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ch. 19 soft-tissue injury

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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  


   


 

 

 

 

 

 
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