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#NUR1447 > Week 1: Skin and Wound Healing > Flashcards

Week 1: Skin and Wound Healing Flashcards

1. Identify the layers of the skin and the associated structures 2. List the functions of the skin 3. Describe the stages of wound healing 4. Discuss the implications of ageing skin on wound development and wound healing 5. Discuss healing processes: primary, secondary and delayed primary (tertiary) intention 6. Identify different types of wounds and their characteristics. 7. Outline methods used to classify wounds 8. Discuss nutritional requirements for wound healing

1
Q

Definition

The outermost layer of the skin, providing a protective barrier and composed of stratified squamous epithelial cells.

A

Define

Epidermis

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2
Q

Definition

A type of chronic wound commonly found in individuals with diabetes, often on the feet or legs.

A

Define

Diabetic Ulcer:

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3
Q

Definition

Damage to the skin caused by heat, chemicals, electricity, or radiation.

A

Define

Burn

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4
Q

Definition

The phase where new tissue, including collagen and blood vessels, is formed to replace damaged tissue.

A

Define

Proliferation

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5
Q

Define

Laceration

A

A tear or cut in the skin, often jagged or irregular.

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6
Q

Define

Stratum Basale

A

The deepest layer of the epidermis, where new skin cells are produced and where melanocytes (cells that produce pigment) are found.

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7
Q

Define

Puncture

A

A deep, narrow wound caused by a sharp object penetrating the skin.

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8
Q

Abnormal growths or masses that may cause or be associated with skin wounds.

A

Tumors

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9
Q

Definition

The outermost layer of the epidermis, consisting of dead, flattened cells that are continuously shed and replaced.

A

Define

Stratum Corneum

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10
Q

Definition

Wounds that do not heal within the expected timeframe and often require specialized care.

A

Define

Chronic Wounds

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11
Q

Define

Secondary Intention

A

Healing of a wound where edges are not approximated, leading to the formation of granulation tissue and more noticeable scarring.

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12
Q

Definition

Healing of a wound where edges are closely approximated, resulting in minimal scarring.

A

Define

Primary Intention

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13
Q

Define

Primary Intention

A

Healing of a wound where edges are closely approximated, resulting in minimal scarring.

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14
Q

Definition

A deep, narrow wound caused by a sharp object penetrating the skin.

A

Define

Puncture

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15
Q

Definition

Clean, straight cuts often caused by surgical instruments or sharp objects.

A

Define

Incisions

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16
Q

Define

Acute Wounds

A

Wounds that heal in a predictable and timely manner, typically following the normal stages of healing.

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17
Q

Define

Papillary Layer

A

The upper layer of the dermis, characterized by loose connective tissue and providing nutrients to the epidermis through its capillaries.

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18
Q

Define

Dermis

A

The layer of skin beneath the epidermis, containing connective tissue, blood vessels, nerves, and appendages such as hair follicles and sweat glands.

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19
Q

Definition

Wounds that heal in a predictable and timely manner, typically following the normal stages of healing.

A

Define

Acute Wounds

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20
Q

Define

Incisions

A

Clean, straight cuts often caused by surgical instruments or sharp objects.

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21
Q

Definition

A combination where a wound is initially left open to allow for infection control and then closed later to promote healing with less risk of complications.

A

Define

Delayed Primary (Tertiary) Intention

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22
Q

Definition

A wound caused by scraping or rubbing, typically affecting only the outer layer of skin.

A

Define

Abrasion

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23
Q

Definition

A tear or cut in the skin, often jagged or irregular.

A

Define

Laceration

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24
Q

Define

Superficial Wounds

A

Wounds that involve only the outer layers of skin.

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25
Q

Define

Stratum Corneum

A

The outermost layer of the epidermis, consisting of dead, flattened cells that are continuously shed and replaced.

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26
Q

Definition

Healing of a wound where edges are not approximated, leading to the formation of granulation tissue and more noticeable scarring.

A

Define

Secondary Intention

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27
Q

Define

Stratum Lucidum

A

A thin, clear layer found only in thick skin (such as the palms and soles), providing an additional layer of protection

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28
Q

Define

Full Thickness Wounds

A

Wounds that extend through the entire dermis and may involve subcutaneous tissue or deeper structures.

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29
Q

Definition

The final phase where the wound matures and strengthens, with collagen fibers reorganizing and tissue gaining strength and elasticity.

