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PT Exam - 1 > Integ Exam Intro- Class 3 > Flashcards

Integ Exam Intro- Class 3 Flashcards

1
Q

when did PT get involved with wounds

A

first and second world wars

were called reconstruction aides

primarily infected gun shot wounds

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2
Q

role of PT

A

sharp debridement

modalities

dressing selection

compression therapy

fxnal mobility

education

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3
Q

our role is

A

fxnal based

wound management

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4
Q

role –> fxnal based

A

biomechanics and fxnal mobility

strengthening and ROM

ADLs

discharge planning

pt education

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5
Q

biomechanics and fxnal mobility

A

WB considerations

mobility considerations

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6
Q

wound management –> role

A

wound assessments and interventions

pt eduacation

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7
Q

wound assessments and interventions

A

wound bed prep

dressing recommendations

wound care modalities

compression therapy

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8
Q

wound bed prep

A

debridement

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9
Q

layers of the skin

A

epidermis

dermis

subcutaneous tissue

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10
Q

fxn of the skin

A

protective

immunological

homeostasis

thermoregulation

neurosensory

social-interaction

metabolist

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11
Q

partial thickness would

A

includes the epidermis and part of the dermis

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12
Q

full thickness wound

A

through dermis

may extend into subcutaneous tissue, muscle and bone

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13
Q

wound

A

structural or physiological disruption of skin that incites normal or abnormal repair responses

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14
Q

acute wounds

A

heal in a timely manner

go through an expected course of tissue repair

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15
Q

chronic wounds

A

fail to heal in an expected time frame

arterial, venous, neuropathic nature

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16
Q

types of wound repair

A

primary intention

secondary intention

tertiary intension

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17
Q

primary intention

A

surgical intervention to heal a wound

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18
Q

secondary intension

A

our body heals on its own

the body granulates and create scar tissue on its own

epithelization to resurface the wound

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19
Q

tertiary intention

A

wound is left open for a reason

left open for 4-5 days

then cleaned out again and sewed back up

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20
Q

reasons to leave a wound open –> tertiary

A

allow infection, inflammation and moisture to leave the wound

avoid tension necrosis

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21
Q

all 3 types of healing…

A

go through the same 3 phases of healing

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22
Q

whats the difference b/w the 3 types of healing

A

scar tissue formation

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23
Q

phases of healing

A

inflammatory

proliferative

maturation

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24
Q

inflammatory phase –> signs

A

edema

erythema

warmth

pain

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25
Q

inflammatory phase characterized by

A

vascular and cellular response

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26
Q

inflammatory phase has a predominance of

A

leukocytes –> macrophages

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27
Q

proliferative phase

A

formation of granulation tissue and reepithelization

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28
Q

the proliferative phase includes

A

wound contraction

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29
Q

maturation phase

A

collagen fibers reorganize

scar strength 70-80% of normal skin

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30
Q

vascular response –> inflammatory phase

A

platelets activate

fibrinogen is converted

vasoconstriction

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31
Q

what is released during the vascular phase of the inflammatory phase

A

chemoattractant

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32
Q

_______ of leukocytes –> vascular response

A

margination

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33
Q

macrophages…. –> vascular response

A

predominate

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34
Q

the proliferative phase is predominated by

A

cellular activity to repair traumatized tissue

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35
Q

what cellular activity repairs tissue –> proloferative phase

A

neovascularization

fibroplasia

re-epithelization

36
Q

neovascularization –> proliferative phase

A

growth factors, low O2 and lactic acid promote angiogenesis

37
Q

fibroplasia –> proliferative phase

A

formation of granulation tissue

38
Q

formation of granulation tissue –> fibroplasia

A

dense vascular network

fibroblasts and ground substance (extracellular matrix)

