Lesson visuals · Diagrams v2

Pictures that teach — the professional set

Every figure below is a professionally drawn, openly licensed medical illustration or clinical photo — Blausen Medical, OpenStax, Servier-grade sources — with the license recorded under each card. No hand-drawn art.

Skin integrity

Pressure injury — the stages, in real clinical photos

Stage 1 pressure injury: intact skin with non-blanchable redness over the sacrum

Stage 1Intact skin · non-blanchable redness over a bony prominence

Stage 2 pressure injury: shallow open wound with a pink-red bed

Stage 2Partial-thickness · pink, moist bed or a blister — no fat visible

Stage 3 pressure injury: deep crater with yellow slough, fat visible

Stage 3Full-thickness · fat visible — bone, tendon, muscle NOT exposed

Stage 4 pressure injury: large deep wound with exposed underlying structures

Stage 4Full-thickness · muscle, tendon or bone exposed

Unstageable pressure injury: wound bed completely covered by black eschar

UnstageableBed hidden by slough or eschar — depth cannot be judged until it is cleaned

Deep tissue pressure injury: heel with deep purple-maroon discoloration

Deep tissue injuryIntact skin, deep red–purple — the damage starts deep, at the bone–muscle layer

These are real wound photographs — the same way nursing textbooks teach staging. Stage by depth, never by size.

Stage by depth, not by size. A small sore can be Stage 4 if it reaches bone — and a wound covered by eschar cannot be staged at all until the dead tissue is removed.

Photos: Dweekat et al., International Journal of Environmental Research and Public Health, CC BY 4.0 — via OpenStax Medical-Surgical Nursing §28.3, Figures 28.5(a)–28.10 (panel (a) photographs only).

Burns

Burns — depth of the burn

Normal skin

1st degreesuperficial

2nd degreepartial-thickness

3rd degreefull-thickness

1st · superficial

Epidermis only · red, painful, no blisters · heals in about a week

2nd · partial-thickness

Into the dermis · blisters, moist, very painful · heals in about 2–3 weeks

3rd · full-thickness

All layers destroyed · white, brown or charred, leathery · the center may feel nothing — the nerves are gone · needs grafting

Depth decides the story. Superficial burns hurt and heal. Full-thickness burns destroy the nerve endings, so the center may not hurt at all — that silence is a danger sign, not a comfort.

Illustration: BruceBlaus / Blausen Medical, "1st, 2nd, and 3rd degree burns", CC BY-SA 4.0 (via Wikimedia Commons). Degree chips are page overlays, not part of the artwork.

Burns

Burns — rule of nines

OpenStax rule of nines chart, front and back: head and neck 9 percent, upper limbs 9 percent each, trunk 36 percent, genitalia 1 percent, lower limbs 18 percent each

The split

Head & neck 9% · each arm 9% · trunk front 18% · trunk back 18% · each leg 18% (9 front + 9 back) · perineum 1% = 100%

Children differ

A child's head is proportionally larger — use the pediatric (Lund–Browder) chart for kids.

The fastest surface-area estimate in the burn unit. Count in nines — and remember this is the adult chart.

Illustration: OpenStax College, Anatomy & Physiology, CC BY 3.0 (via Wikimedia Commons, "513 Degree of burns"). Labels are part of the original figure.

Medication administration

IM injection sites

1 · Deltoid — upper arm

Blausen illustration of the deltoid injection site, labeled with the acromion, deltoid muscle and level of the armpit

Thickest part of the muscle, about 5 cm (2–3 fingerbreadths) below the acromion. Small volumes only — the bursa sits above, the radial nerve below.

2 · Vastus lateralis — outer thigh

Blausen illustration of the thigh showing the vastus lateralis outer middle third injection zone on both legs

The middle third of the outer thigh, between the greater trochanter and the knee.

First choice for IM adrenaline in anaphylaxis — this muscle absorbs fastest. That is exactly what the app's anaphylaxis lesson teaches.

3 · Ventrogluteal — the hip, by hand landmarks

Blausen illustration of ventrogluteal landmarking: palm on the greater trochanter, fingers spread toward the front of the hipbone

Palm on the greater trochanter (the art's "Large Bone at Hip"), index finger to the ASIS ("Front of Hipbone"), middle finger along the iliac crest — inject inside the V between the fingers. Clear of the sciatic nerve; a safe site for larger volumes.

Landmarks first, needle second. Every safe IM site is found by bone landmarks — acromion, greater trochanter, iliac crest — never by guessing a spot on the skin.

Illustrations: BruceBlaus / Blausen Medical, CC BY-SA 4.0 (via Wikimedia Commons). The deltoid image is cropped from the source's rear-end & deltoid figure; labels are the original artwork.

Cardiac · ECG

ECG — one heartbeat, labeled

One beat, three waves, three intervals. If you can measure the PR and the QRS on a single complex, you can read any strip the exam puts in front of you.

PNLE Companion artwork — waveforms generated from a parametric beat template on a true 25 mm/s · 10 mm/mV grid (same verified waveforms as v1, restyled).

Cardiac · ECG

ECG — the board rhythm patterns

Read every strip the same way: rate, rhythm, P waves, QRS. Two of these six are act-first emergencies — VF gets a shock; asystole gets CPR and epinephrine, never a shock.

PNLE Companion artwork — parametric waveforms, restyled for v2.

Maternal & child

Fetal circulation — the three shunts

OpenStax fetal circulation diagram: fetus with labeled ductus arteriosus, foramen ovale, ductus venosus, umbilical arteries and vein, and placenta

Ductus venosus — umbilical vein → inferior vena cava, bypassing the liver

Foramen ovale — right atrium → left atrium, bypassing the lungs

Ductus arteriosus — pulmonary artery → aorta, bypassing the lungs

OxygenatedMixedDeoxygenated

Before birth, the placenta is the lung. Three shunts route blood around the fluid-filled lungs — and all three are supposed to close once the baby takes its first breaths.

Illustration: OpenStax College, Anatomy & Physiology, CC BY 3.0 (via Wikimedia Commons, "2139 Fetal Circulation"). Labels are part of the original figure; the shunt list below it is ours.