The Differentiation of Epidermis II

Total Page:16

File Type:pdf, Size:1020Kb

The Differentiation of Epidermis II /. Embryol. exp. Morph., Vol. 17, 1, pp. 107-117, February 1967 107 With 4 plates Printed in Great Britain The differentiation of epidermis II. Alternative pathways of differentiation of embryonic chicken epidermis in organ culture ByJ. W. DODSON1 From the Strangeways Research Laboratory, Cambridge INTRODUCTION In the present study, two series of experiments have been made to investigate the role of the dermis in determining alternative pathways of differentiation in the epidermis. Previous work has shown that the scaly metatarsal epidermis of 12-day chicken embryos, when isolated in culture on a plasma clot or various other substrata, fails to develop normally and undergoes a characteristic sequence of differentiative and degenerative changes (McLoughlin, 1961a; Wessells, 1962;Dodson, 1963,1966). On the other hand, the separated epidermis, when cultivated in combination with either its own dermis or a gel of collagen, survives and forms a stratum corneum (Dodson, 1963, 1966). The questions arise of whether the changes produced in the epidermis by growth in isolation can be reversed by subsequent recombination of the epithelium with the dermis, and if so at what stage the degeneration becomes irreversible. Accordingly, in the first series of experiments, epidermis was cultivated in isolation for various periods of time, then recombined with dermis and cultivated further; the explants were examined histologically for signs of a keratinizing epithelium. In a similar experiment, Wessells (1963) found that proliferating columnar basal cells appeared in epidermis isolated for 10 or 24 h, then recombined with dermis for a further 1 or 2 days, but longer periods of segregation were not tested, nor was further differentiation described. The differentiation of the epidermis of embryonic chicken skin in culture can also be altered profoundly by treatment with excess of vitamin A (Fell & Mellanby, 1953; Fell, 1957). When the whole skin of 7-, 13-, or 18-day embryos was treated, keratinization was inhibited and a mucous metaplasia was in- duced; the latter change, however, was less extensive and less frequent in the oldest skin. Originally it was not known whether this action of the vitamin was directly on the epidermis or whether it was mediated through changes produced in the dermis. McLoughlin (1961a) noted, however, that in isolated limb 1 Author's address: Department of Zoology, University of Bristol, Bristol, U.K. 108 J. W. DODSON epidermis from 5-day chicken embryos, squamous changes associated with slight keratinization in control explants were inhibited by the vitamin and in the treated explants a thin layer of mucus appeared; this result indicated that in this very young material the changes were due to a primary action of the vitamin on the epithelium. The second series of experiments recorded in the present paper was made to determine whether the vitamin also acts directly on the partly differentiated epidermis of older embryos and whether the isolated epithelium from such embryos can undergo a full mucous metaplasia when grown on a collagen gel in the presence of excess of vitamin A. MATERIALS AND METHODS Epidermis was separated from dermis after Versene treatment of the scaly skin of the anterior tarso-metatarsal region of 12-day chicken embryos (stages 37^-38^ of Hamburger & Hamilton, 1951). The techniques of separation, cultivation, and histological examination have been described in a previous paper (Dodson, 1966). Sheets of separated epidermis were spread over either rayon-acetate rafts (Schaflfer, 1956) or pieces of Millipore filter, type HA (Millipore Filter Corp., Bedford, Mass.); they were then cultivated for 12-48 h at 37-5 °C by the watch-glass technique of Fell & Robison (1929) on clots made of 12 drops of fowl plasma and 8 drops of embryo extract. The pieces of separated dermis were placed on rayon rafts on clots and kept at room temperature (18-20 °C) until required for recombination, except that when epidermis was isolated for 48 h, dermis was prepared freshly immediately before recombination. After incubation the epidermis was carefully removed from the raft or filter and was placed on the inner surface of a piece of dermis (i.e. the surface not bearing the basement membrane) on a raft; a second piece of dermis was then placed over the epithelium, again with its inner surface next to the latter tissue. This 'sandwich' technique obviated the necessity of determining the basal surface of the twisted sheet of isolated epidermis, and placing the inner surface of the dermis next to the epithelium prevented the extant basement membrane on the dermis from being confused with any newly formed basement membrane next to the epidermis. The recombined tissues were cultivated on a clot as before, for periods ranging from 3 h to 7 days. For the experiments on the effect of vitamin A, gels of collagen from acetic