Ch 30-39 Test Review Flashcards
produce oil that coats the hair and skin
Sebaceous glands
produce and secrete sweat
Sweat glands
Where do you find dead skin cells, keratin, melanin granules?
Epidermis
Where do you find nerve endings, blood vessels, sweat glands, hair follicles, and sebaceous glands?
Dermis
What is the outer most layer of the skin?
Epidermis
What is the layer of the skin under the epidermis?
Dermis
What layer of skin is between the muscle and dermis, fatty layer?
Subcutaneous
What is the reason systolic increases in pt w/ massive head injury?
The production of catacholimines (epi, nor-epi) that results in vasoconstriction
What would you expect to find in pt w/ an injury from a vascular structures within ABD
Initially a normal ABD assessment, identified by unexplained shock/ shock that is out of proportion to pt injury’s
absence of breath sounds, unilateral chest rise, pulses paradoxus, tachy- w/ progression into V-tach/v-fib, JVD, Narrow pulse pressure, tracheail deviation
Are S/S of what?
tension pneumo
Becks triad, (hypotension, jvd, muffled heart sounds), electrical alterans, narrow pulse pressure, equal breath sounds
Are S/S of what?
pericardial tamponade-
open, bubbling wound, tachycardia, tacyphena, restlessness, diminished breath sounds, hyperresonant sounds
Are S/S of what?
open pneumo-
decompensated shock, hypoxia, agitation, anxiety, tachypnea, dyspnea, trachea diveation, hemopytisis, dullness upon percussion
Hemothorax
How to calculate MAP?
(Diastolic x 2) + systolic. THEN divided by 3
How to treat epistaxis?
Pinch nose, lean forward, maintain airway
Common cause of shock and death in trauma pt
Hypovolemia
Treatment for cornea abrasions & retinal detachments?
Supportive Care
Treatment for an Orbital Injury?
supportive care, if eyes something, cover one eye and bandage both
Treatment for Chemical eye exposure
Flush with a lot of water. Minimum 5 min, remove contacts after initial flush
S/S of basilar skull fx
CSF drainage from ears and nose, Raccoon eyes & battle signs
CSF will have elevated reading of glucose
Which of the follow is the most important intervention for the pt with increasing intracranial pressure?
Ventilations
Treating pt’s w/ electrical shock from high volt electric line
Outside of ABC’s, Most important is fluid resuscitation
Shock that is a widespread dialation of blood vessels
Distributive
Shock that is blockage of blood flow
Obstructive
Shock that is a blockage in heart
Cardiogenic
Shock that is fluid loss
Hypovolemic
Shock that is d/t spina cord injury
Neurogenic
Shock that is vasodialation from allergic reaction,
Anaphylactic
Shock that is sudden nervous system reaction
Psychogenic
Shock that is from systemic infection, fever,
Septic
You called to the scene of a pt who was thrown from a vehicle and on approach you see has a severely lacerated left arm with moderated venous bleeding, which of the following do you do first.
Ax for life threats
Which of the following injures may present w/ dysp, anxiety, jvd, tracheal deviation?
Tension Pneumonia
Which of the following has the greatest kinetic energy.
5lbs ball w/ greater speed i think it was at like 20 or 40 mph
Kinetic energy=
mass divided by 2
plus velocity
What type on injuries accounts for majority of MVC fatalities
Head injuries
Patho of Decreasing pulse pressure in hemorrhagic shock is d/t to what?
decreased blood volume, causes a decrease in returning blood to
Know to treat conscious pt with pelvis trauma
Appropriate ax for type of injury
Application of pelvic binder and IV fluids(NS or LR)
Reason for icp from TBI’s?
Tissue edema
Which of these best explains the path of physiologic reason of a low systolic b/p with a tension pneumo
Reduction in cardiac output d/t increased intrathoracic pressure causing compression of the heart and inferior vena cava. (Decreased preload)
Vasoconstriction
How to treat superficial burns
Stop the burning process, relive pain. Careful to cool the burn, but not the whole pt. No ointments/creams/salves. Transport in position of comfort.
How to treat partial thickness burns
Cool the burn, do not pop blisters, elevate extremity to prevent edema, pain control.
Full thickness burns
Dry dressing, fluid resuscitation, pain management if needed.
crush syndrome w/ trapped are, unable to medicate or run fluids
TQ
What’s the reason a pt’s b/p increased with a closed head injury.
Vasoconstriction
L shoulder pain, Kehr sign, is an indication of what?
spleen, diaphragmatic injuries
What would you expect to find for AX findings for pt’s w/ injured kidneys
Pain upon inspiration in the abdomen and flank areas, and hematuria
In traumatic asphyxia what causes petechiae
D/t massive increase in the major veins of head,neck , and kidneys, then passes into the capillary beds and causes them to rupture.
