Question 1

The first stage of wound healing is:

Accepted Answer

The first stage of wound healing is hemostasis, which involves the formation of a blood clot to stop bleeding.

Question 2

You are called to a commercial creamery, where an employee got his arm trapped in the ice cream mixing machinery. You note that the skin has been pulled off his hand and arm from the mid forearm down. The patient's muscles, tendons, and bones are exposed. This type of injury is a(n):

Accepted Answer

In a degloving injury, the skin and underlying tissue are stripped away from the underlying structures, which is the case in this scenario where the employee's skin has been pulled off his hand and arm. An amputation involves the complete removal of a body part, while a skinning injury typically refers to a less severe injury where a portion of the skin is torn or scraped off. A crush injury involves compression of a body part, which may or may not result in skin and tissue damage. Therefore, the best choice in this scenario is C) degloving injury.

Question 3

For most open soft tissue wounds managed by the paramedic in the prehospital setting, which of the following is a desirable characteristic of the dressing applied?

Accepted Answer

A desirable characteristic of a dressing for most open soft tissue wounds is to keep the wound dry. This helps prevent bacterial growth and infection. The other options, occlusive, adherent, and nonabsorbent, may not be appropriate for all wounds and may impede healing.

Question 4

Which of the following statements about crush injuries is most accurate?

Accepted Answer

The actual source of bleeding in crush injuries may be hard to identify as the injury can cause damage to deep tissue and blood vessels, leading to internal bleeding that may not be easily noticeable. A, C, and D are inaccurate as crush injuries can be either closed or open injuries, spongy sensation on palpation may not always be present, and deformity is not always present in crush injuries.

Question 5

In which type of soft tissue injury is the skin cut or torn, leaving a flap of skin attached?

Accepted Answer

An avulsion is a type of injury where the skin is torn and a flap of skin is left, which can sometimes be partially or completely detached from the body.

Question 6

The tough, fibrous sheaths that bundle skeletal muscle are called:

Accepted Answer

The tough, fibrous sheaths that bundle skeletal muscle are called fascia. Tendons attach muscles to bones, fibers make up the individual cells within the muscle, and sarcolemma is the membrane that surrounds the muscle cell.

Question 7

Your patient is a 19-year-old man who received a penetrating knife wound to his chest. On your arrival, he is lying supine with a visible chest wound that is bleeding slightly. You can hear the sucking sound of air moving in and out of the wound. This wound is best managed with:

Accepted Answer

A penetrating wound to the chest that is causing air to leak into the pleural space is indicative of a tension pneumothorax, a life-threatening condition that requires immediate intervention. An occlusive dressing sealed on three sides and open on the fourth will help to prevent further air from entering the pleural space while still allowing for air to escape during exhalation. It is important to avoid using bulky dressings or adherent bandages as these may worsen the tension pneumothorax. A sterile, wet dressing is not indicated as it will not effectively seal the wound and may lead to further air entry.

Question 8

A nonpenetrating injury caused by blunt trauma that damages blood vessels, causing pain and discoloration, is a(n):

Accepted Answer

A contusion is a nonpenetrating injury caused by blunt trauma that damages blood vessels, causing pain and discoloration. Ecchymosis refers to the discoloration of the skin caused by bleeding underneath, which is a symptom of a contusion. Strain refers to muscle or tendon damage, and abrasion refers to a scraping of the skin.

Question 9

In which of the following ways does the integumentary system prevent pathogens from entering the body?

Accepted Answer

The integumentary system provides a physical barrier to the environment, preventing pathogens from entering the body.

Question 10

Which of the following medications may be indicated in the treatment of a patient with a crush injury?

Accepted Answer

Sodium bicarbonate is used in crush injuries to alkalinize the urine and prevent myoglobin-induced renal damage.

Question 11

You are assessing an assault victim and note a contusion over the abdomen. Which of the following should you remember while caring for this patient?

Accepted Answer

A contusion to the abdomen should always increase your index of suspicion for underlying injury. While a contusion over a critical area, such as the spleen or liver, could be serious, even a contusion to a non-critical area could be an indication of underlying injury. Therefore, it is important to investigate further and maintain a high index of suspicion for potential injuries. The absence of rigidity or distension does not definitively rule out serious injury, and the significance of the trauma cannot always be determined by the amount of pain the patient experiences on palpation.

