INSTRUCTIONS. The following questions are to be answered by writing the answer in the space provided or by matching terms as directed.

After you have completed all the questions, scroll to the bottom of the page and check your answers.

1. How many square feet of skin cover the body of the average male? __________

2. About _________ of all blood that circulates through the body goes to the skin.

3. List the three layers of skin.

a. ___________________________________________.

b. ___________________________________________.

c. ___________________________________________.

4. A change in the normal appearance of an individual’s skin could indicate an abnormality or ___________________________________________.

5. How many layers of epidermis are on the palms of the hands and the soles of the feet? _________________

6. List four body parts contained in the second layer of skin.

a. ___________________________________________.

b. ___________________________________________.

c. ___________________________________________.

d. ___________________________________________.

7. Which layer of skin gives the skin its elasticity? _____________________.

8. List three functions of the subcutaneous layer of skin.

a. ___________________________________________

b. ___________________________________________

c. ___________________________________________

9. A wound is _______________________________________________________

________________________________________________________________

10. List four types of wounds.

a. ___________________________________________.

b. ___________________________________________.

c. ___________________________________________.

d. ___________________________________________.

11. A ________________________ is a torn, jagged cut which has gone through the skin tissue and the blood vessels.

12. What is the body’s first response to cell damage (in other words, a wound)?

________________________________________________________________

________________________________________________________________

13. What causes a wound abscess? __________________________________________________________________________

14. List two possible complications of wound healing.

a. ___________________________________________.

b. ___________________________________________.

15. What is a keloid? __________________________________________________

16. Why does dead tissue around a wound slow the healing process?

________________________________________________________________

________________________________________________________________

17. List four factors which influence the body’s ability to grow new tissue; in other words, to heal a wound.

a. ___________________________________________.

b. ___________________________________________.

c. ___________________________________________.

d. ___________________________________________.

18. List the three stages of wound healing.

a. ___________________________________________.

b. ___________________________________________.

c. ___________________________________________.

19. A variety of needles is used in wound closure. Answer the following questions about such needles.

a. What are two types of needles?

(1) ___________________________________________.

(2) ___________________________________________.

b. List the two grades of needles and their use.

(1) ___________________________________________.

(2) ___________________________________________.

c. Uses of different sized needles.

(1) What are smaller needles used for?

_________________________________________.

(2) What are larger needles used for?

__________________________________________

20. List the three major types of suture materials.

a. ___________________________________________.

b. ___________________________________________.

c. ___________________________________________.

21. Answer the following questions.

a. On what part of the body should silk sutures be used? ______________________________________________________________

b. List one advantage and one disadvantage of using metal sutures.

(1) Advantage = ______________________________________________

(2) Disadvantage = ___________________________________________.

c. Synthetic absorbable sutures have many advantages; list one. List one disadvantage of these sutures.

(1) Advantage = ______________________________________________

(2) Disadvantage = ____________________________________________

d. List one advantage and one disadvantage of using skin tapes.

(1) Advantage = _______________________________________________

(2) Disadvantage = ____________________________________________

22. Complete the statements about categories of wound closure.

a. Wound closure by primary intent is _______________________________________________________________________

b. Allowing the wound to granulate on its own without surgical repair is the definition of _____________________________________.

c. Cleaning and dressing the wound with the patient returning for wound closure in three or four days is the definition of _______________________________

23. List the two steps in debridement and excision of a wound.

a. ___________________________________________.

b. ___________________________________________.

24. Why is it necessary to trim the irregularities from the edge of a wound

________________________________________________________________

________________________________________________________________

25. List two reasons why necrotic tissue (dead tissue) around a wound should be excised.

a. ___________________________________________.

b. ___________________________________________.

26. A general principle of suturing is that the base of the suture loop configuration should be _________________________ the top of the suture loop.(how wide)

27. List four general principles of suture removal.

a. ___________________________________________.

b. ___________________________________________.

c. ___________________________________________.

d. ___________________________________________.

28. Match the definitions with the correct term by writing the letter of the definition next to the correct term.

TERM	Definition
____ a. Sheer laceration ____ b. Combined laceration. ____ c. Tension laceration ____ d. Compression laceration	W. Laceration caused by skin striking a flat surface. X. Laceration caused by skin being caught between the bone and an external surface. Y. Characteristics of sheer and compression lacerations. Z. A laceration made by a sharp object such as a knife.

29. Match the definitions with the correct term by writing the letter of the definition next to the correct term.

TERM	DEFINITION
____ a. Cellulitis. ____ b. Empyema. ____ c. Abscess. ____ d. Fistula.	W. Pus collecting in an already existing body cavity. X. Localized infection in which there is an accumulation of pus. Y. Abnormal passage between two internal organs. Z. Inflammation of the deep subcutaneous tissue.

30. In the process of maturation of wound healing, there are three stages. Write the letter of the appropriate description next to the appropriate stage.

STAGE	CHARACTERISTICS
____ a. Stage I. ____ b. Stage II. ____ c. Stage III.	X. Scar is red, hard, thick, and strong. Y. Scar is soft, supple, white, and loose. Z. Scar is soft, fine, and weak.

31. Match the suturing technique in the first column with the advantage of the technique in the second column. Write the appropriate letter from the second column in the space provided next to the letter in the first column.

