NPTE 2026 Integ/Lymphedema Quick Recall

Largest Organ of the Body

Skin: 15-20% of body weight

Epidermis Contents (BLKM)

Basal Cells, Langerhans, keratinocytes, melanocytes

Meissner’s Corpuscles Function

Light touch and texture

(MELT)

Merkel Disks Function

Light tough, pressure and texture

Paninian Corpuscles function

Deep pressure and vibration

Ruffini Endings Function

Detect warmth stretch and deformation in joints

Free Nerve Endings function b

Detect pain temp touch pressure and itch

Free endings = free agent kinda can do whatever

(Like my ball knowledge??)

Krause End Bulb Function

Detect cold temp

Pressure Ulcer DTI

Purple & Closed

Stage 1 Pressure ulcer

Non Blanchable redness & INTACT

Stage 2 Pressure Ulcer

Shallow crater, partial thickness, pinky/red

Stage 3 Pressure ulcer

Full thickness, SubQ fat visible, deep crater

Stage 4 pressure Ulcer

Bone, tendon visible (ew), full thickness, slough & Escher present

Unstageable pressure ulcer

for sure a 3 or 4 but u can’t see the wound bed so you don’t know

Can you reverse stage a pressure wound

No, idk y not it doesn’t make sense but we can’t and i think its stupid

How often do you turn a FRAIL patient

Every 30 min

At what head of bed elevation do we add unnecessary pressure?

30 degrees

How often for position changes for non frail bed bound patients

2 hrs

Where are arterial wounds found?

toes, lateral malleolus, anterior shin

ArteriaL & LateraL

Do arterial wounds drain?

Usually dry > min exudate

What do arterial wounds look like?

Pale, distinct margins

Is there swelling with arterial wounds? Do they smell?

Double no

Does elevation help arterial wounds?

No it hurts like a mf

Where are venous wounds located?

Med & Lat malleoli, below knee

Proximal to medial Malleolus

What do venous wounds look like?

Irregular, hyperpigmented w/ lots of exudate

Do venous wounds smell?

Smelly, swollen and lots of fluid

Do venous wounds hurt?

ugly as hell but not painful

Does elevation help w/ venous wounds

Yup

Interventions for PAD & preferred positioning

Interval walking & legs down posture

Interventions for chronic venous insufficiency & venous Ulcers

Compression for edema and elevate legs

Where are diabetic ulcers found?

WB surfaces of feet

Do epidermal burns scar?

Nah - run of the mill sunburn or in analeigh’s case when she gets anything out of the oven

What color are epidermal burns? Pain level?

Pink

Kinda painful & tender (delayed)

Blanching on DPT burns

Slow capillary refill

Balancing on SPT burns

Brisk capillary refill

SPT burns color & level of ow

Bright pink or red and hurt like hell

DPT burns color and pain

Mixed red and white, dont hurt unless deep pressure applied

Which two burns require skin grafts

Full thickness and subdermal

Why are full thickness burns white

Blood vessels are toast, no blanching either

Level of scarring for SPT and DPT?

SPT - minimal

DPT - lots of scarring

each side of the arm is worth what in the adult rule of 9’s?

4.5%

Each side of the leg is worth what in the adult rule of 9’s?

9%

Face is worth what in the adult rule of 9’s for burns?

4.5%

Anterior thorax is worth what in the adult rule of 9’s ?

18%

A child’s face is worth what in pediatric rule of 9’s

8.5%

A child’s ½ leg is worth what in the rule of 9’s?

6.5%

Genitalia is worth what % for both adult and child rule of 9’s

1%

What differentiates a keloid from hypertrophic scar?

Keloids are outside the original wound boundary while hypertrophic remain within the of boarder

What injuries are keloids common in

Bone injuries

Is serosanguinous fluid normal?

Yup indicates healing - watery w/ tinge of red

What is sanguinous fluid?

Bloody and bright red and an indication of inflammation

When is pus a bad sign

When it is thick and smelly, normally indicates infection but not always???? ‘May be normal as WBC macrophage necrotic cells and turn them to slough’ bro nvm just forget this card

What is it called when a wound has too much moisture

Maceration

What does maceration look like?

White, friable, wrinkled skin & overhydrated

What happens when a wound is too dry

Desiccation

What does desiccation look like

Cracked wound edges with flaky edges, hard or crusty

What are the forms of selective wound debridement? (B-SEA)

Biologic/maggot

Sharp

Enzymatic

Autolytic

When do we use selective debreidment?

When there is more viable than nonviable tissue

Does autolytic debreidment mean the therapist actually does anything

Nope - letting the body do its thing

Methods of nonselective debreidment (WHW)

Wet>dry dressing

Wound irrigation

Hydrotherapy

What’s the difference between wound irrigation and hydrotherapy debreidment

Wound irrigation > pressure washer

Hydrotherapy > whirlpool

When do we use nonselective debreidment

When there is more nonviable than viable tissue

What is viable wound tissue

Granulation tissue

What dressing are used for heavy exudate wounds

Calcium alginates and hydrofiber

When do you use hydrogels over hydrocolloids?

Hydrogels are for infected wounds

Which dressing for dry wounds?

Films

which dressing for mod exudate

Foam

Which dressing for minimal exudate

Hydrogels and hydrocolloids

What dressing for infected wounds

hydrofiber, hydrogel, Calcium alginates & gauze

Do physical therapists treat herpes zoster

Refer and no touchy ( contact precautions)

What precautions do we use of herpes has spread

Airborne

how does herpes zoster manifest

Dermatomal pattern that is painful and raised

CN V & VII involvement

Herpes simplex 1 (HSV-1)

oral lesions & spread through saliva

HSV-1 aggravating factors

Stress, sun or sickness

HSV-2

genital herpes & spread through hoe activities

Kaposi’s sarcoma

Common in aids patients, viral etiology

Does karposis spread through contact

No

Where is dermatitis commonly found

extensor surfaces

Cellulitis

Bacterial skin infection that presents with redness warmth swelling and tenderness

How do we treat cellulitis?

Systemic antibiotics and limb elevation

Cellulitis red flags

Rapid spread, fever or systemic

PT CI for cellulitis

NO massage or compression acutely

which lymphatic duct drains most of the body

thoracic duct on the L

Which lymphatic duct does the upper R quadrant of the body

Right Lymphatic duct

Which organs do lymph nodes originate from

Spleen, tonsils, thymus, bone marrow

Lymphedema

Chronic condition characterized by excessive accumulation of lymph fluid due to mechanical insufficiency of lymphatic system

primary Lymphedema

Congenital

Secondary Lymphedema

Acquired insult to lymphatic system commonly from post surgery for breast or cervical cancer, CVI, radiation, or tumors

Does lipidema have a functioning lymphatic system

Yes works just fine

How to differintiate lipedema from lymphedema

Lipedema is bilateral, almost exclusively in females and has pain and bruising

Lymphangitis

Acute bacterial or viral infection that spreads throughout lymphatic system characterized by red streaks proximal to infection site