Assessing the Integumentary System Flashcards
1
Q
Heaviest single organ of the body
A
Skin
2
Q
Skin is _____ of body weight
A
16%
3
Q
Skin Includes appendages such as
A
hair follicles and sebaceous glands
4
Q
Three layers of the skin
A
epidermis, dermis, subcutaneous layers
5
Q
Functions of the Skin
A
- Protect underlying structures from physical trauma and UV radiation
- Essential in maintaining body temperature, fluid and sensation
- Involved in absorption and excretion, immunity, and synthesis of vitamin D from the sun
6
Q
- Outer visible layer
- Avascular
- Contains keratin
A
Epidermis
7
Q
Dermis is made up of
A
proteins and mucopolysaccharides
8
Q
dermis contains
A
nerve tissues, blood vessels, sweat and sebum glands, and hair follicles
9
Q
Made up of fatty connective tissue
A
Subcutaneous Layer
10
Q
Made up of keratinized cellsh
A
Hair
11
Q
Grows from hair follicles supplied by blood vessels
A
Hair
12
Q
Types of Hair
A
Vellus and Terminal hair
13
Q
Functions of Hair
A
Provides protection by covering the scalp and filtering dust and debris away from the nose, ears, and eyes
14
Q
Short, pale, and fine hair
A
Vellus hair
15
Q
- Dark and coarse
scalp, brows, legs, axillae and perineum
A
Terminal hair
16
Q
Terminal hair can be found on the
A
scalp, brows, legs, axillae and perineum
17
Q
Made up of hard, keratinized cells and grow from a nail root under the cuticle
A
Nails
18
Q
Function of Nails
A
Protect the distal ends of the fingers and toes and aid in picking up objects
19
Q
Other structures of the nail
A
free edge, nailbed, lunula
20
Q
Vascular supply of nails is on the ___________; gives the nail
a pink color
A
nailbed
21
Q
Fingernails grow approximately __________ daily
A
0.1mm
22
Q
produce fatty substance secreted onto the skin surface through the hair follicles and lubricates the hair shaft
A
Sebaceous gland
23
Q
2 types of sweat glands
A
Eccrine glands
Apocrine glands
24
Q
- Widely distributed, open directly onto the skin surface
- Help control body temperature
A
Eccrine glands
25
- Open into hair follicles
- Responsible for adult body odor due to bacterial decomposition
Apocrine glands
26
Axillary glands can be found on
Axillary and genital regions
27
If respiration is impaired, alterations is the skin are most often evident through the development of
cyanosis
28
Bluish discoloration of the skin, as hemoglobin becomes unsaturated with oxygen
CYANOSIS
29
cyanosis is the bluish discoloration of the skin, as _____________________________________________________
hemoglobin becomes unsaturated with oxygen
30
Occurs when O2 saturation is <80% and results in diffuse changes in the skin and mucous membranes
Central Cyanosis
31
Occurs in response to decreased cardiac output
Peripheral Cyanosis
32
Peripheral Cyanosis is evident in areas of the body such
as the
nail beds and lips
33
May also be evident when an individual is chilled
Peripheral Cyanosis
34
Loss of the normal angle between the nail and nail bed owing to bulbous swelling of the soft tissue of the terminal phalanx of a digit due severe and chronic cardiopulmonary diseases
Nail Clubbing
35
Alterations in the cardiovascular system can lead to
circulatory impairment and changes in skin color and temperature
36
is responsible for the conversion of food to absorbable nutrients and elimination of wastes
Gastrointestinal System
37
With GI disorders, the body’s ability to excrete toxins is ________________and _______________________ may become
evident in the skin
impaired; accumulation of toxins
38
Yellowish discoloration of the skin due to bile build-up secondary to impaired bile secretion
Jaundice
39
Lipid deposits in the skin due to altered lipid metabolism
Xanthomas
40
abnormally dry, scaly skin or membranes
Xerosis
41
hyperkeratosis of the skin manifested by red-brown follicular papules that are approximately 2-6mm in diameter, with a central keratotic spinous plug
Phrynoderma
42
chapping and fissuring of the lips
Cheilosis
43
sore, red tongue
Glossitis
44
Xerosis and Phrynoderma is caused by
Vitamin A Deficiency
45
Cheilosis and Glossitis is caused by
Riboflavin Deficiency
46
Capillary fragility resulting in _____________________________ in the skin and _______________________ in the nails
purpura, petechiae, and ecchymosis; splinter hemorrhages
47
Corkscrew hair and Alopecia caused by
Vitamin C Deficiency
48
spoonlike convexity of the nails
Koilonychia
49
Other Skin Manifestations – Iron Deficiency
- longitudinal ridges on the nails
- Koilonychia
- Thinning of hair
- Palmar crease pallor
50
loss of pink color in the palmar creases on the full open palms
Palmar crease pallor
51
Other Skin Manifestations – Protein Deficiency
- Flag sign
- Enamel paint skin
52
alternating horizontal bands of hypopigmentation of the hair
Flag sign
53
dark, dry skin that splits open when stretched, revealing pale areas between the cracks
Enamel paint skin
54
Responsible for filtering the blood, production of red blood cells, and regulation of electrolyte and fluid status
The Urinary System
55
Alteration in the renal function may lead to _____________________________
toxin and fluid build-up
56
Tiny, yellow-white urea crystals deposits on the skin resulting in a frosted appearance as sweat evaporates
Uremic frost
57
Impaired renal function may result in fluid retention as manifested by
edema
58
Autonomic nerve fibers permit sensations of touch, temperature, pressure, vibrations, and pain, control the skin’s blood vessels and glands, regulating the skin’s temperature, moisture, and oiliness
Neurological System
59
- The skin is often dry and cool and becomes puffy, with nonpitting edema.
