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SD IV: Block 3 Week 2 > Environmental Disorders 01: Physical Agents > Flashcards

Environmental Disorders 01: Physical Agents Flashcards

1
Q

What is a contusion?

A

AKA bruise

blunt force injury to blood vessels with subsequent escape of blood into tissue

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2
Q

What is an abrasion?

A

Superficial excoriation of the epidermis

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3
Q

What is a laceration?

A

jagged tear of skin with intact bridging blood vessels, nerves, and connective tissue, force of a blunt object

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4
Q

What is an incision?

A

skin would with sharp margins: severed blood vessels produced by a sharp object (knife, razor0

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5
Q

What is a coup injury? What can cause it to happen?

A

a contusion at the point of contact

If the head is immobile at the time of trauma, only a coup injury, is found

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6
Q

What is a contre-coup injury?

A

a contusion on the brain surface diametrically opposite to it

If the head is mobile, both coup and contrecoup lesions may be found

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7
Q

What are the 4 types of traumatic vascular injuries of head?

A

epidural, subdural, subarachnoid, and intraparenchymal

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8
Q

Hyperextension injury of the spine?

A

rupture of the anterior spinal ligament and excessive posterior angulation?

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9
Q

What type of fracture is hyper flexion injury of the spine associated with?

A

compression associated with a “teardrop” fracture of a vertebral body and produces excessive forward angulation of the cord

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10
Q

Describe the appearance of a contact gunshot would.

A

stellate-shaped, contain soot and gunpowder (fouling)

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11
Q

Describe the appearance of an intermediate-range wound.

A

powder tattooing (stippling) of the skin around the entrance site

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12
Q

Describe the appearance of a long-range would.

A

do not have powder tattooing

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13
Q

Describe the appearance of an exit wound.

A

larger, more irregularly shaped than entrance wounds

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14
Q

Describe the type of injury caused by penetration of a bullet.

A

laceration with tissue tearing, vascular disruption, hemorrhage, and injury along linear path

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15
Q

What does the “blast effect” of a high-velocity projectile cause to happen to the brain?

A

causes an increase in supratentorial pressure and result in death because of impacting of the cerebellum and medulla into the foramen magnum

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16
Q

What changes happen to the brain when a low-velocity projectile penetrates it?

A

increases pressure in the brain at a more gradual rate through hemorrhage and edema

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17
Q

What are some characteristic signs of Shaken baby syndrome?

A

– Retinal hemorrhages: may be the only sign
of the shaken baby syndrome and should be confirmed by ophthalmologist

– Multiple fractures of long bones

– subdural hematomas

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18
Q

What are some causes of burns?

A

fire/flame, scalds, contact with hot objects, electricity and chemicals

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19
Q

What are the 2 major factors to know when analyzing a burn for clinical purposes?

A

depth of burns mostly
percentage of body surface involved

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20
Q

What are the classifications of burns?

A
  • Superficial burns (first-degree burns)
    – confined to epidermis
  • Partial thickness burns (second-degree burns)
    – involve injury to the dermis
  • Full-thickness burns (third-degree burns)
    – extend to the subcutaneous tissue
    – may also involve damage to muscle tissue underneath the subcutaneous tissue (fourth-degree burns)
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21
Q

Describe the gross appearance of full-thickness burns.

A

Full-thickness burns are white or charred, dry, and painless (destruction of nerve endings)

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22
Q

Describe the gross appearance of partial-thickness burns.

A

Partial-thickness burns are pink or mottled with blisters and painful

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23
Q

How would a burn appear histologically on a slide?

A

devitalized tissue would reveal coagulative necrosis, adjacent to vital tissue that quickly accumulates inflammatory cells and marked exudation

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24
Q

In burns > 20% of body surface, rapid shift of body fluids into the interstitial compartments due to systemic inflammatory response syndrome leading to what?

A

hypovolemic shock

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25
Q

Widespread vascular leakiness when a burn occurs can lead to what types of edema?

A

generalized and pulmonary edema

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26
Q

What type of metabolic state is one in when they have burns?

A

hypermetabolic

27
Q

What infections is one prone to with burns?

A

P aeruginosa (most common)

28
Q

How would you treat a burn?

A

early excision and grafting (removing burn)

29
Q

What are forms of hyperthermia?

A

heat cramps
heat exhaustion
Heat stroke

30
Q

What are the main characteristic of heat exhaustion that differentiate it from heat stroke?

A

mental status examination is normal for heat exhaustion

CVS unable to compensate for hypovolemia caused by dehydration

31
Q

What are the main characteristics of heat stroke that differentiate it from heat exahaustion?

A

Core body temperature is >40° C (104° F)
Skin is hot and dry (anhidrosis)
Mental status exam is abnormal

32
Q

Is malignant hyperthermia caused by exposure to high temps?

A

no

33
Q

When does hypothermia occur?

A

When the body T falls below 35C

34
Q

What are the direct effects of hypothermia?

A

physical disruptions within cells by high salt concentrations caused by crystallization of intra and extracellular water (frost bite) – freezing tissue injury

35
Q

What are the indirect effects of hypothermia?

