Soft Tissue Trauma Flashcards
Skin
Largest organ of the human body
Blunt Injury
Injury when energy exchange between the patient and an object is more than the tissues can handle
Soft tissue trauma
Blunt, penetrating and burns
LEADING FORM OF INJURY
SKIN
Protects underlying tissue. Temp regulation. Prevents water loss. Sensory organ for brain.
Two layers
Epidermis and Dermis
Epidermis
Five Layers
-Stratum Corneum top layer that constantly sheds. And four living layers beneath that give rise to the top layer
Melanin granules
Melanocytes: proportional to the darkness of ones skin
Dermis
- Tough, highly elastic.
- Made of collagen fibers, elastic fibers and gel. Fibroblasts: secrete collagen, elastin and ground substance, found within Dermis.
Collagen
Fibrous protein that give high strength to skin and resistance to breakage.
Elastin
Give elasticity to skin
Ground Substance
Gives skin resistance to compression using gel
Dermis Divided
Papillary Dermis: vasculature, provides nutrients to epidermis and thermoregulation
Reticular Layer: dense, irregular connective tissue, gives strength and elasticity
Marcophages and Lymphocytes
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.
Mast cells
Physical injury causes them to synthesize special chemical mediators increasing blood flow resulting in redness and warmth
Cells within dermis
Nerve endings Blood vessels Sweat glands Hair follicles Sebaceous glands
Sub Q layer
Blood vessels, hair and nerves
Skin Tension Lines
Tautness of skin varied in different regions of skin
Closed wound
Soft tissues beneath skin surface are damaged but does not break epidermis
Open Wound
Disruption of the skin. Abrasions, lacerations, bites, impaled objects
Crush Injury
Crushed between two solid objects
Compartment Syndrome
Develop in crush injuries. Anaerobic metabolism occurs because arterial flow and oxygenated blood is cut off from an extremity creating pyruvic acid
Wound Healing
Hemostasis Inflammation Epitheliazation Neovascularization Collagen Synthesis
Hemostasis
The bleeding stops via clotting cascade
Inflammation
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.
Epithelialization
When new epithelial cells are moved to damaged ones. Bottom four layers of skin produce more epithelial cells.
Neovascularization
New blood vessels form as the body attempts to bring oxygen and nutrients to the injured tissue.
Collagen Synthesis
Tough, fibrous protein found in scar tissue, hair and bones. Synthesized by fibroblasts that move to damaged area.
High Risk Wound
Human and Animal Bite
-warm and moist mouth invites bacteria and microogranisms
Impaled
Do not remove unless interfering with airway
Infection
Clues: erythema, pus, warmth, Edema, and discomfort
Gangrene
Clostridium Perfringens is an anaerobic toxin producing bacterium that leads to gangrene. Produces foul smelling gas.
Tetanus
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.
Necrotizing Fascititis
Death of tissue from bacterial infection. Caused by Staphylocoulus Aureus.
Irrigate wounds
Use Normal Saline. If a wound continues to bleed with dressing, apply more and consider tourniquet use
Rhabdomyolysis
When muscles are crushed beyond repair, tissue necrosis develops and releases harmful products
Smiling Death
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
