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NPTE Exam > Other Systems: Study Set 1 > Flashcards

Other Systems: Study Set 1 Flashcards

1
Q

What is the largest organ in the body

A

the skin

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2
Q

what are the layers of the skin from superficial to deep

A
  1. epidermis
  2. dermis
  3. Subcutaneous
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3
Q

True or False:

The epidermis is avascular

A

true

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4
Q

True or false:

The dermis is avascular

A

False

The epidermis is avascular

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5
Q

What are the key functions of the integumentary system

A

protection
sensation
thermoregulation
excretion of sweat
vitamin D synthesis

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6
Q

What are the phases of normal wound healing and how long do they last

A
  1. Inflammatory phase: 1-10 days
  2. Proliferative phase: 3-21 days
  3. Maturation phase: 7 days to 2 years
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7
Q

Name the phase of normal wound healing

Hemostasis is rapidly re-established through platelet activation and the clotting cascade. Necrotic tissue and bacterial debris are killed by mast cells, neutrophils, and leukocytes. Epithelization occurs within 24 hours.

A

Inflammatory phase

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8
Q

Which cells are involved in killing bacteria, necrotic tissue, and debris in the inflammatory phase of normal wound healing

A

neutrophils, leukocytes, and mast cells

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9
Q

Which phase of normal wound healing does epithelialization occur in

A

inflammatory phase

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10
Q

What happens during the inflammatory phase of normal wound healing

A

Hemostasis is rapidly re-established through platelet activation and the clotting cascade. Necrotic tissue and bacterial debris are killed by mast cells, neutrophils, and leukocytes. Epithelization occurs within 24 hours.

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11
Q

Name the phase of normal wound healing:

Capillary buds and granulation tissue begin to fill the wound bed. Keratinocytes, endothelial cells, and fibroblasts form the collagen matrix. Skin integrity is restored

A

Proliferative phase

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12
Q

Which cells are involved in forming the collagen matrix to restore skin integrity during the proliferative phase of normal wound healing

A

Fibroblasts, keratinocytes, and endothelial cells

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13
Q

Which phase is skin integrity restored during normal wound healing

A

proliferative phase

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14
Q

What happens during the proliferative phase of normal wound healing

A

Capillary buds and granulation tissue begin to fill the wound bed. Keratinocytes, endothelial cells, and fibroblasts form the collagen matrix. Skin integrity is restored

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15
Q

Name the phase of normal wound healing

Granulation tissue and epithelial differentiation appear in the wound bed and through fiber reorganization and contractions, the scar from the wound starts to shrink

A

maturation or remodeling phase

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16
Q

What percentage of pre-injury tensile strength does newly repaired tissue have

A

15%

Overtime it will reach 80% of pre-injury tensile strength

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17
Q

True or False:

Hypertrophic scarring does not affect the maturation phase of normal wound healing

A

False, it greatly impacts it. Especially burn scars

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18
Q

A burn scare without hypertrophic scarring will heal in ___-___ weeks.

A burn with hypertrophic scarring may heal up to ____ years

A

4-8 weeks

2 years

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19
Q

Which of the following exerts its primary influence on the hair follicles?

arrector pili muscles
Meissner’s glands
melanocytes
sebaceous glands

A

Arrector pili muscles

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20
Q

Which structure in the epidermis serves as a barrier against fluid, electrolyte, and chemical loss?

basal cells
Langerhans cells
keratinocytes
stratum corneum

A

stratum corneum

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21
Q

What is the proper order of skin layers from superficial to deep?

epidermis, papillary dermis, reticular dermis, subcutaneous
epidermis, reticular dermis, papillary dermis, subcutaneous
reticular dermis, papillary dermis, epidermis, subcutaneous
epidermis, subcutaneous, papillary dermis, reticular dermis

A

epidermis, papillary dermis, reticular dermis, subcutaneous

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22
Q

Which layer of the skin contains melanocytes?

epidermis
dermis
hypodermis
subcutaneous

A

epidermis

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23
Q

What type of gland helps to protect the skin by producing sebum?

apocrine sweat gland
sebaceous gland
ceruminous gland
mammary gland

A

sebeaceous gland

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24
Q

Which of the following inflammatory mediators is responsible for causing pain in an acute wound?

histamine
prostaglandins
phagocytes
renin

A

prostaglandins

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25
Q

The process by which epithelial cells die and produce a protective outer layer is called:

epithelialization
keratinization
granulation
necrotizing

A

keratinization

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26
Q

Label A, B, and C

A

A = Hair shaft
B = Sweat Gland
C = Basal Layer of epidermis

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27
Q

Label D, E, and F

A

D = Sebaceous gland
E= Arrector pilli muscle
F = Hair follicle

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28
Q

Label G and H

A

G = Hair root
H = Sweat gland

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29
Q

What are the four types of burns?

A

Thermal
Radiation
Chemical
Electrical

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30
Q

Which type of burn occurs by conduction or convection?

