Lecture 1

Question 1

three layers of the skin are?

Answer 1

epidermis
dermis
subcutaneous tissue/hypodermis

Question 2

larges portion of the skin, connective tissue between the epidermis and subcutaneous tissue

Answer 2

dermis

Question 3

involved in producing the pigment melanin (brown) which colors the skin and hair?

Answer 3

melanocytes

Question 4

roles as receptors that transmit stimuli to the axon

Answer 4

merkel cells

Question 5

role in cutaneous immune system reactions and protects against microorganism against injury

Answer 5

langerhans cells

Question 6

function of the dermis includes:

Answer 6

Provides strength and structure in the form of collagen and elastic fiber
Strength and structure in the form of collagen and elastic fiber

Question 7

subcutaneous tissue functions

Answer 7

innermost layer of the skinprimarily composed of adipose and connective tissue
provides a cushion between the skin layers and the muscles and bones
protects the nerve and vascular structures that transect the layers
subcutaneous tissues and the amount of fat deposited are important factors in body temperature regulation

Question 8

Hair growth from most rapid:

Answer 8

1. beard
2. hair on scalp
3. axillae
4. thighs
5. eyebrows

Question 9

term for excessive hair growth

Answer 9

hirsutism

Question 10

term for hair loss

Answer 10

alopecia

Question 11

glands associated with hair follicleslubricating the hair and rendering the skin soft and pliable

Answer 11

sebaceous glands

Question 12

Thin, watery secretion calledsweatis produced in the basal coiled portion of the eccrine gland and is released into its narrow duct

Answer 12

eccrine glands

Question 13

Regeneration of the nails:

how long for fingernails and toenails?

Answer 13

Fingernails – 6 months
Toenails – 18 months

Growth is faster in fingernails than toenails and tends to slow with aging

Question 14

functions of the skin

Answer 14

Protection
Sensation
Receptors in the skin are to sense temperature, pain, light touch, and pressure
Fluid balance
[prevents dehydration] –> Epidermis—has the capacity to absorb water, thereby preventing an excessive loss of water and electrolytes
Severe burn, large quantities of fluids and electrolytes may be lost rapidly
Temperature regulation
Vitamin Production
Immune response function

Question 15

Bluish discoloration that results from a lack of oxygen in the blood

Answer 15

cyanosis

Question 16

Purple, black which fades to green, yellow, or brown hues over time;most often seen following trauma

Answer 16

ecchymosis

Question 17

Redness of the skin caused by the dilation of capillaries

Answer 17

erythema

Question 18

Yellowing of the skin

Answer 18

jaundice

Question 19

Inflammatory response

Answer 19

-A sequential reaction to cell injury.

-Neutralizes and dilutes the inflammatory agent, removes necrotic materials, and establishes an environment suitable for healing and repair.
Inflammationis not similar with infection.

-Inflammation is always present with infection, but infection is NOT always present with inflammation

• Mechanism of inflammation is basically the same regardless of the injuring agent
• Intensity of the response depends on the extent and severity of injury and on the injured person’s reactive capacity

Question 20

Inflammatory response can be divided into

Answer 20

Vascular response
Cellular response
Formation of exudate
Healing.

Question 21

Results from outpouring of fluid. Seen in early stages of inflammation or when injury is mild ex. Skin blisters, pleural effusion

Answer 21

serous

Question 22

Found during the midpoint in healing after surgery or tissue injury
Composed of RBCs and serous fluid, which is semi-clear pink and may have red streaks ex. surgical drain fluid

Answer 22

serosanguineous

Question 23

Occurs with increasing vascular permeability and fibrinogen leakage into interstitial spaces
Excessive amounts of fibrin that coats tissue surfaces may cause them to adhere.

Answer 23

fibrinous

Question 24

Results from rupture or necrosis of blood vessel walls

Answer 24

hemorrhagic

Question 25

Consists of WBCs, microorganisms (dead and alive), liquefied dead cells, and other debris

Answer 25

purulent (pus)

Question 26

Found in tissues where cells produce mucus | Mucus production is accelerated by inflammatory response

Answer 26

catarrhal

Question 27

cause of manifestation of redness

Answer 27

Hyperemia from vasodilation

Question 28

cause of manifestation heat

Answer 28

Increased metabolism at inflammatory site | ex. vasodilation

Question 29

cause of manifestation of pain

Answer 29

Change in pH. Nerve stimulation by chemicals (e.g., histamine, prostaglandins). Pressure from fluid exudate

Question 30

cause of manifestation of swelling

Answer 30

Fluid shift to interstitial spaces. Fluid exudate accumulation

Question 31

loss of function

Answer 31

swelling and pain ex. calf enlarged -> compartment syndrome

Question 32

localized area of necrotic soft tissue that occurs when pressure applied to the skin usually a bony prominence

Answer 32

pressure ulcer

Question 33

Braden Scale used for Predicting Pressure Injury Risk

Answer 33

Sensory Perception, Moisture, Activity, Mobility, Nutrition

Question 34

Most common site for pressure ulcers

Answer 34

1. sacrum | 2. heels

Question 35

Intact skin with non-blanchable redness of a localized area | Area may be painful, firm, soft, warmer, or cooler as compared to adjacent tissue.

