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PT exam 2 > integ > Flashcards

integ Flashcards

1
Q

for integ, what is done during evaluation and treatment

A

observation of skin
noting of abnormalities
documentation of this

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2
Q

things that are examined in skin

A

integrity - intact vs not
color
scar formation
hair/nail growth

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3
Q

what is hair/nail growth indicative of

A

healthy dermis with adequate circulation

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4
Q

what could cause skin to not be intact

A

decubitus - pressure ulcers
opening skin injuries
surgical incisions
burns/frostbite

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5
Q

what should be documented with surgical incisions

A

location, length
# of staples/sutures
wet/dryness
oozing or not
bandage condition

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6
Q

how to document wound location

A

precise anatomical terminology
wound relations to anatomical landmarks
side and body surface of lesion

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7
Q

what characteristics of wounds will be measured

A

location / size

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8
Q

how are burn sizes calculated typically

A

rule of 9s
% of total body surface

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9
Q

what is the difference between turgor in young vs old adults

A

young - no delay before rebound
old - delay before rebound

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10
Q

what are age related skin changes

A

thinning
translucent
pale

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11
Q

what are characteristics of integumentary integrity

A

structure and quality
color
epithelial appendages

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12
Q

what is associated with structure/quality of integ

A

age-related skin changes
periwound hydration
turgor
quality of skin - dry/scaly vs moisturized
scar formation

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13
Q

what could be affected around a wound

A

skin color
- erythema / hemosiderin staining

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14
Q

what is hemosiderin staining indicative of

A

longstanding vascular disease as RBC leak out of circulation

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15
Q

what is bluish periwound color indicative of

A

long standing ischemia

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16
Q

if there is a periwound blueish tint, will there be epithelial appendages

A

no, they cannot support hair/nail growth

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17
Q

what is a sign of arterial insufficiency

A

shiny hairless, pigmented skin

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18
Q

during vascular exam, what should you inspect

A

symmetry of limbs
skin color, size, shape
edema
ulcerations
varicosities

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19
Q

what causes edema

A

acute injury response
retention of salt and water
venous stasis
right heart failure
hypoalbumienemia
lymphedema
increased capillary permeability
orthostatic edema

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20
Q

salt and water retention can cause

A

dependent edema due to increased interstitial fluid

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21
Q

what is venous stasis

A

obstruction of veins that can lead to edema

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22
Q

what are characteristics of right heart failure

A

decreased heart pumping
increased hydrostatic pressure
dependent edema
jugular vein distention
enlarged liver

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23
Q

what is kwashiorkor disease? what is it an example of?

A

severe protein malnutrition that causes abnormal swelling in the extremities and abdomen

hypoalbumienemia

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24
Q

what is associated with Hypoalbumienemia

A

decreased osmotic pressure
feet, leg, eyelid edema initially
common w/ poor nutrition (decreased protein)
more typical in poor countries, especially infants

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25
Q

what are characteristics of lymphedema

A

damaged, obstructed, inflamed or fibrosed lymph vessels causing pitting/non-pitting edema in an extremity

26
Q

what causes increased capillary permeability

A

burns, allergies, inflammation

27
Q

what will increased capillary permeability lead to

A

local / dependent edema

28
Q

what are characteristics of orthostatic edema

A

sitting/standing for a long time
little muscle contraction
dependent edema

29
Q

what is pitting vs non pitting edema

A

pitting - accumulation of interstitial fluid that causes a pit when pressure is applied

“not easily moved away from pressure”

30
Q

how to test edema

A

press for 5-10 sec
measure time it takes to respond

31
Q

how to document edema

A

location: ____ cm below landmark, 1+ to 4+ scale and type of edema

32
Q

what # mm are related to pitting edema scale

A

1+ = <2 mm
2+ = 2-4 mm
3+ = 5-7 mm
4+ = >7 mm

33
Q

what is the verbal descriptor of edema

A

1+ = barely perceptible depression
2+ = easily identifiable, rebounds in <15 sec
3+ = rebounds in 15-30 sec
4+ = depression lasts >30 sec

34
Q

what are measurements of edema

A

circumferential or volumetric method

35
Q

what is important to remember for edema test and measures

A

to measure non-injured extremity for comparison

36
Q

what are linear measurements of edema

A

tape measure recordings of girth at predetermined landmarks

37
Q

what is the reference point for the forefoot

A

MTP joints

38
Q

what is the reference point for the midhand

A

proximal palmar crease

39
Q

what is the reference point for the forearm

A

ulnar styloid process

40
Q

what is the reference point for the mid-calf / distal thigh

A

lateral malleolus
tibial tuberosity

41
Q

what are the marked locations for the figure 8 pattern of ankle edema measurements

A

navicular tuberosity
base of 5th metatarsal
distal tip of lateral malleolus
distal tip of medial malleolus
tibialis anterior tendon

42
Q

process of figure 8 ankle edema measurements

A
  1. start tape measure mid-way between tib ant tendon and lateral malleolus at anterior aspect of ankle
  2. wrap medially to pass the navicular tuberosity through the arch and proximal to base of 5th metarsal
  3. loop back around to tib ant tendon distal to distal tip of medial malleolus
  4. encircle achilles tendon and placed distal to distal end of lateral malleolus
  5. measurement ends at start of tape
43
Q

increased periwound temperature indicates

A

inflammation, infection or impaired circulation

44
Q

what is temperature recorded as? in comparison to what

A

increased, decreased, or normal as compared to contralateral/intact side

45
Q

contralateral difference of greater than ______° indicates

A

4
clinically significant

46
Q

when considering temperature of skin, what are some considerations

A

allowing skin to normalize to room temperature

47
Q

how can skin be normalized to room temperature

A

uncovered for 5 min prior to evaluation if using hand

uncovered for 15 min prior to using thermographer

48
Q

how assess skin temperature by hand

A

back of the hand
assess proximal skin and contralateral side

49
Q

what is xeroderma? what are its characteristics / what worsens it?

A

excessive dryness of the skin
rough and scaly
worsens with dry climates, soaps, drying skin cleaners

50
Q

who is at risk of xeroderma

A

older adults due to dehydration, thinning skin

51
Q

what is eczema/dermatitis

A

superficial inflammation that is more common in older adults

52
Q

what causes eczema and dermatitis

A

hypoproteinemia
venous insufficiency
allergens, irritants
underlying malignancy
drug interaction

53
Q

what are examples of bacterial skin infections

A

impetigo
pyoderma
folliculitis

54
Q

what are examples of viral skin infections

A

warts
shingles
herpes simplex

55
Q

what are examples of fungal skin infections

A

ringworm
athletes foot
jock itch

56
Q

what are some “other” skin infections

A

scabies
lice

57
Q

how to judge skin cancer

A

A - asymmetry
B - border
C - color
D - diameter
E - evolving

58
Q

what are colors associated with skin cancer

A

black, brown, red, white, pink, blue

59
Q

what diameter is noted as possible skin cancer

A

wider than a pencil eraser

60
Q

what types of psoriasis are there

A

chronic
inherited
recurrent
non-infectious

PT exam 2 (9 decks)

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