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INTERNAL MED FINAL > INTEGUMENTARY SYSTEM > Flashcards

INTEGUMENTARY SYSTEM Flashcards

1
Q

T/F: skin is 25-30% of body weight

A

F (15-20%)

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2
Q

How many layers make up the skin? What are they?

A

3: epidermis, dermis, & subcutaneous tissue

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3
Q

What type of lesion consists of macule, papule, plaque, nodule, tumor, wheal, vesicle, & pustule?

A

Primary

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4
Q

What type of lesion consists of scale, crust, thickening, erosion, ulcer, scar, excoriation, fissure, & atrophy?

A

Secondary

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5
Q

How do secondary lesions appear?

A

When there’s changes to primary ones

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6
Q

Which lab value indicates nutritional status?

A

Prealbumin

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7
Q

Which lab value monitors wound healing?

A

Hematocrit

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8
Q

What is the term for hives?

A

Urticaria

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9
Q

What does pruritus mean?

A

Itchy

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10
Q

What does xeroderma mean?

A

Dry skin

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11
Q

The most obvious changes occur first during __________ due to hormones & again during older adulthood.

A

Puberty

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12
Q

What can lead to temporary changes in hair growth patterns or hyperpigmentation of cheeks & forehead?

A
  • BC pills
  • Pregnancy
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13
Q

What are other terms for hyperpigmentation of cheeks & forehead?

A
  • Melasma
  • Preg mask
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14
Q

Blood vessels within the reticular dermis are reduced in _____________

A

Number

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15
Q

When blood vessels become less in # & their walls thin, how does this appear?

A
  • Pale skin
  • Impaired capacity to thermoregulate
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16
Q

A primary factor in loss of protective functions of skin is diminished barrier function of the ___________ ___________

A

Stratum corneum

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17
Q

When the stratum corneum becomes thinner, the skin becomes ____________ & paper thin.

A

Translucent

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18
Q

T/F: a reduction in melanocytes lead to less immune surveillance & increased risk of skin cancer

A

F (langerhans cells)

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19
Q

The ____________ is one of the body’s principal suppliers of vitamin D.

A

Epidermis

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20
Q

The skin is rich in lipids, proteins, & DNA which are sensitive to _____________ damage.

A

Oxidation

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21
Q

What type of infection are impetigo & cellulitis?

A

Bacterial

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22
Q

What type of infection are herpes zoster & warts (verrucae)?

A

Viral

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23
Q

What type of infection are ringworm (tinea corporis), athlete’s foot (tinea pedis), & yeast (candidiasis)?

A

Fungal

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24
Q

What type of infection are scabies & pediculosis?

A

Parasitic

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25
Q

What type of lesions are seborrheic keratosis & nevi (moles)?

A

Benign

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26
Q

What type of lesions are actinic keratosis & bowen disease?

A

Premalignant

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27
Q

What type of carcinoma are basal cell & squamous cell?

A

Malignant nonmelanoma

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28
Q

What are some skin disorders associated w/ immune dysfunction?

A
  • Psoriasis
  • Lupus
  • System sclerosis
  • Polymyositis & dermatomyositis
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29
Q

What are the 4 sources that can lead to burns?

A
  • Thermal
  • Chemical
  • Electrical
  • Radiation
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30
Q

Burn severity is determined by ___________ of injury & total body surface area (TBSA).

A

Depth

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31
Q

Depth of injury is a function of ____________ or source of energy & duration of exposure.

A

Temperature

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32
Q

Describe where 1st, 2nd, 3rd & 4th degree burns occur.

A
  • 1st: Epidermis
  • 2nd: Dermis
  • 3rd: Subcutaneous
  • 4th: Subcutaneous
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33
Q

Which degree burn develops blisters?

A

2nd

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34
Q

T/F: there’s little/no pain in 3rd/4th degree burn bc nerve endings are destroyed

A

T

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35
Q

Describe the breakdown in wallace rule of nines for TBSA.

