Exam 1 Flashcards
Adipose Tissue
Vascular loose connective tissue that stores fat and provides energy, cushioning and insulation
Basement Membrane
Thin, acellular layer separating the epidermis from the dermis
Blisters
Collection of fluid at the junction between the dermis and epidermis due to friction
Callus
Localized buildup of the stratum corneum cells due to pressure or friction
Collagen
main structural protein of the various connective tissues in animals
Dermal Papillae
The ridges and valles of the superior surface of the dermis that conforms with the contours of the epidermal stratum basale to help anchor the two layers together
Elastin
protein in connective tissue that is elastic and allows many tissues in the body to resume their shape after stretching or contracting
Epidermis
Outer, avascular layer of skin
Fascia
Fibrous connective tissue that separates and surrounds structures and facilitates movement between adjacent structures
Fibroblasts
Dermal cell that produces collagen, elastin, granulation tissue and growth factors
Full-thickness Wound
Wound that extends through the epidermis and dermis and into or through the subcutaneous tissues
Hair
Epidermal appendages located within the dermis that are made of soft keratin
Histamine
Chemical mediator released by mast cells that causes vasodilation, increases vessel wall permeability, and attracts other cells to the area
Keratin
A protein produced by keratinocytes. Nails are made of hard keratin; hair is made of soft keratin
Keratinocytes
Epidermal cell that resurfaces a wound and produces keratin
Langerhan’s Cells
Epidermal cells that assist with infection control
Macrophages
Cell that directs the repair process, secretes growth factors and enzymes and destroys bacteria and debris
Mast Cells
Cell that helps initiate inflammation, secretes histamine, enzymes, and chemical mediators
Melanin
Pigment produced by melanocytes that helps protect the body from UV radiation, and is a major determinant in skin color
Melanocytes
Pigment producing cells within the dermis
Merkel Cells
Sensory receptor within the epidermis providing information on light touch
Nails
Epidermal appendage made of hard keratin and located at the dorsal tips of digits
Open Wound
Damage to the skin resulting in a loss of skin integrity
Papillary Dermis
Thin superficial dermal layer consisting of loosely arranged connective tissue
Partial-Thickness Wound
Wound involving the epidermis and part of the dermis
Phagocytizing
Process of engulfing and destroying bacteria or debris
Rete pegs
Protrustions of the epidermal stratum basale that extends into the papillary dermis to help anchor the two layers together
Reticular Dermis
Thick, deep dermal layer consisting of dense, irregularly arranged connective tissue
Sebaceous Gland
Oil gland, epidermal appendage located within the dermis
Sebum
Oily substance that lubricates the skin and hair
Stratum Basale
Deepest epithelial cell layers, contains continuously dividing cells
Stratum Corneum
Outermost epithelial cell layer, consists of dead keratinocytes
Stratum Granulosum
Epithelial cell layer located between the stratum spinosum and straum lucidum
Stratum Lucidum
Epithelial cell layer located between the stratum corneum and stratum granulosum
Stratum Spinosum
Epithelial cell layer located between the statum basale and stratum granulosum
Subcutaneous Tissue
Composed of adipose tissue and fascia; located beneath the dermis; helps support the skin
Sudoriferous Glands
Sweat glands, epidermal appendage located within the dermis
Superficial Wound
Wound involving only the epidermis
White Blood Cells
Cell that helps fight infection
CHAPTER 2: Wound Healing
Wound Healing
Abrasion
Wound caused by scraping or friction to the skin’s surface
Angioblasts
Endothelial cell that lines vessel walls
Angiogenesis
Formation of new blood vessels
Chemotactic agents
Substance that attracts cells
Chemotaxis
Movement along a chemical gradient
Closed wound
A wound in which the epithelial integrity has been restored
Collagenases
Enzyme that breaks down collagen
Contracture
Pathological shortening of scar tissue
Current of Injury
Local change of polarity at the site of integument injury
Cytokines
Signaling protein during the inflammatory phase of would healing
Cytotoxic Agents
Substance that is poisonous to human cells
Dehiscence
Separation of wound margins
Delayed Primary Closure
A combination of primary and secondary wound healing processes in which the wound is first observed before primary closure
Diapedesis
The movement of PMNs through capillary walls
Epibole
Keratinocyte migration over the lip or margin of the dermis
Epithelialization
Process by which keratinocytes resurface the wound defect
