Physiology of Trauma Flashcards
Hydrostatic Pressure
At the arteriole end, nutrients and oxygen are supplied to the interstitial space via fluids pushed out of the capillaries
Osmatic Gradient
At the venule end, the fluids return to the circulatory system through an osmatic gradient
What are the three types of injury?
Acute - caused by macrotrauma, usually a single insult
Subacute - usually after 48-72 hours after acute trauma
Chronic - Caused by repetitive microtrauma
Exudate
Mass of fluid that flows out of the circulatory system and into nearby tissues. Caused by inflammation.
Transudate
Fluid that is pushed through the membrane wall as a result of high pressure
Macrotrauma
Physical damage to the capillary wall. This will result in loss of plasma solids into the interstitial space (exudate) resulting in edema and discolouration.
This leads to the accumulation of necrotic debris at the site of the injury that must be removed before healing can occur.
Ecchymosis
discolouration
Large Haematomas can cause…
Secondary Hypoxic Tissue Necrosis (Aka tissue death due to lack of oxygen)
Why does microtrauma not cause discolouration?
because the swelling in microtrauma is due to tranudate with is fluid loss into the interstitial space due to increased pressure. No RBC are leaked.
What are the effects of Transudate Edema?
Swelling Necrotic Debris Pain Spasm Reduced Joint Motion Secondary Hypoxic Tissue Necrosis
What are the effects of Exudate Edema?
Swelling Necrotic Debris Pain Spasm Reduced Joint Motion Secondary Hypoxic Tissue Necrosis ** main difference is discolouration **
What is healing by 1st intention ?
When edema is controlled the ligament ends will health with minimal scarring and minimal increase in joint laxity
What is healing by 2nd intention?
When edema pushed the ligament ends away from each other and healing occurs with a block of scar tissues. This also results in permanent joint laxity.
How does reducing edema help healing?
Inhibits the size of necrotic debris, reduces chances of secondary hypoxic tissue necrosis, facilitates healing by first intention, reduces pain and maintains joint mobility and function.
What are the steps in the ACUTE treatment of an injury?
Ice: decreases pain and local blood flow Compression: reduces edema Elevation: increases lymphatic draining Restricted Movement Referral
What is shock?
It is the loss of circulatory volume which causes decreased oxygen supply to the CNS and tissues
What causes a predisposition for shock?
extreme fatigue, Extreme dehydration, anxiety and illness
What causes Shock?
blood loss, pain and psychological trauma
What are symptoms of shock?
pale skin, weak rapid pulse, rapid shallow breathing, cool clammy skin
What is the treatment of shock?
911
Maintain body temp
monitor vital signs
Oxygen
What is the Primary Survey?
Airway
Breathing
Circulation
Deadly Bleeding
What is the Secondary Survey?
History Observation Palpation Evaluation of Function Selective tissue tensions
