FINAL flashcards
What are some characteristics of a benign growth?
- does not metastasize
- grow slowly
- well defined capsule
- not invasive
- well differentiated
- low mitotic index
What are some characteristics of a malignant growth?
- rapid growth
- not encapsulated
- invasive
- poorly differentiated
- high mitotic index
- spreads
What are examples of benign tumors?
Lipoma
Hemangioma
Leiomyoma
Chondroma
What are the TMN stages of cancer?
Stage 1: Confined to organ of origin
Stage 2: Locally invasive
Stage 3: Spread to lymph nodes
Stage 4: Spread to distant sites
CIS special case
What cancer stage would it be if the cancer is confined to organ of origin?
stage 1
What cancer stage would it be if the cancer is locally invasive?
stage 2
What cancer stage would it be if the cancer has spread the lymph nodes?
stage 3
What cancer stage would it be if the cancer has spread to distant areas of the body?
stage 4
Neoplasia
abnormal proliferation cells with high degrees of autonomy
Anaplasia
lack of differentiation, primitive cells
Autonomy
cancer cells independent from normal cell control
Markers
substances produced by cancer cells
What are some examples of environmental risk factors for cancer?
Tobacco Radiation Alcohol Sexual behavior (HPV) Diet Obesity Occupational hazards Electromagnetic fields?
What can we modify our treatment for someone on chemo?
Decrease intensity, in order to not fatigue the patients
Tissue after radiation?
the tissues becomes fibrotic and hard
PH of skin
4.5-5-5
Vital functions of skin
- Regulating temp
- Sensations: touch, pressure, and pain
- Preventing loss of body fluids
- Excretory organ
- Interface
- Prevents invasion
What are some age related changes that occur to the epithelium?
Sweat glands diminish
Epithelial and fatty layers atrophy
Collagen and elastin shrink and degenerate
Decrease 1 percent per year of adult life
When there is a pressure wound where does the most damage occur? superficially or deeper?
- Deeper muscle tissue can be necrotic before damage to the overlying tissue is apparent
- If time pressure threshold is exceed damage can occur even after the pressure has been relieved
HOTSPOTS
Heels Occiput Toes Sacrum Posterior buttcheek Occipital protuberance Thoracic spine Scapula
Shear
mechanical force that is parallel
Macerated skin is ____ more likely to become ulcerated?
5 times
What are the wound healing processes?
primary intention
delayed primary intention
second intention
WOUND HEALING: primary healing
wound has little to no tissue loss (Body is healing itself)
WOUND HEALING: delayed primary intention
healing occurs when significant tissue loss can be repaired surgically with a skin or mm graft
WOUND HEALING: secondary intention
describes the process of healing a wound without the benefit of surgery
Scar tissue is stronger than normal skin T/F?
FALSE- scar tissue will never have the same strength
Induration
tissue firmness that may occur around a wound margin
Erythema
inflammatory redness of the skin due to engorged capillaries
Maceration
wet skin
Undermining
tunneling effect or pocket occurring under the pressure ulcers edges or margins
Slough
nonviable tissue is loosely attached
Eschar
nonviable dead wound (black)
Granulation
formation in wounds of soft, pink, fleshy projections consisting of capillaries surrounded by fibrous collagen
Pressure wound stages
Stage 1: Intact skin non-blanchable
Stage 2:Partial thickness loss of dermis where you can see a shallow open ulcer without slough. Intact or open serum filled blister.
Stage 3: Full thickness tissue loss, subq fat may be visible, but no bone or mm. Slough. Undermining and tunneling
Stage 4: Full thickness with exposed bone, tendon, or mm
UNSTAGABLE: covered by eschar, can’t be stages
Stage 1 pressure wound treatment
- Remove the pressure
- Do not rub or massage prominence
- Do not use donuts
Stage 2 pressure wound treatment
- Remove pressure
- Keep clean
- Keep blisters intact if possible
- Cover with light dressing if ulcer is open (DAILY)
Stage 3 pressure wound treatment
- Remove pressure
- Eliminate slough
- Manage exudate
- Monitor for infection
- Treat pain
Stage 4 pressure wound treatment
- Remove pressure
- Eliminate slough or eschar
- Manage exudate
- Treat pain
- Monitor for infection
transparent film
- Allows oxygen penetration
- Autolytic debridement
- Good for stage 1-2
Foam
- Non occlusive
- Highly absorbent
- Up to 7 days
- NOT FOR DRY WOUNDs
What dressings should we use to manage exudate?
- foam
- alginates
What should we use to eliminate slough?
Autolytic, enzymatic or sharp debridement
Hydrocolloids
- swells with exudate
- Waterproof—helps with autolytic debridement
- Use on shallow stage II pressure ulcers
- Can trap moisture under the dressing causing maceration
Hydrogels
- Applied to base of the wound to soften eschar
- Use in wounds that are dry, contain hard
eschar - Provide some soothing, pain relieving
properties - CON: require secondary dressing
Alginates
- Seaweed based woven fibers: exudate
- Highly absorbent
- Can be left in wound bed for several days
- Require a secondary dressing
- Good on highly draining stage III and IV ulcer
What are some signs of a arterial insufficiency ulcer?
- painful
- red
- no drainage
- well defined edges
What are some signs of a venous insufficiency ulcer?
- not painful
- drainage
- irregular edges
- shallow
How to you treat a arterial venous insufficiency?
LOWERING the LEGS
no compression
Examples of selective debridement?
Enzymatic
autolytic
maggots
Examples of non-selective debridement?
Wet to dry
whirlpool
RULES of 9’s
Head 9 Chest 9 Stomach: 9 Front of arms 4.5 Whole arm would be 9 Genitals 1 Front of leg 9 Back of leg 9
With what burn percentage is there a risk of dying?
over 25 percent of the body burned
Burn degrees?
1st degree burn: Skin is red
2nd degree partial thickness: Blisters
3rd degree full thickness : Charring
What is the difference between keloids and hypertrophic scaring?
Keloids grow beyond the original wound boundary compared to hypertrophic scarring which stays WITHIN the wound boundaries
Pelvic floor grades of severity
- Discomfort
- Frequently limits intercourse
- Incapacitating problem, abstinence
What percentage of women do not seek pelvic floor health?
60 percent
What is the most important pelvic floor exercise?
KEGALS
Diastasis exercises?
Bridging Pelvic tilts Dead bug Braced crutch Pank
