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Med Surg 1 > MIDTERMS: Integ: Burns & conditions > Flashcards

MIDTERMS: Integ: Burns & conditions Flashcards

1
Q

The outermost, avascular layer of the skin exposed to the environment. It provides waterproofing and protection from infection.

A

epidermis

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2
Q

Name and describe the layers of the epidermis.

A

Corneum: Horny layer, waterproofs and protects from infection.
Lucidum: Clear layer, found on palms and soles.
Granulosum: Retains water and regulates heat.
Spinosum: Protects basale layer.
Basale: Regeneration layer, contains melanocytes for skin pigmentation.

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3
Q

: Large blisters (raised >5mm), associated with grade II pressure ulcers, and can follow a dermatome.

A

bullae

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3
Q

: A small, fluid-filled blister (<5mm) that can be transferred through touch.

A

vesicle

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3
Q

The “true skin” layer, 20-30x thicker than the epidermis. Contains blood vessels, lymphatics, collagen, elastic fibers, and appendages like sweat glands and hair follicles.

A

dermis

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4
Q

Superficial, linear erosion of the skin caused by scratching, leading to a break in the epidermis and potential scarring.

A

excoriation

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5
Q

Thickened, rough skin due to repeated rubbing, often seen in conditions like eczema.

A

lichenification

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6
Q

A flat, discolored skin area that is darker than the surrounding skin.

A

macule

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7
Q

A firm, doughy skin elevation (5-20mm), circumscribed and solid.

A

nodule

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8
Q

A small raised lesion on the skin, typically <5mm.

A

papule

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9
Q

Abnormal keratinization leading to scale-like skin.

A

dyskeratosis

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9
Q

Loss of nail integrity, leading to brittle, opaque nails, often due to nutritional deficiencies or pressure.

A

onycholysis

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10
Q

Superficial loss of the epidermis, often healing without scarring.

A

erosion

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10
Q

What is a plaque in dermatology?

A

A flat-topped, scale-like lesion >5mm that peels off, resembling a scab.

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10
Q

What is a scale in terms of skin?

A

Superficial dead epidermal cells that peel off, giving a scaly appearance.

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10
Q

A pus-filled, raised skin lesion commonly seen in acne, boils, and folliculitis.

A

pustule

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11
Q

An irregular, edematous area of skin, often itchy and red, commonly seen in allergies or insect bites.

A

wheal

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11
Q

Define exocytosis in skin pathology.

A

Invasion of inflammatory cells into the epidermis.

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11
Q

Destruction of intercellular connections within the epidermis.

A

acantholysis

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11
Q

Loss of epidermis extending into the dermis or deeper, often healing with scarring.

A

ulceration

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11
Q

What is vacuolization?

A

Damage at the basal cell membrane level.

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11
Q

What is hyperkeratosis?

A

Abnormal thickening of the stratum corneum with excessive keratin.

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11
Q

Hyperplasia of the dermal papillae, causing a loss of skin integrity.

A

papillomatosis

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12
Q

Hyperpigmentation caused by constant rubbing, pressure, or shearing.

A

acanthosis

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12
Q

A form of keratinization where nuclei are retained in the stratum corneum.

A

parakeratosis

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13
Q

What is spongiosis?

A

Intercellular edema within the epidermis.

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13
Q

What does red color in a wound indicate?

A

Viable tissue with granulation, indicating healing.

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13
Q

What key information is needed for evaluating a patient with an open wound?

A

Age, sex, occupation, medical history, past interventions, wound development history, symptoms, progression, and any interventions.

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14
Q

When is a wound considered chronic?

A

When it persists for more than 3 months.

14
Q

Classify wounds based on etiology.

A

Surgical (e.g., appendectomy, laparotomy)
Traumatic (e.g., fights, accidents)
Chronic (e.g., pressure ulcers)

14
Q

What are the thickness classifications of wounds?

A

Partial thickness
Full thickness

15
Q

What is a wound?

A

A break in the integrity of body structures.

16
Q

What does pink color in a wound indicate?

A

Epithelializing wounds showing pink margins or islands on the surface.

17
Q

What is Marjolin’s ulcer?

A

A malignant degeneration that occurs progressively.

18
Q

What does yellow color in a wound signify?

A

Sloughy wounds with a layer of viscous adherent slough.

19
Q

What does black color in a wound indicate?

A

Necrotic wounds covered with devitalized epidermis.

20
Q

What is a suspected deep tissue injury (SDTI)?

A

Discoloration of skin without an opening in the wound.

20
Q

Common sites for pressure ulcers in a sitting position?

A

Ischium, heel, elbow, buttocks.

21
Q

Describe the stages of pressure ulcers.

A

Stage I: Nonblanchable erythema, intact epidermis.
Stage II: Partial thickness, may blister.
Stage III: Full thickness destruction into subcutaneous tissue.
Stage IV: Deep tissue destruction to fascia, muscle, bone, or joint.

22
Q

Describe the superficial burn.

