Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

VTS(ECC) Preparation > Musculoskeletal system & Wound Management > Flashcards

Musculoskeletal system & Wound Management Flashcards

1
Q

Clean wounds

A

Atraumatic and sterile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Clean, contaminated wounds

A

Minor break in aseptic technique and only minor contamination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Contaminated wound

A

Recent wound with trauma that has bacterial contamination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Dirty/infected wound

A

Older wound that is exudative with evidence of bacterial contamination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Open fracture classes

A

Grade I; small break in skin by bone penetrating
Grade II; soft tissue trauma with the fracture caused by external trauma
Grade III; extensive soft tissue injury with increased communition of the bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Stages of wound healing

A

Inflammation
Debridement
Repair/proliferation
Maturation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Inflammation stage of wound healing

A

Within 5 days of injury
Haemorrhage, vasoconstriction and platelet aggregation initially occur and then within 5-10min there is vasodilation > fibrinogen and clotting as neutrophils, monocytes, fibroblasts endothelial cells and inflammatory mediators are brought to the site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Debridement phase of wound healing

A

Happens concurrently with inflammation phase and involves WBC entry (neutrophils first) approximately 6 hours after injury which removes ECF debris via phagocytosis. Macrophages are formed within 24-48h of wound occurring and monocytes activate fibroblastic activity stimulating collagen formation and angiogenesis > removal of necrotic tissue, bacteria and foreign material

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Repair/proliferation phase of wound healing

A

Occurs after 5-7 days of initial wound and lasts 2-4 weeks
Angiogenesis, granulation tissue formation and epithelialisation occur. Fibroblasts proliferate and synthesise collagen providing a granulation bed for epithelialisation witch wound contraction evident after 5-9 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Maturation wound healing phase

A

Occurs 17-20 days after
Adequate collagen has been deposited, wound contraction and remodelling of epithelium is occurring
Can take years to heal and only achieve 80% of strength

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Addressing patients that present with wounds

A

Stabilise; cover open fractures, stabilise ABC, thoroughly examine patient
Assess and Debridement wounds; decontaminate, create healthy wound bed and promote healing
Broad spectrum antimicrobials (broader spectrum the further it penetrates)
Daily assessment of wounds and further Debridement, bandage changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Sugar and honey for wounds

A

Both bactericidal and promote accelerated sloughing of necrotic tissue and formation of the granulation bed
Both osmotic so draw bacteria and debris out of wound
Used in Debridement phase until healthy granulation tissue visible
Change bandage daily or when significant strike through present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Bandage layers

A

Primary; directly on wounds, determines if adherent or non-adherent bandage
Secondary; padded and aids in absorption of exudates
Tertiary; outermost protective layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Adherent v. Non-adherent bandages

A

Adherent: I.e. wet-to-dry
Non-adherent: hydrogels etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Delayed primary closure

A

Performed 2-5 days after injury for wounds that have areas of questionable healing, large +- contaminated wounds
Performed once evidence of a healthy granulation bed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Vacuum assisted wound therapy

A

Set to 75-120mmHg
Improves vascularisation, granulation tissue formation and decreases wound size and volume
Contraindicated; coagulopathy, necrotic wounds, exposed organs/nerves/bones etc, untreated osteomyelitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Hyperbaric O2 for wound treatment

A

100% O2 provided under pressure
Increasing O2 to damaged tissues promoting leukocyte oxidative killing of bacteria, reduces oedema and increases nutrient content to the wound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Most common bacteria to wounds

A

Staphylococcus, streptococcus and e.Coli, enterococcus, proteus, pseudomonas
Bite wounds: clostridium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

First degree burns

A

Superficial and only involve the epidermis
Epidermis will be erythemous and painful to touch
Rapid healing and re-epithelialisation within a week
No wound management required and no systemic effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Second degree burns

A

Involve the epidermis and the superficial dermis or may go into deeper dermis
Epidermis will be charred and will slough; plasma leakage will occur and painful or decreased pain sensation if deeper
Hair follicles intact still or not if deeper
May or may not have systemic effects depending on depth
Epithelialisation with minimal scar within 10-21 days unless deeper than scarring and surgical management required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Third degree burns

A

Full thickness
Skin black and lethargy and eschar
Insensitive to touch
Requires extensive wound management for healing I.e. grafts and flaps
May have life-threatening systemic consequences

22
Q

Fourth degree burns

A

Much the same as third degree
Extensive wound management with grafts/flaps required to prevent restrictive joint movement

23
Q

Burns

A

Take around 3 days to show full extent and those that have TBSA >20% have severe metabolic consequences and those >50% TBSA should have their owners counselled for euthanasia as very poor prognosis

24
Q

Estimating total body surface area burned (TBSA)

