Lab # 2 Practical # 1 Clinical Considerations Flashcards
What type of burns need a skin graft?
Third degree burns for sure and 2nd degree burns if they do not heal. Recall skin won’t regenerate if stratum basale won’t heal.
What is the purpose of the skin graft?
1) protect against fluid loss infection 2) promote tissue healing 3) Cosmetics 4) reduce scar formation 5) prevent loss of function
Types of skin graft
Artificial: integra, apligraft, and transite 2) autologous skin transplantation
autologous skin transplantation
epidermis tissue removed and grown in culture
Cyanosis (definition, cause, presentation)
1) blue discoloration of the skin, mucous membranes, and nail beds 2) blood isn’t picking up enough oxygen forming methemoglobin 3) presentation inherent in the definition
Jaundice (definition, cause, presentation)
1) yellowing of skin, sclera of the eyes, and or mucous membranes 2) build up of bilirubin indicative of liver disease 3) presentation inherent in definition.
Erythema (definition, cause, presentation)
1) redness of skin 2) blood fills capillaries in the dermis in response to skin injury, heat, infection, inflammation, allergy, blushing, embarrassment
Pallor (definition, cause, presentation)
1) paleness of skin 2) shock or anemia, skin becomes pale when thin regions of the skin (lips) Special consideration, easier to see with dark people in their gums or nail beds.
Bilirubin composition
aged/dead RBCs
Hemangiomias (definition, cause, presentation)
1) localized benign tumor of the skin and subcutaneous layer 2) abnormal increase in the amount of blood vessels in an area 3) port-wine-stain
Port-wine-stain
flat, pink, red or purple lesion at the nape of the neck. Is an example of a hemangiomia
Contact dermatitis (definition, cause, presentation)
1) inflammation of the dermis 2) exposure to chemical, allergy, physical trauma 3) redness, itching, and swelling
Eczema (definition, cause, presentation)
1) inflammation of the skin 2) unknown - genetics maybe allergy 3) patches of red, itchy, dry, and blistering skin commonly on the wrists, elbows, or backs of knees.
Psoriasis (definition, cause, presentation)
1) chronic skin disorder 2) keratinocytes divide more quickly from the stratum basale to the stratum corneum shed immaturely and never keratinized 3) ex: dandruff
Erysipelas (definition, cause, presentation)
1) Streptococcal infection of the skin, if left untreated can become systemic and involve the lymphatic and cardiovascular systems. 2) streptococcal infection 3) very sharp margin between the red and tender skin and uninvolved skin.
Keloid (definition, cause, presentation)
1) elevated and irregular darkened area of excess scar tissue 2) collagen formation during healing extends beyond the original site of injury 3) tender, painful 4) region affected : dermis and subcutaneous tissue
Hives (definition, cause, presentation)
skin marked by red dense elevated patches that are often itchy 2) infection, physical trauma, medication, stress, food allergies
Burn
damage caused by heat, electricity, chemicals or more. defined by depth and extent of effected area
Local-effects
injury to skin tissues directly in contact w/damaging agent
systemic-effects
greater threat to life: large h20 loss, loss of plasma proteins, shock, bacterial infection, reduced blood circulation, diminished immune response
Major burn definition
1) 3rd degree 10% 2) 2nd degree 25% 3) 3rd degree on face, hands , feet, perineum (anal and urogenital regions)
Burn and Death
When burns cover 70% of the body 50% of the patients die
1st degree (type of burn, affected area, signs, healing)
1) partial thickness burn 2) epidermis 3) mild pain and blisters (mild erythema) 4) healing in 3-6 days
2nd degree (type of burn, affected area, signs, healing)
1) Partial thickness burn 2) epidermis and dermis 3) red blisters, swelling, some skin function loss, edema, pain 4) 3-4 wks (if no infection)
3rd degree burn (type of burn, affected area, signs, healing)
1) Full thickness burn 2) epidermis, dermis, tendons, nerves, and other affected tissues 3) loss of skin and tissue function, swelling, numb, skin graft needed 4) heals extremely slow. YOU NEED A SKIN GRAFT
vitiligo (definition, cause, presentation)
1) Partial or complete loss of melanocytes from patches of skin 2) autoimmune attack on melanocytes 3) irregular patches on skin
Acne (definition, cause, presentation)
1) inflammation of sebaceous glands 2) at puberty, androgens cause sebaceous glands to grow and increase sebum production (bacteria colonize sebum)
Cyst Acne (definition, cause, presentation)
1) permanent scar on the epidermis caused by bacterial colonization of sebaceous gland 2) presents as cyst or sac
Transdermal drug administration
administering a drug through an adhesive patch that passes through the epidermis and to the dermis
Scopolamine
TDA; motion sickness
Fentanyl
TDA: pain relief cancer
estradiol
TDA; estrogen replacement
nicotine
TDA: smoking
nitroglycerine
TDA: angina pectoris
Pressure Ulcers (definition, cause, presentation)
A.K.A decubitus ulcers 1) lesion on the skin or mucous membrane 2) constant deficiency of blood flow to tissues 3) affected tissue usually over bony projection that has been exposed to pressure.
Non-melanoma cancers
50% more common in males (Basal Cell carcinoma, Squamous cell carcinoma)
Squamous cell carcinoma (percentage of skin cancer cases, layer of origin, metastasis)
1) 20% 2) arises from stratum spinosum 3) variable tendency to metastasize
Basal cell carcinoma (percentage of skin cancer cases, layer of origin, metastasis)
1) 78% 2) arises from stratum basale 3) Rarely metastasize
Malignant melanoma (percentage of skin cancer cases, layer of origin, metastasis)
1) 2% 2) arise from monocytes 3) metastasize rapidly
ABCD’s of malignant melanomas
A - Asymmetry B - Border (indisinct, scalloped, indented) C - Color (uneven, color) D - Diameters (moles x less than 6mm pencil eraser , melanoma x greater than 6 mm
Risk Factors for skin cancer
1) age 2) Sun exposure, 3) skin type 4) family history 5) immunosuppressed
