ch. 19 soft-tissue injury
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| Soft tissue trauma is the leading form of what | injury
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| Open wounds count for approximately ________ ED room visits every year | 6.5 million
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| The _____ or ______ is a complex organ with a crucial role in maintaining the constancy of the internal environment | skin or integument
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| 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
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| Name the outermost layer of the skin | the epidermis
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| The epidermis consists of 5 layers. Name the outer most layer | stratum corneum
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| What cells are known as the melanocytes | melanin
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| The darkness of a persons skin is directly proportional to the amount of what | Melanin
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| What is the layer of skin just below the epidermis | dermis
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| In the dermis are numerous fibroblasts, which are cells that secrete what | collagen, elastin, and ground substance
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| What does collagen do for the skin | It gives the skin a high resistance to breakage do to mechanical stress.
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| What does elastin do for the skin | it provides elasticity for the skin
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| What does ground substance do for the skin | Provides resistance to compression
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| the dermis is subdivided into 2 layers. Name them | the papillary dermis, and the reticular layer.
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| what does the reticular layer do | provides strength and elasticity
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| what does the papillary dermis do | provides nutrients to the epidermis and helps with thermal regulation
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| Macrophages and lymphocytes are also found where | the dermal layer
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| 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.
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| during strenuous activity the sweat glands can secrete how much fluid in an hour. | 1000ml
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| The layer of tissue below the dermis is the _____ layer and contains mostly ________ tissue | subcutaneous, adipose
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| What benifiet does subcutaneous tissue provide | insulation from extreme heat or cold
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| Below the subcutaneous tissue is a thick, dense layer of fibrous tissue known as the | deep fascia
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| Where is dynamic tension found | over muscle
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| When you have surgery to improve the apperence of a scar this is called | scar revision
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| During inflammation chemicals and proteins known as chemotactic factors are released for what reason | to call repairing cells into the area.
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| Mast cells release _______ as part of the bodies response in the early stages of inflammation | histamine
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| Inflammation ultimatly leads to what | the removal of foreign material damaged cellular parts, and invading microorganisms.
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| 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
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| In _______________, new blood vessels form as the body attempts to bring oxygen and nutrients to the injured tissue | neovascularization
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| Collagen is a tough fibrous protien found in what | scar tissue, hair, bones, and connective tissue
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| Name 2 wounds that carry a high risk for infection | animal and human bites
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| What type of scar typically forms in people with darkly pigmented skin | keloid scar
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| What type of scar forms in areas subject to high tissue stress | hypertrophic scar
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| Open injuries should be sutured or closed within | 6-8 hours
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| Larger openings and deeper penitrations result in a higher risk of what | infection
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| what is erythema | reddening of the skin
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| red streaks adjacent to the wound indicate that the patient has developed _________ | lymphangitis
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| tetanus is caused by an infection with an anaerobic bacterium called | clostridium tetani
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| tetanus infection can cause what | toxin release that causes muscle contractions so strong they can fracture a bone
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| Necrotizing fasciitis involves what | the death of tissue
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| Necrotizing fasciitis has a mortality rate of what | 70-80%
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| What type of wound is a gunshot | puncture
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| in an avulsion the part of the flap that connects the flap to the body is called what | pedicle
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| The longer an injured area stays compressed the greater the chance of what | systemic complications
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| When vessels are crushed and torn they often lose the ability to do what | constrict
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| What can lead to calcifications that can interfere with normal blood flow and normal nervous tissue function is what | hyperphosphatemia
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| Compartment syndrome presents with the six P's. What are they | Pain, Paresthesia, Paresis, Pressure, Passive stretch pain, and Pulselessness.
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| In an explosion what happens during primary phase | a pressure wave rapidly develops
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| In an explosion what happens during secondary phase | a blast wind occurs
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| 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
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| In an explosion what happens during quanternary phase | Injuries result from the misc. events. IE burns from the explosion
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| Gunshot wounds and stab wounds warrent what | complete removal of the patients clothing
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| Trauma patients are often critically injured, and life threats evolve _______ _______., so reassessments may reveal problems | over time
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| What directly covers a wound and controls bleeding | a dressing
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| what keeps the dressing in place | a bandage
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| When are occlusive dressings indicated | when it is important to keep air from passing through the material
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| Why are wet dressing limited to their use in the field | because they provide a medium for bacteria and other pathogens to grow
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| Application of a cold compress will help do what to an open wound | reduce pain and deminish blood flow
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| 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,
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| 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
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| A minor neck laceration can lead to what | an air embolism
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| 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.
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| what should you do with torso injuries that are holes | apply an occlusive dressing and tape three sides down
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| elbow injuries have a higher risk for what, and why? | Neurovascular compromise because of the limited space available for blood vessels and nerves.
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| A key complication of crush syndrome is what? It can be prevented with aggressive fluid therapy | renal failure
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| Why is lactated ringers not recommended for use in cases of crush syndrome | it has potassium in it
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| 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.
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| 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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