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195 Cards in this Set
- Front
- Back
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Ankle-brachial index
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indirect measure of peripheral perfusion, calculated as the systolic pressure of the ankle divided by the systolic pressure of the brachium. Normally .9-1.1
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Arterial insufficiency
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decreased arterial blood supply, most commonly due to arteriosclerosis
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Arteriography
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invasive procedure in which radioactive dye is used to assess blood flow
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Arteriosclerosis
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general term for thickening and hardening of arterial walls
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Atherosclerosis
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systemic, degenerative process in which the arterial lumen is gradually encroached upon by plaque formation
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Bottoming out
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occurs when there is less than 3/4 to 1 inch of support material between the patient and support surface
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Calf muscle pump
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pressure changes within the venous system in which muscle contraction forces blood proximaly
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Capillary closing pressure
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amount of external pressure that must be applied to prohibit capillary blood flow, generally 13-32 mmHg
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Capillary refill
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indicator of surface blood flow. Normally less than 3 seconds
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Cellulitis
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inflammation of connective tissue; infection in, or close to, the skin
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Compression garment
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custom or off-the-shelf compression sleeve for venous insufficiency, lymphedema, or burn scar management
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Deep veins
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located within muscles, roughly parallel arterial system
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Dermatitis
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inflammation of the skin associated with itching, redness, and open lesions
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Fibrin cuff theory
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Theory that venous insufficiency ulcers are due to the development of fibrin cuffs around the capillaries
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Hand check
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method to assess for bottoming out by placing outstretched hand palm up between the support surface and the patient
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Hemosiderin deposition
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occurs when the byproduct of the breakdown of red blood cells is forced into the interstitium by venous hypertension
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Homans' sign
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Assessment technique historically used to identify a deep vein thrombosis that has since been found to be inaccurate
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Ischemia reperfusion injury
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repeated bouts of localized tissue ischemia from pressure or peripheral arterial disease and reperfusion that may cause gradual, progressive tissue damage
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Ischemic ulcers
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arterial insufficiency ulcer
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Laplace's law
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formula describing the determinants of the amount of compression exerted by a bandage
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Ligation
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Tying off ; perforating veins may be ligated to reduce hypertension in the superficial veins
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Lipodermatosclerosis
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hyperpigmentation and accompanying erythema, indruation, and plaque-like structural changes due to long-standing venous insufficiency
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Maceration
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skin that is white, friable, overhydrated and sometimes wrinkled
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Musculocutaneous flap
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surgical procudeure used to close category/stage 3 and 4 pressure ulcers by rotating a muscle and overlying tissue along with the blood supply to fill the wound defect
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Perforating veins
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veins that pierce the fascia to connect the deep and superficial venous systems
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Plethysmography
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noninvasive medical test to assess peripheral blood flow
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Pressure ulcer
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wound caused by unrelieved pressure, or combination of pressure and shear
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Pressure-reducing device
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support surface that reduces interface pressure more than a standard hospital mattress or chair surface but not below 23-32 mm Hg
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Pressure-relieving device
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support surface that constantly reduces tissue interface pressure below 23 mm Hg
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Pruritus
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severe itching
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Reactive hyperemia
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localized area of blanchable erythema
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Rubor of dependency
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test to assess arterial blood flow
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Static support surface
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nonmoving pressure-reducing device that provides cushioning and pressure distribution
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Tissue interface pressure
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the amount of pressure between a body part and support surface
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Venography
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invasive procedure in which radioactive dye is used to assess venous blood flow
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Venous hypertension
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increased backward pressure within the venous system
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Venous stasis ulcer
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ulcer caused by venous insufficiency
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Granuloma
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chronic inflammation around a foreign body
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Hydrogels
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Moisture-retentive occlusive wound dressing that is 80-99% water or glycerin based, available in sheets and as an amorphous gel
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Composite dressings
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multilayer dressings made from a combination of wound dressing categories
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moisture barriers
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substance used to protect the periwound and intact sin from excessive moisture. Some moisture barriers are also safe for use on rashes and broken skin
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primary dressing
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wound covering that comes into direct contact with the wound bed
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secondary dressing
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wound dressing placed over the primary dressing that provides increased protection, cushioning, absorption, and/or occlusion
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moisture-retentive dressings
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specialized synthetic or organic wound dressing
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hydrocolloid
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moisture-retentive occlusive wound dressing consisting of gelatin, pectin, and carboxymethylcellulose hydrophillic particles with an adhesvie backing
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Abscess
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localized collection of pus within body tissues
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Aerobes
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bacteria that require oxygen to survive
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Anaerobes
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bacteria that cannot survive in oxygen-rich environment
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Antibiotics
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oral or intravenously delivered substance that destroys or inhibits the growth of microorganisms
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Antifungal
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type of antimicrobial that destroys yeast and molds
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Antimicrobial
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substance that destroys or inhibits the growth of microorganisms
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Autolytic debridement
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form of debridement that uses endogenously produced enzymes to digest necrotic tissue
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Bactericidal
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antimicrobial agent that is capable of killing bacteria
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Bacteriostatic
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antimicrobial agent that inhibits bacterial cell growth
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Biofilms
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communities of microorganisms that are attached to a wound surface and encased with a glycocalyx
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Biologic debridement
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the use of sterile maggots to debride a wound
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colonization
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normal presence of small number of microbes (less than or equal to 10 to the third organisms/gram of tissue)
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contamination
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presence or anticipated presence of blood, wound fluid, or other potentially infectious waste
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critical colonization
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point at which increasing wound bioburden begins to adversely affect wound healing
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eschar
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Black necrotic tissue that may be either soft or hard.
