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Integumentary > Intro - cells, levels, wound healing > Flashcards

Intro - cells, levels, wound healing Flashcards

1
Q

Skin receives ___ resting cardiac output

A

1/3 resting cardiac output

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2
Q

Skin is composed of ___

A

connective tissue

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3
Q

Skin Function

A
  • Thermoregulation: sweating, vasodilation, vasoconstriction
  • Sensation
  • Metabolism of Vit. D
  • Protection from shear
  • protection from water loss
  • body image, expression
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4
Q

3 main layers

A
  • Epidermis
  • Dermis
  • Subcutaneous/hypodermis
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5
Q

How does epidermis receive nutrients?

A

Avascular, by diffusion from the dermis

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6
Q

Langerhan’s cells location

A

Epidermis

Stratum spinosum

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7
Q

Layers of the Epidermis

A
  • Stratum Corneum
  • Stratum Lucidum
  • Stratum Granulosum
  • Stratum Spinosum
  • Stratum basale
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8
Q

Keratinocytes

A
  • skin cells
  • majority of epithelial cells
  • Accumulate keratin: vital for water loss control through the skin
  • attracted to injured area by neutrophils and advance in a sheet to resurface area
  • cannot bridge the gap, so roll under at edges of full thickness
  • Majority in stratum spinosum
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9
Q

Corneocytes

A
  • differentiated keratinocytes surrounded by cornified envelope
  • Outermost keratinocytes
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10
Q

Langerhans Cells

A
  • Contain distinctive granules
  • “probably” monocytic in origin (WBC)
  • Involved in cutaneous delayed hypersenstivity
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11
Q

Melanocytes

A
  • Produces skin pigment
  • between/beneath basal layer
  • synthesizes melanin from Tyrosine
  • branches reach up through layers and squirt out the pigmentation
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12
Q

Merkel Cells/Discs

A
  • mechanoreceptors attached to keratinocytes that provide sensation to light touch
  • touch receptor cells
  • Disc: dermis
  • Cell: epidermis
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13
Q

Epidermal appendages: Hair Follicles

A
  • regulates temperature by trapping air between hair and skin’s surface
  • Lines with epidermal cells that regenerate epidermis after abrasions
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14
Q

Epidermal Appendages: Sebaceous glands

A
  • attached to hair follice
  • lubricates skin and hair
  • protects skin from bacteria with sebum
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15
Q

Epidermal Appendages: Sudoriferious glands

A
  • everywhere but lips and ears

- secretes sweat

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16
Q

Epidermal Appendages: Nails

A
  • originate from basal layer

- protects tips of digits

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17
Q

Stratum Corneum

A
  • flat dead cells filled with keratin
  • shed, replace, repeat
  • barrier to heat, light, bacteria, and some chemicals
  • dryness inhibits bacterial growth
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18
Q

Stratum Lucidum

A
  • palms and soles of feet
  • clear fat dead cells
  • contains eledin: transforms into keratin
  • replaces she stratum corneum
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19
Q

Stratum Granulosum

A
  • 3-5 rows of flattened cells

- Contains keratohyalin: precursor to waterproofing protein keratin found in above layers

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20
Q

Stratum Spinosum

A
  • multiple rows of polyhedral cells
  • Contains: keratinocytes, merkel cells, langerhan cells
  • attached together my desmosomes
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21
Q

Stratum Basale (Germinativum)

A
  • site of new cell production
  • single row of keratoncytes connected by hemadesmosomes
  • nails arise to protect tips of digits
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22
Q

Basement membrane

A
  • attaches epidermis to dermis
  • Comprised of type IV collagen fibers
  • filters substances moving from dermis to epidermis
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23
Q

Dermis Functions

A
  • Contains: sensory organs, vasculature, epidermal appendages, cells to protect against infection
  • thickest layer
  • gives skin the bulkiness (turgor) - 2-4 mm
  • produces collagen and elastin for skin
24
Q

Dermis Cells

A
  • Fibroblasts
  • Macrophages
  • WBC
  • Mast Cells
  • Sensory Receptors
25
Q

Fibroblasts

A
  • produce collagen and elastin
  • crucial in wound healing
  • lay down ground work for healing
26
Q

Papillary Region

A
  • Top 1/5 of dermis
  • finger-like projections into epidermis
  • allows for capillaries to get more blood into epidermis
  • allows for nutrient/o2 exchange
  • Contains Meisner’s corpuscles: touch sensors
  • Loose connective tissue and elastin
27
Q

