Integumentary system

Question 1

epidermis layers top to bottom

Answer 1

Come Lets Get Sun Burnt
stratum corneum
stratum lucidum
stratum granulosum
stratum spinosum
stratum basale

Question 2

epidermis contents

Answer 2

keratinocytes, melanocytes, langerhans cells, basal cells

Question 3

dermis contents

Answer 3

collagen, reticulum, fibroblasts, macrophages, lymphatic glands, blood vessels, nerve fibers,

Question 4

meisner corpuscles

Answer 4

discriminate btw touch and vibration on cutaneous surface

Question 5

Krause end bulbs

Answer 5

cold sensation

Question 6

pacinian corpuscles

Answer 6

pressure and vibration

Question 7

ruffini endings

Answer 7

hot sensation

Question 8

golgi tendon organs

Answer 8

sensitive to m contraction force

Question 9

venous insufficiency

Answer 9

• blood from body (body part) cant go back to heart
• results in edema and/or skin abnormalities/ulcerations
• mild to moderate pain
• venMO - proximal to medial malleolus
• irregular shallow appearance
• Hemosiderin staining - brown/flaking
• elevation decreases pain

Question 10

arterial insufficiency

Answer 10

heart not able to deliver blood to distal parts of body
- lack of adequate blood flow to region of body
- severe pain (cramping) especially afer walking for few minutes (arterial claudication)
- toe, lower 1/3 leg, lateral malleolus
- smooth edges, well defined, deep
- shiny, yellow nails, thin, hair loss
- elevation increases pain
- related to DM

Question 11

what to remember about pressure ulcer staging

Answer 11

doesn’t backsage

Question 12

where are these ulcers located:
1. diabetic
2. venous
3. arterial
4. pressure

Answer 12

1. weight-bearing surface of foot
2. proximal to medial malleolus, edamatous (because blood is stuck)
3. lateral malleolus, distal toes, areas of trauma
4. unrelieved external pressure on area

Question 13

Herpes Zoster

Answer 13

-aka shingles
- pain/paresthesia/rash in dermatomal pattern
- easily spread
- unilateral
- red with white/silvery appearance
- raised to palpation (<2mm height)

Question 14

herpes simplex virus: type 1 vs 2

Answer 14

type 1: around lips and cheeks, upper half of ody
type 2: lower half of body - genitals

Question 15

Wheals

Answer 15

itchy, raised hives
- can be from allergy

Question 16

pustules

Answer 16

pus filled, infection, inflamed

Question 17

vesicles

Answer 17

fluid, circular shaped
less than .5cm
if more than .5cm - bulla

Question 18

macerated wound

Answer 18

white friable, overhydrated, and wrinkled skin
- can cause uncontrolled wound damage, perspiration, or incontinence
- want to keep close to wound moist and around moist dry

Question 19

dressings for very mild exudates

Answer 19

transparent films

Question 20

dressings for mild exudate

Answer 20

hydrogel, hydrocolloid

Question 21

dressings for moderate exudate

Answer 21

foams

Question 22

dressings for heavy exudate

Answer 22

calcium alginates, hydrofiber

Question 23

selective debridement

Answer 23

• removal of only non-viable tissue from wound
• enzymatic - topical application
• sharps - use of scalpel, scissors, forceps
• autolytic debridement - use body’s own mechanism to remove nonviable tissue

Question 24

non-selective

Answer 24

remove viable and non-viable tissue when >50% is non-viable
- wet to dry dressings - apply moist gauze over necrotic tissue to be completely dried and removed
- wound irrigation - moves necrotic tissue from wound bed using pressurized fluid
- hydrotherapy - use whirlpool with agitation directed toward wound requiring debridement

Question 25

red, yellow, black

Answer 25

red= good, getting better, keep it clean and moist
yellow= infection - remove infection first
black = necrosis- clean and dry, nonselective

Question 26

what to clean pressure injuries with initially

Answer 26

sterile saline

Question 27

rule of nines for adults

Answer 27

ant head: 4.5%
ant torso: 18%
ant leg: 9%
ant arm: 4.5%
perineum: 1%

Question 28

burns percentage for <13 y/o

Answer 28

ant head: 8.5%
ant torso: 18%
ant arm: 4.5%
ant leg: 6.5%
perineum: 1%

Question 29

scars: 3 types

Answer 29

normal scar - flat and similar to skin color
hypertrophic scar - healed wound with thick fibrous tissue that remains within original wound border
keloid: - excessive scar tissue grows outside original margins of wound

Question 30

positioning patients with burns

Answer 30

want to make sure no 2 surfaces are touching

Question 31

position ant neck burn

Answer 31

common - flexion
put into hyperextension with rigid cervical orthoses

Question 32

position shoulder/axilla burn

Answer 32

common deformity - adduction and IR
put into abduction, flexion, ER

Question 33

position elbow burn

Answer 33

common: flexion and pronation
put into extension and supination - splint into extension

Question 34

position hand burn

Answer 34

common: claw hand
keep in intrinsic plus and wrap each finger separately

Question 35

position hip and groin burn

Answer 35

common: flexion and adduction
position in extension and abduction

Question 36

position knee burn

Answer 36

common: flexion
put in extension - can use posterior knee splint or KAFO

Question 37

position ankle burn

Answer 37

common: PF
put into neutral - Use AFO

Question 38

slough

Answer 38

wet, yellow

Question 39

eschar

Answer 39

black, dry

Question 40

primary healing

Answer 40

surgical intervention
wound healing time shorter
dehiscence (wound breaking open) more common

Question 41

secondary healing

Answer 41

wound heals on own
steps: contraction, re-epithelialization or both
deeper wounds heal by replacing injured tissue with scar tissue
contact-inhibition - tissue continuously grows and stops growing when new tissue touches each other

Question 42

dressing for non-infected wound

Answer 42

hydrocolloid, films, gauze

Question 43

dressings for odor

Answer 43

charcoal

Question 44

dressings dry to wet:

Answer 44

films, hydrogel, hydrocolloid, foams, alginate, hydrofiber