A

Thermal

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31
Q

Which type of burn occurs through direct contact with a hot liquid, fire, or steam

A

thermal

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32
Q

Which type of burn occurs when an electric current runs through the body

A

electrical

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33
Q

Which type of burn typically has an enter and exit wound

A

electrical

34
Q

Which type of burn would a lightning strike be

A

electrical

35
Q

Which type of burn occurs when chemical compounds come intact with the body

A

chemical

36
Q

Which type of burn occurs by external mean radiation therapy

A

radiation

37
Q

What are the three zones of injury in regards to burns

A
  1. Coagulation zone
  2. Stasis zone
  3. Hyperemia zone
38
Q

Describe the coagulation zone of a burn injury

A

The coagulation zone is the area of the most severe injury with irreversible damage

39
Q

Describe the stasis zone of a burn injury

A

The stasis zone surrounds the coagulation zone in which the damage is reversible

40
Q

Describe the hyperemia zone of a burn injury

A

The hyperemia zone is a zone of inflammation in which the damage will fully recover without intervention or permanent damage

41
Q

During iontophoresis, if a burn is going to occur, it is more likely to occur under the (positive/negative) electrode

A

negative

42
Q

What are the 5 burn classifications

A
  1. Superficial
  2. Superficial partial thickness
  3. Superficial deep thickness
  4. Full-thickness
  5. Subdermal
43
Q

Describe what a superficial burn looks like and the expected healing time

A

A superficial burn only affects the epidermis
It will be red, slight edema but will not scar
Healing will take 2-5 days

44
Q

Describe what a superficial partial thickness burn looks like and the expected healing time

A

A superficial partial thickness damages the epidermis and the upper portion of the dermis.
This is extremely painful with blisters but no scarring
Healing will take 5-21 days

45
Q

Describe what a deep partial thickness burn looks like and the expected healing time

A

A deep partial thickness burn damage the epidermis and the majority of the of the dermis.
This will create moderate pain with blistering and discoloration.
Scarring will occur
Healing will take 21-35 days

46
Q

Describe what a full-thickness burn looks like and the expected healing time

A

A full-thickness burn damages the epidermis and all of the dermis into the subcutaneous layer.
This will create minimal pain with eschar
A skin graft will be needed
Healing will take weeks to months depending on the size

47
Q

Describe what a sub-dermal burn looks like and the expected healing time

A

A sub-dermal burn damages the epidermis, dermis, subcutaneous layer and into the muscle/bone
This requires surgical intervention
Healing will take extensive time.

48
Q

There are two types of wound debridement: Selective and non-selective. What are the three types of selective wound debridement

A
  1. Autolytic
  2. Enzymatic
  3. Sharp
49
Q

There are two types of wound debridement: Selective and non-selective. What are the three types of non-selective wound debridement

A
  1. Wet to dry
  2. Wound irrigation
  3. Hydrotherapy
50
Q

Which type of wound debridement uses scissors, scalpel, or forceps to remove large amounts of thick necrotic tissue

A

sharp debridement

51
Q

Which type of wound debridement is used to apply a topical enzyme to prepare the necrotic tissue and is used if autolytic debridement is not working

A

enzymatic

52
Q

Which type of wound debridement is used in order to aid the body’s natural healing process

A

autolytic

53
Q

Which type of wound debridement is used by putting a wet gauze over necrotic tissue so that the tissue adheres to the gauze and can be pulled off

A

wet to dry

54
Q

Which type of wound debridement uses pressurized fluid on loose or infected wounds?

A

Wound irrigation/pulse lavage

55
Q

Which type of wound debridement uses a whirlpool to soften and loosen necrotic tissue

A

whirlpool

56
Q

True or False:

The rule of nines accounts for the level of severity a burn is

A

false, it accounts for the percentage of body affected by a burn not severity

57
Q

Describe healing by primary intention

A

Clean smooth edges reapproximated by sutures or staples that leave little to no scarring. Blisters or abrasions heal by primary intention within seventy two hours

58
Q

Describe healing by secondary intention

A

Wounds with tissue loss that cannot be reapproximated, so granulation tissue fills in the wound bed with wound closure and scar formation. Typically a result of diabetes or pressure damage that will leave a bigger scar than primary intention

59
Q

Describe healing by tertiary intention

A

Also referred to as delayed primary intention healing. The wound may be left open due to its high risk of developing infection/sepsis. Once the risk of infection is gone, the wound is closed by primary intention.

60
Q

How does age play a factor in wound healing

A

as we age, the epidermis gets thinner and puts the patient at higher risk for friction/pressure injuries. Metabolism is slowed which is correlated to decreased wound healing

61
Q

How does edema play a factor in wound healing

A

Excessive edema increases tissue pressure which then decreases availability of oxygen and nutrients that are necessary for wound healing

62
Q

How does infection play a factor in wound healing

A

Infectious bacteria compete with the body’s own cells for available nutrients. Bacteria can release toxins that can cause further damage to the body

63
Q

How does lifestyle and medication play a factor in wound healing

A

Regular physical activity and nutrition facilitate wound healing. Some meds have side effects that suppress the immune system which alters the wound healing process

64
Q

How does obesity play a factor in wound healing

A

Poor periwound skin quality is susceptible to fissuring which increases the risk of infection. Increased skin tension heightens the risk of skin tears and limits options for approximation. Skin folds create moist, warm, environments that can lead to maceration and bacteria growth

65
Q

(contamination/colonization/infection) is the presence of non-replicating bacteria on a wound surface that causes no additional tissue injury and does not stimulate an inflammatory immune response

A

contamination

66
Q

(contamination/colonization/infection) is the presence of replicating bacteria on a wound surface that does not invade or further injure tissues and does not stimulate an inflammatory immune response. This process can delay wound healing, however bacteria in this stage occasionally benefit wound healing by preventing more virulent organisms from proliferating in the wound bed.

