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Christina-Summer 25 > Integ: Lecture 1 - Healing > Flashcards

Integ: Lecture 1 - Healing Flashcards

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1
Q

The skin receives ____ of resting cardiac output

A

1 / 3

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2
Q

Where is the thinnest skin located?

Thickest?

A

Eyelid/eardrum

Hands/feet

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3
Q

Describe the layers of the skin

A

Epidermis: 5 thin layers

Dermis: 2 thick layers

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4
Q

T or F: the epidermis is vascular

A

F

It is avascular

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5
Q

Which part of the skin produces vitamin D

A

Epidermis

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6
Q

Complete renewal of epidermis takes _____ days

A

45-75

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7
Q

What cell mainly handles re-epithelialization

A

Keratinocyte (90% of it)

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8
Q

What is a melanocyte

A

pigment producing

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9
Q

Merkel cells

A

Mechanoreceptors for light touch

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10
Q

What are langerhan’s cells

A

Immune system cells in skin

derived from bone marrow

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11
Q

T or F: The dermis is vascular

A

T

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12
Q

Where are superficial lympathatics and epidermal appendages contained in the skin

A

Dermis

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13
Q

Where do blisters occur

A

Between papillary dermis and the stratum basale

called: Rete ridges

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14
Q

What layer of the skin provides sensation

A

dermis

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15
Q

What is the main cell of the dermis

A

Fibroblast

produces collagen and elastin

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16
Q

What is a macrophage

A

Peak 48-72 hours after injury,

housed in dermis,

clean cellular debris and fight infecion

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17
Q

White blood cells

Mastcells

A

Both housed in dermis

WBC- fight infection

Mast cell - produce histamine

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18
Q

Adipose tissue is highly ___________

A

Vascular

Shiney yellow/white little balls

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19
Q

Fascia looks like what

A

shiny white or yellow strands when healthy

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20
Q

A stage 2 pressure injury is ________-thickness

A

partial

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21
Q

A stage 3 or 4 pressure injury is ________-thickness

A

full

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22
Q

What are the 4 phases of wound healing

A

Hemostasis

Inflammation

Proliferation

Maturation/remodeling

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23
Q

What are the cardinal signs of inflammaiton

A

Edema

Rubor

Warmth

Pain

Decreased function

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24
Q

What is the first cell to arrive at a site of injury

A

PMN Polymorphonuclear neutrophils

Stimulates vascular growth and fibroblast migration, secretes inflammatory mdiatiors

kills bacteria and macrophages

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25
What do macrophages do
Direct repair process, kill bacteria and pathogens
26
What cells form a plug to stop bleeding
platelets
27
What are the signalling proteins of the inflammation phase called?
cytokines
28
The proliferation phase starts _____ hours after an injury it consists of what 4 events
48 hours Angiogenesis Granulation tissue formation Wound contraction Epithelialization
29
formation of new blood cells
angiogenesis
30
what happens in granulation tissue formation?
MMPs degrade debris formed during inflammation temporary latticework of CT is built by fibroblast to fill void (granulation tissue)
31
amount of contraction is affected by?
shape,size,depth of wound
32
what is epithelialization?
keratinocutes reepithelialize area; cant happen over non viable tissue
33
What cells are responsible for wound contraction
Myofibroblast
34
What heals faster: circular wound or square/rectangular wounds
Square/rectangle
35
The maturation and remodeling phase for a wound can take up to _______, most change occurs within _______
2 years 6-12 months
36
The new collage put down in the remodeling phase is type _____, the old collage is type ______ and is broken down by collagenase
Type 1 Type 3
37
Fully remodeled collagen is only ___% as strong as the original, if it is broken and repaired again it is __% as strong
80% 64% (keeps being 80% as strong each generation)
38
What are MMP (Matrix Metalloprotease)
Inflammatory mediatiors (the boss of the wound) Takes part in all 3 healing phases Play a large role when woound becomes chronic (too many of them)
39
The epidermis normally has a _______ charge A wound usually has a ______ charge
Electronegative Positive Note: this current difference is what starts wound healing cascade
40
Intact skin has a PH of what Damage to skin can do what?
4-6.5 Increase PH/loss of acidity
41
What can increase skin acidity
Urine/stool Systemic disease
42
Eczema, dermatitis can _______ skin acidity
Decrease acidity (higher ph)
43
MMPs role in the inflammatory phase??
removes damaged ECM and bacteria
44
MMPs role in proliferation?
latticework on capillary basement for angiogenesis
45
MMPs role in remodelling?
contraction of scar ECM
46
what plays a large role when wounds become chronic?
matrix metalloproteases (MMPs)
47
What is wound primary closure (surgery)
Wound is cleaned and edges are approximated and closed
48
What is secondary wound closure
Wound is left open to heal on is own through the 3 phases
49
What is delayed primary closure
Where the surgeon leaves the wound open temporarily to monitor for infection before eventually closing it
50
What is dehiscence
Where primary wound closure from a surgery opens back up
51
Hypogranulation vs hypergranulation
Hypo- wound fails to granulate hyper- granluation occurs outside wound
52
A chronic wound is defined by medicare as _____
taking more than 30 days to close
53
Technical definition of chronic wound (not medicare)
Wound is stuck in a phase of healing with no progress
54
What are senescent cells
Dr flynns brother useless cells usually found in chronic wounds
55
Chronic wounds typically have ______ levels of MMP
higher +dont respond to growth factor +lower level tissue inhibitors of matrix metalloprotease (TIMPs)
56
Why do you want to do change the dressing of a wound as less-frequent as you can?
To avoid changing temp
57
Optimal temp for wound healing? When is it too cold?
37-38C Below 12C
58
Should you let a wound "air out"
No, wounds cannot become too dry wounds must stay hydrated
59
What is normal water intake for a person? Normal intake if u have a wound?
30-35ml per kg of BW 2.7-3.7L per day
60
How can you tell if someones dehydrated
1% decrease in bodyweight decreased urine output/dark color decreased skin turgor
61
Why is vitamin A important?
Improves **tensile strength** of tissue increases **collagen** synthesis Helps w/ longterm corticosteroid use note: can damage liver if too much
62
Why is vitamin C important?
absorb iron/ antioxidant/ synthesis collagen/ capillary integrity
63
Why is vitamin E important
**Antioxidant**/ decrease inflammation phase/ enhance immune function/ decreases platelet adhesion
64
Why is Vitamin K important
Essential for blood clotting
65
How does Zinc help wound healing
Aids in **collagen** and **protein synthesis** and cell proliferation/ normal **immune** function
66
Why is iron important
O2 transport, immune function
67
Why is copper important
Required for hemoglobin synethsis and iron absorption
68
why is magnesium important
Deficiency can cause HTN and vasoconstriction often caused by diabetes/alcoholism/diarrhea/dehydration
69
Why is calcium important
Required for fibrin synthesis
70
What happens at these Loss of lean bodymass percentages? 10% 20% 30% 40%
10%- impaired immunity 20% - impaired healing and thin skin 30% - no healing, new wounds can form 40%- death
71
What do creatinine levels indicate
Kidney function
72
What do albumin levels indicate
protein deficiency
73
What do prealbumin levels indicate same for serum transferrin levels
see how change in protein in impactng patient serum transferrin- looks at protein status/recent changes
74
What do C-reactive protein levels indicate
Indicates inflammation
75
What do blood glucose levels indicate
increase risk for ulcer, infection, impaired healing
76
What do BUN levels indicate
decreased healing

Christina-Summer 25 (15 decks)

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