Exam 8: Skin, Connective Tissue, and Systemic Conditions Flashcards
1
Q
Skin Facts (11)
A
- largest organ
- 2 layers (epi (dermis))
- epi contains skin growth cells
- dermis does not regenerate
- environmental barrier
- protects from infection
- controls temp
- prevent fluid loss
-provides sensory info - contributes to identity
- produces vitamin D
1
Q
Skin Conditions Facts (5)
A
- can indicate other systemic diseases
- can be irritating vs. degrading
- can impact dermatomes and sensations bc receptors are in the skin layers (PNS)
- since skin changes as we age, it predisposes adults to skin conditions
- cardiopulmonary dysfunc. can impact skin
2
Q
types of burns
A
first degree = superficial
second degree = partial thickness
third degree = full thickness
3
Q
1st degree (superficial) burn
A
- epidermal layer
- redness and pain
- dry, no blisters
- sunburn
- heals 3-6 days
- no scarring
4
Q
2nd degree (partial thickness) burn
A
- epidermal & dermal layer
- some dermis remains
- large, thick-walled blisters
- deep red to waxy white
- moist
- heals 7-20 days
- scarring
5
Q
3rd degree (full thickness) burn
A
- epidermal, dermal, and into subcutaneous fat
- charred black, cherry red, tan, pearly white
- dry and leathery hard
- scar + risk of contracture
6
Q
measures of burn severity
A
- %TBSA (total body surface area)
- rule of nines (divide surface area into areas of 9%)
- inaccurate
- lund and browder chart
- more accurate and frequently used
- burn depth
- superficial, partial thickness, full thickness
7
Q
mechanism of thermal burn injuries (8)
A
- flames
- steam
- hot liquids
- hot metals
- electricity
- radiation
- toxic chemicals
- extreme cold
8
Q
hospital medical management of burns
A
- skin grafting
- used if it will take 3+ weeks to heal
- reduces length of hospital stay, pain, and scarring complications
- eschar is removed, graft is applied
- autograft (persons own skin)
- alternatives may be needed depending on burn size
9
Q
OT role in burns (7)
A
- education
- exercise
- positioning
- adaptive equipment
- ADL’s
- splinting
- scar management
10
Q
isolation (burn)
A
- C-Diff or VRE
- gown + gloves
- limit patient movement from isolation room
- avoid sharing equip. and always sterilize after use
11
Q
protective isolation (burn)
A
- used to protect vulnerable patient (immunosuppressed)
- chemotherapy
- transplant
- burn or wound patient
- precautions
12
Q
issues with skin integrity (pressure ulcers)
A
- pressure areas (bony prominences)
- skin shearing
- moisture due to incontinence
- poor circulation such as peripheral vascular disease
- poor nutrition, weight loss, bony prominences
- pressure mapping
- braden scale
13
Q
pressure ulcers stages
A
- stage I
- stage II
- stage III
- stage IV
- full thickness wound
- suspected deep tissue injury (can open up quickly)
14
Q
stage I pressure ulcer
A
- nonblanchable erythema usually over bony prominences or other pressure areas
- hard to detect color changes on darker skin
- warmth, tenderness, redness, texture changes
- won’t become ulcerated unless action is to relieve is not taken
15
Q
stage II pressure ulcer
A
- loss of skin
- blisters or open area
- subcutaneous tissue
- shallow
- reddish
- may have slight drainage
16
Q
stage III pressure ulcer
A
- full-thickness skin loss down to subcutaneous fat or fascia
17
Q
stage IV pressure ulcer
A
- full-thickness skin loss with exposure of bone
18
Q
teaching to learn
A
- types and thicknesses of burns
- types and stages of pressure ulcers
19
Q
what is cellulitis?
A
- bacterial infection of the skin
- face and lower leg most common
- skin checks vital for SCI
- check extremities, back, buttocks, skin folds, contractures
20
Q
etiology of cellulitis
A
- one or more bacteria enter through a crack or break in the skin
- streptococcus or staphylococcus
- recent surgery sites, open wounds, animal bites, athletes foot
21
Q
(venous) stasis ulcers
A
- due to CHF or PVD
- body doesn’t absorb fluid so it pools in the legs
- typically will weep
- acute or chronic
- often treated for pitting edema
22
Q
what is compartment syndrome?
A
swollen muscle compresses blood vessels and nerves in the leg
23
Q
compartment syndrome
A
- inflammation in a closed area, skin + connective tissue
- following trauma to area with large bruise/ hematoma
- surgical intervention: large open wound that heals slowly
24
Q
OT process of compartment syndrome
A
- inflammation management
- pain management
- wound healing
25
Q
treating open wounds
A
- wet & dry dressings
- can the client shower/ change their own dressings?
