Integumentary system Flashcards
epidermis layers top to bottom
Come Lets Get Sun Burnt
stratum corneum
stratum lucidum
stratum granulosum
stratum spinosum
stratum basale
epidermis contents
keratinocytes, melanocytes, langerhans cells, basal cells
dermis contents
collagen, reticulum, fibroblasts, macrophages, lymphatic glands, blood vessels, nerve fibers,
meisner corpuscles
discriminate btw touch and vibration on cutaneous surface
Krause end bulbs
cold sensation
pacinian corpuscles
pressure and vibration
ruffini endings
hot sensation
golgi tendon organs
sensitive to m contraction force
venous insufficiency
- 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
arterial insufficiency
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
what to remember about pressure ulcer staging
doesn’t backsage
where are these ulcers located:
1. diabetic
2. venous
3. arterial
4. pressure
- weight-bearing surface of foot
- proximal to medial malleolus, edamatous (because blood is stuck)
- lateral malleolus, distal toes, areas of trauma
- unrelieved external pressure on area
Herpes Zoster
-aka shingles
- pain/paresthesia/rash in dermatomal pattern
- easily spread
- unilateral
- red with white/silvery appearance
- raised to palpation (<2mm height)
herpes simplex virus: type 1 vs 2
type 1: around lips and cheeks, upper half of ody
type 2: lower half of body - genitals
Wheals
itchy, raised hives
- can be from allergy
pustules
pus filled, infection, inflamed
vesicles
fluid, circular shaped
less than .5cm
if more than .5cm - bulla
macerated wound
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
dressings for very mild exudates
transparent films
dressings for mild exudate
hydrogel, hydrocolloid
dressings for moderate exudate
foams
dressings for heavy exudate
calcium alginates, hydrofiber
selective debridement
- 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
non-selective
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
red, yellow, black
red= good, getting better, keep it clean and moist
yellow= infection - remove infection first
black = necrosis- clean and dry, nonselective
what to clean pressure injuries with initially
sterile saline
rule of nines for adults
ant head: 4.5%
ant torso: 18%
ant leg: 9%
ant arm: 4.5%
perineum: 1%
burns percentage for <13 y/o
ant head: 8.5%
ant torso: 18%
ant arm: 4.5%
ant leg: 6.5%
perineum: 1%
scars: 3 types
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
positioning patients with burns
want to make sure no 2 surfaces are touching
position ant neck burn
common - flexion
put into hyperextension with rigid cervical orthoses
position shoulder/axilla burn
common deformity - adduction and IR
put into abduction, flexion, ER
position elbow burn
common: flexion and pronation
put into extension and supination - splint into extension
position hand burn
common: claw hand
keep in intrinsic plus and wrap each finger separately
position hip and groin burn
common: flexion and adduction
position in extension and abduction
position knee burn
common: flexion
put in extension - can use posterior knee splint or KAFO
position ankle burn
common: PF
put into neutral - Use AFO
slough
wet, yellow
eschar
black, dry
primary healing
surgical intervention
wound healing time shorter
dehiscence (wound breaking open) more common
secondary healing
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
dressing for non-infected wound
hydrocolloid, films, gauze
dressings for odor
charcoal
dressings dry to wet:
films, hydrogel, hydrocolloid, foams, alginate, hydrofiber
