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Integumentary 1 - Midterm > Phases of Burn Rehab, Bed Rest & Biomechanics - Class 5 > Flashcards

Phases of Burn Rehab, Bed Rest & Biomechanics - Class 5 Flashcards

(63 cards)

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1
Q

timeline for development of tissue restrictions

A

burn scar contracture

muscle adhesion

tendons and sheaths

adaptive muscle shortening

ligament and joint capsule

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2
Q

burn scar contracture

A

1-4 days

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3
Q

muscle adhesion

A

3-5 days

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4
Q

tendons and sheaths

A

5-21 days

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5
Q

adaptive muscle shortening

A

2-3 weeks

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6
Q

ligament and joint capsule

A

1-3 months

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7
Q

precautions/contraindications for tissue restrictions

A

finger burns

extremely resistive or combative pts

exposed tendons

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8
Q

finger burns

A

of in determinant depth or until wound closure

esp over PIP joint

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9
Q

exposed tendons

A

only AROM exercises

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10
Q

LE burns and ambulation

A

vascular concerns

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11
Q

vascular concerns

A

blood stasis/clotting

hydrostatic pressure

dependent position

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12
Q

dependent position

A

inadequate venous return

tissue engorgement

edema

bleeding

pain

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13
Q

inadequate venous return

A

leads to venous stasis

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14
Q

how can we counter these vascular concerns

A

pressure wrappings

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15
Q

pressure wrappings

A

ace wraps

tubular elastic supports

unna’s boot

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16
Q

ace wraps

A

figure 8

spiral

more pressure distally w/ decreasing amounts of pressure proximally

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17
Q

tubular elastic supports

A

tubi-grip

TEDS stocking

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18
Q

effects of bed rest on multi organ systems

A

integumentary

respiratory

CV

edema formation

decreased CO

MS system

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19
Q

integumentary

A

scar contraction

abnormal scarring

cosmesis

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20
Q

abnormal scarring –> integ

A

keloid

hypertrophic

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21
Q

respiratory system

A

inhalation injury

decreased respiratory ventilation/perfusion ration = SOB

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22
Q

inhalation injury –> respiratory system

A

major cause of burn death

edema in lungs –> alveolar collapse –> decreased perfusion –> hypoxemia

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23
Q

CV system

A

physiology of fluid balance and edema formation

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24
Q

edema formation has

A

increased vascular permeability

histamine from mast cells, basophils, platelets

endothelial cells and blood vessels swell

proteins leak from intravascular to intestinal

water follows change in pressure gradient

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25
when is edema accumulation the greatest
first 8 hrs
26
how long may edema continue
24-36 hrs
27
when does edema resolve
7-10 days
28
edema may persist for
2-3 weeks
29
decreased CO
increase HR resting HR increases decreased SV reduced mean arterial pressure
30
MS system --> what happens to muscle protein
metabolized d/t decreased in circulating proteins from edema
31
what do we need muscle proteins for
wound healing
32
how much strength is lost
3% per day 19-20% per week 50% in 3-5 weeks
33
body weight --> MS system
loss of BW >20% is fatal
34
what occurs --> MS
osteoporosis from disuse
35
normal skin is composed of
collagen fiber elastic fibers surrounded by an amorphous ground substance
36
collagen fibers are
long individual coiled
37
what are collagen fibers responsible for
tensile strength of tissue resiliency
38
elastic fibers are
straight branched interconnected
39
what are elastic fibers responsible for
skin tension provide tissue recoil
40
what do GAGs do
lubricate tissue act as a buffer to dampen force
41
normal content of GAG
41.5% hyaluronic acid 55% dermatan sulfate 4.5% chondroitin 4 sulfate
42
altered content GAGs after burn
18.5% hyaluronic acid 55.1% dermatan sulfate 26.4% chondroitin 4 sulfate
43
stress strain curve
strain elongation
44
strain
elongation change in length of tissue divided by original tissue length and multiplied by 100
45
strain to maturity
16% --> 4% at maturity
46
curve
divided into 2 primary portions
47
2 portions of curve
plastic elastic
48
plastic portion
permanent change in physical constitution of tissue
49
when does plastic begin and end
begins at yield point ends at break point
50
elastic portion
recoverable deformation fibers lost in burn scar
51
when does elastic portion start/end
beings at the time of force application ends at the peak of curve (yield point)
52
the elastic portion is divided into
3 phases
53
3 phases of elastic portion
complaint transitional linear
54
compliant
tissue elongation w/ application of little force
55
transitional
greater application of force is required to gain a further increase in tissue length
56
linear
further elongation of tissue requires a much greater increase in force
57
when force is applied to skin --> curve
fibers align in the direction of the load ground substance is displaced b/w fibers
58
hysteresis
delay in tissue resuming its original length
59
successive length induction
increase in tissue length occurs with repeated elongation of tissue
60
what is successive length induction also referred to as
pre-conditioning repeated stretching
61
stress relaxation
progressive reduction in the amount of force required to maintain a tissue at a particular length positioning and static splinting
62
tissue creep
progressive elongation of tissue overtime in response to the application of constant force dynamic splinting, tissue expanders
63
strain rate
force applied to tissue per unut of time

Integumentary 1 - Midterm (23 decks)

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