Med Trauma Week 2 Practice quiz

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Questions and Answers

What is the primary role of the epidermis in the skin?

Regulates body temperature

Serves as a barrier to infection (correct)

Connects skin to underlying tissues

Cushions the body from stress

Which phase of wound healing involves the formation of granulation tissue?

Remodeling Stage

Inflammation

Hemostasis

Proliferative Phase (correct)

Which layer of the skin is responsible for the sensations of heat and touch?

Subcutaneous Layer

Epidermis

Basement Membrane

Dermis (correct)

What is the main function of the basement membrane?

Separates epidermis from dermis Signup and view all the answers

What occurs during the hemostasis phase of wound healing?

Vessels constrict and bleeding is controlled Signup and view all the answers

What is NOT one of the main functions of the skin?

Production of hormones Signup and view all the answers

What type of collagen is most dominant in scar tissue after wound healing?

Type I collagen Signup and view all the answers

What best describes granulation tissue?

New connective tissue and microscopic blood vessels Signup and view all the answers

What is the primary cause of trench foot?

Prolonged exposure to wet conditions Signup and view all the answers

Which type of frostbite involves cold, hard, wooden skin?

Deep frostbite Signup and view all the answers

What complication arises from the combination of ice crystal formation and microvascular occlusion in frostbite?

Cellular dehydration and death Signup and view all the answers

Which group is most commonly affected by immersion foot?

The homeless population Signup and view all the answers

What should be done immediately for a patient suspected of having frostbite?

Remove the patient from cold/wet environment Signup and view all the answers

What is the primary reason that treatment for environmental soft tissue injuries is often inadequate?

Limited pre-hospital treatment and prevention strategies Signup and view all the answers

In which stage of injury is the area likely to have a crater-like appearance due to damage beneath the skin?

Stage 3 Signup and view all the answers

Which of the following best describes frostnip?

Mild tissue damage due to prolonged exposure to non-freezing cold Signup and view all the answers

What is a significant physiological risk factor for environmental soft tissue injuries?

Impaired peripheral or distal circulation Signup and view all the answers

Which skin condition is primarily associated with repeated exposure to cold and wet environments?

Chilblains Signup and view all the answers

Which stage of injury presents the highest risk of severe complications like infection?

Stage 4 Signup and view all the answers

What typical characteristics define non-freezing cold injuries (NFCIs)?

Possible significant disabilities requiring prompt medical attention Signup and view all the answers

Who is at the greatest risk of environmental soft tissue injuries?

Adult males aged 30-49 with behavioral risks Signup and view all the answers

What is a characteristic of closed wounds?

They often result in internal bleeding. Signup and view all the answers

Which type of wound is caused by a sharp or pointed object?

Punctures/Impaled Signup and view all the answers

What defines a Class IV surgical wound?

Open and infected with possible foreign objects. Signup and view all the answers

Why should never an impaled object be removed?

It can interfere with airway management or chest compressions. Signup and view all the answers

What injury result involves full thickness skin loss with non-approximatable edges?

Avulsion Signup and view all the answers

Which of the following is a sign that a wound may require hospital treatment?

Wound over a joint that opens when the joint is moved. Signup and view all the answers

What type of wound is characterized by a combination of puncture and crush injury?

Bite Signup and view all the answers

What is a primary risk factor for Class III contaminated wounds?

Open wounds with signs of obvious contamination. Signup and view all the answers

What characteristic is typical of hematomas?

Blood collects beneath the skin. Signup and view all the answers

Which of these is typically associated with a gunshot wound?

Assess for both entrance and exit wounds. Signup and view all the answers

What is the primary purpose of inflammation in response to injury?

To localize and remove injurious agents Signup and view all the answers

Which phase occurs first in the inflammatory response?

Acute Phase Signup and view all the answers

Passive immunity in neonates is primarily derived from which source?

Antibodies transferred from mother Signup and view all the answers

Which type of immunity involves antibodies produced within the individual's own body?

Acquired Immunity Signup and view all the answers

What are antibodies produced by in the immune system?

B-cells Signup and view all the answers

What does the Complement System enhance in the immune response?

Ability of antibodies and phagocytic cells Signup and view all the answers

Which antibody is most commonly found in the body?

IgG Signup and view all the answers

During which phase of inflammation does tissue rebuilding occur?

Proliferation Phase Signup and view all the answers

In cell-mediated immunity, which type of cells primarily identifies and attacks infected cells?

T-cells Signup and view all the answers

Which of the following is a characteristic sign of inflammation?

