Chapter 5 - Soft-Tissue Trauma Flashcards by Al Townsend

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

pg 93

7 percent

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Which glands secrete sweat?

pg 94

Sudoriferous glands

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

Lymphocytes

Fibroblasts

Macrophages

Mast cells

All

pg 94

All

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

pg 94

adventitia, media, intima

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

pg 94

arteries

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

pg 94

arterioles.

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The sheet of thick, fibrous material surrounding muscles is the

pg 95

fascia.

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

pg 96

False

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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

pg 96

E. All except B

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

pg 96

contusion.

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Which of the following wounds is not considered open?

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

pg 96

C. Contusion

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

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

pg 98

D. Incision

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Crush injuries usually involve injury to

pg 97

blood vessels.

muscles.

bones.

internal structures.

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

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

pg 97

B. Crush injury

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

pg 98

puncture.

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

pg 98

degloving injury.

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

pg 99

False

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

pg 100

hemostasis.

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

pg 100

False

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

pg 101

chemotactic factors.

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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.

pg 101

E. fibroblasts.

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

pg 101

inflammation.

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

pg 101

60 percent

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Infection usually appears how long after the initial wound?

pg 102

2 to 3 days

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Which of the following is an infection risk factor with soft tissue wounds? ## Footnote A. Advancing age D. Cat bites B. Crush injury E. All of the above C. NSAID use

pg 102 E. All of the above

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

pg 102 True

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

pg 103 five years ago.

Which of the following can interfere with normal clotting? ## Footnote A. Aspirin D. TPA B. Warfarin E. All of the above C. Streptokinase

pg 103 E. All of the above

The location at greatest risk for compartment syndrome is the

pg 103 calf.

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

pg 103 hypertrophic scar formation.

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

pg 105 True

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

pg 105 4 hours

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

pg 105 Kidney failure Abnormal vascular calcifications Cardiac dysrhythmias Hypovolemia

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

pg 106 occlusive.

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

pg 108 elastic bandages.

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.

pg 108 True

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

pg 109 Type of bleeding Stopping further hemorrhage Rate of hemorrhage Volume of blood lost

What is one of the primary objectives of bandaging?

pg 111 Hemorrhage control

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

pg 111 True

The restoration of circulation once a tourniquet is released may cause ## Footnote

pg 111 Shock Renal failure Hypovolemia Lethal dysrhythmias

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

pg 112 loosen the bandage.

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

pg 112 Morphine sulfate

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

pg 113 occlusive dressing.

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

pg 113 gauze dressing.

Which of the following is NOT a distal sign that a circumferential bandage is too tight? ## Footnote A. Diaphoresis D. Tingling B. Pallor E. Swelling C. Loss of pulses

pg 114 A. Diaphoresis

Which of the following glands secrete a waxy substance? A. Sudoriferous glands D. Adrenal glands B. Sebaceous glands E. Pituitary glands C. Subcutaneous glands

pg 94 B. Sebaceous glands

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

pg 94 epidermis.

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

pg 94 Adventitia, media, intima

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

pg 94 capillaries.

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

pg 95 True

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

pg 96 True

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

pg 97 hematoma.

Prolonged crush injury (crush syndrome) permits the accumulation of

pg 97 myoglobin. uric acid. potassium. lactic acid.

A likely cause of an avulsion is a(n) ## Footnote A. animal bite. B. severe glancing blow to the scalp. C. machinery accident. D. degloving injury. E. all of the above.

pg 98 E. all of the above.

The natural ability of the body to halt blood loss is

pg 100 hemostasis.

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

pg 100 True

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

pg 101 lymphocytes.

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

pg 101 epithelialization.

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

pg 101 neovascularization.

The booster for tetanus is effective for

pg 103 10 years.

Which of the following can interfere with normal clotting? ## Footnote A. Aspirin D. Clopidogrel B. Heparin E. All of the above C. tPA

pg 103 E. All of the above

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

pg 103 keloid scar formation.

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.

pg 104 False

The process of actual tissue death is

pg 105 necrosis.

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

pg 106 True

The type of dressing that promotes clot development is

pg 106 adherent.

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

pg 107 self-adherent roller bandage.

If bleeding from a wound is difficult to control you should

pg 111 apply direct digital pressure to the wound.

The dangers of a tourniquet include ## Footnote 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.

pg 111 E. all of the above.

The restoration of circulation once a tourniquet is released may cause all of the following, EXCEPT ## Footnote A. emboli. B. shock. C. lethal dysrhythmias. D. massive vasoconstriction. E. renal failure.

pg 111 massive vasoconstriction.

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

pg 112 True

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

pg 112 False

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

pg 113 position of function.

The recommended procedure for packaging an amputated part for transport includes

pg 114 keeping it moist and cool.

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

pg 115 True

T/F - Recognition of compartment syndrome is usually straightforward

pg 116 False

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

pg 116 True

A wound involving which of the following requires transport? ## Footnote A. Nerves B. Blood vessels C. Tendons D. Ligaments E. All of the above

pg 118 E. All of the above