4) Soft tissue injuries Flashcards
Injury which opening occurs in skin & organs protrude through is:
Evisceration
Most common location for compartment syndrome to occur?
1st “P” of compartment syndrome?
What ECG changes would indicate hyperkalemia?
= Distal leg, anterior compartment
= Pain
= Peaked T Waves
Crush syndrome occurs when trapped/crushed for how long:
Crush injury is what type of wound:
PT has lower L-leg trapped underneath a farm tractor for the last 5hrs. PT presents w/ obvious signs on hyperkalemia. What is 1st line IV med for this patient?
= usually for longer than 4 hours
= Closed soft tissue injury
= Sodium Bicarbonate
The skin is known collectively as the:
Skin, considered what of body & what % of total body weight:
Which layer of skin primarily insulates the body against heat loss?
Glands w/in the dermis that secrete a lubricant are called the:
Outermost layer of skin is the:
What part of the integumentary system receives no blood supply?
= Integumentary system
= Organ, 16% of total body weight
= Subcutaneous Layer
= Sebaceous glands
= Epidermis
= Epidermis
Sodium Bicarbonate is delivered PT’s suspected w/ hyperkalemia at:
Dose of Calcium Chloride for hyperkalemia & line of med?
= 50 mEq as last line
= 500-1000 mg/3mins IV as 1st line med
Which type of wound has a small opening into the skin, but may be quite deep, and is often caused by instruments such as nails, ice picks, or pencils?
= Puncture
Which of the following best describes an avulsion?
Which of the following is considered an open wound?
Which soft tissue injury causes a greater amount of hemorrhage?
= Flap of skin partially/completely torn away from underlying tissue
= Laceration
= Avulsion
Thick, fibrous, inflexible membranes surrounding muscle that help bind muscle groups together are called:
Fascia
1Blunt non-penetrating injuries that crush/damage lil blood vessels:
2Contusion is considered what type of injury:
3Minor bleeding associated w/ cap/ wounds often continues b/c:
4A hematoma or collection of blood beneath the skin:
5PT sustained a blow to frontal region of his head & now has a large lump present at the point of impact. This lump referred to as:
1= Contusions
2= Closed soft tissue blunt injury
3= Capillaries cannot contract and thus continue to bleed
4= Is most commonly caused by injury to an artery
5= Hematoma
An injury in which the mechanism of injury tears the skin off the underlying muscle, tissue, blood vessels, and bone is called a(n):
Degloving injury
A rapid trauma assessment should be performed on:
Which of the following is true regarding soft-tissue injuries?
Impaled object may only be removed during what conditions?
= Any patient with a significant MOI
= Most open wounds require only simple care and limited suturing
= CPR is needed and impaled object interferes with chest compressions & The impaled object is causing an obstruction of the patient’s airway
Afferent nerves:
Efferent nerves:
=sensory nerves “ahhh”
=motor “effect”
Thickest skin @:
Thinnest skin @:
= Palms & Soles have thickest skin
= eyelids 1st & genitalia 2nd
(Soft tissue injuries)
= Risk factors: age (50-70kilos blood) (1yr old ⅓ of gatorade bottle), alcohol/ drug use, Occupation
Layers of skin:
Epidermis, Dermis (papillary & Reticular Lvls), Subcutaneous
Epidermis:
dead skin cells, no vasculature, astratum corneum, cells are pushed out & are replaced, Sebum (waxy oil lubes (hands), top layer of skin
Subcutaneous:
= adipose tissue, most thermal temp/ reg/, (regs cold>heat)
Dermis:
2 layers of dermis:
Papillary:
Reticular:
Sebaceous glands:
Sudoriferous Glands:
= Middle layer of skin
= papillary & Reticular layer
= contains the Glands, blood vessels, nerves “nipple, Nerves”
=contains the venules arterioles, capillaries “Reticular network circul/”
= sebum lubricate palms
= SNS n postsynaptic acetylcholine for response
Blood vessels:
Blood in venous system:
Most of vaso construction by:
= veins low pressure w/ valves, arteries no valves w/ lots tunica media
= ⅔ in venous system,
= Capillaries: most of vaso construction
1Lymphatic system:
2Lymph node:
3Spleen relation:
4Lymphatic pathway:
5Sign lymphatic system not working:
1= “body’s garbage system” macrophages eats then system of channels to tissues 1 direction, no pump, dumps into a node
2= were garbage collects
3= Carries “trash” of pathogen destruction to nodes for macrophages
4= >Vessels> nodes> spleen> up to L/R subclavian vein, to kidneys
5= Gray poop
Tendons:
Ligaments:
Fasciae:
Tension lines/Langer lines:
= connects muscle to bone, strong, full of collagen “tend to bone”
= connects bone to bone aligning joints & easily tear
= band sheet of CT stabilizes, encloses, & separates M. compartments
= “way skin is grooved together”, cut against line hard to close & leaves bigger opening, effects healing process
Contusions:
Hematoma:
Severe hematomas to major compartments may contribute to:
= bruise made by ecchymosis: black & blue
= artery bleed, tamponades & helps hemostasis
= hypovolemia
1Crush injury:
2Crush syndrome:
3Cellular Lvl:
4 Crush syndrome signs:
5 Crush syndrome Rx:
1= deep injury damage can be massive w/ minimal signs on skin itself
2= body part trapped>4hrs, cells anaerobic>hyperkalemia>TDP torsades de pointes, Aka: traumatic Rhabdomyolysis
3= accumulation of quantities of myoglobin O2, K, lactic acid, toxins, can clog kidneys, can cause severe metabolic acidosis
4= urine is dark red, Shark Peaked T waves
5= 1st Ca-Chloride, 2nd Albuterol, 3rd Sodium Bicarb, Dex w/ Insulin
Avulsion:
= separates & creates flap/chunk from skin (“chunk missing)
Tend to bleeds worst of cuts & more than complete amputation & Very prone to infection & can go to circulatory system > degloving
