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A: Lauren Summer 2025 > Integumentary Week 1 > Flashcards

Integumentary Week 1 Flashcards

(74 cards)

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1
Q

The skin receives ____ of resting cardiac output?

A

1/3

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2
Q

The epidermis is _____ and has ____ layers, and the dermis is _____ and has 2 layers.

A

Epidermis is THIN with 5 layers

Dermis is THICK with 2 layers

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3
Q

Functions of the epidermis (7)

A

-physical barrier
-fluid regulation
-light touch sensation
-thermoregulation
-helps w/ excretion
-Vit D production
-cosmetic appearence + communication

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4
Q

True or false: the Epidermis is vascular

A

False! It is avascular

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5
Q

All of the layers of the skin renew in _____ days.

A

45-75 days

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6
Q

What is the main type of cell in the epidermis?

A

Keratinocytes, about 90% of all cells

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7
Q

Merkel cells are mechanoreceptors that provide information on _____.

A

Light touch sensation

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8
Q

Langerhan’s cells are derived from where? What function do they have?

A

Derived from bone marrow

Mainly helps the immune system by moving antigens on the skin to lymph nodes and T lymphocytes to be processed/resolved

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9
Q

What are some functions of the dermis? (4)

A
  1. supports + nourishes epidermis
  2. infection control
  3. thermoregulation
  4. provides sensation
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10
Q

Where do blisters form? What is another name for this area?

A

Junction of the papillary dermis and the stratum basale

Also called the RETE RIDGES

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11
Q

What is the main cell of the dermis?

A

Fibroblasts, they produce collagen and elastin!

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12
Q

Function of Macrophages

A

Peak 48-72 hours after injury, eat away all the cellular debris and injured cells to start the rebuilding process and fight infection

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13
Q

Function of mast cells

A

Release histamine and enzymes to recruit inflammatory cells. This also accelerates the death of injured cells so they can be removed and replaced.

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14
Q

What is adipose tissue? What are its functions?

A

Highly vascular connective tissue

Stores fat, acts as a cushion, and stores energy

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15
Q

What are the two types of subcutaneous tissue?

A

Adipose tissue and fascia

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16
Q

What are the functions of fascia?

A

Separate and support structures

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17
Q

What tissue is involved in a superficial wound? What are some examples?

A

Only the epidermis is affected

Abrasions, 1st degree burns, sunburns

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18
Q

What tissue is involved in a partial-thickness wound? What are some examples?

A

Involves both the epidermis and the dermis

Blisters, 2nd degree burns, and stage II pressure injuries

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19
Q

What tissue is involved in a full-thickness wound? What are some examples?

A

The epidermis, dermis, and subcutaneous tissues are all affected

Full-thickness burns, stage III or IV pressure injuries

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20
Q

What are the four phases of wound healing?

A
  1. Hemostasis
  2. Inflammation
  3. Proliferation
  4. Maturation / Remodeling
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21
Q

When does the inflammatory phase begin?

A

immediately after injury

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22
Q

How do blood vessels acutely respond to an injury?

A

First, the blood vessels CONSTRICT to reduce blood loss. After a platelet plug forms, the vessels DILATE to cover the area in fluid (the fluid becomes EXUDATE from this point on)

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23
Q

What are polymorphonuclear neutrophils (PMN’s)?

A
  1. first cell to the site of injury
  2. Kill bacteria
  3. Start new vascular growth
  4. Secretes inflammation mediators and matrix metalloproteases (this encourage the body to heal)
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24
Q

When does the proliferation phase begin and end?

A

Begins within 48 hours of injury, and ends when the wound is completely resurfaced

