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NPTE Prep_Mitch > Integumentary > Flashcards

Integumentary Flashcards

1
Q

5 key functions of the integ system

A 
Protection
sensation
thermoregulation
excretion of sweat
vitamin D synthsis
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2
Q

Wound Healing: Inflammatory stage

A

1-10days
platelet activation, clotting cascade, kill bacteria,
Establishes a clean wound bed which triggers tissue regeneration

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3
Q

Wound Healing; Proliferative phase

A

3-21 days

formation of new tissue, capillary buds and granulation tissue fill bed, skin integrity is restored

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4
Q

Wound Healing: maturation/remodeling phase phase

A

7 days to 2 years
granulation tissue and epithelial differentiation appear in wound bed, fiber reorganization, thin/shrinking of scar, new tissue =15% of strength, mature tissue can increase up to 80%

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5
Q

primary intention

A

occurs with acute wounds and min tissue loss, use sutures/staples/adhesives to close wound, min scarring, typically superficial of partial thinkness wounds

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6
Q

Secondary intention

A

healing without superficial closure due to infection, necrosis, irregular edges, etc. Assoc with DM, ischemic conditions, pressure ulcers. Require ongoing wound care/ large scars.

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7
Q

Tertiary intention

A

delayed primary intention due to possible complications of dehiscence/sepsis. Closed by primary intention once risk factors are mitigated.

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8
Q

Arterial Insufficiency Ulcers

A

Smooth edges, lack granulation tissue, deep, severe pain, diminished pulses, decreased skin temp, thin shiny skin, leg elev inc pain

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9
Q

Venous insufficiency ulcers

A

irregular shape, shallow, mild/mod pain, normal pulses, inc edema, flaky dry skin, brownish color, elev leg decreases pain

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10
Q

Neuropathic ulcers

A

well defined circle or oval, good granulation tissue, no pain, decreased skin temp, dry inelastic, shiny skin, loss of protective sense.

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11
Q

Wound classification: Superficial

A

trauma to skin, epidermis intact (non-blistering sunburn)

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12
Q

Wound classification: partial thickness

A

extends through epidermis, into dermis but not all the way through. (abrasions, blisters, skin tears)

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13
Q

Wound classification: full thickness

A

through dermis into deeper structures such as subQ fat. (deeper than 4mm)

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14
Q

wound classification: subcutaneous wound

A

through integ tissue into subq fat, muscle, tendon, bone. require secondary intentions typically

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15
Q

Pressure ulcer staging: Stage I

A

intact skin, non-blanchable rednes, local coloration differs from surrounding area, usually on bony prominence

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16
Q

Pressure ulcers: Stage II

A

partial thickness, shallow open ulcer with red/pink wound bed,

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17
Q

Pressure ulcer: Stage III

A

full thickness tissue loss, subQ fat may be visable but not bone or muscle tissue, can have tunneling /undermining

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18
Q

Pressure ulcer: Stage IV

A

Full thickness tissue loss with exposed bone, tendon or muscle, osteomyelitis is possible

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19
Q

Pressure ulcer: Suspected deep tissue injury

A

purple of maroon areas of intact skin or blood filled blister

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20
Q

Pressure Ulcer: unstageable

A

full thickness tissue loss, base is covered by slough and/or eschar. cant stage until enough shit is removed

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21
Q

Serous

A

clear light color, thin, watery. normal in healthy healing wound

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22
Q

Sanguineous

A

red color, thin, watery. red due to blood. indicative of new blood vessel growth or disruption of blood vesels

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23
Q

sersnguineous

A

light red/pink, thin, watery. normal in healthy healing wound. observe during inflamm and proliferative stages.

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24
Q

seropulent

A

cloudy or opaque, yellow or tan, thin watery. may be early warning of infection. Abnormal

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25
Q

Purulent

A

yellow or green, thick viscous. abnormal. indicator of infection

26
Q

Eschar

A

hard leathery, black/brown, dehydrated tissue, firmly adhered to wound

27
Q

Gangrene

A

death or decay of tissue from loss of blood flow. can also be charaterzed based on type of bacteria

28
Q

hyperkeratosis (callus)

A

white grey. firm or soggy based on moisture level

29
Q

slough

A

moist, stringy, or mucinous. white/yellow tissue loosly attached in clumps to the wound bed.

