medcon2

Question 1

Skin function

Answer 1

Thermoregulation
Sensation
Metabolism of Vit D
Protects against shear
Protects from water loss

Question 2

Epidermis

Answer 2

Regeneration (45-75 days)
Prevents water loss- 90% keratinocytes
Synthesizes vit D
Provides pigmentation
Protects against shear, friction, and toxic irritants (Langerhans cells)

Question 3

Dermis

Answer 3

Organs and vasculature (ECM)
Thickest layer of skin 2-4mm
Provides structure (collagen) and elasticity (elastin) to skin through fibroblasts

Question 4

Hypodermis

Answer 4

Superficial fascia
Contains deep blood vessels and nerve endings
Insulation, reserve energy, cushion (fatty layer/subcutaneous)

Question 5

Effects of aging

Answer 5

Dermal thickness
Fatty layer
Collagen and elastin
Sensation and metabolism
Sweat glands
Circulation and perfusion
Epidermal regeneration

Question 6

Wound healing phase 1

Answer 6

Hemostasis

Question 7

Phase 1: hemostasis

Answer 7

immediate- platelets
vasoconstriction
occurs immediately after injury
How: platelet aggregation, fibrin deposition, clot is end product

Question 8

Wound healing phase 2

Answer 8

Inflammatory

Question 9

Phase 2: Inflammatory

Answer 9

0-4 days- neutrophils, macrophages
vasodilation and phagocytosis
starts at time of injury and lasts 3-7 days
How: increased perfusion, vessel permeability, temperature

Question 10

Wound healing phase 3

Answer 10

Proliferation

Question 11

Phase 3: Proliferation

Answer 11

4-21 days-macrophages, fibroblasts, endothelial cells, epithelial cells
Overlaps and follows the inflammatory occurs
How: angiogenesis- capillary buds extend into the wound bed
Granulation- Collagen synthesis by fibroblasts

Question 12

Wound healing phase 4

Answer 12

Remodeling

Question 13

Phase 4: remodeling

Answer 13

Up to 2 years- fibroblasts
Wound contraction and collagen reorganization
Begin as granulation tissue is formed. Predominantly occurs 21-28 days after injury, can continue for 1-2 years post injury until it reaches maturation
How: collagen synthesis and lysis
Chronic remodeling- imbalance in collagen synthesis and lysis, dehiscence, keloids

Question 14

Acute wound

Answer 14

Healing sequence continuous and within expected time frame
Little to no complaints

Question 15

Chronic wound

Answer 15

Failure/delay of healing
>6 months
Does not respond to regulatory growth signals
Associated with repeated trauma, poor perfusion/oxygenation, excessive inflammation, concomitant disorders/genetic factors
Dormant, senescent cells

Question 16

Wound close- primary intention

Answer 16

surgical closure, fast

Question 17

Wound closure- secondary

Answer 17

granulation, epithelialization

Question 18

Wound closure- tertiary

Answer 18

granulation, epithelialization, delayed primary intention

Question 19

Subjective

Answer 19

history, pain, type

Question 20

Systems screen

Answer 20

Communication, movement system, cardiovascular, integumentary

Question 21

Wound characteristics

Answer 21

Wound edge to edge in a straight line
CM
Length 12-6
Width 3-9
Measure longest and widest part

Question 22

Wound size

Answer 22

Depth- deepest area around wound
Tunneling/sinus tract- tissue loss into the depths of the wound
Undermining- tissue loss parallel to wound surface
Fistula- abnormal connection between 2 epithelium lined structures

Question 23

Exudate (drainage)

Answer 23

Amount
Color- Red- healthy
Character- Clear- serous, clear and some blood- serosanguinous, pus- purulent, hydrocolloids and some silvers- dressing residue
Odor

Question 24

Edges and peri wound

Answer 24

Defined/undefined
Regular/irregular
Attached/unattached
Epiboly
Fibrotic/callus/firm
Maceration- softening of edges by seepage of exudate from wound bed

Question 25

Vascular testing screening