A

Define

Maturation (Remodeling)

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30
Q

Definition

A thin, clear layer found only in thick skin (such as the palms and soles), providing an additional layer of protection

A

Define

Stratum Lucidum

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31
Q

Definition

The deeper layer of the dermis, composed of dense irregular connective tissue, providing structural support and elasticity.

A

Define

Reticular Layer

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32
Q

Define

Abrasion

A

A wound caused by scraping or rubbing, typically affecting only the outer layer of skin.

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33
Q

Define

Partial Thickness Wounds

A

Wounds that extend through the epidermis and into the dermis but do not reach deeper structures.

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34
Q

Define

Stratum Granulosum

A

A layer of the epidermis where cells begin to die and accumulate granules that contribute to the formation of the skin’s waterproof barrier.

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35
Q

Define

Hemostasis

A

The initial phase where bleeding is controlled through clot formation and vasoconstriction.

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36
Q

Define

Maturation (Remodeling)

A

The final phase where the wound matures and strengthens, with collagen fibers reorganizing and tissue gaining strength and elasticity.

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37
Q

Definition

Wounds that extend through the epidermis and into the dermis but do not reach deeper structures.

A

Define

Partial Thickness Wounds

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38
Q

Definition

The upper layer of the dermis, characterized by loose connective tissue and providing nutrients to the epidermis through its capillaries.

A

Define

Papillary Layer

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39
Q

Definition

The deepest layer of the epidermis, where new skin cells are produced and where melanocytes (cells that produce pigment) are found.

A

Define

Stratum Basale

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40
Q

Define

Pressure Ulcer

A

A sore that develops from prolonged pressure on the skin, often over bony areas.

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41
Q

Definition

The initial phase where bleeding is controlled through clot formation and vasoconstriction.

A

Define

Hemostasis

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42
Q

Define

Epidermis

A

The outermost layer of the skin, providing a protective barrier and composed of stratified squamous epithelial cells.

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43
Q

Definition

A layer of the epidermis where cells begin to die and accumulate granules that contribute to the formation of the skin’s waterproof barrier.

A

Define

Stratum Granulosum

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44
Q

Definition

The layer of skin beneath the epidermis, containing connective tissue, blood vessels, nerves, and appendages such as hair follicles and sweat glands.

A

Define

Dermis

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45
Q

Definition

A sore that develops from prolonged pressure on the skin, often over bony areas.

A

Define

Pressure Ulcer

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46
Q

Define

Proliferation

A

The phase where new tissue, including collagen and blood vessels, is formed to replace damaged tissue.

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47
Q

Definition

Wounds that extend through the entire dermis and may involve subcutaneous tissue or deeper structures.

A

Define

Full Thickness Wounds

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48
Q

Define

Contusions

A

Bruises resulting from blunt trauma, causing damage to underlying tissues without breaking the skin.

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49
Q

Define

Reticular Layer

A

The deeper layer of the dermis, composed of dense irregular connective tissue, providing structural support and elasticity.

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50
Q

Definition

The stage where the body responds to injury with redness, heat, swelling, and pain to prevent infection and clear debris.

A

Define

Inflammation

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51
Q

Definition

The layer of the epidermis where cells begin to become more polygonal and interconnected, providing structural strength.

A

Define

Stratum Spinosum

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52
Q

Define

Burn

A

Damage to the skin caused by heat, chemicals, electricity, or radiation.

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53
Q

Definition

Wounds that involve only the outer layers of skin.

A

Define

Superficial Wounds

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54
Q

Define

Stratum Spinosum

A

The layer of the epidermis where cells begin to become more polygonal and interconnected, providing structural strength.

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55
Q

Define

Inflammation

A

The stage where the body responds to injury with redness, heat, swelling, and pain to prevent infection and clear debris.

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56
Q

Definition

Bruises resulting from blunt trauma, causing damage to underlying tissues without breaking the skin.

A

Define

Contusions

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57
Q

Definition

The layer of tissue below the dermis, consisting of loose connective tissue and fat, which provides insulation and cushioning.

A

Define

Hypodermis (Subcutaneous Layer)

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58
Q

Define

Delayed Primary (Tertiary) Intention

A

A combination where a wound is initially left open to allow for infection control and then closed later to promote healing with less risk of complications.

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59
Q

Define

Tumors

A

Abnormal growths or masses that may cause or be associated with skin wounds.

