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Clinical Conditions > Exam 8: Skin, Connective Tissue, and Systemic Conditions > Flashcards

Exam 8: Skin, Connective Tissue, and Systemic Conditions Flashcards

1
Q

Skin Facts (11)

A
  • largest organ
  • 2 layers (epi (dermis))
  • epi contains skin growth cells
  • dermis does not regenerate
  • environmental barrier
  • protects from infection
  • controls temp
  • prevent fluid loss
    -provides sensory info
  • contributes to identity
  • produces vitamin D
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1
Q

Skin Conditions Facts (5)

A
  • can indicate other systemic diseases
  • can be irritating vs. degrading
  • can impact dermatomes and sensations bc receptors are in the skin layers (PNS)
  • since skin changes as we age, it predisposes adults to skin conditions
  • cardiopulmonary dysfunc. can impact skin
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2
Q

types of burns

A

first degree = superficial
second degree = partial thickness
third degree = full thickness

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3
Q

1st degree (superficial) burn

A
  • epidermal layer
  • redness and pain
  • dry, no blisters
  • sunburn
  • heals 3-6 days
  • no scarring
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4
Q

2nd degree (partial thickness) burn

A
  • epidermal & dermal layer
  • some dermis remains
  • large, thick-walled blisters
  • deep red to waxy white
  • moist
  • heals 7-20 days
  • scarring
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5
Q

3rd degree (full thickness) burn

A
  • epidermal, dermal, and into subcutaneous fat
  • charred black, cherry red, tan, pearly white
  • dry and leathery hard
  • scar + risk of contracture
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6
Q

measures of burn severity

A
  • %TBSA (total body surface area)
  • rule of nines (divide surface area into areas of 9%)
  • inaccurate
  • lund and browder chart
  • more accurate and frequently used
  • burn depth
  • superficial, partial thickness, full thickness
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7
Q

mechanism of thermal burn injuries (8)

A
  • flames
  • steam
  • hot liquids
  • hot metals
  • electricity
  • radiation
  • toxic chemicals
  • extreme cold
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8
Q

hospital medical management of burns

A
  • skin grafting
  • used if it will take 3+ weeks to heal
  • reduces length of hospital stay, pain, and scarring complications
  • eschar is removed, graft is applied
  • autograft (persons own skin)
  • alternatives may be needed depending on burn size
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9
Q

OT role in burns (7)

A
  • education
  • exercise
  • positioning
  • adaptive equipment
  • ADL’s
  • splinting
  • scar management
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10
Q

isolation (burn)

A
  • C-Diff or VRE
  • gown + gloves
  • limit patient movement from isolation room
  • avoid sharing equip. and always sterilize after use
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11
Q

protective isolation (burn)

A
  • used to protect vulnerable patient (immunosuppressed)
  • chemotherapy
  • transplant
  • burn or wound patient
    • precautions
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12
Q

issues with skin integrity (pressure ulcers)

A
  • pressure areas (bony prominences)
  • skin shearing
  • moisture due to incontinence
  • poor circulation such as peripheral vascular disease
  • poor nutrition, weight loss, bony prominences
  • pressure mapping
  • braden scale
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13
Q

pressure ulcers stages

A
  • stage I
  • stage II
  • stage III
  • stage IV
    • full thickness wound
  • suspected deep tissue injury (can open up quickly)
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14
Q

stage I pressure ulcer

A
  • nonblanchable erythema usually over bony prominences or other pressure areas
  • hard to detect color changes on darker skin
  • warmth, tenderness, redness, texture changes
  • won’t become ulcerated unless action is to relieve is not taken
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15
Q

stage II pressure ulcer

A
  • loss of skin
  • blisters or open area
  • subcutaneous tissue
  • shallow
  • reddish
  • may have slight drainage
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16
Q

stage III pressure ulcer

A
  • full-thickness skin loss down to subcutaneous fat or fascia
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17
Q

stage IV pressure ulcer

A
  • full-thickness skin loss with exposure of bone
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18
Q

teaching to learn

A
  • types and thicknesses of burns
  • types and stages of pressure ulcers
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19
Q

what is cellulitis?

A
  • bacterial infection of the skin
  • face and lower leg most common
  • skin checks vital for SCI
  • check extremities, back, buttocks, skin folds, contractures
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20
Q

etiology of cellulitis

A
  • one or more bacteria enter through a crack or break in the skin
  • streptococcus or staphylococcus
  • recent surgery sites, open wounds, animal bites, athletes foot
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21
Q

(venous) stasis ulcers

A
  • due to CHF or PVD
  • body doesn’t absorb fluid so it pools in the legs
  • typically will weep
  • acute or chronic
  • often treated for pitting edema
22
Q

what is compartment syndrome?

