes or rubs off the skin, and severe abrasions require skin grafting to repair. skin tears involve the removal of the epidermis or dermis through friction or shearing forces, often in vulnerable populations such as the elderly. skin injuries are potentially complicated by foreign bodies such as glass, metal, or dirt that entered the wound, and skin wounds often require cleaning. treatment trauma surgeons operating on a united states marine much of medical practice is dedicated to the treatment of injuries. traumatology is the study of traumatic injuries and injury repair. certain injuries may be treated by specialists. serious injuries sometimes require trauma surgery. following serious injuries, physical therapy and occupational therapy are sometimes used for rehabilitation. medication is commonly used to treat injuries. emergency medicine during major trauma prioritizes the immediate consideration of life-threatening injuries that can be quickly addressed. the airway is evaluated, clearing bodily fluids with suctioning or creating an artificial airway if necessary. breathing is evaluated by evaluating motion of the chest wall and checking for blood or air in the pleural cavity. circulation is evaluated to resuscitate the patient, including the application of intravenous therapy. disability is evaluated by checking for responsiveness and reflexes. exposure is then used to examine the patient for external injury. following immediate life-saving procedures, a ct scan is used for a more thorough diagnosis. further resuscitation may be required, including ongoing blood transfusion, mechanical ventilation and nutritional support. pain management is another aspect of injury treatment. pain serves as an indicator to determine the nature and severity of an injury, but it can also worsen an injury, reduce mobility, and affect quality of life. analgesic drugs are used to reduce the pain associated with injuries, depending on the person's age, the severity of the injury, and previous medical conditions that may affect pain relief. nsaids such as aspirin and ibuprofen are commonly used for acute pain. opioid medications such as fentanyl, methadone, and morphine are used to treat severe pain in major trauma, but their use is limited due to associated long-term risks such as addiction. in addition to medications, non-pharmacological interventions can be beneficial when treating pain. the mnemonic tweed sash summarises some of these: non-pharmacological analgesic strategies psychological interventions t therapeutic touch (e.g. hand-holding) w warn about painful interventions e explain what is, or is about to, happen e eye contact d defend (patient) dignity physical interventions s stabilise fractures a apply dressings to cover burns s soft surface (avoid rigid spinal boards or stretchers) h hypothermia avoidance complications complications may arise as a result of certain injuries, increasing the recovery time, further exasperating the symptoms, or potentially causing death. the extent of the injury and the age of the injured person may contribute to the likelihood of complications. infection of wounds is a common complication in traumatic injury, resulting in diagnoses such as pneumonia or sepsis. wound infection prevents the healing process from taking place and can cause further damage to the body. a majority of wounds are contaminated with microbes from other parts of the body, and infection takes place when the immune system is unable to address this contamination. the surgical removing of devitalized tissue and the use of topical antimicrobial agents can prevent infection. hemorrhaging of blood is a common result of injuries, and it can cause several complications. pooling of blood under the skin can cause a hematoma, particularly after blunt