integumentary system ch.13 Flashcards

1
Q

includes

A
skin 
nails
hair
mucous membranes
glands
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2
Q

functions

A
  • protects the body from pathogen invasions
  • regulates temperarure
  • senses environmental changes
  • maintains water balance
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3
Q

skin layers

A
  • hypodermis: inner
  • dermis: middle
  • epidermis: outer
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4
Q

hypodermis

A

blood vessels
nerves
immune cells

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5
Q

dermis

A

dense connecitve tissue, fatty tissue

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6
Q

keratin

A

protein that strengths skin

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7
Q

melanin

A

pigment that protects from ultraviolet rays

  • allows u to tan
  • as you get older you loose melatin
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8
Q

sebaceous glands

A

produce sebum to moisturize and protect the skin

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9
Q

sweat glands

A

eccrine glands
- secrete through skin pores in response to the sympathetic nervous system

apocrine glands
- open into hair follicles in the axillae, scalp, face, and external genitalia

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10
Q

integumentary conditions

A
  • result in impaired skin integrity

- result in risk for infection

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11
Q

changes associated with aging: decreased sensations

A

of pain, vibration, cold, heat, pressure, and touch

  • secondary to decreased blood flow to touch receptors
  • decreased blood flow to the brain
  • increase the risk of injury including falls, decubitus ulcers, burns, and hypothermia
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12
Q

changes associated with aging: decreased elasticity, integrity, and moisture

A
  • environmental factors, genetic makeup, and nutrition
  • contribute to these changes, especially sun exposure
  • blue eyed, fair skin people show more of these changes
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13
Q

changes associated with aging: appearance

A

thin, pale, and translucent

  • epidermis thins even though the number of cell layers remains unchanged
  • melanocyte numbers decrease but increase in size

large pigmented spots (lentigos) may appear in sun exposed areas

changes in connective tissue reduce skin strength and elasticity

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14
Q

changes associated with aging: dermis blood vessels

A

becomes fragile, leading to bruising, cherry angiomas, and other smilar conditons

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15
Q

changes associated with aging: sebaceous glands

A

produce less sebum

  • men experienc a minimal decrease, usually after the age of 80
  • women gradually produce less sebum beginning after menopause
  • difficult to maintain skin moisture
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16
Q

changes associated with aging: subcutanous fat layer

A

thins

  • increases risk of skin injury and reduces the ability to maintain body temperature
  • changes the actions of some medications
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17
Q

changes associated with aging: repairs

A

more slowley

  • wound healing may be up to four times longer
  • contributes to decubitus ulcer formation and infections
  • the prescence of chronic diseases along with other changes with agin further delays healing
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18
Q

urticaria

A
  • raised erthematous skin lesions (welts)
  • short lived and harmless
  • can impair breathing is around the face and progress to anaphylaxis and shock
  • diffuse welts that blanch and pruitus
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19
Q

urticaria cause

A
  • result of a type 1 hypersensitivity reaction often triggered by food and medicine
  • emotional stress
  • excessive perspiration, disease
  • autoimmune conditons, and leukemia
  • infections
  • occurs when histamine release is initiated by these substances or conditions
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20
Q

urticaria manifestations

A

welts that blanch and pruritus

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21
Q

urticaria diagnosis

A

history
physical examination
allergy testing
skin biopsy

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22
Q

urticaria treatment

A
  • avoid hot baths or showers
  • avoid further irritation
  • antihistamines
  • epinephrine
  • corticosteroids
  • maintain respiratory status
23
Q

infectious integumentary disorders

A
  • skin infections are common
  • organisms gain access through breach in skin or mucous membrane
  • triggers inflammatory responses
  • occur in any skin layer or structure
  • may be acute or chronic and severity varies
  • resolves with treatment
24
Q

bacterial infections

A
  • can be caused by any of the normal flora bacteria
  • varies from mild to life threatening
  • staphylococcus and streptococcus genera are common culprits
25
Q

bacterial infections: cellulitis

A
  • occurs deep in the dermis and sub q tissue
  • results from a direct invasion of pathogens through a break in skin, especially those breaches where contamination is likely, or spreads from an existing skin infection
  • appears as a swollen , warm, tender area of erythema
26
Q

cellulitis manifestations

A

indicators of infection

  • fever
  • leukocytosis
  • malaise
  • arthralgia
27
Q

cellulitis complications

A

necrotizing fasciitis
septicema
septic shock

28
Q

viral infectons: herpes zoster (shingles)

