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Flashcards in 1] Evaluation And Intervention Deck (152):
1

8 functions of the skin

Protect from infection
Conserve body fluids
Temp regulation
Excretion
Secretion
Produce Vit D
Appearance
Sensation

2

3 layers of the skin

Epidermis
Dermis
Hypodermis (subcutaneous)

3

Epidermis has how many layers?

5

4

What are the 5 layers of the epidermis?

Stratum corneum (outer)
Stratum lucidum
Stratum granulosum
Stratum spinosum
Stratum basale (inner)

5

Outermost layer of the skin

Epidermis

6

Thickness of eye lids

.05 mm

7

Thickness of palms/soles

1.5 mm

8

4 cells in epidermis

Melanocytes
Langerhan cells
Merkel cells
Keratinocytes

9

Produce melanin, a pigment that contributes to skin color & absorbs UV light to
protect DNA from damage.

Melanocytes

10

Participate in immune responseby fighting various microbes that invade the skin.

Langerhan cells

11

Sensory receptor cells that areresponsible for sensation of touch.

Merkel cells

12

Produce keratin, a tough protectiveprotein that protects skin & creates water repellent
seal.

Keratinocytes

13

Deepest layer of the epidermis

Stratum basale

14

Divides continuously
Contains stem cells which continually divide & push
new cells to surface.

Stratum basale

15

Contains melanocytes and merkel cells

Stratum basale

16

Thickest layer of the skin

Stratum spinosum

17

Prickle cells interlock and support skin

S. Spinosum

18

Involved in transfer of substances in and out of body

S spinosum

19

Has basal cells and langerhan cells

S spinosum

20

Which layer initiates keratinization?

S granulosum

21

How on does keratinization take?

4 weeks

22

? produce ?, a tough protectiveprotein that makes up the majority of the
structures of the skin, hair, and nails

Keratinocytes
Keratin

23

What happens as kcytes move through the stratum granulosum and lucidum ?

They enlarge, flatter and adhere together

24

What happens at the end of keratinization?

Cells fuse together into tough durable material that continues to surface to the skin

25

Appears only in thethicker areas of the skin, i.e. fingertips, palms, and soles

S lucidum

26

Comprised of dead keratinocytes &
protects against UVrays.

S lucidum

27

10-30 layers of continuously shedding dead
keratinocytes which are replaced from below

S corneum

28

Lipids help seal these dead cells together to form a barrier to keep water out/in.

S corneum

29

Shedding process is how many days in the young?

26-30

30

Shredding process is how many days in the elderly?

42-50 days

31

3 functions of the dermis

Regulate temperature
Give dermis nutrients saturated with blood
Store water

32

2 layers of the dermis

Papillary
Reticular

33

Thin arrangement of collagen fibers

Papillary layer of dermis

34

How is the papillary layer connected to the epidermis?

Via papillae

35

Sensory touch receptors in the papillary layer

Meissners corpuscle

36

Contains thick collagen fibers arranged parallel to skin surface

Reticular layer

37

Reticular layer contains what corpuscles that do?

Pacinian corpuscles that are sensory receptors for deep pressure

38

What two things in the dermis do you need to help your healing tissue be strong?

Collagen and elastin

39

Supply nutrients and oxygen to the skin
Takes away cell waste and cell products
Transports vitamin D produced in the skin to the rest of the body
Constricts and dilates to aid with temperature regulation

Functions of blood vessels

40

Bathes the skin tissues withlymph, a substance that
contains infection-fighting
cells of the immune system

Lymph vessels

41

Attempt to destroy any
infection or invading
organisms as the lymph
circulates to lymph nodes

Lymph vessels

42

Average person has approximately 3 million of these

Sweat glands

43

3 types of sweat glands

Apocrine
Eccrine
Sebaceous

44

Found only in armpits, areolae of nipples andgenital regions

Apocrine sweat glands

45

Larger, deeper and produce thicker secretionsthan eccrine glands

Apocrine sweat glands

46

Become active at puberty

Apocrine sweat glands

47

Found over the entire body
Collect ducts deep in skin that connect to surface

Eccrine glands

48

Sweat is a mix of ?

