What is the extracellular matrix in the dermis made of?

Sugars, protein, collagen, and elastin

Blood vessels, lymphatics, and epithelial cells

Fibroblasts, macrophages, and mast cells

Connective tissue, adipose, and nerves

Sugars, protein, collagen, and elastin

* The extracellular matrix is made of sugars, protein, collagen, and elastin.

Which choice BEST describes the function of tendons?

Attaches bone to bone

Connects muscle to bone

Provides a surface for bones to glide over

Surround muscles to reduce friction

Connects muscle to bone

* Tendons are fibrous connective tissues that have the specific function of connecting muscles to bones.

What BEST describes the characteristics of healthy skeletal muscle?

White and shiny in appearance

Pearly white ribbon-like appearance

Pink to dark red in color with striation

Pale pink without striation

Pink to dark red in color with striation

* When healthy healthy skeletal muscle is characterized by a pink to dark red color and is firm with striation.

What is the primary composition of fascia?

Adipose tissue

Collagen

Keratin

Muscle tissue

Collagen

* Fascia is a sheath of connective tissue that is primarily composed of collagen.

Which component of blood is PRIMARILY involved in forming the INITIAL phase of a blood clot?

Red blood cells

White blood cells

Platelets

Eosinophils

Platelets

* Platelets are crucial in the initial phase of blood clotting, as they create a platelet plug at the site of injury.

What role does melanin play in protecting the skin from ultraviolet radiation?

Creates a physical barrier by scattering and absorbing UV rays

Increases transepidermal water loss to cool the skin

Creates a protective film called the acid mantle

Stimulates sweating to enhance evaporation and subsequent cooling

Creates a physical barrier by scattering and absorbing UV rays

*Melanin protects against ultraviolet radiation by scattering and absorbing UV rays, creating a barrier that decreases the amount of UV penetration.

What type of wound closure is described as allowing the wound to heal without approximating the edges?

Primary intention

Secondary intention

Tertiary intention

Quaternary intention

Secondary intention

* Secondary intention healing allows the wound to fill in with granulation tissue naturally when edges cannot be approximated.

What phase of wound healing does re-epithelialization occur in?

Proliferative

Hemostasis

Maturation

Inflammatory

Proliferative

* Epithelial cells migrate across the wound bed, covering the wound during the proliferative phase.

What is the primary purpose of the hemostasis phase during the wound-healing process?

To promote rapid re-epithelialization of the wound surface

To initiate a clotting cascade and form a plug to stop bleeding

To increase the tensile strength through collagen synthesis

To bring the edges of the wound together using mechanical means

To initiate a clotting cascade and form a plug to stop bleeding

* Hemostasis phase is characterized by forming a clotting cascade, leading to a stable hemostatic plug to stop bleeding. This is crucial for preventing further blood loss and stabilizing the wound.

Which phase of wound healing is primarily responsible for the cleanup of debris and bacteria from the wound?

Proliferative

Maturation

Inflammatory

Remodeling

Inflammatory

* The inflammatory phase specifically targets removing bacteria and debris, preparing the wound for healing by facilitating a clean environment.

Which characteristic is typical of chronic wounds?

They heal in an orderly manner.

They usually heal in 30 days.

They typically heal by secondary intention.

They seldom involve prolonged inflammation.

They typically heal by secondary intention.

* Secondary Intention- a medical term for a wound that is left open and allowed to heal naturally from the bottom up, rather than being stitched or stapled shut. Chronic wounds usually heal by secondary intention.

Which INTRINSIC factor is known to impact wound healing significantly?

Smoking

Alcohol use

Environment

Advanced age

Advanced age

* Advanced age is an intrinsic factor that can impact wound healing.

What disease hinders oxygen delivery to tissues due to blockages caused by crescent-shaped red blood cells?

Diabetes mellitus

Lupus Erythematous

Cardiovascular disease

Sickle-cell anemia

Sickle-cell anemia

* Sickle-cell anemia hinders oxygen delivery to tissues due to blockages caused by crescent-shaped RBCs.

What percentage of the uninjured skin does final matured scar tissue possess?

50%

60%

80%

100%

80%

* Scar tissue eventually achieves 80% of the tensile strength of the original uninjured skin.

How does the use of corticosteroids affect wound healing?

Prolongs the inflammatory phase

Effectively treats biofilm

Reduces collagen synthesis

Increases collagen synthesis

Reduces collagen synthesis

* Corticosteroids can reduce collagen synthesis, which is critical for the strength of new tissue.

How do matrix metalloproteinases (MMPs) affect chronic wounds?

They enhance collagen synthesis.

They degrade essential proteins and ECM.

They stimulate rapid epithelialization.

They reduce inflammation.

They degrade essential proteins and ECM.

Matrix Metalloproteinases (MMPs) are: Are a large family of calcium-dependent, zinc-containing enzymes (endopeptidases). Their primary function is to break down and remodel proteins in the extracellular matrix (ECM), which is the structural network supporting cells in tissues

What is a primary benefit of using standardized clinical assessment tools in wound management?

They provide a personalized approach to wound care.

They ensure consistency and accuracy in assessments.

They reduce the need for documentation.

They eliminate the need for clinical judgment.

They ensure consistency and accuracy in assessments.

* Standardized tools ensure that wound assessments are consistent and accurate, which helps track progress and compare outcomes.