- wound vac
- minimize moisture at area (urine)
26
Q
OT role in treating open wounds
A
- ADLs with restrictions
- mobility with wound vac
- covering wounds for showering
- non-pharmacological pain management
27
Q
skin checks
A
- pressure areas in:
- bed
- wheelchair
- recliner/ geri-chair
- wearing oxygen all the time
- wearing a splint
28
Q
psoriasis facts (6)
A
- autoimmune
- flaky, dry, itchy, thickened skin
- psoriatic arthritis
- scratching can open areas
- overgrowth of skin
- creates plaque of scaly skin
29
Q
eczema facts (3)
A
- related to allergies
- more prevalent in children
- causes persistent itching
30
Q
temporary skin conditions
A
- dermatitis
- eczema
- allergic dermatitis
- often due to topical irritants
- asthma & allergies are more prone
- eczema
- hives
- rashes
31
Q
OT role in wound healing
A
- encourage good nutrition
- assess for pressure areas and teach positioning, provide equipment for positioning
- minimize skin shearing
- ADLs with wounds
- showers, bandage changes, skin checks
32
Q
Ehlers-Danlos Syndrome
A
- connective tissue disorder
- overly flexible joints and skin
- fragile skin
- joints prone to injury
- usually sports that involve flexibility
- can involve heart and digestion
33
Q
Marfan Syndrome
A
- connective tissue disorder
- affects heart, eyes, blood vessels, and bones
- tall and thin people with long arms, legs, fingers, and toes
34
Q
scleroderma
A
- skin, autoimmune disorder, and systemic disorder
- causes hardening of the skin and organs
- causes Raynaud’s Syndrome (vasospasms, intolerance of temp changes)
- scarring & contractures
- fingers contracted into claw-like position
35
Q
what is fibromyalgia? (6)
A
- systemic condition
- hurts all over (near joints)
- exhausted
- can’t figure out what is specifically wrong with client
- can stop people from functioning normally
- chronic
36
Q
etiology of fibromyalgia
A
- unknown
- sleep disturbances
- injury
- infection
- females
- 20-60 years old
37
Q
fibromyalgia symptoms (9)
A
- achy pain
- widespread pain in muscles, ligaments, and tendons
- fatigue (sleep problems)
- tender points - where slight pressure causes pain
- headaches
- heightened sensitivity
- IBS
- paresthesia in arms and hands
- depression/ mood changes
38
Q
fibromyalgia treatment
A
- antidepressants
- muscle relaxants
- stress reduction
- healthy lifestyle
- exercise program
- relaxation techniques, biofeedback and receiving information about chronic pain
39
Q
what is chronic fatigue syndrome?
A
- systemic condition
- aka myalgic encephalomyelitis
- unknown cause
- related to Lyme Disease?
- fevers, fatigue, achiness, poor activity tolerance
- frequent infections
- enlarged lymph nodes
- encephalopathy can occur
40
Q
systemic lupus erythematosus (5)
A
- systemic condition
- impact joints (like RA)
- impact on heart, liver, kidneys
- unknown cause
- environmental factors lead to autoimmune reactions of the body (allergies, infections/exposures)??
41
Q
prevalence of SLE
A
- proportion of population increasing
- new cases decreasing
- females
- 15-40 yrs.
- northern ireland & black caribbean descendants
42
Q
symptoms of SLE (10)
A
- arthritic inflammatory responses
- rashes (butterfly on face)
- joint pain
- renal or CNS involvement
- blood disorders
- depression
- exacerbations and remissions
- cardiac systems
- photo sensitivity
- oral ulcers
43
Q
amputations
A
- congenital
- acquired
44
Q
congenital amputation
A
absence of limb or part at birth
45
Q
acquired amputation
A
loss of limb or part due to trauma or surgery
46
Q
reasons for surgical amputation
A
- severe infection or gangrene
- removal of cancerous tumors
- severe injury with no hope of salvage
47
Q
LE amputations
A
- 82% related to diabetes of peripheral vascular disease
- conventional treatments
- medication adjustment
- therapy
- surgical amputation is last resort
- limb needs to be well shaped for maximal prosthetic function
48
Q
amputation postoperative complications
A
- neuroma
- nerve tissue bundle
- phantom sensation
- feeling that the amputated limb is still there
- phantom pain
- pain from the amputated portion of the limb
- weakness
- from prolonged inactivity
- skin breakdown
- falls
49
Q
occupational impact of amputations (6)
A
- balance is impacted, especially with LE amputations
- psychological adjustment
- phantom pain management
- residual limb wrapping
- don/doff prosthesis
- prosthesis training
50
Q
advantages of early prosthetic fit (7)
A
- decreased edema/ pain
- accelerated healing
- maintenance of 2-handed functioning
- decreased stay in hospital
- increased prosthetic use and acceptance/ psychological adjustment
- improved rehab
- increased proprioceptive input through residual limb
51
Q
symptom management of fatigue (5)
A
- energy conservation
- task simplification
- pacing
- prescribed exercise
- sleep hygiene techniques
52
Q
symptom management of scar management (3)
A
- scar massage
- teach self scar massage
- gentle stretching and PROM
53
Q
edema control methods
A
- swelling of an area related to inability of the lymph nodes to move lymph (tissue fluid)
- assessment
- measurement (volumeter, measurement)
- treatment
- compression garments, retrograde massage, lymphedema
- assessment
