Intergumentary Chap 53 Flashcards
(122 cards)
1
Q
What is the epidermis?
A
Top layer of skin
Stratified squamous epithelial tissue (dead cells)
Avascular (no capillaries)
2
Q
What does the epidermis do?
A
Acts as a barrier against pathogens & chemicals
3
Q
What is Keratin?
A
Protein in epidermis/hair/nails
Relatively waterproof
4
Q
What does Keratin do?
A
Helps prevent dehydration
5
Q
What is Melanin?
A
Protein made in lower epidermis by melanocytes
Amount made is genetically controlled
6
Q
What does Melanin do?
A
Give color to skin/hair
A pigment barrier that protects epidermis from UV rays
7
Q
What are Ultraviolet (UV) Rays?
A
They are mutanigenic from the sun or artificial light
8
Q
What are Langerhans’ cells?
A
A macrophage in the epidermis
Presents foreign antigens to helper T cells
1st step to destroy pathogens that penetrate the
epidermis
9
Q
What is the Dermis?
A
Consists of 2 layers
Papillary region
Reticular region
Is where hair/nail follicles are found
Vascular (has capillaries)
10
Q
What is the Papillary region?
A
Outer region
Made of adipose tissue & elastin
Where capillaries are found
Nourishes the epidermis
11
Q
What is the Reticular region?
A
Made of cells called fibroblasts
Collagen- forms the strength of dermis
Elastin - allows for recoil - skin elastic
12
Q
What is Hair?
A
Eyelashes
Eyebrows
Nostrils
Head
13
Q
What is the function of Eyelashes/Eyebrows?
A
Keeps dust & sweat out of eyes
14
Q
What is the function of nostril hairs?
A
Filters & warms air entering nasal cavity
15
Q
What is the function of head hair?
A
Provides thermal insulation
16
Q
Where are nails found?
A
On the ends of fingers and toes
17
Q
What is the function of nails?
A
Protects ends of digits from mechanical injury
Helpful in picking up small objects
18
Q
What are Receptors?
A
Free nerve endings for heat/cold/pain
Encapsulated nerve endings for touch/pressure
Found in dermis
19
Q
What do Sebaceous glands do?
A
Secretes the liquid sebrum
Inhibits growth of bacteria
Prevents hair & skin from drying out
20
Q
What are Sudoriferous glands?
A
aka - sweat glands
2 different kinds
Apocrine glands
Eccrine glands
Both are effective cooling mechanisms
21
Q
Where are Apocrine glands?
A
In the axillae & genital areas
Are modified sweat glands
Activated by stress & emotion
22
Q
Where are Eccrine glands found?
A
Face
Palms
Soles of feet
Activated by elev temp/exercise
23
Q
What are Ceruminous glands?
A
Modified sweat glands
Found in dermis of ear canals
24
Q
What do Ceruminous glands secret?
A
Cerum (earwax)
25
What does Cerum do?
Prevents drying of outer surface of ear drum
26
What do the blood vessels do?
Provide tissue nourishment
| Maintain body temp
27
What does vasodilation do?
In warm environment increases blood flow
| & loss of heat to air
28
What does vasoconstriction do?
In cold environment decreases blood flow
| Conserves body heat
29
Where is the Subcutaneous tissue?
Btw dermis and muscle
30
What does the Subcutaneous tissue do?
Has WBC that destroy pathogens
Cushions bones
Provides insulation from cold
Energy storage (most important) adipose
31
Factors in the aging integumentary system
```
Hair follicles inactive
Melanocytes die
Hair gray - thinning
Epidermis cell division slows
Fibroblast in dermis die
Skin becomes thinner
Slower healing
Collagen/Elastin deteriorate
Wrinkles
Sebaceous/Sweat glands less active
Fat in Subcutaneous layer decreases
Temp hard to regulate
Skin becomes dry
```
32
Describe assessment tool "WHAT"S UP"
W - where is it? is it anywhere else?
H - how does it feel? - itch-burn-hurt?
A - Aggravating & alleviating factors
does scratching ease it
do soaps aggravate it
T - Timing - how long has it been a prob - does it
reoccur?
S - Severity - Discomfort - scale 0-10
U - Useful other data - any other symptoms
P - Patient's perception - What do you think causes
the rash?
33
Describe skin of neonate?
Very thin
| Friable (easily broken)
34
Describe skin of adolescent
Skin thickens
Active sebaceous eccrine & apocrine glands
Changes in body hair (hormonal)
35
Describe skin of elderly
```
Loss of elasticity (tugor)
Loss of moisture
Decrease activity of sebaceous & sweat glands
Skin gets thinner
Fragile
Wrinkled
```
36
What affects skin color>
Temp
Oxygenation
Blood flow
Exposure to UV rays
37
What causes Pallor?
