Pta Boards Other Sysyems

Front 1

a

Back 1

a

Front 2

b

Back 2

b

Front 3

c

Back 3

c

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artierial insufficiency ulcers

prt 1

Back 4

▪location

Lower one-third of leg, toes, web spaces (distal toes, dorsal foot, lateral maleolus)

▪AppearanceSmooth edges, well defined; lack granulation tissues tend to be deep

▪Minimal Exudate

▪Pain Severe

▪Diminished or absent Pedal Pulses

p1

Front 5

arterial insufficientcy ulcers

prt2

Back 5

edema normal

skin temp decreased

tissue change thin and shiny, hair loss, yellow nails

misc leg elevation increases pain

prt2

Front 6

venous insufficiency ulcers

prt 1

Back 6

location proximal to medial malleolus

appears irregular shape and shallow

moderate/heavy exudate

mild to mod pain

normal pedal pulse

prt1

Front 7

venous insufficiency ulcers

prt2

Back 7

edema increased

skin temp normal

tissue change flaking dry skin brownish discoloration

misc leg elevation decreases pain

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neuropathic ulcers

prt 1

Back 8

location areas of the foot susceptible to pressure or shear forces during weight bearing

appearance well defined oval or circle, callused rim, cracked periwound tissue, little to no wound bed necrosis with good Granulation

low/mod exudate

pain none, however dysesthesia may be reported

pedal pulse Diminished or absent, unreliable ankle brachial index with diabetes

Front 9

neuropathic ulcers

prt

2

Back 9

edema normal

skin temp decreased

tissue change dry, inelastic, shiny skin, decreased ir absent sweat and oil production

misc loss of protective sensation

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pressure ulcer staging

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stage 1

stage 2

stage 3

stage 4

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Front 11

hydrocolloids

Back 11

gel forming polymers varies permeability absorbs exudate into a gel like mass

does not attach to wound but intact skin

indication

useful for partial and full-thickness wounds. The dressings can be used effectively with granular or necrotic wounds

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hydrocolloids

advantages

Back 12

Advantages Provides a moist environment for wound healing Enables autolytic debridement Offers protection from microbial contamination Provides moderate absorption Does not require a secondary dressing Provides a waterproof surface

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hydrocolloids disadvantages

Back 13

Disadvantages May traumatize surrounding intact skirn upon removal May tend to roll in areas of excessive friction Cannot be used on infected wounds

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Hydrogels Hydrogels

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consist of varying amounts of water and gel-forming materials such as glycerin The dressings are available in sheet form or amorphous form

Indications: moisture retentive and commonly used on superficial and partial-thickness wounds (e.g. abrasions blisters, pressure ulcers) ,that have minimal drainage

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hydrogels

advantages

Back 15

. Provides a moist environment for wound healing

. Enables autolytic debridement

. May reduce pressured and diminish pain

. Can be used as a coupling agent for ultrasound

. Minimally adheres to wound

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hydrogels

disadvantages

Back 16

Disadvantages Potential for dressings to dehydrate

Cannot be used on wounds with significant drainage

Typically requires a secondary dressing.

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Foam dressings

Indiations:

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hydrophilic dressing, allows exudate to be absorbed into foam

Indiations:

are used to provide protection and absorption over partial and full-thickness wounds with varying levels of exudate. They can also be used as secondary dressings over amorphous hydrogels

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foam dressing

advantages

Back 18

Advantages

Provides a moist environment for wound healing

Available in adhesive and non- adhesive forms

Provides prophylactic protection and cushioning

Encourages autolytic debridement

Provides moderate absorption

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foam dressing disadvantages

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Disadvantages May tend to roll in areas of excessive friction

Adhesive form may traumatize periwound area upon removal

Lack of transparency makes inspection of wound difflcult

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transparent film

Back 20

thin membranes made from"transparent polyurethane

dressings are permeable to vapor and oxygen, but are largely impermeable to bacteria and water. They are highly elastic, allow easy visual inspection of the wound

indications: are useful for superficial wounds (Scalds and abrasions lacerations) or partial thickness wounds with minimal drainage

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transparent film

advantages

Back 21

Advantages

▪Provides a moist environment for wound healing

▪Enables autolytic debridement

▪Allows visuaiization of the wounds;

▪Resistant to shearing and frictional forces

▪Cost effective over time

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transparent film

disadvantages

Back 22

Disadvantages Excessive accumulation of exudates can result in periwound maceration

Adhesive may traumatize periwound area upon removal

Cannot be used on infected wounds

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gauze

Back 23

Indications:

commonly used on infected or nonInfected wounds of any sized

the dressings can be used for wet-to-wet, wet-to-moist or wetto-dry debridement:

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gauze advantages

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Advantages Readily available, cost effective dressings

