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NPTE > Integumentary > Flashcards

Integumentary Flashcards

1
Q

Cells in the epidermis

A

Keratinocytes
Melanocytes
Langerhans Cells
Basal Cells

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2
Q

Cells in the dermis

A

Collagen
Retinaculum
Fibroblasts
Macrophages
Lymphatic Glands
Blood Vessels
Nerve Fibers

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3
Q

Function of Langerhans Cells

A

immune

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4
Q

Function of Basal Cells

A

forms new skin cells

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5
Q

Function of Retinaculum Cells

A

stucture, elasticity

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6
Q

Receptor functions: Meissner

A

light touch
texture

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7
Q

Receptor functions: Merkel Disc

A

light touch
texture
pressure

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8
Q

Receptor functions: Pacinian

A

pressure
vibration

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9
Q

Receptor functions: Ruffini

A

heat
stretch
joint deformation

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10
Q

Receptor functions: Free Nerve Endings

A

pain
temperature
pressure
tickle
itch

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11
Q

Receptor functions: Krause End Bulbs

A

cold

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12
Q

Stages of cold sensation

A

CBAN: Cold > Burning > Aching > Numb

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13
Q

Herpes Zoster: presentation

A

Pain & paresthesia of affected dermatome.
Often unilateral.
Rash w/ clusters of fluid-filled vesicles, raised bumps.
Pink & silvery appearance.

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14
Q

Herpes Zoster: most common cranial N affected?

A

Trigeminal (more often affects ones that are BOTH sensory/motor)

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15
Q

Herpes Zoster: precautions

A

Airborne
Contact

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16
Q

Herpes Simplex types & precautions

A

Type 1: above the waist (usually mouth).
Type 2: below the waist (genital).
Contact Precautions

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17
Q

Venous Insufficiency definition

A

Veins not bringing blood back to heart, blood pooling in limb.

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18
Q

Arterial Insufficiency definition

A

Lack of blood flow to body region.

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19
Q

Venous vs Arterial Insufficiency: skin appearance

A

Venous: wet
Arterial: dry

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20
Q

Venous vs Arterial Insufficiency: common wound locations

A

Venous: medial malleolus.
Arterial: lateral malleolus, lower leg, toe, dorsum of foot.

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21
Q

Venous vs Arterial Insufficiency: wound appearance

A

Venous: irregular, shallow, flaking, brown, hemosiderin staining.
Arterial: smooth edges, deep, shiny, pale yellow, necrotic.

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22
Q

Venous vs Arterial Insufficiency: pain

A

Venous: mild-mod
Arterial: severe

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23
Q

Venous vs Arterial Insufficiency: other symptoms

A

Venous: edema
Arterial: intermittent claudication

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24
Q

Venous vs Arterial Insufficiency: how does elevation affect pain?

A

Venous: pain relief
Arterial: increased pain

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25
Q

Venous Insufficiency occurs with…

A

Clots
Valves in veins not functioning properly

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26
Q

Arterial Insufficiency occurs with…

A

HTN
Diabetes

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27
Q

Pressure Ulcers: stages are defined by what? How many stages?

A

Thickness & wound characteristics.
4 Stages.

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28
Q

Stage 1 Pressure Ulcer

A

Thickness: intact skin
Characteristics: non-blanchable redness

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29
Q

Stage 2 Pressure Ulcer

A

Partial Thickness (superficial)
Characteristics: pink/red wound bed, shallow crater

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30
Q

Stage 3 Pressure Ulcer

A

Full Thickness (subQ fat visible)
Characteristics: slough/eschar, deep crater, possible undermining & tunneling

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31
Q

Stage 4 Pressure Ulcer

A

Full Thickness (exposed bone, tendon, or muscle)
Characteristics: slough/eschar, often undermining & tunneling

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32
Q

What makes a pressure ulcer “unstageable”?

A

Covered with slough/eschar, unable to measure depth.

33
Q

Can pressure ulcers be backstaged?

A

NO.
Stage only changes if it gets worse.
If healing, still considered whatever stage it started as (e.g., Stage 3 recovering).

34
Q

Deep Tissue Injury appearance

A

Skin intact.
Purple/maroon (bruise-like)

35
Q

Diabetic Ulcers are often located where?

A

WB surface of foot

36
Q

How do we measure wound size?

A

Length x Width x Depth.
With disposable ruler.
Disposable cotton swab to measure depth.

37
Q

Wound examination: what tissue types are we looking at?

A

Granulation Tissue = viable/healthy.
Necrotic Tissue = non-viable/dead.

38
Q

Wound edge descriptions & which is most ideal?

A

Thin is ideal.
Indurated (thick).
Epibole (rolled).

39
Q

What kind of drainage is most ideal?

A

Clear, thin, watery (transudate, serosanguinous, or serous).

