Final Exam New Material Flashcards
1
Q
Skin body weight %
A
15-20%
2
Q
Skin function
A
-protection
-holding organs
-sensory
-fluid balance
-temp control
-absorb radiation
-vit D making
-synth. lipids
3
Q
Primary Skin Lesion
A
-1st
-response to meds or radiation
-Macule, papule, tumor, wheal
4
Q
Secondary Skin Lesion
A
-changes to primary lesion
-scale, crust, scar, ulver, atrophy
5
Q
Factors Affecting Ability to Heal
A
-tobacco, psychological status, nutrition
6
Q
Skin Lab Values
A
-Pre-albumin: nutritional status
-glucose
-hemoglobin
-hemocrit: wound healing
7
Q
Aging in Integumentary Sys.
A
-changes in hair (color, thinning, balding, pattern)
-Changes in skin (hyperpigmentation, wrinkling, pain perception, thinning, temp regulation, less vit D production—> osteoporosis)
-Vascular changes (decreased healing, decreased vascularity, thinning)
-Decreased protection (statrum corneum, less langerhans cells (loss of immune surveillance)
8
Q
Atopic Dermatitis
A
-chronic or relapsing inflammatory skin disease characterized by pruritus
-precursor to allergies
9
Q
Contact Dermatitis
A
-acute or chronic skin inflammation caused by exposure to an external agent, that may act as an irritant or allergen
10
Q
Eczema/Dermatitis
A
-superficial itchy inflammation of the skin caused by irritant exposure, allergies, or genetics
-ebbs and flows
11
Q
Stasis Dermatitis
A
-development of erythematous itchy plaques that may open to form shallow ulcers on the lower legs
- underlying venous hypertension and resultant venous insufficiency
12
Q
Rosacea
A
-chronic facial disorder of middle-aged and older people
-form of acne, vascular and allergen components
13
Q
Incontinence-Associate Dermatitis
A
-skin damage resulting from chronic urine or feces exposure
14
Q
Bacterial Skin infections
A
-impetigo
-cellulitus
15
Q
Viral Skin infections
A
-Herpes Zoster
-Warts
16
Q
Fungal Skin infections
A
-Ringworm
-Athelets foot
-Yeast
17
Q
Parasitic Skin infections
A
-Scabies
-Pediculosis (lice)
18
Q
Skin Cancer Benign lesions
A
-Seborrheic keratosis
-nevi (moles)
19
Q
Skin Cancer Premalignant Lesions
A
-actinic keratosis
-bowen disese
20
Q
Skin Cancer Malignant Nonmelanoma Carcinomas
A
-basal cell carcinoma
-Squamous cell carcinoma
21
Q
Skin Disorders Associated with Immune Dysfunction
A
-Psoriasis
-Lupus
-System sclerosis
-Polymyositis
22
Q
Burn Severity
A
-depth (determined by temperature, source, and duration) and total body surface involved
23
Q
1st Degree Burn
A
-epidermis damage
-sun, UV, brief flame/water/flash
-mild, no blisters
-painful, tingling, eased by cool water
-3-7
24
Q
2nd Degree Burn
A
-epidermis and dermis
-Scalding liquids or immersion of liquids
-blisters, edema, weaping
-pain, cold sensitive
-14-28 days
25
3rd Degree Burns
-epidermis, dermis, subcutaneous damage
-prolonged exposure
-fat exposed, dry surface
-no pain
-no healing w/o grafts, skin liquifies in 2-3 weeks, hypertrophic scarring
26
Wallace Rule of Nines
-9% on arms and head (3)
-18% on legs and both sides of torso (4)
-1% on genitals
27
Burn Admissions
-75% thermal (43% flame, 34% scalding)
-Chemical
-Electrical
-Radiation
28
Burn Mortality Determinants
-TBSA
-age
-inhalation injuries
29
Cardiovascular Sys. effects of Burns
-vasoactive substances from injured tissues
-decreased circulating blood volume
-increased HR
-CO: decreases in the beginning, returns to normal, then increases in 24 hrs
30
Renal and GI sys. effects of Burns
-shunting of blood from kidneys to intestines
-Oliguria: decreased urine output
-Paralytic ileus: intestinal dysfunction
31
Immune Sys. effects of Burns
-immunosuppression
-increased infections
32
Electrical Burns