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60
Q

Define

Hypodermis (Subcutaneous Layer)

A

The layer of tissue below the dermis, consisting of loose connective tissue and fat, which provides insulation and cushioning.

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61
Q

Define

Diabetic Ulcer:

A

A type of chronic wound commonly found in individuals with diabetes, often on the feet or legs.

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62
Q

Define

Chronic Wounds

A

Wounds that do not heal within the expected timeframe and often require specialized care.

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63
Q

What is the outermost layer of the skin?

A

Answer: Stratum Corneum

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64
Q

Which skin layer is only present in thick skin like the palms and soles?

A

Answer: Stratum Lucidum

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65
Q

In which layer of the epidermis do keratinocytes begin to form a waterproof barrier?

A

Answer: Stratum Granulosum

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66
Q

What is the primary function of the Stratum Spinosum?

A

Answer: Provides structural integrity and contains Langerhans cells for immune response.

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67
Q

Which layer of the epidermis contains melanocytes and Merkel cells?

A

Answer: Stratum Basale

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68
Q

What is the primary tissue type found in the Papillary Layer of the dermis?

A

Answer: Loose connective tissue

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69
Q

Which layer of the dermis contains hair follicles and sweat glands?

A

Answer: Reticular Layer

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70
Q

What type of tissue makes up the Hypodermis (Subcutaneous Layer)?

A

Answer: Adipose tissue and connective tissue

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71
Q

How does the skin contribute to thermoregulation?

A

Answer: Through sweat production and blood vessel dilation/constriction.

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72
Q

Which function of the skin is related to removing waste products?

A

Answer: Excretion

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73
Q

What type of cells in the skin are involved in immune defense?

A

Answer: Langerhans cells

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74
Q

What is the immediate response to injury called?

A

Answer: Hemostasis

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75
Q

During which phase of wound healing do white blood cells remove debris and bacteria?

A

Answer: Inflammation

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76
Q

What phase involves the formation of granulation tissue?

A

Answer: Proliferation

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77
Q

Which phase of wound healing involves collagen remodeling and tissue strengthening?

A

Answer: Maturation (Remodeling)

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78
Q

What effect does reduced collagen production have on wound healing in older adults?

A

Answer: Slower repair and less strength in healed tissue.

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79
Q

How does decreased elasticity affect aging skin?

A

Answer: Increases the risk of skin tears and pressure ulcers.

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80
Q

What happens to the epidermis as we age?

A

Answer: It becomes thinner, making it more prone to injury and slower to regenerate.

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81
Q

How does impaired immune function affect wound healing in older adults?

A

Answer: Increases susceptibility to infections.

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82
Q

What impact does reduced blood supply have on aging skin?

A

Answer: Slows the delivery of nutrients and oxygen to the wound site.

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83
Q

What is the method of healing where the edges of a clean wound are brought together?

A

Answer: Primary Intention

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84
Q

Which healing process involves the wound healing naturally from the bottom up, resulting in larger scar tissue?

A

Answer: Secondary Intention

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85
Q

What is the term for a wound initially left open due to contamination, then closed surgically after risk is minimized?

A

Answer: Delayed Primary (Tertiary) Intention

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86
Q

What is an abrasion?

A

Answer: A superficial wound caused by friction, usually involving the epidermis.

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87
Q

What type of wound is caused by a sharp object and has a high risk of infection?

A

Answer: Puncture

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88
Q

Which type of wound is characterized by an irregular tear-like injury caused by blunt trauma?

A

Answer: Laceration

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89
Q

How is a burn classified?

A

Answer: By depth (superficial, partial-thickness, full-thickness)

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90
Q

What causes a pressure ulcer?

A

Answer: Prolonged pressure, often over bony prominences.

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91
Q

What is a diabetic ulcer and why does it occur?

A

Answer: An ulcer that occurs in diabetic patients due to neuropathy and poor circulation.

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92
Q

Which nutrient is essential for collagen synthesis and immune function?

A

Answer: Vitamin C

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93
Q

What role does protein play in wound healing?

A

Answer: Essential for tissue repair and immune function.

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94
Q

Which mineral is important for protein synthesis, cell proliferation, and immune function?

A

Answer: Zinc

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95
Q

Why is vitamin A important for wound healing?

A

Answer: It is crucial for epithelialization and immune function.

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96
Q

What function does iron serve in the healing process?

