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Integumentary System
Test 4
76
Physiology
Graduate
08/01/2011

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Term
The deepest epidermal layer that is firmly attached to the dermis.
Definition
Stratum Basale (Basal Layer)
Term
This epidermal layers helps to regenerate skin, consists of actively miotic stem cells, and consists of a single row of the youngest keratinocytes.
Definition
Stratum Basale (Basal Layer)
Term
Cells in this layer undergo rapid division, hence its alternate name, stratum germinativum.
Definition
Stratum Basale (Basal Layer)
Term
The outermost layer of keratinized cells.
Definition
Stratum Corneum (Horny Layer)
Term
This layer of the epidermis accounts for three quarters of the epidermal thickness. Functions include waterproofing, protection from abrasion and penetration, and rendering the body relatively insensitive to biological, chemical, and physical assaults.
Definition
Stratum Corneum (Horny Layer)
Term
Name the 2 layers of the dermis
Definition
Papillary
Reticular
Term
Consists of areolar connective tissue with collagen and elastic fibers.
Definition
Papillary Layer
Term
Its superior surface contains peglike projections called dermal papillae. Dermal papillae contain capillary loops, Meissner's Corpuscles, and free nerve endings.
Definition
Papillary Layer
Term
This layer accounts for approximately 80% of the thickness of the skin.
Definition
Reticular Layer
Term
Consists of collagen fibers in this layer that add strength and resiliency to the skin. Elastin fibers provide stretch-recoil properties.
Definition
Reticular Layer
Term
Name the 6 functions of the integumentary system.
Definition
Protection
Body Temperature Regulation
Cutaneous Sensation
Metabolic Functions
Blood Reservoir
Excretion
Term
How does the skin serve as a protection barrier?
Definition
Chemical Barriers - Slightly acidic surface (helps protect from bacterial invasion)
Physical/Mechanical Barriers
Biological Barriers
Term
How does the skin serve to regulate blood temperature?
Definition
Dilation (cooling) and contriction (warming) of dermal vessels.
Increasing sweat gland secretions to cool the body
Term
How does the skin provide cutaneous sensation.
Definition
Exoreceptors sense touch and pain
Term
What are the skins metabolic functions.
Definition
Synthesis of vitamin D in dermal blood vessels
Term
How is the skin a blood reservoir?
Definition
Skin blood vessels store up to 5% of the body's blood volume
Term
How does the skin perform excretion?
Definition
Limited amounts of nitrogenous wastes are eliminated from the body in sweat
Term
Name the 3 burn degrees.
Definition
1. Superficial Partial Thickness
2. Partial Thickness
3. Full Thickness
Term
Which this type of burn, only the epidemis is damaged. Symptoms include localized redness, swelling, and pain.
Definition
Superficial Partial Thickness
Term
This type of burn is where the epidermis and upper regions of dermis are damaged. Symptoms include redness, swelling, pain, and blisters.
Definition
Partial Thickness
Term
With this burn, the entire epidermis and part of the papillary dermis is damaged.
Definition
Partial Thickness
Term
This is the most painful type of burn because nerve endings are exposed. It can heal on its own in 7-14 days.
Definition
Partial Thickness
Term
This type of burn is painful because free nerve endings are closer to the surface than normal.
Definition
Superficial Partial Thickness
Term
This burn is where the entire thickness of the skin is damaged. This is where the burn goes all the way into the reticular layer.
Definition
Full Thickness
Term
This type of burn appears gray-white, cherry red, or black; there is less pain or no pain because the free nerve endings are destroyed.
Definition
Full Thickness
Term
Most of these types of burns will require skin grafting to heal because these burns will not heal on their own.
Definition
Full Thickness
Term
__ will be performed in the case of a circumferential burn in which the blood flow to the distal extremity is comprised.
Definition
Escharotomy
Term
Why must PTs be very aggressive with burn pts?
Definition
Burn scar contracture can occur in 1-4 days
Term
Has the potential to heal on its own from the edges. Slow to heal. If large, will get grafted.
Definition
Deep Dermal Burn
Term
What does TBSA stand for?
Definition
Total Burn Surface Area
Term
Usually an electrical burn. There will be an entrace and exit wound. It can go down to the muscle/bone.
Definition
Subdermal Burn (4 degree)
Term
Imbalances in essential nutrients can lead to what?
Definition
Cell injury/death
Term
Deficiencies of __ __ interfere with protein synthesis, which is needed to replace those lost thru normal catabolism, growth, and in preparation for cell replication.
Definition
Amino Acids
Term
What are normal albumin levels?
Definition
3.5 g/dL
Term
The lab value that is most widely used to measure protein.
