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Integumentary > 1] Evaluation And Intervention > Flashcards

1] Evaluation And Intervention Flashcards

1
Q

8 functions of the skin

A 
Protect from infection
Conserve body fluids
Temp regulation
Excretion
Secretion
Produce Vit D
Appearance
Sensation
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2
Q

3 layers of the skin

A

Epidermis
Dermis
Hypodermis (subcutaneous)

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3
Q

Epidermis has how many layers?

A

5

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4
Q

What are the 5 layers of the epidermis?

A 
Stratum corneum (outer)
Stratum lucidum
Stratum granulosum
Stratum spinosum
Stratum basale (inner)
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5
Q

Outermost layer of the skin

A

Epidermis

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6
Q

Thickness of eye lids

A

.05 mm

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7
Q

Thickness of palms/soles

A

1.5 mm

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8
Q

4 cells in epidermis

A

Melanocytes
Langerhan cells
Merkel cells
Keratinocytes

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9
Q

Produce melanin, a pigment that contributes to skin color & absorbs UV light to
protect DNA from damage.

A

Melanocytes

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10
Q

Participate in immune responseby fighting various microbes that invade the skin.

A

Langerhan cells

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11
Q

Sensory receptor cells that areresponsible for sensation of touch.

A

Merkel cells

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12
Q

Produce keratin, a tough protectiveprotein that protects skin & creates water repellent
seal.

A

Keratinocytes

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13
Q

Deepest layer of the epidermis

A

Stratum basale

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14
Q

Divides continuously
Contains stem cells which continually divide & push
new cells to surface.

A

Stratum basale

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15
Q

Contains melanocytes and merkel cells

A

Stratum basale

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16
Q

Thickest layer of the skin

A

Stratum spinosum

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17
Q

Prickle cells interlock and support skin

A

S. Spinosum

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18
Q

Involved in transfer of substances in and out of body

A

S spinosum

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19
Q

Has basal cells and langerhan cells

A

S spinosum

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20
Q

Which layer initiates keratinization?

A

S granulosum

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21
Q

How on does keratinization take?

A

4 weeks

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22
Q

? produce ?, a tough protectiveprotein that makes up the majority of the
structures of the skin, hair, and nails

A

Keratinocytes

Keratin

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23
Q

What happens as kcytes move through the stratum granulosum and lucidum ?

A

They enlarge, flatter and adhere together

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24
Q

What happens at the end of keratinization?

A

Cells fuse together into tough durable material that continues to surface to the skin

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25
Q

Appears only in thethicker areas of the skin, i.e. fingertips, palms, and soles

A

S lucidum

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26
Q

Comprised of dead keratinocytes &

protects against UVrays.

A

S lucidum

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27
Q

10-30 layers of continuously shedding dead

keratinocytes which are replaced from below

A

S corneum

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28
Q

Lipids help seal these dead cells together to form a barrier to keep water out/in.

A

S corneum

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29
Q

Shedding process is how many days in the young?

A

26-30

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30
Q

Shredding process is how many days in the elderly?

A

42-50 days

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31
Q

3 functions of the dermis

A

Regulate temperature
Give dermis nutrients saturated with blood
Store water

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32
Q

2 layers of the dermis

A

Papillary

Reticular

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33
Q

Thin arrangement of collagen fibers

A

Papillary layer of dermis

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34
Q

How is the papillary layer connected to the epidermis?

A

Via papillae

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35
Q

Sensory touch receptors in the papillary layer

A

Meissners corpuscle

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36
Q

Contains thick collagen fibers arranged parallel to skin surface

A

Reticular layer

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37
Q

Reticular layer contains what corpuscles that do?

A

Pacinian corpuscles that are sensory receptors for deep pressure

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38
Q

What two things in the dermis do you need to help your healing tissue be strong?

A

Collagen and elastin

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39
Q

Supply nutrients and oxygen to the skin
Takes away cell waste and cell products
Transports vitamin D produced in the skin to the rest of the body
Constricts and dilates to aid with temperature regulation

A

Functions of blood vessels

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40
Q

Bathes the skin tissues withlymph, a substance that
contains infection-fighting
cells of the immune system

A

Lymph vessels

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41
Q

Attempt to destroy any
infection or invading
organisms as the lymph
circulates to lymph nodes

A

Lymph vessels

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42
Q

Average person has approximately 3 million of these

A

Sweat glands

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43
Q

3 types of sweat glands

A

Apocrine
Eccrine
Sebaceous

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44
Q

Found only in armpits, areolae of nipples andgenital regions

A

Apocrine sweat glands

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45
Q

Larger, deeper and produce thicker secretionsthan eccrine glands

A

Apocrine sweat glands

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46
Q

Become active at puberty

A

Apocrine sweat glands

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47
Q

Found over the entire body

Collect ducts deep in skin that connect to surface

A

Eccrine glands

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48
Q

Sweat is a mix of ?