- It may develop a yellow hue as carotene accumulates
- The hair becomes dull, brittle, and sparse
Hypothyroidism
60
- The skin is warmer, sweatier, and smoother than usual
- The nails are thin and brittle and may separate from the nail plate
- The hair is fine and silky, with patchy hair loss
Hyperthyroidism
61
Thyroid Disease
- Hypothyroidism
- Hyperthyroidism
62
Adrenal Disease
- Hypofunction (Addison’s Disease)
- Hyperfunction (Cushing’s Syndrome)
63
Bronze discoloration of the skin and alopecia
Hypofunction (Addison’s Disease)
64
Violaceous striae, facial acne, hirsutism, acanthosis nigricans
Hyperfunction (Cushing’s Syndrome)
65
Involved in protecting the body from both external and endogenous factors
Lymphatic/Immune System
66
Impairments in the immune system may result in typical ________________________
rashes or lesions
67
Skin Manifestations due to impairments in the immune
system:
- Hypersensitivity reaction
- Psoriasis
- Butterfly rash in Systemic Lupus Erythematosus
68
GROWTHS
- Ask if the patient is concerned about any new growths or rashes
- If the patient reports a new growth, pursue the patient’s
personal and family history of skin cancer.
69
If the patient reports a new growth, pursue the patient’s
personal and family history of ____________________.
skin cancer
70
Note the __________________________________ of any past skin cancer and ask about _____________________________________________
type, location, and date; regular self-skin examination and use of sunscreen
71
the most important symptom when assessing rashes
itching
72
frontal hairline regression and thinning on the posterior vertex
Male pattern hair loss
73
thinning that spreads from the crown down without hairline regression
Female pattern hair loss
74
temporary hair loss due to the excessive shedding of resting or telogen hair several months after a person experiences a traumatic event or stress
Telogen effluvium
75
an autoimmune disorder that results in unpredictable, patchy hair loss
Alopecia areata
76
fungal infection of the scalp that causes itchy, scaly, bald patches on the head
Tinea capitis
77
a superficial infection of the proximal and lateral nail folds adjacent to the nail plate that arises from local trauma due to nail biting, manicuring or frequent immersion in water
Paronychia
78
a bulbous swelling of the soft tissue at the nail base, with the loss of the normal angle between the nail and the proximal nail fold. Seen in congenital heart disease, interstitial lung disease and lung cancer
Nail clubbing
79
depression of the central nail with a “Christmas tree” appearance from small horizontal depressions, resulting from repetitive trauma from rubbing the index finger over the thumb or vice versa
Habit Tic deformity
80
increased pigmentation in the nail matrix, leading to a streak as the nail grows out
Melanonychia
81
painless separation of the whitened opaque nail plate from the pinker translucent nail bed which may be caused by trauma from excess manicuring, psoriasis, fungal infection, and allergic reactions to nail cosmetics.
Onycholysis
82
a fungal infection of the nails that cause discoloration, thickening, and separation from the nail bed
Onychomycosis
83
nail plate turns white with a ground-glass appearance, a distal band of reddish brown, and obliteration of the lunula. Seen in liver disease, heart failure, and diabetes.
