PTA exam Integumentary

secondary to ischemia from inadequate circulation

inadequate functioning of the venous resulting in inadequate circulation and eventual tissue damage

pressure against the skin over a bony prominence results in localized ischemia and/or tissue necrosis

• combo ischemia and neuropathy
• well defined
• plantar surface under met heads

• lower 1/3 of leg, web spaces, toes
• smooth edges, well defined, lack granulation, deep
• severe pain
• dim or absent pedal pulses
• decreased skin temp
• thin and shiny, yellow nails, hair loss
• leg elevation increases pain

• prox to medial malleolus
• irregular shape, shallow
• mild to mod pain
• normal pulse
• increased edema
• flaking, dry skin, brownish
• leg elevation decreases pain

• removes only non-viable tissue
• Sharp
• Enzymatic
• Autolytic

• removes both viable and non-viable "mechanical"
• wet-to-dry dressings
• wound irrigation
• whirlpool/hydrotherapy

scraping away of the surface layers of the skin

• skin is not broken
• pain, swelling and discoloration

• swelling or mass of blood localized
• usually caused by a break in a blood vessel

• irregular tear or wound
• associated with trauma

enters into the interior of an organ or cavity

• made by a sharp pointed object
• through the skin into underlying tissues

lesion on the surface of the skin or of the mucous membrane produced by the sloughing of inflammatory, necrotic tissue

• Age- decreased metabolism
• Illness--often = diminshed O2 and nutrients at cell level
• Infection-impacts essential activity
• Lifestyle
• Medication

• clear, light color
• thin, watery
• normal in healthy wound

• red, thin watery
• indicative of new blood vessel growth or disruption of blood vessels

• lith red or pink
• thin, watery
• can be normal in healing wound

• opaque, yellow or tan
• thin, watery
• can be early warning sign of infection

• yellow or green
• thick, viscous
• usually infected

observable pressure related alteration of intact skin

• partial thickness skin loss of epidermis and/or dermis
• presents as an abrasion

• full thickness skin loss
• may extend down to but not through the fascia
• deep crater w/or w/o undermining

full thickness skin loss with extensive destruction, tissue necrosis or damage to supporting structures

• outer epidermis
• may be red with slight edema
• no scarring

• epidermis and upper portion of dermis
• painful
• blisters
• minimal to no scarring

• complete destruction of epidermis and majority of the dermis
• discolored w/ broken blisters
• damage to nerve endings may = only mod pain
• hypertrophic/keloids

• complete destruction to epi/dermis w/ partial damage to sub q fat layer
• grafts
• eschar
• minimal pain

• complete destruction of the epi/dermis, sub q
• may involved muscle and bone
• surgery

• head and neck 9
• anterior trunk 18
• post trunk 18
• bil ant arm/hand 9
• bil post arm/hand 9
• genial 1
• bil ant leg and foot 18
• post ant leg and foot 18
• Babies: 9% from LE and added to head, 1% each year added back

temporary taken from another human to cover large area (usually cadaver)

permanent graft from own body

temp graft from another species

only the superficial layer of the dermis with the epidermis

contains the full dermis and epidermis

• superficial
• avascular
• allows for hair follicles, sebaceous glands and sweat glands

• Vascular
• Under epidermis
• contains hair follicles, sebaceous and sweat glands