Bone anatomy

Bone Anatomy and Pressure Ulcers : 

Bone Anatomy and Pressure Ulcers By Manuel A. Gallegos RN, BSN

Objectives: : 

Objectives: 1. Introduction to function and anatomy of the skeleton (Skeleletal video) 2. Define pressure ulcer 3. Identify stages and risk areas 4. Prevention of Decubitus Ulcers

Function of Bones : 

Function of Bones Vital organs are protected by the skeletal system: the brain is protected by the surrounding skull as the heart and lungs are encased by the sternum and rib cage Bodily movement is carried out by the interaction of the muscular and skeletal systems Blood cells are produced by the marrow located in some bones Bones serve as a storage area for minerals such as calcium and phosphorus

Basic Skeleton : 

Basic Skeleton

Question 1 : 

Question 1 The bones provide all of the following functions except? A. Assist with bodily movement B. Are a storage area for minerals C. Bones produce bodily fluids such as saliva D. Protect vital organs that include brain and heart Answer: C Bones produce what type of fluid? An average of 2.6 million red blood cells are produced each second by the bone marrow to replace those worn out and destroyed by the liver

Definition and Causes of Pressure Ulcers : 

Definition and Causes of Pressure Ulcers An area of skin that breaks down when you stay in one position for too long without shifting your weight The constant pressure against the skin reduces the blood supply to that area, and the affected tissue dies Tends to happen in areas that aren't well padded with muscle or fat and that lie just over a bone, such as your spine, tailbone (coccyx), shoulder blades, hips, heels and elbows Pressure sores are more likely to occur if you are immobilized by acute illness, injury or sedation — even for a brief time such as after an operation or accident Living with long-term spinal cord injuries

Pressure Ulcer Stages : 

Pressure Ulcer Stages Stage I: Intact skin with non-blanchable redness of a localized area usually over a bony prominence and may be painful, firm, soft, warmer or cooler as compared to adjacent tissue Stage II: Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed and may also present as an intact or open/ruptured serum-filled Stage III: Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed Stage IV: Full thickness tissue loss with exposed bone, tendon or muscle and may include undermining and tunneling

Stages of Pressure Ulcers : 

Stages of Pressure Ulcers

Pressure ulcer risk areas : 

Pressure ulcer risk areas

What stage of pressure ulcer are these? : 

What stage of pressure ulcer are these?

What stage is this pressure ulcer? : 

What stage is this pressure ulcer?

Question 2 : 

Question 2 You notice a client has a redness on the heel of his foot and when you push on it, it does not turn white or change back to pink. Instead it stays red. What type of pressure ulcer is it? Stage I Because it is non-blanchable, does not have a blister, and is not open

Prevention of Pressure Ulcers : 

Prevention of Pressure Ulcers Changing your position at least once every two hours, even during the night Use a pressure-reducing mattress or bed Daily skin inspections for pressure sores are an integral part of prevention A family member or caregiver can help if you're not able to do it yourself

Prevention continued : 

Prevention continued If an area of your skin is red or discolored but not broken, keep pressure off the sore Wash it gently with mild soap and water, dry thoroughly, and apply a protective wound dressing If you see skin damage or any sign of infection such as drainage from a sore, a foul odor, and increased tenderness, redness and warmth in the surrounding skin Get medical help immediately

Question 3 : 

Question 3 The 83 year old lady in your care cannot walk and is confined to her bed. You must make sure she does not develop skin breakdown by doing the following: A) Checking the patients skin at least once a day. B) Changing position at least every four hours. C) If an area of your skin is red or discolored, keep pressure off the sore D) A and C only E) None of the above The answer? D

Summary : 

Summary 1. Bones provide us with protection of vital organs, allow us to move, produce red blood cells, and serve as storage area for minerals 2. Pressure ulcers are areas of damaged skin and tissue that develop when sustained pressure cuts off circulation to vulnerable parts of your body, especially the skin on your buttocks, hips and heels 3. There are four stages of pressure ulcers. Stage I has non-blanchable redness , Stage II has partial thickness loss of dermis, Stage III has subcutaneous fat may be visible but bone, tendon or muscle are not exposed , and Stage IV has bone, tendon or muscle exposed 4. We prevent ulcers by checking the patient everyday, using an appropriate mattress, changing position often, reporting damaged skin promptly