Terry nails
84
transverse depressions of the nail plates, usually bilateral, resulting from temporary disruption of the proximal nail growth from systemic illness
Beau’s lines
85
punctuate depressions of the nail plate caused by defective layering of the superficial nail plate by the proximal nail matrix. Usually associated with psoriasis
Pitting
86
Seen in arterial insufficiency, decreased blood supply, and anemia
Pallor
87
Bluish discoloration of the skin, nailbeds, and mucosa
Cyanosis
88
Yellowish discoloration of the skin and mucosa
Jaundice
89
Roughening and darkening of skin in localized areas especially the posterior neck
Acanthosis nigricans
90
skin redness and warmth
Erythema
91
arise from normal skin due to irritation or disease
Primary lesions
92
arise from changes in primary lesions
Secondary lesions
93
reddishbluish lesions, are seen with bleeding, venous pressure, aging, liver disease, or pregnancy
Vascular lesions
94
indicates fungal infection
Blue-green fluorescence
95
- small raised spot measuring <1cm
Papule
96
small flat spot measuring <1cm
Macules
97
larger flat spot measuring >1cm
Patches
98
larger raised spot measuring >1cm
Plaque
99
raised, fluid-filled, and small lesion measuring <1cm
Vesicle
100
raised, fluid-filled, and large lesion measuring >1cm
Bulla
101
small, palpable collection of neutrophils or keratin that appears white
Pustules
102
inflamed hair follicle; multiple ________________ together form a carbuncle
Furuncle
103
multiple furuncles together form a
carbuncle
104
larger and deeper than a papule
Nodule
105
encapsulated collections of fluid or semisolid
Subcutaneous mass/cyst
106
area of localized dermal edema that evanesces within a period of 1-2 days
Wheal
107
small, linear or serpiginous pathways in the epidermis created by the scabies mite
Burrow
108
loss of superficial epidermis that does not extend to the dermis
Erosion
109
skin mark left after healing of wound or lesion that represents replacement by connective tissue of the injured tissue
Scar (Cicatrix)
110
skin loss extending past epidermis with necrotic tissue loss
ulcer
111
linear crack in the skin that may extend to the dermis and may be painful
fissure
112
round red or purple macule that is 1-2mm in size. It is secondary to blood extravasation and associated with bleeding tendencies or emboli to skin
Petechia
113
round or irregular macular lesion that is larger than a petechial lesion
Ecchymosis
114
a localized collection of blood creating an elevated ecchymosis
Hematoma
115
papular and round, red or purple lesion found on the trunk or extremities. Normal age-related skin alteration
Cherry angioma
116
red arteriole lesion with a central body with radiating branches. Associated with liver disease, pregnancy, and
vitamin B deficiency
Spider angioma
117
bluish or red lesion with varying shape found on the legs and anterior chest. Associated with varicosities
Telangiectasis (Venous star)
118
Increased moisture or diaphoresis may occur in conditions such as
fever or hyperthyroidism
119
Decreased moisture occurs with
dehydration or hypothyroidism
120
Clammy skin is typical in
shock or hypotension
121
Cold skin may accompany
shock or hypotension
122
Cool skin may accompany
arterial disease
123
Very warm skin may indicate a
febrile state or hyperthyroidism
124
refers to how easily the skin can be pinched
Mobility
125
refers to the skin’s elasticity and how quickly the skin returns to its original shape after being pinched
Turgor
126
- Associated with lymphedema
- Usually bilateral
- No skin ulceration or pigmentation
Non-pitting edema
127
Caused by abnormal or blocked lymph vessels
Non-pitting edema
128
- Associated with chronic venous insufficiency
- Usually unilateral
- Skin ulceration and pigmentation may be present
Pitting edema
129
Severe malnutrition may cause a
copper-redhair color
130
Excessive scaliness may indicate
dermatitis
131
Dull, dry hair may be seen with
hypothyroidism and malnutrition
132
Pustules with hair loss in patches are seen in __________________, a contagious fungal disease
tinea capitis
133
may result from infections of the scalp, discoid or systemic lupus erythematosus, and some types of chemotherapy
Patchy hair loss
134
is a characteristic of Cushing’s disease and results from an imbalance of adrenal hormones or it may be a side effect of steroids
Hirsutism
135
facial hair on females
Hirsutism
136
Pale or cyanotic nails may indicate
hypoxia or anemia
137
may be caused by trauma.
Splinter hemorrhages
138
occur after acute illness and eventually grow out
Beau’s lines
139
Yellow discoloration may be seen in
fungal infections or psoriasis
140
also common in psoriasis
Nail pitting
141
Thickened nails (especially toenails) may be caused by
decreased circulation, and is also seen in
onychomycosis
142
the most common causes of diffuse hair thinning are
male and female pattern baldness
143
Hair shedding at the roots is common in
telogen effluvium and alopecia areata
144
Presence of a reddened area that fails to blanch with pressure and changes in temperature, consistency, sensation or color
Stage 1 Pressure Ulcer
145
The skin forms a blister or sore.
Stage 2 Pressure Ulcer
146
Partial-thickness skin loss or ulceration involving the epidermis, dermis or both
Stage 2 Pressure Ulcer
147
A crater appears in the skin, with full-thickness skin loss and damge to or necrosis of subcutaneous issue that may extend to, but not through underlying muscle
Stage 3 Pressure Ulcer
148
There is full-thickness skin loss, with destruction, tissue necrosis, or damage to underlying muscle, bone and sometimes tendons and joints
Stage 4 Pressure Ulcer
149
Rough, flaky, dry skin is seen in
hypothyroidism
150
Decreased mobility is seen with
edema
151
Decreased turgor is seen in
dehydration
152
TYPES OF PERIPHERAL EDEMA
Non-pitting edema
pitting edema
153
Difference between non-pitting and pitting edema
Non-pitting edema
- Associated with lymphedema
* Caused by abnormal or blocked lymph vessels
* Usually bilateral
* No skin ulceration or pigmentation
Pitting edema
- Associated with chronic venous insufficiency
- Usually unilateral
- Skin ulceration and pigmentation may be present
154
There is normally a ___________________________ between the nail base
and the skin
160-degree angle
155
180-degree angle with spongy sensation
Early clubbing
156
greater than 180-degree angle
late clubbing
157
Spoon nails (concave) may be present with
iron deficiency anemia
