Exam 3 Health Assessment Ch 9 Flashcards
Concepts interrelated to tissue integrity
perfusion, oxygenation, nutrition, motion, tactile sensory perception, elimination, and pain
Skin and accessory structures
hair, nails, sweat glands, and sebaceous glands
Primary functions of skin
protection (external and internal), retain body fluids and electrolytes, sensory input, temperature regulation, production of vitamin D, excretion of sweat, urea, and lactic acid, expression of emotion (blushing), and repair of its own wounds
three layers of skin
Epidermis, dermis, and hypodermis
The epidermis
outer layer of stratified squamous epithelium.
Avascular
Deepest layer is stratum germinativum
30 days for cells to regenerate die and slough off
Melanocytes secrete
melanin, which provides pigment for the skin and hair
Dermis
Highly vascular layer of connective tissue
fibers that react to touch, pain, and temperature
1-4 mm thick
Hypodermis
Subcutaneous layer
support structure for the dermis and epidermis
loose connective tissue
fatty cells help retain heat, provide a protective cushion, and provide calories
what forms our hair
epidermal cells in the dermis
Each hair consist of
root, a shaft, and a follicle.
skin tissue adjacent to the nail
paronychium
Capillary refil
< 2 seconds
normal color of nails
pink
Eccrine sweat glands
Regulate body temperature by water secretion
most wide spread sweat gland on body
found in great numbers on hands and feet and forehead
Apocrine sweat glands
found in the axillae, nipples, areolae, anogenital area, eyelids and external ears.
begin secretion at puberty, strongly influenced by hormones.
decomposition of the apocrine sweat produced body odor
Sebaceous glands
lipid rich called sebum keeps skin lubricated
mostly in face and scalp
not found in palms and soles of feet
General health history
Present health status
past health history and family history
personal and psychosocial history
Problem based history
skin
hair
nails
The most commonly reported symptom of skin disease
pruritis
Puritus (itching)
Ask when it started, did it start suddenly or onset, where it started and has it spread.
-This may help provide clues to the cause.
Alleviating and aggravating for itching
this data may provide clues to the cause.
if taking an antihistamine relieves the itch,
the cause may be an allergy
common factors for puritus
allergic response (hives), exposure to chemicals, infestation of scabies, lice, or insect bites. Systemic diseases such as biliary cirrhosis and some types of cancer, such as, lymphoma may cause pruritus
What to look for on skin
Pruritus, rash, pain, lesion or changes in mole, change in skin color, skin texture, and wounds
Rash
Not generally a disease, but a symptom of an allergic response, skin disorder, or systemic illness
Questions to ask for a rash
- when did it start
- did the rash appear initially raised or flat
- does the rash itch or burn
- alleviating factors & aggravating factors
- any other syptoms
- do you have known allergies to foods, plants, skin/hair, products, laundry detergent, chemicals, or animals
- does anyone in the family have a similar rash
Questions to ask for pain
- describe the pain
- when did it start
- location
- spread
- is the pain only on the skin surface or does it go deep inside
Lesions may result from
acne, trauma, infections, exposure to chemicals, or other irritants, tumors, or other systemic diseases.
Changing or irregular mole may be a sign of
malignant lesion
causes of change in skin color
medications, anemia, or a systemic disease (liver disease causing jaundice.
Localized changed in skin color may be caused by
tissue perfusion, cyanosis, bruising, or vitiligo
dry skin
xerosos
oily skin
seborrhea
dry skin could be a cause of
and existing systemic disease like Thyroid disease, or related to environmental condition such as low humidity or poor skin lubrication.
Wound documantation
Location and how long it has been there.
problems with wound healing may suggest
nutritional or metabolic problems, infection, or poor circulation
Changed in hair can be a result of
stress or systemic disease
decrease in hair growth on an extremity may indicate
problems with arterial circulation.
Increase in hair growth may indicate
an ovarian or adrenal tumor
Hyperthyroidism can cause the nail
to separate from the nail bed and make the nail appear “dirty”
Cyanosis in light skin
Grayish-blue tone, especially in nail beds, earlobes, lips, mucous membranes, palms, and soles of feet.
Erythemain light skin
Reddish tone with evidence of increased skin temperature secondary to inflammation
Petechiae in light skin
lesions appear as small. reddish-purple pinpoints
Ecchymosis (bruise) in light skin
Dark red, purple, yellow, or green color, depending on age of bruise
Cyanosis in dark skin
Ashen-gray color most easily seen in the conjunctiva of the eye, oral mucous membranes and nail beds
Ecchymosis in dark skin
deeper bluish or black tone; difficult to see unless it occurs in an area of light pigmentation
Erythema in dark skin
deeper brown or purple skin tone with evidence of increased skin temperature secondary to inflammation
Jaundice in darker skin
Yellowish-green color
pallor in dark skin
loss of underlying healthy red tones of the skin
Petechiae in dark skin
difficult to see; may be evident in the buccal mucosa of the mouth or sclera