Question 12

Which of the following are likely to accumulate in the bloodstream following a large crush injury?

Accepted Answer

A large crush injury can lead to the release of myoglobin, potassium and lactic acid from damaged muscle tissue. Myoglobin can accumulate in the bloodstream and cause kidney damage, while high levels of potassium can also be harmful to the body. Lactic acid can contribute to metabolic acidosis. Therefore, all of the above are likely to accumulate in the bloodstream following a large crush injury.

Question 13

You arrive on the scene of a patient with severe blunt trauma to the face. You hear gurgling as you approach the patient. After opening the airway with a manual maneuver, what should your next action be?

Accepted Answer

Suctioning is the next step after opening the airway in a patient with gurgling sounds, as it indicates the presence of blood, vomit, or other fluids that can obstruct the airway. Clearing the airway is a priority to ensure the patient can breathe.

Question 14

You have responded for an injured person at an address you know to be a motorcycle clubhouse. Your patient was attacked by another party with a broken beer bottle. Your patient has a large laceration on her neck with moderate bleeding. Which property of your dressing material is most important in caring for this patient?

Accepted Answer

The answer of You have responded for an injured person...

Question 15

Your patient is a 35-year-old man who has his leg trapped under a section of concrete from an industrial accident. While awaiting removal of the concrete, which type of IV fluid is indicated for administration to this patient?

Accepted Answer

Normal saline is the preferred IV fluid for initial resuscitation in trauma patients, as it helps to maintain blood pressure and volume until definitive care can be provided.

Question 16

The layer of skin that contains adipose tissue is the ________ layer.

Accepted Answer

The subcutaneous layer, also known as the hypodermis, is a layer of adipose (fat) tissue located beneath the dermis.

Question 17

Which of the following is best described as the accumulation of a pocket of blood in the tissues?

Accepted Answer

A hematoma is a localized collection of blood outside of vessels within the tissues. It usually occurs due to trauma, injury, or surgery.

Question 18

Your patient is an 18-year-old man who stepped on a nail in the barnyard. The nail penetrated his tennis shoe and punctured his foot. On your arrival, the patient has removed the nail and the shoe. The wound is about 2 mm in diameter with minor bleeding that has been controlled. The skin around the wound is red. The patient does not want to be transported but asks if you can give him "some ointment and a Band-Aid." You should explain to the patient that this type of injury is associated with an increased risk of:

Accepted Answer

Puncture wounds, especially those caused by dirty objects like nails, are at a high risk for infection due to the introduction of bacteria deep into the tissue. Despite the small size of the wound, it is important for the patient to seek medical attention to prevent complications such as tetanus or a more serious infection. A Band-Aid and ointment alone will not suffice as proper wound care.

Question 19

The acute breakdown of muscle fibers in crushing injury is called:

Accepted Answer

Rhabdomyolysis is the acute breakdown of muscle fibers that can occur in crushing injuries, causing the release of myoglobin into the bloodstream. Choice A (myoglobinemia) is related to the release of myoglobin but not specific to crushing injuries. Choice B (sarcoidosis) is not related to muscle breakdown or crushing injuries. Choice C (rouleaux formation) is a phenomenon where red blood cells stack on top of each other, which is not related to muscle breakdown.

Question 20

When caring for an amputated part, which of the following principles apply?
1) Place the unwrapped part in a dry plastic bag, and seal it.
2) Place the part in a plastic bag with the part wrapped in gauze moistened with lactated Ringer's solution or normal saline, and seal it.
3) Always transport the part with the patient.
4) Keep the part moist, and place it in a container of cold water.
5) Keep the part dry, and place it in an ice-filled container.

Accepted Answer

The correct answer is 2, 4. The amputated part should be placed in a plastic bag with the part wrapped in gauze moistened with lactated Ringer's solution or normal saline, and sealed. The part should be kept moist and placed in a container of cold water.

Quiz 4: Soft Tissue Trauma