A

Involves the epidermis, red erythematous, dry, and heals in 2-3 days.

22
Q

What is an unstageable pressure ulcer?

A

Ulcer with slough/eschar that obscures the depth.

22
Q

What are the degrees of burn injury?

A

1st degree: Sunburn.
2nd degree: Blisters.
3rd degree: Full thickness involving deeper layers.

22
Q

What pressure can cause ischemia in tissue?

A

External pressure exceeding 32 mmHg for prolonged periods.

22
Q

A risk assessment tool consisting of six factors to evaluate risk for pressure ulcers.

A

Braden Scale

23
Q

What is the role of nutrition in wound healing?

A

Essential for synthesizing tissues; protein, vitamin C, and zinc are crucial.

23
Q

They are used for partial thickness (PT) and full thickness (FT) wounds with varying amounts of exudate, as well as secondary dressings over amorphous hydrogels.

A

FOAM DRESSINGS

23
Q

hydrophilic polyurethane materials with phobic layers that absorb exudates. They come in sheets or pads and can be semi-permeable, available in adhesive and non-adhesive forms.

A

FOAM dressings

23
Q

What are the disadvantages of GAUZE dressings?

A

They can adhere to the wound bed, are highly permeable requiring frequent changes, and may increase the infection rate.

23
Q

What are the characteristics to observe during wound evaluation?

A

Size, depth, shape, surrounding tissue, color, temperature, and edema.

23
Q

What are the advantages of GAUZE dressings?

A

They are readily available, cost-effective, can be used alone or with other dressings, and can add layers for treatment.

23
Q

What are the disadvantages of FOAM DRESSINGS?

A

: They can roll in areas with excessive friction, may traumatize the peri-wound area, and are difficult to inspect.

23
Q

made from calcium salt of alginic acid (from seaweed), are highly permeable, non-occlusive, and require a secondary dressing.

A

ALGINATES

23
Q

What are the uses of ALGINATES?

A

They are suitable for PT and FT wounds, particularly pressure ulcers, venous ulcers, and infected wounds.

24
Q

made of polyurethane with water-resistant adhesives, are permeable to water and oxygen but impermeable to water and bacteria, and are highly elastic.

A

TRANSPARENT FILM dressings

24
Q

What are the advantages of ALGINATES?

A

They have high absorptive capacity, enable autolytic debridement, provide protection from microbial contamination, and can be used for both infected and non-adhering wounds.

25
Q

What are the uses of TRANSPARENT FILM dressings?

A

They are used for superficial wounds and PT wounds with minimal drainage.

26
Q

What is a skin graft?

A

A skin graft is the placement of a healthy layer of new skin onto a wound site to close the wound, prevent infection, protect underlying tissue, and expedite healing.

27
Q

What are the types of skin grafts?

A

Autografts (from the same person), allografts (from other humans), and xenografts (from animals, often pigs).

28
Q

What are the forms of skin grafts?

A

Partial or split-thickness grafts (epidermis and part of dermis) and full-thickness grafts (epidermis and entire dermis).

29
Q

What are the indications for skin grafts?

A

Severe burns, ulcers, biopsies, and wounds with extensive skin loss.

30
Q

What is the recommended time frame for starting range of motion exercises post-surgery?

A

Range of motion exercises should begin three weeks post-surgery.

31
Q

What is the purpose of a Circulator Boot?

A

Designed to compress the leg to increase blood flow, each treatment lasts about 40 minutes and it is not intended for home use.

32
Q

: What are some wound cleansing solutions and their purposes?

A

Povidone-Iodine: Useful against bacteria and viruses but toxic to fibroblasts.
Acetic Acid (0.5%): Effective against Pseudomonas but can change tissue color.
Sodium Hypochlorite (2.5%): Used primarily for necrotic tissue.
Dakin’s Solution: Antiseptic for wound cleaning.

33
Q

What are major dressing categories and their key performance characteristics?

A

Alginates: Exudate absorption, autolytic debridement.
Foams: Retain moisture, absorb exudate.
Gauzes: Absorb exudate, mechanical debridement.
Hydrocolloids: Retain moisture, autolytic debridement.
Hydrogels: Retain moisture, occlusions.
Wound fillers: Obliterate dead space, absorb exudate.

34
Q

: How do the Norton and Braden scales compare?

A

Norton Scale: Focuses on physical and mental condition, with a score ≥ 12 indicating risk.
Braden Scale: Assesses activity, mobility, sensory perception, and nutrition.

35
Q

What wound care modalities are used for pressure ulcers?

A

Hydrotherapy: For debridement of large exudating wounds.
Electrical Stimulation: For stage III and IV ulcers unresponsive to conventional therapy.
Experimental Treatments: Hyperbaric oxygen, low-energy laser therapy, ultrasonography.

36
Q

Q: What surgical treatments are used for pressure ulcers?

A

A: Surgical options include direct closure, skin grafting, and skin flaps to reduce healing time and prevent complications.

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Med Surg 1 (15 decks)

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