General Principles of Trauma and Wounds Flashcards
Definition of trauma
injury to the body caused by physical or chemical factors, resulting in wounds and possible complications
Definition of a wound
The disruption of the anatomical continuity of tissue caused by the application of force
Physical factors that can cause injury
- mechanical force
- thermal elements
- electrical current
- barotrauma
- irradiation
- ultrasound
The natures and extent of wounds depends on
- the object or instrument causing the wound
- the amount of energy discharged during impact
- the conditions under which the energy is discharged
- the nature of the affected tissue
- condition of the target
How can immersion in cold water kill?
- sudden death by neurogenic cardiac arrest
- hypothermia after prolonged immersion
Definition of an abrasion
Destruction of superficial layers of skin that may be caused by compression or friction
Types of abrasions
- tangential/ graze/ brush
- scratches
- impact
- friction
Definition of a bruise
Extravasation of blood into soft tissue spaces due to the breaking of vessel walls caused by blunt force
Extent of bruising depends on:
- amount of force
- type of tissue
Complications of lacerations
- haemorrhage
- infections
Definition of an incised wound
A superficial wound in which the size of the wound on the surface is larger than the depth of the wound
Definition of a stab wound
A penetrating wound caused by a sharp or blunt instrument in which the depth of the wound is greater than the length
How to describe a sharp force wound
- site
- shape
- length
- depth
- structures damaged
Complications of incised wounds
- harmorrhage
- infection
- paralysis
Types of haemorrhage
- primary
- reactionary
- secondary
Classification of shock
- cardiogenic
- hypovolaemic
- septic
- neurogenic
Types of embolisms
- thrombo-embolism
- air embolism
- amniotic fluid embolism
- fat embolism
- foreign body embolism
Microscopic features that can help you to age wounds
- capillary vasodilatation
- margination and diapedesis of polymorphonuclear white cells
- scab formation
- re-epithelialisaiton
- fibroblastic proliferation
- healing and scar formation
- haemosiderin may be present from 24hrs
Definition of a laceration
A tear in tissue produced by blunt force injury such that tissue is stretched, crushed, sheared or avulsed
General features of lacerations
- common over bony prominences
- characterised by tissue bridges
- linear lacerations produced by long thin objects
- irregular or Y-shaped produced by flat objects or surfaces
Where are defensive incised wounds found?
- palms
- backs of hands
- forearms
- upper arms
Factors determining the skin appearance of a stab wound
- shape of the weapon
- angle of thrust
- movement of the blade
- skin tension
- Langer’s lines
Stages of shock
- non-progressive (compensated)
- progressive
- irreversible
Possible effects of shock (findings on PM)
- hypoxic-ischaemic encephalopathy
- subendocardial harmorrhage
- shock lung
- shock kidneys (ATN)
- centrilobular necrosis of liver
- adrenal gland haemorrhage
- gastric and duodenal ulceration (Curling’s and Cushings)
Results of wound infection
- local sepsis
- septicaemia
- gas gangrene
- tetanus
Major disorders associated with DIC
- trauma (crush, burns)
- obstetric (abruption, embolism)
- infections
- neoplasms (leukaemia)
- miscellaneous (snake bite)
Definition of an embolism
An intravascular solid, liquid or gaseous material that is carried in the circulation and lodges within a blood vessel distant from its site or origin or point of entry into the circulation
Origin of PE
- lower extremity
- right heart
- pelvic
Mechanisms of air embolism
- trauma
- dysbarism
- therapeutic and diagnostic procedures
- obstetric
Mechanisms of death in air embolism
- blockage of vessels
- acute right heart failure
- DIC
Sources of fat embolism
- bone injuries
- soft tissue trauma
- burns
- pancreatitis
Types of ballistics
- internal
- external
- terminal
