Integumentary PT (IER Chapter 5)
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| Dermatitis (eczema) | Inflammation of the skin with itching, redness, skin lesions possibly caused by: allergies or contact dermatitis (poison ivy, chemicals, etc.), actinic (photosensitivity, UV), atopic (unknown, associated with allergy hereditary or psychological
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| Bacterial Infections: Impetigo | Superficial infection caused by staph or srept; associated with inflammation, small pus filled vesicles, itching, contagious, common in children & elderly
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| Bacterial Infections: Cellulitis | Inflammation of connective tissue in or close to the skin. Poorly defined & widespread. Skin is hot, red and edematous
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| Viral Infections: Herpes 1 (herpes simplex) | A cold sore or fever blister.
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| Viral Infections: Herpes 2 | STD
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| Viral Infections: Herpes Zoster (shingles) | Caused by chickenpox virus infecting a posterior nerve root. Pain & tingling along a dermatome. Usually with fever & chills. Heat & ultrasound contraindicated & may worsen symptoms.
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| Fungal Infections: Ringworm (tinea corporis) | Transmitted through direct contact. Involves hair, skin, or nails. Itchy & treated with antifungal drugs
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| Fungal Infections: Athletes foot (tinea pedis) | Typically between the toes; causes erythema, inflammation, itching, pain. Can progress to cellulitis if untreated.
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| Immune Disorders of the skin: Psoriasis | Chronic disease with erythematous plaques covered with a silvery scale; common on ears, scalp, knees, elbows, genitalia. Is variable with exacerbations & remissions. Itchy & pain from cracked lesions.
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| Immune Disorders of the skin: Lupus Erythematosus | Progressive inflammatory disorder of connective tissues characterized by red rash with raised, red, scaly plaques.
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| Immune Disorders of the skin: Scleroderma | Chronic diffuse disease of connective tissue causing fibrosis of skin, joints, blood vessels & internal organs. Usually accompanied by Reynaud's. Symmetrical involvement of extremities & face.
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| Immune Disorders of the skin: Polymyositis | Disease of connective tissue characterized by edema, inflammation, degeneration, and dermatitis usually associated.
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| Three Zones of Burn Wounds | Coagulation - irreversible injury & cell death; Stasis - cell injury & potential death 24-48hrs if not treated; Hyperemia - minimal cell injury, cells should recover
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| Superficial Burn (1st degree) | Damage to epidermis only. Erythema, slight edema, no blistering. Full healing in 3-7 days
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| Superficial Partial Thickness Burn (2nd degree) | Epidermis & upper layers of dermis are damaged. Blisters, inflammation & severe pain. Healing in 7-21 days.
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| Deep Partial Thickness Burn (2nd degree) | Severe damage to epidermis & dermis with injury to nerve endings, hair follicles & sweat glands. Red or white appearance, edema, blistering & severe pain. Healing occurs through scar formation in 21-28 days.
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| Full Thickness Burn (3rd degree) | Complete destruction of epidermis, dermis, and subcutaneous tissue; may extend into muscle. White, gray, or black in appearance. Dry surface, edema, eschar, & little pain. Hypertrophic scarring likely.
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| Subdermal Burn (4th degree) | Damage down to the bone from electrical burn or prolonged contact with flames. Destruction of vascular system may lead to necrosis. Requires extensive surgery & potentially amputation.
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| Rule of Nines | Head & neck (9%), Anterior trunk (18%), Posterior trunk (18%), Each Arm (9%), Each Leg (18%), Perineum (1%)
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| Burn Classification: Critical | 10% with 3rd degree, 30% with 2nd degree
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| Burn Classification: Moderate | <10% with 3rd degree, 15-30% with 2nd degree
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| Burn Classification: Minor | <2% with 3rd degree, 15% with 2nd degree
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| Allograft (homograft) | Use of other human skin such as cadaver
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| Xenograft (heterograft) | Use of skin from other species such as pig
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| Cultured skin | Lab grown from patient's own skin
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| Autograft | Use of patient's own skin
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| Split-thickness graft | Contains epidermis and upper layers of dermis from donor site
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| Full-thickness graft | Contains epidermis and dermis from donor site
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| Venous Ulcer | Over medial malleolus, normal pulses, not painful, normal or bluish coloring, normal temperature, marked edema, possible thickening of skin, wet with large amounts of exudate
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| Arterial Ulcer | Common in toes, feet and on bony areas (shins), pulses poor or absent, severe pain, intermittent claudication & pain at rest, pale/red depending on position, cool temperature, thin-shiny-atrophic skin, loss of hair on foot & toes, thick nails
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| Staging of Pressure Ulcers: Stage I | Non-blanchable erythema of intact skin.
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| Staging of Pressure Ulcers: Stage II | Partial-thickness skin loss. Presents clinically as an abrasion, blister, or shallow crater.
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| Staging of Pressure Ulcers: Stage III | Full-thickness skin loss possibly down to (but not through) fascia. Presents clinically as a deep crater.
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| Staging of Pressure Ulcers: Stage IV | Full-thickness skin loss down to muscle/bone.
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| Serous Drainage | Watery-like serum
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| Purulent Drainage | Containing pus
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| Sanguineous | Containing blood
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| Moisture-retentive (occlusive) wound dressings | Maintain a moist environment, facilitates autolytic debridement & wound healing. Utilizes dressings: alginate, tansparent film, foam, hydrogel, hydrocolloid
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| Unna Boot | Dressing with ointments: zinc oxide, calamine & gelatin. Often used for venous ulcers.
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| E-Stim for Wound Healing | Continuous direct current or high volt pulsed
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| Positioning to relieve pressure | In bed - every 2hrs, in wheelchair - pushups every 15mins
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| Transparent Films | Impermeable to water & bacteria. Used for stage I&II pressure ulcers because they promote autolytic debridement and allow visualization & protection of the wound.
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| Hydrocolloids | Adhesive wafers containing particles that interact with wound fluid to form gelatinous mass. Protects partial thickness wounds, promotes autolytic debridement, maintains a moist healing environment, impermeable to bacteria & nonadherent to healing tissue
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