-multi system injuries as it travels through the body
-small entrance wounds, large exit wounds
-Alternating Current worse than Circulating Current
33
Chemical Burns
-continue to burn until neutralized
-alkaline burn deeper
34
Burn Locations/Effects
-Hand and joint burns can cause loss of use
-Circumferential burns can create a tourniquet
35
Inhalation Injuries
-respiratory failure, pneumonia, sepsis
36
Emergent phase of Burns
- fluid retention
-ventilatory magement
37
Acute Phase of Burns
-wound management
-infection prevention
-debridement
-skin grafting
-PT
38
Rehabilitative Phase of Burns
-return to max independence and function
39
Autografts
-full thickness burn to permanently close the burn
40
Allografts
-homografts
-cadaver skin
41
Xenografts
-heterografts
-pigskin
42
Biosynthetic Grafts
-collagen and synthetics
43
Integumentary Ulcers
-Diabetic Ulcers: neuropathic ulcers
-Wagner System:
0: preulcerative
1: superficial
2: Penetrate through subcutaneous
3: Osteitis, abscess
4: Gangrene of digit
5: Gangrene of foot
44
Pressure Injuries
-unrelieved pressure; Interface (externally) and Shearing forces
-Bony prominences: heels, sacrum, ishtub, greater troch, elbows, and scapula
-can't be back staged, must be resolved
45
Pressure Injury Stages
1: Intact skin
2: Partial thickness; exposed dermis
3: Full thickness skin loss
4: Full thickness skin and tissue loss
Unstageable: Obscured full thickness and loss
Deep Tissue: Persistent deep red discoloration
46
Pressure Injury RF
Intrinsic Factors: decreased sensation, mobility, incontinence, activity levels, nutritional status
Extrinsic factors: pressure, shear, friction, moisture
47
Pressure Injury Lab values
Hemoglobin, hematocrit, prealbumin, total protein
48
CVD Signs & Symptoms & biomarkers
Biomarkers: BP, PVC, LDL
-edema, heart attack symptoms
49
Aging and CVS
Quiz: Cyanosis, decreased HR, increased cholesterol
-reduction in function, myocytes, capillary density
-Atheroscerlosis
-Arterial walls stiffen with age and become dilated, loss of elasticity
50
Gender Differences CVS
Women (more): mitral valve prolapse, fatal arrhythmias, increased bleeding episodes
51
Metabolic Syndrome
-3/5
1. Waist circumference
2. Reduced HDL <40 and 50
3. High BP
4. High BG >100
5. Elevated triglycerides >150
52
Ateriosclerosis
group of diseased of thickening and loss of elasticity of arterial walls
1. Atherosclerosis: plaques of fat in inner layer
2. Monckeberg Arteriosclerosis: middle layer destruction from calcium diposites
3. Arteriolosclerosis: thickening of walls of small arteries
53
PCI
-Percutaneous coronary intervention
-balloon in LCA
54
CABG
-coronary artery bypass graft
-saphenous graft
55
Coronary Stent
-stent to open artery and move plaque
56
Adrenergic receptor agonist
orthostatic hyotension; hypertension
57
Adrenergic receptor antagonist
-hypertension
58
ACE inhibitor
-heart failure, hypertension
59
Angiotensin II blockers
-heart failure, hypertension
60
Beta blockers
-angina, arrhythmias, hypertension, heart failure
61
Antiarrhythmics
-arrhythmias and heart failure
62
Direct Renin Inhibitiors
hypertension
63
Calcium channel blockers
angina, hypertension, arrhythmias
64
Hemostatics
Excessive bleeding
65
Cholesterol-modifying agents
-CHD prevention, dyslipidemias, high cholesterol, arterosclerosis
66
Antidiuretics
-central diabetes
67
Diuretics
Heart failure, hypertension, edema
68
Phosphodiesterase inhibitors
-pulmonary arterial hyperension
69
Vasodilators
angina
70
Angina Pectoris
-workload exceeds o2 supply to heart and demand
-pain discomfort in chest
71
Hypertensive CVD
Primary (idiopathic), secondary (cause), Malignant (target organ damage)