acid-extracted rat tail tendon were prepared as described in the previous paper. Vitamin A alcohol was dissolved in ethanol and added to fresh fowl plasma to give a concentration of either 2-4 or 9 i.u. per ml in the final plasma-embryo extract clot. The medium for control explants contained the same amount of ethanol (0-1 %). Pieces of collagen gel were soaked in clot exudate (H. B. Fell, personal communication) containing either vitamin A or ethanol alone, and freshly separated epidermis was spread on them; the explants mounted on the Differentiation of epidermis in culture 109 collagen gel were then placed on a clot and incubated at 37-5 °C for 2-12 days. All explants were subcultured on to fresh clots every 2 days, and after fixation were examined histologically. RESULTS 1. Epidermis grown alone, then recombined with dermis Epidermis grown in isolation on a raft developed as described previously (Dodson, 1966). The basal cells very rapidly became flattened, the epithelium thickened, and the cells lost their regular, layered arrangement; some cells showed signs of differentiation, but by 2 days in culture most nuclei were pycnotic (Plate 1, figs. A-D). On Millipore filter the results were variable, some explants developing as above while others became attached to the filter and sometimes formed a layered arrangement. The latter grew slightly differently after recombination and are described separately; the main description refers to epidermis isolated on rafts or unattached to Millipore filter. Thirty-three explants of epidermis were grown in isolation for 24 h, then recombined with dermis. The epidermis was thickened and there were two or three layers of flattened cells at the basal surface. Mitosis had ceased, but the cytoplasm was still basophilic. The periderm, which had migrated round to the lower surface at the edges of some explants, had begun to develop its charac- teristic granules (Plate 1, fig. A). Within 3 h of the recombination, the epidermis was enveloped by dermal cells, which made close and continuous contact with the basal layer, but not with the periderm. A new periodic acid-Schiff (PAS)- positive and aniline blue-staining basement membrane first appeared under some areas of basal cells at about 10 h after recombination (Plate 2, fig. E), but it was not present under the whole basal layer until 20-27 h. Closely associated with the appearance of the basement membrane were reorientation and division of the basal cells. Although nearly all these elements were flattened at 10 h, after 15 h many were cuboidal and by 20 h most were cuboidal or even columnar (Plate 2, fig. F); flattened cells persisted in some regions, however, even after 4 and 5 days. Mitosis, which had ceased in the isolated epidermis, reappeared in both flattened and cuboidal basal cells at 10-15 h after recombination. The s. basale, re-formed 10-20 h after recombination, pushed up layers of differentiating cells which, together with the layers of flattened cells that de- veloped during isolation, formed a s. spinosum. Meanwhile the upper parts of the epidermis continued to develop as though still isolated and many of the cells became pycnotic, although the lower cells, immediately above the regene- rating epithelium, retained their basophilia longer and tended to differentiate further than the more distal cells. Cornified cells first appeared in the regenerating epithelium after 2-3 days (Plate 2, fig. G) and by 5 days a well-arranged kera- tinizing epithelium had been formed. In the most healthy explants the re- generated epidermis extended over the inner surface of the surrounding dermis, so that a keratinizing pearl was formed, in the centre of which were the remains 110 J. W. DODSON of the upper parts of the isolated epidermis. The dermis, both above and below the epithelium, underwent the normal development found in culture: the cells were healthy and produced more intercellular material; the basement mem- branes remaining on the outer surfaces were sometimes seen, even after 2 days in vitro, but often were not detected. When isolated for 30 h, the histological appearance of the epidermis was similar to that at 24 h, but of thirteen explants isolated for this time, only five redeveloped a viable epithelium when recombined with dermis for 2 days; some cuboidal, dividing basal cells, a few layers of s. spinosum, and a basement membrane were present (Plate 3, fig. H). In the other explants there were occasional small groups of living basal cells on a basement membrane, but there was no continuous s. basale and no stratified arrangement. Except for these basal cells, the rest of the epidermis continued to behave as though still isolated. Although a basement membrane was present after 2 days' recombination, the earliest time of its appearance was not determined. After 36 h of isolation, many epidermal cells, including those that were unoriented between the whorls and also those that were flattened on the lower surface, resembled cells of the lower s.
