Skin Anatomy, Slatter 20, Tobias 75

Front 1

skin is what % of a dog's body weight?

Back 1

12%

Front 2

epidermis is derived from what embryonic tissue type?

Back 2

ectoderm

Front 3

the dermis is derived from what embryonic tissue type?

Back 3

mesenchymal

Front 4

what are the 3 major layers of the epidermis

Back 4

stratum cylindricum

stratum spinosum

stratum corneum

Front 5

the stratum cylindricum and stratum spinosum collectively are known as what?

Back 5

stratum germinativum

Front 6

what percent of dermal fibers in the dermis are composed of collagen?

Back 6

90%

Front 7

the 2 indistinct layers of the dermis are the:

Back 7

superficial stratum papillare
deep stratum reticulare

Front 8

the stratum papillare has what type of fibers?

the stratum reticulare has what type of fibers?

Back 8

papillare: fine elastic and reticular fibers

reticulare: dense collagen bundles

Front 9

what does the adnexa of skin include?

Back 9

hair follicles
sweat glands
sebaceous glands

all are of ectodermal origin

Front 10

Errector pilli muscles are innervated by?

Back 10

autonomic nervous system

Front 11

hair follicle pigmentation granules come in what 3 colors?

Back 11

brown, black, yellow

Front 12

Anal sac is lined with what cell type?s

Back 12

stratified squamous epithelium

Front 13

define apocrine

Back 13

the secreted product is concentrated at the free end and is release with a small amount of cytoplasm

Front 14

define holocrine

Back 14

the entire secreting cell is release as part of the secreted product

Front 15

define neurocrine

Back 15

the secreting cell remains intact through the dormation and secretion of the product

Front 16

the panniculus musculature is composed of which muscles?

Back 16

platysma

sphincter colli superficialis

sphincter colle profundus

cutaneous trunci

Front 17

in the cat, the platysma is subdivided in the cervical region into what 2 muscles, and along what line?

Back 17

supercervicocutaneous muscle and
cervicofacial muscle

divided along the line of attachment to the skin

Front 18

what are the 3 levels of the cutaneous vascular system?

Back 18

the deep, subdermal, or subcutaneous plexus

the middle, or cutaneous plexus

the superficial or subpapillary plexus

Front 19

which of the 3 plexuses is the major vascular network to the underlying skin?

Back 19

the deep, subdermal, or papillary plexus

Front 20

why does canine skin generally not blister with superficial burns?

Back 20

because their capillary loop system andpapillary bdies of their vascular system are poorly developed

Front 21

where should skin be undermined to avoid cutting off its vital blood supply?

Back 21

In the fascial plane beneath the cutaneous musculature to preserve the subdermal plexus

HOWEVER, if the area is devoid of musculature, one should undermine in the fascial plane well below the dermal surface

Front 22

tissue expanders, presuturing, and skin stretchers all take advantage of what phenomenon

Back 22

mechanical creep

Front 23

clinical features of cutaneous asthenia are

Back 23

increased skin fragility
hyperelasticity
laxity

Front 24

2 layers of skin? and beneath that

Back 24

epidermis
dermis

and hypodermis beneath composed of fat and CT

Front 25

differences in skin blood supply between dogs and cats

Back 25

dogs: greater density of collateral sq vessels

cats: smaller number and wider distribution of cutaneous perforators

Front 26

another term for primary wound healing

Back 26

first intention healing
healing of sutured wound (def)

Front 27

2 other terms for delayed primary closure?

definition?

Back 27

secondary closure

third intention healing
closure performed 5 or more days after wound initiation

Front 28

second intention healing

Back 28

heals without suturing

Front 29

how do healing rates doffer between primary and secondary healing?

Back 29

same, except with primary the area is smaller

Front 30

rate of epithilialization?

is tissue as strong as skin

Back 30

1mm/day

no

Front 31

tensile strength of a 5mm wide strip normal canine skin?

Back 31

9.9kg

Front 32

how strong is wounded skin in comparison to normal skin?
2 weeks post op?
3-4 weeks?
several months
one year

Back 32

5-10% as strong at 14d post sx

25% as strong at 3-4 weeks

70-80% at several months

80% at 1 year

Front 33

strength of sutured wounds in cats compared to dogs?

Back 33

one stuy wounds were only half as strong as in dogs at 7d post op

Front 34

what is false healing?

Back 34

in cats, where wounds appear healed and then dehisce after suture removal

Front 35

cats vs dogs, vascularity and wound strength

Back 35

cats lowere perfusion first week post op followed by more rapid gain during second week.

by 2 weeks perfusion was the same

lower wound breaking strength than dogs at 7d post op

cats have more problems with healing. may ant to leave sutures in longer than 2 weeks

Front 36

effect of SQ removal on wound healing?