72
Myocardial Infarction
Type 1: atherosclerotic plaque
Type 2: Mismatch between o2 supply and demand, no plaque
73
Orthostatic Hypotension
-decrease in BP 20 with pulse increase standing from sitting
74
Arrhythmias
-HR disturbance from SA node
75
Rheumatic Fever
-endocarditis from strep may lead to heart disease
76
Aneurysm
-stretching of BV 50% or more
-most common in abdominal aorta
-abdominal and low back pain
77
Thrombophlebitis
-deep vein thrombosis
-pulmonary embolism: DVT breaks lose and travels to heart, most common hospital readmission and death
-varicose veins: dilation of veins with incompetence of valves
-swelling of vein from clot
78
Lymphatic System
-one way system to cary filtrate, pressure driven
-absorb macros, maintain fluid balance, fight infection, removal of debris
79
Lymphedema
-accumulation of water and proteins in tissue leading to tissue fibrosis and swelling
-goal to put fluid back into ducts
-Primary (idiopathic) or Secondary (acquired: filariasis (most common in world) from parasitic worm, radiation, surgery, cancer(most common cause of secondary in US)
-Stage 0 to Stage III (elephantiasis)
80
RUE Lymphatics
-drain into right lymphatic duct
81
LUE Lymphatics
-drain into left subclavian vein
-3/4ths of flow
82
Superficial Lymphatic vessels
-rely on osmotic pressures
83
Deep lymphatic vessels
-venous pumps from muscles
84
Initial lymphatics
-lymphatic capillaries
-1 cell thick
85
Lymphatic valves
Lymphangion: segment of vessels btwn valves
-prevent backflow
86
Lymphatic trunks
-increase in size gradually
87
Lymph Vessel network
-contracts rhythmically
-embedded in fatty ttissue
-ANS innervation
-high pressure can deteriorate walls
-backflow of lymph causes lymphedema
88
Lymph Nodes
-filter, adjust fluid concentration, produce lymphocytes and macrophages
-100x the normal resistance
89
Lymphedema PT Implications
-consider effects on skin and structures
-check lymph nodes (immobile, increase in size, enlarged)
90
Lymphangitis
inflammation of lymphatic vessels
-usually due to strep
91
Lymphadentits
inflammation of lymph nodes
-infections in the body
Acute: LN enlarged
Chronic: scarred LN with fibrous CT
92
Lymphedenopathy
enlargement of lymph nodes
93
Normocytic Anemia
normal size
94
Macrocytic Anemia
abnormally large
95
Microcyic Anemia
abnormally small
96
Normochromic
normal amounts of hemoglobin
97
Hyperchromic
high hemoglobin
98
Hypochromic
low hemoglobin
99
Anisocytosis
various sizes
100
Poikilocytosis
various shapes
101
Destruction of RBC
-hemolysis
-congenital or acquired
102
Decreased Production of RBC
1. Low erythropoietin
2. Lack of response to EPO
3. Nutrition deficiency: Fe, B12, folate
4. Anemia of chronic disease (ACD): inflammation
5. Chronic kidney disease
6. Bone marrow disorders
7. Radiation induced bone marrow failure
103
Anemia PT Implications
-less exercise tolerance
-fatigue
-vital signs
104
Primary Hemostasis
-platelet plug for blood clotting
- need platelets and von willebrand factor
-easy bruising and mucosal bleeding
105
Thrombocytopenia
-decreased platelets below 150,000
106
Secondary Hemostasis
-vascular damage exposes tissue factor
-necessitates the presence of clotting factors
-hemophilia A (80%, lack of CF 8) and B (15%, lack of CF 9)
-serious bleeding
107
Mild Hemophilia
-15%
-spontaneous hemorrhages
-need trauma
108
Moderate Hemophilia
-15%
-minor trauma
109
Severe Hemophilia
-60%
-spontaneous bleeding or slight trauma
-joints and muscles
110
UTI
-ecoli
-most common infection in hostpitals
-pain in suprapubic, lower abs, flank
-catheter care
111
Pyelonephritis
-urine backs up into renal pelvis
