About what percentage of soft tissue wounds become infected, with a significant resultant
morbidity?
pg 93
7 percent
Which glands secrete sweat?
pg 94
Sudoriferous glands
Which of the following types of cells are found in the dermis?
Lymphocytes
Fibroblasts
Macrophages
Mast cells
All
pg 94
All
The layers of the arteries and veins proceeding in order from exterior to interior are the
pg 94
adventitia, media, intima
The blood vessels responsible for distributing blood to the major regions and organs of the
body are the
pg 94
arteries
The blood vessels able to change their lumen size by a factor of five are the
pg 94
arterioles.
The sheet of thick, fibrous material surrounding muscles is the
pg 95
fascia.
T/F - Lacerations that run parallel to skin tension lines will cause the wound to gape.
pg 96
False
Which of the following types of wounds are unlikely to heal well?
A. Wounds that gape
B. Wound associated with static tension lines
C. Wounds associated with dynamic tension lines
D. Wounds perpendicular to tension lines
E. All except B
pg 96
E. All except B
The type of wound characterized by erythema usually seen during the prehospital setting is the
pg 96
contusion.
Which of the following wounds is not considered open?
A. Laceration D. Puncture
B. Abrasion E. Avulsion
C. Contusion
pg 96
C. Contusion
Which of the following wound types is characterized as a surgically smooth, open wound?
A. Abrasion D. Incision
B. Contusion E. Avulsion
C. Laceration
pg 98
D. Incision
Crush injuries usually involve injury to
pg 97
blood vessels.
muscles.
bones.
internal structures.
Which of the following is NOT usually considered an open wound?
A. Abrasion D. Degloving injury
B. Crush injury E. Avulsion
C. Incision
pg 97
B. Crush injury
The wound that poses the greatest risk for serious infection is the
pg 98
puncture.
The injury in which the skin is pulled off a finger, hand, or extremity by farm or industrial
machinery is called a
pg 98
degloving injury.
T/F - Amputations that occur cleanly are likely to be associated with severe hemorrhage.
pg 99
False
Vascular, platelet, and coagulation are phases of the process called
pg 100
hemostasis.
T/F - When torn or cut, the muscles in the capillaries constrict, thereby limiting hemorrhage.
pg 100
False
The agents that recruit cells responsible for the inflammatory response are called
pg 101
chemotactic factors.
The cells that attack invading pathogens directly or through an antibody response include all of
the following, EXCEPT
A. macrophages. D. granulocytes.
B. lymphocytes. E. fibroblasts.
C. white blood cells.
pg 101
E. fibroblasts.
The stage of the healing process in which the phagocytes and lymphocytes are most active is
pg 101
inflammation.
Regenerated skin, after about four months, is about how strong compared to the original skin?
pg 101
60 percent
Infection usually appears how long after the initial wound?
pg 102
2 to 3 days
Which of the following is an infection risk factor with soft tissue wounds?
A. Advancing age D. Cat bites
B. Crush injury E. All of the above
C. NSAID use
pg 102
E. All of the above
T/F - Closing wounds with staples or sutures increases the risk of infection.
pg 102
True
It is common practice to provide tetanus boosters if the patient’s last booster was over
pg 103
five years ago.
Which of the following can interfere with normal clotting?
A. Aspirin D. TPA
B. Warfarin E. All of the above
C. Streptokinase
pg 103
E. All of the above
The location at greatest risk for compartment syndrome is the
pg 103
calf.
The excessive growth of scar tissue within the boundaries of the wound is called
pg 103
hypertrophic scar formation.
T/F - The nature of crush injury produces an injury area that is an excellent growth medium for
infection.
pg 105
True
A crush injury that produces crush syndrome usually requires what minimum time of
entrapment?
pg 105
4 hours
What is likely with the release of entrapment in the patient suffering crush syndrome?
pg 105
Kidney failure
Abnormal vascular calcifications
Cardiac dysrhythmias
Hypovolemia
The type of dressing that prevents the movement of fluid or air through the dressing is:
pg 106
occlusive.
The bandages that increase pressure beneath the bandage with each consecutive wrap are
pg 108
elastic bandages.
T/F - Not only is the skin the first body organ to experience trauma, it is often the only one to
display the signs of injury.
pg 108
True
What are important factors to consider in the assessment and management of external hemorrhage?
pg 109
Type of bleeding
Stopping further hemorrhage
Rate of hemorrhage
Volume of blood lost
What is one of the primary objectives of bandaging?
pg 111
Hemorrhage control
T/F - Insufficient tourniquet pressure may increase the rate and volume of hemorrhage.
pg 111
True
The restoration of circulation once a tourniquet is released may cause
pg 111
Shock
Renal failure
Hypovolemia
Lethal dysrhythmias
After bandaging a patient’s severely hemorrhaging forearm wound, you notice that the limb is
cool, capillary refill is slowed, and the radial pulse cannot be found. You should
pg 112
loosen the bandage.
