common skin disorders of the integumentary system
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| What is Dermatitis (eczema) assoc. with? | inflammation of the skin, redness, itching and skin lesions
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| List 2 causes of Dermatitis | Allergic (contact dermatitis) and Actinic (photosensitivity)
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| What does the acute stage of dermatitis include | red, oozing, crusting rash, extensive erosions, and exudate
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| What does the sub-acute stage of dermatitis include | scaling, scattered plaques and erythamatous skin
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| What does the chronic stage of Dermatitis include | thick skin, marks due to scratching and postinflammatory pigmentation
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| When treating a pt with dermatitis what substance should you avoid using when utilizing some modalities | alcohol
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| Daily care for dermatitis includes what 2 things | lubrication and hydration
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| How does bacteria typically enter the body | by entering an abrasion or puncture wound
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| What 2 bacteria typically cause impetigo | staphylococci and streptococci
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| Give 4 features of impetigo | itching, inflammation, contagious, and assoc. with small pus filled vesicles
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| Cellulitis is suppurative inflamm of ________ or _________ tissue in or close to the skin | cellular, connective
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| What 2 bacteria usually cause cellulitis to form | staphylococci and strptococci
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| Describe the appearence of an area with cellulitis (5) | poorly defined, widespread, hot skin, red skin, edematous (swelled) skin
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| Is cellulitis contagious | yes, it can be
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| A person with cellulitis shouls do what 3 things to manage their condition | cool, wet dressings and antibiotics, and elevate the extremity
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| What conditions can result from untreated cellulitis (4) | lymphangitis, gangrene, sepsis, and abcess
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| What is an abcess | cavity, pus-filled, inflammed tissue
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| An abcess is the result of a ______ infection | local
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| What type of bacteria usually causes an abcess | staphylococcal
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| What 2 places is Herpes I usually found | mouth and face
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| What 2 symptoms are assoc. with herpes I | itching and soreness
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| Where is Herpes II found usually | genital
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| How is Herpes II spread | by sexual contact
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| Shingles is also known as | Herpes Zoster
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| Why does shingles happen | It is a reactiviation of the chicken pox virus lying dormant in the cerebral ganglia, or ganglia of posterior nerve roots
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| in Herpes zoster the pt. gets pain and tingling along spinal or cranial nerve ________ pattern | dermatome, it follows the infected nerve
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| What symptoms are assoc. with herpes zoster (6) | itching, soreness, fever, chills, malaise, and GI disturbances
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| The neuralgic pain from herpes zoster may last _________, ________ or ________ | weeks, months, years
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| Herpes Zoster is only contagious in people that have not had what childhood virus | chicken pox
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| What 2 modalities are contraindicated for patients with active Herpes Zoster | ultrasound and heat
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| Is there a cure for Herpes zoster | no, conservative management using steroids, and anti-viral tx's
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| What virus causes warts | HPV (human papilloma viruses)
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| How are warts contracted | through direct contact
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| What type of precautions should be used with someone who has warts | standard precautions
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| What is the management for warts | cryotherapy, acids, over-the-counter meds, electrodesication
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| Ringworm and athletes foot are 2 types of _______ infection | fungal
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| How is ringworm and athletes foot transmitted | direct contact
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| what type of precautions are used if tx'ing a pt with ring worm or athletes foot | standard precautions
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| Parasitic infections are cuased by | insect or animal contact
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| scabies is becuase of | mites that borrow into the skin
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| you treat scabies with | scabicide
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| lice is a type of _____________ infection | parasitic
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| lice are treated with | special soap or shampoo
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| how are parasitic infections transmitted | direct contact
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| what type of precautions should be used when a patient has a parasitic infection | standard
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| Name some immune disorders of the skin (4) | psoriasis, lupus, scleroderma and polumyositis
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| is psoriasis acute or chronic | chronic
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| what type of course does psoriasis run | exaccerbations and remissions