A
  • 9% Head
  • 9% Each upper extremity
  • 18% Each thorax (anterior & posterior)
  • 18% Each lower extremity
  • 1% Genital
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36
Q

T/F: males are more commonly admitted to burn centers

A

T

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37
Q

Thermal burns account for approx ____% of all burn center admissions.

A

75

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38
Q

Inflammatory response can be local (small burns) or _____________ (extensive burns).

A

Systemic

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39
Q

What are the major systems affected by burns?

A
  • CV
  • Renal & GI
  • Immune
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40
Q

What type of substances are released from injured tissue immediately which increases capillary permeability?

A

Vasoactive (catecholamines, histamine, serotonin, leukotrienes, & prostaglandins)

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41
Q

T/F: extensive burns will result in edema in only burned tissue

A

F

42
Q

What increases in response to catecholamine release & hypovolemia?

A

HR

43
Q

How does CO change w/ cutaneous burn?

A
  • Decreases in beginning
  • Returns to normal
  • Increases about 24 hrs after injury
44
Q

Where does the body shunt blood from during initial response?

A

Kidneys & intestines

45
Q

What is the term for decreased urine output?

A

Oliguria

46
Q

What is paralytic ileus?

A

Intestinal dysfunction

47
Q

Electricity travels through body resulting in internal tissue damage & potential ____________ injury.

A

Multisystem

48
Q

T/F: entrance wounds for electrical wounds tend to be larger than exit wounds

A

F

49
Q

What kind of wounds in electrical burns may be negligible compared to soft tissue & muscle damage?

A

Cutaneous

50
Q

T/F: alternating current is more dangerous than direct current

A

T

51
Q

Out of acids & alkalis, which one results in deeper burn injuries?

A

Alkalis

52
Q

Burns of the hands & ____________ can result in permanent physical & vocational disability.

A

Joints

53
Q

What type of burns may produce tourniquet-like effect & lead to compartment syndrome or total occlusion of circulation?

A

Circumferential

54
Q

What do most full-thickness burns occur in conjunction w/?

A
  • Superficial
  • Partial-thickness
55
Q

What is the most common & threatening complication of burn injuries?

A

Infection

56
Q

What are the complications due to inhalation injury?

A
  • Respiratory failure
  • Pneumonia
  • Sepsis
57
Q

What type of scarring do burns lead to?

A

Hypertrophic

58
Q

What are the 3 phases of the clinical course for patient in burn unit?

A
  • Emergent
  • Acute
  • Rehab
59
Q

Which phase is associated w/ fluid resuscitation, ventilatory management, assessment of extent of burn, & early wound management?

A

Emergent

60
Q

Which phase is associated burn wounds management & infection prevention, debridement & skin grafting, & PT?

A

Acute

61
Q

Which type of skin transplantation is from person’s own skin to treat full-thickness burn?

A

Autograft

62
Q

Which type of skin transplantation is from cadaver skin?

A

Allo/homografts

63
Q

Which type of skin transplantation is from pigskin?

A

Xeno/heterografts

64
Q

Biosynthetic grafts are made from a combo of ____________ & synthetics.

A

Collagen

65
Q

What are the 3 classic determinants of burn mortality?

A
  • TBSA
  • Age
  • Inhalation injury
66
Q

Which skin disorder is caused by neuropathy, vascular insufficiency, radiation, systemic sclerosis, vasculitis, & prolonged pressure?

A

Integumentary ulcers

67
Q

What are the types of integumentary ulcers?

A
  • Diabetic ulcers
  • Arterial insufficiency ulcers
68
Q

What are the 2 ways in which neuropathic ulcers may be classified?

A
  • Wagner system
  • Site, ischemia, neuropathy, bacterial infection, area, depth (SINBAD) score
69
Q

Which grade on wagner system is preulcerative lesions, healed ulcers, or presence of bony deformity?

