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Medical PCM I > Wounds > Flashcards

Wounds Flashcards

1
Q

Duration of inflammatory phase

A

Injury to day 4 post injury

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2
Q

Cardinal signs of inflammation (english)

A

Redness, swelling, warmth, pain

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3
Q

Cardinal signs of inflammation (Latin)

A

Rubor, Tumor, Calor, Dolore

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4
Q

Endothelial cells produce?

A

Blood vessels

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5
Q

Epithelial cells produce?

A

Skin

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6
Q

Fibroblasts produce?

A

Collagen

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7
Q

Duration of proliferative phase

A

Day 4 to day 21

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8
Q

Theory of hypergranulation tissue

A

Too much oxygen promotes hypergranulation (because synthesis is oxygen dependent). Epithelial cells can’t climb the hump of tissue against gravity and epithelialization is stopped. Skin will start to grow under wound.

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9
Q

Duration of maturation phase

A

Day 21 to 2 years post injury

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10
Q

Characteristics of an immature scar

A

Red, raised, rigid

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11
Q

Characteristics of a mature scar

A

Pale, planar, and pliable

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12
Q

Epibole

A

Hypergranulation causes skin to start to migrate under wound and cause edges of wound to be rounded

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13
Q

When is angiogenesis complete?

A

At the end of the inflammatory stage

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14
Q

Formula for percent chnage

A

(Baseline area - current area)/Baseline area

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15
Q

Crater

A

Tissue defect extending at least to the subcutaneous layer

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16
Q

Dead space

A

Any open area produced as a result of undermining, tunneling, or sinus tracking

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17
Q

Dermis

A

Contains blood vessels, nerve endings, epidermal appendages; composed of collagen and elastin fibers; thickenss depends on site and function

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18
Q

Epidermis

A

Functions for protection, sensation, temperature control;

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19
Q

Fistula

A

Abnormal passage between two organs or between an organ and outside of the body

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20
Q

Sinus Tract

A

A soft cavity or channel without defined edges that involves an area larger than the visible surface of the wound

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21
Q

Subcutaneous tissue

A

Fatty tissue, not well vascularized

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22
Q

Black wound color

A

Presence of necrotic tissue
Usually dry
Least healthy of wound types
Needs debridement/cleaning

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23
Q

Yellow wound color

A

Presence of necrotic tissue, possible infection
Usually heavy exudate
Less healthy than Red wound
Needs debridement/cleaning

