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Pathophysiology > Session 3: Disorders of Skin Integrity/ Healing / MSK > Flashcards

Session 3: Disorders of Skin Integrity/ Healing / MSK Flashcards

1
Q

functions of the skin

A

protection , thermoregulation, sensation

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2
Q

epidermis

A
  • 1st layer; protective layer / physical barrier
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3
Q

dermis

A

provides strength and supports the epidermis, has sweat glands, nerve endings, blood vessels, and lymph glands within

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4
Q

subcutaneous fat

A

subcutaneous fat - provides insulation and a cushion to surround your vital organs

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5
Q

Infectious process affecting the skin

A

bacterial , viral, fungal, or parasitic

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6
Q

Allergic / Hypersensitivity infectious process affecting the skin

A

atopic dermatitis ,urticaria, drug induced skin eruptions, allergic contact dermatitis

inflammation response

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7
Q

Viral infection process affecting the skin

A

warts (HPV) , Herpes Simplex (HSV-1 & -2) , Herpes zoster, Shingles

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8
Q

Fungal Infectious Process affecting the skin

A

organisms that cause infection known as tinea (all fungal infections have tinea)

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9
Q

Yeast Infectious Process affecting the skin

A

thrust (white patch on tongue and around mouth)

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10
Q

Bacterial Infectious Process affecting the skin

A

impetigo and staph infections

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11
Q

Cellulitis

A

acute condition spreading infection of the dermis or SQ layer of the skin; it is an inflammatory infection; diabetes, immunodeficiency , or impaired circulation , and conditions that result in breaks of skin integrity

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12
Q

atopic dermatitis

A

Eczema >Type I hypersensitivity (true allergic reaction)

Lichenification in the chronic stage due to chronic inflammation

Treatment focus = dryness , pruritus, infection, and inflammation

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13
Q

Urticaria (hives) =

A

hypersensitivity

results from histamine release from mast cells and basophils
increased vascular permeability allows fluid to leak into the tissues , causing edema and wheal formation

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14
Q

contact dermatitis

A

cutaneous reaction to topical irritation or allergy

Type IV Hypersensitivity

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15
Q

Angioedma

A

life threatening, development of edema around mouths , lips, tongue, pharynx , larynx

Hypersensitivity

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16
Q

epidermal cell detachment and bullae (fluid-filled blisters) form

A

Drug induced Skin Eruptions
Hypersensitivity

-erythema multiforme
occurs after herpes infection

-Toxic epidermal necrolysis

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17
Q

erythema multiforme

A

Drug induced Skin Eruptions Hypersensitivity

occurs after herpes infection

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18
Q

Toxic epidermal necrolysis

A

Drug induced Skin Eruptions Hypersensitivity

exaggerated response to ultraviolet light when the drug is taken in combination with sun exposure; people can experience photo sensitivity on drugs

anti-infective agents
antihistamines
diuretics
NSAIDs

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19
Q

1st degree burn

A

superficial partial thickness burns
involved only outer layer of epidermis
-painful, reddened, dry (sunburn)

20
Q

second degree partial thickness

A

burns involve the epidermis and various degrees of the dermis
painful , moist, red, and water filled blisters

21
Q

second degree full thickness

A

burns involve entire epidermis and dermis

very painful, loss of tactile sensation, dry, flat blisters

22
Q

third degree burns

A

full thickness burns extend into SQ tissue and may involve muscle and bone

waxy white or yellowish tan, painless, hard, dry , and leathery

all nerve fibers destroyed

23
Q

Pressure Ulcers

A

Blood flow becomes obstructed

-May be due to external pressure or shear

external pressure = blocks oxygen to tissue and accumulation of metabolic end products

shear = sliding of one tissue to another , stretching and bending blood vessels causing damage and clots

-Tissue damage from
ischemia to skin

friction = damages the epidermis interface

moisture = alters pH of skin and compromises epidermal integrity

24
Q

strain

A

a stretching injury to a muscle or a musculotendinous unit caused by mechanical overloading

25
Q

Sprain

A

involves the ligamentous structures surrounding the joint , pain and swelling subside more slowly than in a strain

caused by abnormal or excessive movement of the joint

26
Q

subluxation

A

a partial dislocation in which the bone ends in the joint are still in partial contact with each other

can be congenital , traumatic, or pathological

27
Q

avulsion

A

is an injury in which a body structure is torn off by either trauma or surgery

28
Q

Compartment syndrome

A
  • condition of increased pressure within a limited space that compromises the circulation and function of the tissues in the space

limited space for swelling due to fascia

can be acute or chronic

acute = after a fracture

chronic = exertion from long distance runners and others involved in a major change in activity level

tissue becomes Ischemic (restriction in blood supply)

you can have : pain out of proportion, nerve damage, paralysis, muscle infraction

