skin and wound healing Flashcards

1
Q

name the 3 layers of the skin

A

epidermis, dermis and hypodermis

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2
Q

list the layers of the epidermis from supeficial to deep

A

corneum
lucideum
granulosum
spinosum
germinativum

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3
Q

function of the corneum

A

acid mantle protecting skin from bacteria
resistant to thermal, chemical, mechanical forces

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4
Q

function of the lucidum

A

forms boundary between corneum and granulosum

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5
Q

which parts of the body is lucidum found

A

palms of hands and soles of feet

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6
Q

function of granolsum

A

as cells travel through the nucleus is destroyed, cells flattended and cellular contents are converted into keratin

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7
Q

function of the spinosum

A

contain large oval nuclei.
langerhans cells here

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8
Q

function of the stratum germinativum or basale

A

forms junction between epidermis and dermis

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9
Q

what do the fibroblasts secrete in the superficial dermal layer

A

fibronectin and hyaluronic acid

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10
Q

what anchors the deep dermal layer to the subcut tissue

A

thick bundles of collage

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11
Q

what is the name of the junction between the epidermis and dermis

A

rete ridges/ pegs

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12
Q

what is contained with the subcut tissue

A

loose connective tissue
lots of fat cells
fewer blood vessels
nerve fibres and lymph vessels

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13
Q

one of the main functions of subcut tissue

A

attaches the dermis to underlying structures and ensures ongoing blood supply. provides cushioning.

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14
Q

list the 6 functions of skin

A

protection
thermoregulation
sensation
immune response
metabolism
blood reservoir
excretion

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15
Q

explain how the skin is protective in terms of a physical barrier

A

tightly joined epidermal cells, keratin and oily secretion block in and out

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16
Q

explain how the skin is protective in terms of a chemical barrier

A

acid mantle keeps pH low, preventing bacteria from multiplying.
langerhans fight infection
melanocytes protect DNA

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17
Q

explain how the skin is protective in terms of a biological barrier

A

macrophulges engulf and dispose of MO

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18
Q

which part of the hypothalamus controls heat loss

A

anterioir

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19
Q

which part of the hypothalamus controls heat production

A

posterioir

20
Q

how does the skin thermoregulate

A
  • muscle tone /shivering
  • vasodilate/ constrict
21
Q

what do langerhans cells do

A

fight bacteria

22
Q

what do macrophages do

A

engulf and dispose MO

23
Q

what do mast cells do

A

support immune system

24
Q

who is at risk of VIT D deficiency

A

elderly
indoors
crohns
coeliac

25
Q

list 5 functions of the skin that decline with age

A

injury response
cell replacement
sensory perception
VIT D production
immune response

26
Q

what happens to the epidermis with aging

A

corneum becomes drier and more brittle
decreased langerhans - reduced immunity
decrease in melanocytes - dyschromia
alteration in pH - reduces acid mantle

27
Q

what happens to the dermis during aging

A

decreased thickness
fewer cells
fewer blood cells
fewer fibres
sebum decreases
sweat gland production declines

28
Q

factors that make individuals more susceptible to multiple skin conditions include:

A

normal aging
incontinence
reduced mobility
increased dependence

29
Q

list 5 ways wounds can be classified

A

aetiology
location
type of injury
depth/ tissue loss
clinical appearance

30
Q

list the 3 phases of wound healing

A

inflammation
proliferation
maturation

31
Q

how long should the inflamm phase go on for

A

2-5 days

32
Q

what are the main goals during the inflamm phase

A

haemostasis through a blood clot
oedema

33
Q

what does the clot in the inflammatory phase release

A

histamine and other vasoactive chemicals causing vasodilation causing an influx of leukocytes, erthrocytes, plasma proteins

34
Q

how long should the proliferative phase go on for

A

2-24 days

35
Q

list the 5 processes that occur during the proliferative phase

A

angiogenesis
collagen synthesis
cross linking
epithelialisation
contraction

36
Q

what is the function of angiogenesis

A

restoring blood flow to the wound. more oxygen, increased profusion

37
Q

what is the function of collagen synthesis

A

keratinocyte migration results in strengthening the wound

38
Q

how long does maturation go on for

A

24 days -1 or 2 years

39
Q

when does maturation commence

A

only once wound is closed

40
Q

describe primary intention

A

when there is minimal tissue loss and wound edges can be held together by sutures etc. scaring minimal

41
Q

describe secondary intention

A

when the wound is left open for a period of time and allowed to close by epithelialisation and contraction. granulation occurs from wound base. epithelialisation occurs across the wound bed with formation of scar being thicker.

42
Q

describe free flaps

A

complete segment with anastomosis of blood supply to vessels within wound

43
Q

describe pedicle flaps

A

skin and subcut tissue is trasnferred to another site

44
Q

list 6 risks for poor wound healing

A

malnutrition
elderly
diabetes
obesity
diseased state

45
Q

why does diabetes impact wound healing

A

high BGLs can cause decreased functioning of WBC
less able to fight bacteria
damaged circulation… neuropathy.. damaged nerve endings.. numbness.. unaware