Module 1- KEY TERMS Flashcards
Very fine, slightly acidic film over the epidermis.
-This and the stratum corneum make the skin less permeable to water, and indirectly protect the skin from microorganisms.
ACID MANTLE
Vascular, loose connective tissue that stores fat and provides energy, cushioning and insulation.
Stores FAT SOLUBLE VITAMINS (ADEK)
glistening white to pale yellow appearance
Darker if dehydrated
ADIPOSE TISSUE
Collection of fluid at the junction between the dermis and epidermis, due to friction
BLISTER
Areas of the body, such as the heel or sacrum, which are protected by a relative thin layer of subcutaneous tissue only.
-tend to be susceptible to pressure ulcers
BONY PROMINENCE
Localized build up of stratum corneum cells due to pressure or friction.
CALLUS
The binding of a cell to a surface, extracellular matrix or another cell using molecules such as selectins, integrins, and cadhedrins
CELL ADHESION
Main supportive protein of the skin
COLLAGEN
Protein in connective tissue that is elastic and allows many tissues in the body to resume their shape after stretching or contracting.
ELASTIN
An arm or a leg
EXTREMITY
Fibrous connective tissue that separates and surrounds structures and facilitates movement between adjacent structures
FASCIA
Wound that extends through the epidermis and dermis and into, or through, the subcutaneous tissue
Subcutaneous wound
Subdermal Tissue wound
Stage III or IV Pressure Injury
Ex
Full thickness burn
FULL THICKNESS WOUND
Epidermal appendages located within the dermis that are made of soft keratin
Help regulate body temp by trapping air
-each contains a sebaceous gland (produces SEBUM)
HAIR
Chemical mediator released by mast cells which causes vasodilation and increased vessel wall permeability, and attracts other cells to the area
HISTAMINE
Protein produced by keratinocytes.
Nails- hard
Hair- soft
KERATIN
Epidermal cell that resurfaces a wound and produces keratin
90% of epidermal cells
Keratinocytes
Epidermal cell that assists with infection control
- attack and engulf foreign bodies
- present in deeper laters of the epidermis
LANGERHANS’ CELL
Cell that directs the repair process, secretes growth factors and enzymes, and destroys bacteria and debris
MACROPHAGES
Cell that helps initiate inflammation through secretion of HISTAMINE, ENZYMES and CHEMICAL MEDIATORS
MAST CELL
Dark pigment of the skin and hair
Formed by melanocytes
-protects the skin from UV radiation
MELANIN
Pigment-producing cell within the epidermis (melanin)
-located in the STRATUM BASALE
MELANOCYTE
Sensory receptor within the epidermis providing information on light touch
Attached to keratinocytes by desmosomes
MERKEL’s CELL
Epidermal appendage made of HARD keratin and located on the dorsal tips of the digits
NAIL
Thin superficial dermal layer consisting of loosely arranged connective tissue embedded in the gelatinous GROUND SUBSTANCE.
PAPILLARY DERMIS
Wound involving the epidermis and part of the dermis.
2nd degree burn
Blister
Stage II pressure injury
PARTIAL THICKNESS WOUND
Process of engulfing and destroying bacteria and or debris
PHAGOCYTIZING
Thick, deep dermal layer consisting of dense, irregularly arranged connective tissue
80% of dermal thickness
RETICULAR DERMIS
Oil gland, epidermal appendage located within the dermis
- produces sebum
SEBACEOUS GLAND
Oily substance that lubricates the skin and hair
May slow bacterial growth
SEBUM
Deepest epithelial cell layer, attached to the dermis below by the basal membrane.
Contains a single row continuously dividing cells (keratinocytes)
AKA Stratum Germanitivum
STRATUM BASALE
Outermost epithelial cell layer
Consists of dead keratinocytes
- can be 20-30 cells thick, up to 3/4 of the thickness of the epidermis
-serves as a physical barrier from trauma and infection
STRATUM CORNEUM
Epithelial cell layer with 3-5 flattened rows with increasing concentrations of keratin.
Between STRATUM SPINOSUM & STRATUM LUCIDUM
STRATUM GRANULOSUM
Epithelial cell layer containing a few flattened layers of dead keratinocytes (appear clear thru a microscope).