Recommended publications
  • Nerve Block of Lateral Femoral Cutaneous Nerve of the Thigh
    18VTLLAA 1 Nerve block of lateral femoral cutaneous nerve of the thigh. Dr. Robert M Raw (MD) . MBChB, MFGP, MPraxMed, DA, FCA. Professor of Anesthesia retired Editor of Regional-Anesthesia.Com INDEX. 1. Introduction 2. Anatomy 3. Choice of local anesthetic 4. General indications 5. Complications and side effects 6. Conclusion ------------------------------------------------------------------------------------ 1. INTRODUCTION The lateral femoral cutaneous nerve of the thigh (LFCN) is the single human nerve most subject to anatomic variations. Figure #1shows the dermatome of LFCN. The nerve is small and mostly invisible under ultrasound scanning. For nerve block success, drug must be injected into four fascial compartments, each of which a variant nerve type may pass through in different individuals. 2. ANATOMY The lateral femoral cutaneous nerve is a sensory nerve supplying the skin on the lateral aspect of the thigh. That sensory area nearly reaches the thigh posterior midline and the thigh anterior midline. Its superior limit passes over the greater trochanter and its inferior limit nearly reaches the height of the patella. The typical LCNT, in 60% of patients, is a branch of the lumbar plexus deriving from the dorsal divisions of nerve roots L2 and L3. The LFCN forms within the psoas muscle, and exits the pelvis medial to the anterior superior iliac spine (ASIS) and under the inguinal ligament. It then passes over the sartorius muscle, under fascia lata, before branching into its final Figure 1. Classic dermatomal distribution of the divisions. In forty percent of patients the LFCN lateral femoral cutaneous nerve (LFCN), derived has completely different anatomy, but from Sobotta. fortunately the nerve always passes in proximity to the proximal sartorius muscle.
    [Show full text]
  • Preparatory: 1 Venous Access and Medication Administration: 4
    Preparatory: 1 Venous Access and Medication Administration: 4 W4444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444 UNIT TERMINAL OBJECTIVE 1-4 At the completion of this unit, the EMT-Critical Care Technician student will be able to safely and precisely access the venous circulation and administer medications. COGNITIVE OBJECTIVES At the completion of this unit, the EMT-Critical Care Technician student will be able to: 1-4.1 Review the specific anatomy and physiology pertinent to medication administration. (C-1) 1-4.2 Review mathematical principles. (C-1) 1-4.3 Review mathematical equivalents. (C-1) 1-4.4 Differentiate temperature readings between the Centigrade and Fahrenheit scales. (C-3) 1-4.5 Discuss formulas as a basis for performing drug calculations. (C-1) 1-4.6 Calculate oral and parenteral drug dosages for all emergency medications administered to adults, infants and children. (C-2) 1-4.7 Calculate intravenous infusion rates for adults, infants, and children. (C-2) 1-4.8 Discuss legal aspects affecting medication administration. (C-1) 1-4.9 Discuss the "six rights" of drug administration and correlate these with the principles of medication administration. (C-1) 1-4.10 Discuss medical asepsis and the differences between clean and sterile techniques. (C-1) 1-4.11 Describe use of antiseptics and disinfectants. (C-1) 1-4.12 Describe the use of universal precautions and body substance isolation (BSI) procedures when administering a medication. (C-1) 1-4.13 Describe the indications, equipment needed, techniques utilized, precautions, and general principles of peripheral venous cannulation (Including saline locks). (C-1) 1-4.14 Describe the indications, equipment needed, techniques utilized, precautions, and general principles of intraosseous needle placement and infusion.