30
Q

Wound healing: red-yellow-black system: Red

A

pink granulation tissue> protect wound, maintain moist environ

31
Q

Wound healing: red-yellow-black system: Yellow

A

moist yellow slough: > remove exudate and debris; absorb drainage

32
Q

Wound healing: red-yellow-black system: Black

A

black, thick eschar firmly adheared > debride necrotic tissue

33
Q

dessicated

A

drying out or dehydration of the wound.

34
Q

desquamation

A

peeling or shredding of outer layers of epidermis. usualle occurs in small scales

35
Q

ecchymosis

A

discoloration below intact skin from trauma or blood seepage. typically blue/ black changing to green/yellow. Bruise

36
Q

Epidermis

A

avascular, flat squamous cells, round basal cells, and melanocytes

37
Q

Dermis

A

vascular, contains hair follicles, sebaceous glands, sweat glands, lymph and BV, nerve endings

38
Q

Erythema

A

diffuse redness from capillary dilation, congestion/ inflamm

39
Q

friable

A

tissue that redily tears/ bleeds when gently palpated

40
Q

Hematoma

A

localized swelling/ mass of clotted blood

41
Q

hypergrnaulation

A

increased thickness of the granular layer of the epidermis that exceeds the surface height of skin

42
Q

hyperpigmentation

A

darker than the surrounding areas

43
Q

hypertrophic scaring

A

abnormal scar form excessive collogen formation. raised, red, firm, disorganized collogen formation

44
Q

Keloid

A

red, raised, thick, excessive scar outside boundary of original wound

45
Q

maceration

A

skin softening and degeneration, from prolonged exposure to water or other fluids

46
Q

Turgor

A

relative speed that skin regains its normal appearance after being lightly pinched. indicator of elasticity and hydration

47
Q

compression garments and scars

A

recommended for burns needing more than 14 days to heal. sustained compression. 15-35 mmHg. 22-23 hours/day.

48
Q

Silver sulfadiazine

A

Advantage: used w/o dressings, painless, pplied to wound directly, broad spectrum, effective against yeast
Disadvantage:does not penetrate eschar

49
Q

Silver Nitrate

A

Adv: broad spectrum, non-allergenic, painless dressing
Dis: poor penetration, Discolors (making assessment difficult), can casue electrolyte imbalance, painful removal

50
Q

Povidone-iodine

A

Adv: broad spectrum, anti-fungal, easily removed with water
Dis: not effective against pseudomonas, may impair thyroid function, painful application

51
Q

Mafenide Acetate

A

Adv: broad spectrum, penetrates burn eschar, may be used with/ without occlusive dressings
Dis: metabolic acidosis, compromise resp function, inhibit epithialization, painful application

52
Q

Gentamicin

A

Adv; broad spectrum, may be covered of left open to air

Dis: has caused resistant strains, ototoxic, nephrotoxic

53
Q

Nitrofurazone

A

Adv: bacteriocidal, broad spectrum
Dis: may lead to overgrowth of fungus and psudamonas, painful application.

54
Q

Skin Graft: Allograft (homograft)

A

temporary graft taken from another human (cadaver)

55
Q

Autograft

A

permanent skin graft from donor site from self

56
Q

escharotomy

A

open/ remove eschar to reduce tension, relieve pressure, enhance circulation

57
Q

Full thickness graft

A

contains dermis and epidermis

58
Q

Heterograft

A

temporary graft from another species

59
Q

Mesh graft

A

skin graft altered to cover larger area

60
Q

sheet graft

A

skin graft directly transferred to prepared recipient site

61
Q

split thickness graft

A

superficial layer of dermis and all of epidermis

62
Q

Z-Plasty

A

surgical procedure to eliminate a scar contracture. Z incisions allows contracture to change configuration and lengthen scar.

NPTE Prep_Mitch (7 decks)

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