A

Answer: Necessary for oxygen transport and collagen synthesis.

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97
Q

Why are carbohydrates and fats important in wound healing?

A

Answer: They provide energy for the healing process.

98
Q

What is the largest organ in the body?

A

Answer: The skin

99
Q

What percentage of the body’s weight is made up by the skin?

A

Answer: Approximately 15%

100
Q

What are the epidermal appendages found in the skin?

A

Answer: Hair, nails, sebaceous glands, and sweat glands

101
Q

Name the three main layers of the skin.

A

Answer: Epidermis, dermis, hypodermis (subcutaneous layer)

102
Q

What type of cells predominantly make up the epidermis?

A

Answer: Epithelial cells

103
Q

Why is the epidermis considered avascular?

A

Answer: It does not have a blood supply; nutrients and oxygen are diffused from the dermis.

104
Q

What happens to epidermal cells as they move closer to the surface?

A

Answer: They lose their nuclei and eventually become dead cells.

105
Q

Where do new epidermal cells originate?

A

Answer: From stem cells in the stratum basale.

106
Q

What is the role of melanocytes in the stratum basale?

A

Answer: They determine skin color (darkness).

107
Q

Which cells in the epidermis assist in touch sensation?

A

Answer: Merkel cells and Meissner’s corpuscles

108
Q

What is the function of Langerhans cells in the stratum spinosum?

A

Answer: They activate lymphocytes in response to antigens and protect against infections.

109
Q

What forms the acid mantle in the stratum corneum?

A

Answer: Dead cells that protect against fungi, bacteria, abrasion, dehydration, and penetration.

110
Q

Name the two sub-layers of the dermis.

A

Answer: The reticular layer and the papillary layer

111
Q

What is the primary composition of the reticular layer?

A

Answer: Collagen and reticular fibers

112
Q

What is the role of fibroblasts in the dermis?

A

Answer: They produce collagen and elastin, providing strength and elasticity.

113
Q

What feature of the papillary layer enhances nutrient supply and waste removal?

A

Answer: Finger-like projections that interlink with the epidermis

114
Q

How do macrophages in the dermis contribute to skin health?

A

Answer: They are part of the immune system and help fight infections.

115
Q

List some appendages that project from the dermal layer.

A

Answer: Hair, sebaceous glands, nails, sweat glands

116
Q

What is the primary composition of the hypodermis?

A

Answer: Adipose tissue

117
Q

How does the thickness of the hypodermis vary between males and females?

A

Answer: Contributes 20-25% of body weight in females and 15-20% in males.

118
Q

What are the main functions of the hypodermis?

A

Answer: Anchors the skin to underlying muscles and bones, stores fat, provides cushioning, and acts as an insulator.

119
Q

What is the primary function of the skin?

A

Protection

120
Q

How does the skin contribute to thermoregulation?

A

Answer: Through sweat production and blood vessel dilation/constriction.

121
Q

Which function of the skin involves sensory receptors for touch, pain, temperature, and pressure?

A

Sensation

122
Q

What role does the skin play in metabolism?

A

Answer: It synthesizes vitamin D upon exposure to UV radiation.

123
Q

How does the skin act as a reservoir?

A

Answer: By storing nutrients and water.

124
Q

What function of the skin involves the removal of waste products?

A

Excretion

125
Q

What layer of the skin is responsible for providing nutrients to the epidermis?

A

dermis

126
Q

Which layer of the skin is involved in anchoring the skin to underlying structures?

A

Answer: The hypodermis (subcutaneous layer)

127
Q

What is the primary role of the papillary layer in the dermis?

A

Answer: To optimize nutrient supply and waste removal by increasing the surface area for exchange with the epidermis.

128
Q

What are the projections called that extend from the epidermis into the dermis?

A

Answer: Rete ridges or pegs

129
Q

What do the papillae in the dermis project into?

A

Answer: The epidermis

130
Q

What is the function of the rete ridges and papillae in the skin?

A

Answer: They provide an anchor, preventing the epidermis and dermis from sliding against each other.

131
Q

How does the epidermal/dermal junction contribute to skin integrity?

A

Answer: By interlocking the epidermis and dermis, which prevents them from sliding apart.

132
Q

What happens to the epidermal/dermal attachment during scar tissue formation?

A

Answer: The attachment is damaged, leading to less effective anchoring and potentially resulting in weaker skin structure.

133
Q

What impact does scar tissue formation have on wound healing?

