Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PCM Last Exam > Advanced Derm Procedures - King > Flashcards

Advanced Derm Procedures - King Flashcards

1
Q

reading

A

lab manual 183-189

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

steps to derm procedure

A 
evaluate area
cleanse area
anesthetize area
complete procedure
follow up care and suture removal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

wound evaluation

A

damage to structures, nerves, tendons, vessels, joints, bones

not recognizing - significant errors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

nerve injury

A

laceration of hand

test light touch and motor function

2-pt discrimination - hand and finger injuries

best control - compare B/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

tendon injuries

A

resting deformity

forces opposed muscles unopposed

exam - check entire ROM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

vacsular injuries

A

emergency

delayed cap refill distal laceration

look for hematoma in area

expanding pulsatile mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

bone injury

A

get an X-ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

foreign bodies

A

complaint of feeling foreign body - specific and should not be ignored

localized pain or tenderness in high risk wound

pain worse with active/passive motion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

imaging studies

A

for all wounds involving glass - or other wound if foreign body suspected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

glass or inorganic

A
  • plain X-ray

glass as small as 1mm - on xray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

organic material

A

wood, plastic - no Xray

ultrasound, CT, or MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CI to wound closure

A

acute wound >6 hours old (face is exception)

foreign debris - not completely removed

active ooze of blood

dead space under skin

too much tension on wound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

not to do primary closure

A

risk of infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

facial laceration

A

should close it

heal up well - lots of blood supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

delayed primary closure

A

pack with gauze

hope of being able to sutures within 3-4 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

don’t close

A

if need surgical consultation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

surgical consult needed if

A

deep wound hand or foot

full thickness - eyelid, lip, ear

lac - nerve, artery, bone, joint

penetrating of unknown depth

severe crush injury

severely contaminated wound

wound with worry for cosmetic outcome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

cleanse wound

A

saline is best
or tap water

can hurt - pain control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

betadine

A

causes tissue necrosis - don’t dump in wound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

epinephrine

A

decrease bleeding with anesthetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

bupivicaine

A

long acting - 2-4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

lidocaine

A

1 hour lasting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

avoid epinephrine

A

finger, nose, penis, earlobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

admin of anesthetic

A

use smallest needle
-25 gauge ok

inject slowly - acidic - hurts

wait 5-10 minutes after inject

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

langers lines

A

close parallel to these lines

not perpendicular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

non-absorbable suture

A

need to be removed

silk
nylon (ethilon)
polypropylene (prolene)
cotton
stainless steel
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

nylon

A

good for skin closure

synthetic - no tissue rxn

28
Q

silk/cotton

A

organic material

-body defense attack - inflammation

29
Q

polypropylene

A

synthetic

  • stronger than nylon
  • easier to work with
  • costs more
30
Q

lowest tensile strength

A

silk

31
Q

high tensile strength, low cost, no tissue reactivity, requires lots of knots

A

nylon

32
Q

plasticity

A

polypropylene

stretch - accommodate wound welling

33
Q

stainless steel

A

thoracic surgeon - if split sternum

34
Q

absorbable suture

A

in subQ layers - or deep layers

catgut
chromic gut

35
Q

catgut

A

from sheep - intestine

separate collagen layer

significant tensile strength - 5-7 days

36
Q

lasts 5-7 days

A

catgut

37
Q

lasts 10-14 days

A

chromic gut - treated with chromium salts to protect from proteolytic enzymes

38
Q

rapidly absorbed oral cavity

A

chromic gut

39
Q

polyglactin 910

A

vicryl

lubricated - chain of sugars

60-90 days

40
Q

60-90 days

A

vicryl

less tissue reactivity

41
Q

ideal for subQ sutures

A

vicryl

tensile and knot strength
less tissue reactivity
lasts 60-90 days

42
Q

monocryl

A

monofilament
poliglercaprone 25

less contamination - monofilament

loses tension - 21 days

43
Q

polyglycolic acid

A

dexon

braided polymer
25 days - 50% tensile strength

binding and snagging when wet

44
Q

interrupted technique

A

doesn’t give good cosmetic result

bad distribution of tension

45
Q

continuous suture

A

baseball stitch

closes wound quickly
-cosmetically better than interrupted

if breaks - all suture out

46
Q

subcuticular technique

A

no needle marks around wound

better cosmetic

47
Q

vertical mattress

A

everts wound edges

48
Q

horizontal mattress

A

most strength**

high tension areas - over joints

49
Q

layered closure

A

to give more strength

close - muscle, fascia, dermis

dermis - gives strength

50
Q

tissue adhesives

A

dermabond - 2-octylcyanoacrylate

do in low tension areas
-less strength than suture

also avoid moist areas

51
Q

avoid tissue adhesives

A

moist areas

high tension areas

52
Q

CI for tissue adhesive

A

immunosuppressed
diabetes
contaminated
jagged or complex lac

avoid mucosal surfaces, groin, axilla

53
Q

biopsy

A

incisional and excisional

54
Q

incisional biopsy

A

take portion of area out

shave and punch

55
Q

excisional biopsy

A

entire area of abnormal tissue removed

56
Q

excisional biopsy dimension

A

length 3-4x width

30 degrees or less at periphery

57
Q

wound healing

A

inflammation
proliferation
maturation

initially - hemostasis and cross-linked fibrin formation

58
Q

wounds don’t completely heal

A

until 1 year

continue to remodels

59
Q

aftercare

A

antibiotic ointment

24 hours - remove dressing

wash area - gentle soap and water - don’t soak

leave open to air after couple days

elevated - decreased swelling - improve healing

white petrolatum - as effective as antibiotic - not necessary - may delay

60
Q

time to heal face

A

3-5 days

61
Q

time to heal scalp

A

7-10 days

62
Q

time to heal arm

A

7-10 days

63
Q

time to heal trunk

A

10-14 days

64
Q

time to heal legs

A

10-14 days

65
Q

time to heal hands or feet

A

10-14 days

66
Q

time to heal palms/soles

A

14-21 days

67
Q

suture removal

A

decrease scarring
-remove while scar weak

steri strip across scar after suture removed

PCM Last Exam (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions