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Integumentary, Endocrine, & Multi Systems > Integ Management for PTs > Flashcards

Integ Management for PTs Flashcards

1
Q

Layers of the Skin (superficial to deep)

A
  1. Epidermis
  2. Dermal-Epidermal Junction (basement membrane)
  3. Dermis
  4. Hypodermis (layer below the skin, not really skin)
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2
Q

Layers of the Epidermis

A
  1. Stratum corneum
  2. Stratum lucidum
  3. Stratum granulosum
  4. Stratum spinosim
  5. Stratum basale
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3
Q

Blanchable versus non-blanchable

A

Blanchable skin is normal, the area pressure is applied will turn red but return to original color.

Non-blanchable skin is abnormal, the area pressure is applied will turn red and remain red meaning there is a collection of blood underneath the skin.

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4
Q

Rete Pegs

A

Rete pegs allow for increased attachment between the epidermis and dermis and help distribute pressure.

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5
Q

Epidermis

A
  • Thin stratified epithelium that ranges from 0.06 to 0.6 mm thick
  • Gives rise to hard keratinized structures (nails, hair)
  • Cellular, avascular, water resistant
  • Contains melanin
  • Has five layers, and grows from the bottom up
  • Sheds on average every 28-30 days (until age 60, then it sheds every 60 days)
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6
Q

Functions of the Epidermis

A
  • Protection (infection, shear/friction, water loss, toxic irritants)
  • Vitamin D synthesis
  • Thermoregulation (regulation, retention, dissipation)
  • Sensation (light touch)
  • Pigmentation (melanocytes)
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7
Q

Main Cells in the Epidermis

A
  1. Keratinocytes –> synthesis of keratin
  2. Melanocytes –> synthesis of melanin
  3. Langerhan’s cells –> immune response (looks for other organisms trying to enter the skin)
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8
Q

Main Cells in the Dermis

A
  1. Fibroblasts –> collagen synthesis
  2. Collagen –> insoluble connective tissue protein
  3. Elastin –> primary protein in elastic tissue
  4. Macrophages –> Phagocytosis
  5. Mast cells –> Provide histamine for vasodilation
  6. Lymphatic glands –> removal of microbes and interstitial waste
  7. Blood vessels –> thermoregulation; metabolic skin requirements
  8. Nerve fibers –> sensory perception
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9
Q

Dermis

A
  • Thickest layer (2-4 mm)
  • Provides support and nutrition to epidermis
  • Responsible for giving skin its bulkiness
  • Vascularized and innervated
  • Major proteins are collagen and elastin
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10
Q

Functional Components of Epidermis

A
  • Stratum corneum
  • Keratinocytes
  • Melanocytes
  • Merkel cells (important for neural coding of light touch stimuli)
  • Langerhans’ cells (outermost guard of the skin)
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11
Q

Functional Components of Dermis

A
  • Hair follicles
  • Sweat glands
  • Sebaceous glands
  • Nerve endings
  • Lymph vessels
  • Capillaries
  • Collagen
  • Elastin
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12
Q

Dermal Appendages

A
  • Hair follicles
  • Sebaceous glands
  • Sweat glands
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13
Q

Epithelial Islands

A

Irregular wound healing where there is epithelialization within the wound in little spots, typically it heals from outside in

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14
Q

Hypodermis (Subcutaneous tissues)

A
  • Superficial fascia –> anchors skin to underlying structures
  • Blood vessels and nerve endings
  • Fat (adipose tissue) –> insulates and pads underlying structures
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15
Q

Injury to the skin may result in…

A
  • Functional changes
  • Physiologic changes (amputation, loss of tissue)
  • Body image change (facial skin, along with underlying muscles capable of expressions)
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16
Q

Erosion

A

Loss of superficial epidermis, probably no bleeding, redness, repair by local inflammatory response

17
Q

Partial Thickness Skin Loss

A

Loss of epidermis and part of the dermis, bleed, reepithelization for repair

18
Q

Full Thickness Skin Loss

A

Loss of epidermis, dermis extending into subcutaneous tissue/hypodermis, secondary intention repair through scars

19
Q

Which type of skin loss is the most painful?

A

Partial thickness

20
Q

Full Thickness

A

Complete skin loss with loss of muscle, bone, and tendon

21
Q

What is a concern for full thickness injuries down to bone?

A

Osteomyelitis

22
Q

Skin Changes with Aging

A

Decreased:
- Thickness of epidermis/dermis
- Subcutaneous fat
- Collagen and elastin
- Size of Rete ridges/pegs
- Sensation and metabolism
- Sweat glands
- Circulation
- Reduced mast cells

  • Up to 4x slower healing than younger populations
23
Q

Acute Wound

A

Disruption of the layers of skin and underlying tissues that follows these:
- Planned/unplanned event
- Healing proceeds in typical and timely fashion
- Surgical
- Abrasion/laceration

24
Q

Chronic Wounds

A

Disruption of the layers of skin and underlying tissues that follows these:
- Exists longer than 2 weeks or longer
- Does not proceed through normal healing process
- Examples: Pressure ulcers, diabetic neuropathic ulcers

25
Q

Normal Wound Healing Phases

A
  • Hemostasis (creation of blood clot to stop bleeding)
    1. Inflammatory Phase (0-4 days)
    2. Proliferative Phase (4-21 days)
    3. Maturation Phase (21 days to 2 years)
26
Q

Hemostatic Phase

A

Stop bleeding, injury exposes blood to collagen and initiates coagulation factor.

Integumentary, Endocrine, & Multi Systems (12 decks)

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