Term
|
Definition
thermal
chemical
electrical
radiation |
|
|
Term
| thermal burns are sustained from what 4 types of trauma |
|
Definition
flame
liquid
steam
hot object |
|
|
Term
| the severity of a thermal burn is proportional to what |
|
Definition
| contact time and temeprature |
|
|
Term
| temperatures must exceed what to cause damage to teh skin |
|
Definition
|
|
Term
| Heat is absorbed and distributed through the tissues denatures the cells protein they die from what |
|
Definition
| traumatic and/or ischemic necrosis |
|
|
Term
| 2 types of chemical burns |
|
Definition
|
|
Term
| acidic burns react with the cell protein to cause what |
|
Definition
|
|
Term
|
Definition
|
|
Term
| why are acidic chemical burns less severe |
|
Definition
| coagulation necrosis causes a tanning effect and prevents further depth destruction |
|
|
Term
| what type of necrosis do alkaline burns cuase |
|
Definition
|
|
Term
| alkaline burns are likely to be _____ thickness |
|
Definition
|
|
Term
| Severity of a chemical burn is determined by what |
|
Definition
amount and concentration of the chemical
amount of contact time |
|
|
Term
| how does electricity burn |
|
Definition
| heat is produced in the human tissue as the body resists the flow of the current |
|
|
Term
| the higher the ____ the higher the resistance |
|
Definition
|
|
Term
| Tissue resitance from least to greatest (4) |
|
Definition
nerve
blood vessel
muscle
bone |
|
|
Term
| the greater the _____ content the less the resistance |
|
Definition
|
|
Term
| 3 complications unique to teh electrical burn pt |
|
Definition
A Fib
Tetanic fracture
compartment syndrome |
|
|
Term
| how soon can radiation burns manifest after the initation of radiation therapy |
|
Definition
|
|
Term
| s/s of radiation burns (3) |
|
Definition
| tight, itchy, hypersensitive |
|
|
Term
| Radiation burns: progression of the damage includes (3) |
|
Definition
epidermal and dermal atrophy
fibrotic changes
eventually blistering and weeping |
|
|
Term
| Radiation burns: tx protocol |
|
Definition
| moisturizing and reducing the symptoms of dryness and itching (hydrogel, tenderwet, topical steroids, aquaphor) |
|
|
Term
| Radiation burns: protection of teh burn |
|
Definition
| protection from mechanical stress (loose clothing, no jewelry, no adhesives, no heat/ice, no scratching) |
|
|
Term
| 3 zones of damage for burns |
|
Definition
zone of coagulatoin
zone of stasis
zone of hyperemia |
|
|
Term
| 3 zones of damage: what happens to the cells in the zone of coagulation |
|
Definition
| cells irreversiblly damaged and skin death |
|
|
Term
| 3 zones of damage: center of burn wound, area of greatest heat transfer |
|
Definition
|
|
Term
| 3 zones of damage: zone adjacent to zone of coagulation |
|
Definition
|
|
Term
| 3 zones of damage: reaction within the zone of stasis |
|
Definition
| pronounced inflammatory reaction |
|
|
Term
| 3 zones of damage: what may cause cell death within 24-48 hrs within the zone of stasis |
|
Definition
|
|
Term
| 3 zones of damage: zone farthest from point of insult |
|
Definition
|
|
Term
| 3 zones of damage: site of minimal cell damage |
|
Definition
|
|
Term
| 3 zones of damage: how soon should tissue recover in the zone of hyperemia |
|
Definition
| within 7 days without ill effects |
|
|
Term
| Burn Depth: How many degrees |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Burn Depth: superficial/partial thickness |
|
Definition
|
|
Term
| Burn Depth: deep partial thickness |
|
Definition
|
|
Term
| Burn Depth: full thickness |
|
Definition
|
|
Term
|
Definition
|
|
Term
| superficial burns damage what layer of the skin |
|
Definition
|
|
Term
| "classic" type of superficial/1st degree burn |
|
Definition
|
|
Term
| s/s of superficial/1st degree burns (3) |
|
Definition
epidermal damage, dermal irritation