A

Answer: Scar tissue formation can impair the integrity and function of the skin, leading to a less effective barrier and potential changes in skin elasticity.

134
Q

What does a partial-thickness wound affect that a superficial wound does not?

A

Answer: The dermis, in addition to the epidermis.

135
Q

What is a wound?

A

Answer: An injury to the integument or underlying structures that may or may not result in the loss of skin, impairing the physiological function of the tissue.

136
Q

Why is identifying the etiology of a wound important?

A

Answer: It is vital for accurately classifying the wound and creating an appropriate treatment plan.

137
Q

What defines an acute wound?

A

Answer: Wounds that heal within a normal time frame and can be surgical or non-surgical.

138
Q

How long do chronic wounds typically persist?

A

Answer: Longer than six weeks.

139
Q

What type of wound involves only the epidermis?

A

Answer: Superficial wound.

140
Q

Which wound type progresses into the dermis?

A

Answer: Partial thickness wound.

141
Q

What is involved in a full thickness wound?

A

Answer: Subcutaneous tissue and may extend into underlying structures such as muscle, tendon, or bone.

142
Q

What is location-based classification of wounds?

A

Answer: Classification of wounds based on their location, such as leg ulcers or diabetic foot ulcers.

143
Q

What are penetrating wounds?

A

Answer: Wounds caused by penetration injuries that extend through more than one surface layer of the skin.

144
Q

What is the difference between clean and contaminated wounds?

A

Answer: Clean wounds are usually surgically created and do not penetrate organs; contaminated wounds result from accidental injuries or surgical procedures with gross spillage from the GI tract.

145
Q

Describe a contusion.

A

Answer: A wound resulting from a blow or blunt object, leading to swelling, bruising, discoloration, and pain.

146
Q

What happens in an abrasion?

A

Answer: The surface of the skin is scraped or rubbed, removing one or several layers, typically resulting in a superficial wound that heals quickly.

147
Q

What characterizes an incision?

A

Answer: Clean edges, usually made by a sharp instrument, resulting in minimal tissue damage and typically healing quickly.

148
Q

What is a laceration?

A

Answer: A wound with jagged edges caused by blunt force trauma, resulting in tissue ridging.

149
Q

Describe a puncture wound.

A

Answer: A deep wound caused by a sharp, pointed object like a nail, with a small skin opening that may not bleed but can easily become infected.

150
Q

What distinguishes a penetrating wound from other types?

A

Answer: It extends through more than one surface layer of the skin, affecting deep tissue and possibly internal organs.

151
Q

What are the classifications of burns?

A

Answer: Superficial, partial thickness, and full thickness.

152
Q

How do fractures relate to wound classification?

A

Answer: Broken bones can penetrate the skin surface, causing damage to all layers and underlying structures.

153
Q

What are ulcers?

A

Answer: Open wounds caused by a break in the skin that fails to heal properly, typically chronic and lasting longer than six weeks.

154
Q

What are tumors in the context of wounds?

A

Answer: Masses of abnormal tissue that arise from pre-existing body cells, characterized by unrestrained growth and no purposeful function.

155
Q

What is an open wound?

A

Answer: A wound where the skin has been penetrated, providing a portal of entry for microorganisms.

156
Q

What defines a closed wound?

A

Answer: The skin remains intact, but there may be soft tissue damage, internal injury, and possible bleeding. An example is a contusion.

157
Q

What are the three main stages of wound healing?

A

Answer: Inflammation (and haemostasis), Proliferation (reconstruction), Maturation.

158
Q

How do the stages of wound healing relate to each other?

A

Answer: The phases overlap and their time intervals vary.

159
Q

How long does the inflammatory phase last?

A

Answer: 2-5 days.

160
Q

What is the primary goal of haemostasis in wound healing?

A

Answer: To form a clot that facilitates the healing process and prevent excessive blood loss.

161
Q

What role does histamine play during the inflammatory phase?

A

Answer: It causes vasodilation of surrounding tissue to facilitate the influx of leukocytes, erythrocytes, and plasma proteins into the wound.

162
Q

Name the classic signs of inflammation observed during this phase.

A

Answer: Erythema (redness), oedema (swelling), heat, and pain.

163
Q

What is the role of neutrophils, monocyte-macrophages, and T-lymphocytes in wound healing?