Which medication may be administered to help alleviate pain associated with soft tissue
injury?
pg 112
Morphine sulfate
With a large and gaping wound to the neck, use a(n)
pg 113
occlusive dressing.
The type of dressing recommended for blood and fluid leaking from the auditory canal is a(n)
pg 113
gauze dressing.
Which of the following is NOT a distal sign that a circumferential bandage is too tight?
A. Diaphoresis D. Tingling
B. Pallor E. Swelling
C. Loss of pulses
pg 114
A. Diaphoresis
Which of the following glands secrete a waxy substance?
A. Sudoriferous glands D. Adrenal glands
B. Sebaceous glands E. Pituitary glands
C. Subcutaneous glands
pg 94
B. Sebaceous glands
The layer of skin that is made up of mostly dead cells and provides the waterproof envelope that
contains the body is the
pg 94
epidermis.
Identify the layers of the arteries and veins in order from exterior to interior.
pg 94
Adventitia, media, intima
The blood vessels that have a wall only one cell thick are the
pg 94
capillaries.
T/F - In the limbs, fascia define compartments with relatively fixed volumes.
pg 95
True
T/F - Lacerations perpendicular to skin tension lines will cause the wound to gape.
pg 96
True
The wound type characterized by a collection of blood under the skin
pg 97
hematoma.
Prolonged crush injury (crush syndrome) permits the accumulation of
pg 97
myoglobin.
uric acid.
potassium.
lactic acid.
A likely cause of an avulsion is a(n)
A. animal bite.
B. severe glancing blow to the scalp.
C. machinery accident.
D. degloving injury.
E. all of the above.
pg 98
E. all of the above.
The natural ability of the body to halt blood loss is
pg 100
hemostasis.
T/F - Most blood vessels, when cut cleanly, will withdraw and constrict, limiting the rate of
hemorrhage.
pg 100
True
The cells that attack invading pathogens directly or through an antibody response are
pg 101
lymphocytes.
The stage of the healing process in which skin cells regenerate to restore a uniform layer of skin
cells along the wound border is
pg 101
epithelialization.
The stage of the healing process in which capillaries grow to perfuse the healing tissue is
pg 101
neovascularization.
The booster for tetanus is effective for
pg 103
10 years.
Which of the following can interfere with normal clotting?
A. Aspirin D. Clopidogrel
B. Heparin E. All of the above
C. tPA
pg 103
E. All of the above
The excessive growth of scar tissue beyond the boundaries of the wound is
pg 103
keloid scar formation.
T/F - The patient is not likely to experience pressure injury, even when immobilized for a lengthy
period on a long spine board, PASG, or rigid splint.
pg 104
False
The process of actual tissue death is
pg 105
necrosis.
T/F - Most dressings used in prehospital emergency care are sterile, nonocclusive, nonadherent,
absorbent dressings.
pg 106
True
The type of dressing that promotes clot development is
pg 106
adherent.
The type of bandage that has limited stretch and conforms well to the body contours is the
pg 107
self-adherent roller bandage.
If bleeding from a wound is difficult to control you should
pg 111
apply direct digital pressure to the wound.
The dangers of a tourniquet include
A. increased hemorrhage if pressure is not sufficient.
B. possible loss of limb.
C. accumulation of toxins in the limb.
D. tissue damage beneath the tourniquet.
E. all of the above.
pg 111
E. all of the above.
The restoration of circulation once a tourniquet is released may cause all of the following,
EXCEPT
A. emboli.
B. shock.
C. lethal dysrhythmias.
D. massive vasoconstriction.
E. renal failure.
pg 111
massive vasoconstriction.
T/F - You should remove gross contamination from a wound if you can do so quickly and without
further injury.
pg 112
True
T/F - Scalp hemorrhage is rarely severe or difficult to control.
pg 112
False
The ideal position for splinting a limb is halfway between extension and flexion and is called the
pg 113
position of function.
The recommended procedure for packaging an amputated part for transport includes
pg 114
keeping it moist and cool.
T/F - Most patients of crush syndrome can be identified before extrication is complete.
pg 115
True
T/F - Recognition of compartment syndrome is usually straightforward
pg 116
False
T/F - With compartment syndrome, motor and sensory function are frequently normal.
pg 116
True
A wound involving which of the following requires transport?
A. Nerves
B. Blood vessels
C. Tendons
D. Ligaments
E. All of the above
pg 118
E. All of the above