–> matrix contains collagen and elastin

39
Q

proliferative phase includes

A

wound contraction

40
Q

proliferative phase –> re-epithelialization

A

keratinocyte migration

form wound edge –> within wound

41
Q

combination of granulation and epithelium tissue

A

biochemically correct wound environment

42
Q

biochemically correct wound environment

A

the wound will close

keep it moist (do not let it dry out) and keep a dressing on it

43
Q

how long does the remodeling phase last

A

up to a yr or more

44
Q

in the remodeling phase –> fibers are

A

reoriented

45
Q

what happens to the extracellular matrix in the remodeling phase

A

consistency changes

46
Q

wound strength –> remodeling phase

A

reaches up to 80% of pre-injured state

47
Q

factors impeding wound healing

A

local factors

clinician induced factors

systemic factors

48
Q

local factors

A

bio-burden

tissue perfusion

wound desiccation

foreign bodies

pressure

shear

friction

49
Q

bio-burden

A

bacterial loads: 10^5/gm of tissue = clinical infection

50
Q

tissue perfusion

A

macro v. micro circulation

51
Q

shear

A

undermining

52
Q

systemic factors

A

stress situations

obesity

temp

comorbidities

nutrition

age

53
Q

stress situations

A

psychological stress, pain or noise

54
Q

obesity

A

increased complications –> increased infections and days on a vent –> decreased tissue perfusion and oxygenation

immobility and prolonged hospitalization

55
Q

temp

A

hypothermic stress –> thermoregulatory vasoconstriction

56
Q

comorbidities

A

DM

immunocompromised conditions

cancer

arterial/venous insufficiency

57
Q

nutrition

A

essential for body’s response to infection and injury

58
Q

serum albumin

A

< 3.5 g/dL

gives picture of the past three weeks on nutrition

decreases as we get older

affected by dehydration

59
Q

prealbumin

A

< 18g/ dL

not eating enough, gives picture of last 2-3 days

little more accurate

60
Q

elderly pts –> nutrition

A

@higher risk from decreased appetite

difficulties with eating and swallowing

61
Q

age –> decreased

A

healing response

cohesion b/w epidermal and dermal layers

skin moisture

62
Q

clinical consideration –> age

A

dressing frequency

selective v. non-selective

decreased cytotoxic agents

63
Q

clinician induced factors

A

meds

topical agents

over utilization

dressing

poor infection control

64
Q

meds

A

antibiotics

steroids

NSAIDS

immunosuppressing drugs

65
Q

topical agents

A

bacteriostatic and cytotoxic (to fibroblasts)

66
Q

over utilization

A

whirlpool

electrical stimulation

intermittent pneumatic compression therapy

67
Q

dressings

A

wet –> dry dressings

synthetic dressings

dressings adhesives

68
Q

wet–> dry dressings

A

for mechanical debridement only

when packed to firmly

pieces of gauze fibers left behind

when gauze allowed to dry out

69
Q

synthetic dressings

A

when used improperly

70
Q

dressing adhesives

A

may cause skin tears

71
Q

poor infection control

A

clinicians who dont wash their hands

no gloves donned

poor sterile technique

72
Q

wound infections will

A

delay healing

73
Q

how do wound infections delay healing

A

affecting collagen metabolism

-decreases synthesis
-increases lysis of collagen

74
Q

effects of wound infections are related to

A

toxins

enzymes

wastes from bacteria deposited into environment

75
Q

infections decrease

A

amount of O2 for collagen synthesis and for oxidative killing by neutrophils

76
Q

goal for health care team

A

to prevent bacterial contamination of wounds

to deal with present infections

to prevent contamination of themselves and of other pts when caring for other pts with infections

77
Q

local infection

A

erythema or skin discoloration

edema

warmth

induration

increased pain

purulent wound exudate w/ or w/o foul odor

78
Q

systemic infection

A

increased temp

increased WBCs

confusion or agitation

red streaks from wound

tachycardic

tachypneic

hypotension

79
Q

inflamed v. infected –> erythema

A

inflamed –> well defined borders, not as intense

infected: intense discoloration, well demarcated and distinct borders, red stripes and streaking

80
Q

inflamed v. infected –> temp

A

inflamed: elevated locally

infected: systemic fever

81
Q

inflamed v. infected –> exudate character

A

inflamed: bleedings and serosanguinous –> serous

infected: serous and seropurulent –> purulent

82
Q

inflamed v. infected –> exudate amount

A

inflamed: usually minimal, decreases in 3-5 days

infected: mod-heavy and remains high

83
Q

inflamed v. infected –> exudate odor

A

inflamed: +/- due to necrotic tissue

infected: specific to pathogen

84
Q

inflamed v. infected –> pain

A

inflamed: variable

infected: persistent

85
Q

inflamed v. infected –> edema and induration

A

inflamed: slight swelling, firmness at wound edge

infected: edema and induration is localized and with warmth

PT Exam - 1 (15 decks)

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