40
Q

Drainage: Transudate appearance

A

Clear
Thin
Watery

41
Q

Drainage: Serosanguineous appearance

A

Clear (hints of pink/red/brown)
Thin
Watery

42
Q

Drainage: Serous appearance

A

Clear (amber)
Thin
Watery

43
Q

Drainage: Sanguinous appearance

A

Bloody
Indicates inflammation

44
Q

Drainage: Pus appearance

A

Yellow/brown

45
Q

Drainage: Infected Pus appearance

A

Hues of green/blue
Viscous yellow
Foul odor

46
Q

Maceration periwound skin: appearance

A

White, wrinkled

47
Q

Maceration periwound skin: indicates what?

A

Wound is too moist

48
Q

Causes of Maceration periwound skin

A

Uncontrolled drainage.
Incontinence.
Improper wound care.

49
Q

Desiccation periwound skin: appearance

A

Cracked, flaky, crusty

50
Q

Desiccation periwound skin: indicates what?

A

Wound is too dry

51
Q

Causes of Desiccation periwound skin

A

Dehydration.
Infection.
Improper wound care.

52
Q

Steps of wound care

A
  1. Clean
  2. Debride
  3. Dress
53
Q

What should wounds be cleaned with?

A

Sterile saline for most.
Iodine for infected wounds.

54
Q

What is Selective Debridement & when should it be used?

A

Removes only the nonviable tissue.
Use if <50% necrotic or infected.

55
Q

What is Nonselective Debridement & when should it be used?

A

Removes both viable & nonviable tissue.
Use if >50% necrotic or infected.

56
Q

Selective debridement techniques

A

Sharp: using scalpel/forceps.
Enzymatic: topical enzymes.
Autolytic: moist dressings to promote body’s natural healing mechanisms.

57
Q

Nonselective debridement techniques

A

Wet to Dry Dressing: apply moist gauze, then remove when it’s dry (like waxing).
Irrigation: pressurized fluid.
Hydrotherapy: similar to irrigation, but in a whirlpool.

58
Q

How do we determine dressing type?

A

Based on the amount of exudate (fluid) & whether the wound is infected.

59
Q

Dressings for none to very mild exudate (dry)

A

Transparent films (Tagaderm, OpSite).

60
Q

Dressings for minimal exudate

A

Hydrogel
Hydrocolloid

61
Q

Dressings for moderate exudate

62
Q

Dressings for excessive exudate (wet)

A

Calcium Alginate
Hydrofiber

63
Q

Dressings for infected wounds

A

Calcium Alginate
Hydrofiber
Hydrogel
Gauze

64
Q

What dressing type should NOT be used for infected wounds?

A

Foam - bc this will spread the infection

65
Q

Burn thickness is based on what factors? List the types.

A

Based on tissue layer involved & presentation.
1. Superficial
2. Superficial Partial
3. Deep Partial
4. Full
5. Subdermal

66
Q

Superficial thickness burn

A

Epidermis.
Dry, red.
No open areas.

67
Q

Superficial Partial thickness burn

A

Epidermis & some of Dermis.
Mottled red, weeping blisters.
Blanches to pressure w/ quick capillary refill.
Extremely painful.

68
Q

Deep Partial thickness burn

A

Epidermis & Dermis.
Red & white.
Blanches to pressure w/ slow capillary refill.
Impaired pinprick sensation.

69
Q

Full thickness burn

A

Epidermis, Dermis, & some of SubQ.
Dry, leathery eschar (may be white & black).
Lack of pain, pressure, & temperature.

70
Q

Subdermal thickness burn

A

Epidermis, Dermis, & SubQ.
Dry, charred.
Exposed deeper tissues.

71
Q

RYB System: management of Red wounds

A

Cover the wound, keep it moist.
Transparent dressing over gauze moistened with saline. OR hydrogel, hydrocolloid, or foam dressing.

72
Q

RYB System: management of Yellow wounds

A

Remove yellow layer.
Moisture-retentive dressing: hydrogel, foam, or moist gauze (with or without debriding enzyme).
Debridement: hydrotherapy or irrigation.

73
Q

RYB System: management of Black wounds

A

Debridement: enzymatic, sharp, hydrotherapy, or irrigation.

74
Q

RYB System: management of wounds w/ inadequate blood supply OR non-infected heel ulcers

A

Do NOT debride.
Keep it clean & dry.

75
Q

What is the Rule of Nines?

A

For burns, to estimate % of body surface area affected.

76
Q

Rule of Nines body parts counted

A
  1. Head = 9%
  2. L Arm = 9%
  3. R Arm = 9%
  4. L Anterior leg = 9%
  5. L Posterior leg = 9%
  6. R Anterior leg = 9%
  7. R Posterior leg = 9%
  8. Chest = 9%
  9. Abdomen = 9%
  10. Upper Back = 9%
  11. Lower Back = 9%
  12. Perineum = 1%
77
Q

Normal scar appearance

A

Flat, similar to skin color

78
Q

Hypertrophic scar appearance

A

Thick fibrous tissue
Stays within original wound border

79
Q

Keloid scar appearance

A

Thick fibrous tissue
Grows outside of original wound border

NPTE (28 decks)

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