Integumentary Terms

Question 1

Layers of the skin: Epidermis

Answer 1

• Outer, most superficial layer
• Contains NO blood vessels

Question 2

Layers of the skin: Dermis

Answer 2

• Inner layer
• Composed of collagen and dense irregular connective tissue
• Contains blood vessels, lymphatics, nerve endings sebaceous and sweat glands

Question 3

Layers of the skin: Subcutaneous Tissue

Answer 3

• Deep to dermis
• also known as subcutaneous fat/superficial fascia
• consists of loose connective tissue and fat
• provides insulation, support, and cushion for skin; stores energy for skin
• deep investing fascia and muscles lie deep to subcutaneous layer

Question 4

Melanoma Examination Criteria

Answer 4

A: Assymetry

B: Border

C: Color

D: Diameter (> 6 mm or a pencil eraser)

Question 5

4 Wound Measurements:

Answer 5

Location

Size and Shape

Tissue Characteristics

Exudate Characteristics

Question 6

Inflammatory Phase of Wound Healing

Answer 6

• time of injury to 3-5 days after
• Characteristics:
  
  • redness
  • edema
  • warmth
  • pain
  • decreased ROM
• neutrophils and macrophages

Question 7

Granulation/Proliferation Phase of Wound Healing

Answer 7

• 2-3 days after injury for 2-3 weeks
• Characteristics
  
  • granulation buds
  • epithelialization
  • wound contraction
  • granulation tissue filling the defect
  • epithelial cells migrating from wound margins
• Fibroblasts, myofibroblasts and epithelial cells
  
  • fibroblasts synthesize collagen, GAGs, and elastin
• Reepithelialization occurs as cells migrate from wound margin to provide a protective barrier preventing fluid and electrolyte loss and reducing the chances of infection

Question 8

Maturation, Repair and Matrix Formation Phase of Wound Healing

Answer 8

• begins within 2-4 wks of injury continues till healed
• Characteristics:
  
  • weaker collagen being replaced by strong
  • collagen alignment dependent on force imposed
  • healing complete when epithelium covers the surface but scar remodeling can last up to 2 years
• Normal scar formation
  
  • 6-12 wks: bright pink scar, immature
  • 12-15 mo: changes to a sof lavendar and finally light pink scar
  • mature scar will be soft, white, and flat

Question 9

Intrinsic vs. Extrinsic Delays in Wound Healing

Answer 9

• intrinsic
  
  • aging, chronic disease, circulatory dx, malnutrition, neuropathy
• extrinsic
  
  • medications, necrotic tissue, infection, excessive pressure, wrong dressing
• chronic inflammation
  
  • not healing wound
  • halo of redness
  • purple hue

Question 10

Primary Wound Union

Answer 10

• healing that takes place after a noninfected laceration or surgical incision
• no major loss of connective tissue
• sealing by blood clot within hours
• epithelialization and fibroblast proliferation from 1-3 days
• subsequential formation of collagen ~1wk
• total strength increase by end of month 2

Question 11

Secondary Wound Union

Answer 11

• prolonged process of dermal healing that results from necrosis of tissue due to inflammation or traumatic destruction (ulcer)
• “beefy red” appearance indicates healthy healing of the wound and no debridement or chemical antibacterial agent is indicated
• moist wound healing sould be promoted except in the presence of infection

Question 12

Tertiary (delayed Primary) Wound Healing

Answer 12

a delay in the suturing of a site for 5-7 days is indicated:

• wound contamination
• large tissue loss
• excessive edema
• healing sequence similar to an injury treated with a primary union except delayed by a week

Question 13

Bone Healing sequence

Answer 13

• occurs within a few days if not infected
• considerable hemorrhage
• proliferation of osteoblasts
• formation of a callus in about a week
• remodeling into bone