Definition
Pre-Albumin Level
Term
__ __ is needed after cell injury for healing to occur.
Definition
Cell replication
Term
What 2 nutrients are essential in wound healing?
Definition
Copper
Zinc
Term
Name the phases of wound healing.
Definition
Inflammatory Phase
Proliferation Phase
(Epithelialization Phase included here)
Remodeling Phase
Term
Name 3 chemical mediators that are released during the inflammatory phase.
Definition
Histamine
Kinins
Prostaglandins
Term
Promotes vasodilation of local arterioles, increases permeability of local capillaries, promotes exudates formation.
Definition
Histamine
Term
Induce chemotaxis of leukocytes and induced pain
Definition
Kinins
Term
Produce free radicals
Definition
Prostaglandins
Term
Stimulats fibroblast activity
Definition
PDDF
Term
Release results in increased capillary permeability and capillaries leak fluid
Definition
Chemical Mediators
Term
Allows more filtrate containing oxygen, nutrients, blood clotting proteins, and antibodies to enter the inflamed area.
Definition
Increased capillary permeability
Term
Eat debris, activates and stops inflammatory response
Definition
Macrophages
Term
During this phase of wound healing, there is hemostasis and breakdown of debris/pathogens at the site and platelets
Definition
Inflammatory Phase
Term
Derived growth factor (PDGF) for clot formation
Definition
Platelets
Term
Also secrete cytokines and growth factors that bring important players at the injury site.
Definition
Platelets
Term
Name the 4 cardinal signs of the inflammatory phase
Definition
Redness
Swelling
Pain
Heat
Term
What are the goals for the inflammatory phase?
Definition
1. Control bleeding, swelling and pain
2. Ice, pressure, assist with clotting
Term
Too much __ requires debridement
Definition
Fibrin
Term
1st on the seen to combat infection
Definition
Neutrophils (WBC)
Term
This phase of wound healing begins once fibroblasts arrive.
Definition
Proliferation Phase
Term
Begins after 3-5 days and can last for weeks
Definition
Proliferation
Term
__ tissue is stimulated by macrophases
Definition
Granulation
Term
Name 3 ways in which granulation tissue is stimulated by macrophages.
Definition
1. Cross linking of collagen
2. Fibroblasts form chains that coil and form spirals that overlap
3. 3 chains involved to give you granulation tissue
Term
This process/phase stimulates angiogenesis and fibroplasias
Definition
Proliferation
Term
Growth factor release stimulates __ to the area
Definition
Fibroblasts
Term
In this phase, the wound bed matrix is established
Definition
Proliferation
Term
During the proliferation phase, why are fibroblasts moving into the space and angiogenesis is occurring?
Definition
Need blood flow to area, otherwise will become ischemic and die
Term
Eschar presents in the proliferation phase, what does eschar mean?
Definition
Thick, leathery
Term
Is eschar good for healing?
Definition
NO, bad because it impedes fibroblasts, histamine, and prostaglandin function
Term
Where skin is coming together and putting ont he top layer to cover the wound
Definition
Epithelialization
Term
Times when epithelial cells proceed faster than granulation tissue
Definition
Hypergranulation
Term
This race is more prone to excessive scarring.
Definition
African Americans
Term
Creates cosmetic and function problems (compression garments for burn pts help with excessive contraction that creates excessive scarring)
Definition
Excessive wound contraction
Term
__ and __ - after this phase, wound has 80% of pre-wound strength
Definition
Contracture and Fibroplasia
Term
This phase consists of resurfacing and closure. Keratinocytes move in and close wound and melanocytes give color. Cells in the dermis start to lose adhesion and move across the matrix in a leapfrog fashion
Definition
Epithelialization Phase
Term
Day 7 and forward
Definition
Remodeling Phase
Term
Where collagen becomes deposited into matrix, becomes organized. Collagen fibers are laid down in a linear fashion to give you a stable scar. Continue with ROM to amke sure the scar remains flexible and doesn't contract.
Definition
Scar Maturation
Term
During this phase, the scar becomes avascular and white, decreases in fibroblasts, decreased number of capillaries. Sometimes may have an increase in capillaries, which causes a hypertrophic scar.
Definition
Remodeling Phase
Term
__ tissue turns into scar tissue
Definition
Granulation
Term
The remodeling phase can continue for 1-2 years. On average, the wound would be healed between __
Definition
12-18 months
Term
Name the 3 Rs for hypertrophic
Definition
Raised
Rigid
Red
Term
Has the 3 R's, but with surrounding tissue involved as well. Grows out of its defined area of injury. Will not regress on its own, if excised, will grow back. May need surgery to remove.
Definition
Keloid
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