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Mod 2 > Skin and Tissue Healing and Wound Pics<3 > Flashcards

Skin and Tissue Healing and Wound Pics<3 Flashcards

1
Q

Which layer?
avascular
multilaminar
melanocytes
merkel discs
Langerhans cells

A

Epidermis

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2
Q

What is the function of Keratinocytes and Melanocytes and what layer are they in?

A

Produce keratin
Produce Melanin
Stratum basale in the epidermis

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3
Q

What is the function of the Merkel cells and the langerhans cells?
What layer are they in?

A

Merkel: light touch - statum basale
Langerhans: skin immune response - stratum spinosum

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4
Q

Which layer?
thicker
dermal appendages
highly vascular
fibroblasts/macrophages/WBCs
Mast Cells

A

Dermis

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5
Q

What are the dermal appendages

A

Sweat Glands
Sebaceous Glands (oil)
Fair follicles

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6
Q

What are fibroblasts responsible for in the dermis?

A

collagen/elastin

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7
Q

Which layer?
adipose tissue
fascia
highly vascular

A

Hypodermis

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8
Q

Which layer allows skin to move freely?

A

Hypodermis

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9
Q

If a wound is superficial what layer is it through?

A

epidermis

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10
Q

If a wound is partial thickness what layer is it through?

A

epidermis and some dermis

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11
Q

If a wound is full thickness what layer is it through

A

all 3 layers

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12
Q

What is the most common type of wound, what will it look like?

A

Venous
brawny, edema, weepy

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13
Q

What is the 1st phase of healing?
whats going on here

A

Hemostasis:
transudate leaks out
brief vasoconstriction and platelet aggregation for blood clotting
beginning of immune response

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14
Q

What is the 2nd phase of healing?
whats going on here and how long?

A

Inflammatory Phase:
0-3 days
vasodilate for histamine response
Mast cells
polymorphonuclear neutrophils (PMNs) - clean
macrophages - kill bacteria to allow cellular growth

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15
Q

What is the 3rd phase of healing?
whats going on here and how long

A

Proliferative phase:
4-12 days
fibroblasts proliferate
angiogenesis and vascularization
granulation tissue
epithelialization

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16
Q

When does granulation and epithelialization occur in healing?

A

4-12 days (proliferative phase)

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17
Q

What has to be present for epithelialization to occur? Where does it happen first?

A

the 3 appendages (hair, oil, sweat)
at the borders of wound

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18
Q

What is the 4th phase of healing? What is going on and how long

A

Maturation/Remodeling
up to 2 years
reorganize matrix
collagen from III to I
reorient along lines of stress
80% of original elasticity

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19
Q

What is healing by primary intention

A

clean cut and sewn back together

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20
Q

What is healing by secondary intention?

A

more gaping
closing on its own
not sewn or sitiched

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21
Q

what is healing by tertiary intention?

A

(delayed primary)
left open until it is ready to be sewn

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22
Q

What kind of wounds would be healed with tertiary intension?

A

contaminated wounds
cant sew closed until the infection/yuckies are out

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23
Q

Wagner Ulcer Grade
0:
1:

A

0: pre-ulcer, healed, or at risk
1: superficial, w/o subcutaneous

24
Q

Wagner Ulcer Grade
2:
3:

A

2: through the skin, bone, ligament
3: osteotitis, abcess, osteomylitis

25
Q

Wagner Ulcer Grade
4:
5:

A

4: gangrene of digit
5: gangrene of foot –> need amputation

26
Q

UT classification of Diabetic Foot Ulcers:
I:
II:
III:

A

I: superficial
II: capsule
III: bone/osteomyelitis/deep abscess

27
Q

UT classification of Diabetic Foot Ulcers:
A:
B:
C:
D:

A

A: non infected, non ischemic
B: infected, non ischemic
C: non infected, ischemic
D: infected and ischemic

28
Q

National Pressure Injury Staging:
Stage 1:
Stage 2:

A

1: non blanchable erythema, skin not exposed
2: skin expoed, partial thickness (epi and part of dermis)

29
Q

National Pressure Injury Staging:
Stage 3:
Stage 4:

A

3: Full thickness, nothing exposed, slough
4: full thickness, bone/ligament/muscle exposed

30
Q

National Pressure Injury Staging:
Unstageable:
Deep pressure injury:

A

Unstageable: full thickness, depth unknown bc eschar covering it
deep pressure: sever black and blue, depth unknown

31
Q

What is a keloid and who’s most at risk?

A

bubbled up scar, beyond original bounds
people who are darker skinned

32
Q
A

Venous Wound

33
Q

What kind of bacteria causes green slough

A

Pseudomonas bacteria

34
Q
A

Venous Wound

35
Q
A

Venous Wound

36
Q
A

Pressure Wound

37
Q
A

Cellulitis

38
Q
A

Venous

39
Q
A

Arterial

40
Q
A

Arterial

41
Q
A

Dry gangrene

42
Q
A

Arterial?

43
Q
A

Arterial

44
Q
A

Arterial

45
Q
A

Cellulitis

46
Q
A

Corns

47
Q
A

Neuropathic Ulcer

48
Q
A

Charcot foot

49
Q
A

Neuropathic

50
Q

How does HbA1c effect healing

A

lower HbA1c = faster healing

51
Q

When would you use toe brachial index on a patient?

A

if they have microvascular disease and/or calcified proximal vessels

52
Q

What is normal ankle systolic? what range is difficult? what is the goal for diabetics?

A

norm: > 60mmhg
difficulty with 60-80
diabetics >90

53
Q

What toe systolic do we want for healing?

A

> 30mmhg

54
Q

What is normal, equivocal, and abnormal TBI

A

<0.7-0.9
<0.65 - 0.7
<0.65

55
Q

What ABI is unlikely to heal with someone with PAD

A

< 0.5

56
Q

What ABI is associated with impending tissue necrosis

A

< 0.3

57
Q

What is PreAlbumin and what level in unlikely to heal

A

last 2-4 days nutritional status
< 5

Mod 2 (4 decks)

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