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induration
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Firm edema
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infection
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invasion and multiplication of microorganisms within body tissues; wound culture reveals greater than 10 to the fifth microbes per gram of tissue
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mechanical debridement
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form of debridement using force to remove devitalized tissue, foreign material, and debris from a wound bed
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pitting edema
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Swelling in which a depression remains within the involved tissue after the application of digital pressure
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resistive
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if a bacteria cannot be killed by certain antimicrobial
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selective debridement
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removal of specific areas of devitalized tissue; may include sharp, enzymatic, or autolytic debridement
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sensitive
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if a bacteria can be killed by a certain antimicrobial
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sharp debridement
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selective debridement using forceps, scissors, or scalpel
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slough
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Necrotic tissue that is yellow or tan in color and has a stringy or mutinous consistency.
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tunneling
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A narrow passageway within a wound bed
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undermining
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Area of tissue under the wound edges that becomes eroded, resulting in a large wound with a small opening
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Abrasion
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Wound caused by scraping or friction to the skin's surface.
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Angioblasts
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Endothelial cell that lines vessel walls.
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Angiogenesis
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Formation of new blood vessels
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Chemotactic Agents
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Substance that attracts cells.
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Chemotaxis
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Movement along a chemical gradient.
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Closed Wound
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A wound in which the epithelial integrity has been restored.
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Collagenase
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Enzyme that breaks down collagen.
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Contracture
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Pathological shortening of scar tissue resulting in a deformity.
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Current of injury
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Local change of polarity at the site of integumentary injury.
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Cyotkines
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Signaling protein during the inflammatory phase of wound healing.
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Cytotoxic Agents
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Substance that is poisonous to human cells.
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Dehiscence
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Separation of wound margins.
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Delayed primary closure
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A combination of primary and secondary wound healing processes in which the wound is first observed before primary closure.
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Diapedesis
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The movement of PMNs through capillary walls.
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Epibole
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Keratinocyte migration over the lip or margin of the dermis
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Epithelialization
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Process by which keratinocytes resurface the wound defect
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Exudate
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Mixture of fluid, high levels of protein, and cells
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Fibroblast
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Dermal cell that produces collagen, elastin, granulation tissue, and growth factors.
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Granulation Tissue
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Temporary structure composed of vascularized connective tissue that fills the wound void.
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Growth Factors
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Growth promoting substance that increases or enhances cell size, proliferation, or activity.
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Healed Wound
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A closed wound with tissue strength approaching normal.
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Histamine
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Chemical mediator released by mast cells that causes vasodilation, increases vessel wall permeability, and attracts other cells to the area.
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Hypergranulation
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Error of proliferative phase in which too much granulation tissue is formed and epithelialization is delayed.
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Hypertrophic Scarring
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Overproduction of collagen that stays within the confines of the original wound.
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Hypogranular
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A pothole-type wound that fails to build a sufficient granulation tissue matrix.
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Inflammation
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First phase of wound healing, characterized by rubor, calor, tumor, dolor, and functiolaesa; vascular and cellular response to injury of living tissue.
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Integrins
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Cell surface receptors that allow cells to reversibly bind to extracellular matrix.
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Keloids
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Scar due to the overproduction of collagen that extends beyond the confines of the original wound.
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Macrophages
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Cell that directs the repair process, secretes growth factors and enzymes, and destroys bacteria and debris.
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Margination
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When PMNs are pushed to the sides of a vessel wall.