Can be used alone or in combination with other dressings or topical agents

Can modify number of layers to accommoilate for changing wound status

Can be used on Infected or non-infected wounds

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gauze

disadvantages

Back 25

Disadvantages

▪Has a tendency to adhere to wound bed

▪Highly permeable and therefore requires frequent dressing changes (prolonged use decreases cost effectiveness)

▪Increased infection rate compared to occlusive dressings

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alginates

Back 26

consist of calcium salt of actinic acid from seaweed.

highly permeable and non occlusive

require secondary dressings

Indications: typically used on partial and full-thickness draining wounds such as, pressure wounds or Venous insufflidiency vulcers.

are often used on infected wounds dueto the likelihood of excessive drainaget

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Alginates

advantages

Back 27

Advantages

▪High absorptive capacity :

▪Enables autolytic debridement Offers

▪protection from Microbial contamination

▪Can be used on infected or non-infected wounds

▪Nonadhering to wound

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alginates

disadvantages

Back 28

Disadvantages

▪May require frequent dressing changes based on level of exudate

▪Requires a secondary dressing

▪Cannot be used on wounds with an exposed tendon, joint capsule or bone

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debridement

red yellow black system

Back 29

Red

Wound Description: Pink granulation tissue

Goals: Protect wound; maintain moist environment

Yellow

Wound Description: Moist yellow slough

Goals: Remove exudate and debris, absorb drainage

Black

Wound Description: Black, thick eschar firmly adhered

Goals: Debride necrotic tissue

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rule of 9

9%

Back 30

head neck,

bilateral anterior arm forearm and hand,

bilateral anterior arm forearm and hand,

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rule of 9

18

Back 31

anterior trunk

posterior trunk

bilateral anterior leg and foot

bilateral posterior leg and foot

(genital is 1%)

Front 32

burn area

deformity and splint type

Back 32

extension causes discomfort will bend Into burn (gen flex, add)

splinting will prevent this motion to decrease contracture

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Front 33

hypothalamus pathology

Back 33

hypothalamus Dysfunction

Hypothalamus tumors (e.g., ependymomas)

Inflammatory processes (e.g.,sarcoidosis)

Trauma (e.g., skull fracture)

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pituitary pathology

Back 34

Hypopituitarism:

This condition occurs when there is a decreased or absent hormonal secretion from the anterior pituitary gland. Typical disorders may include short stature (dwarfism), delayed growth and puberty, sexual and reproductive disorders, and diabetes insipidus.

Hyperpituitarism: This condition occurs when there is an excessive secretion of one or more hormones under the pituitary gland's control.

Disorders and symptoms are dependent on the hormone(s) that are affected. Some disorders include gigantism or acromegaly, hirsutism, amenorrhea, infertility, and impotence

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Thyroid Pathology

Back 35

Hypothyroidism:

This condition occurs when there are decreased levels of thyroid hormones in the bloodstream slowing metabolic processes. Symptoms may include fatigue, weakness, weight gain, delayed puberty, and retarded growth and development

Hyperthyroidism:

This condition occurs when there are excessive levels of thyroid hormones in the bloodstream.:

Graves' disease is a common form of hyperthyroidism. Symptoms can include an increase in nervousness, excessive sweating, weight loss, increase in blood pressure, exophthalmos, myopathy, chronic periarthritis, and an enlarged thyroid gland

p182

Front 36

parathyroid pathology

Back 36

Hypoparathyroidism: This condition occurs due to hyposecretion or low-level production of parathyroid hormone by the parathyroid gland. Symptoms may include hypocalcemia, neurological symptoms such as seizures, cognitive defects, short stature, tetany, muscle pain, and cramps.

Hyperparathyroidism:

This condition occurs due to excessive levels of hormone production by the parathyroid gland that leads to disruption of calcium, phosphate, and bone metabolism. Symptoms may include renal stones and kidney damage, depression, memory loss, muscle wasting, bone deformity, and myopathy.

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Front 37

adrenal pathology

Addison's Disease

Back 37

is a form of adrenal dysfunction that presents with hypofunction of the adrenal cortex Subsequently there is decreased production of both cortisol (glucocorticoid) and aldosteron (mineralocorticoid).

Etiology

-When the adrenal Cortex produces insufflicient cortisol and aldosterone hormones it is termed Addison's disease

Signs and symptoms

- Symptoms include a widespread metabolic dysfunction secondary to cortisol deficiency as welI as fluid and electrolyte imbalances secondary to aldosterone dysfunction. The person may experience hypotension, weakness, anorexia, weight loss, altered pigmentation, and if left untreated this condition will result in shock and possible death.

Treatment

- Treatment primarily consists of long-term pharmacological intervention using synthetic corticosteroids and mineralocorticoids.

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adrenal pathology

Cushing's Syndrome

Back 38

is a form of adrenal dysfunction that, prents with hyper functionthe adrenal gland, allowing for excessive amounts of cortisol (glucocorticoid) production.

