Chapter 5 - Soft-Tissue Trauma Flashcards

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1
Q

About what percentage of soft tissue wounds become infected, with a significant resultant
morbidity?

A

pg 93

7 percent

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2
Q

Which glands secrete sweat?

A

pg 94

Sudoriferous glands

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3
Q

Which of the following types of cells are found in the dermis?

Lymphocytes

Fibroblasts

Macrophages

Mast cells

All

A

pg 94

All

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4
Q

The layers of the arteries and veins proceeding in order from exterior to interior are the

A

pg 94

adventitia, media, intima

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5
Q

The blood vessels responsible for distributing blood to the major regions and organs of the
body are the

A

pg 94

arteries

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6
Q

The blood vessels able to change their lumen size by a factor of five are the

A

pg 94

arterioles.

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7
Q

The sheet of thick, fibrous material surrounding muscles is the

A

pg 95

fascia.

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8
Q

T/F - Lacerations that run parallel to skin tension lines will cause the wound to gape.

A

pg 96

False

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9
Q

Which of the following types of wounds are unlikely to heal well?

A. Wounds that gape
B. Wound associated with static tension lines
C. Wounds associated with dynamic tension lines
D. Wounds perpendicular to tension lines
E. All except B

A

pg 96

E. All except B

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10
Q

The type of wound characterized by erythema usually seen during the prehospital setting is the

A

pg 96

contusion.

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11
Q

Which of the following wounds is not considered open?

A. Laceration D. Puncture
B. Abrasion E. Avulsion
C. Contusion

A

pg 96

C. Contusion

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12
Q

Which of the following wound types is characterized as a surgically smooth, open wound?

A. Abrasion D. Incision
B. Contusion E. Avulsion
C. Laceration

A

pg 98

D. Incision

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13
Q

Crush injuries usually involve injury to

A

pg 97

blood vessels.

muscles.

bones.

internal structures.

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14
Q

Which of the following is NOT usually considered an open wound?

A. Abrasion D. Degloving injury
B. Crush injury E. Avulsion
C. Incision

A

pg 97

B. Crush injury

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15
Q

The wound that poses the greatest risk for serious infection is the

A

pg 98

puncture.

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16
Q

The injury in which the skin is pulled off a finger, hand, or extremity by farm or industrial
machinery is called a

A

pg 98

degloving injury.

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17
Q

T/F - Amputations that occur cleanly are likely to be associated with severe hemorrhage.

A

pg 99

False

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18
Q

Vascular, platelet, and coagulation are phases of the process called

A

pg 100

hemostasis.

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19
Q

T/F - When torn or cut, the muscles in the capillaries constrict, thereby limiting hemorrhage.

A

pg 100

False

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20
Q

The agents that recruit cells responsible for the inflammatory response are called

A

pg 101

chemotactic factors.

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21
Q

The cells that attack invading pathogens directly or through an antibody response include all of
the following, EXCEPT

A. macrophages. D. granulocytes.
B. lymphocytes. E. fibroblasts.
C. white blood cells.

A

pg 101

E. fibroblasts.

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22
Q

The stage of the healing process in which the phagocytes and lymphocytes are most active is

A

pg 101

inflammation.

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23
Q

Regenerated skin, after about four months, is about how strong compared to the original skin?

A

pg 101

60 percent

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24
Q

Infection usually appears how long after the initial wound?

A

pg 102

2 to 3 days

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25
Q

Which of the following is an infection risk factor with soft tissue wounds?

A. Advancing age D. Cat bites
B. Crush injury E. All of the above
C. NSAID use

A

pg 102

E. All of the above

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26
Q

T/F - Closing wounds with staples or sutures increases the risk of infection.

A

pg 102

True

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27
Q

It is common practice to provide tetanus boosters if the patient’s last booster was over

A

pg 103

five years ago.

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28
Q

Which of the following can interfere with normal clotting?

A. Aspirin D. TPA
B. Warfarin E. All of the above
C. Streptokinase

A

pg 103

E. All of the above

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29
Q

The location at greatest risk for compartment syndrome is the

A

pg 103

calf.

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30
Q

The excessive growth of scar tissue within the boundaries of the wound is called

A

pg 103

hypertrophic scar formation.

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31
Q

T/F - The nature of crush injury produces an injury area that is an excellent growth medium for
infection.

A

pg 105

True

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32
Q

A crush injury that produces crush syndrome usually requires what minimum time of
entrapment?

A

pg 105

4 hours

33
Q

What is likely with the release of entrapment in the patient suffering crush syndrome?

A

pg 105

Kidney failure

Abnormal vascular calcifications

Cardiac dysrhythmias

Hypovolemia

34
Q

The type of dressing that prevents the movement of fluid or air through the dressing is:

A

pg 106

occlusive.

35
Q

The bandages that increase pressure beneath the bandage with each consecutive wrap are

A

pg 108

elastic bandages.

36
Q

T/F - Not only is the skin the first body organ to experience trauma, it is often the only one to
display the signs of injury.

A

pg 108

True

37
Q

What are important factors to consider in the assessment and management of external hemorrhage?

A

pg 109

Type of bleeding

Stopping further hemorrhage

Rate of hemorrhage

Volume of blood lost

38
Q

What is one of the primary objectives of bandaging?

A

pg 111

Hemorrhage control

39
Q

T/F - Insufficient tourniquet pressure may increase the rate and volume of hemorrhage.