A
  • caused by the varicella-zoster virus
  • appears in adulthood years after primary infection of varicella in childhood
  • virus lies dormant on a cranial nerve or a spinal nerve dermatone untill it is activated years later
  • virus affects this nerve only, giving the condition its typical unilateral manifestations
29
Q

herpes zoster (shingles) manifesations

A
  • pain
  • paresthesia
  • red or silvery vesticaulr rash develops in a line over the area innervated by the affected nerve (may last for weeks or months)
  • extremely sensitive skin
  • pruritis
30
Q

herpes zoster (shingles) complications

A

neuralgia and blindness

31
Q

herpes zoster (shingles) treatment

A

antivirals
antidepressants
anticonvulsants
vaccines

32
Q

pressure injuries

A
  • soft tissue injuries that result of unrelieved mechanical pressure
  • results in areas of necorsis and ulceration where the tissue is compressed between bony prominences and extrernal hard surfaces
  • can develop in 1-2 hours if pressure is not relieved
  • classification using a stagng system but not all injuries follow a linear progression
33
Q

pressure injuries common sites

A
sacrum
ischial tuberosities
trochanters
malleoli
heels
can develop anywhere
34
Q

pressure injuries risk factors

A
advancing age
impaired circulation 
tissue perfusion 
immobilization 
malnutriton 
decreased sensation 
incontinence
35
Q

stage 1

A

skin is intact, nonblanchable erthema is present

36
Q

stage 2

A

erosion or blister with or without true ulcerations, no exposed sub c tissue

37
Q

stage 3

A

full thickness skin loss with damage to sub q tissue down to the underlying fascia

38
Q

stage 4

A

full thickness skin loss with extensive destruction, tissue necrosis, and damage to exposed supporting structures

39
Q

deep tiisue injury

A

skin may or may not be intact

underlying tissue is damaged

40
Q

unstageable

A

full thickness skin tissue loss in which the extent of damage cannot be determined because it is hidden by slough or eschar

41
Q

pressure injuries complications

A

challenging mitigating factors

  • ulcers can become infected with hospital acquired
  • antibitoic resistant organism
  • sinus tracts
  • osteomyelitis
  • cellutitis
  • tissue calcifcation
  • bactermia
  • meningitis
  • endocaridits
  • squamous cell carcinoma
42
Q

pressure injuries diagnosis

A

physical examination

additional test depending upon the stage

43
Q

pressure injuries treatment

A
reduce pressure 
care for wound 
minimize infection 
support nutritional needs
pain management 
antibiotics 
negative pressure therapy 
topical recombinant growth factors 
electrical stimulation therapy 
therapeutic ultrasonography 
surgical closure 
skin grafts
44
Q

pressure injuries healing

A

take weeks, prevention is critical
several scales developed to assess risk:
- norton scale
- braden scale

45
Q

skin cancer

A
  • abnormal growth of skin cells
  • most frequently occurring cancer in us
  • usually on arms and neck
  • early detection is crucial to positive outcomes
46
Q

skin cancer risk factors

A
  • uv exposure
  • natural or artifical
  • most prevalent in males, caucasians, those with fair complaxtion, and those with a family history
47
Q

skin cancer: basal cell carcinoma

A
  • most common
  • develops from abnormal growth of cells in the lowest layer of the epidermis
  • rarely metastasizes
48
Q

skin cancer: squamous cell carcinoma

A

involves changes in the squamous cells, found in the middle layer of the epidermis

49
Q

skin cancer: melanoma

A
  • develops in the melanocytes
  • least common type but most serious
  • often metastasizes to other areas
50
Q

skin cancer suspicious features

A
  • asymmetry
  • border irregularity
  • color variations
  • diameter larger than 6mm
  • any skin growth that bleeds or will not heal
  • any skin grwoth that changes in appearance over time
51
Q

ABCDE

A

A: asymmetry: moles have assymetrical apperance

B: border: a mole that has blury and or jagged edges

C: color: mole that has more than one color

D: diameter: moles with a diameter larger than a pencil eraser

E: evolution: a mole that has gone through sudden changes in size, shape, or color

52
Q

skin cancer diagnosis

A

history
physical examination
biopsy

53
Q

skin cancer prevention

A

limiting or advoiding exposure to uv light

54
Q

skin cancer treatment

A
cryosurgery
excision surgery 
laser therapy 
Mohs surgery 
examining each layer under microscope 
curettage
electrodesiccation 
electric needle to destroy any cells
radiation therapy 
chemo