A

0

70
Q

Which grade on wagner system is superficial ulcer w/o subq tissue involvement?

A

1

71
Q

Which grade on wagner system is penetration through subq tissue, may expose bone, tendon, lig, or jt capsule?

A

2

72
Q

Which grade on wagner system is osteitis, abscess, or osteomyelitis?

A

3

73
Q

Which grade on wagner system is gangrene of digit?

A

4

74
Q

Which grade on wagner system is gangrene of foot requiring disarticulation?

A

5

75
Q

Pressure injuries are lesions caused by ____________ pressure resulting in damage to underlying tissue.

A

Unrelieved

76
Q

What are old terms for pressure injuries?

A
  • Pressure ulcer
  • Decubitis ulcer
  • Bed sore
77
Q

Where do pressure injuries usually occur?

A

Over bony prominences (ex: heels, sacrum, ischial tubs, greater trochanters, elbows, scaps)

78
Q

The current staging system of pressure injuries are reflective of range of what?

A

Skin pigmentation

79
Q

Which stage of pressure injury is nonblanchable erythema of intact skin?

A

1

80
Q

Which stage of pressure injury is partial-thickness skin loss w/ exposed dermis?

A

2

81
Q

Which stage of pressure injury is full-thickness skin loss?

A

3

82
Q

Which stage of pressure injury is full-thickness skin & tissue loss?

A

4

83
Q

Which type of pressure injury is obscured full-thickness skin & tissue loss?

A

Unstageable

84
Q

Which type of pressure injury is persistent nonblanchable deep red, maroon, or purple discoloration?

A

Deep tissue

85
Q

T/F: wounds can be back-staged

A

F

86
Q

Once lesion fills w/ granulation tissue & closes, it should be documented as what?

A

Healing stage # (# original deepest level documented)

87
Q

The 2 primary causative factors for development of pressure injuries are ___________ pressure (externally) & pressure w/ shearing forces.

A

Interface

88
Q

What is the term for sweating to an unusual degree?

A

Diaphoresis

89
Q

What are the categories of the braden scale (1-4)?

A
  • Sensory perception
  • Moisture
  • Activity
  • Mobility
  • Nutrition
  • Friction & shear
90
Q

What does continuous pressure on soft tissues b/t bony prominences & hard or unyielding surfaces lead to?

A
  • Compressed capillaries
  • Blood flow occlusion
  • Ischemia & tissue necrosis
91
Q

____________ tissue predisposes bacterial invasion & subsequent infection, preventing healthy granulation.

A

Necrotic

92
Q

What are the type of patterns pressure injuries appear as?

A
  • Circular
  • Shape of objects
  • Elongated/irregular
93
Q

____________ ulcers often large, undermined wounds & extend to bone bc tissue mass there is thin & erodes easily.

A

Sacral

94
Q

What are these symptoms evidence of?
- Erythema
- Heat
- Swelling
- Pain
- Purulence
- Delayed healing
- Foul odor

A

Infection bc of pressure injury

95
Q

Foul-smelling discharge in pressure injuries are a result of ____________ enzymes from bacteria & macrophages dissolving necrotic tissues.

A

Proteolytic

96
Q

T/F: necrotic tissue in pressure injuries are insensate but surrounding tissue has pain

A

T

97
Q

What lab values are important for pressure injuries?

A
  • HG
  • Hematocrit
  • Prealbumin
  • Total protein
  • Lymphocytes
98
Q

For a high risk patient that needs frequent position changes, list the time for in bed, sitting, & if can move independently.

A
  • In bed: 2 hrs
  • Sitting: 1 hr
  • Independently: 15 min
99
Q

T/F: for repositioning, position the patient at 45 degree oblique angle when sidelying

A

F

100
Q

The head of the bed should be elevated no more than how many degrees when patient is supine?

A

30

INTERNAL MED FINAL (6 decks)

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