99% water and 1% salt and fats

49

These glands secrete sweat and regulates body temp

Eccrine glands

50

Secrete oils that keep skinsupple and smooth,
waterproofs, protects from overgrowth of
bacteria/fungus

Sebaceous sweat glands

51

Empties via ducts into base of hair follicle
Secretes sebum

Sebaceous glands

52

What is sebum?

Mixture of fats, waxes and hydrocarbons

53

Collagen is for ?
Elastin is for?

Durability
Flexibility

54

Protein is made by

Fibroblasts

55

Supports epidermis by giving durability

Collagen

56

Similar protein that keeps skin flexible

Elastin

57

Nerve endings contain

Pain and touch receptors

58

Smooth muscle attached to hair follicle

Erector pilli muscles

59

Has blood vessels, nerves, lymph, hair follicles also cross into this layer

Hypodermis/subcutaneous layer

60

How do epidermis and dermis heal?

Regeneration

61

How does everything else besides epidermis and dermis heal?

Repair

62

What is regeneration

Tissue is replaced with like tissue

63

What is repair?

Scar formation; tissues repair by “filling in” with scar tissue

64

What phase is 4 -6 days in normal healing?

Inflammatory phase

65

How long does normal healing usually take?

2 -4 weeks

66

Purpose:
 Body reacts to the wound and sets the process of healing in motion
 Clear away dead cells and bacteria

Inflammatory phase

67

Hemostasis is?

Inhibiting oxygen of surrounding tissue

68

What is a vascular response?

Local transient vasoconstriction in response to the injury

69

What’s released during vascular response?

Platelets, leukocytes, erythrocytes

70

Vascular response is mediated by ? And prolonged by. ?

Mediated by norepinephrine and prolonged by serotonin

71

Vasodilation occurs when

Bradykinin and histamine are released from damaged tissue

72

Begin to digest bacteria and become part of the exudate
Cells consist of neutrophils, eosinophils, and basophils

Polymorphonuclear granulocytes

73

Give rise to macrophages, lymphocytes and platelets

Mononuclear granulocytes

74

Main function of macrophages

Phagocytosis

75

Angiogenesis begins with

Macrophages

76

4 chemical mediators

Histamine
Serotonin
Kinins
Prostaglandins

77

Phase is 4/6 to 21 days

Proliferation phase

78

4 stages of proliferation phase

Re-epithelialization
Fibroblasts
Neovascularization
Contraction

79

Recreating permeability barrier

Re-epithelialization

80

Replacement and reinforcement of new tissue (granulation tissue)

Fibroplasia

81

New blood supply

Neovascularization

82

Decreasing wound size

Contraction

83

Migration of epithelial cells across a wound
Basement membrane forms

Re-epithelialization

84

Dermal fibroblasts change into myofibroblastsand migrate into the wound and makes collagen

Fibroplasia

85

Process that occurs as the wound closes due to the loss of tissue
Begins approx the 5th day

Contraction

86

Movement of pre-existing tissue toward thecenter – NOT the formation of new tissue

Contraction

87

Which phase is 21 days to 2/3 years

Maturation/remodeling phase

88

Phases of healing

Inflammatory
Proliferation
Maturation/remodeling

89

Tensile strength will reach about 70-80% of original tissue by week 12

Maturation/remodeling phase

90

Collagen and elastin form in this phase

Maturation/remodeling phase

91

What’s a prediction of wound healing?

If the surface area decreases by 39% at 2 weeks- has better chance of healing

92

If phases of healing and sequence of events occur in an orderly fashion, wounds are
considered

Acute

93

If wounds fall out of the orderly healing
cascade of events, wounds are considered

Chronic

94

Acute wounds usually happen as a result of

Trauma or surgery

95

Abrasions are

Acute

96

Avulsions are

Acute wounds

97

Crush wounds

Acute

98

Burns

Acute

99

Cuts and lacerations

Acute

100

Missile wounds

Acute

101

Punctures

Acute

102

Caused by tangential shearing of skin by a rough surface

Abrasions

103

Most commonly caused by road surface during MVA “road rash”

Abrasions

104

What’s degloving?

