Midterm Flashcards

1
Q

Epidermis is how thick

A

.06-.6 mm

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2
Q

What cells form the epidermis?

A

Keratinized stratified Squamos

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3
Q

Pigmentation comes from number of ______________. Have __________ for dark skin and ____________ for light skin.

A

Melanocytes
Fewer
More

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4
Q

Basil layer

Strauss baselie

A

Deepest responsible for kerantocytes

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5
Q

Stratum spinosum

A

Keratin layers

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6
Q

Stratum granulosum

A

Flattened keratinocytes

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7
Q

Stratum lucid

A

Clear layer of dead keratinocytes

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8
Q

Stratum corneum

A

Horny layer

Entirely layer of dead kerantocytes

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9
Q

Darker the skin more_____________

A

Cohesive

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10
Q

Dermis contains

A

Epidermal appendages
Rede ridges
Dermal papillae

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11
Q

Epidermal apendages include

A

Hair follicle
Sebaceous glands
Sudorferous glands
Nails

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12
Q

Rede ridges

A

Epithelial extension project into dermis

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13
Q

Dermal papillae

A

Interdigdating with rede ridges

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14
Q

Dermis is made up of

A

Collagen
Blood vessels
Lymph n
Epidermal appendages

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15
Q

Function of dermis

A

Sensation
Nutrient
Strength skin
Contribute to healing

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16
Q

What are the two layers of the dermis

A

Papillary

Reticular

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17
Q

Papillary layer is

A

Blister, surface of skin

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18
Q

Reticular layer

A

Structural support

Type one collagen, vasculature, nerves, hair, elastic fibers

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19
Q

Subcutaneous or hypodermis layer

A

Fatty layer

Highly vascularized

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20
Q

Pear shape adipose

A

Weight in hips
Subcutaneous fat
Vascularized, padding, release energy

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21
Q

Apple shape weight

A

Weight in the middle
Visceral fat
DM, heart condition, surround internal organs

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22
Q

Function of the skin

A
Barrier to infection
Regulate heat loss
Sensation 
Excretion 
Biochemical 
Produce vitamin d
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23
Q

Papillary layer of dermis

A

Blister, split the surface

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24
Q

Reticular layer of dermis

A

Structural support

Type one collagen, vasculature, nerve, hair, elastic fiber

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25
Q

Adipoctyes action

A

Appetite control, regulate bp, coagulation, mm

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26
Q

Leptins action

A

Control the CnS,

Inc energy consumption

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27
Q

Skin phototype

A

Smallest amount of radiation predicts skins vulnerability to UV light

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28
Q

Skin color depends on

A

Number of melanocytes

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29
Q

Variation in skin tone dependent on

A

Amount of melanin

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30
Q

Skin color function

A

Protect from UV light, protect from photo damage, absorb and deflect Rays

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31
Q

Erosion ( abrasion) stage 1

A

Heal with epithelization

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32
Q

Ulcer

A

Below the epidethelium into the dermis

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33
Q

Stage 2

A

Partial thickness

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34
Q

Stage 3

A

Full thickness need a skin graft to heal

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35
Q

Function of the ground substance (gag and water)

A

Nutrition to CT
Barrier against infection
Fluid fiber distance of collage, reticular and elastin

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36
Q

Damage to the CT leads to

A

Change in scar tissue
Decrease water and gags
Dec critical fiber distance
Dec amount of collagen

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37
Q

Phase one healing-inflammation

A

Hemostasis- control bleeding with platelets
Phagocytosis- marcoohages cells PMN
Angiogenesis- mast cells

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38
Q

Phase two - proliferative

A

Angioblast
Fibroblast- secrete tropocollagen, synthesize gag, replaced by scar tissue
Myofibroblast- wound contraction
Keratinocytes

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39
Q

Phase 3 remodeling

A

Reorient along the stress line

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40
Q

Clinical implications for healing through the three stages

A
Encourage gag re synthesis
Prevent cross linking
Promote appropriate movement
Rice
Appropriate mvmt 
Strength and function
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41
Q

