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NPTE > Integumentary > Flashcards

Integumentary Flashcards

(79 cards)

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1
Q

Cells in the epidermis

A

Keratinocytes
Melanocytes
Langerhans Cells
Basal Cells

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2
Q

Cells in the dermis

A

Collagen
Retinaculum
Fibroblasts
Macrophages
Lymphatic Glands
Blood Vessels
Nerve Fibers

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3
Q

Function of Langerhans Cells

A

immune

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4
Q

Function of Basal Cells

A

forms new skin cells

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5
Q

Function of Retinaculum Cells

A

stucture, elasticity

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6
Q

Receptor functions: Meissner

A

light touch
texture

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7
Q

Receptor functions: Merkel Disc

A

light touch
texture
pressure

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8
Q

Receptor functions: Pacinian

A

pressure
vibration

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9
Q

Receptor functions: Ruffini

A

heat
stretch
joint deformation

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10
Q

Receptor functions: Free Nerve Endings

A

pain
temperature
pressure
tickle
itch

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11
Q

Receptor functions: Krause End Bulbs

A

cold

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12
Q

Stages of cold sensation

A

CBAN: Cold > Burning > Aching > Numb

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13
Q

Herpes Zoster: presentation

A

Pain & paresthesia of affected dermatome.
Often unilateral.
Rash w/ clusters of fluid-filled vesicles, raised bumps.
Pink & silvery appearance.

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14
Q

Herpes Zoster: most common cranial N affected?

A

Trigeminal (more often affects ones that are BOTH sensory/motor)

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15
Q

Herpes Zoster: precautions

A

Airborne
Contact

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16
Q

Herpes Simplex types & precautions

A

Type 1: above the waist (usually mouth).
Type 2: below the waist (genital).
Contact Precautions

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17
Q

Venous Insufficiency definition

A

Veins not bringing blood back to heart, blood pooling in limb.

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18
Q

Arterial Insufficiency definition

A

Lack of blood flow to body region.

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19
Q

Venous vs Arterial Insufficiency: skin appearance

A

Venous: wet
Arterial: dry

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20
Q

Venous vs Arterial Insufficiency: common wound locations

A

Venous: medial malleolus.
Arterial: lateral malleolus, lower leg, toe, dorsum of foot.

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21
Q

Venous vs Arterial Insufficiency: wound appearance

A

Venous: irregular, shallow, flaking, brown, hemosiderin staining.
Arterial: smooth edges, deep, shiny, pale yellow, necrotic.

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22
Q

Venous vs Arterial Insufficiency: pain

A

Venous: mild-mod
Arterial: severe

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23
Q

Venous vs Arterial Insufficiency: other symptoms

A

Venous: edema
Arterial: intermittent claudication

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24
Q

Venous vs Arterial Insufficiency: how does elevation affect pain?