A

Answer: They protect against bacterial invasion, remove dead tissue and bacteria through phagocytosis, and provide a clean wound site.

164
Q

How long does the proliferative phase typically last?

A

Answer: 2-24 days.

165
Q

What is angiogenesis?

A

Answer: The development of new blood vessels to restore vascularity and supply nutrients and oxygen required for wound healing.

166
Q

What happens during collagen synthesis?

A

Answer: Fibroblasts increase, forming the extracellular matrix and strengthening the wound.

167
Q

What is the purpose of cross-linking in wound healing?

A

Answer: To organize collagen fibers and increase the tensile strength of the tissue.

168
Q

What is epithelialisation?

A

Answer: The process where epithelial cells regenerate and cover the newly formed connective tissue.

169
Q

Describe the role of contraction in wound healing.

A

Answer: It involves the movement of wound edges to reduce the size of the wound and facilitate closure. Excessive contraction can lead to contractures.

170
Q

When does the maturation phase begin?

A

Answer: Once a wound is closed.

171
Q

How long does the maturation phase last?

A

Answer: 24 days to 1-2 years.

172
Q

What key processes occur during the maturation phase?

A

Answer: Ongoing re-modelling of collagen, cell differentiation, and regaining 80% of normal strength.

173
Q

What is the expected strength of the tissue at the end of the maturation phase?

A

Answer: Approximately 80% of normal strength.

174
Q

Why might haemostasis be considered a separate phase in some diagrams?

A

Answer: It is sometimes shown separately due to its critical role in the initial response to tissue injury and the formation of a clot.

175
Q

What can excessive wound contraction lead to?

A

Answer: Contractures, which can cause disfigurement and/or loss of function, especially in areas like the hands, face, and neck.

176
Q

What is healing by primary intention?

A

Answer: Healing by primary intention occurs when there is minimal tissue loss and the wound edges are held together by sutures, clips, tape, or glue.

177
Q

What is the typical result of primary intention healing?

A

Answer: Scarring is minimal.

178
Q

What type of wounds are typically treated with primary intention?

A

Answer: Wounds with minimal tissue loss and clean edges that can be approximated.

179
Q

What characterizes healing by secondary intention?

A

Answer: The wound is left open and heals through epithelialisation and contraction, with granulation occurring from the base of the wound.

180
Q

How does granulation occur in secondary intention healing?

A

Answer: Granulation occurs from the wound base, and epithelialisation moves across the wound bed.

181
Q

Why might secondary intention be used for certain wounds?

A

Answer: It is often used for wounds that are contaminated or infected.

182
Q

What is a common feature of scars formed through secondary intention?

A

Answer: The scar tends to be thicker due to the formation of new tissue.

183
Q

What is the purpose of delayed primary intention (tertiary intention) in wound healing?

A

Answer: It is used for infected wounds or wounds with foreign bodies, often requiring intensive cleaning before closure.

184
Q

How long are wounds typically left open in delayed primary intention healing?

A

Answer: Wounds are generally left open for 3-5 days.

185
Q

What is a fasciotomy wound and why is it used?

A

Answer: A fasciotomy wound allows drainage of underlying tissue and is used to relieve pressure or infection.

186
Q

What are the two types of skin grafts?

A

Answer: Partial thickness and full thickness.

187
Q

What is the purpose of a skin graft?

A

Answer: To speed up the healing process and reduce the risk of infection.

188
Q

Describe the process of applying a skin graft.

A

Answer: A piece of healthy skin is transferred to another site, detached from its blood supply, formed into a mesh, and stretched across the wound. New skin grows around the graft.

189
Q

What is the typical outcome of a skin graft?

A

Answer: It results in a relatively good cosmetic outcome with effective skin regrowth.

190
Q

What is a flap in wound healing?

A

Answer: A flap is a surgical relocation of tissue from one part of the body to another to reconstruct a primary defect.

191
Q

What are the three types of flaps?

A

Answer: Free flaps, pedicle flaps, and rotational flaps.

192
Q

What characterizes a free flap?

A

Answer: A free flap is a complete segment with an anastomosis of blood supply to vessels within the wound.

193
Q

How does a pedicle flap work?

A

Answer: Skin and subcutaneous tissue are transferred with its own blood supply retained via a pedicle until new blood supply at the graft site is established.

194
Q

What is a rotational flap?

A

Answer: Tissue is rotated to cover an adjacent defect while retaining its original blood supply.