Vasoconstriction
Decreased blood flow
Anemia
38
Whgre to assess for Pallor?
Face
Conjunctivae
Nail beds
Lips
39
What causes Erythemia?
```
Vasodilation
Circulatory changes
Increased blood flow
Fever
Inflammation
```
40
Where to assess for Erythemia?
Face
| Area of trauma
41
What causes Jaundice?
Liver disease
42
Where to assess for Jaundice?
Sclera (eyes)
43
What causes Cyanosis?
Cardiac issues
Pulmonary issues
Perfusion issues
44
Whree to assess for Cyanosis?
```
Lips
Nail beds
Conjunctivae
Palms
NOTE: Medietranean people naturally have bluish
tint to lips NOT cynotic
```
45
What causes brown color of skin?
Increased Melanin
Chornic exposure to sun
Pregnancy
Chronic peripheral vascular dz (lower legs)
46
Whre to assess for brown color?
Face
| Aerolae/nipples
47
What are Lesions?
Any change or injury to tissue
48
What is a Primary lesion?
Initial reaction to a dz process
49
What is a Secondary Lesion?
Changes in primary lesion caused by
trauma
scratching
infection
50
Describe naturally Dark skin
Reddish undertones
| Pinkish buccal mucosa, tongue, nails, lips
51
Describe Pallor in dark-skinned pt
Mucous membranes ash-gray color
Lips/nail beds paler than usual
Skin yellow/brown to ash/gray
52
Describe Erythemia in a dark skinned pt?
Purple/gray color
53
Describe Cyanosis in a dark-skinned pt
Grayish skin
| Bluish nailbeds. palms, soles
54
Describe jaundice in a dark-skinned pt
```
Yellowish/orange
Oral mucosa (hard palate)
Sclera closest to cornea
```
55
Describe assessment for Moisture/Dryness
Observe moisture.dryness. scales. flakes
Moisture can be found in skin folds
S/b normally smooth & dry
Flaking/scales = dry skin &/or inflammatory dz
56
What causes Edema?
Buildup of fluid in tissues
| Skin becomes stretched/dry/shiny
57
What is dependent edema?
Appears in the lower part of the body(R-sided heart failure)
| feet/ankles/sacrum
58
What is Petechiae?
Reddish purple hemorrhagic spots smaller that 0.5mm
59
What is Eccymosis?
A bruise that changes color from blue-black to greenish-brown/yellow over time
60
What is a Macule?
Primary lesion
| Flat non-palbable change in skin color (freckles)
61
What is a Papule?
Primary lesion
| Palpable solid raised lesion (ringworm,wart,mole)
62
What is a Nodule?
Primary Lesion
| fibroma (fibroid tumor - benign)
63
What is a Vesicle?
Primary lesion
| Sm raised area contains serous fluid less that 1 cm blister like (shingles, chix pox)
64
What is a Bulla?
Primary lesion
| Vesicle or blister larger that 1 cm (burns, contact dermatitis)
65
What is a Pustule?
Primary lesion
| Sm elev in skin/vesicle/bulla w/semisolid/solid/liquid exudates (impetigo, scabies, acne)
66
What is a Wheal?
Primary lesion
| Round transient elev of skin caused by dermal edema surrounding capillary dilation (hives, insect bites)
67
What is Plaque?
Primary lesihn
| Patch or solid raised lesion on skin/mucous memb > 1cm (psoriasis)
68
What is a Cyst?
Primary lesion
| Closed sac/pouch tumor w/semisolid/solid/liquid material (sebaceous cyst)
69
What is a Scale?
Secondary lesion
| very dry skin (cradle cap, psoriasis)
70
What is Crust?
Secondary lesion
scab
impetigo
71
What is Excoriation?
Secondary lesion
| Traumatized abrasion
72
What is a Fissure?
Secondary lesion
Athlete's foot
Anal fissures
73
What is an Ulcer?
Secondary lesion
| open sore to dermis
74
What is Lichenification?
Secondary lesion
| Thick/hard skin due to intense scratching
75
What is a Scar?
Secondary lesion
| Result of wound healing
76
What is Alopecia?
Hair loss
77
What is terminal hair?
```
Hair on scalp
Eyebrows
Axillae
Pubic area
Face/chest of men
```
78
What is Vellus hair?
Soft shiny hairs that cover the body
79
What do you assess in Nail beds?
```
Color
Shape
Texture
Thickness
Abnormalities
```
80
What re normal findings in Nails?
Pink
Smooth
Hard
Slightly convex
Firm base
Elderly - yellowish/gray color, thickening/ridges
Dark skinned pt - brown or black btw nail & base
81
What are abnormal findings in Nails?
