Integ. Lecture 2 Test 1 Flashcards

1
Q

What happens in the hemostasis phase in normal wound healing?

A

Blood clots form
Bleeding stops
Blood clot is broken down

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2
Q

How long does the hemostasis phase last in normal wound healing?

A

0-2 minutes

should be in full production by 2 hours

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3
Q

What happens in the inflammatory phase of normal wound healing?

A

Vascular
Exudate
Reparative

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4
Q

What happens in the vascular stage of the inflammatory process?

A

leakage fluid
proteins into wound
brings in allow needed structures to survive

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5
Q

What happens in the Exudate stage of the inflammatory phase?

A

Neutrophils come first
begin clean up
battle foreign debris and bacteria

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6
Q

What happens in the Reparative stage of the inflammatory process

A

Macrophages come in
wound healing begins*****
Battle bacteria and dead cells
Begin to lay down new tissue

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7
Q

What happens in the proliferative/epithelialization phase and when does it start?

A

starts around 2 days to 2 weeks

Granulation
angiogenesis (new blood cells)
New ECM (extra cellular matrix)
    -Fibroblasts, new vessels, and collagen
Contraction via myofibroblasts
Epithelialization
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8
Q

How long does the inflammatory phase last?

A

0-2 days

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9
Q

What happens in the remodeling phase?

A

Type 3 collagen to type 1 collagen
Decrease in vascular need=pink, turning to white
+3 year process of change

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10
Q

How long does the remodeling phase last?

A

2 year to 2 weeks (toughening the skin)

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11
Q

T/F Any acute injury beyond the epidermis and through the BMZ causes bleeding?

A

TRUE

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12
Q

T/F Overlapping occurs during the different phases of normal wound healing?

A

TRUE

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13
Q

What helps to stop the bleeding of the a wound during the hemostasis phase?

A

Aggregation and activation of platelets

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14
Q

What type of cells release clotting factors?

A

Injured

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15
Q

What does a blood clot consist of?

A

Fibrin
Aggregated platelets
Blood cells

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16
Q

Hemostasis is further achieved by a brief period of _________ to the injured area

A

Vasoconstriction

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17
Q

What is the purpose of the clot?

A
  • Seals disrupted vessels to control blood loss
  • Provides a temporary bacterial barrier
  • Provides a reservoir of growth factors
  • Provides an interim matrix that serves as scaffolding for migrating cells
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18
Q

What is the process of breaking down a clot?

A

Fibrinolysis

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19
Q

What happens 10-15 minutes after tissue injury in the inflammatory phase?

A

Vasoconstriction subsides
Vasodilation and cell permeability increases
Chemoattraction by damaged cells and platelets attract leukocytes to clean up the area

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20
Q

First cells to arrive in the new wound are?

A

Neutrophils

—Present within minutes of the injury and dominate the area for 2-3 days

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21
Q

Primary function of neutrophils?

A

Remove bacteria and foreign debris via phagocytosis

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22
Q

After neutrophils arrive to the injured site what cells come in next?

A

Macrophages

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23
Q

What is the role of macrophages?

A

finishing bacteria and breaking down damaged tissue removal

Damaged cells are replaced

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24
Q

What is the process that occurs during the proliferative stage?

A

Granulation
Angiogenesis
Wound Contraction
Epithelialization

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25
Q

What happens during the granulation phase in proliferative phase?

A

Fibroblasts and capillary buds develop at the edges of the wound and gradually advance toward the center forming a bed of granulation (from the edges to the middle)

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26
Q

When does the granulation phase happen? (how many days out)

A

3-4 post injury after the inflammatory phase subsides

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27
Q

What affects granulation tissue formation?

A

Perfusion status
O2 levels
Nutritional status
Glucose levels

28
Q

What happens in the angiogenesis phase of proliferative?

A

New extra cellular is formed by collagen fiber deposition and new capillary loops

29
Q

What are the two mechanism angiogenesis occurs by?

