Flashcards in 1] Evaluation And Intervention Deck (152):
8 functions of the skin
Protect from infection
Conserve body fluids
Produce Vit D
3 layers of the skin
Epidermis has how many layers?
What are the 5 layers of the epidermis?
Stratum corneum (outer)
Stratum basale (inner)
Outermost layer of the skin
Thickness of eye lids
Thickness of palms/soles
4 cells in epidermis
Produce melanin, a pigment that contributes to skin color & absorbs UV light to
protect DNA from damage.
Participate in immune responseby fighting various microbes that invade the skin.
Sensory receptor cells that areresponsible for sensation of touch.
Produce keratin, a tough protectiveprotein that protects skin & creates water repellent
Deepest layer of the epidermis
Contains stem cells which continually divide & push
new cells to surface.
Contains melanocytes and merkel cells
Thickest layer of the skin
Prickle cells interlock and support skin
Involved in transfer of substances in and out of body
Has basal cells and langerhan cells
Which layer initiates keratinization?
How on does keratinization take?
? produce ?, a tough protectiveprotein that makes up the majority of the
structures of the skin, hair, and nails
What happens as kcytes move through the stratum granulosum and lucidum ?
They enlarge, flatter and adhere together
What happens at the end of keratinization?
Cells fuse together into tough durable material that continues to surface to the skin
Appears only in thethicker areas of the skin, i.e. fingertips, palms, and soles
Comprised of dead keratinocytes &
protects against UVrays.
10-30 layers of continuously shedding dead
keratinocytes which are replaced from below
Lipids help seal these dead cells together to form a barrier to keep water out/in.
Shedding process is how many days in the young?
Shredding process is how many days in the elderly?
3 functions of the dermis
Give dermis nutrients saturated with blood
2 layers of the dermis
Thin arrangement of collagen fibers
Papillary layer of dermis
How is the papillary layer connected to the epidermis?
Sensory touch receptors in the papillary layer
Contains thick collagen fibers arranged parallel to skin surface
Reticular layer contains what corpuscles that do?
Pacinian corpuscles that are sensory receptors for deep pressure
What two things in the dermis do you need to help your healing tissue be strong?
Collagen and elastin
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
Bathes the skin tissues withlymph, a substance that
cells of the immune system
Attempt to destroy any
infection or invading
organisms as the lymph
circulates to lymph nodes
Average person has approximately 3 million of these
3 types of sweat glands
Found only in armpits, areolae of nipples andgenital regions
Apocrine sweat glands
Larger, deeper and produce thicker secretionsthan eccrine glands
Apocrine sweat glands
Become active at puberty
Apocrine sweat glands
Found over the entire body
Collect ducts deep in skin that connect to surface
Sweat is a mix of ?
99% water and 1% salt and fats
These glands secrete sweat and regulates body temp
Secrete oils that keep skinsupple and smooth,
waterproofs, protects from overgrowth of
Sebaceous sweat glands
Empties via ducts into base of hair follicle
What is sebum?
Mixture of fats, waxes and hydrocarbons
Collagen is for ?
Elastin is for?
Protein is made by
Supports epidermis by giving durability
Similar protein that keeps skin flexible
Nerve endings contain
Pain and touch receptors
Smooth muscle attached to hair follicle
Erector pilli muscles
Has blood vessels, nerves, lymph, hair follicles also cross into this layer
How do epidermis and dermis heal?
How does everything else besides epidermis and dermis heal?
What is regeneration
Tissue is replaced with like tissue
What is repair?
Scar formation; tissues repair by “filling in” with scar tissue
What phase is 4 -6 days in normal healing?
How long does normal healing usually take?
2 -4 weeks
Body reacts to the wound and sets the process of healing in motion
Clear away dead cells and bacteria
Inhibiting oxygen of surrounding tissue
What is a vascular response?
Local transient vasoconstriction in response to the injury
What’s released during vascular response?
Platelets, leukocytes, erythrocytes
Vascular response is mediated by ? And prolonged by. ?