    [Show full text]
  • Handbook ESRA
    TECHNIQUES HEAD & NECK 4 Intracranial surgery p. 3 Eye blocks p. 5 Face anatomy p. 16 Face particularity p. 23 Ophtalmic nerve blocks p. 27 Maxillary nerve blocks p. 33 Mandibular nerve blocks p. 46 THORAX & ABDOMEN 50 Epidural anaesthesia in Cardio-thoracic surgery p. 50 Ilioinguinal-Iliohypogastric block p. 55 Peri-umbilical & Rectus sheath block p. 57 Pudendal block p. 58 UPPER LIMB 61 Choice of a technique p. 61 Brachial plexus anatomy p. 65 Interscalen block p. 68 Supraclavicular blocks p. 73 Infraclavicular blocks p. 80 Axillary block p. 83 LOWER LIMB 90 Lumbar plexus block p. 90 Iliofascial block p. 100 Obturator block p. 102 Sciatic blocks o Sciatic blocks - parasacral nerve approach p. 109 o Sciatic blocks - posterior popliteal approach p. 115 Ankle blocks p. 119 AXIAL BLOCKS 123 Lumbar epidural p. 123 OBSTETRICS AXIAL BLOCKS 126 Epidural p. 126 PERIPHERAL BLOCKS Pudendal block p. 58 2 Aknowledgement The provenience of the materials included in this handbook is from the Learning Zone on the official site of “European Society of Regional Anesthesia and Pain Therapy”. http://www.esra-learning.com/ 2007 3 HEAD & TABLE OF CONTENTS NECK • Intracranial surgery • Eye blocks • Face anatomy • Face particularity • Ophtalmic nerve blocks • Maxillary nerve blocks • Mandibular nerve blocks • Cervical plexus blocks HEAD & INTRACRANIAL SURGERY NECK Paul J. Zetlaoui, M.D. Kremlin-Bicetre - France In intra-cranial neurosurgery, scalp infiltration aims to prevent systematic and cerebral hemodynamic variations, contemporary of skin incision. The potential morbidity of these hypertension-tachycardia episodes, even in patients profoundly anaesthetized, is secondary in the increase of the cerebral blood flow and in its deleterious consequences on intra-cranial pressure in these compromised patients.
    [Show full text]
  • The Development of an Intramuscular Injection Simulation for Nursing Students
    Open Access Technical Report DOI: 10.7759/cureus.12366 The Development of an Intramuscular Injection Simulation for Nursing Students Julia Micallef 1 , Artur Arutiunian 1 , Adam Dubrowski 1 1. Health Sciences, Ontario Tech University, Oshawa, CAN Corresponding author: Adam Dubrowski, [email protected] Abstract Intramuscular (IM) injections are preferred over subcutaneous injections for administering medicine such as epinephrine and vaccines as the muscle tissue contains an increased vascular supply that provides ideal absorption of the drug being administered. However, administering an IM injection requires clinical judgment when choosing the injection site, understanding the relevant anatomy and physiology as well as the principles and techniques for administering an IM injection. Therefore, it is essential to learn and perform IM injections using injection simulators to practice the skill before administering to a real patient. Current IM injection simulators either favor realism at the expense of standardization or are expensive but do not provide a realistic experience. Therefore, it is imperative to develop an inexpensive but realistic intramuscular injection simulator that can be used to train nursing students so that they can be prepared for when they enter the clinical setting. This technical report aims to provide an overview of the development of an inexpensive and realistic deltoid simulator geared to teach nursing students the skill of IM injections. After development, the IM simulators were tested and validated by practicing nurses. An 18-item survey was administered to the nurses, and results indicated positive feedback about the realism of the simulator, in comparison to previous models used, such as the Wallcur® PRACTI-Injecta Pads (Wallcur LLC, San Diego, CA).