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24
Q

Red wound color

A

Clean
Mild to moderate exudate
Granulating
Healing; healthiest of wound types

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25
Stage 1 pressure ulcer
Nonblanchable erythema of intact skin that persists for more than thirty minutes after the pressure has been removed In individuals with darker skin, discoloration, warmth, edema, and induration (hardness)
26
Stage 2 pressure ulcer
Partial thickness skin loss involving epidermis, dermis, or both Superficial and presents as an abrasion, blister, or shallow crater
27
Stage 3 pressure ulcer
Full thickness skin loss involving damage to or necrosis of subcutaneous tissue that may extend down to, but not through underlying fascia Presents clinically as a deep crater with or without undermining of adjacent tissue Typically over a bony prominence
28
Stage 4 pressure ulcer
Full thickness skin loss with extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures Undermining and sinus tracts
29
Eschar
Thick, leathery skin on top of wound that is dead tissue
30
What does CEAP stand for?
Clinical, etiology, anatomic, pathophysiological
31
Category I skin tear
Tears in which epidermal tissue can be approximated without loss of coverage
32
Category II skin tear
Tears show scant (25%) to moderate (75%) loss of epidermal tissue
33
Category III skin tear
Tears show complete loss of epidermal tissue
34
Contaminated wound
Containing non-replicating bacteria, other microorganisms, or foreign material
35
Colonized wound
Contain replicating microorgansims adherent to wound, but with no injury to host Indications of infection (purulent exudate, foul odor, or inflammation) are absent
36
Infection
Containing replicating microorganisms within a would with damage to host
37
Equation for infection
Dose x virulence / Host resistance
38
Host resistance influenced by
Nutritional status Disease status Medication use
39
Primary cause of necrotizing facitis and how o treat it
Strept A | Treatment: Aggressive surgical debridement and amputation
40
How many colony forming units indicate infection?
10^5
41
Symptoms of fungal infections
``` Pruritis Inflammation Swelling Skin eruptions Scaling of skin ```
42
Who is at increased risk for fungal infections?
Compromised immune system Antibiotic therapy Diabetes
43
Examples of fungal infections
Candida (thrush and intertriago) Ringworm Athletes foot; jock itch Aspergilli (mold)
44
Bacteriostatic
A substance that prevents or arrests the growth of microorganisms by preventing multiplication
45
Bactericidal
An agent that prevents or arrests the action of microorganisms either by inhibiting their activity or by destroying or killing them
46
Antiseptic
An agent used on living skin, either bactericidal or bacteriostatic
47
Risk Assessment Tools
Braden scale Norton scale (specificity of 0.75) Risk Assessment Pressure Sore (RAPS)
48
Categories of Norton Pressure Sore Risk
``` Physical condition Mental condition Activity Mobility Incontinence ```
49
Guidelines for Bed Pressure - High Risk
Dynamic flotation mattress Low air loss bed system Air-fluidized bed
50
Guidelines for Bed Pressure - Medium Risk
Static air-filled mattress overlay Gel mattress overlay T-foam mattress overlay
51
Guidelines for Bed Pressure - Low Risk
Mattress overlay 3"-4" foam Gel mattress overlay Water-filled mattress overlay
52
Guidelines for Bed Pressure - No Immediate Risk
Sheepskin pads - questionable effect Heel protectors Convoluted foam mattress tops
53
Autolysis
Disintegration of liquefaction of tissue or of cells by the body's own mechanisms, such as leukocytes and enzymes
54
Crusted
Covered over with dried secretions
55
Denude
Removal of epidermis
56
Stripping
Denuding by mechanical means
57
Eschar
Dry, black or brown leathery materials; result of destruction of cells/blood vessels and desiccation of devitalized tissue
58
Ischemia
Deficiency of blood supply to a tissue, often leading to tissue necrosis
59
Macerate
To soften by wetting or soaking; refers to degenerative changes and disintegration of skin when it has been kept too moist
60
Necrosis
Death of tissue
61
Pus
Thick fluid indicative of infection containing leukocytes, bacteria and cellular debris
62
Scab
Dried exudate covering superficial wounds, usually containing hemolytic components
63
Slough
Moist yellowing or gray substance composed of a mixture of fibrin tissue debris and pus that contains bacteria and leukocytes
64
Autolytic
Use of synthetic dressing to cover a wound and allow eschar to self-digest by the action of enzymes present in wound fluids
65
Enzymatic
Topical application of proteolytic substances (enzymes) to breakdown devitalized tissue
66
Mechanical
Removal of foreign material and devitalized or contaminated tissue from a wound by physical forces rather than by chemical or natural forces
67
Non-selective debridement
Removes both healthy and non-healthy tissue
68
Selective debridement
Removes only necrotic tissue
69
Examples of non-selective debridement
``` Wet to dry Vigorous whirlpool jet agitation Wound irrigation Dakin's Hydrogen peroxide ```
70
Examples of selective debridement
Sharp/surgical Enzymatic Autolytic
71
Collagenase (chemical agent) most effective on what kind of tissue
Yellow-green fibrotic tissue and eschars
72
Indications for hydrotherapy
Need for hydration and increased circulation Removal of cellular debris, foreign contaminants, and loosely attached necrotic tissue Softening of thick, hard necrotic eschar Ischemic wounds that have decreased pain when dependent
73
Use of calcium alginates
Moderately to highly exudative full thickness wounds and as fillers for moderately to highly exudative full thickness wound cavities
74
Use of cadexomer iodine
Chronic venous ulcers
75
Use of foam dressings
Full thickness wounds with moderate to heavy exudate
76
Use of hydrocolloid
Wounds with light to moderate exudate
77
Use of hydrogel
To fill a deep, dry wound
78
Use of transparent film
Open partial thickness wounds with minimal exudate or on closed wounds
79
Use of biosynethic dressings
Temporary or extended coverage of skin loss wounds like burns, donor sites, or skin tears
80
Indications for packing
Dead space impairs wound healing and predisposes abcess formation and infection
81
Contraindications for packing
Patient at increased risk for bleeding Damage to tissue Infection

Medical PCM I (4 decks)

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