A

pg 111

True

40
Q

The restoration of circulation once a tourniquet is released may cause

A

pg 111

Shock

Renal failure

Hypovolemia

Lethal dysrhythmias

41
Q

After bandaging a patient’s severely hemorrhaging forearm wound, you notice that the limb is
cool, capillary refill is slowed, and the radial pulse cannot be found. You should

A

pg 112

loosen the bandage.

42
Q

Which medication may be administered to help alleviate pain associated with soft tissue
injury?

A

pg 112

Morphine sulfate

43
Q

With a large and gaping wound to the neck, use a(n)

A

pg 113

occlusive dressing.

44
Q

The type of dressing recommended for blood and fluid leaking from the auditory canal is a(n)

A

pg 113

gauze dressing.

45
Q

Which of the following is NOT a distal sign that a circumferential bandage is too tight?

A. Diaphoresis D. Tingling
B. Pallor E. Swelling
C. Loss of pulses

A

pg 114

A. Diaphoresis

46
Q

Which of the following glands secrete a waxy substance?

A. Sudoriferous glands D. Adrenal glands
B. Sebaceous glands E. Pituitary glands
C. Subcutaneous glands

A

pg 94

B. Sebaceous glands

47
Q

The layer of skin that is made up of mostly dead cells and provides the waterproof envelope that
contains the body is the

A

pg 94

epidermis.

48
Q

Identify the layers of the arteries and veins in order from exterior to interior.

A

pg 94

Adventitia, media, intima

49
Q

The blood vessels that have a wall only one cell thick are the

A

pg 94

capillaries.

50
Q

T/F - In the limbs, fascia define compartments with relatively fixed volumes.

A

pg 95

True

51
Q

T/F - Lacerations perpendicular to skin tension lines will cause the wound to gape.

A

pg 96

True

52
Q

The wound type characterized by a collection of blood under the skin

A

pg 97

hematoma.

53
Q

Prolonged crush injury (crush syndrome) permits the accumulation of

A

pg 97

myoglobin.

uric acid.

potassium.

lactic acid.

54
Q

A likely cause of an avulsion is a(n)

A. animal bite.
B. severe glancing blow to the scalp.
C. machinery accident.
D. degloving injury.
E. all of the above.

A

pg 98

E. all of the above.

55
Q

The natural ability of the body to halt blood loss is

A

pg 100

hemostasis.

56
Q

T/F - Most blood vessels, when cut cleanly, will withdraw and constrict, limiting the rate of
hemorrhage.

A

pg 100

True

57
Q

The cells that attack invading pathogens directly or through an antibody response are

A

pg 101

lymphocytes.

58
Q

The stage of the healing process in which skin cells regenerate to restore a uniform layer of skin
cells along the wound border is

A

pg 101

epithelialization.

59
Q

The stage of the healing process in which capillaries grow to perfuse the healing tissue is

A

pg 101

neovascularization.

60
Q

The booster for tetanus is effective for

A

pg 103

10 years.

61
Q

Which of the following can interfere with normal clotting?

A. Aspirin D. Clopidogrel
B. Heparin E. All of the above
C. tPA

A

pg 103

E. All of the above

62
Q

The excessive growth of scar tissue beyond the boundaries of the wound is

A

pg 103

keloid scar formation.

63
Q

T/F - The patient is not likely to experience pressure injury, even when immobilized for a lengthy
period on a long spine board, PASG, or rigid splint.

A

pg 104

False

64
Q

The process of actual tissue death is

A

pg 105

necrosis.

65
Q

T/F - Most dressings used in prehospital emergency care are sterile, nonocclusive, nonadherent,
absorbent dressings.

A

pg 106

True

66
Q

The type of dressing that promotes clot development is

A

pg 106

adherent.

67
Q

The type of bandage that has limited stretch and conforms well to the body contours is the

A

pg 107

self-adherent roller bandage.

68
Q

If bleeding from a wound is difficult to control you should

A

pg 111

apply direct digital pressure to the wound.

69
Q

The dangers of a tourniquet include

A. increased hemorrhage if pressure is not sufficient.
B. possible loss of limb.
C. accumulation of toxins in the limb.
D. tissue damage beneath the tourniquet.
E. all of the above.

A

pg 111

E. all of the above.

70
Q

The restoration of circulation once a tourniquet is released may cause all of the following,
EXCEPT

A. emboli.

B. shock.

C. lethal dysrhythmias.

D. massive vasoconstriction.

E. renal failure.

A

pg 111

massive vasoconstriction.

71
Q

T/F - You should remove gross contamination from a wound if you can do so quickly and without
further injury.

A

pg 112

True

72
Q

T/F - Scalp hemorrhage is rarely severe or difficult to control.

A

pg 112

False

73
Q

The ideal position for splinting a limb is halfway between extension and flexion and is called the

A

pg 113

position of function.

74
Q

The recommended procedure for packaging an amputated part for transport includes

A

pg 114

keeping it moist and cool.

75
Q

T/F - Most patients of crush syndrome can be identified before extrication is complete.

A

pg 115

True

76
Q

T/F - Recognition of compartment syndrome is usually straightforward

A

pg 116

False

77
Q

T/F - With compartment syndrome, motor and sensory function are frequently normal.

A

pg 116

True

78
Q

A wound involving which of the following requires transport?

A. Nerves
B. Blood vessels
C. Tendons
D. Ligaments
E. All of the above

A

pg 118

E. All of the above