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Mast Cells
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Cell that helps initiate inflammation; secretes histamine, enzymes, and chemical mediators.
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Matrix Metalloproteases (MMPs)
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Proteases that degrade the extracellular matrix.
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Maturation/Remodeling
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Final phase of wound healing during which collagen matures and reorients along the lines of stress.
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Myofibroblasts
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Cell possessing properties of fibroblasts and smooth muscle cells that cause wound contraction.
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Platelets
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Cell that helps control bleeding; releases growth factors and chemotactic agents.
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Polymorphonuclear Neutrophils (PMNs)
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Cell that cleans the wound; secretes enzymes and inflammatory mediators.
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Primary Closure
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Process by which wound heal if the wound margins can be approximated.
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Proliferation
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Second phase of wound healing; building and regenerating phase consisting of angiogenesis, granulation tissue formation, wound contraction, and epithelialization.
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Prostaglandins
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Substance released by injured cells that cause vasodilation.
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Scab
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Collection of necrotic cells, fibrin, collagen, and platelets that covers a superficial wound.
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Secondary Closure
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Wound healing process in which granulation tissue is formed to fill the wound defect.
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Tissue inhibitors of matrix metalloproteases (TIMPs)
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Proteases that regulate the activity of MMPs
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Transudate
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Low-protein collection of fluid caused by increased vascular permeability.
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Wound Contraction
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Process by which myofibroblasts pull wound margins closer together, thereby decreasing the size of the defect
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Neuropathic Ulcer
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Ulcer due to insensitivity; previously referred to as a diabetic ulcer
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Sensory Neuropathy
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Dysfunction of sensory nerves leading to altered or decreased sensation
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Motor Neuropathy
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Dysfunction of motor nerves leading to atrophy, weakness, and/or paralysis
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Autonomic Neuropathy
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Dysfunction of the autonomic nervous system that may result from uncontrolled diabetes
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Charcot Foot
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Neuropathic fracture/dislocation found in patients with diabetes, most commonly resulting in a "rocker bottom" foot deformity
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Total Contact Cast
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Modified short leg cast used to treat uninfected grade 1 or 2 plantar neuropathic ulcers
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Walking Splint
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Bivalved total contact cast used to treat neuropathic ulcers
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Incision and Drainage
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Procedure in which an abscess is surgically opened and thoroughly irrigated
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Superficial Burn
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Also called first-degree burn; involves only the epidermis
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Full-Thickness Burn
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Also called third-degree burn; involves damage of the epidermis and dermis to the subcutaneous tissue
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Subdermal Burn
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Also called fourth-degree burn; results in destruction beyond the dermis down to fat, muscle, tendon, and/or bone
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Rule of Nines
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Method estimated burn size as a percent of total body surface area by dividing the body into sections roughly equal to 9% of total body surface area
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Lund-Browder Classification
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Alternate method to the rule of nines for estimating burn size as a percent of total body surface area. This method takes into consideration age-related changes in body proportions
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Zone of Coagulation
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Central portion of a burn injury that sustains irreparable damage
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Zone of Stasis
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Area of a burn injury surrounding the zone of coagulation that consists of cellular injury and compromised tissue perfusion
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Conversion
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Process of widening and deepening of a burn injury
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Zone of Hyperemia
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Outer edge of a burn injury. Generally heals within 7 to 10 days
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Burn Shock
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Complex clinical syndrome that occurs when perfusion is unable to meet tissue demands after a burn injury
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Escharotomy
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Surgical incision through burn eschar to relieve pressure and restore perfusion
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Fasciotomy
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Surgical incision through fascia to release pressure and restore perfusion
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Lymph capillaries
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The smallest vessels within the lymphatic system, highly permeable
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Anastomosis
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Connection between vessels
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Lymphatic load
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Material that is transported within the lymphatic system
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Dynamic insufficiency
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When lymph transport is unable to accommodate for an increase in lymphatic load. Term can also be applied to the venous system
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Mechanical insufficiency
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When the lymphatic system is unable to transport the normal amount of lymph due to a functional failure of the system. Term can also be applied to the venous system
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Transport capacity
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The ability of the lymphatic system to move fluid
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Primary lymphedema
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Congenital malformation or impairment of the lymphatic system resulting in an accumulation of protein-rich fluid
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Secondary lymphedema
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Disruption or damage to the lymphatic system resulting in an accumulation of protein-rich fluid
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Filariasis
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Form of secondary lymphedema caused by the bite of an infected mosquito
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Elephantiasis
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Severe disfiguring form of lymphedema caused by filariasis
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Lipedema
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Bilateral, symmetrical increase in adipose tissue deposition in the abdomen, buttocks, and lower extremities with sparing of the feet
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Sentinel lymph node
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The first lymph node receiving lymph from a given area, usually a tumor
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Seroma
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The accumulation of serum within the tissue, generally localized into a pocket created by surgery
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Papilloma
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Cauliflower-like projects of the epithelium caused by distended and dilated superficial lymphatics
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Stemmer’s sign
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Inability to pinch a skin fold on the dorsal aspect of a digit. Presence confirms lymphedema in this area
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Acute Wound
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A wound induced by surgery or trauma in an otherwise healthy individual.