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| 3 possible causes of psoriasis (3) | hereditary, drugs, assoc. immune disorder
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| what is psoriasis treated with | corticosteroids, coal tar, methotrexate, UV light (be careful make sure patient is sensitive or allergic to UV light)
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| Lupus is a ________, and ____________ inflammatory disorder of ____________ tissue | chronic, progressive, connective
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| Name the 2 types of lupus | discoid (DLE)and systemic (SLE)
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| Describe discoid lupus (4) | only skin involvement, flares up with sun exposure, hypo/hyper pigmentation, scars b/c of lesions
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| Descibe SLE (systemic) | chronic, multiple organ systems involved, can be fatal b/c of involvemnt in the major organ systems
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| what gender does SLE occur in more men or women | women
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| Symptoms of SLE | butterfly rash, fever, malaise, chronic fatigue, skin lessions, arthralgia, arthritis, anemia, hair loss, photosensitivity, and raynaud's phenomenon (sensitivity to cold)
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| is there a cure for lupus | no
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| how do they treat lupus | corticosteroid, anti-malarials, cytotoxic agents (immunosuppressive agents), pain medicine
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| What are some side effects of corticosteroids to look for in your patients | increased risk of infection, osteoporosis, wt. gain, HTN, bruising, myopathy, tendon ruptures, diabetes, gastric irritation, and low paotassium
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| Scleroderma is a _______, _______ disease of connective tissue | chronic, diffuse (widespread)
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| What does it cause int eh skin, joints, blood vessels and internal organs | fibrosis
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| define fibrosis | taut, firm, hardening
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| In scleroderma with skin involvement is it symmetrical or assymetrical | symmetrical
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| What treatments are there for scleroderma | corticosteroids, vasodilators, analgesics, immunosuppressive agents
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| How can physical therapy affect scleroderma | slow the development of contracture and deformity
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| Scleroderma skin is ________ sensitive skin | pressure
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| Polymyositis is a disease of ________ tissue characterized by inflamm, edema, and degeneration of __________ | connective, muscles
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| What types of muscles are affected by polymyositis | proximal muscles
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| is the damage done by polymyositis symmetrical or assymetrical | symmetrrical
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| If there is cardiac muscle involvement with the patients polymyositis it can be _______ | fatal
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| too much exercise in a patient with polymyositis can cause ___________ muscle fiber ________ | additonal , muscle
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| In polymyositis ____________ and ________ ulcers can result from prolonged bedrest | contractures and pressure
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| is a basal cell carcinoma benign or malignant | malignant
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| does a basal cell carcinoma metastisize | not usually
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| A basal cell carcinoma is assoc with pronlonged _____ ___________- | sun exposure
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| is a basal cell carcinoma fast or slow growing | slow growing
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| Describe the features of a basal cell carcinoma (4) | raised patch, ivory in color, rolled border, indented center
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| Does a squamous cell carcinoma usually metastasize | yes
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| is a squamous cell carcinoma fast or slow growing | fast
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| A squamous cell carcinoma is common on _____ exposed areas | sun
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| Describe a squamous cell carcinoma (3) | flat, red, poorly defined margins
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| What is a malignant melanoma | tumor arsing from melanocytes
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| What are the clincial manifestations of a malignant melanoma? Hint ABCD's | A - assymetry, uneven edgesB - borders, irregular, poorly definedC - color, black , brown, red or whiteD - diameter, larger than 6mm
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| What are the risk factors for a malignant melanoma | intense sun exposure (repeated sun burns), family hx, people with fair skin and/or freckles
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| what is the tx for malignant melanoma | surgical resection
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| define contusion | bruise with pain, swelling, and discoloration, skin is unbroken, APPLY cold immed
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| define ecchymosis | trauma to underlying blood vessels, turns blue cuase blood enters subcutaneous tissue
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| define Petechiae | tiny hemorrhage w/in dermal/submucosal layers, pinpoint in size red or purple in color
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| define abrasion | scraping away of skin
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| define laceration | irregular tear of skin (jagged wound)
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| define Pruritus | itching
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| define urticaria | smooth, red, elevated patches of skin (hives)
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| define rash | local redness and itching
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| define xeroderma | excessive dryness
