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Wound management and integ midterm > Integumentary management for physical therapists > Flashcards

Integumentary management for physical therapists Flashcards

1
Q

what are the two distinct layers of the skin?

A

epidermis
dermis

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2
Q

what occurs at the dermal-epidermal junction?

A

basement membrane

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3
Q

what is the layer under the distinct layers of the skin?

A

subcutaneous aka the hypodermis

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4
Q

what are the layers of the skin in order?

A

epidermis
dermis
adipose tissue
muscle
bone

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5
Q

what is meant by blanch able and non blanchable skin?

A

blanch able turns white after pressing on the skin

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6
Q

what is the dermis?

A

Thin stratified epithelium
Range from 0.06 to 0.6mm
0.4-0.6mm over palms of hands and soles of feet
Gives rise to hard keratinized structures (nails, hair)
Cellular, avascular, water resistant
Composed of 5 layers
90% Keratinocytes (synthesize keratin)
Contains melanin

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7
Q

what are the 5 layers of the epidermis?

A

stratum corner
stratum lucid
stratum granulosum
stratum spinosum
stratum basale

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8
Q

what are the cells of the epidermis?

A

keratinocytes
melanocytes
langerhan cells
basal cells
eccrine unit
procaine unit
hair folicles
nails
sebaceous glands

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9
Q

what are the cells of the dermis called?

A

fibroblasts
collagen
elastin
macrophages
mast cells
lymphatic glands
blood vessels
nerve fibers

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10
Q

what are the cells of the epidermis?

A

adipose

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11
Q

what is the function of a keratinocyte (squamous cell)

A

synthesis of keratin

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12
Q

what is the function of melanocytes?

A

synthesis of melanin

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13
Q

what is the function of langerhan cells

A

immune responce

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14
Q

what is the function of basal cells?

A

epidermal production

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15
Q

what is the function of eccrine unit?

A

thermoregulation by persiratation

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16
Q

what is the function of apocrine unit

A

sweat production

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17
Q

what is the function of hair follicles?

A

protection

18
Q

what is the function of nails?

A

protection

19
Q

what is the function of sebaceous glands

A

produces sebum (oil for lubrication of skin)

20
Q

what is the function of fibroblasts? where are the found?

A

collagen synthesis
dermis

21
Q

what is the function of collagen? where are the found?

A

insoluble connective tissue proteins
dermis

22
Q

what is the function of elastin? where are the found?

A

primary protein in elastic tissues
dermis

23
Q

what is the function of macrophages? where are the found?

A

phagoctosis, intimate growth and repair through growth factor production
dermis

24
Q

what is the function of mast cells? where are the found?

A

provide histamine for vasodilation
dermis

25
Q

what is the function of lymphatic glands cells? where are the found?

A

removal of microbes and intestinal waste
dermis

26
Q

what is the function of blood vessels cells? where are the found?

A

thermoregulation provides metabolic skin requirements
dermis

27
Q

what is the function of nerve fibers? where are the found?

A

sensory perception
dermis

28
Q

what is the function of nerve fibers? where are the found?

A

protection from trauma, energy storage, thermoregulation
subcutaneous

29
Q

what are the functional components of the epidermis?

A

stratum corneum
keratinocytes
melanocytes
Merkel cells
Langerhans’ cells

30
Q

what are keratins?

A

Insoluble fibrous proteins
Extremely resistant to changes in pH, temperature and enzymatic digestion
Two broad categories
Hard
Soft

31
Q

how often does the epidermis shed?

A

Sheds on average every 28-30 days
Until age 60- then every 60 days

32
Q

what are the functions of the epidermis?

A

Protection:
infection, shear/friction, water loss, toxic irritants
Vitamin D synthesis
Thermoregulation
Regulation, retention, dissipation
Sensation (light touch)
Pigmentation (melanocytes)

33
Q

what is the importance of the epidermal-dermal junction and what lies within there?

A

basement membrane: separates the epidermis form the dermis
rete pegs reduce shearing stress between the epidermis and the dermis

34
Q

what is the dermis?

A

Thickest layer of skin (2-4 mm)
20-30X thicker than epidermis
Provides support and nutrition to the epidermis
Responsible for giving skin its bulkiness
Extra-cellular matrix (fibroblasts)
Is vascularized and innervated
Major proteins are collagen and elastin

35
Q

what are the functional components of the dermis?

A

Functional components
hair follicles
sweat glands
sebaceous glands
nerve endings
lymph vessels
capillaries
collagen
elastin

36
Q

what are dermal appendages?

A

Hair follicles
Sebaceous glands
Sweat glands

Lined with epithelial cells
Epithelial islands

37
Q

what are subcutaneous tissues

A

Superficial fascia
Anchors skin to underlying structures
Blood vessels and nerve endings
Fat
Insulates and “pads” underlying structures

38
Q

how are the muscles aligned in the skin organization

A

Separated from subcutaneous fat by fascia
Point of contact to bony prominences
Greatest oxygen demand of all tissues
Most sensitive to ischemia

39
Q

Review what are the three factors the skin provides us? organs of communication and idenfification

A

provides thermoregulation
sensation
metabolism
Organ of communication and identification
Injury can result in:
Functional change
Physiologic change
Body image change
Facial skin, along with underlying muscles capable of expressions

40
Q

what are the levels of skin loss?

A

Wounds are classified by depth of tissue injury
Erosion- loss of superficial epidermis, probably not bleed, redness, repair by local inflammatory response
Partial thickness skin loss- loss of epidermis and part of the dermis, bleed, reepithelization for repair
Full thickness skin loss- loss of epidermis, dermis extending into subcutaneous/hypodermis, secondary intention repair through scar
Full thickness with muscle, tendon, bone

41
Q

what are the skin changes noticed with aging?

A

Decreased:
Epidermal/Dermal thickness
Decreased subcutaneous fat
Collagen and elastin
Size of Rete ridges/pegs
Sensation and metabolism
Sweat glands
Circulation
Reduced mast cells
Epidermal regeneration
Up to 4X slower healing than younger populations

Wound management and integ midterm (16 decks)

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