A

swollen muscle compresses blood vessels and nerves in the leg

23
Q

compartment syndrome

A
  • inflammation in a closed area, skin + connective tissue
  • following trauma to area with large bruise/ hematoma
  • surgical intervention: large open wound that heals slowly
24
Q

OT process of compartment syndrome

A
  • inflammation management
  • pain management
  • wound healing
25
Q

treating open wounds

A
  • wet & dry dressings
  • can the client shower/ change their own dressings?
  • wound vac
  • minimize moisture at area (urine)
26
Q

OT role in treating open wounds

A
  • ADLs with restrictions
  • mobility with wound vac
  • covering wounds for showering
  • non-pharmacological pain management
27
Q

skin checks

A
  • pressure areas in:
    • bed
    • wheelchair
    • recliner/ geri-chair
    • wearing oxygen all the time
    • wearing a splint
28
Q

psoriasis facts (6)

A
  • autoimmune
  • flaky, dry, itchy, thickened skin
  • psoriatic arthritis
  • scratching can open areas
  • overgrowth of skin
  • creates plaque of scaly skin
29
Q

eczema facts (3)

A
  • related to allergies
  • more prevalent in children
  • causes persistent itching
30
Q

temporary skin conditions

A
  • dermatitis
    • eczema
      • allergic dermatitis
      • often due to topical irritants
      • asthma & allergies are more prone
  • hives
  • rashes
31
Q

OT role in wound healing

A
  • encourage good nutrition
  • assess for pressure areas and teach positioning, provide equipment for positioning
  • minimize skin shearing
  • ADLs with wounds
    • showers, bandage changes, skin checks
32
Q

Ehlers-Danlos Syndrome

A
  • connective tissue disorder
  • overly flexible joints and skin
  • fragile skin
  • joints prone to injury
  • usually sports that involve flexibility
  • can involve heart and digestion
33
Q

Marfan Syndrome

A
  • connective tissue disorder
  • affects heart, eyes, blood vessels, and bones
  • tall and thin people with long arms, legs, fingers, and toes
34
Q

scleroderma

A
  • skin, autoimmune disorder, and systemic disorder
  • causes hardening of the skin and organs
  • causes Raynaud’s Syndrome (vasospasms, intolerance of temp changes)
  • scarring & contractures
  • fingers contracted into claw-like position
35
Q

what is fibromyalgia? (6)

A
  • systemic condition
  • hurts all over (near joints)
  • exhausted
  • can’t figure out what is specifically wrong with client
  • can stop people from functioning normally
  • chronic
36
Q

etiology of fibromyalgia

A
  • unknown
  • sleep disturbances
  • injury
  • infection
  • females
  • 20-60 years old
37
Q

fibromyalgia symptoms (9)

A
  • achy pain
  • widespread pain in muscles, ligaments, and tendons
  • fatigue (sleep problems)
  • tender points - where slight pressure causes pain
  • headaches
  • heightened sensitivity
  • IBS
  • paresthesia in arms and hands
  • depression/ mood changes
38
Q

fibromyalgia treatment

A
  • antidepressants
  • muscle relaxants
  • stress reduction
  • healthy lifestyle
  • exercise program
  • relaxation techniques, biofeedback and receiving information about chronic pain
39
Q

what is chronic fatigue syndrome?

A
  • systemic condition
  • aka myalgic encephalomyelitis
  • unknown cause
  • related to Lyme Disease?
  • fevers, fatigue, achiness, poor activity tolerance
  • frequent infections
  • enlarged lymph nodes
  • encephalopathy can occur
40
Q

systemic lupus erythematosus (5)

A
  • systemic condition
  • impact joints (like RA)
  • impact on heart, liver, kidneys
  • unknown cause
  • environmental factors lead to autoimmune reactions of the body (allergies, infections/exposures)??
41
Q

prevalence of SLE

A
  • proportion of population increasing
  • new cases decreasing
  • females
  • 15-40 yrs.
  • northern ireland & black caribbean descendants
42
Q

symptoms of SLE (10)

A
  • arthritic inflammatory responses
  • rashes (butterfly on face)
  • joint pain
  • renal or CNS involvement
  • blood disorders
  • depression
  • exacerbations and remissions
  • cardiac systems
  • photo sensitivity
  • oral ulcers
43
Q

amputations

A
  • congenital
  • acquired
44
Q

congenital amputation

A

absence of limb or part at birth

45
Q

acquired amputation

A

loss of limb or part due to trauma or surgery

46
Q

reasons for surgical amputation

A
  • severe infection or gangrene
  • removal of cancerous tumors
  • severe injury with no hope of salvage
47
Q

LE amputations

A
  • 82% related to diabetes of peripheral vascular disease
  • conventional treatments
    • medication adjustment
    • therapy
  • surgical amputation is last resort
    • limb needs to be well shaped for maximal prosthetic function
48
Q

amputation postoperative complications

A
  • neuroma
    • nerve tissue bundle
  • phantom sensation
    • feeling that the amputated limb is still there
  • phantom pain
    • pain from the amputated portion of the limb
  • weakness
    • from prolonged inactivity
  • skin breakdown
  • falls
49
Q

occupational impact of amputations (6)

A
  • balance is impacted, especially with LE amputations
  • psychological adjustment
  • phantom pain management
  • residual limb wrapping
  • don/doff prosthesis
  • prosthesis training
50
Q

advantages of early prosthetic fit (7)

A
  • decreased edema/ pain
  • accelerated healing
  • maintenance of 2-handed functioning
  • decreased stay in hospital
  • increased prosthetic use and acceptance/ psychological adjustment
  • improved rehab
  • increased proprioceptive input through residual limb
51
Q

symptom management of fatigue (5)

A
  • energy conservation
  • task simplification
  • pacing
  • prescribed exercise
  • sleep hygiene techniques
52
Q

symptom management of scar management (3)

A
  • scar massage
  • teach self scar massage
  • gentle stretching and PROM
53
Q

edema control methods

A
  • swelling of an area related to inability of the lymph nodes to move lymph (tissue fluid)
    • assessment
      • measurement (volumeter, measurement)
    • treatment
      • compression garments, retrograde massage, lymphedema

Clinical Conditions (16 decks)

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