Exudate
Mixture of fluid, high levels of protein and cells
Fibroblast
Dermal cells that produce collagen, elastin, granulation tissue and growth factors
Granulation Tissue
Temporary structure composed of vascularized connective tissue that fills the wound
Growth Factors
Growth promoting substance that increases or enhances cell size, proliferation or activity
Healed Wound
A closed wound with tissue strength approaching normal
Histamine
Chemical mediator released by mast cells that causes vasodilation, increases vessel wall permeability, and attracts other cells to the area
Hypergranulation
Error of the proliferative phase in which too much granulation tissue is formed and epithelialization is delayed
Hypertrophic Scarring
Overproduction of collagen that stays within the confines of the original wound
Hypogranular
A pothole-type wound that fails to build a sufficient granulation tissue matrix
Inflammation
First phase of wound healing, characterized by rubor, calor, tumor, dolor, functionlaesa; vascular and cellular response to injury of living tissue
Integrins
Cell surface receptors that allows cells to reversibly bind to the extracellular matrix
CHAPTER 3: FACTORS AFFECTING WOUND HEALING
Factors Affecting Wound Healing
Acute Wound
A wound induced by surgery or trauma in an otherwise healthy individual
Chronic Wound
A wound, induced by various causes, whose progression through the phases of wound healing is prolonged or arrested
Colonization
Normal presence of a small number of microbes (<= 10^3 organisms/gram of tissue)
Infection
Invasion and multiplication of migroorganisms within body tissues, wound cultures reveals greater than 10^5 microbes/gram of tissue
Macerated
Skin is white, friable, overhydrated and wrinkled
Necrotic
Dead, devitalized tissue adhered to the wound bed
CHAPTER 4: EXAMINATION OF PATIENTS WITH OPEN WOUNDS
Examination of Patients with Open Wounds
Capillary Refill
Indicator of surface blood flow. Normally less than 3 seconds.
Eschar
Black necrotic tissue that may either be soft of hard
Induration
Firm edema
Pitting Edema
Swelling in which a depression remains within the involved tissues after the application of digital pressure
Semmes-Weinstein Monofilaments
Tools used to assess sensory integrity
Sinus Tract
An elongated cavity or abscess that drains to the body surface, may be associated with category/stave IV pressure ulcers
Slough
Necrotic tissue that is yellow or tan in color and has a stringy or mucinous consistency
Tunneling
A narrow passageway within a wound bed
Undermining
Area of tissue under the wound edges that becomes eroded, resulting in a large wound with a small opening
CHAPTER 5: DEBRIDEMENT
Debridement
Autolytic Debridement
Form of debridement that uses endogenously produced enzymes to digest necrotic tissue
Biologic Debridement
The use of sterile maggots to debride the wound
Debridement
The removal of necrotic tissue, foreign material and or debris from a wound bed
Enzymatic Debridement
Form of debridement using topically applied exogenous enzymes to remove devitalized tissue; requiring physician’s prescription
Incision and Drainage
Procedure in which an abscess is surgically opened and thoroughly irrigated
Mechanical Debridement
Form of debridement using force to remove devialized tissue, foreign material, and debris from a wound bed
Nonselective Debridement
The removal of non specific areas of devitalized tissue. May include mechanical or surgical debridement
Selective Debridement
Removal of specific areas of devitalized tissue, may include sharp, enzymatic or autolytic debridement
Selective Sharp Debridement
Form of sharp debridement using scissors or scalpel to cut along the lines of demarcation between viable and nonviable tissue
Serial Instrumental Debridement
Form of sharp debridement using forceps and scissors to remove loosely adherent devitalized tissue. Usually occurs over a number of visits and may require prior tissue prep
Sharp Debridement
Selective debridement using forceps, scissors, or a scalpel
Surfactants
Cytotoxic substances within wound cleansers that lower surface tension of loose particulate matter on a wound bed
Surgical Debridement
The use of scalpels, scissors, or lasers in a sterile environment by a physician by a podiatrist to remove necrotic tissue, foreign material and debris from wound beds
Wet-to-Dry Dressing
Not used much. Consist of moistened gauze placed in or on a wound, left until dry and then removed
Wound Cleanser
Commercially available antiseptic containing surfactants. Not regulated by FDA
Wound Cleansing
The delivery of a wound cleanser to the wound surface using mechanical force to remove lightly adhered necrotic tissue, debris and bacteria