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| How many integumenatary preferred practice patterns are there | 5
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| What is pattern A for Integ | primary prevention for integ disorders
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| What is pattern B for Integ | Superficial skin involved - impaired integrity
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| What is pattern C for Integ | Partial thickness skin and scar formation - impaired integrity
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| What is pattern D for integ | Full-thickness skin and scar formaiton - impaired integrity
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| What is pattern E for integ | skin involvement extending to fascia, muscle or bone and scar formation - impaired ingteg integrirty
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| What types of modalities can you use with a broad spectrum of integumentary disorders (11) | manual lyphatic drainage, therapeutic massage, dressing and topical agents, TENS, HVPC, EMS (electrical muscle stimulation), ultrasound, phonophoresis, hydrotherapy, UV light, compression therapies
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| Name 4 types of Burns | thermal, chemical, electrical and radioactive agents
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| Name the 3 zones of a burn wound | zone of coagulation, zone of statis, zone of hyperemia
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| Name the zone assoc with cell death and irreversible cell injury | zone of coagulation
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| Name the zone assoc with cell injury, patient needs to get treatment within 24-48 hours | zone of stasis
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| Name the zone assoc with minimal cell injury and cell recovery | zone of hyperemia
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| Define a critical burn | 10% of body or more with 3rd degree burns, 30% or more with 2nd degree burns
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| Define a moderate burn | less than 10% with 3rd degree burns, 15-30% of body with 2nd degree burns
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| Define a minor burn | less than 2% with 3rd degree burns and less than 15% with 2nd degree burns
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| Rule of nines (adult) | Head and neck - 9%Ant trunk - 18%Post trunk - 18%Each arm - 9%Each Leg - 18%Perineum - 1%
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| Head, Right ant arm and front of trunk are burned what percentage of the body is burned | 31.5%
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| Left leg (ant/post), perineum, and right ant leg is burned what percentage of the body is burned | 28%
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| post trunk, perinueum and post of both legs is burned what percentage of the body is burned | 37%
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| 1st degree burn is also known as a | superficial burn
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| What is damaged in a 1st degree burn | epidermis only
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| Healing of a 1st degree burn occurs in | 3-7 days
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| A superficial burn (1st) is characterized by (3) | erythema, slight edema, tenderness (NO BLISTERS)
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| A 2nd degree burn is also known as a | superficial partial-thickness burn or Deep partial thickness burn
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| what is damaged in a sup partial thickness burn | epidermis and upper layers of dermis
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| what is a sup partial thickness burn characterized by (3) | inflammation, pain, blisters
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| how long does a sup partial thickness burn take to heal | 7-21 days
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| A deep partial thickness burn damages what structures | epidermis, dermis, and injury to nerve endings, hair follicles and sweat glands
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| what are the characteristics of a deep partial thickness burn | red/white, edema, blistering and severe pain
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| how long does a deep partial thickness burn take to heal | 21-28 days
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| full thickness burn is also known as | 3rd degree burn
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| A 3rd degree burn is what color | white, gray or black (charred)
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| is a 3rd degree burn wet or dry | dry
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| do people have pain with 3rd degree burns | no
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| What is eschar | scab or dry crust must be debrided
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| 3rd degree burns are assoc. with an increased risk of ___________ | infection
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| what is the difference b/t a hypertrophic scar and a keloid scar | BOTH are raised red and firmhypertrophic- stays w/in the borders of original burnkeloid scar - extends beyond the boundaries of the original burn
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| What is a 4th Degree burn also known as | subdermal burn
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| what is destroyed in a 4th degree burn | epidermis, dermis, subcutaneous tissues with muscle and/or bone involvement
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| What causes 4th degree burns | electrical burn, prolonged exposure to flame
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| A 4th degree burn often requires _________ or _________ | surgery or amputation
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| what is the first thing you should do in emergency burn management | immersion in cold water or cold compresses, then cover with sterile bandage (no ointments or creams)
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| What are some of the complications that can occur with a burn injury? | infection, shock, pulm complications (smoke inhalation, pneumonia, restrictive lung disease if trunk is burned), metabolic complications (wt. loss, neg nitrogen balance, decreased energy, Cardiac complications (increased fluid loss = decreased CO)