Etiology

- When the pituitary gland produces excessive ACTH with subsequent hypercoirtisolism, it is termed Cushing's syndrome

Signs and symptoms

- Symptoms evolve over years and can include persistent hyperglycemia, growth failure, truncal obesity, purple abdominal striae, "moon shaped face" "buffalo hump" posteriorly at the base of the neck, weakness, acne, hypertension, and male gynecomastia. Mental changes can include depression, poor concentration, and memory loss.

Treatment

-Treatment may include pharmacological intervention to block the production of the hormones, radiation therapy, chemotherapy or surgery

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pancreas

pathology

Type I Diabetes Mellitus (DM)

Back 39

occurs when the pancreas fails to produce enough or any insulin. This form is normally diagnosed in childhood, but can occur at any age. It is also known as insulin-dependent diabetes or juvenile diabetes Etiology The exact cause is unknown, but genetic predisposition in combination with exposure to a viral or environmental trigger is believed to cause an immune reaction that damages the pancreas with subsequent failure in secretion of endogenous insulin

Signs and symptoms

Symptoms of DM include a rapid onset of symptoms, polyphagia, weight loss, ketoacidosis, polyuria, polydipsia, blurred vision, dehydration, and fatigue

Treatment

Management includes exogenous insulin injections that are required to maintain proper glucose blood levels and avoid complications. Proper nutritional management is also required for blood glucose control, Insulin pumps may be indicated for continuous administration of insulin. Presently, there is no cure and as a result,the goal is to control the regulation of blood glucose levels

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Pancreas Pathology Type 2 Diabetes Mellitus (DM)

Back 40

typically occurs in the population over the age of 40, however, there has been an increase in children diagnosed secondary to a rise in childhood obesity. This form of DM typically retains the ability to produce some endoqenous insulin. i;

Etiology

- occurs secondary to an array of dysfunctions resulting from. the combination of resistance to insulin action and inadequate insulin secretion. This disorder is characterized by hyperglycemia when the body cannot properly respond to insulin. Obesity is found to contribute to this condition by increasing insulin resistance

Signs and symptoms

-Symptoms are relatively the same as with type 1 , however, ketoacidosis does not occur since insulin is still typically produced

Treatment

- Treatment includes blood glucose control through diet, exercise, oral medications or insulin injections when necessary.

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Type I Diabetes Mellitus

Back 41

▪Onset usually less than 25 years of age

▪Abrupt onset

▪5-10% of all cases

▪Etiology: destruction of islets of Langerhans cells secondary to possible autoimmune or viral causative factor

▪Insulin production: very little or none

▪Ketoacidosis can occur

▪Treatment includes insulin injection, exercise and diet

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Type 2 Diabetes Mellitus

Back 42

▪Onset: usually older than 40 years of age

▪Gradual onset

▪90-95% of all cases;

▪Etiology: resistance at insulin receptor sites usually secondary to obesity ethnic prevalence

▪Insulin production: variable

▪Ketoacidosis will rarely occur

▪Treatment includes weight loss, oral insulin, exercise, and diet

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bone mineral regulating agents

Back 43

▪Action: enhance and maximize bone mass as well as prevent bone loss or rate of bone resorption

▪Indications: Paget's disease; osteoporosis; hyperparathyroidism; rickets; hypoparathyroidism; osteomalacia

▪Side effects: gastrointestinal distress, dyspepsia, dysphagia, anorexia, bone pain, arrhythmias '

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Hormone Replacement Agents

Back 44

▪Action: restore normal endocrine function when endogenous production of a hormone is deficient or absent

▪Indications: decrease in endogenous hormone secretion

▪Side effects: (vary by agent)

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Antacid Agents

Back 45

Action:

chemically neutralize gastric acid and increase intragastric pH

Indications: episodic minor gastric indigestion or heartburn peptic ulcers gastroesophageal reflux disease

Side effects: acid rebound phenomenon, constipation or diarrhea, electrolyte imbalances, may affect metabolism of other medications

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Proton Pump Inhibitor Agents

Back 46

Action:

inhibit the H+/K+ ATPase enzyme and block acid secretions from gastric cells into the stomach

Indications:

dyspepsiai, gastroesophageal reflux disease,

Side effects:

acid rebound phenomenon with discontinuation of agent

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urinary incontinence

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Stress Urinary Incontinence (SUI) SUI is the loss of urine due to activities that increase intra-abdominal pressure such as sneezing, coughing, laughing, running, and jumping

Urge Urinary Incontinence (UUI) UUI is the loss of urine after a sudden, intense urge to valid due to the detrusor muscle of the bladder involuntarily contracting during bladder filling

Overflow Urinary Incontinence (OUI) OUI is the loss of urine when the intra-bladder pressure exceeds the urethra's capacity to remain closed due to urinary retention.

Functional Urinary Incontinence (FUI) FUI is the loss of urine due to the inability or unwillingness of a person to use the bathroom facilities prior to involuntary bladder release