COLUMN I SUTURING TECHNIQUE	COLUMN II ADVANTAGE OF TECHNIQUE
____ a. Vertical mattress suture ____ b. Subcuticular suture ____ c. Horizontal mattress suture ____ d. Running suture ____ e. Locked running suture	V. Fast to insert; easy to remove. W. Useful in situations where wound edges have to be pulled together under tension to control bleeding. X. Useful in areas where the wound edges tend to invert. Y. One suture can take the place of two ties. Z. Avoids suture marks; best suited for straight lacerations.

 

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Answers to Lesson 2: Self-Test

1. 16.2 square feet. (para 2-2a)

2. One-third. (para 2-2a)

3. Epidermis layer.

Dermis layer.

Subcutaneous layer. (para 2-2c)

4. A disease of body function. (para 2-2b)

5. 5 layers of epidermis. (para 2-2c(1))

6. You are correct if you listed any four of the following:

Blood vessels.

Nerves.

Lymph vessels.

Hair follicles.

Sweat glands.

Sensory receptors. (para 2-2c(2))

7. The dermis layer (the second layer). (para 2-2c(2))

8. You are correct if you listed any three of the following:

Storehouse for water.

Storehouse for fat.

Insulation function, protecting the body from heat loss.

Pads the body from blows.

Pathway for nerves.

Pathway for blood vessels. (para 2-2c(3))

9. A wound is a break in the continuity of the skin. (para 2-3)

10. Abrasions.

Punctures.

Perforations.

Lacerations. (para 2-3)

11. Laceration. (para 2-3)

12. The body’s first response is inflammation. Blood rushes to the site and the area feels warm to the touch. (para 2-4a)

13. An abscess is caused by an infecting organism. (para 2-4d(3))

14. You are correct if you listed any two of the following: Infection.

Continued bleeding.

Dying tissue.

Improper healing. para 2-4d(1) through (3))

15. A keloid is excessive scar tissue. (para 2-4d(3))

16. Dead tissue restricts blood circulation to a wound area, thus interfering with healing. (para 2-4d(4))

17. You are correct if you listed any four of the following:

Age.

Malnutrition.

Obesity.

Abnormalities in endocrine function.

Hormone production.

Carbohydrate metabolism. (para 2-4e(1) through (4))

18. Inflammation.

Repair.

Maturation. (para 2-4)

19. a. (1) Straight needles.

(2) Curved needles. (para 2-5b(1))

b. (1) Cuticular needle – for use on the skin.

(2) Plastic needle–a sharper needle, used for plastic surgery. (para 2-5b(3))

c. (1) Fine repair such as treating facial lacerations.

(2) Taking bigger bites of tissue such as scalp lacerations. (para 2-5b(4)

20. Nonabsorbable sutures.

Metal sutures.

Absorbable sutures. (para 2-5c(2) through (5))

21. a. Use silk sutures on uncontaminated wounds such as wounds of the face. (para 2-5c(2))

b. You are correct if you chose any one of the following advantages of metal sutures and any one of the following disadvantages of metal sutures.

Advantages of metal sutures:

Quick to use.

Easy to use, if experienced.

Wound healing results the same as for other suture types.

Disadvantages of metal sutures:

Hard to use if inexperienced.

. Sutures can be irritating to the patient. (para 2-5c(3))

c. You are correct if you chose any one of the following advantages of synthetic absorbable sutures and any one of the following disadvantages of synthetic absorbable sutures.

Advantages of synthetic, absorbable sutures

Retains tensile strength for 60 days or more.

Low tissue reaction to this suture; therefore, less pus infection.

Disadvantages of synthetic, absorbable sutures

Suture does not glide through skin easily.

Difficult to tie knot. (para 2-5c(4)(c))

d. You are correct if you chose any one of the following advantages of skin tapes and any one of the following disadvantages of skin tapes.

Advantages of skin tapes

Low incidence of infection.

No suture marks.

Patient does not have to come back to have sutures removed.

Disadvantage of skin tapes

Not practical in body areas that get wet or have motion.

Not practical for young children who tend to pull off tapes.

Tape edges sometimes curl up after the skin tapes have been applied. (para 2-5c(5))

22. a. Wound repair without delay after the injury has occurred. (para 2-6a(1))

b. Wound closure by secondary intent. (para 2-6a(2))

c. Wound closure by tertiary intent. (para 2-6a(3))

23. Irrigate the wound.

Remove the foreign material. (para 2-6b(1))

24. Trim irregularities from the edge of a wound to improve the final appearance of the healed wound. (para 2-6b(2))

25. a. To prevent infection.

b. To prevent abscess. (para 2-6b(4))

26. As wide or wider than. (para 2-6c(3))

27. You are correct if you listed any four of the following:

Use sterile forceps or hemostats.

Use proper suture scissors.

Cut the suture at skin level.

Do not pull a contaminated suture through the suture route.

Pull the suture up and towards the wound at a 45-degree angle.

Pull the suture gently and smoothly.

Support the suture at the suture exit point. (para 2-8b)

28. a Z

b Y

c W

d X (paras 2-3a through d)

29. a Z

b W

c X

d Y (para 2-4d(3))

30. a Z

b X

c Y (para 2-4c)

31. a X

b Z

c Y

d V

e W (paras 2-7a through e)