Lab # 2 Practical # 1 Clinical Considerations

Question 1

What type of burns need a skin graft?

Answer 1

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.

Question 2

What is the purpose of the skin graft?

Answer 2

1) protect against fluid loss infection 2) promote tissue healing 3) Cosmetics 4) reduce scar formation 5) prevent loss of function

Question 3

Types of skin graft

Answer 3

Artificial: integra, apligraft, and transite 2) autologous skin transplantation

Question 4

autologous skin transplantation

Answer 4

epidermis tissue removed and grown in culture

Question 5

Cyanosis (definition, cause, presentation)

Answer 5

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

Question 6

Jaundice (definition, cause, presentation)

Answer 6

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.

Question 7

Erythema (definition, cause, presentation)

Answer 7

1) redness of skin 2) blood fills capillaries in the dermis in response to skin injury, heat, infection, inflammation, allergy, blushing, embarrassment

Question 8

Pallor (definition, cause, presentation)

Answer 8

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.

Question 9

Bilirubin composition

Answer 9

aged/dead RBCs

Question 10

Hemangiomias (definition, cause, presentation)

Answer 10

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

Question 11

Port-wine-stain

Answer 11

flat, pink, red or purple lesion at the nape of the neck. Is an example of a hemangiomia

Question 12

Contact dermatitis (definition, cause, presentation)

Answer 12

1) inflammation of the dermis 2) exposure to chemical, allergy, physical trauma 3) redness, itching, and swelling

Question 13

Eczema (definition, cause, presentation)

Answer 13

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.

Question 14

Psoriasis (definition, cause, presentation)

Answer 14

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

Question 15

Erysipelas (definition, cause, presentation)

Answer 15

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.

Question 16

Keloid (definition, cause, presentation)

Answer 16

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

Question 17

Hives (definition, cause, presentation)

Answer 17

skin marked by red dense elevated patches that are often itchy 2) infection, physical trauma, medication, stress, food allergies

Question 18

Burn

Answer 18

damage caused by heat, electricity, chemicals or more. defined by depth and extent of effected area

Question 19

Local-effects

Answer 19

injury to skin tissues directly in contact w/damaging agent

Question 20

systemic-effects

Answer 20

greater threat to life: large h20 loss, loss of plasma proteins, shock, bacterial infection, reduced blood circulation, diminished immune response

Question 21

Major burn definition

Answer 21

1) 3rd degree 10% 2) 2nd degree 25% 3) 3rd degree on face, hands , feet, perineum (anal and urogenital regions)

Question 22

Burn and Death

Answer 22

When burns cover 70% of the body 50% of the patients die

Question 23

1st degree (type of burn, affected area, signs, healing)

Answer 23

1) partial thickness burn 2) epidermis 3) mild pain and blisters (mild erythema) 4) healing in 3-6 days

Question 24

2nd degree (type of burn, affected area, signs, healing)

Answer 24

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)

Question 25

3rd degree burn (type of burn, affected area, signs, healing)

Answer 25

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

Question 26

vitiligo (definition, cause, presentation)

Answer 26

1) Partial or complete loss of melanocytes from patches of skin 2) autoimmune attack on melanocytes 3) irregular patches on skin

Question 27

Acne (definition, cause, presentation)

Answer 27

1) inflammation of sebaceous glands 2) at puberty, androgens cause sebaceous glands to grow and increase sebum production (bacteria colonize sebum)

Question 28

Cyst Acne (definition, cause, presentation)

Answer 28

1) permanent scar on the epidermis caused by bacterial colonization of sebaceous gland 2) presents as cyst or sac

Question 29

Transdermal drug administration

Answer 29

administering a drug through an adhesive patch that passes through the epidermis and to the dermis

Question 30

Scopolamine

Answer 30

TDA; motion sickness

Question 31

Fentanyl

Answer 31

TDA: pain relief cancer

Question 32

estradiol

Answer 32

TDA; estrogen replacement

Question 33

nicotine

Answer 33

TDA: smoking

Question 34

nitroglycerine

Answer 34

TDA: angina pectoris

Question 35

Pressure Ulcers (definition, cause, presentation)

Answer 35

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.

Question 36

Non-melanoma cancers

Answer 36

50% more common in males (Basal Cell carcinoma, Squamous cell carcinoma)

Question 37

Squamous cell carcinoma (percentage of skin cancer cases, layer of origin, metastasis)

Answer 37

1) 20% 2) arises from stratum spinosum 3) variable tendency to metastasize

Question 38

Basal cell carcinoma (percentage of skin cancer cases, layer of origin, metastasis)

Answer 38

1) 78% 2) arises from stratum basale 3) Rarely metastasize

Question 39

Malignant melanoma (percentage of skin cancer cases, layer of origin, metastasis)

Answer 39

1) 2% 2) arise from monocytes 3) metastasize rapidly

Question 40

ABCD’s of malignant melanomas

Answer 40

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

Question 41

Risk Factors for skin cancer

Answer 41

1) age 2) Sun exposure, 3) skin type 4) family history 5) immunosuppressed