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| The Epidermis heals by | epithelization
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| the dermis heals by | scar formation (injured tissue replaced by CT)
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| Describe the inflammatory phase of healing | 3-5 days, red, edema, warmth, pain, decreased ROM
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| Describe the proliferative phase of healing | fibroblasts form scar, Wound contraction, Re-epithelization may still occur
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| Describe the maturation phase of healing | up to 2 years long, b/c scar formation can last that long, hypertrophic or keloid scar forms
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| What is sepsis | local or generalized invasion of the body by pathogenic microorganisms or their toxins
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| Asepsis and wound care - should clothing be removed | yes
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| Asepsis and wound care - should the wound be cleansed | yes
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| Asepsis and wound care - what 2 techniques are used in wound care management | open - topical anti-bacterial agents on skin with no bandageclosed - dressing on top of a topcial agent
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| Name 3 anti-bacterial topical agents typically used with burns | silver nitrate (used w/wet dressings)surface organisms only, Silver sulfadiazine, andSulfamylon penetrates through eschar
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| If you were working in the hospital with a burn victim what should be monitored | vital signs, urinary output, electrolyte levels, arterial blood gases, gastrointestinal function
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| Primary excision removes what | surgical removal of the eschar
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| A Z-plasty is a resection of a ______ contracture | scar, used to lenthen it
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| Grafts are used to _______ the wound | close
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| Autograft | use pt's own skin
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| Allograft (homograft) | another human's skin
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| Xenograft (heterograft) | skin from another species
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| biosynthetic grafts | collagen and synthetics
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| cultured skin | lab grown from pt's own skin
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| split-thickness graft | epidermis and upper layers of dermis from donor site
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| full-thickness graft | epidermis and dermis from donor site
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| ant neck splinting for burns | hyperext w/plastic cervical orthosis
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| shoulder splinting for burns | flexion, ER, ABD
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| elbow splinting for burns | extension and sup
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| hand splinting for burns | 15 deg wrist extension70 deg MCP extensionPIP and DIP extensionthumb ABD
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| Hip splinting for burns | extension, ABD, neutral rot
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| knee splinting for burns | extension w/post knee splint
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| ankle splinting for burns | df with foot in ankle neutral
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| what is the etiology of arterial ulcers | arteriosclerosis obliterans, non-healing trauma, chronic arterial insufficiency, artheroembolism
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| what is the etiology of venous ulcers | chronic venous infufficicency, venous HTN, hx of DVT, valvular incompetance
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| An arterial ulcer appears | irregular, smooth edges, DEEP wound
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| an venous ulcer appears | dark pigmented, sometimes fibrotic, shallow
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| Where does an arterial ulcer form | distal lower leg usually on toes and feet, lat malleolus, ant tibial area
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| where does on venous ulcer form | med malleolus, and distal lower leg
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| Are pedal pulses absent or present in an arterial ulcer | diminished or absent
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| Are pedal pulses absent or present in an venous ulcer | present
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| When the legs are elevated an arterial ulcer feels _______ painful and a venous ulcer feels _______ painful | more, less
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| does a venous ulcer have exudate | yes
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| Gangrene may be _________ in an arterial ulcer and _________ in a venous ulcer | present, absent
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| what are the assoc signs of a arterial ulcer | trophic changes, pallor in foot upon elevation, Rubor upon dependency
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| What are the assoc signs of venous ulcer | edema, cyanosis upon dependency (not always)
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| what is the etiology of a diabetic ulcer | DIABETES - assoc with arterial and neuropathy
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| where do diabetic ulcers usually occur | plantar aspect of foot sometimes lat malleolus
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| are diabetic ulcers painful | not usually
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| what fatal condition is assoc with diabetic foot ulcers | sepsis
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| Will the pt with a diabetic neuropathy have an ankle reflex | no, b/c of neuropathy
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| A pressure ulcer (Decub, bed sore) is caused by | unrelieved pressure resulting in ishcemic hypoxia and damage to underlying tissues
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| shearing is caused by an | external force
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| friction is caused by an | rolling or sliding over something
