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IER Chapter 5

Integumentary PT (IER Chapter 5)

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
Bacterial Infections: Impetigo Superficial infection caused by staph or srept; associated with inflammation, small pus filled vesicles, itching, contagious, common in children & elderly
Bacterial Infections: Cellulitis Inflammation of connective tissue in or close to the skin. Poorly defined & widespread. Skin is hot, red and edematous
Viral Infections: Herpes 1 (herpes simplex) A cold sore or fever blister.
Viral Infections: Herpes 2 STD
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.
Fungal Infections: Ringworm (tinea corporis) Transmitted through direct contact. Involves hair, skin, or nails. Itchy & treated with antifungal drugs
Fungal Infections: Athletes foot (tinea pedis) Typically between the toes; causes erythema, inflammation, itching, pain. Can progress to cellulitis if untreated.
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.
Immune Disorders of the skin: Lupus Erythematosus Progressive inflammatory disorder of connective tissues characterized by red rash with raised, red, scaly plaques.
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.
Immune Disorders of the skin: Polymyositis Disease of connective tissue characterized by edema, inflammation, degeneration, and dermatitis usually associated.
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
Superficial Burn (1st degree) Damage to epidermis only. Erythema, slight edema, no blistering. Full healing in 3-7 days
Superficial Partial Thickness Burn (2nd degree) Epidermis & upper layers of dermis are damaged. Blisters, inflammation & severe pain. Healing in 7-21 days.
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.
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.
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.
Rule of Nines Head & neck (9%), Anterior trunk (18%), Posterior trunk (18%), Each Arm (9%), Each Leg (18%), Perineum (1%)
Burn Classification: Critical 10% with 3rd degree, 30% with 2nd degree
Burn Classification: Moderate <10% with 3rd degree, 15-30% with 2nd degree
Burn Classification: Minor <2% with 3rd degree, 15% with 2nd degree
Allograft (homograft) Use of other human skin such as cadaver
Xenograft (heterograft) Use of skin from other species such as pig
Cultured skin Lab grown from patient's own skin
Autograft Use of patient's own skin
Split-thickness graft Contains epidermis and upper layers of dermis from donor site
Full-thickness graft Contains epidermis and dermis from donor site
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
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
Staging of Pressure Ulcers: Stage I Non-blanchable erythema of intact skin.
Staging of Pressure Ulcers: Stage II Partial-thickness skin loss. Presents clinically as an abrasion, blister, or shallow crater.
Staging of Pressure Ulcers: Stage III Full-thickness skin loss possibly down to (but not through) fascia. Presents clinically as a deep crater.
Staging of Pressure Ulcers: Stage IV Full-thickness skin loss down to muscle/bone.
Serous Drainage Watery-like serum
Purulent Drainage Containing pus
Sanguineous Containing blood
Moisture-retentive (occlusive) wound dressings Maintain a moist environment, facilitates autolytic debridement & wound healing. Utilizes dressings: alginate, tansparent film, foam, hydrogel, hydrocolloid
Unna Boot Dressing with ointments: zinc oxide, calamine & gelatin. Often used for venous ulcers.
E-Stim for Wound Healing Continuous direct current or high volt pulsed
Positioning to relieve pressure In bed - every 2hrs, in wheelchair - pushups every 15mins
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.
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
Created by: carsonwolf