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Chronic Wound
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A wound, induced by various causes, whose progression through the phases of wound healing is prolonged or arrested due to underlying conditions.
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Colonization
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Normal presence of a small number of microbes
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Infection
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Invasion and multiplication of microorganisms within body tissues.
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Maceration
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Skin that is white, friable, over-hydrated, and sometimes wrinkles.
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Necrotic Tissue
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Dead, devitalized tissue adhered to the wound bed.
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Adipose Tissue
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Vascular, loose connective tissue that stores fat and provides energy, cushioning, and insulation
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Basement Membrane
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Thin, acellular layer separating the epidermis from the dermis
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Blisters
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Collection of fluid at the junction between the dermis and epidermis due to friction.
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Callus
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Localized buildup of stratum corneum cells due to pressure or friction.
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Collagen
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Fibrous protein connective tissue.
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Dermal Papillae
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The ridges and valleys of the superior surface of the dermis that conforms with the contours of the epidermal stratum basale to help anchor the two layers together.
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Elastin
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Connective tissue protein that is highly extensible
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Epidermis
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Outer, avascular layer of skin
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Fascia
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Fibrous connective tissue that separates and surrounds structures and facilitates movement between adjacent structures
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Fibroblasts
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Dermal cell that produces collagen, elastin, granulation tissue, and growth factors.
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Full-Thickness Wound
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Wound that extends through the epidermis and dermis and into or through the subcutaneous tissue.
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Hair
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Epidermal appendages located within the dermis that are made of soft keratin
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Histamine
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Chemical mediator released by mast cells that causes vasodilation, increases vessel wall permeability, and attracts other cells to the area.
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Keratin
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A protein produced by keratinocytes. Nails are made of hard keratin; hair is made of soft keratin
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Keratinocytes
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Epidermal cell that resurfaces a wound and produces keratin
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Langerhans' Cells
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Epidermal cells that assist with infection control
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Macrophages
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Cell that directs the repair process, secretes growth factors and enzymes, and destroys bacteria and debris
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Mast Cells
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Cell that helps initiate inflammation; secretes histamine, enzymes, and chemical mediators
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Melanin
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Pigment produced by melanocytes that helps protect the body from ultraviolet radiation and is a major determinant of skin color.
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Melanocytes
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Pigment producing cells within the epidermis.
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Merkle Cells
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Sensory receptor within the epidermis proving information on light touch.
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Nails
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Epidermal appendage made of hard keratin and located at the dorsal tips of digits.
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Open Wound
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Damage to the skin resulting in a loss of skin integrity.
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Papillary Dermis
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Thin superficial dermal layer consisting of loosely arranged connective tissue
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Partial-Thickness Wound
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Wound involving the epidermis and part of the dermis.
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Phagocytizing
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Process of engulfing and destroying bacteria and debris.
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Rete Pegs
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Protrusions of the epidermal stratum basale that extend into the papillary dermis to help anchor the two layers together.
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Reticular Dermis
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Thick, deep dermal layer consisting of dense, irregularly arranged connective tissue.
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Sebaceous Gland
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Oil gland; epidermal appendage located within the dermis.
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Sebum
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Oily substance that lubricates the skin and hair.
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Stratum Basale
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Deepest epithelial layer; contains continuously dividing cells.
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Stratum Corneum
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Outermost epithelial layer; consists of dead keratinocytes.
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Stratum Granulosum
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Epithelial cell layer located between the stratum spinosum and stratum lucidum.
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Stratum Lucidum
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Epithelial cell layer located between the stratum granulosum and stratum corneum.
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Stratum Spinosum
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Epithelial cell layer located between the stratum basale and stratum granulosum
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Subcutaneous Tissue
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Composed of adipose tissue and fascia; located beneath the dermis; helps support the skin.
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Sudoriferous Glands
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Sweat gland; epidermal appendage located within the dermis
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Superficial Wound
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Wound involving only the epidermis.
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White Blood Cells
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Cell that helps fight infection.
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