Back 36

in one study all tissues deep to panniculus but superficial to thoracodorsal muscle fascia was removed, no effect on skin healing.

Front 37

Back 37

A. Epidermis
B. Dermis
C. Hypodermis
D. Cutaneous Trunci

Front 38

describe differences between canine and human blood supply

Back 38

major cutaneous vessels in dogs are parallel to skin whereas in humans they are perpendicular

Front 39

healing of primary wounds influenced by what factors?

Back 39

tension
pressure
motion
self-mutilation
patient health

Front 40

skin wounds usually closed parallel to lines of tension except where

Back 40

in limbs they may need to be closed perpendicular

Front 41

patient factors that significantly effect wound healing include:

Back 41

uremia
steroid admin
hyperadrenocorticism
geriatric status
malnutrition

Front 42

how does geriatric status affect wound healing?

Back 42

decreased cutaneous perfusion
increased skin fragility
increased risk of infection

Front 43

how does malnutrition effect wound healing?

Back 43

decreased albumin and hemoglobin levels

rat study: starved one group of rats for 2 weeks. measured wound strength and hydroxyproline in normal and malnourished rats

malnurished groups reached same wound strength and hydroxyproline levels at 60d as normal rats at 21d

Front 44

what did they find in a study comparing monocryl with vicryl for intradermal sutures

Back 44

vicryl group had more early swelling and redness, but there was no difference between the two groups later

Front 45

name 2 important amino acids for wound healing

Back 45

cysteine
methionone

also, glutamine, arginine, zinc, fatty acids
vitamin E

Front 46

name 2 advantages of eltrocautery for incisions

Back 46

hemostasis
lymphatic sealing

Front 47

what is knot security of surgeons vs square

how many throws are necessary for different suture types for secure knot at START of continuous line?

Back 47

surgeons and square had same security

polyglycolic acid: 3
polyglactin 910: 3
polypropylene: 3

chromic gut: 4

PDS: 5
nylon: 5

Front 48

whic considered better for small animal incisions: cautery or sharp and why?

wound strength between the two?

Back 48

sharp

cautery (if used improperly)can cause thermal damage to wound that affects cutaneous perfusion and delays healing

sharp incisions had twice the wound strength as those made with cautery at 7-10d post op

scalpel incision had less drainage and faster/stronger healing

Front 49

when skin is incised by radiowaves, CO2 laser, monopolar electrocautery, how far will char extend?

Back 49

radiowaves: 0.171mm
Co2: 0.215
monopolar:0.255

Front 50

one way of hemostasis with small vessels

Back 50

if less than 1mm, ,can grasp with hemostats and twist 360 degrees multiple times.= to a ligature in small vessels

Front 51

when is the "golden period"?

Back 51

up to 3-6 hours after wound initiation. within this time bacteria can mutliple to 10^5 per gram of tissue or mm of exudate

Front 52

how long does it take for degree of tissue necrosis to be established in crushing wounds?

Back 52

3-7days

Front 53

Back 53

describe steps

Front 54

how many throws are necessary for different suture types for secure knot at END of continuous line?

Back 54

polyglycolic acid: 5
polypropylene: 5
chromic gut: 5

polyglactin 910: 6
nylon: 6

PDS:7

Front 55

aberdeen compared to square

Back 55

equally secure

Front 56

does tight SQ closure compromise skin vascular supply

Back 56

not proven

Front 57

study looking at SQ vs no SQ layer closure in cats?

Back 57

no difference grossly, microscopically less seroma in those with SQ layer closed

Front 58

what was foudn in dog study looking at monocryl for intradermal closure vs monocryl or prolene skin sutures?

Back 58

intradermal group had more initial post op swelling and redness but fewer complciations overal by 10-14d

use of absorbably monocryl for skin sutures was associated with more incisional swelling and discharge at 14d post op

Front 59

what did they find in study looking at wound birsting strength with sutures placed 3, 6, or 10mm from linea alba in rats?

Back 59

immediately: sutures placed 10mm away had higher bursting strength

at 4d sutures placed 3 or 6mm (and at closer intervals) had higher bursting strength

Front 60

study looking at spays closed with intradermal monocryl vs cutaneous sutures found what?

Back 60

more inflammtion 18-24 hours post in intradermal group, less inflammation at 10-14d

also, intradermal assctd with less pain in women

Front 61

what is the tucking maneuver?

Back 61

smurfing

Front 62

tissue adhesives vs. skin sutures?