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| what color is a pressure ulcer | red, brown/black or yellow
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| how many stages of pressure ulcers are there | 4
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| A stage I pressure ulcer | nonblanchable erythema, pain/itching, skin may be cool or warm, tissue consitency may be firm or boggy
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| A stage II pressure ulcer | superficial ulcer involves epidermis and/or dermis, abrasion, blister
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| a stage III pressure ulcer | full-thickness skin loss may extend down to but not through underlying fascia, deep crater
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| a stage IV pressure ulcer | full thickness skin loss, extensive destruction of tissue, damage to muscle or bone or suppporting structures
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| To assess the size of a wound what 4 things should be looked at | length, width, depth, and wound area
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| what 2 tools should you use to assess area and depth | film grid, q-tip (depth)
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| What is tunneling | underlying tissue destruction beneath intact skin
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| what is serous fluid | watery-like serum
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| what is purulent fluid | contains pus
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| what is sanguinous fluid | contains blood
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| what is a red wound indicative of | healthy granulated tissue
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| what is a yellow wound indicative of | contains slough(dead tissue) is fibrous tissue
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| what is a black wound indicative | dried necrotic tissue(eschar)
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| what is an indolent ulcer | an ulcer slow to heal, not painful
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| what is a halo of erythema around a wound indicative of | cellulitis
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| What is maceration indicative of | may lead to wound deterioration or enlargement
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| what are trophic changes | wound is poorly arterially supported
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| Name some topical anti-mircrobials | silver nitrate, silver sulfadiazine, erythromycin, gentamycin, neomycin, triple antibiotic
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| Name some anti-inflammatory agents | corticosteroids, hydrocortisone, ibuprofen, indomethacin
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| Name one topic anesthetic | lidocaine
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| Describe a vacuum assisted closure | open cell foam dressing put in a wound, the subatmospheric pressure is controlled, 125mmHG, controls edema, increases blood flow, and removes infectious material
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| what is hyperbaric oxygen therapy | pt reaches 100% oxygen in a chamber with a raised atmospheric pressure, this reverses hypoxia by oversaturating oxygen in blood
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| what is Pulsatile lavage | squeezable bottle with suction to remove wound debris
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| when is a whirlpool indicated in wound care | ulcers with a lot of exudate, slough and necrotic tissue
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| what is wound debridement | removal of necrotic or infected tissue which decreases bacteria and improves wound healing
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| what is an unna boot | a pliable nonstretchable dressing impregnated with ointment
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| what types of e-stim can you use on a wound | direct current with continuous waveform, HVPC, MENS, alternating biphasic current
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| lift don't ______ | drag
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| is it best to use a transfer board in w/c transfers | yes minimize shear and friction forces
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| what is a hydrocolloid | adhesive waters that interact with wound fluid to form a gel over it
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| is a hydrocolloid semiocculsive or occlusive | both
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| what types of wounds would a hydrocolloid be good for | partial-thickness, mild-exudate, supports autolytic debridement of necrotic tissue
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| what is a hydrogel | water or glycerine based gel, insoluble in water
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| what types of wounds would a hyrdrogel be good for | partial to full-thickness, wound with necrosis, radiation burns
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| what is a foam | semipermeable membrane
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| what are the 2 types of foam | hydrophilic or hydrophobic
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| what types of wounds would a foam be good for | partial to full-thickness w/ min-mod exudate, as a 2nd layer,
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| what is an alginate | soft, absorbent which is derived from seaweed, form a viscous hydrophilic gel
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| what types of wounds would an alginate be good for | mod-large amts of exudate, exudate and necrotic wounds, wounds that need packing, infected/noninfected exudating wounds
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| gauze can be used for what 3 techniques | wet to dry, continuous dry, continous moist
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| what types of wounds would a gauze be good for | exudative wounds, wounds with dead space or tunneling, wounds with both necrotic and exudate
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| when should surgical debridement be used | cellulitis, immunocompromised pts, where an infection threatens the pts life
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You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
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Created by:
dcohen
Popular Physical Therapy sets