    [Show full text]
  • The Digestive System
    69 chapter four THE DIGESTIVE SYSTEM THE DIGESTIVE SYSTEM The digestive system is structurally divided into two main parts: a long, winding tube that carries food through its length, and a series of supportive organs outside of the tube. The long tube is called the gastrointestinal (GI) tract. The GI tract extends from the mouth to the anus, and consists of the mouth, or oral cavity, the pharynx, the esophagus, the stomach, the small intestine, and the large intes- tine. It is here that the functions of mechanical digestion, chemical digestion, absorption of nutrients and water, and release of solid waste material take place. The supportive organs that lie outside the GI tract are known as accessory organs, and include the teeth, salivary glands, liver, gallbladder, and pancreas. Because most organs of the digestive system lie within body cavities, you will perform a dissection procedure that exposes the cavities before you begin identifying individual organs. You will also observe the cavities and their associated membranes before proceeding with your study of the digestive system. EXPOSING THE BODY CAVITIES should feel like the wall of a stretched balloon. With your skinned cat on its dorsal side, examine the cutting lines shown in Figure 4.1 and plan 2. Extend the cut laterally in both direc- out your dissection. Note that the numbers tions, roughly 4 inches, still working with indicate the sequence of the cutting procedure. your scissors. Cut in a curved pattern as Palpate the long, bony sternum and the softer, shown in Figure 4.1, which follows the cartilaginous xiphoid process to find the ventral contour of the diaphragm.
    [Show full text]
  • Pressure Ulcer Staging Guide
    Pressure Ulcer Staging Guide Pressure Ulcer Staging Guide STAGE I STAGE IV Intact skin with non-blanchable Full thickness tissue loss with exposed redness of a localized area usually Reddened area bone, tendon, or muscle. Slough or eschar may be present on some parts Epidermis over a bony prominence. Darkly Epidermis pigmented skin may not have of the wound bed. Often includes undermining and tunneling. The depth visible blanching; its color may Dermis of a stage IV pressure ulcer varies by Dermis differ from the surrounding area. anatomical location. The bridge of the This area may be painful, firm, soft, nose, ear, occiput, and malleolus do not warmer, or cooler as compared to have subcutaneous tissue and these adjacent tissue. Stage I may be Adipose tissue ulcers can be shallow. Stage IV ulcers Adipose tissue difficult to detect in individuals with can extend into muscle and/or Muscle dark skin tones. May indicate "at supporting structures (e.g., fascia, Muscle risk" persons (a heralding sign of Bone tendon, or joint capsule) making risk). osteomyelitis possible. Exposed bone/ Bone tendon is visible or directly palpable. STAGE II DEEP TISSUE INJURY Partial thickness loss of dermis Blister Purple or maroon localized area of Reddened area presenting as a shallow open ulcer discolored intact skin or blood-filled Epidermis with a red pink wound bed, without Epidermis blister due to damage of underlying soft slough. May also present as an tissue from pressure and/or shear. The intact or open/ruptured serum-filled Dermis area may be preceded by tissue that is Dermis blister.
    [Show full text]
  • Bio-Implant Reference Manual
    Bio-Implant Reference Manual International Use Only Bio-Implant Reference Manual Saving Lives, Restoring Health is our business. Nowhere is the reality of death more evident than in the decision-making process surrounding tissue and organ donation. It’s a course of action that involves everything from the simple to the complex, from the sadly certain to the certainly optimistic. LifeNet Health takes this tragedy and turns it into hope. Our full line of allograft bio-implants maximizes the precious gift of donated tissue and provides surgeons with the tools they need to improve the lives of patients. By making the finest quality allograft bio-implants easily accessible, we continue to provide exemplary service to clinicians and hospitals. Every year, LifeNet Health distributes over 400,000 bio-implants to meet the urgent needs of hospitals and patients around the world. Our record of safety is unmatched. And our philosophy is simple: When partnering with a bio-implant supplier, your decision should not be based solely on fee, but rather on the overall value you and your patients expect and deserve. At LifeNet Health, we deliver that value by excelling in these critical areas – safety, quality, innovation, service, clinical effectiveness, supply chain reliability and and experience. With LifeNet Health as your primary bio-implant supplier, you are investing in the best possible value to ensure the well-being of your patients and the reputation of your hospital. This is the value of working with LifeNet Health. 2 757-464-4761 x 2000 (OUS) • 888-847-7831 (US & Canada) • ©2014 LifeNet Health, Virginia Beach, VA.
