Midterm

Question 1

What is the largest organ of the body?

Answer 1

skin

Question 2

What are the layers of the skin from outer to inner

Answer 2

epidermis & dermis

Question 3

what layer of the skin is vascular? Avascular?

Answer 3

dermis is vascular & epidermis is avascular

Question 4

what are the functions of the skin?

Answer 4

protection, sensation, fluid maintenance, immunity, thermoregulation

Question 5

What is deep to the dermis & its function?

Answer 5

hypodermis; allow organs to slide over the cutaneous tissue

Question 6

what are the 5 layers of the epidermis from deep to superficial?

Answer 6

stratum basale, stratum spinosum, stratum granulosum, stratum lucidum, & stratium corneum

Question 7

what is the thickest layer of the epidermis?

Answer 7

stratum spinosum

Question 8

what is the purpose of the stratum spinosum

Answer 8

help skin withstand friction & shear forces

Question 9

what is the function of the stratum granulosum

Answer 9

prevent water/fluid loss

Question 10

what is the function of the stratum lucidum

Answer 10

protection from environment

Question 11

what happens in the stratum corneum layer of the epidermis?

Answer 11

keratinocytes become corneacytes

Question 12

what are the primary cells in the epidermis

Answer 12

keratinocytes, melanocytes, langerhan cells, merkel cells

Question 13

where are melanocytes located?

Answer 13

b/t basale & spinosum

Question 14

what is the function of the melanocytes?

Answer 14

give the skin its pigmentation

Question 15

where are langerhan cells located?

Answer 15

in the spinosum

Question 16

where are merkel cells located?

Answer 16

in the stratum basale

Question 17

whats the function of the merkel cells

Answer 17

detect light touch

Question 18

what are the cells that make up the dermis?

Answer 18

fibroblasts, meissner’s corpuscles, pacinian corpuscles, hair follicles

Question 19

what is the purpose of fibroblasts?

Answer 19

generate collagen (type 1) & elastin

Question 20

what is the purpose of meissner’s corpuscles?

Answer 20

detect light touch

Question 21

what is the purpose of pacinian corpuscles?

Answer 21

detect deep pressure & vibration

Question 22

Erosion is classified as what?

Answer 22

superficial; epidermal loss only

Question 23

what are clinical signs of erosion?

Answer 23

erythema, & min to no bleeding

Question 24

Partial thickness wounds are classified as what?

Answer 24

loss of dermis & epidermis

Question 25

what is the clinical sign of a partial thickness wound?

Answer 25

bleeding

Question 26

Full thickness wounds are classified by what?

Answer 26

loss of epidermis, dermis, & hypodermis

Question 27

what are clinical signs of full thickness wounds?

Answer 27

possible exposure of bone/tendon/lig/mm

Question 28

What are the phases of healing?

Answer 28

hemostasis, inflammation, proliferation, remodeling

Question 29

what are clinical signs of hemostasis

Answer 29

inflammation & edema

Question 30

when does hemostasis occur?

Answer 30

less than 1 hr post injury

Question 31

when does the inflammation phase occur?

Answer 31

1 hr-4 days post injury

Question 32

what are clinical signs of the inflammation phase?

Answer 32

increased body temp; rubor, tumor, dolor, calor

Question 33

what is the goal of the inflammation phase of healing?

Answer 33

increase circulation to site of injury

Question 34

what are characteristics of hemostasis phase?

Answer 34

platelet aggregation; cellular action & clot formation; arterial vasoconstriction; influx of neutrophils

Question 35

what are characteristics of inflammation phase?

Answer 35

vasodilation; leukocyte & macrophage formation; angiogensis; autolytic debridment

Question 36

when does the proliferation phase of healing occur

Answer 36

4-12 days post injury

Question 37

what are clinical signs of the proliferation phase

Answer 37

red/granulated tissue; re-epithelialization occurs after granulation tissue

Question 38

what are characteristics of proliferation phase of healing

Answer 38

angiogensis of small vessels; formation of new ECM; proliferation of fibroblasts; PG/collagen synthesis; granulation tissue formation

Question 39

what are the clinical signs of the maturation/remodeling phase of healing

Answer 39

blanching of skin

Question 40

what are primary characteristics of maturation/remodeling phase of healing

Answer 40

wound contraction; fibroblast to myofibroblast conversion; melanocyte aggregation; increased tensile strength; collagen replacement

Question 41

what is recidivism?

Answer 41

reoccurrence of wounds in same area due to decreased tensile strength

Question 42

what is healing by primary intention?

Answer 42

- min tissue loss - good approximation - no scab formation secondary to min cell death - heals in approx 2 wks

Question 43

what is healing by delayed primary (tertiary) intention?

Answer 43

- debris/pathogens in wound - granuloma results - marked inflammatory response

Question 44

what is secondary intention?

Answer 44

usual healing process for non-surgical wounds

Question 45

what is the ECM composed of?

Answer 45

collagen, elastin, PGs

Question 46

what is the purpose of collagen?

Answer 46

helps formulate new tissue

Question 47

what is the purpose of elastin

Answer 47

gives stretch properties

Question 48

what is the purpose of PGs?

Answer 48

act as adhesive property of tissue

Question 49

what is the normal range of WBC count

Answer 49

4.5-11

Question 50

what happens /c increased WBC? Decreased?

Answer 50

``` increased = infection or trauma decreased = decreased immune response to bacteria ```

Question 51

what is the normal hemoglobin range?

Answer 51

12-18 g/dL

Question 52

what happens /c increased hemoglobin? Decreased?

Answer 52

``` increased = wound fails to progress decreased = wound fails to progress, pale appearacne ```

Question 53

what is the normal hematocrit level?

Answer 53

36-50%

Question 54

what happens /c increased and decreased hematocrit?

Answer 54

``` increased = sign of thrombi/emboli decreased = wound fails to progress/pale ```

Question 55

what is normal prothrombin time? (INR)

Answer 55

2.5 seconds

Question 56

what happens /c increased and decreased INR?

Answer 56

``` increased = bleeds easy decreased = increased clotting ```

Question 57

what is the normal HbA1C level?

Answer 57

= 5.7%

Question 58

what happens /c increased HbA1C

Answer 58

delayed wound healing

Question 59

what is the normal glucose range?

Answer 59

<100 mg/dL

Question 60

what happens /c increased glucose level

Answer 60

delayed wound healing

Question 61

explain the red, yellow, black wound classifications

Answer 61

- red = clean, healing, granulating - yellow = possible infection, need to be cleaned, presence of necrotic tissue - black = wound is necrotic & needs cleaning

Question 62

what is the "national pressure ulcer advisory panel pressure ulcer staging system" used for

Answer 62

classifying pressure ulcers; used to describe wound severity, organize treatment protocols, & select & reimburse treatment products

Question 63

What are the wagner ulcer grades?

Answer 63

0: preulcerative lesions; healed ulcers; presence of bony deformity 1: superficial ulcer w/o subcutaneous tissue involvement 2: penetration through subcutaneous tissue; may expose bone, tendon, lig, jt capsule 3: osteitis, abscess, osteomyelitis 4: gangrene of digit 5: gangrene of foot

Question 64

what is the wagner ulcer classification used for commonly?

Answer 64

assessment of diabetic foot ulcers

Question 65

what is the university of texas treatment based diabetic foot classification system used for?

Answer 65

when neuropathy is present & info needed abt infection & circulation

Question 66

what are the values for the university of texas tx based diabetic foot classification system?

Answer 66

``` A = wound depth B = infection C = ischemia D = infection & ischemia ```