inflammatory mediators from sites of epidermal damage, mast cells
slight edema |
|
|
Term
| are blisters present for superficial burns |
|
Definition
|
|
Term
| when does desquamation of superficial burns occur |
|
Definition
|
|
Term
| Prognosis for superficial burns |
|
Definition
| spontaneous healing within 7-10 days with no scarring |
|
|
Term
| Superficial/Partial Thickness Burn/2nd degree: involves what layers of the skin |
|
Definition
| epidermis and papillary dermis |
|
|
Term
| Superficial/Partial Thickness Burn/2nd degree: presence of blisters |
|
Definition
| blisters both ruptured and intact |
|
|
Term
| Superficial/Partial Thickness Burn/2nd degree: how do these blisters heal |
|
Definition
|
|
Term
| Superficial/Partial Thickness Burn/2nd degree: heal by epithelializiation in how long |
|
Definition
|
|
Term
| Superficial/Partial Thickness Burn/2nd degree: skin color change |
|
Definition
|
|
Term
| Superficial/Partial Thickness Burn/2nd degree: capillary refill? |
|
Definition
|
|
Term
| Superficial/Partial Thickness Burn/2nd degree: pain associated |
|
Definition
|
|
Term
| Superficial/Partial Thickness Burn/2nd degree: common examples (3) |
|
Definition
severe sunburn
brief contact burn
brief contact with dilute chemicals |
|
|
Term
| Deep Partial Thickness Burns/2nd degree: layers of the skin damaged |
|
Definition
epidermis
papillary dermis
some reticular dermis |
|
|
Term
| Deep Partial Thickness Burns/2nd degree: skin organs involved (3) |
|
Definition
sweat glands
hair follicles
sensory organs involved |
|
|
Term
| Deep Partial Thickness Burns/2nd degree: how do these burns heal |
|
Definition
granulation
epithelialization |
|
|
Term
| Deep Partial Thickness Burns/2nd degree: edema? capillary refill? |
|
Definition
moderate edema
slugglish capillary refill |
|
|
Term
| Deep Partial Thickness Burns/2nd degree: pain sensation |
|
Definition
|
|
Term
| Deep Partial Thickness Burns/2nd degree: additional potential procedures |
|
Definition
| scarring may need grafting |
|
|
Term
| full thickness burn/3rd degree: skin layers damaged |
|
Definition
epidermal
dermal
subcutaneous |
|
|
Term
| full thickness burn/3rd degree: wound characteristics |
|
Definition
| mottlign changes to dry leather eschar (black, grey, or white) |
|
|
Term
| full thickness burn/3rd degree: pain sensation |
|
Definition
|
|
Term
| full thickness burn/3rd degree: vascular changes |
|
Definition
| no blanching, no regrowth of hair |
|
|
Term
| full thickness burn/3rd degree: medical mgmt |
|
Definition
| debridement and frequently grafting |
|
|
Term
| full thickness burn/3rd degree: PT mgmt |
|
Definition
| preventative measures for minimizing scarring and ROM loss |
|
|
Term
| Subdermal Burns/4th degree: skin layers invovled |
|
Definition
epidermis
dermis
subcutaneous
fascia
muscle and/or bone |
|
|
Term
| Subdermal Burns/4th degree: frequently invovles what procedures (2) |
|
Definition
|
|
Term
| Subdermal Burns/4th degree: examples of (3) |
|
Definition
prolonged thermal contact
strong chemical burns
electrical injuries |
|
|
Term
|
Definition
type (chemical, electrical, thermal, radiation)
total body surface area (rule of 9's) |
|
|
Term
| Extent of Burned Area by surface area: back of 1 adult leg |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: front of 1 adult leg |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: back of 1 adult arm |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: front of 1 adult arm |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: front of adult abdomen |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: back of adult abdomen |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: front of adult head/face |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: back of adult head/face |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: adult genitals |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: back of 1 child leg |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: back of one child arm |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: front of child's 1 leg |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: front of child's 1 arm |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: back of child's head |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: front of child's abdomen |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: back of infant's head |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: front of infant's 1 arm |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: back abdomen of infant |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: front of infant's abdomen |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: buttock of infant |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: back of infant's leg |
|
Definition
|
|
Term
| Extent of Burned Area by surface area: front of infant's leg |
|
Definition
|
|
Term
| which system is the most important in the 1st 72 hours for burns |
|
Definition
|
|
Term
| when does edema peak after a burn |
|
Definition
|
|
Term
| danger of edema with burns |
|
Definition
|
|
Term
| watch should be watched for with hypovolemia (4) |
|
Definition
resting tacchycardia
hypotension
dysrythmias
1st 72 hours cirtical |
|
|
Term
| burn victims will experience this due to overall fluid loss |
|
Definition
|
|
Term
| 4 s/s observed in burn patients |
|
Definition
edema
hypovolemia
shock
impaired perfusion |
|
|
Term
| Prognostic factors for burns (7) |
|
Definition
age of pt
extent, depth, and distribution of burn
premorbid diseases
systemic complications
associated trauma
injuring agent
social circumstances |
|
|
Term
| Burn Intervention Goals: minimize (3) |
|
Definition
pain
risk of infection
cosmetic deformity |
|
|
Term
| Burn Intervention Goals: achieve (1) and prserve (1) |
|
Definition
achieve wound healing in a timely fashion
preserve physical function |
|
|
Term
| Burn Intervention Goals: preserve physical funciton refers to what (7) |
|
Definition
A/PROM
splints
positioning
strengthening
cardiovascular endurance training
pulmonary care
scar mgmt |
|
|
Term
| antimicrobial agents for burns (5) |
|
Definition
silvadene
sulfamylon
polysporin
acticoat
silver nitrate |
|
|
Term
| most common wound dressing |
|
Definition
| topical antimicrobial covered with a nonadheretn gauze |
|
|
Term
| over fresh skin grafts wat product may be used |
|
Definition
| nonadherent synthetic plastic gauze (exudry) |
|
|
Term
| dressing for dry radiation burns |
|
Definition
|
|
Term
| dressing for heavily draining burns |
|
Definition
|
|
Term
| what to avoid when applying wound dressings to burns |
|
Definition
| limit dressing bulk to allow ROM and splints |
|
|
Term
| important note about burn wound surfaces |
|
Definition
|
|
Term
| How to preserve function in a burn pt (4) |
|
Definition
positioning
splinting
A/PROM
Theraputic exercise/conditioning |
|
|
Term
| purpose of positioning to preserve function: (4) |
|
Definition
reduces edema
improves pulmonary hygiene
prevents and reduces contractures
prevents pressure ulcers |
|
|
Term
| purpose of splinting to preserve function (3) |
|
Definition
improves static positioning
protects recent grafts
perform frequent skin cehcks to assess areas of excessive pressure |
|
|
Term
| with splinting what is the purpose of the skin checks |
|
Definition
| if redness last >20 minutse after spint removal, modify splint |
|
|
Term
| surgical mgmt of burns (4) |
|
Definition
escharatomy
debridement
skin grafting
z-plasty |
|
|
Term
| where do autografts come from |
|
Definition
|
|
Term
| where do allografts come from |
|
Definition
|
|
Term
