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Integumentary 1 - Midterm > Phases of Burn Rehab, Bed Rest & Biomechanics - Class 5 > Flashcards

Phases of Burn Rehab, Bed Rest & Biomechanics - Class 5 Flashcards

1
Q

timeline for development of tissue restrictions

A

burn scar contracture

muscle adhesion

tendons and sheaths

adaptive muscle shortening

ligament and joint capsule

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2
Q

burn scar contracture

A

1-4 days

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3
Q

muscle adhesion

A

3-5 days

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4
Q

tendons and sheaths

A

5-21 days

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5
Q

adaptive muscle shortening

A

2-3 weeks

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6
Q

ligament and joint capsule

A

1-3 months

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7
Q

precautions/contraindications for tissue restrictions

A

finger burns

extremely resistive or combative pts

exposed tendons

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8
Q

finger burns

A

of in determinant depth or until wound closure

esp over PIP joint

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9
Q

exposed tendons

A

only AROM exercises

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10
Q

LE burns and ambulation

A

vascular concerns

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11
Q

vascular concerns

A

blood stasis/clotting

hydrostatic pressure

dependent position

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12
Q

dependent position

A

inadequate venous return

tissue engorgement

edema

bleeding

pain

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13
Q

inadequate venous return

A

leads to venous stasis

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14
Q

how can we counter these vascular concerns

A

pressure wrappings

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15
Q

pressure wrappings

A

ace wraps

tubular elastic supports

unna’s boot

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16
Q

ace wraps

A

figure 8

spiral

more pressure distally w/ decreasing amounts of pressure proximally

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17
Q

tubular elastic supports

A

tubi-grip

TEDS stocking

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18
Q

effects of bed rest on multi organ systems

A

integumentary

respiratory

CV

edema formation

decreased CO

MS system

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19
Q

integumentary

A

scar contraction

abnormal scarring

cosmesis

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20
Q

abnormal scarring –> integ

A

keloid

hypertrophic

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21
Q

respiratory system

A

inhalation injury

decreased respiratory ventilation/perfusion ration = SOB

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22
Q

inhalation injury –> respiratory system

A

major cause of burn death

edema in lungs –> alveolar collapse –> decreased perfusion –> hypoxemia

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23
Q

CV system

A

physiology of fluid balance and edema formation

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24
Q

edema formation has

A

increased vascular permeability

histamine from mast cells, basophils, platelets

endothelial cells and blood vessels swell

proteins leak from intravascular to intestinal

water follows change in pressure gradient

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25
Q

when is edema accumulation the greatest

A

first 8 hrs

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26
Q

how long may edema continue

A

24-36 hrs

27
Q

when does edema resolve

A

7-10 days

28
Q

edema may persist for

A

2-3 weeks

29
Q

decreased CO

A

increase HR

resting HR increases

decreased SV

reduced mean arterial pressure

30
Q

MS system –> what happens to muscle protein

A

metabolized

d/t decreased in circulating proteins from edema

31
Q

what do we need muscle proteins for

A

wound healing

32
Q

how much strength is lost

A

3% per day

19-20% per week

50% in 3-5 weeks

33
Q

body weight –> MS system

A

loss of BW

> 20% is fatal

34
Q

what occurs –> MS

A

osteoporosis from disuse

35
Q

normal skin is composed of

A

collagen fiber

elastic fibers

surrounded by an amorphous ground substance

36
Q

collagen fibers are

A

long

individual

coiled

37
Q

what are collagen fibers responsible for

A

tensile strength of tissue

resiliency

38
Q

elastic fibers are

A

straight

branched

interconnected

39
Q

what are elastic fibers responsible for

A

skin tension

provide tissue recoil

40
Q

what do GAGs do

A

lubricate tissue

act as a buffer to dampen force

41
Q

normal content of GAG

A

41.5% hyaluronic acid

55% dermatan sulfate

4.5% chondroitin 4 sulfate

42
Q

altered content GAGs after burn

A

18.5% hyaluronic acid

55.1% dermatan sulfate

26.4% chondroitin 4 sulfate

43
Q

stress strain curve

A

strain

elongation

44
Q

strain

A

elongation

change in length of tissue divided by original tissue length and multiplied by 100

45
Q

strain to maturity

A

16% –> 4% at maturity

46
Q

curve

A

divided into 2 primary portions

47
Q

2 portions of curve

A

plastic

elastic

48
Q

plastic portion

A

permanent change in physical constitution of tissue

49
Q

when does plastic begin and end

A

begins at yield point

ends at break point

50
Q

elastic portion

A

recoverable deformation

fibers lost in burn scar

51
Q

when does elastic portion start/end

A

beings at the time of force application

ends at the peak of curve (yield point)

52
Q

the elastic portion is divided into

A

3 phases

53
Q

3 phases of elastic portion

A

complaint

transitional

linear

54
Q

compliant

A

tissue elongation w/ application of little force

55
Q

transitional

A

greater application of force is required to gain a further increase in tissue length

56
Q

linear

A

further elongation of tissue requires a much greater increase in force

57
Q

when force is applied to skin –> curve

A

fibers align in the direction of the load

ground substance is displaced b/w fibers

58
Q

hysteresis

A

delay in tissue resuming its original length

59
Q

successive length induction

A

increase in tissue length

occurs with repeated elongation of tissue

60
Q

what is successive length induction also referred to as

A

pre-conditioning

repeated stretching

61
Q

stress relaxation

A

progressive reduction in the amount of force required to maintain a tissue at a particular length

positioning and static splinting

62
Q

tissue creep

A

progressive elongation of tissue overtime

in response to the application of constant force

dynamic splinting, tissue expanders

63
Q

strain rate

A

force applied to tissue per unut of time

Integumentary 1 - Midterm (23 decks)

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