• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/40

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

40 Cards in this Set

  • Front
  • Back
What are the phases of wound repair?
phase 1 - inflammatory phase
phase 2 fibroblastic or proliferative phase phase
phase 3 - maturatiion phase
Describe inlammatory phase
1st phase of wound healing, last 3-4 days, or 1- 7 days; aggregation of platelets and hemostasis, coagulation, release of cytokines and mediators
Describe proliferative phase
5-20 days -- collagen fibers are produced and lend strength to wound --aniogenesis, fibroplasia, woudn contraction
Describe remodeling phase
3 weeks to 2 years
deposition of matrix materials ; collagen depsiton/remodeling, reutrn to preinjury sttes; as long as the scar or past ulcer site is erythematous remodilling is occuring
What are some factors that interfere with wound healing?
age, inadquate pefusion, infection, edema, poor nutrition. vitamin and trace element deficiencies, steroieds, radiation
What are some diseases which are associated with or predispose one t chronic wounds?
Diabetes mellitus, venous stasis, collagen vascualr disease
How could you treat non-healing wounds?
debridement of necrotic tissue, control of infection, control of diabetesw mellitus, nutriitonal support, avoidance of trauma, coompression therapy, tapering of steroids, revascularization, hyperbaric oxygen, plastic reconstructive surgery
Name some synthetic absorbable multifilament sutures
Dexon-S
vicryl
Name some synthetic absorbable monofilament sutures
PDS
Maxon
Name some nonabsorbable synthetic monofilament
dermalon, ethilon (nylon) surgilene (polypropylene)
Which are more reactive multifilament or monofilament sutures
Monofilament sutures
Name some synthetic nonabsorbable multifilament sutures
ethibond, neurolon, surgilon
What is primary closure?
wound is immediately suture; must be a clean wound, good scar
What is secondary closure?
infected or dirty wounds are left open, allowed to granulate in from the bottom up, not as good a scar
What is delyared primary closure
infected or dirty wound is left open until immediate threat o infection has passed and then later the wound is closed primaryily with sutures
What is the French Theory for Charcot foot.
Neurovascular theory --
-Trophic centers in the anterior horn of the spinal cord maintain nutrition to joints.
-Trauma to these trophic centers leads to increased blood flow and osteoclastic activity.
What is the German Theory for Charcot foot
Neurotraumatic--
-Repeated trauma from biomechanical stresses during ambulation on an insensate foot.
what are the top factors that lead to cardiac emergencies
1) CHF - manifested by S3 gallop or jugular venous distention
2) rhythm - PAC's or greater than 5 PVC'/min
age - over 70 yaers
4) MI iwthin past 6th months
What do you do if a patient develops white toe after surgery. What kind of vascular problem causes this?
-place foot in dependent position -- loosen bandages -- twist he k-wire -- apply heat to small of back -- PT block -- remove the k-wire -- remove dressing, consider opening wound
caused by arterial problem
What do you do i post-op patient develops Blue toe. What kind of vascular problem cause this
elevate foot -- loosen bandage -- twist k-wire -- remove dressing -- consider opening wound
cause by venous problem.
post-op pain unresponsive to narcotic analgesi usually indicates what?
infection , hematoma, or dressing pressure
What are the 5 W's of post op fever
Wind - Atelectais, aspiratoin pneumonai, PE
Wound - infection , throbmphelbitis (IV site) , pain
Water - UTI, dehydration, constipation
Walking - DVT
Wonder drugs - any drug can casue fever
How can you treate a hematoma?
EARLY: extravasaion - pop a stitch or twon adn squeeze out the fluid
aspiration - aspriate the hematoma using a large bore needle (20 guage)
steroidinjection
woudn re-entry - remove in OR
LATE - gentle heatoe or physical therapy
What does renopathy of the optic fundi indicate
severe hypertension
What important periperative effects do steroids have?
suppression of the hypothalamsus/pituitary adrenal axis
poor wound healing
predisposition to infection
How long should asthma medicines be continued prior to surgery
up to 1.5 hours before surgery
What should yo do for the alcoholic patient befor surgery
The alcoholic pt. should have 3-4 days of rehydration, vitamins, proper diet and no alchohol prior to surgery
serum slbumin should be < 2.3 gm/dl; total lymphocytes should be <900
What pathway does heparin inhibit
intrinsic clotting pathway
Waht pathway does coumadin inhibit
extrinsic clotting pathway
what are some drugs that alter platelet function
aspiroin, NSAIDS, steroids, antihistamines, high doses of iv penicilllin (especially carbenicillin), heparin
What are the signs of von willebrand's disease andhow do you treat it
abnormal factor VIII, prolong PTT & bleeding tiem, treat wit hfresh frozen pasma
What pathway does vitamin K defiency affect?
both intrinsic and extrinsic clotting pathways
What kind of patient do you need to order cervical spin x-rays for before surgery (aside from trauma of course)
patients with rheumatoid arthritis
How does does penicillamine effect wound healing and who might be on it
penicillamine can slow wound healing and RA patient might be taking it
What factors give the most post-op cardiac complications are
S3 gallop with jugular vein distention -- MI within 6 months -- Rhythm other than sinus on pre-op ECG -- greatger than 70 years old -- premature atrial contractions -- significant aortic stenosis
How long should elective surgeryn be postpone post MI
6 monts
What are the major post-op complications for the pulmonary disease patient
atelectasis
What can you do to prevent atelectasis
use incentive spiromety pre and post op
How long do you need to D/C smokikng prior ot surgery in a pulmonary disease pt.
1 week
What patients should you administer heparin 5,000u subQ as prohylaxis for venous thromboembolic diseae
idiopathic thromophlebitis, CHF, Other diseases where venous Stasis may occur