| where do xenografts come from |
|
Definition
|
|
Term
| 2 other types of skin grafts |
|
Definition
cultured epidermal autograft
synthetic skin |
|
|
Term
| benefits of an allograft (7) |
|
Definition
prevents wound dessication
promotes maturaiton of granulation
limits bacterial proliferation
prevents exudative loss of protein and RBC
Decreases wound pain
Increases movement
Decreases eat loss |
|
|
Term
| negatives of xenograt (2) |
|
Definition
less effective
more subgraft bacteria |
|
|
Term
|
Definition
| synthetic collagen dermal analog with silastic epidermal analog |
|
|
Term
| what is Biobrane used for |
|
Definition
|
|
Term
|
Definition
pain is reduced
comes off on its own when reepithelization occurs |
|
|
Term
| what will immediate improvement be seen post-escharatomy if successful |
|
Definition
| immediate improvement in peripheral blood flow |
|
|
Term
| immediate improvement of peripheral blood flow if escharatomy is successful can be seen in normalization of what (3) |
|
Definition
distal pulses
temperature
sensation and movement |
|
|
Term
| risk of what increases post-eschartomoy |
|
Definition
|
|
Term
| split thickness grafts include what what layers of the derms |
|
Definition
| epidermis and superficial dermis |
|
|
Term
| when are split thickness grafts used |
|
Definition
| when cosmetics is not an issue |
|
|
Term
| when is a full thickness graft used |
|
Definition
|
|
Term
| Why do grafts fail: inadequacy reasons (2) |
|
Definition
inadequate excision of dead or infected tissue
inadequate control of edema |
|
|
Term
| Why do grafts fail: 3 other reasons graft fail not related to inadequacy (Poor, Failure, Sepeartion) |
|
Definition
poor circulation
failure to establish connection between graft and host vessels
separation of graft |
|
|
Term
| Why do grafts fail: 3M's of separation |
|
Definition
motion
mechanical trauma
mass (hematoma) |
|
|
Term
| Looks lieka venous ulcer but is not a venous ulcer |
|
Definition
pyoderma gangrenosum
peristomal pyoderma gangrenosum |
|
|
Term
| pyoderma gangrenosum is what type of skin condition |
|
Definition
| ulcerative skin condition |
|
|
Term
| description of pyoderma gangrenosum |
|
Definition
| purple-ish edges that appear hypergranulated may have small pustules along periwound |
|
|
Term
| 50% of Pyoderma gangrenosum is associated with systemic inflammatory diseases such as (6) |
|
Definition
crohn's
ulcerative colitis
IBS
chronic active hepatitis
sero-negative arthritis
malignancies |
|
|
Term
| 4 types of pyoderma gangrenosum |
|
Definition
ulcerative
pustular
bullous
vegitative |
|
|
Term
| tx of pyoderma gangrenosum (3) |
|
Definition
medical mgmt to detect underlying cause
protection of lesions
intralesional injections of trimcinolone actonie, topical steroids, immune suppresives |
|
|
Term
| origin of hidradenitis suppurativa |
|
Definition
| follicular occlusion of the apocrine sweat glands which leads to build up of bacteria and subsequent infection |
|
|
Term
| hidradenitis suppurativa is characterized by what |
|
Definition
swollen
painful inflammed lesions in the groin, axilla, areola, and othe rparts of the body containing the apocrine glands |
|
|
Term
| tx protocol for hidradentis suppurativa |
|
Definition
| tx with moist warm heat to bring the infection to teh surface and break oepn. Once they break open they are easy to heal |
|
|
Term
| physical characteristics of psoriasis |
|
Definition
| round circumscribed erythematous dry and scaly plaques covered with silver/white scales |
|
|
Term
| pathogenesis of psoriasis |
|
Definition
| keratinocyte reproduction goes from 311 hrs to 36 hrs, results in 28x the normal production of epithelial cells |
|
|
Term
|
Definition
no cure
coal tar and UV therapy have antiproliferative affects on the keratinocytes |
|
|
Term
| skin condition in which the knuckle creases dissappear |
