Soft Tissue Trauma Flashcards Preview

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Flashcards in Soft Tissue Trauma Deck (36):
1

Skin

Largest organ of the human body

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Blunt Injury

Injury when energy exchange between the patient and an object is more than the tissues can handle

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Soft tissue trauma

Blunt, penetrating and burns
LEADING FORM OF INJURY

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SKIN

Protects underlying tissue. Temp regulation. Prevents water loss. Sensory organ for brain.

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Two layers

Epidermis and Dermis

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Epidermis

Five Layers
-Stratum Corneum top layer that constantly sheds. And four living layers beneath that give rise to the top layer

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Melanin granules

Melanocytes: proportional to the darkness of ones skin

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Dermis

-Tough, highly elastic.
-Made of collagen fibers, elastic fibers and gel. Fibroblasts: secrete collagen, elastin and ground substance, found within Dermis.

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Collagen

Fibrous protein that give high strength to skin and resistance to breakage.

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Elastin

Give elasticity to skin

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Ground Substance

Gives skin resistance to compression using gel

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Dermis Divided

Papillary Dermis: vasculature, provides nutrients to epidermis and thermoregulation
Reticular Layer: dense, irregular connective tissue, gives strength and elasticity

13

Marcophages and Lymphocytes

Also found within the dermal layer. Part of inflammatory process and combat microogranisms
-when pathogen enters Dermis, macrophages and lymphocytes destroy the microorganism and signal other cells to migrate to the area.

14

Mast cells

Physical injury causes them to synthesize special chemical mediators increasing blood flow resulting in redness and warmth

15

Cells within dermis

Nerve endings
Blood vessels
Sweat glands
Hair follicles
Sebaceous glands

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Sub Q layer

Blood vessels, hair and nerves

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Skin Tension Lines

Tautness of skin varied in different regions of skin

18

Closed wound

Soft tissues beneath skin surface are damaged but does not break epidermis

19

Open Wound

Disruption of the skin. Abrasions, lacerations, bites, impaled objects

20

Crush Injury

Crushed between two solid objects

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Compartment Syndrome

Develop in crush injuries. Anaerobic metabolism occurs because arterial flow and oxygenated blood is cut off from an extremity creating pyruvic acid

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Wound Healing

Hemostasis
Inflammation
Epitheliazation
Neovascularization
Collagen Synthesis

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Hemostasis

The bleeding stops via clotting cascade

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Inflammation

White blood cells and others move to injured site to begin repair and kill invading pathogens that have infiltrated exposed area.
Chemotactic chemicals are released and signal repairing cells to migrate to the site of injury.
Granulocytes and Macrophages engulf bacteria through phagocytosis which involves ingesting the bacteria
Mast Cells release histamine. Histamine causes dilation of blood vessels increasing blood flow and causes redness and warmth.
Histamine makes capillaries more permeable causing fluid to leak out and result in swelling.

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Epithelialization

When new epithelial cells are moved to damaged ones. Bottom four layers of skin produce more epithelial cells.

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Neovascularization

New blood vessels form as the body attempts to bring oxygen and nutrients to the injured tissue.

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Collagen Synthesis

Tough, fibrous protein found in scar tissue, hair and bones. Synthesized by fibroblasts that move to damaged area.

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High Risk Wound

Human and Animal Bite
-warm and moist mouth invites bacteria and microogranisms

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Impaled

Do not remove unless interfering with airway

30

Infection

Clues: erythema, pus, warmth, Edema, and discomfort

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Gangrene

Clostridium Perfringens is an anaerobic toxin producing bacterium that leads to gangrene. Produces foul smelling gas.

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Tetanus

Infection caused by anaerobic bacterium, Clostridium Tetani. (Same family as gangrene). Causes body to produce potent toxin that results in painful muscle contractions strong enough to fracture bones. May first experience "lock jaw" and neck.
-booster needed every 10 years. Inoculation given to patients injured and haven't had it within past 5 years.

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Necrotizing Fascititis

Death of tissue from bacterial infection. Caused by Staphylocoulus Aureus.

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Irrigate wounds

Use Normal Saline. If a wound continues to bleed with dressing, apply more and consider tourniquet use

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Rhabdomyolysis

When muscles are crushed beyond repair, tissue necrosis develops and releases harmful products

36

Smiling Death

The entrapped person is conversing and okay. When freed almost instant cardiac arrest
IV access before removing object
Saline ONLY given. LR has potassium.
Use BiCarb for alkalizing hyperkalemia and metabolic acidosis
Mannitol for too much fluid
*IF PRETREATMENT NOT POSSIBLE, APPLY TQ TO SLOW DOWN REPERFUSION****
D10 with insulin. Uptake of insulin will also uptake potassium
Albuterol for hyperkalemia