Mediated by norepinephrine and prolonged by serotonin
Vasodilation occurs when
Bradykinin and histamine are released from damaged tissue
Begin to digest bacteria and become part of the exudate
Cells consist of neutrophils, eosinophils, and basophils
Give rise to macrophages, lymphocytes and platelets
Main function of macrophages
Angiogenesis begins with
4 chemical mediators
Phase is 4/6 to 21 days
4 stages of proliferation phase
Recreating permeability barrier
Replacement and reinforcement of new tissue (granulation tissue)
New blood supply
Decreasing wound size
Migration of epithelial cells across a wound
Basement membrane forms
Dermal fibroblasts change into myofibroblastsand migrate into the wound and makes collagen
Process that occurs as the wound closes due to the loss of tissue
Begins approx the 5th day
Movement of pre-existing tissue toward thecenter – NOT the formation of new tissue
Which phase is 21 days to 2/3 years
Phases of healing
Tensile strength will reach about 70-80% of original tissue by week 12
Collagen and elastin form in this phase
What’s a prediction of wound healing?
If the surface area decreases by 39% at 2 weeks- has better chance of healing
If phases of healing and sequence of events occur in an orderly fashion, wounds are
If wounds fall out of the orderly healing
cascade of events, wounds are considered
Acute wounds usually happen as a result of
Trauma or surgery
Cuts and lacerations
Caused by tangential shearing of skin by a rough surface
Most commonly caused by road surface during MVA “road rash”
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
Most commonly occurs in industrial
settings with rotary tools or with ejectionsfrom a motor vehicle
Most common injuries are getting
fingers caught in a closing door or feet run over by car.
Occurs when a heavy object falls onto a
portion of a person’s body, splits the skin andmay even shatter or tear underlying
sharp pieces of bone penetrate and tear surrounding soft tissue &skin which created an open wound
Most likely to occur with high energy injuries,
more superficial bones, and among the elderly.
Characterized by a
slice wound created by a sharp object
3 basic mechanisms of injury for lacerations
Small amount of force on a small area which typically results in minimal cell injury due to the sharp
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
High force at makes direct
perpendicular contact causing jagged/shredded wound edges and severe tissue damage (i.e. punch)
Compression MOI for laceration
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.
Deep & narrow wounds created by sharp objects such as nails, knives, or animal
6 types of burns
Boiling water or steam
Hot surface like stove or tar
Live wires or lightning
Acids, basics or caustic materials
Fell off the healing cascade due to prolonged Inflammatory phase
Require topical therapies and appropriate supportive therapies
4 examples of chronic wounds
Arterial, venous, pressure, neuropathic ulcers
Wound environment consists of what 3 things
Any insult to the wound that may delay orinterrupt healing process
What does continuous pressure to a wound do?
Interrupts blood supply and delays healing
Aging process increases which phase and decreases which phase?
Increases inflammatory phase
Decreases maturation phase
Superficial wounds are in the
Partial thickness wounds are in the
Full thickness wounds are in the
Hypodermics or muscle, tendon, bone
Stage 1 pressure injuries
Contusions or bruises
Stage 3 pressure injuries
Partial thickness wound
Stage 3 and 4 pressure injuries
Full thickness wounds
Lacerations and abrasions
Partial thickness wounds
Incontinence associated dermatitis
Partial thickness wound
Diabetic and arterial wounds
Full thickness wounds
3 types of wound prognosis
What is healable prognosis?
The cause of the wound can be corrected or compensated with treatment
What is maintenance wound prognosis
Poor treatment adherence or lack of appropriate resources is the barrier to being healed
What is a palliative prognosis
Cause is not treatable
Coexisting medical conditions or drugs do not prevent healing
Goal of healable?
To promote wound healing
Coexisting medical conditions or drugs that may stall healing
Maintenance wound prognosis
Goal of maintenance wound prognosis
Prevent further deterioration or breakdown
Advocate for them
Coexisting medical conditions prevent normal healing
Palliative wound prognosis