Reticular Region

A
  • dense - connective tissue, collagen, elastin
  • contains adipose, follicles, nerves, oil glands, ducts of sweat glands
  • provides strength and elasticity to skin
28
Q

Subcutaneous/Hypodermis

A
  • Fibers extend through to anchor skin
  • contains deep blood vessels and nerve endings
  • Adipose layer
29
Q

Adipose Functions

A
  • White/pale yellow = healthy
  • dark color = chronic wound
  • Insulates
  • Energy reserve
  • Cushioning
  • Storage for vitamin A, D, E, and K
30
Q

Deep Tissue Contains…

A
  • Muscle
  • Tendon
  • Ligament/Joint capsule
  • Bone
31
Q

Depths of Wounds

A
  • Superficial
  • Partial Thickness
  • Full-thickness
32
Q

Superficial Wound Tissues involved

A

Epidermis

33
Q

Superficial Wound Example

A

First-degree burn

34
Q

Partial Thickness Tissues Involved

A

Epidermis

Dermis

35
Q

Partial Thickness Examples

A
  • Second-degree burns
  • Stage II pressure ulcer
  • Wagner grade 1 ulcer
36
Q

Full thickness wound tissues involved

A
  • Epidermis
  • Dermis
  • Subcutaneous tissue
  • may be into deep tissue layers
37
Q

Full thickness wound exmaples

A
  • third degree burn
  • Subdermal/4th degree burn
  • Stage III pressure ulcer
  • Wagner grade 2-5 ulcer
38
Q

Effects of Aging

A
  • Dermal thickness
  • Fatty layer
  • Collagen and elastin
  • sensation and metabolism
  • sweat glands
  • circulation
  • epidermal regeneration
39
Q

Phases of Wound Healing

A
  • Hemostasis*
  • Inflammatory
  • Proliferative
  • Remodeling
40
Q

Signs of Inflammation

A
  • Redness
  • Pain
  • Temperature
  • Swelling
  • Loss of function
41
Q

Time frame of Inflammation Stage

A

Time of injury –> 3 to 7 days

42
Q

Inflammation Stage

A
  • 11 proteins in plasma migrate to site of wound
  • proteins and phagocytic defense mechamisms migrate from intervascular to extravascular
  • Hemostasis: vasoconstriction, platelet aggregation, clot formation from thromboplastin
43
Q

Inflammation - Margination

A

Leucocytes tend to occupy the periphery and adhere tot he endothelial cells that line the blood cells

44
Q

Inflammation - Vascular Response

A
  • Transudate produces local edema
  • Blood vessels constrict to reduce blood loss
  • Platelet aggregation
  • Activated platelets release chemical mediators
45
Q

Hemostasis

A

Immediate after injury

  • vasoconstriction
  • platelet aggregation
  • clot occurs
46
Q

Polymorphonuclear Leukocytes (PMNs)

A 
-neutrophils
Scavengers
-Kill bacteria
-clean wound
-Secrete inflammatory mediators and MMPs (collagen formation)
47
Q

Neutrophils

A
  • First to injury site, most prevelent WBC at injury site
  • cleanse wound
  • pus = dead neutrophils
  • lasts as long as needed based off of bacteria count
48
Q

Lysozyme

A
  • released by neutrophils
  • enzyme
  • produces free radicals to destroy bacteria
49
Q

Eosinophil

A
  • Allergies
  • larger nucleii
  • motile phyagoctyes
  • anti-parasitic function
50
Q

Basophils

A
  • allergic reaction
  • mast cells after leaving bloodstream
  • release histamine
  • promote fibroblast proliferation and mitosis by release of a mitogen
51
Q

Histamine

A
  • causes vascular dilation
  • increased blood perfusion
  • temporary edema
  • stimulates collagen formation and healing
52
Q

Macrophages

A
  • largest formed element
  • phagocytic - ingest bacteria
  • cleans up cellular debris after an infection
  • drawn to inflamed tissue by chemotaxis
53
Q

Proliferation

A
  • Angiogenesis
  • Granulation Tissue Formation
  • Wound contraction
  • Epithelialization
54
Q

Goal of Proliferation

A
  • Fill in wound defect with new tissue

- restore skin integrity

55
Q

Proliferation time fram

A

3-5 days post injury up to 3 weeks (primary intention)

56
Q

Angiogenesis

A
  • capillary buds extend to wound bed
  • endothelial cells create capillaries with loose junctions
  • collagen synthesis by fibroblasts
  • “new blood cell formation)

Integumentary (4 decks)

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