Sources of burns

A
Flame
Hot liquids
Contact
Electricity 
Hot gas
Chemicals
Friction
Expose to heat and cold
Radiation
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42
Q

Superifical first degree burn

A

Only epidermis
Avascularity
No blister
2-5 days

43
Q

Superifical partial thickness second degree

A

Epidermis into upper layer of dermis
Epidermis completely destroyed
Papillary layer involved causing blisters to form
Heal 5-21 days

44
Q

Deep partial thickness deep second degree

A
Destruction of epidermis and see damage to dermal layer
Appendages ruined or destroyed
Red tan white dull looking
Eschar or coagulation may occur
21-35 days
45
Q

Full thickness burn third degree

A

All epidermal and dermal layers destroyed
Coagulation of necrosis cells, loss of blood vessels, massive edema, cellular inflammation
No pain no blanch

46
Q

Electrical burn fourth degree

A

Destruction of epidermis down to bone
Entrance and exit wounds
Ice berg effect

47
Q

Volts__________, amps___________ nerves

A

Burn, destroy

48
Q

Zone of coagulation

A

Direct intense heat

Skin death,Eschar

49
Q

Zone of statsis

A

Injured cells die within one to two days

Blood supply compromises

50
Q

Zone of hyperemia

A

Redness around the other two zones

51
Q

Breakdown exceeds the production of scars

A

Scars are less bulky

52
Q

Production exceeds breakdown

A

Hypertrophic scars

53
Q

Keloid scar

A

Large firm skin extend beyond boundaries

54
Q

Superifical thick skin graft types

A

Meshed- cover burn with less skin, infected or irregular wound
Sheet- cosmetic, durable, contraction limited

55
Q

Signs of inhalation burn

A
Facial burns
Singed nose hairs
Tinged sputum
Close space injury
Bronchoscope 
Hoarseness
56
Q

Rehab for inhalation injury

A

Clear airway
Good oxygen stats
Monitor SOB
Promote mobilization of secretions

57
Q

Treatment plan for burns

A

Prevent loss of rom
Restore lost function and rom
Return to pre burn status

58
Q

Patient positioning for burns

A

Control edema
Prevent pressure ulcers
Maintain soft tissue elongation

59
Q

Exposed tendons called for what type of rom?

A

AROM

60
Q

Acute PT for a burn patient

A

CPT
Positioning splinting
A and prom
Education

61
Q

Subacute PT for burns

A
CPT 
Positioning 
A and prom
Education 
Hep 
Strength and amb
62
Q

Out PT for burns

A
CPT 
Positioning 
A and prom 
Transfer
Gait
strength 
Scar management 
Education hep
63
Q

Dyschromia

A

Increase in melanin or unequal distribution

After inflammation

64
Q

Hypo pigmentation

A

Localized widespread loss of melanin in skin

65
Q

For arterial insufficiency need to work on

A

Aerobic and strength training

66
Q

For venous insufficiency need to work on

A

External support
Aerobic activity
Strengthening

67
Q

For DM need to work on

A

Aerobic
Strength
Diet
Weight control

68
Q

Goals of wound care

A

Full closure
Prep for surgical closure
Manage wound deterioration
Maintain non healing stable ulcers

69
Q

Surgical debridement involve

A

Non seclective
Remove both viable and non viable tissue
Wide excision to viable tissue with sharp sterile
Removal of bone or necrotic tissue

70
Q

Sharp debridement

A

Selective
Remove no viable tissue
Inc risk of infection

71
Q

Sharp debridement contraindications

A

ABI

72
Q

Sharp debridement indications

A

Extensive necrosis
Advanced cellulitis
Thick Eschar
Callous formation

73
Q

To stop excessive bleeding

A
Pressure for ten minutes 
Elevate 
Ca aliginate
Xiyloccune 
Vasoconstriction 
Nitrate Catherize
74
Q

Mechanical debridement

A
Scrubbing non selective 
Wet to dry
Whirlpool 
Forced irrigation 
Pulsed lavage
75
Q

