caroline

Description:	ch. 19 soft-tissue injury
Category:	Paramedic/EMT
Created by:	klindley on 2009-05-13

Question	Answer
Soft tissue trauma is the leading form of what	injury
Open wounds count for approximately ________ ED room visits every year	6.5 million
The _____ or ______ is a complex organ with a crucial role in maintaining the constancy of the internal environment	skin or integument
The skin has 4 roles or responsibilities. Name them	Protecting the underlying tissue from injury. Temperature regulation, weather tight seal to prevent water loss, and as a sense organ keeping the brain informed abouit the environment
Name the outermost layer of the skin	the epidermis
The epidermis consists of 5 layers. Name the outer most layer	stratum corneum
What cells are known as the melanocytes	melanin
The darkness of a persons skin is directly proportional to the amount of what	Melanin
What is the layer of skin just below the epidermis	dermis
In the dermis are numerous fibroblasts, which are cells that secrete what	collagen, elastin, and ground substance
What does collagen do for the skin	It gives the skin a high resistance to breakage do to mechanical stress.
What does elastin do for the skin	it provides elasticity for the skin
What does ground substance do for the skin	Provides resistance to compression
the dermis is subdivided into 2 layers. Name them	the papillary dermis, and the reticular layer.
what does the reticular layer do	provides strength and elasticity
what does the papillary dermis do	provides nutrients to the epidermis and helps with thermal regulation
Macrophages and lymphocytes are also found where	the dermal layer
there are 5 different structures that you can find in the dermis. Name them	nerve endings, blood vessels, sweat glands, hair folicle, and sebaceous gland.
during strenuous activity the sweat glands can secrete how much fluid in an hour.	1000ml
The layer of tissue below the dermis is the _____ layer and contains mostly ________ tissue	subcutaneous, adipose
What benifiet does subcutaneous tissue provide	insulation from extreme heat or cold
Below the subcutaneous tissue is a thick, dense layer of fibrous tissue known as the	deep fascia
Where is dynamic tension found	over muscle
When you have surgery to improve the apperence of a scar this is called	scar revision
During inflammation chemicals and proteins known as chemotactic factors are released for what reason	to call repairing cells into the area.
Mast cells release _______ as part of the bodies response in the early stages of inflammation	histamine
Inflammation ultimatly leads to what	the removal of foreign material damaged cellular parts, and invading microorganisms.
ato replace the area of damage in a soft tissue injury, an new layer of epithelial cells must be moved into thi region. A process known as	epithelialization
In _______________, new blood vessels form as the body attempts to bring oxygen and nutrients to the injured tissue	neovascularization
Collagen is a tough fibrous protien found in what	scar tissue, hair, bones, and connective tissue
Name 2 wounds that carry a high risk for infection	animal and human bites
What type of scar typically forms in people with darkly pigmented skin	keloid scar
What type of scar forms in areas subject to high tissue stress	hypertrophic scar
Open injuries should be sutured or closed within	6-8 hours
Larger openings and deeper penitrations result in a higher risk of what	infection
what is erythema	reddening of the skin
red streaks adjacent to the wound indicate that the patient has developed _________	lymphangitis
tetanus is caused by an infection with an anaerobic bacterium called	clostridium tetani
tetanus infection can cause what	toxin release that causes muscle contractions so strong they can fracture a bone
Necrotizing fasciitis involves what	the death of tissue
Necrotizing fasciitis has a mortality rate of what	70-80%
What type of wound is a gunshot	puncture
in an avulsion the part of the flap that connects the flap to the body is called what	pedicle
The longer an injured area stays compressed the greater the chance of what	systemic complications
When vessels are crushed and torn they often lose the ability to do what	constrict
What can lead to calcifications that can interfere with normal blood flow and normal nervous tissue function is what	hyperphosphatemia
Compartment syndrome presents with the six P's. What are they	Pain, Paresthesia, Paresis, Pressure, Passive stretch pain, and Pulselessness.
In an explosion what happens during primary phase	a pressure wave rapidly develops
In an explosion what happens during secondary phase	a blast wind occurs
In an explosion what happens during tertiary phase	Victims may be ijured from displacement away from the blast site or collapse of the surrounding structure
In an explosion what happens during quanternary phase	Injuries result from the misc. events. IE burns from the explosion
Gunshot wounds and stab wounds warrent what	complete removal of the patients clothing
Trauma patients are often critically injured, and life threats evolve _______ _______., so reassessments may reveal problems	over time
What directly covers a wound and controls bleeding	a dressing
what keeps the dressing in place	a bandage
When are occlusive dressings indicated	when it is important to keep air from passing through the material
Why are wet dressing limited to their use in the field	because they provide a medium for bacteria and other pathogens to grow
Application of a cold compress will help do what to an open wound	reduce pain and deminish blood flow
what are the guidlines to preserving an amputated part	rinse with cool sterile saline, wrap loosely with wet sterile guaze, keep it cool but don't get it cold,
what are the don't do's when try to preserve an amputated part.	never warm, never soak in water, naver place directly on ice
A minor neck laceration can lead to what	an air embolism
Open injuries of the neck require what? Why do they require this	An occlusive dressing so air doesn't get drawn into the circulatory system.
what should you do with torso injuries that are holes	apply an occlusive dressing and tape three sides down
elbow injuries have a higher risk for what, and why?	Neurovascular compromise because of the limited space available for blood vessels and nerves.
A key complication of crush syndrome is what? It can be prevented with aggressive fluid therapy	renal failure
Why is lactated ringers not recommended for use in cases of crush syndrome	it has potassium in it
In crush syndrome why do you want to give sodium bicarb	it alkalinizes the blood and urine, which helps prevent kidney failure, treats hyperkalemia, and reverses metabolic acidosis.
what is the care in the ed for sruch syndrome	urine output of at least 300ml/h. provide medications like amiloride, a potassium sparing diuretic. ALLOPURINOL as well