Soft tissue trauma Flashcards
1
Q
Ligaments
A
- Bone to bone
2
Q
Tendons
A
Muscle to bone
Muscle to muscle
3
Q
Layers of the skin
A
- Epidermis
- Dermis
- Nerves, hair, capillaries, macrophages, neutrophils
- Subcutaneous
- Fascia
- Superficial
- connective tissue surrounds fat
- Deep
- Thick, fibrous connective tissue
- Final layer of defense b/w infection internal structures
- Superficial
4
Q
Sprain, treatment
A
Joint going beyond normal ROM, cause swelling and ecchymosis
Splint, pain management, PMS, elevate
5
Q
Different types of closed soft tissue injuries
A
- Contusion
- rupture of small blood vessels and damage to cells in dermis. Ecchymosis
- Hematoma
- Blood tumor
- Large veins or arteries ruptured under skin
- Palpable lump under the skin
- Can bleed up to 1 L
- Sprain
- Forcing joint beyond ROM
- Strain
- Muscles or tendons
- pain, bruising, warm to touch
6
Q
Different types of open tissue injuries
A
- Abrasion
- Laceration
- Linear - regular margins
- Stellate - irregular margin
- Incisions
- Avulsions
- Degloving
- Ring
- Amputations
- Complete
- Partial
- Punctures and Penetrations
- Evisceration
- High pressure injection
7
Q
Amputation treatment
A
Keep part cool, moist sterile dressing. Apply pressure first, then tourniquet.
8
Q
Avulsion treatment
A
Place part back where it belongs, bandage.
9
Q
Crush injury concerns
A
- Can cause
- increased risk of infections
- high pressure in muscle compartment preventing capillary filling, causing hypoxia and cell damage
- If damaged muscle cells leak out, can cause rhabdomyolysis
10
Q
What is rhabdomyolysis in a crush injury?
A
- Cell contents leaking into the bloodstream due to breakdown of muscle tissue, in this case due to crush injury.
- Hyperkalemia, phosphate, lactic acid, thromboplastin, myoglobin. Myoglobin proteins are nephrotoxic, will cause renal failure
11
Q
6 P’s of compartment syndrome
A
Pain
Parasthesia
Paralysis
Pallor
Puffiness
Pulselessness
12
Q
What is compartment syndrome?
A
- Elevation of pressure in a muscle compartment above level of capillary perfusion, ceasing blood flow to area.
- Muscle is crushed but compartment remains intact
13
Q
How does a crush injury lead to rhabdo?
A
- Crush happens, cuases ischemia of the tissue and hypoxia at cell level.
- Decrease in ATP production due to decrease in aerobic metabolism
- Glycolysis continues (anaerobic), acid builds up
- Less ATP means less sodium and potassium, less NaK pump action
- Sodium and water move freely.
- If blood flow returns, get free radical oxygen called oxygen superoxide.
- attacks cell membranes, influx of Ca+ into cells and mitochondria, leads to mitochondria death and cell breakdown
- Cells broken, influx of Na,Ca, Water.
- Efflux of K, Phospate, Lactic acid, thromboplastin, myoglobin.
- LEADS TO RHABDO
14
Q
Folliculitis
A
Bacterial infection of hair follicle
15
Q
Foruncles
A
Bacterial, Folliculitis that spreads to surrounding dermis
