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BSNC 3000 > Module 4 - Tissue Integrity > Flashcards

Module 4 - Tissue Integrity Flashcards

1
Q

Definition of tissue integrity

A

structually intact skin (epithelium, dermis, subq) and mucous membranes

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2
Q

Skin Functions

A

immunity (physical barrier, secrete acidic secretions)
fluid balance (keratinocytes secrete water-repellent secretion)
thermoregulation (sweating, vasodilation, vasoconstriction)
vitamin d synthesis
sensation (sensory receptors located in dermis)

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3
Q

Requirements of skin integrity

A 
good nutrition & hydration
adequate GE/perfusion
mobility
hygiene
immune function
lack of trauma
sensory perception
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4
Q

Skin assessment

A 
intact or non-intact
CWMS
skin turgor
texture
inspect lesions
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5
Q

Resolution

A

damaged cells are reversibly injured and recover

ischemia

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6
Q

Regeneration

A

damaged cells are replaced via cell division –> no scar

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7
Q

Repair

A

damaged cells are replaced by scar tissue (non-functional)

connective tissue replaces functional tissue

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8
Q

Labile cells

A

capable of mitosis –> can regenerate

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9
Q

Permanent cells

A

specialized, functional cells –> cannot regenerate (0 mitosis)

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10
Q

Stable cells

A

stop dividing when growth ceases. can regenerate (divide) when stimulated

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11
Q

Cells with no mitotic ability

A

cardiac cells
neurons
Skeletal muscle

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12
Q

Progenitor cells

A

somewhat specialized cells still capable of mitosis

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13
Q

Examples of stable cells

A 
liver cells
kidney cells
smooth muscle cells
fibroblasts --> wound healing
vascular endothelial cells
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14
Q

Examples of permanent cells

A

skeletal muscle
cardiac muscle
neurons

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15
Q

Ischemia

A

reversible cell injury caused by lack of perfusion

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16
Q

Hypoxia

A

cell injury caused by O2 deprivation

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17
Q

Infarction

A

cell death that occurs d/t lack of blood flow

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18
Q

When does repair (scar tissue) occur

A

cells cannot regenerate
extensive damage
injury is chronic (regeneration cannot keep up with cellular damage

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19
Q

Function of scar tissue

A

provides stability & protection

non-functional –> does not perform the same way as specialized cells

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20
Q

Types of wound healing

A

primary intention
secondary intention
tertiary intention

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21
Q

Primary intention

A

surgical stitches/staples

wounds are well approximated

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22
Q

Secondary intention

A

wound is allowed to heal naturally

granulation/scar tissue formation

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23
Q

Tertiary intention

A

wound infection/contamination/edema has to be treated first

surgical stitches/staples are applied after –> delayed approximation

24
Q

Phases of wound healing

A

Hemostasis
Inflammatory
Proliferative
Remodeling

25
Hemostasis phases
vascular spasm platelet plug coagulation
26
Stages of Inflammation
cellular | vascular
27
Inflammatory cells
WBCs (neutrophils/macrophages) are recruited to clean up cellular debris/fight infection --> prepare area for healing
28
Neutrophil function
phagocytes remove microorganisms break down fibrin clot
29
Macrophage function
phagocyte remove dead cells/debris release growth factors --> angiogenesis, fibroblast proliferation (produce ECM)
30
Proliferative stages
Angiogenesis Fibrogenesis Epithelization
31
Granulation tissue
temporary, delicate tissue highly vascular --> appears smooth, shiny, red contains macrophages, new capillaries, fibroblasts, loose ECM fills in the wound space --> provide foundation for scar formation
32
Remodeling
collagen is broken down (initially collagen is haphazardly laid down) collagen is rearranged in a way that increases tensile strength/range of motion
33
Remodeling timeframe
2-3 weeks up to 2 years
34
When are sutures/staples commonly removed?
Day 7-14
35
Complications of wound healing
``` delayed healing (infection) wound dehiscence hemorrhage hypertrophic scar/keloids contractures strictures adhesions ```
36
Factors delaying wound healing
``` large wound size poor perfusion/hypoxia infection foreign bodies persistence of necrotic tissue poor nutrition weakend immune function certain medications (glucocorticoids) advanced age moisture imbalance movement/tension in wound area ```
37
Causes of impaired perfusion
swelling/immobility compresses blood vessels chronic conditions (PVD, CHF) vasoconstriction --> PSR, smoking, cold temp hemorrhage/dehydration decreases effective circulating volume blood clot --> occludes blood flow
38
Causes of hypoxia
chronic respiratory disease (COPD, obesity, sleep apnea) acute gas exchange impairment (pneumonia, atelectasis, respiratory depression, PE) age related chance in respiratory function (weak muscles, decreased functional alveoli, kyphosis) anemia smoking (CO interferes with O2 binding to Hgb)
39
Infection & wound healing
prolonged injury & inflammation prolonged clearing of debris bacteria compete for available O2/nutrients
40
Signs of wound infection
``` odour purulent exudate redness, warmth, swelling pain fever high WBC count ```
41
Debridement
removal of necrotic tissue to facilitate wound healing
42
Nutrients/vitamins important for wound healing
Zinc Vitamin A Iron
43
Causes of malnutrition
``` dietary restriction N/V poor appetite constipation, paralytic ileus dyspepsia (PSR) drowsiness pre-existing GI disease older adult ```
44
Weakened Immune function
``` PSR older adult diabetes/hyperglycemia immunodeficiency state (HIV/AIDS) malnutrition (protein, zinc, Vitamin D) immunosuppressants (organ transplant, autoimmune disease) corticosteroids chemotherapy, radiation therapy splenectomy ```
45
Corticosteroids & wound healing
inhibit inflammation (good for healing) immunosuppression (suppress leukocyte recruitment) increase risk of infection inhibit collagen synthesis (protein catabolism)
46
Types of wounds
``` acute surgical trauma wounds burns chronic wounds pressure ulcers infected wounds ```
47
Surgical wound classification
clean clean-contaminated contaminated dirty/infected
48
Wound dehiscence
edges of wound separate can occur up to 14 days post-op can be partial/complete
49
Wound evisceration
edges of wound separate & viscera protrude through opening
50
RF for wound dehiscence
excessive tension on surgical wound (movement, vomiting, straining, obesity, swelling) scar tissue weakness (malnutrition, age, corticosteroids) factors delaying wound healing (infection, hypoxia, etc)
51
Stricture
scar tissue that causes a narrowing of the lumen
52
Adhesion
bands of scar tissue that abnormally bind intestinal surfaces
53
Nutrients for wound healing
protein (collagen) carbohydrates/fats (energy, spare protein) water (replace fluid) vitamin c (collagen formation) vitamin a (promotes inflammation) vitamin k (blood clotting) magnesium (protein synthesis, wound repair) copper (connective tissue development) zinc (dna synthesis, protein synthesis, cell proliferation)
54
Slough
accumulation of dead cells | yellow tissue
55
Eschar
necrotic tissue dry or boggy black prevents wound healing
56
Granulation tissue
red, tender, pebbly

BSNC 3000 (11 decks)

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