|
Definition
| scleroderma hardening of the skin |
|
|
Term
| slow, progressive, incurable multisystem disorder involveing hte skin and internal organs |
|
Definition
|
|
Term
| limited systemic scleroderma aka |
|
Definition
|
|
Term
| changes involved with scleroderma (3) |
|
Definition
inflammatory
vascular
sclerotic |
|
|
Term
| there is a hx of what condition with scleroderma |
|
Definition
|
|
Term
| lesions found on the trunk with scleroderma |
|
Definition
|
|
Term
| what happens in scleroderma to make the skin appear hard, shiny, with loss of mobility |
|
Definition
| proliferation of fibroblasts, excessive collagen productoin |
|
|
Term
| diffuse scleroderma will affect what |
|
Definition
|
|
Term
| small pigemnted lesions should be considered suspicious when some or all of the following are present (8) |
|
Definition
rapid growth over a few weeks/months
chanes in pigmentation
inflamed margins
irregular borders
weeping
crusting
bleeding
pruritis |
|
|
Term
| malignancy of endothelial cells that line small blood vessels |
|
Definition
|
|
Term
| clinical variations of Kaposi's sarcoma: (4) |
|
Definition
classic or european
african endemic
immunosuppression
HIV associated |
|
|
Term
| clinical variations of Kaposi's sarcoma: classic or european presentation |
|
Definition
|
|
Term
| clinical variations of Kaposi's sarcoma: african endemic |
|
Definition
|
|
Term
| clinical variations of Kaposi's sarcoma: immunosuppression |
|
Definition
| s/p chemotherapy and transplant |
|
|
Term
| clinical variations of Kaposi's sarcoma: most common in the US |
|
Definition
|
|
Term
| clinical variations of Kaposi's sarcoma: what is HIV associated d/t |
|
Definition
| immunosuppression as a result of HIV |
|
|
Term
| Kaposi's sarcoma presentation |
|
Definition
raised lesion (soft bouncy feeling)
dome dimples and erodes
ends up looking like a venous ulcer |
|
|
Term
| flat kaposi's sarcoma appearance |
|
Definition
| super shallow blisters that almost look like denuded skin, they will drain but won't go away. T cell count is in the basement |
|
|
Term
| most common form of skin cancer |
|
Definition
|
|
Term
| good thing about basal cell carcinoma |
|
Definition
| limited capacity to metstasize |
|
|
Term
| why must basal cell carcinoma be treated aggressively |
|
Definition
| extends deep destroying underlying tissue even into bone |
|
|
Term
| which areas are more suscpetible to basal cell carcinoma |
|
Definition
| sun exposed such as head, neck, and face |
|
|
Term
| physical presentation of basal cell carcinoma when it begins |
|
Definition
| small pink or flesh colored smooth translucent nodule that gets bigger slowly, center becomes depressed may then ulcerate |
|
|
Term
| basal cell carcinoma can also appear what later in its progression |
|
Definition
multicolored flat leasion
periphery that has ulcerated and bled
telangiesctasia are present
beefy red shallow irregularly shaped wound
red circle is called the ring of fire, dgenerates into a wound |
|
|
Term
| what should you look for with basal cell carcinoma |
|
Definition
| satellite lesions which would indicate the cancer's spread |
|
|
Term
| 2nd most common cutaneous malignancy |
|
Definition
|
|
Term
| which carcinoma can metastasize squamos or basal |
|
Definition
|
|
Term
| causes of squamous cell carcinoma (7) |
|
Definition
UV related
exposure to hydrocarbons, arsenic, tobbaco
chronic infections/osteomyelitis
chronic inflammation
human papilloma virus
burns (marjolins ulcer) |
|
|
Term
| unique aspect of cancerous wounds |
|
Definition
very shiny
bleed very easily when they are touched
friable |
|
|
Term
|
Definition
| aggressive ulcerating squamous cell carcinoma presenting in an area of previously traumatized chronically infallmed or scarred skin |
|
|
Term
| deadliest form of skin cancer |
