Vascular, Lymphatic, and Integumentary Disorders Flashcards
Name some of the important functions of the arteries
Carry oxygenated blood away from heart
3-layered walls give strength/elasticity
Ability to change diameter in response to BP or ANS (no valves) Lead to capillaries where gas exchange occurs
Name some important characteristics of the veins
return de-oxygenated blood to heart
superficial = above the fascia
deep = below the fascia
perforating = in between deep/superficial also 3-layered, but HAS valves lower pressure
What are the 2 primary functions of the Lymphatic System? To which part of the cardiovascular system does it connect?
Functions : 1) immune response
2) facilitation of fluid movement between bloodstream and interstitial fluid
**includes lymph vessels, fluid, tissues and organs
Connects/works with Venous System
Describe Phase 1 of healing
Phase 1 = Inflammation
initial decrease in circulation to prevent blood loss
necrosis: programmed death/destruction of damaged cells –creation of clean wound
later, increased blood flow to deliver O2
from injury to day 10 of repair
Describe Phase 2 of healing
Phase 2 = Proliferation
new tissue growth skin integrity restored, differentiation of epithelial cells may lead to fragile scar tissue formation
Angiogenesis: new blood vessel growth
Day 3-20
Describe Phase 3 of healing
Phase 3 = Maturation/Remodeling
continued differentiation of epithelium: scar tissue turns from pink to white
new skin reaches 80% of original tensile strength
replacement of granulation tissue
Day 9- 2 years
What’s different about deep wounds in Phase 3 healing?
hair, sweat glands, sebaceous glands and nerves are rarely ever replaced
What are the main functions of Oxygen in wound healing? How can we help keep a wound oxygenated?
O2 supports healing, helps prevent infection
keep area warm, avoid smoking, stay hydrated, control pain and anxiety
What can prevent oxygen from getting to a wound? what are the results?
Edema and necrotic tissue prevents oxygenation of healing tissue
this leads to higher likelihood of infection
What is debridement? what are the two major types?
Debridement = cleaning necrotic tissue out of the wound
Selective and Non-selective
why is it important to keep wounds moist?
dryness inhibits epithelial cell migration, as well as the supply of nutrients and blood flow
also causes scabbing and eschar (dead black tissue)
**in the right conditions, the body’s own enzymes will degrade eschar (autolytic debridement)
HOW do we keep wounds moist?
use occlusive dressings, only remove bandages when the exudate begins to leak out, keep wounds at the proper temperature
Is nutrition important for wound healing? if so, how do we manage it?
YES! manage through diet, NOT supplements
necessary nutrients include: iron, B12, Folic acid, Vitamin C, Zinc, Vitamin A, Arginine, and protein
What are the important bony landmarks prone to bedsores?

What are the important characteristics of wounds to be noted, measure, and documented?
Etiology: diabetic, vascular, traumatic, etc
Appearance, Location, Size, Shape, Stage of healing
Depth, edges, tunneling/undermining
Base of the wound: what’s happening inside?
Edema, maceration
Pain level
Name the 3 kinds of Wound Closure, and describe them
Primary Intention: edges surgically closed
at risk for **dehiscence: **when wound opens again because of maceration or infestation
Secondary Intention: the wound is left to heal on its own
Tertiary Intention: allowed to heal by secondary intention, but closed by primary
What are the signs of Infection?
Increased drainage
change in color/odor
lingering swelling
redness, warmth
pain and/or tenderness
tissue culture is positive
fever, nausea, fatigue, loss of appetite
Define Arterial Insufficiency and name the main cause
Arterial Insufficiency: lack of adequate blood flow to a region(s) of the body (typically the legs)
main cause = Peripheral Vascular Disease: disrupted arterial blood flow to/ venous return from the extremities
may be related to smoking, cardiac disease, Diabetes Mellitus, Hypertension, renal disease, elevated cholesterol & triglycerides
**obesity and sedentary lifetyle are secondary contributors
Name and define 5 more causes of arterial insufficienty
Arteriosclerosis: thickening, hardening, and loss of elasticiy in arterial walls
Atherosclerosis: plaque formation
Ateriosclerosis Obliterans: peripheral manifestation of arteriosclerosis -throphic changes and resting pain observed, most likely to lead to ulceration
Thromboangitis Obliterans: inflammation leads to arterial occlusion and tissue ischema
Raynaud’s Disease: vasomotor disease of small arteries and arterioles -leads to pallor and cyanosis of fingers and feet, unknown etiology, agravated by cold and emotional distress
What is Intermittent Claudication? Which arterial insufficiency displays it?
Intermittent Claudication: pain that occurs when exercising muscles don’t recieve the blood perfusion needed
occurs in Arteriosclerosis Obliterans
What are the symptoms of arterial insufficiency we’ll see in the clinic?
10-25% of Lower Extremity Ulcers
more likely to lead to limb loss
most frequently on lateral malleoli and the dorsum of feet and toes
most patients have diabetes
trophic changes: abnormal nail growth, decreased foot/leg hair, dry skin, skin is cool to touch
wounds are painful, base is usually necrotic/pale
skin around the wound may be black
decreased pulses, pallor when elevated, rubor when dependent (below the heart)
How do we treat arterial insufficieny?
1 preventative measure: QUIT SMOKING
restore chemical and gaseous homeostatis
provide wound care
if the wound is not healing, or gangrene is present, may have to amputate
Define Venous Insufficiency and name some of the predisposing factors
Venous Insufficiency: Inadequate drainage of venous blood from body parts, resulting in edema and/or skin abnormalities -deemed chronic when it persists for long periods of time
**incidence is much higher than arterial insufficiency: most common cause of leg ulcers
Predisposing Factors: age, lack of exercise, obesity, pregnancy, long hours standing/sitting, heredity
*predictors of ulceration due to Chronic Venous Insufficiency also include history of Deep Vein Thrombosis, # of pregnancies, family history
What symptoms of Venous Insufficiency will we see in the clinic?
Swelling in one or both legs
complaints of itching, fatigue, aching, and/or heaviness of the involved limb
Skin changes: fibrosis (thickening of dermis)
Increased temp in skin of lower legs
Wounds: usually just proximal to medial malleoli, not significantly painful, wet tissue bed, large amount of exudate
May see signs of lymphedema