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25
What are the four events of proliferation?
1. Angiogenesis 2. Granulation Tissue Formation 3. Wound contraction 4. Epithelialization
26
What is granulation tissue?
A latticework of connective tissue made by fibroblasts that fills the space in the wound after the debris has been removed
27
What is wound contraction?
Extracellular matrix contracts and this shrinks the size of the wound. Linear wounds contract and heal the fastest. Square/rectangle wounds contract kind of fast and circular wounds contract the SLOWEST
28
What is the main cell that drives wound contraction?
Myofibroblasts
29
Which cells re-epithelialize a wound?
Keratinocytes
30
During maturation and remodeling, what type of collagen is laid down to strengthen the skin? Which type of collagen is old and broken down?
Type 1 is new and strong Type 3 is old and broken down by collagenase
31
Most change during maturation and remodeling happens when?
During the first 6-12 months. The whole process happens for up to 2 years though
32
Fully remodeled skin is only _____ % as strong as the original tissue.
80%
33
What are the functions of Matrix Metalloproteases (MMP's) in the three phases of healing?
Inflammatory - remove damaged extracellular matrix (ECM) and bacteria Proliferative - forms latticework/scaffold on capillary basement for angiogenesis Remodeling - Contraction of scar tissue
34
What is the faulty mechanism that causes a chronic wound?
Basically it means that a wound is stuck in one of the healing phases forever. It could be caused by an imbalances of chemicals/substances or overactive cells
35
In the skin, which layer is more negative? How does this change when the skin is broken?
Normally, the epidermis (or top layer) is MORE NEGATIVE than the bottom layer. Whenever the skin is broken, the wound becomes MORE POSITIVE than the surrounding tissue, which causes keratinocytes, fibroblasts, and macrophages to migrate toward the center of the wound and start the healing cascade
36
What is the normal pH of skin? What is the function of the skin pH and what is this called?
4-6.5 Having a low acidity helps to protect us from microorganisms. This is called the "acid mantle"
37
What are some factors that can decrease the acidity of skin (raise pH)? What could this cause?
-damage to statum corneum and Hand washing 3x/day both decrease the acidity (raise the pH) This may cause eczema, dermatitis, and dry skin
38
What are some things that could increase the acidity of the skin (lower pH)?
-Perspiration, urine, and stool -Systemic diseases like DM, chronic renal failure, and CVA's
39
What are the different types of wound closure?
Primary - wound is cleaned and edges are pushed together and fixed via sutures or staples Secondary - wound is left open and goes through 3 phases of wound healing Delayed primary closure - wound is intentionally left open to make sure there is no infection present then closed together via stitches or staples
40
What are the different types of abnormal closure?
Dehiscence - a primary closure that opens back up Hypogranulation - not enough granulation tissue to fill in the wound Hypergranulation - too much granulation that goes outside the wound
41
When does a wound become chronic?
When it has not made SIGNIFICANT PROGRESS in 2-6 weeks OR A wound that has not healed in 30 days
42
What are senescent cells?
Cells that do not divide like they should, they just get old and die :(
43
What are some characteristics of chronic wounds? (6)
-Senescent cells -Lower levels of TIMP's -More inflammatory cytokines -Doesn't respond to growth factors -Higher MMP's -Biofilm
44
Why can changing dressings often impact wound healing?
Replacing bandages too frequently will cool off the skin excessively, which is not good for wound healing. Disrupts the normothermic wound environment
45
What is the normothermic wound environment?
the optimal temperature of a wound to have the best healing outcomes 37-38 degrees Celsius / 98.6-100 degrees Farenheit
46
How long does it take for an open wound to dehydrate?
2-3 hours
47
Dehydration of a wound leads to _____
cell death for superficial layer of cells (becomes debris)
48
What are the benefits of covering a wound? (4)
-maintain moisture + temperature -stimulate collagen synthesis -stimulate angiogenesis -enhance contraction
49
What is maceration of a wound?
When a wound gets too wet and the tissue dies from flooding
50
Apart from the normal symptoms of inflammation, what is a telltale sign that someone has an infection?
A decline in the wound status/health with no other explanation or The wound isn't healing as fast as it should be
51
What intervention can we perform as PT's if a patient is having trouble with sensation in their LE's?
A monofilament test! This helps the patient to see if they are at risk for developing unknown cuts / trauma due to the lack of sensation
52
What are some negative consequences of aging on the healing process from a cellular perspective? (3)
1. decreased macrophage, mast, and Langerhans' cells function 2. impaired fibroblasts function 3. decreased cellular turnover
53
When we get older, the ______ in our skin flattens, which makes tears and blisters much more common
Rete ridges
54
Steroids impair or decrease ______ (7)
1. inflammation 2. immune system 3. angiogenesis 4. epithelialization 5. cell proliferation 6. collagen synthesis 7. wound contraction Basically every aspect of the wound healing process
55
NSAIDS decrease inflammation, but significantly less than _____.
steroids
56
Tissue O2 levels decrease ______ % for one hour after ________.
30%; one cigarette
57
True or false. Using cytotoxic topicals such as hydrogen peroxide are recommended for wound management
False! They are super strong and may cause more harm than good
58
What is the definition of hydration?
A 1% decrease in body weight due to fluid loss
59
What are some signs of dehydration? (6)
-decreased urine output -dark urine -rapid decrease in body weight -decreased skin turgor -dry wound bed -increased necrotic tissue/eschar
60
What is the recommended amount of water intake? How does this change when healing from a wound?
Normal: 30-35 mL of fluid / kg of body weight Wound: 2.7-3.7 liters per day
61
Wound drainage can cause a significant decrease in what nutrient?
Protein
62
If you don't have enough carbs to provide the needed energy for repair and regeneration, your body converts ______ and _____ for energy.
fat; protein
63
Which vitamins are fat soluble?
A, E, and K
64
What are the four functions of fats?
1. Backup energy source after carbs 2. carries vitamines A, E, and K 3. Makes up cell membranes 4. Helps with thermoregulation
65
Which vitamin is required for collagen synthesis and formation of granulation tissue?
Vitamin A
66
Vitamin A supplementation can reverse the negative side effects of _______.
Long-term corticosteroid usage
67
Which vitamin can be directly applied into a wound bed to improve healing?
Vitamin A
68
What are the functions of Vitamin C?
-maintain tissues -absorb iron -synthesize collagen -antioxidant
69
Functions of Vitamin E
-antioxidant -decreases inflammation -enhances immune system -decreases platelet adhesion
70
Functions of Vitamin K
-essential for blood clotting If you lack Vitamin K, inflammation phase may last longer and wounds bleed more easily
71
Which minerals are essential for wound healing? (5) Name one function for each
Zinc - helps w/ collagen and protein synthesis Iron - essential component for hemoglobin and O2 transport Copper - needed for hemoglobin synthesis + iron absorption Magnesium - deficiency leads to vasoconstriction and HTN Calcium - needed for fibrin synthesis + blood clotting
72
How do you calculate lean body mass?
Subtract body fat weight from total body weight
73
What are the different consequences of losing lean body mass?
10% LBM loss - impaired immunity 20% LBM loss - impaired healing and skin begins to thin 30% LBM loss - no healing and new wounds form 40% LBM loss - death
74
What labs are important for wound healing? What do these mean?

A: Lauren Summer 2025 (9 decks)

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