A

colonization

67
Q

(contamination/colonization/infection) The presence of replicating bacteria that invades viable tissue beyond the wound surface causing a visible inflammatory immune response. Infection will significantly delay wound healing and, if untreated, can progress to sepsis, osteomyelitis, and gangrene

A

infection

68
Q

What are the nine bony prominences that are associated with pressure injuries if a patient is in supine for too long?

A

occiput
spine of scapula
inferior angle of scap
verterbral spinous processes
medial epicondyle of humerus
posterior iliac crest
scrum
coccyx
heel

69
Q

What are the seven bony prominences that are associated with pressure injuries if a patient is in prone for too long

A

forehead
anterior portion of acromion process
anterior head of humerus
sternum
ASIS
patella
dorsum

70
Q

What are the eight prominences that are associated with pressure injuries if a patient is in sidelying for too long

A

ears
lateral portion of acromion process
lateral head of humerus
lateral epicondyle of humerus
greater trochanter
head of fibula
lateral malleolus
medial malleolus

71
Q

What are the three bony prominences that are associated with pressure injuries if a patient is sitting in a chair for too long

A

spine of scap
vertebral spinous process
ischial tuberosity

72
Q

What is an abrasion wound

A

A wound caused by a combination of friction and shear forces

73
Q

What is an avulsion wound

A

a serious wound resulting from tension that causes skin to become detached from underlying structures

74
Q

If a patient has an arterial insufficiency ulcer, they should

(rest/exercise)
avoid leg (elevation/depression)
avoid (cold/heat)

A

rest
avoid leg elevation
avoid heat

75
Q

arterial/venous insufficiency wounds are a result secondary to inadequate circulation

A

venous

76
Q

arterial/venous insufficiency wounds are a result secondary to inadequate circulation of oxygenated blood

A

arteial

77
Q

arterial/venous insufficiency wounds are a result secondary to inadequate circulation of oxygenated blood

A

arterial

78
Q

If a patient has an venous insufficiency ulcer, they should

(avoid/use) compression
avoid leg (elevation/depression)
(exercise/rest)

A

use compression to control edema
should elevate legs above heart when resting/sleeping
exercise

79
Q

Describe the following characteristics of a lower extremity arterial insufficiency ulcer

Location
Appearance
Exudate
Pain
Pedal Pulses
Edema
Skin Temp
Tissue Changes
Leg elevation increasing or decreasing px

A

Location - Lower 1/3 of leg, distal toes, dorsal foot, lateral malleoli
Appearance - smooth edges, deep, well defined
Exudate - minimal
Pain - severe
Pedal Pulses - diminished or present
Edema - normal
Skin Temp - decreased
Tissue Changes - thin and shiny, hair loss, yellow nails
Leg elevation increasing or decreasing px - elevation increasing px

80
Q

Describe the following characteristics of a lower extremity venous insufficiency ulcer

Location
Appearance
Exudate
Pain
Pedal Pulses
Edema
Skin Temp
Tissue Changes
Leg elevation increasing or decreasing px

A

Location - proximal to medial malleolus
Appearance - irregular shape, shallow
Exudate - moderate/heavy
Pain - moderate
Pedal Pulses - normal
Edema - increased
Skin Temp - normal
Tissue Changes - flaking dry skin, brownish discoloration
Leg elevation increasing or decreasing px - elevation decreases px

81
Q

Describe the following characteristics of a lower extremity neuropathic ulcer

Location
Appearance
Exudate
Pain
Pedal Pulses
Edema
Skin Temp
Tissue Changes
Leg elevation increasing or decreasing px

A

Location - areas of the foot susceptible to pressure
Appearance - oval or circle, callused rim, no necrosis with good granulation
Exudate -low/moderate
Pain - none
Pedal Pulses - decreased or absent, unreliable ABI
Edema - normal
Skin Temp - decreased
Tissue Changes - dry, inelastic, shiny, decreased sweat production
Leg elevation increasing or decreasing px - elevation creates a loss of protective sensation

82
Q

Define the following

superficial wound
partial thickness wound
full thickness wound
subcutaneous wound

A

superficial - trauma to the epidermis but not through the epidermis
partial - trauma to the epidermis and down to the dermis, but not through the dermis
full thickness - trauma through the dermis and into subcutaneous tissue
subcutaneous tissue - trauma down to the muscle/bone

NPTE Exam (54 decks)

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