Back 62

one study which created random pattern skin flaps in dogs found that wounds closed with skin sutures vs glue and few skin sutures had equal tensile strength

but one day post op glue had less tensile stength (only 15% of sutured group), so not recommended for wounds under tension

glue can cause foreign body reaction in SQ

Front 63

fibrin sealants

Back 63

human and bovine have been studied.
do not increase wound breaking strength over sutures alone

only used experimentally

Front 64

how long does it take dog ears to regress in human studies?

Back 64

ears less than 8mm regress completely by 132 days

Front 65

how do lidocaine and bupivicaine work?

Back 65

bind to neuronal membrane receptors, inhibiting Na ion influx. membranes become less stable, which inhibits initiation of action potential and conduction of nerve impulses, preventing pain sensation

Front 66

what is a step defect and what is the consequence

name 3 ways to correct this

Back 66

when wound edges are not opposed in level fashion

epithelialiazation is delayed

1.bites at same depth on either side of incision
2.half buried horizontal mattress sutures
3.stiff suture across wound to elevate low side

image on front of slide is demonstrating dog ear, with apex cutaneous suture used to correct it

Front 67

triple ab over primarily closed wounds

Back 67

provide moisture
may enhance epithelialization

Front 68

do NSAIDS effect wound healing?

Back 68

theoretically should but studies have shown no effect

dogs, rats, mice
rats: no effect on tile strength at 3-7d
mice: no effect on healing at 28d

Front 69

what happens with application of 5% lidocaine patches to wounds in humans

Back 69

blocks pain, but can still feel pressure, touch, temperature

Front 70

pharmacokinetics of 5% lidocaine patches applied to normal skin in dogs?

Back 70

systemic absorption by 12 hours,
steady state by 24-48 hours post applilcation
dramatic decline in drug [ ] after 60 hours

low blood levels until 6 hours post patch removal

has not been reported for when applied over wound

Front 71

local block before or after skin incision?

affect on wound healing?

Back 71

before. one study showed that when blocked before skin incision was made dogs had lower post-op pain scores and required less opiod that when blocked after skin incision

analgesic effect seemed to last for 24hours (longer than expected based on halflife)

no deleterious effects on wound healing in this study

Front 72

how deep do cold packs penetrate?how long should they be left on and why?

Back 72

all the way to periosteum

not longer than 20min to avoid injury or delayed wound healing from vasoconstriction

Front 73

wounds that are perfectly apposed can have an epithelial seal within ___ hours?

Back 73

24

Front 74

under what circumstances would you consider closing a traumatic wound primarily?

Back 74

if occurred within 3-6 hours,

wound edges fresh and vascularized

no evidence or history of crushing injury

no visible contamination or debris after wound contamination

Front 75

what do they call the loop at the end of the suture line?

Back 75

penultimate loop

Front 76

how long should suture tags be?

Back 76

3-4mm for buried knots

Front 77

what needle type is recommended for sq closure?

Back 77

1/2 or 3/8 circle taper

Front 78

does a continuous SQ layer compromis blood supply more than an interrupted layer?

Back 78

some think so, but no evidence

Front 79

where should tacking sutures be avoided?

Back 79

in areas where skin moves freely(over thorax)

Front 80

how big should bites in SQ be?

Back 80

0.5-1cm

Front 81

how are intradermal and subcuticular different?

Back 81

they are the same

Front 82

what are the 2 different types of intradermal closure?

Back 82

vertical: bites placed perpindicular to skin edge, incorporate sq

horizontal, along skin edge, just dermis

Front 83

needle type for skin sutures?

Back 83

usually 3/8 circle on cutting

Front 84

does horizontal mattress sutures result in inverting/everting/apposition?

Back 84

any, depending on how they are placed

Front 85

does vertical mattress result in apposition, inverting or everting

Back 85

everting or apposition

Front 86

what is a benefit to ford interlocking?

Back 86

same fetures as continuous, but if line breaks, the locking may keep incision opposed partly

Front 87

which is stronger in tissues under tension, horizontal or vertical mattress?

Back 87

vertical

Front 88

how are bites taken for a vertical mattress intradermal pattern?

Back 88

from deep to superficial on near side, and from superficial to deep on far side

benefit is that you are unlikely to compromised blood supply-because suture is parallel to cutaneous perforator vessels

Front 89

describe these ways to correct a dog a dog ear

Back 89

A:removal of small triangles

B: removal of one large triangle

C: removal of ellipse

D: removl of arrowhead

E. half z correction

Front 90

what are some ways to correct crescent shaped defects?

Back 90