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Integ > Lecture 1 - Healing > Flashcards

Lecture 1 - Healing Flashcards

1
Q

The skin receives ____ of resting cardiac output

A

1 / 3

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2
Q

Where is the thinnest skin located?

Thickest?

A

Eyelid/eardrum

Hands/feet

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3
Q

Describe the layers of the skin

A

Epidermis: 5 thin layers

Dermis: 2 thick layers

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4
Q

T or F: the epidermis is vascular

A

F

It is avascular

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5
Q

Which part of the skin produces vitamin D

A

Epidermis

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6
Q

Complete renewal of epidermis takes _____ days

A

45-75

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7
Q

What cell mainly handles re-epithelialization

A

Keratinocyte (90% of it)

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8
Q

What is a melanocyte

A

pigment producing

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9
Q

Merkel cells

A

Mechanoreceptors for light touch

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10
Q

What are langerhan’s cells

A

Immune system cells in skin

derived from bone marrow

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11
Q

T or F: The dermis is vascular

A

T

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12
Q

Where are superficial lympathatics and epidermal appendages contained in the skin

A

Dermis

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13
Q

Where do blisters occur

A

Between papillary dermis and the stratum basale

called: Rete ridges

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14
Q

What layer of the skin provides sensation

A

dermis

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15
Q

What is the main cell of the dermis

A

Fibroblast

produces collagen and elastin

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16
Q

What is a macrophage

A

Peak 48-72 hours after injury,

housed in dermis,

clean cellular debris and fight infecion

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17
Q

White blood cells

Mastcells

A

Both housed in dermis

WBC- fight infection

Mast cell - produce histamine

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18
Q

Adipose tissue is highly ___________

A

Vascular

Shiney yellow/white little balls

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19
Q

Fascia looks like what

A

shiny white or yellow strands when healthy

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20
Q

A stage 2 pressure injury is ________-thickness

A

partial

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21
Q

A stage 3 or 4 pressure injury is ________-thickness

A

full

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22
Q

What are the 4 phases of wound healing

A

Hemostasis

Inflammation

Proliferation

Maturation/remodeling

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23
Q

What are the cardinal signs of inflammaiton

A

Edema

Rubor

Warmth

Pain

Decreased function

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24
Q

What is the first cell to arrive at a site of injury

A

PMN Polymorphonuclear neutrophils

Stimulates vascular growth and fibroblast migration, secretes inflammatory mdiatiors

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25
Q

What do macrophages do

A

Direct repair process, kill bacteria and pathogens

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26
Q

What cells form a plug to stop bleeding

A

platelets

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27
Q

What are the signalling proteins of the inflammation phase called?

A

cytokines

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28
Q

The proliferation phase starts _____ hours after an injury

it consists of what 4 events

A

48 hours

Angiogenesis

Granulation tissue formation

Wound contraction

Epithelialization

29
Q

What cells are responsible for wound contraction

A

Myofibroblast

30
Q

What heals faster: circular wound or square/rectangular wounds

A

Square/rectangle

31
Q

The maturation and remodeling phase for a wound can take up to _______, most change occurs within _______

A

2 years

6-12 months

32
Q

The new collage put down in the remodeling phase is type _____, the old collage is type ______ and is broken down by collagenase

A

Type 1

Type 3

33
Q

Fully remodeled collagen is only ___% as strong as the original, if it is broken and repaired again it is __% as strong

A

80%

64%

(keeps being 80% as strong each generation)

34
Q

What are MMP (Matrix Metalloprotease)

A

Inflammatory mediatiors (the boss of the wound)

Takes part in all 3 healing phases

Play a large role when woound becomes chronic (too many of them)

35
Q

The epidermis normally has a _______ charge

A wound usually has a ______ charge

A

Electronegative

Positive

Note: this current difference is what starts wound healing cascade

36
Q

Intact skin has a PH of what

Damage to skin can do what?

A

4-6.5

Increase PH/loss of acidity

37
Q

What can increase skin acidity

A

Urine/stool

Systemic disease

38
Q

Eczema, dermatitis can _______ skin acidity

A

Decrease acidity (higher ph)

39
Q

What is wound primary closure (surgery)

A

Wound is cleaned and edges are approximated and closed

40
Q

What is secondary wound closure

A

Wound is left open to heal on is own through the 3 phases

41
Q

What is delayed primary closure

A

Where the surgeon leaves the wound open temporarily to monitor for infection before eventually closing it

42
Q

What is dehiscence

A

Where primary wound closure from a surgery opens back up

43
Q

Hypogranulation vs hypergranulation

A

Hypo- wound fails to granulate

hyper- granluation occurs outside wound

44
Q

A chronic wound is defined by medicare as _____

A

taking more than 30 days to close

45
Q

Technical definition of chronic wound (not medicare)

A

Wound is stuck in a phase of healing with no progress

46
Q

What are senescent cells

A

Dr flynns brother

useless cells

usually found in chronic wounds

47
Q

Chronic wounds typically have ______ levels of MMP

A

higher

+dont respond to growth gactor

+lower level tissue inhibitors of matrix metalloprotease (TIMPs)

48
Q

Why do you want to do change the dressing of a wound as less-frequent as you can?

A

To avoid changing temp

49
Q

Optimal temp for wound healing?

When is it too cold?

A

37-38C

Below 12C

50
Q

Should you let a wound “air out”

A

No, wounds cannot become too dry

wounds must stay hydrated

51
Q

What is normal water intake for a person?

Normal intake if u have a wound?

A

30-35ml per kg of BW

2.7-3.7L per day

52
Q

How can you tell if someones dehydrated

A

1% decrease in bodyweight

decreased urine output/dark color

decreased skin turgor

53
Q

Why is vitamin A important?

A

Improves tensile strength of tissue

increases collagen synthesis

Helps w/ longterm corticosteroid use

note: can damage liver if too much

54
Q

Why is vitamin C important?

A

absorb iron/ antioxidant/ synthesis collagen/ capillary integrity

55
Q

Why is vitamin E important

A

Antioxidant/ decrease inflammation phase/ enhance immune function/ decreases platelet adhesion

56
Q

Why is Vitamin K important

A

Essential for blood clotting

57
Q

How does Zinc help wound healing

A

Aids in collagen and protein synthesis and cell proliferation/ normal immune function

58
Q

Why is iron important

A

O2 transport, immune function

59
Q

Why is copper important

A

Required for hemoglobin synethsis and iron absorption

60
Q

why is magnesium important

A

Deficiency can cause HTN and vasoconstriction

often caused by diabetes/alcoholism/diarrhea/dehydration

61
Q

Why is calcium important

A

Required for fibrin synthesis

62
Q

What happens at these Loss of lean bodymass percentages?

10%

20%

30%

40%

A

10%- impaired immunity

20% - impaired healing and thin skin

30% - no healing, new wounds can form

40%- death

63
Q

What do creatinine levels indicate

A

Kidney function

64
Q

What do albumin levels indicate

A

protein deficiency

65
Q

What do prealbumin levels indicate

same for serum transferrin levels

A

see how change in protein in impactng patient

serum transferrin- looks at protein status/recent changes

66
Q

What do C-reactive protein levels indicate

A

Indicates inflammation

67
Q

What do BUN levels indicate

A

decreased healing

67
Q

What do blood glucose levels indicate

A

increase risk for ulcer, infection, impaired healing

Integ (14 decks)

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