A

slow chilling may induce vasoconstriction and increase vascular permeability leading to edema and hypoxia

36
Q

What are some non freezing types of tissue injury?

A
  • Exposure to wet cold: Trench foot and immersion foot
  • Exposure to dry cold: Chillblain (pernio)
37
Q

What are the phases of frostbite and describe them.

A
  1. Pre-freeze phase: anesthesia of affected tissue, endothelial leakage of plasma, vasoconstriction and increased viscosity of plasma
  2. Freeze-thaw phase: extracellular ice crystallization caused water to exit the cell > intracellular volume depletion and cell death
  3. Post-thaw: microvascular collapse, sludging, stasis, and cessation of blood flow in capillaries, endless, and arterioles > necrosis
38
Q

Treatment of frostbite.

A

rapid, complete thawing by immersion of injured part in 40C to 41C circilating water

Pain meds

Don’t use dry heat or allow tissue to refreeze

39
Q

Which is more dangerous AC or DC?

A

AC is 3 times more dangerous

40
Q

What is the main cause of death of electrical injury?

A

cause cardiorespiratory arrest, the most common cause of death due to electrical injury.

41
Q

Most common cause of death from being hit by lightening?

A
  • Most common cause of death from lightening is cardiorespiratory arrest
42
Q

What is the primary cause of death in drowning?

A

laryngospasm and pulmonary injury > hypoxemia and acidosis, and their effects on the brain and other organ systems

43
Q

What is a major risk factor that causes drowning in adults and teens?

A

acute ethanol intoxication

44
Q

Compare and contrast wet and dry drowning.

A

When there is drowning caused by initial laryngospasm followed by relaxation and aspiration of water this is wet drowning

Dry drowning is asphyxia from laryngospasm without aspiration

45
Q

What is diving reflex?

A

occurs in water that is colder than 20° C (70° F).Characteristics include bradycardia, peripheral vasoconstriction (shunts blood to more vital areas), blood shifting (shift of blood to the thoracic cavity to prevent atelectasis of the lungs), and prolonged survival without O2 in both conscious and unconscious people

46
Q

How does respiratory alkalosis increase glycolysis?

A

increases glycolysis by activating phosphofructokinase (PFK), the rate-limiting run of glycolysis. This results in an increased synthesis of 2,3 bisphosphoglycerate (2,3 BPG) which rightward shifts the O2 dissociation curve, causing increased delivery of O2 to tissue

47
Q

When does AMS occur?

A

acute mountain sickness usually occurs at elevations of > 8000 feet (2440 m)

48
Q

When is HACE caused?

A

High altitude cerebral edema is common above 12,000 feet (3658 m)

49
Q

What does treatment of HACE include?

A
  • Treatment includes immediate descent, O2, and dexamethasone
50
Q

What height is HAPE common?

A

High altitude pulmonary edema
* More common > 14,500 feet (4420 m)

51
Q

Treatment for HAPE?

A
  • Treatment: O2 and Nifedipine
52
Q

What is classified under ionizing radiation?

A
  • Ionizing radiation: X rays, gamma rays, high-energy neutrons, alpha particles and beta particles
53
Q

What types of waves are classified as non-ionizing radiation?

A
  • Non-ionizing radiation: UV and infrared light, microwave, and sound waves
54
Q

What is the major biologic effect of ionizing radiation?

A

Cell proliferation: rapidly dividing cells are more vulnerable to injury than are quiescent cells (gonads, bone marrow, lymphoid tissue, and mucosa of GI tract)

55
Q

Patients receiving cancer doses at > 100mSv who receive radiation therapy for cancers are at risk of what?

A

second cancers,”: AML, myelodysplastic syndrome, solid tumors

56
Q

What is the the bystander effect when referencing DNA damage and carcinogenesis?

A

damaged cells alter the behavior of non-irradiated surrounding cells through the production of growth factors and cytokines

57
Q

What are effects of radiation injury?

A

radiodermatitis, potential for SCC

58
Q

Chronic GI system effects of radiation characteristically involve what adverse effects?

A
  • Chronic: development of adhesions with potential for bowel obstruction
59
Q

What are some cytoplasmic changes that occur in cells that have experience radiation injury?

A

cytoplasmic swelling, mitochondrial distortion, and degeneration of the endoplasmic reticulum

60
Q

What are some immediate post-irradiation vascular changes?

A

vasodilation,

higher doses: endothelial cell swelling necrosis and
dissolution of walls of small vessels

61
Q

What are some vascular changes that can occur later to those with irradiation damage?

A

– endothelial cell proliferation,
intimal thickening: marked narrowing /obliteration of lumen

62
Q

What is the most dangerous non-ionizing radiation injury?

A

UV-B is most damaging to the skin

63
Q

What is a major effect on the skin of those who get non-ionizing radiation injuries? (associated conditions)

A

actinic (solar) keratosis

Cancers associated with UVB light injury

Basal cell carcinoma (most common), SCC, Melanoma

SD IV: Block 3 Week 2 (8 decks)

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