What are some of the key factors assessed by the Malnutrition Screening Tool (MST)?

Level of physical activity

Amount of sleep

Unintentional weight loss

Skin integrity

Unintentional weight loss

* The MST includes questions about unintentional weight loss to help identify patients at risk for malnutrition.

What does the acronym SMART stand for?

Simple, Manageable, Attainable, Relevant, Time-based

Specific, Measurable, Attainable, Relevant, Time-based

Specific, Manageable, Attainable, Realistic, Time-sensitive

Simple, Measurable, Appropriate, Realistic, Timely

Specific, Manageable, Attainable, Realistic, Time-sensitive

* SMART stands for: Specific, Measurable, Attainable, Relevant, Time-based

Which laboratory test is commonly used to assess protein status and is a good indicator of nutrition over the past few days?

Serum Albumin

Hemoglobin A1C

Prealbumin

Blood Urea Nitrogen (BUN)

Prealbumin

* Prealbumin has a short half-life of 2 to 3 days, making it a good indicator of recent protein intake and nutritional status over the past few days.

What percentage of weight loss over six months is considered significant and warrants further evaluation by a dietitian?

2%

5%

10%

7.5%

7.5%

* Now, a 10% weight loss over six months is considered significant and may indicate malnutrition or other underlying health issues, warranting further evaluation.

Which team model integrates knowledge and methods from various disciplines, maintaining discipline-specific roles but collaborating closely and sharing information?

Multidisciplinary

Interdisciplinary

Transdisciplinary

Unidisciplinary

Multidisciplinary

* Multidisciplinary teams work independently but coordinate their efforts. Interdisciplinary teams integrate knowledge and methods from various

Meaning of Interdisciplinary collaboraton

A workflow that synthesizes and weaves different fields together to create a cohesive, unified approach

Multidisciplinary team approach

A workflow that has experts working independently in parallel, keeping their disciplinary boundaries.

If a clinician notices a low prealbumin level, which test result should they check to determine if this reading is altered by inflammation?

C-Reactive Protein (CRP)

Serum Albumin

Blood Glucose

Blood Urea Nitrogen (BUN)

C-Reactive Protein (CRP)

* CRP levels indicate the presence of inflammation, which can affect prealbumin readings, differentiating between nutritional deficiencies and inflammatory responses.

Which body mass index indicates that a patient is underweight?

17.5

18.5

20.4

25.9

17.5

* A body mass index that is below 18.5 is considered underweight.

What is the primary characteristic of a vesicle?

Solid elevated lesion greater than 1 cm

Circular, fluid-filled lesion up to 1 cm

Flat, discolored spot less than 1 cm

Large, thickened area greater than 1 cm

Circular, fluid-filled lesion up to 1 cm

* A vesicle is characterized as a small, fluid-filled lesion up to 1 cm in diameter.

What type of lesion is a solid, elevated area greater than 1 cm diameter and can extend below the skin’s surface?

Papule

Macule

Vesicle

Nodule

Nodule

A nodule is a solid, elevated lesion greater than 1 cm in diameter and can extend into deeper layers of the skin.

A clinician performs a skin assessment and observes white, star-shaped scars on a patient's inner ankle. Based on these findings, what condition might the clinician suspect?

Telangiectasia

Lichenification

Atrophie blanche

Ecchymosis

Atrophie blanche

* Atrophie blanche is characterized by white, star-shaped scars that commonly appear on the lower legs, ankles, or feet, often associated with poor blood supply and delayed healing.

what is Telangiectasia?

Refers to the permanent widening of tiny blood vessels (capillaries, arterioles, or venules) near the surface of the skin or mucous membranes. It appears as fine red, blue, or purple lines or branch-like patterns, often commonly referred to as "spider veins" Seen on face- cheeks, nose etc.

What is Lichenification?

A skin condition characterized by thick, leathery, and hardened skin with deep, exaggerated wrinkles or skin lines. It is the skin's protective response to chronic, long-term scratching or rubbing, which creates a frustrating itch-scratch cycle

What condition is this?

Ecchymosis

Telangiectasia

Lichenification

Lichenification

Definitions

• Purpura –

The term purpura is used to describe violaceous non-blanching hemorrhagic lesions larger than 2 mm (if smaller, it is called "petechiae". That can be flat or raised so they can be macules, papules, patches, or plaques. The term "palpable purpura" is used in association with indicate small vessel vasculitis.

What is ecchymosis?

The medical term for a common bruise. It occurs when small blood vessels break and leak blood into the tissues just beneath the skin or mucous membranes, creating a flat, dark purple, blue, or red patch that is larger than 1 cm in diameter.

What is hematoma

A raised bruise...localized collection of clotted or pooled blood that gathers outside of a blood vessel. Often caused by trauma or injury, they can range from harmless, superficial bruises to serious, life-threatening conditions depending on their size and location in the body

A clinician performs a skin assessment and presses on a red area of the patient's skin to check for blanching. What should the clinician expect to see if the area is blanchable?

The area remains red without any change.

The area turns white temporarily and then returns to red.

The area turns blue and stays blue.

The area becomes more swollen.

The area turns white temporarily and then returns to red.

* Turning blue suggests cyanosis. If the area is blanchable, it will turn white (blanch) when pressure is applied and then return to red once the pressure is released, indicating good blood flow.