Exam 1 - Integumentary System Flashcards Preview

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Flashcards in Exam 1 - Integumentary System Deck (29):
1

Nails

Nails
Protect the distal end of the fingers and toes

2

Lunula

Lunula-white area, part of matrix

3

Cuticle

Cuticle: prevents infection/moisture from getting under the skin

4

Common or concerning symptoms?
What do you ask?

Hair loss, rash, moles

“Have you noticed any changes in your skin or your hair?”
“Have you noticed any moles that have changed size, shape, color, or sensation?”
“Have you noticed any new moles?”

5

Skin cancers are most common cancers in the US. Where is it most prevalent?

Most prevalent on hands, neck, and head

6

Role of PA and Skin

Early detection of suspicious moles
Protective measures for skin care
Hazards of excessive sun exposure

7

Basal cell carcinoma

Comprises 80% of skin cancers
Shiny and translucent, they grow slowly and rarely metastasize

8

Squamous cell carcinoma

Comprises 16% of skin cancers
Crusted, scaly, and ulcerated, they can metastasize

9

Melanoma

Melanoma
Comprises 4% of skin cancers
Rapidly increasing in frequency, they spread rapidly
Most lethal, but if found early almost 100% curable
Common between age 25-29, indoor tanning increases risk 75%

10

ABCDE: screening lesions for possible melanoma

A for asymmetry
B for irregular borders, especially ragged, notched, or blurred
C for variation or change in color, especially blue or black
D for diameter ≥6 mm or different from other moles, especially changing, itching, or bleeding
E for evolution

11

Health Promotion Tips

Examine your body front and back in mirror
Look at right and left sides with arms raised
Bend elbows and look carefully at forearms, upper underarms, and palms
Look at backs of legs and feet
Spaces between toes
Soles
Examine back of neck and scalp with hand mirror
Part hair for closer look
Check back and buttocks with a hand mirror

12

Patient education on sun exposure

Avoiding excess sun exposure
Use umbrellas/protective hats, sunglasses, clothing
SPF 15 minimum to all sun exposed skin
SPF 15 blocks over 90% of UVB

13

SPF

SPF rating denotes #minutes it takes for skin to redden when exposed to UVB
Indoor tanning beds considered “carcinogenic to humans”

14

Skin Exam

Color, moisture, temperature, turgor, mobility, texture, lesions

15

Color of skin

Patients often notice change in color before physician
Look for increased pigmentation, loss of pigmentation
Look for redness, pallor, cyanosis, and yellowing

16

Where is red color best assessed?

Red color of oxyhemoglobin best assessed at fingertips, lips, and mucous membranes
In dark-skinned people, palms and soles

17

Where is cyanosis best assessed?

For central cyanosis, look in lips (circumoral cyanosis), oral mucosa, and tongue

18

Where is jaundice best assessed?

Jaundice - sclera

19

Parts of skin exam:

Moisture
>Dryness, sweating, and oiliness

Temperature
>Use back of fingertips
>Identify warmth or coolness of skin

Texture
>Roughness or smoothness

Mobility and turgor
>Lift fold of skin
>Note ease with which it lifts up (mobility) and speed with which it returns to place (turgor)

20

What do you do when you encounter a lesion?

Note characteristics
Anatomic location and distribution
Patterns and shapes
Type of lesion (macules, papules, nevi, vesicles)
Color

21

Hair

Note quantity, distribution, and texture

22

Nails

Inspect and palpate fingernails/toenails
Note color, shape, lesions
Longitudinal bands of pigment may be a normal finding in people with darker skin

23

Decubitus ulcers

People confined to bed are particularly susceptible to skin damage and ulceration (decubitus ulcers)

24

When do ulcers occur?

Pressure sores result when sustained compression obliterates arteriolar and capillary blood flow to the skin

25

How are bed sores assessed?

Assess these patients by carefully inspecting the skin that overlies the sacrum, buttocks, greater trochanters, knees, and heels.

26

Nonpalpable flat lesions

Nonpalpable flat lesions
Macule
Patch

27

Depressed Lesions

Depressed lesions
Erosion
Excoriation
Fissure
Ulcer

28

Palpable raised lesions

Palpable raised lesions
Papule
Plaque
Nodule
Cyst
Wheal
Vesicle
Bulla
Pustule
Burrow
Scale crust
Lichenification
Scar
keloid

29

Good skin and bad skin documentation examples

“Color good. Skin warm and moist. Nails without clubbing or cyanosis. No suspicious nevi. No rash, petechiae, or ecchymoses.”

“Marked facial pallor, with circumoral cyanosis. Palms cold and moist. Cyanosis in nailbeds of fingers and toes. One raised blue-black nevus, 1x2 cm, with irregular border on right forearm. No rash.”