Key Terms Flashcards
Where is CSF located?
Located in the subarachnoid space.
What percent of CSF makes up total brain weight?
10-20% of brain weight
How much CSF is in the average adult?
140 ml
What is the production rate of CSF?
Production rate: up to 21 ml/hr. On average 50-100 ml produced daily
How much CSF is removed in a LP? How fast does it get regenerated?
usual amount removed for an LP (4-8mls) is regenerated in less than an hour.
Granulating wound bed:
healthy red tissue which is deposited during the repair process, presents as pinkish/red colored moist tissue and comprises of newly formed collagen, elastin and capillary networks. The tissue is well vascularized and bleeds easily
Epithelializing wound bed:
process by which the wound surface is covered by new epithelium, this begins when the wound has filled with granulation tissue. The tissue is pink, almost white, and only occurs on top of healthy granulation tissue
Sloughy wound bed:
the presence of devitalized yellowish tissue. Is formed by an accumulation of dead cells. Must not be confused with pus
Necrotic wound bed:
wound containing dead tissue. It may appear hard dry and black. Dead connective tissue may appear grey. The presence of dead tissue in a wound prevents healing
Hyper granulating wound bed:
granulation tissue grows above the wound margin. This occurs when the proliferative phase of healing is prolonged usually as a result of bacterial imbalance or irritant forces.
What is a Hyper granulating wound bed a characteristic of?
a chronic wound
How is a wound measured?
Assessment and evaluation of the healing rate and treatment modalities are important components of wound care. All wounds require a two-dimensional assessment of the wound opening and a three- dimensional assessment of any cavity or tracking
What are the Two-dimensional measurements of a wound and how are they measured?
Use a paper tape to measure the length and width in millimeters. The circumference of the wound is traced if the wound edges are not even - often required for chronic wounds. (You may also consider photography)
How do we measure a wound depth? (Three -dimensional measures)
the wound depth is measured using a dampened cotton tip applicator
A wound appears to have Raised wound edges, what would this indicated?
where the wound margin is elevated above the surrounding tissue may indicate pressure, trauma or malignant changes
A wound appears to have Rolled wound edges, what would this indicated?
rolled down towards the wound bed may indicate wound stagnation or wound chronicity
A wound appears to have Contraction of the wound edges, what would this indicated?
wound edges are coming together, signs of healing
What is sensation?
increased pain or the absence of sensation should be noted
How do healthy wound edges appear?
Healthy wound edges present as advancing pink epithelium growing over mature granulated tissue.
A wound appears to have dusky wound edges, what would this indicated?
dusky edges indicate hypoxia
A wound appears to have erythema wound edges, what would this indicated?
erythema indicates physiological inflammatory response or cellulitis
What is Exudate?
Is produced by all acute and chronic wounds (to a greater or lesser extent) as part of the natural healing process. It plays an essential part in the healing process.
How does exudate play an essential part in the healing process?
- Contains nutrients, energy and growth factors for metabolizing cells
- Contains high quantities of white blood cells
- Cleanses the wound
- Maintains a moist environment
- Promotes epithelialization
What happens if there is too much exudate? Too little?
Too much exudate leads to maceration and degradation of skin while too little can result in the wound bed drying out.
What is a Blood Borne Pathogen?
Pathogenic microorganisms present in blood and other potentially infectious material (OPIM) that are able to cause disease in humans
What are the 3 big BBP?
- Hepatitis B virus (HBV, HepB)
- Hepatitis C virus (HCV, HepC)
- Human immunodeficiency virus (HIV)
What is the role of a splint?
Splints applied initially (ED, UC) to immobilize joint above and joint below. Splints allow the soft tissue to swell. Can change to cast after swelling reduced.
What safety precautions do we have to keep in mind when applying a splint?
Pad all bony prominences well & Do not wrap too tightly
When do we use a Long arm splint?
Distal humerus fx, forearm fx, elbow injuries
When do we use a Sugartong splint?
Distal radius fx, radial/ulnar fx
When do we use a Ulnar Gutter splint?
Metacarpal fx, proximal phalanx fx
When do we use a Thumb Spica splint?
Scaphoid fx, 1st metacarpal fx, thumb fx
When do we use a Short Leg Posterior splint?
Ankle fx, distal tibia fx
What is Compartment Syndrome?
The build up of pressure in soft tissues can cut off blood supply and lead to permanent damage of muscles and nerves.
What do we use for cast padding?
Webril, Synthetic material used to provide a cushion between the limb and the fiberglass.
How do we implement cast padding?
Generally 2 layers+ are used
Wrap cast padding around the extremity in a distal to proximal fashion; overlap each turn to cover the previous one by 50 percent.
Be careful to avoid wrinkles because they can create pressure points.
Do not wrap too tightly as can cut off circulation
What places get extra cast padding?
Extra padding at fibular head, malleoli, patella and olecranon
What is Mohs Surgery?
Uses tissue sparing margins, and examines 100% of the margins for cancer cells.
What are the indications for Mohs Surgery?
Skin cancers that:
- Develop on areas where preserving cosmetic appearance and function are important
- Have recurred after previous treatment or are likely to recur
- Are located in scar tissue
- Are large
- Have edges that are ill-defined
- Grow rapidly
What are the 3 main types of skin cancer?
- Basal Cell Cancer
- Squamous Cell Cancer
- Malignant Melanoma
What do you know about Basal Cell Cancer?
It is the most common skin cancer and is frequently found on the nose, face, neck and arms.
What do you know about Squamous Cell Cancer?
It is the 2nd most common skin cancer and surgery is usually curative, but 3%-4% may spread distantly.
What are the ABCDE’s of Melanoma?
ABCD’s: Asymmetry, Border, Color, Diameter (larger than 6 mm)
What are the treatments and their efficacies for skin cancer?
- ED&C: 85%
- Topicals/Radiation 75% - 85%
- Simple Excision 88%
- Mohs Surgery >96%
What is the epidural space?
The space bounded by:
• the ligamentum flavum posteriorly
• the spinal periosteum laterally
• and the dura anteriorly
What goes into epidural anesthesia?
Epidural anesthesia involves placing catheters into the epidural space, allowing continuous infusions administration of local anesthetics.
What is the primary site of action of epidural anesthesia?
The primary site of action of epidurally administered local anesthetics is on the spinal nerve roots.
What is Xanthochromia?
A yellow, discoloration of the CSF, due to lysis of RBCs. Discoloration begins after RBCs have been in spinal fluid for about two hours, and remains for two to four weeks.
What is Xanthochromia indicative of?
A SAH. Xanthochromia is present in more than 90 percent of patients within 12 hours of subarachnoid hemorrhage.
What angle do you administer IM anesthesia?
90 degrees
What angle do you administer subcutaneous anesthesia?
45 degress
What angle do you administer intradermal anesthesia?
15 degrees