A

99% water and 1% salt and fats

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49
Q

These glands secrete sweat and regulates body temp

A

Eccrine glands

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50
Q

Secrete oils that keep skinsupple and smooth,
waterproofs, protects from overgrowth of
bacteria/fungus

A

Sebaceous sweat glands

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51
Q

Empties via ducts into base of hair follicle

Secretes sebum

A

Sebaceous glands

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52
Q

What is sebum?

A

Mixture of fats, waxes and hydrocarbons

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53
Q

Collagen is for ?

Elastin is for?

A

Durability

Flexibility

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54
Q

Protein is made by

A

Fibroblasts

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55
Q

Supports epidermis by giving durability

A

Collagen

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56
Q

Similar protein that keeps skin flexible

A

Elastin

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57
Q

Nerve endings contain

A

Pain and touch receptors

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58
Q

Smooth muscle attached to hair follicle

A

Erector pilli muscles

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59
Q

Has blood vessels, nerves, lymph, hair follicles also cross into this layer

A

Hypodermis/subcutaneous layer

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60
Q

How do epidermis and dermis heal?

A

Regeneration

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61
Q

How does everything else besides epidermis and dermis heal?

A

Repair

62
Q

What is regeneration

A

Tissue is replaced with like tissue

63
Q

What is repair?

A

Scar formation; tissues repair by “filling in” with scar tissue

64
Q

What phase is 4 -6 days in normal healing?

A

Inflammatory phase

65
Q

How long does normal healing usually take?

A

2 -4 weeks

66
Q

Purpose:
 Body reacts to the wound and sets the process of healing in motion
 Clear away dead cells and bacteria

A

Inflammatory phase

67
Q

Hemostasis is?

A

Inhibiting oxygen of surrounding tissue

68
Q

What is a vascular response?

A

Local transient vasoconstriction in response to the injury

69
Q

What’s released during vascular response?

A

Platelets, leukocytes, erythrocytes

70
Q

Vascular response is mediated by ? And prolonged by. ?

A

Mediated by norepinephrine and prolonged by serotonin

71
Q

Vasodilation occurs when

A

Bradykinin and histamine are released from damaged tissue

72
Q

Begin to digest bacteria and become part of the exudate

Cells consist of neutrophils, eosinophils, and basophils

A

Polymorphonuclear granulocytes

73
Q

Give rise to macrophages, lymphocytes and platelets

A

Mononuclear granulocytes

74
Q

Main function of macrophages

A

Phagocytosis

75
Q

Angiogenesis begins with

A

Macrophages

76
Q

4 chemical mediators

A

Histamine
Serotonin
Kinins
Prostaglandins

77
Q

Phase is 4/6 to 21 days

A

Proliferation phase

78
Q

4 stages of proliferation phase

A

Re-epithelialization
Fibroblasts
Neovascularization
Contraction

79
Q

Recreating permeability barrier

A

Re-epithelialization

80
Q

Replacement and reinforcement of new tissue (granulation tissue)

A

Fibroplasia

81
Q

New blood supply

A

Neovascularization

82
Q

Decreasing wound size

A

Contraction

83
Q

Migration of epithelial cells across a wound

Basement membrane forms

A

Re-epithelialization

84
Q

Dermal fibroblasts change into myofibroblastsand migrate into the wound and makes collagen

A

Fibroplasia

85
Q

Process that occurs as the wound closes due to the loss of tissue
Begins approx the 5th day

A

Contraction

86
Q

Movement of pre-existing tissue toward thecenter – NOT the formation of new tissue

A

Contraction

87
Q

Which phase is 21 days to 2/3 years

A

Maturation/remodeling phase

88
Q

Phases of healing

A

Inflammatory
Proliferation
Maturation/remodeling

89
Q

Tensile strength will reach about 70-80% of original tissue by week 12

A

Maturation/remodeling phase

90
Q

Collagen and elastin form in this phase

A

Maturation/remodeling phase

91
Q

What’s a prediction of wound healing?

A

If the surface area decreases by 39% at 2 weeks- has better chance of healing

92
Q

If phases of healing and sequence of events occur in an orderly fashion, wounds are
considered

A

Acute

93
Q

If wounds fall out of the orderly healing

cascade of events, wounds are considered

A

Chronic

94
Q

Acute wounds usually happen as a result of

A

Trauma or surgery

95
Q

Abrasions are

A

Acute

96
Q

Avulsions are

A

Acute wounds

97
Q

Crush wounds

A

Acute

98
Q

Burns

A

Acute

99
Q

Cuts and lacerations

A

Acute

100
Q

Missile wounds

A

Acute

101
Q

Punctures

A

Acute

102
Q

Caused by tangential shearing of skin by a rough surface

A

Abrasions

103
Q

Most commonly caused by road surface during MVA “road rash”

A

Abrasions

104
Q

What’s degloving?

