Exam 2 - Chpt 12 Flashcards
What are the layers of the skin?
epidermis
dermis
subq layer
epidermis characteristics
tough made of keratin contains melanocytes, melanin thicker on soles, palms 4 week turnover
dermis characteristics
inner supportive layer made of collagen resilient, elastic hair follicles are rooted contains nerves, sensory receptors, blood vessels, lymphatics, sebaceous glands, sweat glands
subq layer characteristics
made of adipose tissue
stores fat, insulates, cushions, allows sin to slide over structures underneath
glands and appendages of the skin
hair
sebaceous glands
sweat glands
nails
hair is made of ___
keratin
two types of hair
vellus
terminal
secrete oily sebum, an oily substance, up the hair shaft, that lubricates and waterproofs the skin
sebaceous glands
___ ___ is a component of body temperature control
sweat production
these glands open directly to surface of the skin and produce sweat
eccrine glands
type of sweat gland that are associated with hair follicles that are in armpits and genitals
secretes milky substance that is consumed by bacteria to create musky human odor
apocrine
hard plates of keratin
nails
what are you look for during inspection and palpation of nails
shape, contour
consistency
color
capillary refill
functions of the skin
protection barrier to infection, water, electrolyte loss perception temp. regulation self-image/recognition communication wound repair excretion of wastes produce Vitamin D
subjective findings
CC Hx of present illness PMHx Family Hx ROS functional assessment
history of present illness
location character severity timing setting aggravating, relieving factors associated factors pt perception
PMHx
sx hx recurring problem? other skin problems? food, drug allergies medications sunburns tattoos birthmarks
ROS - integumentary
change in mole? excessive moisture, dryness itching, burning rash, sores hair loss hirsuitism (face hair in women) change in nails pain
functional assessment - integumentary
usual self care protection at work, play wigs, toupees care during heat sun avoidance with lupus what kind of work? exposures at work, play
how to prepare pt for integumentary assessment
warm environment
privacy
uncover area in question or have pt disrobe
inspection - integumentary
color moisture texture thickness lesions bruising vascularity swelling
palpation - integumentary
temp: assess with back of hand moisture texture thickness massess edema mobility turgor
normal skin color may have which color overtones
yellow, green
skin texture will ___ with ethnic and racial traits
vary
thickest skin
palms, soles
thinnest skin
oral mucosa, genitals
thin, shiny skin may indicate ___
PAD
brown skin is indicative of ___
PVD
where to assess skin turgor
clavicle
ABCDEF
asymmetry border irregularities color variation diameter >6mm elevation, enlargement funny looking
stage 1 pressure ulcer
non-blancable erythema
can form within 2 hours
stage 2 pressure ulcer
partial-thickness skin loss
involves epidermis, possibly dermis
stage 3 pressure ulcer
full-thickness skin loss
muscle, tendon
stage 4 pressure ulcer
full-thickness skin, tissue loss
bone
types of vascular skin lesions
ecchymosis: bruising hemangioma hematoma petechiae port-wine stain purpura spider angioma venous lake
infectious skin lesions
tinea: yeast
rubeola: measles
rubella: german measles
varicella
herpes simple
herpes zoster/shingles
impetigo
allergic/inflammatory skin lesions
contact dermatitis
eczema
psoriasis
malignant skin lesions
BCC
SCC
melanoma
Kaposia’s sarcoma: associated with HIV/AIDS
infant skin conitions
mongolian spots harlequin color change erythema toxicum acrocyanosis physiologic jaundice milia store bites lanugo port-wine stain, other birthmakrs
adolescent skin conditions
acne
blackheads
whiteheads
pregnant skin conditions
striae
linea nigra
chloasma: brown patch on face
vascular spiders
older adult skin conditions
senile lentigo: liver spots dry skin acrochordons: skin tags thin skin decrease turgor hair: less, brittle, alopecia nails: rate of growth decreases, brittle, thickness
if a person has lots of skin tags, assess for ___
diabetes
most important environmental risk factor for skin cancer
UV radiation from sun
indoor tanning sources
self-skin examinations education
examine once a month
well lighted room
full length mirror
ask significant other to help
functions of the skin
regulate body temp synthesize vitamin D stores blood, fat excrete body waste protects against heat, UV rays, trauma, and bacteria perceive touch, pressure, pain protect against water, electrolyte loss repair surface
major function of the cutaneous glands
excrete uric acid, ammonia, Na, K, other metabolic waste
regulate temperature
protect against bacterial growth
soften, lube, waterproof skin and hair
resisting water loss in low-humidity environments
fine, short hair that grows over the entire body except for lips, nipples, palms of hands, soles of feet, parts of external genitals
vellus hair
darker, coarser, longer hair terminal hair is located where?
eyebrows scalp axillae pubic region legs face, chest - most men
trichotillomania
hair twisting, plucking
environmental influences of hair, skin, nails
sunlight
temperature
working with hands
circumscribed, painless thickening of the epidermis
callus
what causes calluses
pressure
weight bearing
friction
common callus sights
fingers
palms
toes
soles of eet
paronychia
frequent, prolonged immersion of hands in water
where to assess skin changes for those with dark complexion
lips oral mucosa sclera palms of hands conjunctivae
skin cancer risk factors
prolong sun exposure hx skin cancer occupation exposure - chemicals, coal, tar tanning booths immunosuppression
melanoma risk factors
family hx
personal hx
moles that are atypical in growth or appearance
> 50 moles
