Skin Structure and Function 5 - Tutorial Flashcards
Spongiosis?
Intracellular edema
Parakeratosis?
Mode of keratinisation (keratin hardening) characterised by the retention of nuclei in the stratum corneum
Abscess?
A swollen area within body tissue containing an accumulation of pus
Rete pegs?
Downwards thickening of the epidermis between dermal papillae
6 requirements for healthy skin?
Intact physical barrier Functioning immune system Functioning vasculature/ adequate supply and drainage (arterial, venous, lymphatics and capillaries) Normal sensory nerve function Functioning sweat glands Adequate nutrition
What is slough?
What is it made of?
Necrotic tissue separating from living structure
Mixture of dead cells, polymorphs + bacteria
Should slough be removed from a wound?
Yes - has a negative effect on wound healing
How is slough removed from a wound?
Chemically or physically by debridement
What are the 3 stages of wound healing?
Inflammation
Proliferation
Tissue remodelling
What happens during inflammation in wound healing?
Platelets form initial clot and release inflammatory mediators
Leukocytes debride the wound bed by phagocytosing bacteria and scavenging cellular debris
Inflammation gradually decreases as keratinocyte proliferation and new tissue formation becomes predominant
What happens during proliferation in wound healing?
Cells divide to re-epitheliase the wound surface
Granulation tissue formation is stimulated
Fibroblasts lay down matrix and contract the wound (fibroplasia)
Epithelial cells develop into new blood vessels (angiogenesis)
What happens during tissue remodelling in wound healing?
New tissue is converted into mature scar tissue over a period of months
Fibroblasts lay down collagen to improve the tensile strength of the scar and restore the normal dermal matrix
Primary intention of surgical wounds?
An acute wound is closed by approximating wound edges
Secondary intention of surgical wounds?
Acute wound is left to heal on its own - takes longer but can produce satisfactory results
What is a burn?
Thermal injury to the skin
What layers of the skin does a first degree burn affect?
Appearance?
Epidermis only
Erythematous, wet, extremely painful
What layers of the skin does a second degree/ partial thickness burn affect?
Appearance?
Epidermis and dermis
Red, blistered, wet/ weeping, painful
What layers of the skin does a third degree burn affect?
appearance?
Extends beyond dermis
White or black, charred, dry, numb
6 causes of delayed healing of a wound?
Infection Poor arterial blood supply Poor nutrition Impaired venous return Repeated trauma/ pressure Systemic disease e.g. diabetes/ anaemia
What is another name for a decubitus ulcer?
Pressure sore/ bed sore/ pressure ulcer/ pressure wound
Causes of a bed sore? (4)
Prolonged pressure over bony area
Lack of blood flow (2 - 3 hours)
Friction from bedding/ clothing
Sweat, blood, urine, faeces
Stages of development of a bed sore?
- Skin unbroken but shows a pink or reddened area (may be tender or itch)
- skin is red, swollen and painful. Blisters may be present. Upper layers of skin begin to die
- sore has broken through skin and wound extends down to deeper layers of tissue. Crater-like ulcers are present Wound is prone to infection
- sore extends beyond the skin and into fat, muscle and bone tissue. Blackened dead tissue called “eschar” ma be seen in deep opened wounds
Prevention of Bed Sores? (6)
Identify at risk groups Use special mattresses Turn patient regularly Keep skin clean and hydrated Regularly assess skin Good nutrition
