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Exam 9 > Soft-Tissue Trauma > Flashcards

Soft-Tissue Trauma Flashcards

1
Q

What is the first tissue of the human body to experience the effects of trauma?

A

Integumentary system

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2
Q

____ are blunt, no penetrating injuries that crush and damage small blood vessels.

A

Contusions

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3
Q

What is the term given to general reddening of the skin due to dilation of the superficial capillaries?

A

Erythema

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4
Q

The skin is comprised of _____ percent of total body weight.

A

16

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5
Q

Risk factors for soft-tissue wounds include?

A

Age, alcohol or drug abuse, and occupation

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6
Q

______ is blue-black discoloration of the skin due to leakage of blood into the tissues.

A

Ecchymosis

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7
Q

Contusions are more pronounced in areas where?

A

The mechanism causing injury and skeletal structure trap the skin

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8
Q

Define hematoma

A

Collection of blood beneath the skin or trapped within a body compartment

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9
Q

A hematoma in the thigh can contain over ______ of blood before swelling becomes noticeable.

A

A liter

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10
Q

What is the most minor of injuries that violate the skin?

A

Abrasions

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11
Q

A ____ is an open wound that penetrates more deeply into the dermis than an abrasion.

A

Laceration

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12
Q

The orientation of tension in the skin is revealed in characteristic patterns called?

A

Tension lines.

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13
Q

Lacerations cutting across the tension lines have a tendency to be?

A

Pulled apart

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14
Q

Static tension is noted in areas with _____ movement of this and structures beneath. (Anterior ______ or ______).

A

Limited

Anterior abdomen or between joints in extremities

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15
Q

Dramatic tension lines occur where?

A

Elbow, wrist, knee

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16
Q

If orientation parallels tension lines, wound may _____.

A

Remain closed

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17
Q

If orientation is perpendicular to tension lines, wound may ________.

A

Gape open

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18
Q

An ____ is a surgically smooth laceration which bleeds ____.

A

Incision

Freely

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19
Q

A ______ involves a small entrance wound with damage that extends into the bodies interior.

A

Puncture

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20
Q

What occurs when a flap of skin, although cut or torn, is not torn completely loose from the body.

A

An avulsion

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21
Q

What type of injury is frequently seen with blunt trauma to the skull where the scalp is torn and folds back?

A

Avulsion

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22
Q

What is homeostasis?

A

The body’s natural ability to stop bleeding; the ability to clot blood

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23
Q

_____ cannot contract and thus continue to bleed.

A

Capillaries

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24
Q

____ begin the clotting process.

A

Platelets

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25
Q

What are the chemicals released by white blood cells that attract more white blood cells to an area of inflammation?

A

Chemotactic factors

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26
Q

_____ are white blood cells charged with the primary purpose of neutralizing foreign bacteria.

A

Granulocytes

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27
Q

Which cell is the immune system cell that has the ability to recognize and ingest foreign pathogens?

A

Macrophage

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28
Q

______ attack invading pathogens directly or through an antibody response.

A

Lymphocytes

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29
Q

What does histamine do inside the body?

A

It dilates pre-capillary blood vessels, increases capillary permeability, and increases blood flow into and through the injured or infected tissue

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30
Q

What is another word for swollen?

A

Edematous

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31
Q

What results from inflammation?

A

The clearing away of dead and dying tissue, removal of bacteria and other foreign substances, and the preparation of the damaged area for rebuilding.

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32
Q

What is the epithelialization stage of healing?

A

It is the stage in which epithelial cells migrate over the surface of the wound

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33
Q

In clean, surgically prepared surgical wounds, complete epithelialization may take place in as little as ________.

A

48 hours

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34
Q

What is neovascularization?

A

New growth of capillaries in response to healing

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35
Q

What is collagen?

A

It is the body’s main structural protein

A strong, tough fiber forming part of hair, bones, and connective tissue

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36
Q

What are fibroblasts?

A

Specialized cells that form collagen

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37
Q

_____ involves reorganizing collagen fibers into near, parallel bands.

A

Remodeling

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38
Q

What are the most common causes of skin and soft tissue infections?

A

Staph and strep

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39
Q

Which bacteria colonized on the surface of normal skin?

A

Staph

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40
Q

Infections usually appear within ___ to ____ days and present with?

A

2-3 days

Pain, tenderness, erythema, warmth

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41
Q

What are the risk factors for infection?

A

Hosts health
Type and location of wound
Associated contamination
Treatment

42
Q

Which type of patients have a greater risk of infection?

A

Diabetics
Elderly
Infirm
COPD

43
Q

What types of drugs reduce the body’s inflammation response?

A

Nonsteroidal anti-inflammatory drugs NSAIDS

For example - Colchicine (med for gout)

44
Q

_____ agents, which are used to combat rapidly reproducing cells in cancer patients, also disrupt cell regeneration at an injury site.

A

Neoplastic

45
Q

Well-vasculated areas are _____ to infection.

A

Resistant

46
Q

Distal extremities are _______ for infection.

A

Greater risk

47
Q

When are antibiotics most helpful for deep wounds?

A

Within the first hour

48
Q

Antibiotics for the treatment of gram positive infections include?

A

Anti-staph penicillins, cephalosporins

49
Q

Tetanus is caused by?

A

Bacterium

And is anaerobic

50
Q

Tetanus presents with?

A

Few signs or symptoms at the local wound site and widespread, painfully involuntary muscle contractions.

51
Q

Lock jaw is usually seen with?

A

Tetanus

52
Q

______ is a powerful inhibitor of platelet aggregation.

A

Aspirin

53
Q

What are some examples of anticoagulants?

A

Warfarin
Heparin
TPA
Streptokinase

54
Q

______ interfere with or break down the protein fibers that form clots and we used to prevent or destroy obstructions at critical locations.

