Cardio 3 2

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Author:
jld15
ID:
305715
Filename:
Cardio 3 2
Updated:
2015-07-26 08:26:14
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Cardio
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Cardio 3 2
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  1. Papillary dermis
    • Outermost layer
    • Loosely woven fibers in gelatinous matrix called ground substance
    • Blisters occur here if friction
    • Collagen and reticular fibers
    • ---Important in healing wounds
  2. Reticular dermis
    • Innermost layer
    • Connective tissue that provides increased structural support to the skin
    • Collagen that anchors it to subcutaneous tissue, fascia, muscle, and bone
  3. Epidermis Function
    • Supports and nourishes epidermis
    • infection control
    • thermoregulation
    • sensation
    • Houses epidermal appendages – Hair, Glands, Nails
  4. Subcutaneous tissue
    • Layer of loose connective tissue
    • High proportion of fat cells
    • Insulates body
    • Absorbs shock
  5. Functions of Skin
    • 1 Protection of internal structures
    • 2 Sensory perception (nerve cells inside)
    • 3 Thermoregulation
    • 4 Excretion
    • 5 Metabolism
    • 6 Absorption
    • 7 Social communication
  6. Aging
    • 50% reduction cell turnover rate
    • 20% reduction in dermal thickness
    • Reduction in dermal vasculature
    • Redistribution of subcutaneous tissue
    • Decreased number of Langerhan’s cells
    • 50% decrease in fibroblast and mast cells
    • Decreased sensation
    • Decreased # sweat glands
    • Decreased absorption through the skin
    • Decreased ability to synthesize vitamin D
  7. Ramifications for Elderly patients
    • Bruising
    • Pressure and thermal damage
    • Shears and tears
    • Hyper and hypothermia
    • Infection
    • Types of wound healing
    • Primary intention
    • Secondary intention
    • Tertiary intention
  8. Primary Intention
    • Involves reepithelialization.
    • Mostly superficial wounds involving the epidermis or wound with clean edges pulled tightly together like a surgical wound.
    • Heal in 4 – 14 days and result in minimal scarring.
  9. Secondary Intention
    • Wound that involves tissue loss - EG, pressure ulcers, burns, surgical dehisced wounds, traumatic injury
    • Edges can’t be easily approximated. Healing occurs by wound repair.
    • Classified as: *****
    • ---Partial thickness
    • ---Full thickness.
    • During healing, wound will fill with granulation tissue, scar forms, and reepithelialization occurs primarily from the wound edges.
    • Longer to heal, more complications
  10. Tertiary Intention
    • Wound deliberately left open to allow edema or infection to resolve or permit removal of exudate.
    • After this period, wound is closed by surgeon
    • More scarring than primary intention wounds, but less scarring than secondary intention wounds.
  11. Wound Healing
    • Phases overlap
    • 1. Inflammation
    • 2. Proliferation
    • 3. Maturation/remodeling
  12. Inflammation
    • ***Occurs immediately, 2-5 days in healthy individuals.
    • vasoconstriction and platelet plug to stop flow of blood
    • WBC kill bacteria nad damaged tissue
    • Mast cells produce histamine for inflammation to bring more chemical mediators here
  13. Proliferation
    • 2 days to 3 weeks depending on size
    • Angiogenesis
    • Granulation tissue formation
    • Wound contraction
    • Epithelialization
  14. Maturation/Remodeling
    • Collagen synthesis continues at a rapid rate after wound closure.
    • The wound is strengthened and reorganized to fit the surrounding tissue.
    • Remodeling continues up to 2 years with the greatest amount of change in the first 6 months to one year.
    • Wounds usually have only 80% of the skin’s original tensile strength.

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