Swelling (tumor) Signup and view all the answers

Study Notes

Inflammatory Response

Inflammation is an adaptive mechanism to disease or injury, but may cause negative effects if excessive or prolonged.
Its primary function is to contain and eliminate injurious agents while facilitating blood flow and immune cell access to the affected site.
Triggers for inflammation include physical injuries (cuts, extreme temperatures), chemical exposure (acids and bases), ischemia, allergies, and infections.
Inflammation progresses through three basic stages:
- Acute Phase: Vasodilation increases blood flow; macrophages engulf pathogens.
- Proliferation Phase: Tissue rebuilding with collagen by fibroblasts.
- Remodeling Phase: Strengthening of repaired tissue.
Classic signs of inflammation include redness, swelling, pain, and warmth.

Immune Response

Immune responses are categorized into natural/passive immunity and acquired humoral immunity.
Passive immunity involves antibodies produced in another organism, such as maternal antibodies transferred during pregnancy.
Acquired immunity arises from direct exposure to pathogens or through vaccination.
Antibodies (IgG, IgM, IgA, IgD, IgE) are proteins produced by B-cells to fight specific pathogens, binding to antigens to promote their destruction.
IgG is the most common antibody; IgE is linked to allergic reactions.
Antigens trigger immune responses and can be harmful pathogens or non-pathogenic allergens.
The complement system enhances antibody and phagocyte function but does not adapt over time like antibodies.
Cell-mediated immunity is primarily facilitated by T-cells, which detect and eliminate infected or abnormal cells.

Anatomy of the Skin

The integumentary system is the body's outermost organ layer, comprising the skin and auxiliary structures (hair, nails).
Skin represents 12-15% of total body weight and serves three main functions: protection, regulation, and sensation.
The epidermis is the outer barrier; the basement membrane separates it from the dermis, containing cytokines and growth factors.
The dermis houses connective tissue and sensory receptors, while the subcutaneous layer connects skin to underlying tissues.
The skin provides a physical barrier, regulates temperature and water balance, and contains sensory receptors for touch, pain, and temperature.

Soft Tissue Injuries & Healing Process

Wounds disrupt tissue integrity; deeper injuries that reach muscle or organs are termed complicated wounds.
Phases of wound healing include:
- Hemostasis: Clot formation via blood vessel constriction and platelet aggregation.
- Inflammation: Chemical mediators induce swelling, controlling bleeding and preventing infection.
- Proliferation: Collagen deposition and granulation tissue formation promote tissue repair.
- Remodeling: Collagen type transitions occur, finalizing skin repair with scarring.

Wound Classification

Closed wounds arise from blunt trauma, typically involve less external bleeding:
- Contusions involve vessel disruption beneath the epidermis.
- Hematomas are blood collections under the skin.
- Abrasions are partial thickness injuries with skin scraping.
Open wounds result from blunt or penetrating trauma, often with significant bleeding or risk of infection:
- Lacerations are skin tears or splits.
- Punctures occur from sharp objects; avoid removing impaled objects unless necessary.
- Gunshot wounds may present unpredictably; assess entrance and exit.
- Injection injuries introduce substances into the body.
- Avulsions result in full-thickness skin loss, often in extremities.
- Degloving injuries involve skin detachment from underlying tissue.
- Amputations are complete or partial limb losses.
- Bites may present various injury types and have high infection risk.

Surgical Wound Classifications

Wounds are classified based on infection risk:
- Class I (Clean): No infection signs; closed wounds.
- Class II (Clean-Contaminated): Clean with organ entry but no significant spillage.
- Class III (Contaminated): Open wounds with visible contamination.
- Class IV (Dirty/Infected): Open wounds, potentially infected with debris.

Wounds Requiring Hospital Treatment

Significant wounds include:
- Depth over 6mm/0.25in or length over 19mm/0.75in, especially with jagged edges.
- Deep wounds involving fat, muscle, or bone.
- Wounds over a joint may require surgical intervention for proper healing.
Important care strategies include routine repositioning, skin care, and nutrition support to prevent complications.

Environmental Soft Tissue Injuries

Two categories: Non-freezing cold injuries (NFCI) and frostbite, with frostbite being more severe.
NFCIs can cause significant disability; common in adults aged 30-49 due to behavioral risk factors.
Frostnip is the mildest form, resulting from prolonged cold exposure without freezing.
Chilblains develop due to repeated exposure to cold and wet conditions, leading to tissue damage.
Trench foot arises from extended wet conditions causing tissue edema and possible injury.
Frostbite manifests severe tissue loss and risks long-term disability; treatment should focus on warming and revascularization.

Frostbite Assessment

Skin appearance ranges from mild blanching in frostnip to hard, necrotic skin in deep frostbite.
Immediate action includes removing the patient from cold environments and monitoring for signs of severe cold exposure and internal injury.

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