Between STRATUM GRANULOSUM and STRATUM CORNEUM
STRATUM LUCIDUM
Epithelial cell layer omconsiting of several rows of more mature SPINY keratinocytes (keratin filaments appear spiny)
Between STRATUM BASALE and STRATUM GRANULOSUM
STRATUM SPINOSUM
Adipose tissue and fascia located beneath the dermis
helps support the skin
AKA HYPODERMIS
Consists of ADIPOSE TISSUE and FASCIA
SUBCUTANEOUS TISSUE
Sweat gland
Epidermal appendage within the dermis
Secrete sweat into ducts leading to the surface of the skin
SUDORIFEROUS GLAND
Wound only involving the epidermis
Abrasion
1st degree burn
SUPERFICIAL WOUND
Fibrous cord of connective tissue continuous with the fibers of a muscle
Attaching the muscle to bone or cartilage
TENDON
Cell that helps fight infection
Neutrophils Lymphocytes Monocytes Eosinophils Basophils
WBC
Dermal cell
Produces collagen, elastin, granulation tissue and growth factors
FIBROBLASTS
EPIDERMAL CELL TYPES
KERATINOCYTES
MELANOCYTES
MERKEL CELLS
LANGERHANS CELLS
EPIDERMAL APPENDAGES
Hair
Glands
Nails
99% water plus some salts and metabolic waste products
SWEAT
FUNCTIONS OF THE EPIDERMIS (7)
1) chemical and physical barrier
2) fluid regulation
3) critical to wndogenous Vit D production
4) light touch sensation
5) assists with excretion
6) thermoregulation
7) cosmesis
How does the skin play a role in Vit D synthesis?
Converts 7-dehydrocholesterol to cholecalciferol when exposed to UV light.
2 LAYERS OF THE DERMIS
Papillary Dermis
Reticular Dermis
DERMAL CELL TYPES
FIBROBLASTS
MACROPHAGES
WBC
MAST CELLS
FUNCTIONS OF THE DERMIS (5)
1) nourishment for epidermis
2) thermoregulation
3) assists with infection control
4) sensation - nerve endings
5) houses epidermal appendages
Regularly arranged COLLAGEN FIBERS
May be enclosed in a fibrous sheath
TENDONS
Regularly arranged fibers surrounded by fascia
Dark red in color due to its rich vascular supply
Will appear gray/black if nonviable
MUSCLES
Regularly arranged fibers
DENSE CONNECTIVE TISSUE
Ligaments
Dense connective tissue with fibers running in varied direction.
JOINT CAPSULES
Outermost layer of the skin
Regenerates itself every 4-6 weeks
Thin
Avascular
EPIDERMIS
Innermost layer of the skin
Contains a network of nerve endings, blood vessels, lymphatics, capillaries, sweat & sebaceous glands, hair follicles
DERMIS
Corpuscle of touch
Located in the Papillary Dermis
Contains nerve endings
Meissner’s Corpuscle
Wound caused by scraping or friction to the skin’s surface
Superficial Wound
Abrasion
Endothelial cell that lines vessel walls
Angioblast
Formation of new blood vessels
Angiogenesis
Granular leukocyte which releases histamine
Basophil
Substance that attracts cells
Chemotactic Agent
Movement along a chemical gradient
Chemotaxis
Wound’s epithelial integrity has been restored
Closed Wound
Endogenous enzyme
Breaks down collagen during the MATURATION & REMODELING phase of wound healing.