Avulsions

105

Caused when a portion of the skin is
caught on a sharp object while the body is moving away from the object and a flap of skin is removed

Avulsions

106

Most commonly occurs in industrial
settings with rotary tools or with ejectionsfrom a motor vehicle

Avulsions

107

Most common injuries are getting
fingers caught in a closing door or feet run over by car.

Crush wound

108

Occurs when a heavy object falls onto a
portion of a person’s body, splits the skin andmay even shatter or tear underlying
structures.

Crush wounds

109

sharp pieces of bone penetrate and tear surrounding soft tissue &skin which created an open wound

Open fracture

110

Most likely to occur with high energy injuries,
more superficial bones, and among the elderly.

Open fracture

111

Characterized by a
slice wound created by a sharp object
which leaves
straight/even edges

Cuts/incisions

112

3 basic mechanisms of injury for lacerations

Shearing
Tension
Compression

113

Shearing

Small amount of force on a small area which typically results in minimal cell injury due to the sharp
instrument

114

High amount of force at an angle with a blunt object which tears skin with significant tissue damage (i.e.grazing injury)

Tension MOI for laceration

115

High force at makes direct
perpendicular contact causing jagged/shredded wound edges and severe tissue damage (i.e. punch)

Compression MOI for laceration

116

High velocity projectiles (3000 ft/sec)
create negative pressure waves known as ? behind the bullet which
causes expansion & collapse of tissue and even further damage.

Cavitation

117

Deep & narrow wounds created by sharp objects such as nails, knives, or animal
teeth

Puncture wounds

118

6 types of burns

Flame
Scald
Contact
Electrical
Chemical
Frostbite

119

Scald burn

Boiling water or steam

120

Contact burn

Hot surface like stove or tar

121

Electrical burn

Live wires or lightning

122

Chemical burn

Acids, basics or caustic materials

123

Frostbite burns

Excess cold

124

Fell off the healing cascade due to prolonged Inflammatory phase

Chronic wounds

125

Require topical therapies and appropriate supportive therapies

Chronic wounds

126

4 examples of chronic wounds

Arterial, venous, pressure, neuropathic ulcers

127

Wound environment consists of what 3 things

Moisture
Necrotic tissue
Wound temperature

128

Any insult to the wound that may delay orinterrupt healing process

Trauma

129

What does continuous pressure to a wound do?

Interrupts blood supply and delays healing

130

Aging process increases which phase and decreases which phase?

Increases inflammatory phase
Decreases maturation phase

131

Superficial wounds are in the

Epidermis

132

Partial thickness wounds are in the

Dermis

133

Full thickness wounds are in the

Hypodermics or muscle, tendon, bone

134

Stage 1 pressure injuries

Superficial wound

135

Contusions or bruises

Superficial wounds

136

Stage 3 pressure injuries

Partial thickness wound

137

Stage 3 and 4 pressure injuries

Full thickness wounds

138

Skin tears

Partial thickness

139

Venous wounds

Partial thickness

140

Lacerations and abrasions

Partial thickness wounds

141

Incontinence associated dermatitis

Partial thickness wound

142

Diabetic and arterial wounds

Full thickness wounds

143

3 types of wound prognosis

Healable
Maintenance
Palliative

144

What is healable prognosis?

The cause of the wound can be corrected or compensated with treatment

145

What is maintenance wound prognosis

Poor treatment adherence or lack of appropriate resources is the barrier to being healed

146

What is a palliative prognosis

Cause is not treatable

147

Coexisting medical conditions or drugs do not prevent healing

Healable

148

Goal of healable?

To promote wound healing

149

Coexisting medical conditions or drugs that may stall healing

Maintenance wound prognosis

150

Goal of maintenance wound prognosis

Prevent further deterioration or breakdown
Advocate for them
Promote adherence
Manage pain

151

Coexisting medical conditions prevent normal healing

Palliative wound prognosis

152

prevent further skin breakdown,
trauma, and infection; promote comfort; pain management

Goal of palliative wound prognosis