Acute: ecoli, abrupt, flank pain over costovertebral angle
Chronic: vesicoureteral reflux
112
Renal Neoplasms
-Renal cell (most common): resistant to chemo
1. Clear cell
2. papillary
-urothelial carcinoma
-renal sarcoma
-wilms tumor
-renal lymphhoma
Metastasizes to sternum
113
Renal Calculi
-nephrolithiasis
-Calcium most common
-colicky pain from groin to flank
-hematauria
114
Chronic kidney disease
-decreased GFR <60 for 3 months
RF
-diabetes
-high BP
-neuropathy
Signs
-hyperglycemia
-angiotensin II (vasoconstriction)
-elevated BUN and creatine
115
Stages of CKD
G0 >90: reversible
G3a 45-59: increases albumin
G4 15-29: proteinuria
G5 <15: uremia
116
Hemodialysis
-arm
-requires BV merging (fistula)
117
Peritoneal Dialysis
-ambulatory or cycling
-peritoneum
118
Sensory and motor control of Detrusor
-parasympathetic
-pelvic nerve
119
Control of PV
-pudendal
-somatic motor
120
Most common Pelvic disorder in PT
-chronic pelvic pain syndrome
121
Acute Bacterial prostatitis
-infection of prostate
-bacterial, viral, std
-issues with voiding
122
Chronic Prostatitis
-recurrent infection
-sexual dysfunction
IIIA: dysfunction with inflammation, no infection
IIIB: dysfunction w/o inflammation or infection
123
Asymptomatic Prostatitis
-WBC in semen and prostate
124
Benign prostatic hyperplasia
-decreased cell death
-hyperplasia
-Rectal exam or PSA test
125
Prostate Cancer
-adenocarsinoma (most common)
126
Hypoxemia
-lack of o2 of arterial blood
-most common pulmonary condition
-hypoxia
127
Pneumonia
-aspiration, chemicals or infections
-most common hospital acquired infections
-mostly viral and non life threatening
-preceded by an infection
-rust colored spitum (bacterial)
-watery (viral)
128
Acute Bronchitis
-inflammation of trachea and bronchi
-viral
129
COPD
-preventable and treatable
-airflow limitation to airway and alveoli due to loss of competency or increased mucus
-environmental
1. chronic bronchitis
2. emphysema
130
Chronic Bronchitis
-productive cough lasting 3 months for 2 years
-scarring of bronchus, obstruct airways
131
Emphysema
-enlargement of air spaces and loss of elasticity
-centriacinar (most common)
132
Asthma
-inflammation and bronchoconstriction and airflow resistance
Extrinsic (allergic: t cells, IgE) intrinsic (nonallergic)
133
Sleep Apnea
-obesity related
-obstructed (most common): daytime symptoms too
134
Adverse Drug Event
-Injury due to meds
-Dose related (predictable)
-Non-dose related (unpredictable)
135
Drug-Drug interaction
- drugs react unfavorably
136
Drug-Disease
-worsen existing disease
137
Side effects
-occur within therapeutic dose ranges
138
Overdosage toxicity
-predictable toxic effect
139
Mild Overdose
-altered tasted, anxiety, dizziness, shakiness
140
Moderate Overdose
-cramps, dyspnea, hyper or hypotension, heart issues
141
Severe Overdose
-arrythmia, seizures, edema, hypotension, cardiac arrest
142
Rheumatoid Arthritis
-autoimmune of synovial tissue
-osteoporosis, nodules, heart issues, dry eyes, nerve neuropathy, weight loss
143
Sepsis
-organ dysfunction due to infection
-can also be caused from non-infection and immune response
-Septic shock: circulatory shut down with hypotension
-elevated lactate, acidosis, low WBC
144
Multiple organ dysfunction syndrome
-most often caused by sepsis
-complications of disease
-common cause of death
-Increased BUN, lactate, low WBC, low platelets, acidosis
145
pH maintenance
-7.35-7.45
- blood buffer systems
-excretion of carbonic acid from lungs
-excretion of bicarbonate by kidneys
Co2 increases/decreases = respiratory acidosis (hypoventilation and CO2 retention)/alkalosis (hyperventilation; pulmonary or non)