Systemic effects of whirlpool

A
Inc hr, rr
Sedation 
Mm relax
Analgesia 
Change in temp
76
Q

Enzyme debridement

A

Selective

Liquefy necrotic tissue

77
Q

Autolytic debridement

A

Most selective

Use mositure retaining dressing to allow body’s own macrophages neutrophils and phagocytes

78
Q

Maggot debridement

A

Selective

Disinfect and promote growth of fibroblasts

79
Q

Ideal dressing

A

Keep moist allow gaseous exchanges, thermal insulate, impreamble to microgranism, non adherent or traumatic

80
Q

Non occlusive dressing

A

No air or drainage
Allow drainage to evaporate
Acute surgical wounds, primary adhesion, infected, highly drainage

81
Q

Semi occlusive dressing

A

Allow gaseous and vapor exchange

Autolytic debridement, scant, moderate draining

82
Q

Occlusive dressing

A

Keep everything out
Automatic debridement, minimum drainage, perineal wound, primary shallow wound, 2nd deep cavity wound, 2nd skin protection

83
Q

Moderate to high absorptive

A
Gauze 
Alignates
Hydro fibers
Foam 
Filter
84
Q

Low to no absorptive

A

Hydro colloids
Transparent films
Impregnated gauze

85
Q

Hydrating dressing

A

Hydrogel

86
Q

Misallenous dressing

A

Composits, contact layer, negative wound therapy

87
Q

Inflammation cells

A

Macrophages +

Neutrophils -

88
Q

Fibroblast cells

A

Fibroblast +

89
Q

Remodel cells

A

Myofibroblast +

Epidermal -

90
Q

Wet -> dry dressing

A

Mod to high absorptive
Mechanical non selective debridement of necrotic wound
Wound fillers
Readily available

91
Q

Wet -> moist

A

Semipermeable occlusive filter over gauze over wound bed
Prevent drying out of wound
Mechanical selective debridement.
Put directly on wound

92
Q

Wet-> wet

A
Help take gauze that is packed into wound out 
Wound fillers
Put into wound
Put on to keep from drying out 
Semipermeable or occlusive film dressing
93
Q

Wound packing

A

With gauze to allow absorption of moisture and for undermining
Aide in autoltyic debridement
Semipermeable to mositure vapor

94
Q

Films

A
Thin membrane coated with layer of acrylic adhesive 
No absorb 
Moisture vapor oxygen premeable
Autoltyic debridement. 
Secondary dressing
95
Q

Hydrogels

A
Group of polymers contains water in gel base
Provide moisture to the bed 
Absorb exudate 
Aids in autoltyic debridement 
Relieves pain 
Necrotic arterial wound 
On dry wound
96
Q

Alginates or hydro fiber

A
From Ca and Na salts 
Maintain wound moisture 
Highly absorptive 
Doesn't adhere to wound 
Secondary dressing 
Hemostitc -aliginate 
No min drainage
97
Q

Foams

A

Mod to high absorptive
Maintain wound mositure
Aids in autoltyic debridement.
May have adhesive border

98
Q

Hydro colloids

A
Combo of foams with adhesives 
Maintain mositure of wound bed
Totally occlusive 
Aids in autoltyic debridement 
No secondary dressing 
No drainage held
99
Q

Enzymes

A

Eat necrotic tissue

Cover with something else

100
Q

Bolster dressing

A

Additive layer to help maintain moisture and pressure

High drainage first absorb by gauze

101
Q

Non sticks

A

Silicon, petroleum gauze

Good to allow fluid to seek through won’t stick to wound

102
Q

Antibacterial dressing

A
Silver based 
- inactivated bacterial DNA 
Iodine based
- good against bacteria, mycobacterium, fungus, Protozoa, virus 
- skin prep or sough infected 
Topical antiseptics 
-used only on acute wounds. Bad for healthy tissue 
Topical antibiotics
- short periods, clinical wounds infection 
Honey based 
- debridement of necrosis tissue 
- inhibit bacterial growth
103
Q

Wound stimulating dressing

A

Collagen dressing
- stimulate fibroblasts
Hypotonic saline
- gauze impregnate with sodium and chloride
Hypergranulation tissue and necrotic tissue
- draws fluid out of cells by setting up an osmotic gradient