Exam 2 Flashcards
Body surfaces, such as the skin and digestive tract, normally contain a small number of resident bacteria and fungi called
Microflora
What is the body’s first line of defense against infection?
skin surface barriers, skin and body’s immune system help protect against infection.
What is considered the normal pH of the skin?
5.5, it’s an acidic enviornment, so that it discorages microbial growth
What is the body’s second line of defense?
cellular and chemical defenses, such as neutrophils, langerhan cells, macrophages, the inflammatory response helps direct many of these cells.
A cascade of proteins produced by the body that enhances the body’s defense against pathogens. Made up of 30 inactive circulating plasma proteins. Activated when it recognizes antibodies on the surface of a pathogen. This is known as
the complement system.
Presence of microbes on wound surface, that is considered normal and has no effect on wound healing.
contamination
Presence of replicating microbes on wound surface, that is considered normal and has no effect on wound healing
Colonization
Increasing wound biorburned that reaches a critical point and begins to adversely affect the host, is considered abnormal. Causes a plateu in wound healing or decline in wound status. Signs and symptoms of infection are likely. Considered an abnormal response. Is known as
Critical colonization. can have critical colonization in a different area from the wound, which means it will not affect the status of the wound.
Replicating microbes invade viable body tissues, abnormal response, decline in would status, signs and symptoms of infection likely is known as
infection, infection is microbe concentration of greater than 10^5 microorganisms /gram of tissue, infection will delay or stop wound healing
What is the equation for wound healing?
(number of bacteria x bacterial virulence)+ interaction between microbes/ host resistance + modifying factors
Modifying factors include
- Host’s overall health
- Presence of pathology
- Steriod use
- Presence of nonviable tissue
- Proper wound management
List 4 Adverse Effects of high Microbe concentrations
- Compete with host cells for oxygen and nutrients
- Bacterial EXOTOXINS may be cytotoixic
- BACTERIAL ENDOtoxins may activate host inflammatory process
- Wound infections delay and may prevent wound healing
List the Local Factors that can increase risk of infection
- Ischemia
- Necrotic tissue
- Wound debris
- Chronic wounds
List host factors that can increase risk of infection
- Break in the skin
- diabetes
- Malnutrition
- Obesity
- Steriod use
- Immunocompromised
- Increased age
What is the difference between signs of inflammation vs. signs of infection?
same as signs of inflammation except excessive and disproportionate to size and extent of wound. Also there is a noted decline in wound status despite appropiate care
If Rubor in a patient’s wound is present what is considered a sign that it is just inflammation and not infection?
Well-Define erythemal border
If Rubor in a patient’s wound is present what is considered that it is a sign of infection?
-POORLY define erthyemal border
disproportionate amount of erythema
possible PROXIMALLY directed erythemal streaking
What is considered “a tell-tale sign” of vascular invovlvement?
streaking
If calor was present in a patient’s wound how can a you tell if it is just inflammation vs. infection?
with inflammation there would be a localized increase in temp
If calor was present in a pateint’s wound how can you tell that the wound is infected?
Large localized temperature increase; may be febrile
If TUMOR was present in a wound how can you tell it’s just due to inflammation?
small amount of edema, proportioanate to wound
If TUMOR was present in a wound how can tell it’s due to infection?
Edema would be dispropotionate to wound size.
Periwound may be indurated, which is to push on the wound and it feels like pushing into clay, very hard and firm and doesn’t rebound
If DOLOR was present how can you tell if a wound is inflamed vs. infected?
-Pain that is proportionate to wound size/extend: will be inflammed
Pain that is increased or new pain and disproportionate to size is infected
If the patient presented with loss of function how can you tell if a would is infected or just inflammed?
- Temporary in affected area-inflammation
2. malaise, tachycarida, hypotension, altered mental status–>infection
If a patient’s wound presented with drainage, how can you tell it is inflammed vs. infected?
- Drainage is proportinate to size, Thin consistency, serous or serosaguinous- inflammed
- IF drainage is disporportionate to size, thick, purulent, creamy, white, green, blue colors, may have odor–>infection
If you note there is a decline a patient’s wound status how can you tell it’t due to inflammation vs. infection?
- Inflammation follows 3 normal phases of wound helaing
2. Infection healing plateus, decreased granulation tissue looks like cobble-stone and changes color.
What type of patient is at great risk to present with a “silent infection”?
patients who are immunocompromised or have inadequate perfusion are at greater risk and are less likely to exhibit the classic signs of infection because of their tempered immune system.
List 2 examples of a silent infection
- Abcess: localized collection of pus composed of devitlaized tissue. Because the infection is contained within the abcess, the body may no recognize the actual infection
- Aterial Insufficiency leading to gangrenous toe. the body may not be able to mount a proper defense against infection because of inadequate circulation to the affected area. This will make the classic s/s of infection unapparent.