A

Venous: pain relief
Arterial: increased pain

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25
Venous Insufficiency occurs with...
Clots Valves in veins not functioning properly
26
Arterial Insufficiency occurs with...
HTN Diabetes
27
Pressure Ulcers: stages are defined by what? How many stages?
Thickness & wound characteristics. 4 Stages.
28
Stage 1 Pressure Ulcer
Thickness: intact skin Characteristics: non-blanchable redness
29
Stage 2 Pressure Ulcer
Partial Thickness (superficial) Characteristics: pink/red wound bed, shallow crater
30
Stage 3 Pressure Ulcer
Full Thickness (subQ fat visible) Characteristics: slough/eschar, deep crater, possible undermining & tunneling
31
Stage 4 Pressure Ulcer
Full Thickness (exposed bone, tendon, or muscle) Characteristics: slough/eschar, often undermining & tunneling
32
What makes a pressure ulcer "unstageable"?
Covered with slough/eschar, unable to measure depth.
33
Can pressure ulcers be backstaged?
NO. Stage only changes if it gets worse. If healing, still considered whatever stage it started as (e.g., Stage 3 recovering).
34
Deep Tissue Injury appearance
Skin intact. Purple/maroon (bruise-like)
35
Diabetic Ulcers are often located where?
WB surface of foot
36
How do we measure wound size?
Length x Width x Depth. With disposable ruler. Disposable cotton swab to measure depth.
37
Wound examination: what tissue types are we looking at?
Granulation Tissue = viable/healthy. Necrotic Tissue = non-viable/dead.
38
Wound edge descriptions & which is most ideal?
Thin is ideal. Indurated (thick). Epibole (rolled).
39
What kind of drainage is most ideal?
Clear, thin, watery (transudate, serosanguinous, or serous).
40
Drainage: Transudate appearance
Clear Thin Watery
41
Drainage: Serosanguineous appearance
Clear (hints of pink/red/brown) Thin Watery
42
Drainage: Serous appearance
Clear (amber) Thin Watery
43
Drainage: Sanguinous appearance
Bloody Indicates inflammation
44
Drainage: Pus appearance
Yellow/brown
45
Drainage: Infected Pus appearance
Hues of green/blue Viscous yellow Foul odor
46
Maceration periwound skin: appearance
White, wrinkled
47
Maceration periwound skin: indicates what?
Wound is too moist
48
Causes of Maceration periwound skin
Uncontrolled drainage. Incontinence. Improper wound care.
49
Desiccation periwound skin: appearance
Cracked, flaky, crusty
50
Desiccation periwound skin: indicates what?
Wound is too dry
51
Causes of Desiccation periwound skin
Dehydration. Infection. Improper wound care.
52
Steps of wound care
1. Clean 2. Debride 3. Dress
53
What should wounds be cleaned with?
Sterile saline for most. Iodine for infected wounds.
54
What is Selective Debridement & when should it be used?
Removes only the nonviable tissue. Use if <50% necrotic or infected.
55
What is Nonselective Debridement & when should it be used?
Removes both viable & nonviable tissue. Use if >50% necrotic or infected.
56
Selective debridement techniques
Sharp: using scalpel/forceps. Enzymatic: topical enzymes. Autolytic: moist dressings to promote body's natural healing mechanisms.
57
Nonselective debridement techniques
Wet to Dry Dressing: apply moist gauze, then remove when it's dry (like waxing). Irrigation: pressurized fluid. Hydrotherapy: similar to irrigation, but in a whirlpool.
58
How do we determine dressing type?
Based on the amount of exudate (fluid) & whether the wound is infected.
59
Dressings for none to very mild exudate (dry)
Transparent films (Tagaderm, OpSite).
60
Dressings for minimal exudate
Hydrogel Hydrocolloid
61
Dressings for moderate exudate
Foams
62
Dressings for excessive exudate (wet)
Calcium Alginate Hydrofiber
63
Dressings for infected wounds
Calcium Alginate Hydrofiber Hydrogel Gauze
64
What dressing type should NOT be used for infected wounds?
Foam - bc this will spread the infection
65
Burn thickness is based on what factors? List the types.
Based on tissue layer involved & presentation. 1. Superficial 2. Superficial Partial 3. Deep Partial 4. Full 5. Subdermal
66
Superficial thickness burn
Epidermis. Dry, red. No open areas.
67
Superficial Partial thickness burn
Epidermis & some of Dermis. Mottled red, weeping blisters. Blanches to pressure w/ quick capillary refill. Extremely painful.
68
Deep Partial thickness burn
Epidermis & Dermis. Red & white. Blanches to pressure w/ slow capillary refill. Impaired pinprick sensation.
69
Full thickness burn
Epidermis, Dermis, & some of SubQ. Dry, leathery eschar (may be white & black). Lack of pain, pressure, & temperature.
70
Subdermal thickness burn
Epidermis, Dermis, & SubQ. Dry, charred. Exposed deeper tissues.
71
RYB System: management of Red wounds
Cover the wound, keep it moist. Transparent dressing over gauze moistened with saline. OR hydrogel, hydrocolloid, or foam dressing.
72
RYB System: management of Yellow wounds
Remove yellow layer. Moisture-retentive dressing: hydrogel, foam, or moist gauze (with or without debriding enzyme). Debridement: hydrotherapy or irrigation.
73
RYB System: management of Black wounds
Debridement: enzymatic, sharp, hydrotherapy, or irrigation.
74
RYB System: management of wounds w/ inadequate blood supply OR non-infected heel ulcers
Do NOT debride. Keep it clean & dry.
75
What is the Rule of Nines?
For burns, to estimate % of body surface area affected.
76
Rule of Nines body parts counted
1. Head = 9% 2. L Arm = 9% 3. R Arm = 9% 4. L Anterior leg = 9% 5. L Posterior leg = 9% 6. R Anterior leg = 9% 7. R Posterior leg = 9% 8. Chest = 9% 9. Abdomen = 9% 10. Upper Back = 9% 11. Lower Back = 9% 12. Perineum = 1%
77
Normal scar appearance
Flat, similar to skin color
78
Hypertrophic scar appearance
Thick fibrous tissue Stays within original wound border
79
Keloid scar appearance
Thick fibrous tissue Grows outside of original wound border

NPTE (28 decks)

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