A

Production of new vessels by local endothelial cells

Recruitment of circulating stem progenitor cells (starts new cells spontaneously)

30
Q

T/F Contraction of a wound happens when the force pulls the edges of the wound together so the granulation tissue and the new epithelial cells don’t have to travel as far

A

TRUE

31
Q

T/F the epithelialization and contraction happen at the same time in the proliferative phase?

A

TRUE

32
Q

What type of cells form around the edges of the wound and migrate inward?

A

Basal Cells

33
Q

What is contact inhibition?

A

when epithelial cells moving across a wound bed come in contact with other epithelial cells
Ceases migration of epithelial cells across a wound bed

34
Q

New skin is ___% as strong as original tissue

A

15%

35
Q

As the new skin becomes stronger it is around ___% as strong as the original skin?

A

80%

*Never will be as strong as it was

36
Q

What phase completes the last wound healing process?

A

Remodeling phase

37
Q

What are the 3 types of wound closure?

A
  • Primary
  • Secondary
  • Tertiary
38
Q

What is the type of wound closure that is the result from a severe infection?

A

Tertiary

39
Q

What type of wound closure is when wound edges are approximated and secured with sutures, stapes, glues?

A

Primary

40
Q

What type of wound closure results in the smallest scars?

A

primary

41
Q

What type of wound closure is characterized by prolonged periods of inflammatory and proliferative phases?

A

Secondary

42
Q

What type of wound closure benefits from skin grafts/flaps, substitutes or other surgical interventions?

A

Secondary

43
Q

What type of wound closure benefits from negative pressure wound therapy

A

Tertiary

44
Q

What are the 4 types of exudate?

A
  • Serous
  • Purulent
  • Fibrinous
  • Hemorrhagic
45
Q

What is another name for exudate?

A

Drainage

46
Q

T/F Purulent exudate is very common in a venous ulcer?

A

FALSE–Serous exudate

47
Q

What type of exudate is a liquid that is slightly thicker than water and is light yellow?

A

Serous

48
Q

What type of exudate is a good clinical indicator that there is an infection present?

A

Purulent

49
Q

What type of exudate can become adherent to the wound bed?

A

Fibrinous

50
Q

What type of exudate is red, thick drainage?

A

Hemmoragic

51
Q

What type of exudate has the sign of infection or trauma to the area causing capillaries to break down and bleed spontaneously?

A

Hemmoragic

52
Q

What type of exudate is reddish, thin, and watery drainage?

A

Sanguineous

53
Q

What type of exudate occurs with trauma to blood vessels (can occurring during injury or the healing process)?

A

Sanguineous

54
Q

What type of exudate is clear, pink, thin, and watery drainage?

A

Serosanguineous

55
Q

What type of combination exudate is normal to see in wound healing ?

A

Serosanguineous

56
Q

What type of exudate is yellowish and cloudy?

A

Seropurulent

57
Q

What type of combination exudate is a good sign of wound infection?

A

Seropurulent

58
Q

What type of exudate is dark red and viscous?

A

Hemopurulent

59
Q

What type of contains bacteria, inflammatory cells, and tissue that is dead or dying?

A

Hemopurulent

60
Q

What does partial thickness wound depth include?

A

Partial loss of dermal tissue that is confined to epidermis and superficial dermis

61
Q

What does full thickness wound depth include?

A

involves total loss of dermal tissue that may involve deeper tissues (muscles, bone, subcutaneous)

62
Q

T/F In an acute wound it generally moves rapidly and predictably through the healing process?

A

TRUE

63
Q

What are chronic wounds frequently caused by?

A
  • Vascular compromise
  • chronic inflammation
  • repetitive trauma to injured tissue
64
Q

which wound results in less durable closure? (acute/chronic)

A

chronic

65
Q

What are acute wounds caused by?

A

trauma or surgery

66
Q

What are 7 factors that influence wound healing?

A
  1. Level/presence of infection
  2. Size of wound (amount and depth of tissue involved)
  3. Location
  4. Type of wound
  5. Amount of available blood
  6. Co-morbidities
  7. Nutrition