195
Q

What is created as a result of flap surgery?

A

Answer: A secondary defect that may require skin grafting or primary closure.

196
Q

What are some risks associated with poor wound healing?

A

Answer: Being under-nourished, elderly, having diabetes, obesity, and other disease states.

197
Q

How does being under-nourished affect wound healing?

A

Answer: It causes delays in wound healing and increases the risk of wound infection.

198
Q

What are some causes of malnutrition that affect wound healing?

A

Answer: Insufficient nutrient intake, malabsorption syndromes, high output gastrointestinal fistulae, disorders, drug intolerances, and food-drug interactions.

199
Q

How can age impact wound healing?

A

Answer: Ageing affects skin thickness, resistance to shear and friction, increases comorbidities, impacts mobility and cognition, and can lead to poor nutrition.

200
Q

What are some age-related factors that may affect wound healing?

A

Answer: Increased comorbidities, reduced mobility, impaired cognition, financial constraints impacting nutrition.

201
Q

How does diabetes impair wound healing?

A

Answer: High blood glucose levels impair white blood cell function, damage circulation, slow blood flow, and decrease nutrient delivery to wounds.

202
Q

What are the effects of high blood glucose levels on wound healing?

A

Answer: Impaired white blood cell function, reduced ability to fight bacteria, decreased circulation, and slow healing.

203
Q

How does neuropathy from diabetes affect wound healing?

A

Answer: It causes numbness in the lower extremities, increasing the risk of injury.

204
Q

How does obesity impact wound healing?

A

Answer: It negatively affects the immune system, increases susceptibility to infection, and may cause a chronic low-level inflammatory state.

205
Q

What are the effects of increased subcutaneous tissue in obesity?

A

Answer: It increases demand on the circulatory system and is poorly vascularised, which can negatively impact wound healing.

206
Q

How does anaemia affect wound healing?

A

Answer: It reduces the amount of circulating oxygen to the wound, impairing healing.

207
Q

What impact does malignancy have on wound healing?

A

Answer: Malignancy can interfere with healing due to tumour growth, compromised local circulation, infection, and impaired nutrition. Treatment like chemotherapy or radiotherapy may also impair healing.

208
Q

Why is nutrition important in wound healing?

A

Answer: Nutrition is essential for providing the nutrients needed for tissue oxygenation, metabolic energy, protein synthesis, and enzymatic reactions involved in wound healing.

209
Q

What roles do cytokines and growth factors play in wound healing?

A

Answer: They coordinate the complex process of wound healing, which involves haemostasis/inflammation, proliferation, and remodelling.

210
Q

What proportion of patients may require dietary supplementation for wound healing?

A

Answer: Approximately 50%.

211
Q

Which of the following is the outermost layer of the skin?

A. Epidermis
B. Dermis
C. Hypodermis
D. Subcutaneous tissue

A

A. Epidermis

212
Q

The dermis is primarily composed of which type of tissue?

A. Epithelial tissue
B. Connective tissue
C. Muscle tissue
D. Nervous tissue

A

B. Connective tissue

213
Q

Which structure in the skin is responsible for producing sweat?

A. Sebaceous gland
B. Sweat gland
C. Hair follicle
D. Nail bed

A

B. Sweat gland

214
Q

Where are the sensory receptors for touch located in the skin?

A. Epidermis
B. Dermis
C. Hypodermis
D. Subcutaneous tissue

A

B. Dermis

215
Q

Which layer of the skin contains the blood vessels and nerve endings?

A. Epidermis
B. Dermis
C. Hypodermis
D. Subcutaneous tissue

A

B. Dermis

216
Q

Which of the following is NOT a function of the skin?

A. Protection from environmental hazards
B. Regulation of body temperature
C. Absorption of nutrients
D. Sensation

A

C. Absorption of nutrients

217
Q

How does the skin contribute to temperature regulation?

A. By producing hormones
B. By secreting sweat
C. By absorbing heat
D. By dilating blood vessels

A

B. By secreting sweat

218
Q

The skin’s role in vitamin D synthesis occurs in which layer?

A. Epidermis
B. Dermis
C. Hypodermis
D. Subcutaneous tissue

A

A. Epidermis

219
Q

What is the first stage of wound healing?

A. Proliferation
B. Hemostasis
C. Inflammation
D. Maturation

A

B. Hemostasis

220
Q

During which stage of wound healing does the tissue repair and regeneration primarily occur?

