Integumentary

Question 1

Briefly describe the pathophysiology of pressure injuries

Answer 1

such as pressure sores/ulcers.

occur when pt is bedridden or when pressure is applied for prolonged periods in an unconscious pt or a pt immobilised on a longboard.

implicated tissues are starved of oxygen, leading to localised hypoxia and cell deterioration.

classified in 4 stages:

Stage 1 - skin appears red/discoloured but is not broken. this remains for more than 30 mins following removal of pressure.

Stage 2 - epidermis becomes broken and a superficial open sore develops.

Stage 3 - the sore continues down through the dermis and subcutaneous fat tissue.

Stage 4 - the sore continues down and penetrates the underlying muscle and may even go as far as the bone. Profound tissue necrosis will be present, accompanied by discharge from the site.

Most commonly found:

• heels
• toes
• sacrum
• hips
• elbows
• shoulders
• back of head
• any area subjected to prolonged periods without movement

Question 2

Define the term ‘thermal injury’

Answer 2

A thermal injury is: damage to some or all layers of the skin(epidermis, dermis, and subcutaneous tissue) caused by making contact with heated objects, such as boiling water, steam, hot cooking oil, fire, and hot objects.

Question 3

Describe the pathophysiology of burns in relation to burn depths

Answer 3

1st degree burns.

• limited to the epidermis
• red, painful, dry
• regeneration occurs rapidly from remaining epidermal cells.
• eg. sunburn

2nd degree burns.

• destroys the epidermis
• upper dermis are red, moist and often blister
• regeneration of the epidermis can occur because epithelial cells from sweat glands, sebaceous glands, and hair follicles in the dermis can multiply, and with time, form new epidermis
• heal without significant scarring

3rd degree burns.

• destroy epidermis and dermis down to the subcutaneous tissue
• charred and dry
• pain is reduced because of destruction of sensory nerve ending in the skin
• as all epithelial cells are destroyed, regeneration of epidermis can only occur from the margins of the burn
• this type of regeneration can only proceed, a few cm into the injured area
• skin grafting is required for larger injuries
• excessive scarring occurs