1] Evaluation And Intervention Flashcards
1
Q
8 functions of the skin
A
Protect from infection Conserve body fluids Temp regulation Excretion Secretion Produce Vit D Appearance Sensation
2
Q
3 layers of the skin
A
Epidermis
Dermis
Hypodermis (subcutaneous)
3
Q
Epidermis has how many layers?
A
5
4
Q
What are the 5 layers of the epidermis?
A
Stratum corneum (outer) Stratum lucidum Stratum granulosum Stratum spinosum Stratum basale (inner)
5
Q
Outermost layer of the skin
A
Epidermis
6
Q
Thickness of eye lids
A
.05 mm
7
Q
Thickness of palms/soles
A
1.5 mm
8
Q
4 cells in epidermis
A
Melanocytes
Langerhan cells
Merkel cells
Keratinocytes
9
Q
Produce melanin, a pigment that contributes to skin color & absorbs UV light to
protect DNA from damage.
A
Melanocytes
10
Q
Participate in immune responseby fighting various microbes that invade the skin.
A
Langerhan cells
11
Q
Sensory receptor cells that areresponsible for sensation of touch.
A
Merkel cells
12
Q
Produce keratin, a tough protectiveprotein that protects skin & creates water repellent
seal.
A
Keratinocytes
13
Q
Deepest layer of the epidermis
A
Stratum basale
14
Q
Divides continuously
Contains stem cells which continually divide & push
new cells to surface.
A
Stratum basale
15
Q
Contains melanocytes and merkel cells
A
Stratum basale
16
Q
Thickest layer of the skin
A
Stratum spinosum
17
Q
Prickle cells interlock and support skin
A
S. Spinosum
18
Q
Involved in transfer of substances in and out of body
A
S spinosum
19
Q
Has basal cells and langerhan cells
A
S spinosum
20
Q
Which layer initiates keratinization?
A
S granulosum
21
Q
How on does keratinization take?
A
4 weeks
22
Q
? produce ?, a tough protectiveprotein that makes up the majority of the
structures of the skin, hair, and nails
A
Keratinocytes
Keratin
23
Q
What happens as kcytes move through the stratum granulosum and lucidum ?
A
They enlarge, flatter and adhere together
24
Q
What happens at the end of keratinization?
A
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
