Integumentary System Flashcards
what is herpes zoster vs herpes 1 and herpes 2
herpes zoster is the shingles virus that follows a dermatomal pattern, typically T11-T12. Burning, tingling, one sided pain typically occurs. The rash is painful!
Herpes 1(simplex) is what you get with a cold sore by contact. no clue contact and antiviral medication
Herpes 2 is genital herpes from sexual contact.
when someone is independent with transfers and is unable to walk, what would be the more likely cause of ischial tuberosity ulcers, friction or tissue loading
tissue loading. They can transfer independently do that makes it less likely to be friction. However, the pt is not walking so pressure builds from prolonged sitting.
Serous drainage is
a clear, watery drainage.
Chylous drainage is
milky and white, usually after abdominal surgeries due to the damage or trauma to the cisterna chyli or adjacent lymphatic trunks
sanguineous drainage is usually
thin and bloody, post surgery at surgical sites
purulent drainage is
thick and has an odor and has large amount of bacteria inside of it
staging of pressure injuries stage 1
stage 1: nonblanchable erythema of intact skin. may have temperature changes, and tissues can be firm or boggy, can be painful or itchy. redness not always visible (darker skin).
staging of pressure injuries stage 2
partial thickness skin loss, with the epidermis or dermis or both. superficial ulcer. shows as blister, abrasion or shallow crater.
staging of pressure injuries stage 3
full thickness, damage/necrosis of subcutaneous tissue. may go to underlying fascia (not through). deep crater
staging of pressure injuries stage 4
full thickness, extensive destruction, tissue necrosis, damage to muscle bone or supporting structures. undermining and sinus tracts may be here
unstageable pressure injury
tissue depth obscured to eschar or slough or both. extent of damage cannot be determined.
deep tissue injury
discoloration of tissue like a bruise that is not reversible and will likely progress to a full thickness injury.
differentiate between an arterial and a venous wound
arterial wounds typically on the dorsum of the foot, lateral leg and toes. painful with leg elevation. no drainage. edema in dependent positions. deep can go to tendons or bones.
venous is usually around the distal lower leg or medial malleolus and the wound is irregular shaped, shallow and dark pigmentation. dependent position causes pain in the wound. edema presents. little pain.
describe how elevation and dependency differ between arterial and venous wounds
in arterial wounds, the pain will be increased with elevation and there will be swelling/edema in the dependent position.
venous, the pain increase with dependent position. the legs are comfy with elevation.
where are neuropathic ulcers usually found
in the forefoot area, specifically on the metatarsal heads, toes, or over an area of increased weight-bearing that may be present because of a foot deformity. Neuropathic ulcers are typically not found on the leg.
pressure injuries are typically found over
bony prominences
what size moles should be inspected carefully
anything with a diameter bigger than 0.25 inches.
A single lesion with more than one shade of black, brown, or blue may be a sign of …
malignant melanoma
malignant melanomas have what kind of edges
uneven and notched.
differentiate between the 3 types of wound intentions
primary: the wound is sutured or stapled shut after surgery, or a wound like a partial thickness or ulcer can heal on its own by tissue approximation.
Secondary: this is when there are any of the 4 ulcers, full thickness kinds of wounds where there is no approximation. This also happens with necrosis or debris in the wounds
tertiary: this happens when there is a delayed primary intention. Surgery that cannot be sutured up right away due to risk of sepsis or dehiscence.
timeline of healing phases
inflammation (0-10 days)
proliferation (3-21 days)
maturation (7 days - 2 years)
what is an alginate
a highly absorptive and highly permeable and non-occlusive dressing that is used for partial or full thickness burns that are infected/ave a lot of drainage.
can alginates be used on wounds with deep structures present?
no
you have a patient with an infected venous ulcer wound with a lot of exudate. The pt states that the ulcer bleeds a lot too. What kind of dressing may be appropriate
alginate, because it is absorptive and occlusive but still non-permeable. will help keep microbes out and will help to keep the wound bed dry.
Wagner Ulcer classification
0: no open lesion, pre-ulcerative lesions, healed ulcers, presence of bony deformity
1: superficial ulcer
2: deep ulcer potentially exposing bone, tendon, ligament due to through subcutaneous tissue
3: deep ulcer with osteomyelitis, osteitis, abscess
4: gangrene of digit
5: gangrene of foot (disarticulation required)
superficial burn
this is just the epidermis outer layer with redness and very little edema. there will be no peeling of the skin here.
superficial partial thickness
epidermis and upper dermis that will result in redness and blanching, but with brisk capillary refill. There will be weeping blisters and there will be pain and sensitivity and changes in temperature
deep partial thickness
severe burn to epidermis and dermis with nerve damage, hair follicle damage and swear gland issues. red, waxy, white will popped blisters, wet. There will be blanching but poor cap refill. This results in ability to sense pressure, but not light touch or not pin prick
full thickness
goes through epidermis, dermis, subcutaneous and you will have white charred dark tan or black skin. there is no blanching and no cap refill and the skin is dry and leathery. But little pain because nerve ending destroyed.
subdermal burn
destruction of dermis, epidermis, subcutaneous and maybe to bone muscle. From prolonged flame or electrical burn. This might need amputation. the vascular system is messed up too.
why is sharp debridement contraindicated for dry eschar on a heel
because the dry eschar may be acting as a barrier protective barrier for the wound.
what is Larval therapy
using maggots for debridement
what type of dressing is recommended for diabetic ulcer healing
hydrogel
what is the Barden scale
assess risk of skin breakdown, looks at mobility, activity, sensation, moisture, nutrition, friction, and shear
Morse scale looks at
fall risk
undermining is
horizontal erosion under a wound.
tunneling is
vertical erosion
serosanguinous vs sanguinous
serosanguinous: pink and watery.
Sanguinous is red and watery
keloid vs hypertrophic scar
keloid extends beyond the original boundaries of the burn/injury
hypertrophic stays within the boundaries.
if you have a wound with granulation tissue and with slough, and you are trying to get rid of just slough, what do you do
selective debridement like with an enzyme, so something like collagenase.
granulation and epithelialization means the wound is healing…
well
is deep manual pressure good for pushing edema out when you have acute wounds in the legs
no, it is too aggressive and can damage capillaries down there.
do opioid medications delay wound healing?
no correlation.
can hydrogen peroxide be used with granulation wounds and non infected wounds
no because the oxygen reacts with the hydrogen peroxide making bubbles, which is a form of non selective debridement and therefore might hurt the kind of wound descried.
charcoal is used on a wound when there is
an odor
silver is used on a wound when there is
bacteria, since it is selectivity toxic to bacteria
how do you take LE edema measurements
start at the floor in a weight bearing position and take a measurement every centimeter from the floor to the groin.
what condition is hallmarked by silver scaled papules and plaques in the scalp, elbows, knees, back, and buttocks
psoriasis
psoriasis is commonly associated with erosive arthritis of what joints
the DIP joints on the hand