29
Q

Rhabdomyolysis

A
  • life threatening complication of severe muscle trauma with muscle cell loss
  • can lead to Acute tubular necrosis, cardiac dysrhythmias, shock
  • rapid breakdown of muscle that causes the release of intracellular contents
  • other causes : medications, anesthesia, malignant hyperthermia
30
Q

acute or chronic infection of the bone causes

A

(can be internal or external infection)

direct penetration or contamination of an open fracture or wound

seeding through the bloodstream

extension from a contiguous site

skin infection in people with vascular insufficiency

31
Q

acute or chronic infection of the bone complications

A

large abscesses and the need for multiple surgical debridements. Other potential complications include growth arrest/limb length discrepancy

32
Q

acute or chronic infection of the bone treatment

how to identify cause?

A

identify the cause through blood aspiration cultures, antimicrobial agents first parenterally and then orally

33
Q

Hematogenous osteomyelitis

A

Type of Osteomyelitis

infection that reaches the bone through the blood stream

34
Q

Contiguous Spread Osteomyelitis

A

Type of Osteomyelitis

secondary to a contiguous focus of infection

direct inoculation from an exogenous source

35
Q

chronic osteomyelitis

A

Type of Osteomyelitis

occurs secondary to an open wound or infected tissue, occurs in adults

hallmark = sequestrum

36
Q

osteoporosis

A

complex , multifactorial chronic dx

a loss of mineralized bone mass causing increased porosity of the skeleton and susceptibility to fractures = weakening of bone

develops when the remodeling cycle is disrupted and imbalanced

manifestations =
pain, bone deformity, pathological fractures

management =
wt bearing exercise , adequate calcium, vitamin D

37
Q

Osteomalacia

A

inadequate mineralization of bone = bones not hardening / soft bones

causes : vitamin D deficiency , critical low levels of phosphate due to renal losses

results in : bone pain ,tenderness, fx

38
Q

Rickets

A

failure or delay in calcification of the cartilaginous growth plate in children whose epiphyses have not yet fused

manifestations : deformation of long bones and delay in mineralization

39
Q

osteoarthritis

A

not systemic

most prevalent form of arthritis

about wear and tear of bone; a slow progressive destruction of articular cartilage of weight bearing joints and fingers

you lose the covering of the bone (articular cartilage) over time and now it’s exposed to synovial fluid and then osteophytes are made

manifestations : Heberden and Bouchard, pain stiffness

40
Q

gout

A

disruption in uric acid production or excretion

rich man dx; has more to do with the diet of the patient

have high levels of uric acid in the blood and other body fluids

urate crystal precipitates into the joint space causing crystallization in joint space

causes : purine synthesis or breakdown is accelerated, poor uric acid secretion in kidneys

41
Q

rheumatoid arthritis

A

systemic inflammatory dx

unknown cause with a genetic predisposition

begins in the synovium and then you develop a pannus
it’s not a tumor but impedes the joint space

42
Q

Articular issues of RA

A

synovial inflammation and joint architecture is damaged due to pannus

swan neck & boutonniere deformity (fingers will swoop and dip)

43
Q

Extra-articular issues of RA

A

a systemic problem; going to happen well beyond the joint space

elevated erythrocyte sedimentation rate (ESR) correlates with dx

Rheumatoid factor (RF) antibody

they can develop rheumatoid nodules

44
Q

Fracture Blisters

A

skin bullae and blisters representing areas of epidermal necrosis with separation of the epidermis form underlying dermis by edema fluid

because of localized swelling, the intracompartmental pressure becomes to high and fluid is coming to surface

can be a warning for compartment syndrome

seen in twisting injuries and excessive joint manipulation

45
Q

Complex Regional Pain Syndrome (CRPS)

A

neurological condition that impacts limbs and results from surgery or injury

pain is prominent symptom of the disorder; abnormal pain response

treatment focus on pain management

46
Q

Thromboemboli

A

the person with a lower extremity fracture is at risk for development of pulmonary

embolism and deep vein thrombosis
emboli enters into blood stream and can kill

47
Q

Fat Embolism Syndrome

A

presence of fat droplets in small blood vessels of lungs, kidneys , brain, and other organs after a long bone or pelvic fracture

manifestations : seizures , focal neurological deficits

Pathophysiology (4 decks)

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