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Equine Medicine 1 > Wounds, Injuries > Flashcards

Wounds, Injuries Flashcards

1
Q

Classification of injuries by cause

A
  1. Mechanical caused
  2. Chemical caused
  3. Thermal caused
  4. Radioactive caused
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2
Q

Thermal caused injuries. Burns. Degrees

A

Burn - combustio
—
1 degree: combustio erythematosa
Dry fur, swollen skin, warm, loss of epithelium
—
2 degree: combustio bullosa
Vasodilation, leak of serum, vesicles, pain
—
3 degree: combustio escharctica
Cell injuries, protein aggregation, thrombosis, necrosi
—
4 degree: carbonisatio

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3
Q

Thermal caused injuries. Frostbites. Degrees

A

Frostbite — congelatio
—
1 degree: ischaemia, hyperaemic, leak of serum, not sensitive
—
2 degree: stasis, thrombus, vesicles, infection
—
3 degree: cell degeneration, stop of circulation, necrosis, loss of larger body parts

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4
Q

Chemical caused necrosis

A
  • acid caused -> coagulation necrosis
  • alkali caused -> colliquation necrosis
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5
Q

Radioactive injuries

A
  • very rare in vet medicine
  • locally: redness, vesicles, loss of hair, necrosis, depigmentation, hyperkeratosis, ulceration
  • generally: vomitus, diarrhoea, apathy
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6
Q

Electricity caused injuries

A
  • above 50mA critic general status
  • above 100mA always death
  • local symptoms: cell degeneration, cell coagulation
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7
Q

Electricity caused injuries

A
  • above 50 mA critic general status
  • above 100 mA always death
  • local symptoms: cell degeneration, cell coagulation
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8
Q

Determination of injury

A

Loss of continuity in the skin, mucous membrane or in the organ with or without underlying tissue damage

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9
Q

How do we classify wounds?

A
  1. Localisation
  2. Shape and size
  3. Types
  4. Origin
  5. Age
  6. Healing stadium
  7. In what way (?)
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10
Q

Classification of wounds. Localisation

A
  • anatomical region (e.g. head, neck, thoracical region etc)
  • skin, mucous membrane, muscle, tendon, joint, etc
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11
Q

Classification of wounds. Shape and size

A
  • point-like
  • line-like
  • lobed
  • cavernous (пещеристый)
  • loss of materia
  • loss of body part
    —
  • regular
  • irregular
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12
Q

Classification of wounds. Types

A
  • superficial: e.g. graze (царапина), erosion, abrasion (натертость ?) (denuding of the epidermis, minimal bleeding, some serum exsudation)
  • deep
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13
Q

Classification of wounds. Origin

A
  1. Surgical
  2. Traumatical
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14
Q

Classification of wounds. Age

A
  • fresh
  • old
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15
Q

Classification of wounds. Healing stadium

A
  • regularity healing
  • irregularily healing
  • infected or with complication
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16
Q

Classification of wounds. In what way (specific wounds)

A
  • incised -> vulnus scissum et caesum
  • lacerated -> vulnus lacerum s. ruptum
  • confused -> vulnus contusum
  • puncture -> vulnus punctum
  • gunshot -> vulnus scolopetarum
  • bite -> vulnus morsum
17
Q

Wound caused by incision?

A

Vulnus scissum et caesum

18
Q

Wound caused by bite?

A

Vulnus morsum

19
Q

Vulnus scissum et caesum (incised wounds)

A
  • produced by sharp objects
  • tissue damage is minimal
  • edges of wound are linear and smooth
  • pain is minimal
  • underlying tissues are damaged only in the line
20
Q

Lacerated wounds

A
  • produced by irregular objects
  • tissue damage is extensive
  • edges of wound are smooth
  • painful
  • extensive damage of underlying tissue
21
Q

Vulnus contusum - confused wounds

A
  • produced by dull objects
  • extensive tissue damage
  • irregular edges of wound
  • very painful
  • extensive damage of underlying tissues
  • prognosis is unfavourable
22
Q

Vulnus punctum - puncture wounds

A
  • produced by sharp ended objects
  • superficial -> point-like; deep -> channel
  • anaerobic infection very probable
23
Q

Vulnus morsum - bite wounds

A
  • carnivores -> puncture wounds
  • herbivores -> contused wounds
  • anaerobe infection very probable
24
Q

Vulnus sclopetarium - gunshot wounds

A
  • inlet: primer necrotical zone
  • channel: necrobiotical zone
  • outlet: molecular commotional zone
25
Q

What are 2 processes involved in healing?

A

Repair and regeneration
—
Regeneration: replacement of damaged tissues with normal cells of type lost. Tissue type should be capable to mitosis (epithelium, bone and liver)
—
Repair: stopgap reaction designed to reestablish the continuity of interrupted tissues, results in scar tissue

26
Q

Wound healing of partial thickness wounds (abrasion, erosion)

A

Primarily by migration and proliferation of epidermal cells from the underlying epithelium + adnexal structures (hair follicles, swear and sebaceous glands) with little participation of inflammatory or mesenchymal cells

27
Q

Wound healing of full thickness wounds

A

Involves 3 coordinated phases:
1. acute inflammation
2. cellular proliferation
3. remodelling with scar formation

28
Q

What is special in wound healing in horses?

A
  • many traumatic wounds can not be sutured in horses because of massive tissue loss, extreme contamination, continuous movement and skin tension
  • study: primary closure was successful in only 24% of horse wounds and 39% of pony wounds (>50% of wounds located on the limb)
29
Q

Acute inflammation.

A
  1. Bleeding, pain - immediately
  2. Vasoconstriction - 5-10 minutes
    Mediated by: sympathomimetic amines, thromboxane (eicosanoid, produced by platelets. Main role is to promote platelet aggregation and vasoconstriction)
  3. Vasodilation
  4. Increased capillary permeability
    Mediated by: histamine, bradykinin, prostaglandins (E1, E2) (pain!), leukotriene B4
    => cellular and non-cellular blood components can enter into the wound by diapedesis. Blood components will form fibrinogen-fibrin-fibronektin accumulation
  5. Fibrocellular clot
    Barrier to protect subcutaneous tissues. PMNs (polymorphonuclear neutrophils) die - release enzymes - pus
  6. Fibrocellular clot dehydrates -> scab
  7. Accumulation of an inflammatory exsudate
    —
    Duration: 6-12 hours
30
Q

Cellualar components in the wound during inflammatory stage of acute inflammation

A
  • Neutrophils - break down tissue debris, kill microorganisms. (Although the neutrophils help create a favourable wound environment and serve as a source of pro inflammatory cytokines, the are not essential to repair in uninflected wounds
  • Mononcytes, lymphocytes, complements, Ig - remove damaged tissues, combat infection, provide the building blocks needed for subsequent wound repair
31
Q

Debridement stage of acute inflammatory phase

A
  • 6 hours after injury
  • removal of damaged and necrotic tissues
  • elimination of any infection
  • duration depends on quantity of necrotic tissue, contamination of the wound
  • polymorphonuclear leukocytes - aid breakdown of injured tissues
  • Igs and complement system - opsonins - removal of bacteria
  • monocytes and macrophages - phagocytosis, also regulate fibroblast functions and attract fibroblasts to the wound
    —
    fibroblasts influx means end of this stage

Equine Medicine 1 (2 decks)

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