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Integumentary > 7] Venosu Ulcers > Flashcards

7] Venosu Ulcers Flashcards

1
Q

3 reasons why wounds do not heal

A

Inadequate vascular support
Excessive pressure
Inadequate nutritional support to grow new tissue

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2
Q

locatedin subcutaneous tissues

A

Superficial veins

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3
Q

accompany

the arteries and are deep to fascia and muscles

A

Deep veins

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4
Q

penetrate fascia to

connect the superficialand deep veins

A

Perforating veins

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5
Q

Proper venosu return

A

calf muscle forcing bloodupward; as muscle
relaxes, valve opens and
blood flows

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6
Q

Venous insufficiency

A

valvesbecome damaged and

blood leaks backwards

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7
Q

Thrombi scar the intima andcause valvular incompetence

A

Venous Insufficiency

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8
Q

Failure of valves results in

A

Venous HTN

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9
Q

Venous HTN causes ? Of superficial veins and fluid is forced ?

A

Distention (swollen or enlarged); into interstitial space

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10
Q

3 other theories of venous insufficiency

A

Pericapillary fibrin cuffs
Leukocyte trapping
Micoangiopathy

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11
Q

—fibrinogen leaks from capillaries And creates a barrier between the capillary and the tissue it supplies

A

Pericapillary fibrin cuffs—

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12
Q

WBC adhere to the capillary

endothelium because of sluggish blood flow 2o venous hypertension; this leads to inflammation

A

Leukocyte trapping

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13
Q

venous congestion leads to damagedcapillaries surrounding the wound (dilation, elongation,
tortuosity, stasis, thrombus)

A

Microangiopathy—

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14
Q

leads to extravasation offluid and cells

A

Venosu HTN

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15
Q

Causes of venous insufficiency

A

Outflow obstruction
 Valve insufficiency
 Loss of muscle pump

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16
Q

How many stages of Venous Insufficiency

A

3

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17
Q

venous system overloaded, edema

results

A

Stage 1

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18
Q

Venous system overloaded

A

Stage 0

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19
Q

How do you treat stage 1

A

Compression, elevation, exercise

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20
Q

Lymphatic
system becomes damage from overuse for an
extended period of time, lymphedema results (alsopigmentation,
varicosities, pain)

A

Stage II

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21
Q

How do you treat stage II

A

CDT

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22
Q

severe skin changes due to tissue

hypoxia and necrosis

A

Stage III

23
Q

How do you treat stage III

A

CDT and wound care

24
Q

Risk factors for venous ulcers (9)

A 
1] Thrombosis of deep venous system
 Postphlebitic syndrome
 CHF
 Incompetent valves
 Obesity
 Pregnancy
 Superficial vein regurgitation
 Muscle weakness
 Varicose veins
25
Q

It’s usuall where

A

LE not involving feet

26
Q

Wound margins

A

Irregular

27
Q

Pain

A

Painless to moderate

28
Q

Drainage

A

Moderate ot heavy

29
Q

Edema

A

Firm

30
Q

Other characteristics of venosu ulcers

A

Moist
Irregular ridges
Firm, fibrotic, infuriated surrounding skin
Yellow, fibrous film cover

31
Q

Observation of venous ulcer

A

Hemosiderin staining

Shiny, taut, sclerotic skin

32
Q

Pitting edema scale ranges from

A

1 + to 4+

33
Q

pit is noticeable deep and may last more than a minute

A

3+

34
Q

somewhat deeper pit, disappears in 10-15

seconds

A

2+

35
Q

pit is very deep, lasts 2-5 minutes, extremity is grossly distorted

A

4+

36
Q

slight pitting, no visible distortion,

disappears rapidly

A

1+

37
Q

Normal circulation – leg volume increases gradually through arterial inflow (venous fill time test)

A

10-15 sec

38
Q

volume increases rapidly

through arterial inflow and venous backflow. Peripheral veins become obvious

A

Venous insufficiency

39
Q

Goals of Treatment

A

 Decrease venous pressure
 Decrease edema and prevent reoccurrence
 Optimize wound healing environment
 Prevent recurrence due to chronic nature of disease

40
Q

If not healing > 0.1 cm a week, probably

A

Not going to be healed at 6 weeks

41
Q

If a suspected venous ulcer does not improve after 6 weeks, recommendation is for a

A

biopsy to rule out malignancy, vasculitis, pyoderma

gangrenosum, or infection

42
Q

Wound interventions

A

Dressings
Debridement
Topicals/antibiotics

43
Q

Do you do whirlpool for edema management?

A

NO!!!

44
Q

Contraindications for compression

A

ABI less than 0.7
Thrombus
Infection
Acute CHF

45
Q

Arterial ulcer location

A

Toes, dorsal foot

46
Q

Venous ulcer location

A

Pretibial or prox to medial malleolus

47
Q

Appearance for arterial vs venous ulcer

A

A: pale
V: beefy red

48
Q

Depth of arterial vs venous ulcer

A

A: deep
V: shallow

49
Q

Pain for a vs v

A

A: severe
V: achy, heavy

50
Q

Pedal pulses for a vs v

A

A: decreased or absent
V: normal

51
Q

Edema/girth for a vs v

A

A: normal
V: increased

52
Q

Skin temps or a vs v

A

A: cool
V: normal or mild warm

53
Q

Tissue changes for a vs v

A

A: yellow nails, shiny, no hair
V: dry skin, hemosiderin staining

54
Q

Leg elevation in a vs v

A

A: increases pain
V: decreases pain and swelling

Integumentary (15 decks)

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