    [Show full text]
  • Avoid Empiric Treatment for Vulvar Skin Disorders
    December 1, 2008 • www.familypracticenews.com Women’s Health 27 Avoid Empiric Treatment for Vulvar Skin Disorders BY NANCY WALSH vulva and anus. Hypopigmentation also is characteristic, ment once daily after soaking. “I believe the Temovate New York Bureau with scarring and architectural changes including phimo- brand is much better than the generic, probably because sis of the clitoris, resorption of the labia minora, and nar- of the vehicle,” he said. The corticosteroid should be con- L AKE B UENA V ISTA, FLA. — Empiric treatment rowing of the introitus causing recurrent tearing. It prob- tinued until active disease has resolved, not just for the 2 with corticosteroids should be avoided in patients who pre- ably is autoimmune, because patients have a high incidence weeks specified in the package insert. sent with vulvar symptoms such as burning, itching, pain, of other autoimmune diseases, especially thyroid disease. A second vulvar condition, lichen simplex chronicus, and dyspareunia, according to Dr. Andrew T. Goldstein. Lichen sclerosus can develop at any age, including is characterized by thick, lichenified skin of the labia ma- These patients should have a careful examination of the childhood, and is more common than generally appreci- jora and interlabial sulcus, accompanied by erosions, fis- vulva using a colposcope, and if a lesion is present, a 4- ated, with a prevalence of 1 in 70 women. But “you have suring, and tears in the skin that result from the patient’s mm punch biopsy is warranted. to look for it. The vulva is not just something to separate scratching in her sleep, said Dr.
    [Show full text]
  • Nomina Histologica Veterinaria, First Edition
    NOMINA HISTOLOGICA VETERINARIA Submitted by the International Committee on Veterinary Histological Nomenclature (ICVHN) to the World Association of Veterinary Anatomists Published on the website of the World Association of Veterinary Anatomists www.wava-amav.org 2017 CONTENTS Introduction i Principles of term construction in N.H.V. iii Cytologia – Cytology 1 Textus epithelialis – Epithelial tissue 10 Textus connectivus – Connective tissue 13 Sanguis et Lympha – Blood and Lymph 17 Textus muscularis – Muscle tissue 19 Textus nervosus – Nerve tissue 20 Splanchnologia – Viscera 23 Systema digestorium – Digestive system 24 Systema respiratorium – Respiratory system 32 Systema urinarium – Urinary system 35 Organa genitalia masculina – Male genital system 38 Organa genitalia feminina – Female genital system 42 Systema endocrinum – Endocrine system 45 Systema cardiovasculare et lymphaticum [Angiologia] – Cardiovascular and lymphatic system 47 Systema nervosum – Nervous system 52 Receptores sensorii et Organa sensuum – Sensory receptors and Sense organs 58 Integumentum – Integument 64 INTRODUCTION The preparations leading to the publication of the present first edition of the Nomina Histologica Veterinaria has a long history spanning more than 50 years. Under the auspices of the World Association of Veterinary Anatomists (W.A.V.A.), the International Committee on Veterinary Anatomical Nomenclature (I.C.V.A.N.) appointed in Giessen, 1965, a Subcommittee on Histology and Embryology which started a working relation with the Subcommittee on Histology of the former International Anatomical Nomenclature Committee. In Mexico City, 1971, this Subcommittee presented a document entitled Nomina Histologica Veterinaria: A Working Draft as a basis for the continued work of the newly-appointed Subcommittee on Histological Nomenclature. This resulted in the editing of the Nomina Histologica Veterinaria: A Working Draft II (Toulouse, 1974), followed by preparations for publication of a Nomina Histologica Veterinaria.