Wound Scrubbing
Mechanical debridement using a sponge, brush or gauze along with a fluid to break the adherence of devitalized tissue and debris from the wound bed
CHAPTER 17: BASIC DERMATOLOGY
Basic Dermatology
Abscess
Localized collection of purulent material in a cavity formed by necrosis and disintegration of tissues
Alopecia
Absence of hair in normally hairy areas of skin
Aphtha
Small ulcers of the mucous membranes
Bulla
A rounded or irregularly shaped blister greater than .5 cm in diameter, containing serous or seropurulent material
Burrow
Small and short (as in scabies) or long and tortuous tunnels in the epidermis
Carbuncle
Necrotizing infection of the skin and subcutaneous tissues composed of a group of furnuncles (boils)
Cellulitis (Erysipelas)
Inflammation of cellular tissue, purulent inflammation of the dermis, subcutaneous tissue and soft tissues
Comedo/Comedones
Plug of keratin and sebum in an orifice, blackhead
Crusts
Dried blood, serum or pus mixed with epithelial and bacterial debris
Cutaneous Horn
Localized spike-shaped area of marked overgrowth of keratin; can stick out above the skin a half an inch or more
Denune
Loss of epidermis
Ecchymosis
A macular red or purplish-blue hemorrhage in the skin or mucous membrane more than 2 cm in diameter
Erosion
Loss of all or potions of the epidermis; heals without scar tissue
Erythroderma
A generalized redness of the skin
Excoriation
Linear of punctate abrasion produced by mechanical trauma
Fibrosis
Formation of excessive fibous collagen in the tissues
Fissure
Linear crack or cleft through the epidermis and often into the dermis
Follicular Plugs
Keratin plugs in the hair follicle 1-3 mm in size
Furnuncle
A localized pygoenic infection originating in a hair follicle
Granuloma
Chronic inflammatory tissue composed of macrophages, fibroblasts, and granulation tissue
Keratoderma
Hyperplasia of the stratum corneum
Keratosis
Horny thickening of the skin
Kerion
Nodular inflammatory, pustular lesion due to fungal infection
Lesion
Pathological or traumatic loss of normal tissue continuity, structure, or function
Lichenification
Chronic thickening of the epidermis with exaggeration of its normal markings, often from excessive rubbing or scratching
Macule
Small, circumscribed change in skin color, nonpalpable, present in various shapes
Malperforans Ulcer
Seen in diabetics and Hansen’s disease: associated with neuropathy so the ulcers are painless yet deep and destructive
Milia/Milium
Whitish papules, 1-2 mm in diameter with no visible opening onto skin surface
Necrobiosis
Describes partial degeneration of tissue
Nodule
Papule greater than 1 cm in diameter, deeper and firmer than a papule; centered in the dermis or subcutaneous adipose
Papilloma
Benign tumor projecting from the skin
Papule
Circumscribed, solid elevations up to .5 cm in diameter, present in various shapes
Patch
Macule greater than 1 cm in diameter
Petechia
Punctate hemorrhage spot 1-2 mm in diameter
Plaque
Papule greater than .5 cm in diamter; often formed by coalescence of papules, generally flat but may have central depressions
Poikiloderma
Dermatosis characterized by variegated cutaneous pigmentation, atrophy and telangiectasia
Primary Lesion
Lesion that appears first
Pruritus
Irritating skin sensation that elicits the scratch response; itch
Pupura
Discoloration of the skin and mucosa due to extravasation of blood
Pustule
Small elevations of the skin containing purulent material
Rash
Temporary eruptions of the skin
Scales
Dry or greasy laminated masses of keratin
Scar
Collagen and connective tissue that replaces lost dermis
Sclerosis
Hardening or induration of the skin often due to fibrosis
Secondary Lesion
Primary lesion that has been modified by trauma, regression or other extraneous factors
Sinus
Cavity of channel in the tissue
Stria Cutis Distensae
A band or streak of linear, atrophic, pink, white, or purple lesions of the skin due to changes in connective tissue
Sycosis
Chronic pustular folliculitis and perifolliculitis involving the beard area
Telangiectasia
Visible vascular lesion formed by dilation of small cutaneous blood vessels
Tumor
Soft or firm, movable or fixed mass of various shape, larger than 2 cm
Vegetation
A growth of pathological tissue consisting of multiple closely set papillary masses
Verruca
Epidermal tumor caused by a papillary virus, describes lesion with a warty surface
Vesicle
Circumscribed, fluid containing, epidermal elevation 1-10 mm in size
Vibex
A narrow linear mark; usually hemorrhage from scratching
Wheal
Localized skin edema of irregular shape and variable size that is transient and superficial
Xerosis
Dryness of the skin, usually presents and scaling, superficial fissures and pruritus