|
Definition
|
|
Term
| population in which melanoma is most common in |
|
Definition
| fair skin blue or green eyes |
|
|
Term
|
Definition
| supercially on the skin, mucus membranes, even nails and eyes |
|
|
Term
| Melanoma can spread where |
|
Definition
| deep rapdily to blood/lymphatic system |
|
|
Term
| extra caution for melanoma prevention |
|
Definition
family hx
more than 50 moles on body |
|
|
Term
|
Definition
| spreads quickly but high cure rate with early detection |
|
|
Term
| idiopathic inflammatory condition characterized by collagen degeneration |
|
Definition
| necrobiosis lipica diabeticorum |
|
|
Term
| NLD patients are typically which population |
|
Definition
|
|
Term
| Necrobiosis Lipodica Diabeticorum: how do the lesions develop |
|
Definition
|
|
Term
| Necrobiosis Lipodica Diabeticorum: tx |
|
Definition
topical and intralesional steroids
skin grafting |
|
|
Term
| Necrobiosis Lipodica Diabeticorum: problem with tx |
|
Definition
| skin grafting usually does not work |
|
|
Term
| Necrobiosis Lipodica Diabeticorum: typical location |
|
Definition
|
|
Term
| Necrobiosis Lipodica Diabeticorum: recent studies with what are very encouraging |
|
Definition
|
|
Term
| fungal overgrowth which presents as red pinpoint papules frequently with satellite lesions |
|
Definition
|
|
Term
| candidiasis is caused by what |
|
Definition
| fungal overgrowth caused by candida albicans or other candida species |
|
|
Term
| candidiasis: overgrowth of normally present flora d/t (7) |
|
Definition
antibiotic therapy
diabetes
topical steroids
skin maceration/moisture
oral contraceptives
pregnancy
immune deficiencies |
|
|
Term
|
Definition
|
|
Term
| candidiasis material used to tx |
|
Definition
| intra dry = underarmour material with silver in it helps keep moisture away |
|
|
Term
| common contagious skin infection of streptococcus either/and staphylococcus |
|
Definition
|
|
Term
|
Definition
mupirocin 2% ointment
antibiotics rarely needed |
|
|
Term
|
Definition
|
|
Term
| wrappign protocol for impetigo |
|
Definition
| soak the wound and the punt neosporin on it with gauze wrapping |
|
|
Term
| systemic lupus presentation |
|
Definition
malar rash
discoid lesions
mucus membrane lesions
plaques
photosensitivity
urticaria |
|
|
Term
| where are the plaques for systemic lupus usually located |
|
Definition
|
|
Term
| discoid lupus erythematosus characteristics |
|
Definition
chronic skin condition
inflammation
scarring type skin lesions
occur on face, ears, scalp, and at times on other body areas |
|
|
Term
| discoid lupus: characteristics of the lesions |
|
Definition
watery appearance
center of which appears lighter in color surrounded by darker than normal skin
hair loss in normally hairy areas |
|
|
Term
| discoid lupus: is considered to be primarily involve the skin it can also involve what in some |
|
Definition
|
|
Term
| discoid lupus: commonly misdiagnosed as what |
|
Definition
|
|
Term
| rare autoimmune disorder in which the body produces antibodies against specific proteins in the skin and mucus membranes causing epidermal blisters |
|
Definition
|
|
Term
| where does pemphigus usually begin |
|
Definition
|
|
Term
| pemphigus can rarely be related to these 2 rx |
|
Definition
ace inhibitors
chelating agents such as penicillamine |
|
|
Term
|
Definition
|
|
Term
|
Definition
| massive doses of oral steroids |
|
|
Term
|
Definition
| pathologic inflammation leaidng to desctruction of blood vessels |
|
|
Term
| vasculitis is associated with many conditions such as (6) |
|
Definition
connective tissue disease
lupus
Wegeners granulomatosis
chemical exposure
henoch schonlein syndrome
malignancy |
|
|
Term
| physical appearance of vascultis |
|
Definition
bilateral and below knees
stocking glove appearance
palpable purpura, painful |
|
|
