Soft Tissue Trauma

Question 1

Skin

Answer 1

Largest organ of the human body

Question 2

Blunt Injury

Answer 2

Injury when energy exchange between the patient and an object is more than the tissues can handle

Question 3

Soft tissue trauma

Answer 3

Blunt, penetrating and burns

LEADING FORM OF INJURY

Question 4

SKIN

Answer 4

Protects underlying tissue. Temp regulation. Prevents water loss. Sensory organ for brain.

Question 5

Two layers

Answer 5

Epidermis and Dermis

Question 6

Epidermis

Answer 6

Five Layers

-Stratum Corneum top layer that constantly sheds. And four living layers beneath that give rise to the top layer

Question 7

Melanin granules

Answer 7

Melanocytes: proportional to the darkness of ones skin

Question 8

Dermis

Answer 8

• Tough, highly elastic.
• Made of collagen fibers, elastic fibers and gel. Fibroblasts: secrete collagen, elastin and ground substance, found within Dermis.

Question 9

Collagen

Answer 9

Fibrous protein that give high strength to skin and resistance to breakage.

Question 10

Elastin

Answer 10

Give elasticity to skin

Question 11

Ground Substance

Answer 11

Gives skin resistance to compression using gel

Question 12

Dermis Divided

Answer 12

Papillary Dermis: vasculature, provides nutrients to epidermis and thermoregulation
Reticular Layer: dense, irregular connective tissue, gives strength and elasticity

Question 13

Marcophages and Lymphocytes

Answer 13

Also found within the dermal layer. Part of inflammatory process and combat microogranisms
-when pathogen enters Dermis, macrophages and lymphocytes destroy the microorganism and signal other cells to migrate to the area.

Question 14

Mast cells

Answer 14

Physical injury causes them to synthesize special chemical mediators increasing blood flow resulting in redness and warmth

Question 15

Cells within dermis

Answer 15

Nerve endings
Blood vessels
Sweat glands
Hair follicles
Sebaceous glands

Question 16

Sub Q layer

Answer 16

Blood vessels, hair and nerves

Question 17

Skin Tension Lines

Answer 17

Tautness of skin varied in different regions of skin

Question 18

Closed wound

Answer 18

Soft tissues beneath skin surface are damaged but does not break epidermis

Question 19

Open Wound

Answer 19

Disruption of the skin. Abrasions, lacerations, bites, impaled objects

Question 20

Crush Injury

Answer 20

Crushed between two solid objects

Question 21

Compartment Syndrome

Answer 21

Develop in crush injuries. Anaerobic metabolism occurs because arterial flow and oxygenated blood is cut off from an extremity creating pyruvic acid

Question 22

Wound Healing

Answer 22

Hemostasis
Inflammation
Epitheliazation
Neovascularization
Collagen Synthesis

Question 23

Hemostasis

Answer 23

The bleeding stops via clotting cascade

Question 24

Inflammation

Answer 24

White blood cells and others move to injured site to begin repair and kill invading pathogens that have infiltrated exposed area.
Chemotactic chemicals are released and signal repairing cells to migrate to the site of injury.
Granulocytes and Macrophages engulf bacteria through phagocytosis which involves ingesting the bacteria
Mast Cells release histamine. Histamine causes dilation of blood vessels increasing blood flow and causes redness and warmth.
Histamine makes capillaries more permeable causing fluid to leak out and result in swelling.

Question 25

Epithelialization

Answer 25

When new epithelial cells are moved to damaged ones. Bottom four layers of skin produce more epithelial cells.

Question 26

Neovascularization

Answer 26

New blood vessels form as the body attempts to bring oxygen and nutrients to the injured tissue.

Question 27

Collagen Synthesis

Answer 27

Tough, fibrous protein found in scar tissue, hair and bones. Synthesized by fibroblasts that move to damaged area.

Question 28

High Risk Wound

Answer 28

Human and Animal Bite

-warm and moist mouth invites bacteria and microogranisms

Question 29

Impaled

Answer 29

Do not remove unless interfering with airway

Question 30

Infection

Answer 30

Clues: erythema, pus, warmth, Edema, and discomfort

Question 31

Gangrene

Answer 31

Clostridium Perfringens is an anaerobic toxin producing bacterium that leads to gangrene. Produces foul smelling gas.

Question 32

Tetanus

Answer 32

Infection caused by anaerobic bacterium, Clostridium Tetani. (Same family as gangrene). Causes body to produce potent toxin that results in painful muscle contractions strong enough to fracture bones. May first experience “lock jaw” and neck.
-booster needed every 10 years. Inoculation given to patients injured and haven’t had it within past 5 years.

Question 33

Necrotizing Fascititis

Answer 33

Death of tissue from bacterial infection. Caused by Staphylocoulus Aureus.

Question 34

Irrigate wounds

Answer 34

Use Normal Saline. If a wound continues to bleed with dressing, apply more and consider tourniquet use

Question 35

Rhabdomyolysis

Answer 35

When muscles are crushed beyond repair, tissue necrosis develops and releases harmful products

Question 36

Smiling Death

Answer 36

The entrapped person is conversing and okay. When freed almost instant cardiac arrest
IV access before removing object
Saline ONLY given. LR has potassium.
Use BiCarb for alkalizing hyperkalemia and metabolic acidosis
Mannitol for too much fluid
IF PRETREATMENT NOT POSSIBLE, APPLY TQ TO SLOW DOWN REPERFUSION***
D10 with insulin. Uptake of insulin will also uptake potassium
Albuterol for hyperkalemia