What do you think would receive the most damage from chemical burns?
The eye
What stage of shock is multisystem organ failure?
Irreversible
What stage of shock presents with hypotension, ams, Bradycardia, irregular respiration, ashen skin?
Decompensated
What stage of shock presents with normal b/p, tachycardia, pale cool clammy, anxiety, sense of impending doom?
Compensated
Rule of 9’s for adults. (Remember, they will try and trip you up. By only giving you half a body part, ie chest, but not abdomen, anterior arm, not whole arm)
head 9, trunk 18, upper extremities 9, lower extremities 18 back 18, genitals 1, palms, 1
Rule of 9’s for toddlers
head 12, trunk 18, back 18, upper extremities 9, lower extremities 16.5 genitals 1
Rule of 9’s for infants
head 18, torso 18, back 18, upper extremities 9, lower extremities 13.5, genitals 1
Which sign presents with left shoulder pain when lying with legs elevated indicates ruptures spleen?
Kehr Sign
Bradycardia, HTN, abdnormal breathing, widene pulse pressure- indicates ICP.
Cushing Triad
hypotension, jvd, muffled heart tones- cardiac tamponade
Beck’s Triad
grabbing lower calf- no movement of foot indicates a rupture achilles tendon.
Name the test
Thompson
pt drops to heels from tiptoes. Pain in the right lower quadrant indicicates acute appendicitis
Name the test
Merkle heel drop-
resistance to extension while hip is flexed -sign of meningitis
Name the sign
kernels signs (kerning)-
flexion of hips and knees in response to neck flexion- signs of meningitis
Name the sign
Brudzinski
toes fan out- normal in pecs under 2, abnormal in anything older, can be a sign of SCI
Name the sign
Babinksi
which of the following injuries has the highest risk of air embolism involving the heart or lungs.
Lac jugular.
Why is reassessment of a pt w/ a spinal cord injury so important?
determine if a pt is stabilizing or deteriorating. Monitoring for signs of shock, specifically neurogenic shock.
Which of the following causes decreased in b/p in decompensated shock?
decrease in b/p signifies that a significant amount of blood has been lost. Ie: hypovolemic shock.
Bone shapes examples of each
Examples of long bones
femur, tibia, radius
Bone shapes examples of each
Examples of short bones
Tarsals, carpals
Examples of flat bones
Sternum, ribs
Examples of irregular bones
vertebrae, pelvis, facial bones
Which bones is classified as a sesamoid?
Patella
Which nerve controls eye movement- have the pt follow an object with eyes in a vertical, horizontal, and diagonal movement?
Nerve 3, Occulomotor
Which nerve is responsible for facial sensation and chewing-smile?
Nerve 7-facial nerve-
Which nerve movement, sensation, and abd organs.- smile and swallow?
Nerve 10 - Vagus
Which nerve is responsible for facial sensation and chewing-smile?
nerve 5- trigeminal-
Refer to pic of vertebrae
Which vertebrae is called the Atlas
C1
Which vertebrae is called the Axis
C-2
partial dislocation of a joint. When a joint is moved beyond it’s range of motion.
Subluxation
What type of moi could possible cause concussion, subluxation, transactions, and compressions?
Concussion- direct blow to the head, blow to the face, neck, or anywhere else on the body with and impulsive force that is transmitted to the head. MVC’s, Falls, assaults and sports injuries.
Destruction of muscle tissue leading to a release of potassium and myoglobin. Can be caused by crush syndrome d/t prolonged compression force that impairs muscle metabolism and circulation. Other causes include: drug abuse, prolonged immobility, dehydration, and muscle disorders.
Rhabdomyolysis
What kinds of injury would expect if a person got hit directly by lightning?
Blast like injury patterns: damage to the tympanic membranes, muscle damage, rhabdo, temporary and permanent paralysis, cardiac and respiratory arrest.
moi for upper airway burns
super heated gases, high water soluble gases.
moi for lower airway burns-
steam, hot particulate matter, low water soluble gases
what do you think would most likely cause a lower airway burn?
steam
Hyper extension-
when the body is pushed out from a stationary head, causing avulsion fractures at C1 and C2.
Hangman’s fracture-
lateral force and snapping the head sideways. Fracture occurs at C1 and C2
Rotation-flexion injuries
forward movement of the head with rotation, usually caused but high acceleration forces, C1 and C2 involved
flexion injury
forward movement of the head, result from rapid deceleration or direct blow to the occiput. C1 and C2 are involved