```
Clubbing (hypoxia)
Spoon nails (anemia)
Thick nails (fungal infection)
```
82
What are Spoon nails?
Concave nails
aka koilonychias
May be associated w/anemia
83
What are Beau's lines?
Transverse depressions in the nails
84
What are Splinter hemorrhages?
Red or brown streaks in nail bed caused by trauma
85
What is Paronychia?
Inflammation of the skin at base of nail from biting nails and/or cuticles
86
Why are skin cultures done?
To determine presence of fungi, bacteria & viruses
87
What are three types of skin biopsies?
Punch
Shave
Incisional
88
Describe Punch skin biopsy
Sm round cutting instrument (punch) to cut cylinder-shaped plug of tissue for full-thickness specimen
89
Describe Shave skin biopsy
Removes just the area risen above the skin
90
Describe incisional skin biopsy
use of scapel to make incision
| Needs sutures to close
91
What is Wood's Light Examination?
Use of blacklight (UV rays) to detect fluorescent material in skin &U hair
92
What is a Scratch Test?
To determine specific allergies (immediate reaction)
Scratch or prick skin w/allergen
If Wheal appears test is positive
NOTE: Must have resuscitation equip nearby in case of severe anaphylactic reaction
93
What is a Patch Test?
To determine specific allergies (over time)
Allergen s applied to occlusive tape patched then applied to skin
Removed after 2 days
Reaction noted within 2-5 days
94
Why is a wet dressing used?
```
Decrease inflammation
Cleanse & dry wound
To provide environment for drainage to infected area
Can be sterile or clean
Applied Q3-4 hrs for 15-30 mins
Not more than 72 hrs
```
95
What is Balneotherapy?
Therapeutic bath
For applying meds to lrg areas of skin & debridement
Also used to relieve itching and inflammation Used for 15-30 mins liquid s/b warm
Bath tub
96
What are some basic topical medications?
```
Lotions
Ointments/creams
Gels
Pastes
Corticosteroids
```
97
What are Lotions used for?
Cooling
| Anti-itch
98
What are Ointments/Creams used for?
Protects skin
Lubricates
Prevents water loss
99
What are Gels?
Semisolid emulsions that turn to liquid
| Many steroids are gels
100
What are Pastes?
Made of ointments & powders
| Used for inflammation
101
What are Corticosteroids used for?
Reduce/relieve pain & itching
Reduce inflammation
Overuse can cause thinning skin
102
What is Intralesion Therapy used for?
Anti-inflammatory action
| Treat psoriasis & keloids (on people of color on skin)
103
What is an occlusive dressing used for?
Sealing a wound - air-tight
| Used for no more than 12/hrs per day
104
What is an alginates dressing?
```
Made from brown seaweed
Packed into wound
Absorbs exudates
Provides moist environment for healing
(ie kaltostat, seasorb)
```
105
What is a microbial dressing?
Topical drsg w/silver, iodine & polyhexamethal biguanade
| For draining non-healing wounds (ie aquacel, tegaderm)
106
What is a collagen drsg used for?
To stimulate new tissue crowth
107
What is Promogram Matrix drsg used for?
For veins and arteries
Diabetic foot ulcers
Venous leg ulcers
Surgical wounds
108
What are composite drsgs?
Combining 2 or more distinct products into a single drsg
109
What is a contact layers drsg?
Non-adherent drsg layers
Allows exudates to flow to 2ndry drsg
To protect wound
Provides moist environment
110
What is a Foam drsg used for?
Used to provide moist environment
| Provide thermal protection
111
What is a Hydrocolloid drsg?
An occlusive or semi-occlusive drsg
Provides moist environment
Allows clean wound to granulate
ie tegaderm - duoderm
112
What is a Hydrogel drsg?
Water or glycerine amorphous gel in gauze or sheet drsg
Moist healing
Promotes ganulation
113
What is an Impregnated gauze drsg?
Woven or non-woven material w/medication already in it
| Xeroform
114
What are transparent film drsgs?
Adhesive semi-permeable-waterproof
Used for moist healing
Promotes granulation
115
What are wound fillers?
Sterile products that absorb exudate
| ie wet dressing
116
What protein in epidermal cells make skin relatively waterproof?
Keratin
117
What is function of subcutaneous fissure?
Cushions bony prominenced
Provides insulation
Stores energy
118
How do arterioles in the dermis respond to cold environment?
Constrict to conserve heat
119
What tissue stores fat in subcutaneous tissue?
Adipose tissue
120
What substance is formed when UV rays strike skin?
Melanin and Vitamin D
121
What layer of skin if unbroken, prevents entry of most pathogens?
Stratum corneum *outer layer of epidermis)
122
WBC that destroy pathogens that enter breaks in skin are found in what struction?
Subcutaneous tissue
