Integumentary

Question 1

What sensory quality have free nerve endings in dermis?

Answer 1

Pain/itch

Question 2

What sensory quality have Merle’s Disc in dermis?

Answer 2

Touch/pressure

Question 3

What sensory quality have Ruffing/Krause cells in dermis?

Answer 3

Tenperature

Question 4

What sensory quality have Meißner/Parcini cells in dermis?

Answer 4

Vibration

Question 5

Layers of skin (3)

Answer 5

Epidermis
Dermis ( glands. Hair root and follicle,
Hypodermis (fat/vessels/

Question 7

Skin turgor=

Answer 7

Skin tension
Skin turgor/dehydration test

Question 8

Wound healing phases (3)

Answer 8

Inflammation
Proliferation
Maturation

Question 9

Inflammation phase (time/signs)

Answer 9

1-4 days
Pain, red, swell, heat

Question 10

Proliferation phase (time/signs)

Answer 10

4-20 days
Deposition and creation of connective tissue

Question 11

Maturation phase (time / signs)

Answer 11

21 days to 2years
Strengthening, reorganization, remodelling of collagen

Question 12

Partial thickness wound healing

Answer 12

Epithelialization
-> only part of dermis injured (<100%)

Question 13

Full thickness wound healing

Answer 13

Granulation
-> when 100% of dermis injured
-> scar tissue

Question 14

Rule of I’d (Burns) adults

Answer 14

Head (front OR back) 4.5%
Thorax (front OR back) 18%
Arms (front OR back) 4.5%
Legs (front OR back) 9%
72%= total

Question 15

Burn considerations/treatment

Answer 15

Contraction prevention in neutral position

Question 16

Rule of 9’s Kids

Answer 16

Head (front OR back) 9%
Thorax (front OR back) 18%
Arms (front OR back) 4.5%
Legs (front OR back) 7%

Question 17

What condition can be caused by electrical burn?

Answer 17

Rhabdomyolysis
Kidney overload-> breakdown of muscle protein

Question 18

1st degree burn

Answer 18

Superficial redness, hot to touch. Delayed pain
=Sunburn

Question 19

2nd degree burn

Answer 19

Partial thickness
1.) Superficial: blisters, redness, Pain
2.) deep: >50% dermis/ yellow-white, sensitive to pressure, insensitive to light touch or pin prick
–> hypertrophic scaring/keloid likely

Question 20

3rd degree burn

Answer 20

= full thickness
White-brown-black/
Painless
Dry
Keloid likely

Question 21

4th degree burn

Answer 21

= subdermal
Complete charting. Necrosis
->requires skin graft

Question 22

Wagner scale is used for what?

Answer 22

Diabetic/neuropathic ulcers

Question 23

Wagner Scale (0-5 stages)

Answer 23

0= at risk
1= superficial ulcer: total destrt dermis
2= deep ulcer: hypodermal + infection
3= abscess deep U: lmtd necrosis
4= limited gangrene: lmtd necrosis
5= extensive gangrene: necrosis complete foot + systemic effects

Question 24

Pressure injury classification stages

Answer 24

1- non blancheable erythema
2- partial thickness skin loss
3- full thickness to underly fascia
4- full thickness to bone/tendon/mm.
5- unstageable: covered es hat/slough

Question 25

What does Braden Scale assess?

Answer 25

Risk for pressure injury Total =23 15-16;low risk 13-14;moderate risk <12; high risk

Question 26

Pressure injury management turning schedule

Answer 26

Every 2h

Question 27

Pressure injury management

Answer 27

Offload bones Float heels Lift don't drag Bed mobility Skin clean+ dry Nutrition + education

Question 28

Arterial Insufficiency Wound characteristics

Answer 28

Decr. blood supply: artheroskl/ claudic Punched out/ even edges Loss hair/cyanotic/ pale/ ashen Painful Minimal drainage ABI<0.8 + rubor of dependency

Question 29

Venous Insuff. Wound characteristics

Answer 29

Decr blood return Large irregular wounds Shallow depth, inflamed surroundings Edema/ indurated/ hyperpigmented/ hemosiderin, red Mod-max drainage + ABI>0.8 (normal)

Question 30

Activity related symptoms Arterial insuff

Answer 30

Pain w/ activity Relief w/ rest Pain decreased in dependent position (Foot on floor)

Question 31

Activity related symptoms Venous insuff

Answer 31

Edema Minimal pain Decreased pain with elevation (independent positioning)

Question 32

Management arterial insuff wounds

Answer 32

Nutrition/ mod risk factors Revascularization Moist/ optimal wound environment ->occlusive: transparent/gel/hydrocollo Debridement Protect and prevent: foot wear+inspect

Question 33

Management of Venous Insuff wounds

Answer 33

Nutrition/ mod risk factors Compression, Unna boot Control exsudate -> highly absorpt. dressing/ multi layer Debridement = selective Protect + prevent

Question 34

What's more absorptive hydrocolloid or hydro fiber?

Answer 34

Hydrofibers

Question 35

When to use permeable or impermeable wounds

Answer 35

Permeable -> infected wounds Impermeable-> non-infected

Question 36

Negative Wound Pressure Therapy

Answer 36

Occlusive W/ open cell foam =To remove moisture

Question 37

Hyper artic oxygen

Answer 37

Improves oxygenation and therefore wound healing

Question 38

Primary intention wound healing

Answer 38

Stitched up

Question 39

Secondary intention wound healing

Answer 39

Let it cook/ heal on its own from deep to surface

Question 40

Tertiary intention wound healing

Answer 40

Delayed primary closure

Question 41

Maceration

Answer 41

Excessive moisture/ softening of skin Pruny appearance Risk of infection

Question 42

A dehiscated wound means

Answer 42

Wound reopened

Question 43

A dessicated wound mean

Answer 43

Too dry

Question 44

Herpes Zoster (shingles)

Answer 44

Red band/ rash in dermatome

Question 45

ABCDE - Melanoma

Answer 45

Asymmetry Border Color Diameter Evolution

Question 46

Benign melanoma description (ABCDE)

Answer 46

Symmetrical Regular border One color <6mm or 1/4 inch Ordinary mole

Question 47

Malignant melanoma description (ABCDE)

Answer 47

Asymmetrical Uneven borders Two or more colors >6mm or 1/4 inch Changing size, color, shape

Question 48

What is a benign nevus?

Answer 48

Common. Mole

Question 49

What is a wheal

Answer 49

Irregular, transient superficial area of local skin E.g. mosquito bite/ hive...

Question 50

Signs of infected wound

Answer 50

Expansive, irregular erythema Systemic fever Mod-max exudate Serous to purulent exudate Persistent pain Indurated so rounding tissue Increased tissue temp

Question 51

Signs of inflamed wound

Answer 51

Well defined borders Localized temp incr Weak odor Minimal exudate -> seroanguineous Variable pain Slight-min firm tissue

Question 52

What is a papule?

Answer 52

Elevated nevus