    [Show full text]
  • Nails Develop from Thickened Areas of Epidermis at the Tips of Each Digit Called Nail Fields
    Nail Biology: The Nail Apparatus Nail plate Proximal nail fold Nail matrix Nail bed Hyponychium Nail Biology: The Nail Apparatus Lies immediately above the periosteum of the distal phalanx The shape of the distal phalanx determines the shape and transverse curvature of the nail The intimate anatomic relationship between nail and bone accounts for the bone alterations in nail disorders and vice versa Nail Apparatus: Embryology Nail field develops during week 9 from the epidermis of the dorsal tip of the digit Proximal border of the nail field extends downward and proximally into the dermis to create the nail matrix primordium By week 15, the nail matrix is fully developed and starts to produce the nail plate Nails develop from thickened areas of epidermis at the tips of each digit called nail fields. Later these nail fields migrate onto the dorsal surface surrounded laterally and proximally by folds of epidermis called nail folds. Nail Func7on Protect the distal phalanx Enhance tactile discrimination Enhance ability to grasp small objects Scratching and grooming Natural weapon Aesthetic enhancement Pedal biomechanics The Nail Plate Fully keratinized structure produced throughout life Results from maturation and keratinization of the nail matrix epithelium Attachments: Lateral: lateral nail folds Proximal: proximal nail fold (covers 1/3 of the plate) Inferior: nail bed Distal: separates from underlying tissue at the hyponychium The Nail Plate Rectangular and curved in 2 axes Transverse and horizontal Smooth, although
    [Show full text]
  • Unit 4: Medication Administration Fundamental of Nursing
    Unit 4: Medication Administration Fundamental of Nursing Unit 4: Medication Administration: Medication: Is a substance administered for the diagnosis, cure, treatment, relief, or prevention of disease. Six Rights of Medication Administration After paramedics have received the medication or fluid order, they should then administer the drug in question. In performing drug administration, pre-hospital care providers adhere to the six rights of medication administration: 1. Right patient 2. Right medication 3. Right dose 4. Right route 5. Right time 6. Right documentation Basic principle of nurse on drugs administration 1. The nurse must know the drug's prescribed dose, method of administration, actions, expected therapeutic effect, possible interactions with other drugs, and adverse effects. 2. The nurse must know the institution's administration procedures for the client's welfare and the nurse's legal protection. 3. The nurse must Review physician's order for completeness the client's name, date of the order, name of the drug, dose, rout, time of administration, and the physician's signature. 1 Unit 4: Medication Administration Fundamental of Nursing 4. The nurse discusses the medication and its actions with the client; recheck the medication order if the client disagrees with the dose or the physician's order. 5. The nurse must check the physician's order against the client's medication administration record for accuracy. 6. The nurse gives the patient the right to know about the medication he is receiving and the right to refuse it. Routes of Administration A: Enteral Tract Routes The common enteral routes of administration used in general medical practice are as follows: 1.
    [Show full text]
  • Basic Biology of the Skin 3
    © Jones and Bartlett Publishers, LLC. NOT FOR SALE OR DISTRIBUTION CHAPTER Basic Biology of the Skin 3 The skin is often underestimated for its impor- Layers of the skin: tance in health and disease. As a consequence, it’s frequently understudied by chiropractic students 1. Epidermis—the outer most layer of the skin (and perhaps, under-taught by chiropractic that is divided into the following fi ve layers school faculty). It is not our intention to present a from top to bottom. These layers can be mi- comprehensive review of anatomy and physiol- croscopically identifi ed: ogy of the skin, but rather a review of the basic Stratum corneum—also known as the biology of the skin as a prerequisite to the study horny cell layer, consisting mainly of kera- of pathophysiology of skin disease and the study tinocytes (fl at squamous cells) containing of diagnosis and treatment of skin disorders and a protein known as keratin. The thick layer diseases. The following material is presented in prevents water loss and prevents the entry an easy-to-read point format, which, though brief of bacteria. The thickness can vary region- in content, is suffi cient to provide a refresher ally. For example, the stratum corneum of course to mid-level or upper-level chiropractic the hands and feet are thick as they are students and chiropractors. more prone to injury. This layer is continu- Please refer to Figure 3-1, a cross-sectional ously shed but is replaced by new cells from drawing of the skin. This represents a typical the stratum basale (basal cell layer).
    [Show full text]