A

Anticoagulants

55
Q

______ fluid is a cellular component of blood, similar to plasma.

A

Serous

56
Q

In ________, an extremity injury causes significant edema and swelling in the deep tissue.

A

Compartment syndrome

57
Q

When pressure rises above _____ to _____, the blood flow to that muscle group or compartment is compromised and ischemia ensues.

A

45-60mmHg

58
Q

Volkmans contracture occurs when?

A

Scar tissue shortens the length of the muscle strand

59
Q

Which extremities are more susceptible to compartment syndrome?

A

Lower extremities

60
Q

A ______ is a formation resulting from overproduction of scar tissue.

A

Keloid

61
Q

Keloids are more common in?

A

Darkly pigmented individuals and develops on sternum, lower abdomen, upper extremities, and ears

62
Q

What is hypertrophic scar formation?

A

An excessive accumulation of scar tissue, usually within the injury border, that is often associated with dynamic skin tension lines, like at flexion joints

63
Q

Why is hemorrhage with crush injuries difficult to control?

A
  • the actual source of bleeding may be hard to ID
  • several large vessels may be damaged
  • general condition of limb may not support application of direct pressure
64
Q

When does crush syndrome occur?

A

When body parts are entrapped for 4 hours or longer

65
Q

What is rhabdomylosis?

A

Skeletal muscle disintegration)

66
Q

High levels of myoglobin can?

A

Lodge in filtering tubules of the kidney, leading to renal failure

67
Q

What is the leading cause of delayed death in crush syndromes?

A

Renal failure

68
Q

Rising phosphate levels can lead to?

A

Abnormal calcifications in the vasculature and nervous system

69
Q

____ dressings are cotton or fiber like fiber pads that have been specially prepared to be without miccroorganisms.

A

Sterile

70
Q

_____ dressings are clean but are not free of miccroorganisms.

A

Non-sterile

71
Q

Nonsterile dressings are not intended for?

A

Application directly to a wound

They are meant to be placed over a sterile dressing to add bulk or absorptive power

72
Q

What types of dressings are helpful in parenting air aspiration into chest and open neck wounds?

A

Occlusive/nonocclusive dressings

73
Q

_____ dressings are untreated cotton or other fiber pads that will stick to drying blood and fluid that has leaked from open wounds.

A

Adherent

74
Q

_____ dressings are specially treated with chemicals such as polymers to prevent the wound fluids and clotting materials from adhering to the dressing.

A

Nonadherent

75
Q

_____ dressings are dressings impregnated with agents that potentiate the clotting mechanisms, causing more rapid and aggressive clotting.

A

Hemostatic

76
Q

What is the most common and convenient bandage material?

A

Soft, self-adherent, roller bandage

77
Q

____ bandages are soft, self-adherent bandages which are a convenient material for securing dressings.

A

Gauze

78
Q

____ bandages are strong, plastic, paper, or fabric material with adhesive on one side.

A

Adhesive

79
Q

A rapid secondary assessment is done for?

A

Significant mechanisms of injury

80
Q

Focused secondary assessments are done for?

A

No significant mechanism of injury

81
Q

What is the primary method of controlling hemorrhage?

A

Direct pressure

82
Q

What are the three objectives of bandaging to control hemorrhaging?

A

Keep wound clean

Immobilize the wound site

83
Q

To halt hemorrhage, apply firm pressure to site for at least ____ minutes.

A

10

84
Q

_____ can correct acidosis, help prevent renal failure, and correct hyperkalemia.

A

Alkalinition

85
Q

What is the care for crush syndromes?

A

sodium bicarbonate 1mEq/kg initially then 0.25mEq/kg/hr

86
Q

In crush injuries, consider _____mg calcium chloride IVP to counteract dysrhythmias induced by hyperkalemia.

A

500

87
Q

What is the most prominent symptoms of compartment syndrome?

A 
Six Ps
Pain
Paresthesia
Paresis
Pressure
Passive stretching pain
Pulselessness
88
Q

Care at the hospital for crush injury is aggressive and may use techniques such as ___ and _____.

A

Debridement

Hypebaric

89
Q

________ a Xanthine oxidise inhibitor, interferes with the production of uric acid and may help reperfusion of both the kidneys and the skeletal muscles.

A

Allopurinol

90
Q

Compartment syndrome rarely occurs within the first _____ hours after an acute injury.

A

4

91
Q

What is the single most effective prehospital treatment for compartment syndrome?

A

Elevation

92
Q

What does elevation do for a crush syndrome?

A

Reduces edema, increases venous return, lowers compartment pressure, helps prevent ischemia

93
Q

Trauma to the thorax area is likely to injure both the ____ and the ____.

A

Plura

Lungs

94
Q

Dress all open thoracic wounds with ________ dressings.

A

Sterile

95
Q

When should a tetanus booster be obtained by the patient?

A

If time since immunization has been longer than 5 years

96
Q

How does the integumentary system prevent pathogens from attacking the body?

A

The skin provides a protective barrier against pathogens

97
Q

Of the open wounds presenting to emergency departments, up to _____ percent will eventually become infected, resulting in significant morbidity.

A

6.5

98
Q

When an artery is ruptured but the skin is not broken, blood can separate the tissues and pool in a pocket. This pocket of blood is known as a?

A

Hematoma

99
Q

The anaerobic bacterium clostridium perfingens causes a deep space infection called:

A

Gangrene

100
Q

In a soft tissue injury, what may cause a bandage to fit properly at first but later become too tight and reduce circulation?

A

Damaged tissue swelling

101
Q

When bandaging the foot and ankle to create pressure and control bleeding, wrap in a:

A

Distal-to-proximal fashion to avoid forming a venous tourniquet

Exam 9 (11 decks)

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