COLLAGENASE
Decreasing the size of the wound
Process driven by Myofibroblasts
CONTRACTION
Signaling protein
INFLAMMATORY PHASE
Cytokine
State of EXTREME DRYNESS
-physiological fluids that support wound healing are removed
DESSICATION
Movement of PMNs through capillary walls
DIAPEDESIS
Granular leukocyte
Associated with ALLERGIC RESPONSE
EOSINOPHIL
Resurfacing of wound with KERATINOCYTES
EPITHELIALIZATION
RBC
ERYTHROCYTE
Fluid containing high levels of protein and cells
EXUDATE
Temporary structure
Composed of vascular connective tissue
Fills the wound void
GRANULATION TISSUE
Growth-promoting substance
Increases cell size, proliferation, activity
GROWTH FACTOR
Closed wound with tissue strength approaching normal
HEALED WOUND
Oxygen carrying pigment of erythrocytes
Formed in the bone marrow by young erythrocytes
HEMOGLOBIN
Volume percentage of erythrocytes in WHOLE BLOOD
HEMATOCRIT
Chemical mediator Released bu MAST CELLS causes VASODILATION INCREASES CELL WALL PERMEABILITY ATTRACTS OTHER CELLS
HISTAMINE
Key structural and functional component of the EXTRA-CELLULAR MATRIX
KEY COMPONENT OF AMNIOTIC FLUID
Promotes l:
Cell proliferation
Tissue regeneration
Repair
HYALURONIC ACID
First phase of wound healing
Vascular and cellular response to injury of living tissue
Characterized by RUBOR CALOR DOLOR FUNCTIO LAESA
INFLAMMATION
Cell surface receptor
Allows cells to bind reversible to the EXTRACELLULAR MATRIX
INTEGRIN
WBC
protects the body against microorganisms causing disease
LEUKOCYES
Leukocyte
Mononuclear
NONgranular
Participates in IMMUNE RESPONSE
LYMPHOCYTE
Part of the cellular response of the INFLAMMATION PHASE
slow PMNs are pushed to vessel walls
MARGINATION
Mononuclear Phagocytic leukocyte Formed in the bone marrow Then transported to tissues Develops into MACROPHAGE
MONOCYTE
Protease that degrades the extracellular matrix
Matrix Metalloprotease (MMP)
Wound healing PHASE
COLLAGEN matures and reorients along stress lines
MATURATION AND REMODELING
Cell possessing properties of FIBROBLASTS and SMOOTH MUSCLE CELLS
causes CONTRACTION
MYOFIBROBLAST
Granular LEUKOCYTE involved in PHAGOCYTISIS
Neutrophil
Wound cleaner cell
Secretes enzymes and inflammatory mediators
PMN
Polymorphonuclear Neutrophil
Fluid portion of blood
Particulate components are suspended
Plasma
Cell that helps control bleeding
Releases growth factors & chemotactic agents
Platelet
SECOND PHASE OF WOUND HEALING
BUILDING AND REGENERATING CONSISTS OF: Angiogenesis Granulation-tissue formation Wound Contraction Epithelialization
PROLIFERATION
Re-epithelialization of a wound
Pricipal method of healing in PRIMARY INTENTION
REGENERATION
Substance released by INJURED cells that cause VASODILATION
Prostaglandin
FINAL PHASE OF NORMAL WOUND HEALING
Scar tissue is reorganized
REMODELING
PRIMARY MODE OF WOUND CLOSURE IN SECONDARY INTENTION
Repair
Collection of necrotic cells, fibrin, collagen, platelets
Covers a superficial wound
SCAB
Pathological shortening of scar tissue resulting in DEFORMITY
SCAR CONTRACTURE
Disc-shaped structure found in the blood and involved in BLOOD COAGULATION
AKA PLATELET
Thrombocyte
Protease inhibitor of MMPs
TIMPs
TISSUE INHIBITORS OF Matrix Metalloprotease
Low protein collection of fluid caused by increased vascular permeability
TRANSUDATE
Process by which MYOFIBROBLASTS pull wound margins closer together, thereby decreasing the size of the defect
WOUND CONTRACTION
Three Phases of Wound Healing
Inflammation
Proliferation
Maturation/Remodeling
3 Types of Wound Closures
Primary Intention
Secondary Intention
Delayed Primary Intention
An organized and predictable process, consisting of 3 overlapping phases:
Inflammation
Proliferation
Maturation/Remodeling
Normal Wound Healing
The body’s 1st response to injury
controls blood loss,
fends off bacterial invasion
Signals cells to restore the injured are
Does not occur in dead tissue or in tissues without adequate blood flow
Involves cellular and vascular response
INFLAMMATION
Second phase of healing
New tissues are built to fill the gap
Epithelial integrity is restored
Wound is closed
PROLIFERATION
Final phase of healing
Lasts up to 2 years after wound closure
Scar tissue is reorganized according to Wolff’s Law
*scar tissue is less elastic and may only reach a max of 80% of original tissue strength.
MATURATION/REMODELING
When is a wound considered healed?
After it is resurfaced AND maximal attainable tissue strength is achieved.