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Integ > Physiology of wound healing > Flashcards

Physiology of wound healing Flashcards

1
Q

Name the layers of the epidermis from most superficial to most deep

A
  1. Stratum corneum
  2. Stratum lucidum
  3. Stratum granulosum
  4. Stratum Spinosum
  5. Stratum basale
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2
Q

5 layers; Attached to dermis by basement membrane; Avascular; Ridge and groove interdigitation to prevent shearing

A

Epidermis

½ mm thick

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3
Q

What is the turnover time for epidermal regeneration?

A

Age 18-25 years = 14-21 days

Age 35 years = 42 days

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4
Q

What are the 4 big epidermal cell types?

A
  1. Keratinocytes - makes up 90% of cells - produces keratin
  2. Melanocytes - produces melanin
  3. Merkel cells - mechano receptors
  4. Langerhans cells - fight infection in epidermis
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5
Q

What are the functions of the epidermis?

A
  1. Provides a physical and chemical barrier
  2. Regulates fluid
  3. Provides light touch sensation
  4. assists with thermoregulation
  5. Assists with excretion
  6. Critical to endogenous vit D production
  7. contributes to cosmoses/ appearance
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6
Q

2 layers; Highly vascular; Strong and elastic due to collagen and elastin; Network of lymphatics, capillaries, and cutaneous nerve ending

A

Dermis
2-4 mm thick
- beefy, bright red when healthy

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7
Q

What are the two layers of the dermis?

A
  1. papillary - more superficial, fairy thin; loosely woven fibers
  2. reticular - deeper, thicker
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8
Q

What are the cell types found in the dermis?

A
  1. Fibroblasts - produce collagen and elastin; provides flexibility
  2. Macrophages/ WBCs
  3. Mast cells - chemical mediators (histamine); causes vasodilation
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9
Q

What layers do blisters form between?

A

between the bottom layer of the epidermis and top layer of dermis

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10
Q

What are the functions of the dermis?

A
  1. Supports and nourishes epidermis
  2. Houses epidermal appendages
  3. Assists with infection control
  4. Assists with thermoregulation
  5. Provides sensation
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11
Q

What is the function of adipose tissue ?

A
  1. Energy
  2. Cushion (protects underlying tissues)
  3. Insulation
  4. Stores fat-soluble vitamins
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12
Q

What are different types of subcutaneous tissue?

A
  1. Adipose - white/ pale yellow appearance when healthy
  2. Fascia - thin, transparent
  3. Muscles - dark red
  4. Tendons - cream
  5. Ligaments - white in comparison to tendons
  6. Joint capsules - cream
  7. Bone - white
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13
Q

Fibrous connective tissue; Separates and surrounds structures; Facilitates movement

A

Fascia

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14
Q

What tissues are involved in superficial thickness wound?

A

epidermis

  • abrasion, superficial (1st degree) burn, stage 1 pressure ulcer
  • skin is red
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15
Q

What tissues are involved in partial thickness wound?

A

epidermis and dermis
- Superficial partial thickness and deep partial thickness (2nd degree) burn; Stage 2 pressure ulcer; Wagner (diabetic) grade 1 ulcer

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16
Q

What tissues are involved in full thickness wound?

A

Epidermis, Dermis, Subcutaneous tissue, and May extend into deeper tissue
- Full thickness (3rd degree) burn, Subdermal (4th degree) burn, Stage 3 and 4 pressure ulcer, Wagner (diabetic) grade 2-5 ulcer

17
Q

What are the phases of normal wound healing

A
  1. inflammation (4-6 days)
  2. proliferation (4-24 days)
  3. maturation and remodeling (21 days - 2 years)
18
Q

Essential to healing process; Controlling bleeding and combating infection; Signaling cells necessary for repair and regeneration; Vascular and cellular response; Acute usually lasts 24-48 hours then subacute up to 6 days

A

Inflammatory phase

19
Q

What are the cardinal signs of the inflammatory phase?

A
  1. Swelling
  2. Redness
  3. Warmth
  4. Pain
  5. Decreased function
20
Q

Type of response that occurs during inflammation:

  • Transudate produces localized edema
  • Blood vessels constrict to reduce blood loss
  • Platelets cluster together
  • Platelets release chemical mediators
  • Vasodilation: Exudate formation, Histamine release, Prostaglandin release
A

Vascular response

21
Q

What is the cellular response during inflammation?

A
  1. Platelets - initiate wound healing, released from damaged vessels
  2. PMNs - 1st cell to site of injury, cleans the wound
  3. Fibroblasts
  4. Macrophages
  5. Mast cells
22
Q

Rebuilds the damaged structures and provides strength to the wound

  • Four Events: Angiogenesis, Granulation tissue formation (lattice work), Epithelialization (new skin buds on ladder), and Wound contraction
  • Resurfacing of wound bed
  • Red, Beefy, Fragile
A

Proliferative phase

23
Q

Modifies the immature new tissue to mature tissue; Epithelial tissue must be strengthened and reorganized to fit surrounding tissue; Changes in the form, bulk, and strength of epithelial tissue ; New collagen synthesis, Old collagen is broken down, Reorientation of collagen fibers, Induction and Tension Theory

A

Maturation/ remodeling phase

24
Q

What are the two ways soft tissue can heal?

A
  1. Regeneration of new epithelial tissue
  2. Thicker fibrous scar tissue
  • Epidermis = regenerates
  • Dermis = usually regenerates
  • Subcutaneous/Deeper Tissues = scar formation
25
Q

What are the factors that affect wound healing?

A
  1. Wound characteristics
  2. Local factors
  3. Systemic factors
26
Q

What wound are wound characteristics that affect wound healing?

A
  1. Mechanism of onset
  2. Time since onset
  3. Wound location
  4. Wound dimensions
  5. Temperature
  6. Wound hydration
  7. Necrotic tissue or foreign bodies
  8. Infection
27
Q

What timeframe denotes acute vs chronic wounds

A

Acute < 30days

Chronic >30 days

28
Q

extreme dryness

A

desiccation

29
Q

result of too much moisture in wound; skin softens and turns white due to consistently being wet

A

maceration

30
Q

Overproduction of immature collagen, red, raised, fibrous lesion, stays within edges of wound

A

hypertrophic scar

31
Q

Tissue extends beyond edges of original wound

A

keloid scar

32
Q

loss of superficial skin layer

A

denuded

- caused by exposure to urine, feces, wound drainage

33
Q

generalized redness

A

errythemia

34
Q

linear crack in skin extending into dermis or deeper

A

fissure

35
Q

clear, water drainage that is usually seen first

A

transudate

36
Q

yellowy, viscous drainage; more protein, seen further in healing stages

A

exudate

Integ (11 decks)

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