A

Avulsions

105
Q

Caused when a portion of the skin is

caught on a sharp object while the body is moving away from the object and a flap of skin is removed

A

Avulsions

106
Q

Most commonly occurs in industrial

settings with rotary tools or with ejectionsfrom a motor vehicle

A

Avulsions

107
Q

Most common injuries are getting

fingers caught in a closing door or feet run over by car.

A

Crush wound

108
Q

Occurs when a heavy object falls onto a
portion of a person’s body, splits the skin andmay even shatter or tear underlying
structures.

A

Crush wounds

109
Q

sharp pieces of bone penetrate and tear surrounding soft tissue &skin which created an open wound

A

Open fracture

110
Q

Most likely to occur with high energy injuries,

more superficial bones, and among the elderly.

A

Open fracture

111
Q

Characterized by a
slice wound created by a sharp object
which leaves
straight/even edges

A

Cuts/incisions

112
Q

3 basic mechanisms of injury for lacerations

A

Shearing
Tension
Compression

113
Q

Shearing

A

Small amount of force on a small area which typically results in minimal cell injury due to the sharp
instrument

114
Q

High amount of force at an angle with a blunt object which tears skin with significant tissue damage (i.e.grazing injury)

A

Tension MOI for laceration

115
Q

High force at makes direct

perpendicular contact causing jagged/shredded wound edges and severe tissue damage (i.e. punch)

A

Compression MOI for laceration

116
Q

High velocity projectiles (3000 ft/sec)
create negative pressure waves known as ? behind the bullet which
causes expansion & collapse of tissue and even further damage.

A

Cavitation

117
Q

Deep & narrow wounds created by sharp objects such as nails, knives, or animal
teeth

A

Puncture wounds

118
Q

6 types of burns

A 
Flame
Scald
Contact
Electrical 
Chemical
Frostbite
119
Q

Scald burn

A

Boiling water or steam

120
Q

Contact burn

A

Hot surface like stove or tar

121
Q

Electrical burn

A

Live wires or lightning

122
Q

Chemical burn

A

Acids, basics or caustic materials

123
Q

Frostbite burns

A

Excess cold

124
Q

Fell off the healing cascade due to prolonged Inflammatory phase

A

Chronic wounds

125
Q

Require topical therapies and appropriate supportive therapies

A

Chronic wounds

126
Q

4 examples of chronic wounds

A

Arterial, venous, pressure, neuropathic ulcers

127
Q

Wound environment consists of what 3 things

A

Moisture
Necrotic tissue
Wound temperature

128
Q

Any insult to the wound that may delay orinterrupt healing process

A

Trauma

129
Q

What does continuous pressure to a wound do?

A

Interrupts blood supply and delays healing

130
Q

Aging process increases which phase and decreases which phase?

A

Increases inflammatory phase

Decreases maturation phase

131
Q

Superficial wounds are in the

A

Epidermis

132
Q

Partial thickness wounds are in the

A

Dermis

133
Q

Full thickness wounds are in the

A

Hypodermics or muscle, tendon, bone

134
Q

Stage 1 pressure injuries

A

Superficial wound

135
Q

Contusions or bruises

A

Superficial wounds

136
Q

Stage 3 pressure injuries

A

Partial thickness wound

137
Q

Stage 3 and 4 pressure injuries

A

Full thickness wounds

138
Q

Skin tears

A

Partial thickness

139
Q

Venous wounds

A

Partial thickness

140
Q

Lacerations and abrasions

A

Partial thickness wounds

141
Q

Incontinence associated dermatitis

A

Partial thickness wound

142
Q

Diabetic and arterial wounds

A

Full thickness wounds

143
Q

3 types of wound prognosis

A

Healable
Maintenance
Palliative

144
Q

What is healable prognosis?

A

The cause of the wound can be corrected or compensated with treatment

145
Q

What is maintenance wound prognosis

A

Poor treatment adherence or lack of appropriate resources is the barrier to being healed

146
Q

What is a palliative prognosis

A

Cause is not treatable

147
Q

Coexisting medical conditions or drugs do not prevent healing

A

Healable

148
Q

Goal of healable?

A

To promote wound healing

149
Q

Coexisting medical conditions or drugs that may stall healing

A

Maintenance wound prognosis

150
Q

Goal of maintenance wound prognosis

A

Prevent further deterioration or breakdown
Advocate for them
Promote adherence
Manage pain

151
Q

Coexisting medical conditions prevent normal healing

A

Palliative wound prognosis

152
Q

prevent further skin breakdown,

trauma, and infection; promote comfort; pain management

A

Goal of palliative wound prognosis

Integumentary (15 decks)

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