Soft Tissue Trauma

Question 1

What is the largest organ of the human body?

Answer 1

skin

Question 2

Define:

blunt injury

Answer 2

An injury from a direct energy transfer between an object and the patient.

Question 3

What is the leading form of injury?

Answer 3

soft tissue trauma

Question 4

What is the function of the skin?

Answer 4

• It protects underlying tissues.
• Temperature regulator.
• Prevents water loss.
• A sensory organ for brain.

Question 5

Fill in the blank.

The three layers of the skin are the _____, _____, and _____.

Answer 5

epidermis, dermis, subcutaneous

Question 6

What does the epidermis protect from?

Answer 6

• water
• dust
• microorganisms
• mechanical stress

Question 7

What layer of skin are the vessels located in?

Answer 7

dermis

Question 8

What is the purpose of collagen in the skin?

Answer 8

• gives strength to skin
• resistance to breakage

Question 9

Fill in the blank.

_____ gives elasticity to skin.

Answer 9

Elastin

Question 10

What are the structures that can be found within the dermis?

Answer 10

• nerves
• vessels
• sweat glands
• hair follicles
• sebaceous gland

Question 11

Fill in the blank.

The tissue layer beneath the dermis is the ______.

Answer 11

subcutaneous

Question 12

What are skin tension lines?

Answer 12

Tautness of skin that varies throughout the body.

Question 13

Define:

closed wound

Answer 13

Soft tissues injured beneath the surface without breaking the epidermis.

E.g. contusion

Question 14

Define:

open wound

Answer 14

Disruption of the skin.

Ex: Abrasions, lacerations, bites, impaled objects

Question 15

What can result from a crush injury?

Answer 15

Compartment Syndrome

Question 16

How does compartment syndrome affect metabolism?

Answer 16

Anaerobic metabolism occurs because arterial flow and oxygenated blood are cut off, creating pyruvic acid.

Question 17

List the five steps in wound healing.

Answer 17

1. Hemostasis
2. Inflammation
3. Epitheliazation
4. Neovascularization
5. Collagen synthesis

Question 18

Define:

hemostasis

Answer 18

Bleeding stops because of the clotting cascade.

Question 19

Define:

inflammation

Answer 19

White blood cells moves to an injured site and repairs/kills pathogens that have entered the area.

Question 20

Define:

epithelialization

Answer 20

Epithelial cells move up to the damaged epithelial cells.

Question 21

Define:

neovascularization

Answer 21

Formation of new blood vessels.

Question 22

What are some high-risk wounds for infections?

Hint: bite

Answer 22

human and animal bite

Question 23

What should you do with an impaled object in a patient?

Answer 23

Do not remove.

Question 24

What are the signs/symptoms of infection on the skin?

Answer 24

• erythema
• pus
• warmth
• edema
• discomfort

Question 25

What anaerobic, toxin-producing **bacterium** is responsible for **gangrene**?

Answer 25

Clostridium Perfringens

Question 26

What are the **signs/symptoms** of **tetanus**?

Answer 26

* lock jaw * stiff neck ## Footnote Progressive stiffness throughout the body.

Question 27

# Define: Necrotizing Fasciitis | Flesh-eating disease

Answer 27

**Death of tissue** from **bacterial infection**.

Question 28

# Treatment: closed wounds ## Footnote Hint: I-C-E-S

Answer 28

* Ice/Cold Packs * Compression * Elevate * Splint

Question 29

# Define: Rhabdomyolysis

Answer 29

Damaged muscles release myoglobin into the bloodstream.

Question 30

# Fill in the blank. The tissue **beneath** the **subcutaneous** layer is called the \_\_\_\_ \_\_\_\_.

Answer 30

deep fascia

Question 31

What **bacteria** is commonly responsible for **Necrotizing Fasciitis**?

Answer 31

Staphylococus Auerus

Question 32

# Treatment: open wounds

Answer 32

* control bleeding * keep clean * irrigation, if contaminated

Question 33

# Treatment: neck lacerations

Answer 33

occlusive dressing

Question 34

When treating, dressing, or stabilizing a hand/wrist injury, in **what position** should the hand be placed?

Answer 34

position of function ## Footnote Place a gauze roll in the hand.

Question 35

# Treatment: abrasion

Answer 35

**Cover** lightly with sterile dressing.

Question 36

# Treatment: laceration

Answer 36

* direct pressure * dressing * tourniquet, if severe

Question 37

# Treatment: impaled objects

Answer 37

* Do **not** remove. * **Bleeding control** with compression. * Do **not** shorten object unless cumbersome. * **Stabilize** with bulky dressing and immobilize if possible.

Question 38

# Treatment: avulsion of skin

Answer 38

* **Clean/irrigate** avulsed tissue. * **Place back** in anatomic position. * **Cover** with dry sterile dressing.

Question 39

How do you transport an **amputated** body part?

Answer 39

* rinse debris * wrap part in loose saline-moistened gauze * seal in bag * place in cool container

Question 40

# Treatment: Crush Syndrome

Answer 40

* Obtain IV access prior to removal. * Use Normal Saline. * Administer Sodium Bicarbonate. * Administer Mannitol. * Administer 25G D₅₀ with 10 IU Insulin. * Administer Calcium (only if dysrhythmias are present).

Question 41

What is the **urine output** goal for a patient with **crush syndrome**?

Answer 41

300 ml/hr