Answer 35

pressure ulcer stage 1

Question 36

Partial-thickness loss of dermis presenting as a shallow open ulcer with a red-pink wound bed, without slough May also present as an intact or open/ruptured serum-filled or serosanguineous-filled blister Presents as a shiny or dry shallow ulcer without slough or bruising

Answer 36

pressure ulcer stage II

Question 37

Full-thickness tissue loss. Subcutaneous fat may be visible but bone, tendon, or muscle are not exposed May include undermining and tunneling

Answer 37

stage III

Question 38

Full-thickness tissue loss with exposed bone, tendon, or muscle. Slough or eschar may be present. Often includes undermining and tunneling

Answer 38

stage IV

Question 39

Full-thickness tissue loss in which actual depth of ulcer is completely obscured by slough (yellow, tan, gray, green, or brown) and/or eschar (tan, brown, or black) in wound bed

Answer 39

unstageable

Question 40

Purple or maroon localized area of discolored intact skin or blood-filled blister due to damage of underlying soft tissue from pressure and/or shear.

Answer 40

suspected deep tissue injury

Question 41

nursing interventions for pressure ulcers:

Answer 41

``` Relieve Pressure Positioning the patient Use pressure-relieving devices Improve mobility Improve sensory perception ``` ``` Improve tissue perception Improve nutritional status Reduce friction and shear Minimize moisture Promote pressure injury healing ```

Question 42

nutritional deficiences for delaying wound healing

Answer 42

- vitamin c - protein - zinc - inadequate blood suppy - corticosteroid drugs

Question 43

factors that delay wound healing include:

Answer 43

- infection - smoking - mechanical friction on wound - advanced age - obesity - diabetes mellitus - poor general health - anemia

Question 44

dressing generally composed of polyurethane. transparency allows visualization of the wound. used for dry, uninfected wounds or wounds with minimal drainage

Answer 44

transparent films

Question 45

Film-coated gel or polyurethane. Able to hold large amounts of exudate; used for Wounds with moderate to heavy drainage. Often used on new wounds

Answer 45

foam dressing

Question 46

Gelatin, pectin, or carboxymethylcellulose bonded to a film or sheet. Produce a flat occlusive dressing that forms a gel on wound surface; used for wounds with light to moderate drainage

Answer 46

hydrocolloids dressing

Question 47

gels, gel-covered gauze, or sheets. Donate moisture to a dry wound and maintain a moist environment. Can rehydrate wound tissue Dry wounds. Wounds with minimal drainage. Necrotic wounds

Answer 47

hydrogels **used to soften hard scabs that will help it fall off

Question 48

Derived from seaweed or kelp. Form a non-sticky gel on contact with draining wound. Easy to use over irregular-shaped wounds

Answer 48

alginates

Question 49

Wound covers that deliver agents such as silver and iodine, and polyhexamethylene biguanide (PHMB), which have antibacterial properties.

Answer 49

antimicrobials dressing

Question 50

complications of wound healing

Answer 50

``` Adhesion Contractions Dehiscence Evisceration Excess Granulation Tissue (Proud Flesh) Fistula Formation Infection Hemorrhage Hypertrophic Scars Keloid Formation ```

Question 51

A chronic suppurative folliculitis of the perianal, axillary, and genital areas or under the breasts

Answer 51

Hidradenitis Suppurativa

Question 52

Management of Hidradenitis Suppurativa

Answer 52

Warm compresses Loose-fitting clothes over the nodules or lesions NSAIDs to relieve the pain Oral antibiotic Incision and drainage of large suppurating areas

Question 53

a common disorder affecting hair follicles and sebaceous glands. 

Answer 53

acne vulgaris

Question 54

mangement of acne vulgaris

Answer 54

``` Nutrition Avoid sugary food products Hygiene Washing twice a day with soap and water Phototherapy Surgical Management ``` ``` Medication Benzoyl peroxide Topical retinoids Topical antibiotics Oral isotretinoin + oral ATB ```

Question 55

Contagious bacterial infection of superficial layers of skin of honey colored crusts; Lesions common on face, hands, neck, extremities, perineum

Answer 55

impetigo

Question 56

1-2 mm erythematous papules or pustules, progress to vesicles or bullae which rupture

Answer 56

nonbullous

Question 57

Contagious bacterial infection of superficial layers of skin of honey colored crusts; Lesions common on face, hands, neck, extremities, perineum

Answer 57

impetigo

Question 58

management of impetigo

Answer 58

Topical antibiotics if superficial, nonbullous, localized Oral antibiotics for multiple lesions, spread of infection to family members Bullous impetigo in infant – parenteral beta-lactamase-resistant antistaphylococcal penicillin Obtain culture if no response in 7 days Educate about hygiene Exclude from day care until treated for 24 hours

Question 59

clinical findings folliculitis and furuncle

Answer 59

Discrete, erythematous 1-2 mm papules or pustules on inflamed base near follicle Face, scalp, extremities, buttocks, back Nodules with furuncles Pruritus papules, pustules, deep red/purple nodules in areas under swimsuit

Question 60

HSV 1

Answer 60

Gingivostomatitis Herpes labialis Herpetic whitlow

Question 61

HSV 2

Answer 61

Grouped vesicopustules/ulceration Vaginal mucosa, labia, perineum, cervix in females; penile shaft and perineum in males Regional lymphadenopathy

Question 62

HSV type 1

Answer 62

oral mucosa, pharynx, lips

Question 63

HSV type 2

Answer 63

neonatal infection, vulvovaginitis or genital infection

Question 64

Herpetic whitlow

Answer 64

fingers, thumb are swollen and painful