A

Head/neck 9%
1 FL 9% each (18% total)
1 HL 18% each (36% total)
Dorsal trunk 18%
Ventral trunk 18%

25
Q

General approach to burns patients

A
  1. Stabilise ABC
  2. TBSA Score
  3. Full bloods
  4. Correct metabolic derangements
  5. Pain management
  6. Nutrition!
  7. Comfort
  8. AM’s
  9. Wound management
26
Q

Metabolic consequences in burns patients

A

Hypovolaemic shock due to thrombosis, capillary leakage, and massive fluid shifts to burn sites > electrolyte and fluid deficits

Expect these patients to be anaemic, hyproteinaemic, electrolyte derangement, Oliguria, have pre-renal azotaemia and haemolysis

27
Q

Expectations day 2-6 post burns

A

Watch for DIC, UA oedema, immune dysfunction, infection, SIRS and anaemia and address as needed

28
Q

Expectations day 7 onwards for burns

A

Watch closely for hyperthermia, hypoxaemia, sepsis, pneumonia and wound demarcation

29
Q

FFP amount for burns patients

A

0.5ml/kg X TBSA

  • plasma volume equilibriums around day 2 so watch very closely for fluid overload
30
Q

Nutritional requirements for burns patients

A

Full RER
High calorie and protein
Give GI protectants as Gi ulceration common due to Gi hypoperfusion

31
Q

Thermal damage in burns patients

A

May be ongoing so need to address quickly I.e. cooling and aloe Vera

32
Q

Closure of burn wounds

A

Usually delayed until at least days 3-5 due to wanting to know the extent of injury
However initial clipping and lavage and debridement should be done ASAP to limit depth of injury

33
Q

Aloe Vera and silver sulfadiazine in burn wounds

A

Aloe Vera; antithromboxane and prevents progression of thermal injury
Silver sulfadiazine; placed when wound >24h, bactericidal and can be applied 2-3X a day

34
Q

PROM’s

A

Passive rang of motion exercises
Prevent joint contracture, increased lu,Patric flow and prevent soft tissue shortening
There is no active muscle contraction and will not prevent muscle atrophy but very useful if I,Poe enter early

35
Q

AROM exercises +- assisted

A

Good transition from PROM’s
Increases muscle strength and bone strength
Re-educates normal movement patterns

36
Q

Assisted standing benefits

A

Improves muscle strength
Improves circulation
Improves respiratory function
Stimulates proprioceptive inputs
Neuromuscular re-education

37
Q

Walking patients

A

Helps articulate cartilage and connective tissue healing
Improves cardiovascular, lymphatic and respiratory function
Enhances emotional well being

38
Q

Massage

A

Increases blood and lymphatic flow
Improves GI motility
Reduces muscle spasm
Relieves stress and anxiety

39
Q

Petrissage

A

Kneading

40
Q

Effleurage

A

Stroking

41
Q

Tapotement

A

Tapping/percussion

42
Q

Vacuum-assisted closure should not be used on wounds that:
a. are obviously infected
b. are neoplastic in nature
c. cover large areas on the body
d. are older than 24 hours

A

B

43
Q

Patients with burns over large portions of the body can experience retained fluid in the wounds, leading to:
a. fluid overload
b. electrolyte loss
c. better wound healing
d. hyperglycemia

A

B

44
Q

A large wound first treated with honey bandages until granulation tissue forms and then surgically closed undergoes which type of wound closure?
a. Primary closure
b. Delayed primary closure
c. Secondary closure
d. Second intention

A

C

45
Q

According to the rule of 9s, what is the TBSA of a burn involving the head, neck, and one front limb?
a. 9%
b. 18%
c. 27%
d. 36%

A

B

46
Q

Burns affecting the epidermis, dermis, and subcutaneous layer are defined as:
a. first degree
b. second degree
c. third degree
d. fourth degree

A

C

47
Q

Avulsion fractures are broken bones:
a. that involve tendons or ligaments
b. with multiple fragments
c. with a splintered fragment but an incomplete fracture
d. associated with penetration of the skin

A

A

48
Q

Which phase of wound healing begins between 6 and 12 hours post injury?
a. Inflammatory phase
b. Maturation phase
c. Proliferation phase
d. Debridement phase

A

D

49
Q

An enterotomy would be an example of which type of wound?
a. Clean
b. Clean-contaminated
c. Contaminated
d. Dirty

A

B

50
Q

The sebaceous glands are located in which layer of the skin?
a. Epidermis
b. Dermis
c. Subcutaneous layer
d. Muscle layer

A

B

51
Q

A wound that causes damage to underlying tissues and capillaries but does not break the skin is which type of wound?
a. Avulsion
b. Laceration
c. Abrasion
d. Contusion

A

D

VTS(ECC) Preparation (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions