Skin and Tissue Healing and Wound Pics<3

Question 1

Which layer?
avascular
multilaminar
melanocytes
merkel discs
Langerhans cells

Answer 1

Epidermis

Question 2

What is the function of Keratinocytes and Melanocytes and what layer are they in?

Answer 2

Produce keratin
Produce Melanin
Stratum basale in the epidermis

Question 3

What is the function of the Merkel cells and the langerhans cells?
What layer are they in?

Answer 3

Merkel: light touch - statum basale
Langerhans: skin immune response - stratum spinosum

Question 4

Which layer?
thicker
dermal appendages
highly vascular
fibroblasts/macrophages/WBCs
Mast Cells

Answer 4

Dermis

Question 5

What are the dermal appendages

Answer 5

Sweat Glands
Sebaceous Glands (oil)
Fair follicles

Question 6

What are fibroblasts responsible for in the dermis?

Answer 6

collagen/elastin

Question 7

Which layer?
adipose tissue
fascia
highly vascular

Answer 7

Hypodermis

Question 8

Which layer allows skin to move freely?

Answer 8

Hypodermis

Question 9

If a wound is superficial what layer is it through?

Answer 9

epidermis

Question 10

If a wound is partial thickness what layer is it through?

Answer 10

epidermis and some dermis

Question 11

If a wound is full thickness what layer is it through

Answer 11

all 3 layers

Question 12

What is the most common type of wound, what will it look like?

Answer 12

Venous
brawny, edema, weepy

Question 13

What is the 1st phase of healing?
whats going on here

Answer 13

Hemostasis:
transudate leaks out
brief vasoconstriction and platelet aggregation for blood clotting
beginning of immune response

Question 14

What is the 2nd phase of healing?
whats going on here and how long?

Answer 14

Inflammatory Phase:
0-3 days
vasodilate for histamine response
Mast cells
polymorphonuclear neutrophils (PMNs) - clean
macrophages - kill bacteria to allow cellular growth

Question 15

What is the 3rd phase of healing?
whats going on here and how long

Answer 15

Proliferative phase:
4-12 days
fibroblasts proliferate
angiogenesis and vascularization
granulation tissue
epithelialization

Question 16

When does granulation and epithelialization occur in healing?

Answer 16

4-12 days (proliferative phase)

Question 17

What has to be present for epithelialization to occur? Where does it happen first?

Answer 17

the 3 appendages (hair, oil, sweat)
at the borders of wound

Question 18

What is the 4th phase of healing? What is going on and how long

Answer 18

Maturation/Remodeling
up to 2 years
reorganize matrix
collagen from III to I
reorient along lines of stress
80% of original elasticity

Question 19

What is healing by primary intention

Answer 19

clean cut and sewn back together

Question 20

What is healing by secondary intention?

Answer 20

more gaping
closing on its own
not sewn or sitiched

Question 21

what is healing by tertiary intention?

Answer 21

(delayed primary)
left open until it is ready to be sewn

Question 22

What kind of wounds would be healed with tertiary intension?

Answer 22

contaminated wounds
cant sew closed until the infection/yuckies are out

Question 23

Wagner Ulcer Grade
0:
1:

Answer 23

0: pre-ulcer, healed, or at risk
1: superficial, w/o subcutaneous

Question 24

Wagner Ulcer Grade
2:
3:

Answer 24

2: through the skin, bone, ligament
3: osteotitis, abcess, osteomylitis

Question 25

Wagner Ulcer Grade 4: 5:

Answer 25

4: gangrene of digit 5: gangrene of foot --> need amputation

Question 26

UT classification of Diabetic Foot Ulcers: I: II: III:

Answer 26

I: superficial II: capsule III: bone/osteomyelitis/deep abscess

Question 27

UT classification of Diabetic Foot Ulcers: A: B: C: D:

Answer 27

A: non infected, non ischemic B: infected, non ischemic C: non infected, ischemic D: infected and ischemic

Question 28

National Pressure Injury Staging: Stage 1: Stage 2:

Answer 28

1: non blanchable erythema, skin not exposed 2: skin expoed, partial thickness (epi and part of dermis)

Question 29

National Pressure Injury Staging: Stage 3: Stage 4:

Answer 29

3: Full thickness, nothing exposed, slough 4: full thickness, bone/ligament/muscle exposed

Question 30

National Pressure Injury Staging: Unstageable: Deep pressure injury:

Answer 30

Unstageable: full thickness, depth unknown bc eschar covering it deep pressure: sever black and blue, depth unknown

Question 31

What is a keloid and who's most at risk?

Answer 31

bubbled up scar, beyond original bounds people who are darker skinned

Question 32

Answer 32

Venous Wound

Question 33

What kind of bacteria causes green slough

Answer 33

Pseudomonas bacteria

Question 34

Answer 34

Venous Wound

Question 35

Answer 35

Venous Wound

Question 36

Answer 36

Pressure Wound

Question 37

Answer 37

Cellulitis

Question 38

Answer 38

Venous

Question 39

Answer 39

Arterial

Question 40

Answer 40

Arterial

Question 41

Answer 41

Dry gangrene

Question 42

Answer 42

Arterial?

Question 43

Answer 43

Arterial

Question 44

Answer 44

Arterial

Question 45

Answer 45

Cellulitis

Question 46

Answer 46

Corns

Question 47

Answer 47

Neuropathic Ulcer

Question 48

Answer 48

Charcot foot

Question 49

Answer 49

Neuropathic

Question 50

How does HbA1c effect healing

Answer 50

lower HbA1c = faster healing

Question 51

When would you use toe brachial index on a patient?

Answer 51

if they have microvascular disease and/or calcified proximal vessels

Question 52

What is normal ankle systolic? what range is difficult? what is the goal for diabetics?

Answer 52

norm: > 60mmhg difficulty with 60-80 diabetics >90

Question 53

What toe systolic do we want for healing?

Answer 53

> 30mmhg

Question 54

What is normal, equivocal, and abnormal TBI

Answer 54

<0.7-0.9 <0.65 - 0.7 <0.65

Question 55

What ABI is unlikely to heal with someone with PAD

Answer 55

< 0.5

Question 56

What ABI is associated with impending tissue necrosis

Answer 56

< 0.3

Question 57

What is PreAlbumin and what level in unlikely to heal

Answer 57

last 2-4 days nutritional status < 5