A. Hemostasis
B. Inflammation
C. Proliferation
D. Maturation

A

C. Proliferation

221
Q

Which stage of wound healing involves the remodeling and strengthening of collagen fibers?

A. Hemostasis
B. Inflammation
C. Proliferation
D. Maturation

A

D. Maturation

222
Q

In which stage of wound healing is the formation of granulation tissue most prominent?

A. Hemostasis
B. Inflammation
C. Proliferation
D. Maturation

A

C. Proliferation

223
Q

Which of the following is a common issue in elderly skin that affects wound healing?

A. Increased sweat gland activity
B. Decreased number of sebaceous glands
C. Increased number of fibroblasts
D. Improved vascularization

A

B. Decreased number of sebaceous glands

224
Q

How does ageing skin typically affect wound healing?

A. Increases the rate of healing
B. Decreases the elasticity of the skin
C. Enhances collagen production
D. Improves blood flow to wounds

A

B. Decreases the elasticity of the skin

225
Q

Ageing skin often shows which change that can impact wound healing?

A. Increased thickness
B. Decreased number of blood vessels
C. Increased elasticity
D. Enhanced cell turnover

A

B. Decreased number of blood vessels

226
Q

Which type of wound healing involves the edges of the wound being brought together with sutures or staples?

A. Primary intention
B. Secondary intention
C. Tertiary intention
D. Quaternary intention

A

A. Primary intention

227
Q

In which type of wound healing is the wound left open to heal by granulation and contraction?

A. Primary intention
B. Secondary intention
C. Tertiary intention
D. Quaternary intention

A

B. Secondary intention

228
Q

Delayed primary intention involves which of the following?

A. Immediate closure of the wound
B. Wound left open initially and then closed after infection risk decreases
C. Healing by secondary intention only
D. Use of grafts for wound closure

A

B. Wound left open initially and then closed after infection risk decreases

229
Q

Which type of healing is characterized by the wound being intentionally left open for a period of time before closure?

A. Primary intention
B. Secondary intention
C. Tertiary intention
D. Quaternary intention

A

C. Tertiary intention

230
Q

Which type of wound is characterized by a break in the skin where the edges are clean and the wound is easily approximated?

A. Incision
B. Laceration
C. Abrasion
D. Puncture

A

A. Incision

231
Q

A wound with jagged edges caused by a blunt force is known as a:

A. Incision
B. Laceration
C. Abrasion
D. Puncture

A

B. Laceration

232
Q

Which type of wound is caused by a sharp object piercing the skin and underlying tissues?

A. Incision
B. Laceration
C. Abrasion
D. Puncture

A

D. Puncture

233
Q

What type of wound is characterized by skin rubbing off due to friction?

A. Incision
B. Laceration
C. Abrasion
D. Puncture

A

C. Abrasion

234
Q

Wounds can be classified based on all of the following EXCEPT:

A. Cause of injury
B. Color of wound bed
C. Depth of tissue injury
D. Duration of healing

A

B. Color of wound bed

235
Q

Which classification method describes wounds by their depth?

A. Acute vs. chronic
B. Partial-thickness vs. full-thickness
C. Surgical vs. traumatic
D. Clean vs. contaminated

A

B. Partial-thickness vs. full-thickness

236
Q

The classification of a wound as ‘chronic’ typically refers to:

A. Wounds that heal within a predictable time frame
B. Wounds that do not heal within the normal healing time
C. Wounds that are surgical in nature
D. Wounds that are expected to heal quickly

A

B. Wounds that do not heal within the normal healing time

237
Q

Which nutrient is most crucial for collagen synthesis in wound healing?

A. Carbohydrates
B. Vitamin C
C. Vitamin A
D. Iron

A

B. Vitamin C

238
Q

A deficiency in which mineral is commonly associated with impaired wound healing?

A. Zinc
B. Calcium
C. Magnesium
D. Potassium

A

A. Zinc

239
Q

Which macronutrient is essential for energy and cellular repair during wound healing?

A. Proteins
B. Fats
C. Carbohydrates
D. Fiber

A

C. Carbohydrates

240
Q

Inadequate protein intake in a patient with a wound may result in:

A. Increased collagen synthesis
B. Decreased wound inflammation
C. Delayed wound healing
D. Enhanced immune response

A

C. Delayed wound healing

#NUR1447 (5 decks)

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