Path-Physical Injuries
Terms
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- Abrasion
- superficial tearing of epidermis; rapid repair; heal w/o scarring
- Contusion
- collection of blood extravascularly; damage depends on location
- Hematoma
- collection of blood under skin
- Laceration
- sloppy cut (do not confuse with incision- intentional)
- avulsion
- tearing away of a large chunk of tissue
- Fracture
- bone OR rupture of outer membrane of body organ (eg. liver)
- Puncture
- small round holes in the skin
- Blast injuries
-
(sudden increase or decrease in P)—can result in traumatic death
Air blast: P waves enter body orifices (lungs/GI tract can explode)
Water blast: same thing, but need less F in an explosion to cause same amt of damage as an air blast
Immersion blast: P waves act on body surfaces - Caisson’s disease (decompression sickness):
-
the bends & the chokes
Nitrogen or helium gas breathed under high P, rapid decompression, gaseous emboli in blood; ISCHEMIC NECROSIS(in brain, heart, etc) - Frostbite
-
- severe hypothermia (acute- freezing temps)
- damage from hypoxia & membrane rupture (cells freeze) - Trench foot
- prolonged exposure to cold (chronic- non-freezing temps)
- Cold- localized injury--Mechanism
-
vasoconstriction of periph capillaries in R. to cold
Prolonged vasoconstriction: ischemic damage to mm and nn
Vasomotor paralysis: capillary dilation & congestion: erythema
Endothelial cell damage; fluid loss (transudate), blistering
Thrombi, occluded vessels, ischemic necrosis, gangrene All happens in few hours w/ frostbite - 1st degree burn
- sunburn; erythema, some edema, some necrotic area; no scarring
- 2st degree burn
-
does not involve adnexal structures (sweat glands, etc)
blistering; erythema & edema; maybe scarring - 3rd degree burn
- full thickness burn of dermis & epidermis; involves adnexal structures; exudates not contained- common complication of infection of exudates: scarring common
- Escar
- tissue as a result of burns; attempt by the body to seal off the body
- Tx of Burns
-
skin grafts (from ano area of person’s body, from cadaver, from lab)
Complication: abnormal scarring: viscious cicatrisation - Body can be divided into _____ trunks to describe how much of body burned
- 9%
- Heat cramps:
- dehydration (in conc in electrolytes causes cramping)
- Heat exhaustion:
- mm exhausted from cramping (from heat cramps)
- Heat pyrexia (heat stroke):
- dehydration; next step after heat exhaustion; heat goes to brain; metabolism can func at that temp- pass out
- Malignant hyperthermia
- Individual lacking an enzyme needed to metabolize some gaseous inhalants used during anesthesia --increased body temperature during surgery
- Electrical Injury
-
Burns at site of entry and exit; damage depends on pathway takes through body
If electricity runs through areas of ï‚ conductivity (heart, etc): can be fatal
If runs through areas of high resistance, get burns - 2 forms of Ionizing Radiation Injury
- Electromagnetic Rays or Charged Particles
- Ionizing Radiation Injury
-
-Transfers e to cells and hits DNA
-Radioresponsiveness of cells differ, higher in in cells with higher mitotic activity
-Exposure: varies w/ how close you are to the site of radiation - Results of Ionizing Radiation Injury
-
Hematopoietic syndrome: Low radiation doses; mild decrease of bone marrow and blood cells
GI syndrome: erosion and ulceration of GI mucosa
Cerebral syndrome: high dose of radiation; convulsions, coma, death - Ionizing Radiation used as treatment for ________
- neoplasms
- Mechanism of Ionizing Radiation Injury
-
--Cell changes: Nucleus swells (or in severe damage shrinks); vacuoles form; mitos become disorderly.
Vascular changes: Early: vascular dilation: see focal areas of necrosis in blood vessels
Late: vessel has scarring in medial areas—fibrosis & adhesions
Ectatic vessels