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PT 854 Integument > Types of Wounds (Test 1 Lecture 2) > Flashcards

Types of Wounds (Test 1 Lecture 2) Flashcards

1
Q

What are the 4 phases of normal healing?

A

Hemostasis (Coagulation)
Inflammation
Proliferation
Remodeling

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2
Q

How far must an injury into the skin go to cause bleeding?

A

Through the epidermis and BMZ

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3
Q

Which phase initiates the activation of platelets to help stop bleeding?

A

Hemostasis

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4
Q

What do blood clots consist of?

A

Fibrin
Aggregated platelets
Blood cells

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5
Q

Whats the purpose of a clot?

A

Seals disrupted vessels to control blood loss
Provide temporary bacterial barrier
Provide a reservoir of growth factors
Provides an interim matrix that serves as scaffolding for migrating cells

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6
Q

What is the process of breaking down a clot called?

A

Fibrinolysis

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7
Q

What is the purpose of the inflammatory phase?

A

To control infection and establish a clean wound bed

  • Breaks down devitalized tissue
  • White blood cells eliminate excess bacteria
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8
Q

When does vasoconstriction subside and vessels dilate and cell permeability increases?

A

Inflammatory Phase

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9
Q

How do leukocytes get to the area of the wound?

A

Chemoattraction by damaged cells and platelets attract the leukocytes

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10
Q

What are the 3 processes of the inflammatory phase?

A

Vascular Stage
Exudate Stage
Reparative/Proliferative Stage

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11
Q

What happens during the vascular stage of the inflammatory phase?

A 
Cellular filtration pressures and permeability of cells increases leading to:
Local Edema
Warmth
Erythema
Discomfort/Pain
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12
Q

What happens during the Exudate stage of the inflammatory phase?

A

Fluid passes through the walls of vessels into adjacent tissues/spaces to help deposit fibrins and leukocytes

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13
Q

What are the first cells to arrive in a new wound?

A

Neutrophils

-present within minutes and can dominate area for 2-3 days

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14
Q

What is the primary function of neutrophils?

A

Remove bacteria and foreign debris via phagocytosis

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15
Q

After neutrophils what is the next type of cells to get to the wound and what is their purpose?

A

Macrophages

-responsible for finishing bacteria and breaking down damaged tissue

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16
Q

When does true wound healing start?

A

Reparative stage of the Inflammatory phase

17
Q

What are the processes that occur during the proliferative phase?

A

Granulation
Angiogenesis
Wound Contraction
Epithelialization

18
Q

What happens during granulation and when does it begin?

A

Fibroblasts and capillary buds develop at edges of the wound and advance to the center.
Starts 3-4 days post injury (as inflammatory phase subsides)

19
Q

What are some factors that can affect granulation?

A

Perfusion Status
Oxygen Levels
Nutritional Status
Glucose Level

20
Q

What is new extra-cellular matrix formed by collagen fiber deposition and new capillary loops known as?

A

Angiogenesis

21
Q

What are the 2 mechanisms that angiogenesis can occur?

A
  • Production of new vessels by local endothelia cells

- Recruitment of circulating see progenitor cells

22
Q

How does the wound contraction part of the proliferative phase work?

A

Myofibroblasts exert tractional forces on the new ECM. Force pulls edges of wound together so the granulation tissue and new epithelial cells don’t have to travel as far

23
Q

What happens during epithelialization and when does it occur?

A

Basal cells from edges of wound migrate inward from the wound edges.
Happens at the same time as contraction (day 21)

24
Q

What does epithelialization use as a support structure?

A

Uses ECM and granulation bed

25
Q

What happens during contact inhibition and when does it occur?

A

Ceases migration of epithelial cells across a wound bed

-occurs when epithelial cells moving across a wound bed come in contact with other epithelial cells

26
Q

What type of environment is best for epithelialization?

A

Moist environment

27
Q

How can you tell the difference between granulation and epithelialization?

A

Granulation looks wet and shiny, while epithelialization looks less reflective

28
Q

How strong is skin when it is first formed?

A

15% as strong as original tissue

Will become 80% as strong as original

29
Q

What happens during the remodeling phase?

A

Completes wound healing

Constant cycle of collagen formation and lysis in the scar

30
Q

What type of collagen is it converted to during the remodeling phase?

A

From type 3 to type 1

31
Q

What are the types of wound closure?

A

Primary - Surgical (stitches, stables, duck tape, blah blah)
Secondary closure - Normal phases of wound healing
Tertiary - Wound that is healing naturally then needs reopened to clean out infection (kept open until infection is cleared then closed surgically)

32
Q

What are some characteristics of primary closure?

A

Heals quickly
Minimal scar tissue
Healing can be slowed by infection, trauma, or secondary breakdown

33
Q

What are some examples of secondary closure?

A

Pressure ulcers and dehisced surgical incisions

34
Q

What can help with secondary closure?

A

Skin grafts, substitutes, skin flaps, or other surgical interventions

35
Q

What are the different types of exudate?

A

Serous - Thin and liquidy (pussy, straw colored)
Purulent - Snot colored, thick mucous, smells (sign of infection)
Fibrinous - Cloudy, filled with fibrin, not adherent (can wipe it off)
Hemorrhagic - Not just blood (thinner then blood, full of serous fluid)

36
Q

What are the types of exudate that involve a combination?

A

Sanguineous - Reddish, thin, and watery (occurs with trauma to blood vessels)
Serosanguineous - Clear, pink, think, watery (normal drainage in wound healing
Seropurulent - Yellowish and cloudy (sign of infection
Hemopurulent - Dark red and viscous (contains bacteria, inflammatory cells, tissue that is dead or dying)

37
Q

What factors may inhibit wound healing?

A 
Level/presence of infection
Size of wound
Location
Type of wound
Amount of available blood
Co-morbidites
Nutrition
38
Q

How do you define the depth of the wound?

A

Partial thickness - partial loss of dermal tissue (epidermis and superficial dermis)
Full-Thickness - involves total loss of dermal tissue (can involve deeper tissue, muscle, subQ, Bone)

39
Q

What causes a chronic wound?

A

Vascular compromise
Chronic inflammation
Repetitive trauma to injured tissue

PT 854 Integument (11 decks)

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