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Health Assessment > Exam II Integumentary > Flashcards

Exam II Integumentary Flashcards

1
Q

What does epidermis not have?

A

Blood vessels

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2
Q

What is in the dermis?

A

BVs, all action - accessory organs, nerves, CT, collagen, immune cells, hair follicle

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3
Q

What is in the Subcutaneous tissue?

A

Fat, CT, BVs, lymph.

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4
Q

What purpose does the subcutaneous tissue serve?

A

Energy storage, cushioning, insulatoin

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5
Q

What do sebaceous glands produce?

A

Sebum

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6
Q

Two types of sweat glands

A

Apocrine and eccrine

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7
Q

What’s the difference between apocrine and eccrine sweat glands?

A

Apocrine open into hair follicles, eccrine open to skin.

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8
Q

Blood vessels in the skin dilate to dissipate heat? T/F

A

True

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9
Q

4 different skin pigmentations

A

Melanin
Carotene
Oxyhemoglobin
Deoxyhemoglobin

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10
Q

What purpose does melanin fulfill to the skin?

A

Genetics and sun exposure

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11
Q

Where is carotene in the body?

A

Made in subq fat. In palms, bottoms of feet. Get orange with too much carotene in body.

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12
Q

What is the condition called when you have too much carotene in the body?

A

Carotenemia

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13
Q

What does oxyhemoglobin do for the skin?

A

Gives it red color.

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14
Q

What does deoxyhemoglobin do to the skin?

A

Without O2 is cyanotic

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15
Q

What is deoxyhemoglobin?

A

Hemoglobin that has released it’s O2 into the body.

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16
Q

What is oxyhemoglobin?

A

Combination of hemoglobin and O2

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17
Q

What causes cyanosis?

A

Deoxyhemoglobin

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18
Q

Where does cyanosis appear?

A

Fingertips toes, lips.

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19
Q

What causes peripheral cyanosis?

A

Cold weather.

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20
Q

What causes central cyanosis?

A

Oxygen not being perfused, systemic problem.

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21
Q

2 types of hair

A

Terminal and vellus

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22
Q

What is terminal hair?

A

Scalp, pubis. Facial and armpit hair stars as vellus and become terminal.

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23
Q

What is vellus hair?

A

Born with this to keep us warm

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24
Q

What do we check in the nail plate?

A

Capillary refill

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25
Q

Common or concerning symptoms in the skin

A

Rash
Nonhealing leasions
Moles
Growths
Lesions
Bruising (ecchymosis)
Hair loss
Nail changes

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26
Q

What to look for in color assessment

A

Change in pigmentation
Redness
Cyanosis or pallor
Jaundice
Conjunctive, palms, feet
Skin color

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27
Q

What is vitiligo

A

Hypopigmentation

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28
Q

What happens in vitiligo

A

Melanocytes dies

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29
Q

When does vitiligo set in?

A

10-30 years. Is progressive.

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30
Q

What is a cafe-au-lait spot?

A

Birth mark

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31
Q

What type of cells make a cafe-au-lait spot?

A

Melanocytes

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32
Q

What is tinea versicolor?

A

Fungal infection

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33
Q

What does tinea versicolor look like?

A

Hypopigmentation from yeast overgrowth.

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34
Q

How is tinea versicolor treated?

A

OTC Lotrimin

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35
Q

What is acanthosis nigricans?

A

Darkened color around neck, folds in wrists and legs, from high levels of insulin.

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36
Q

What is a precursor to acanthosis nigricans?

A

Obesity. Probably undiagnosed diabetes.

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37
Q

Check skin for what 56 things?

A

Moisture
Temperature
Texture
Mobility and turgor
Edema
Skin lesions

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38
Q

What is the skin lesion called a macule?

A

Flat colored spot on skin (freckle, flat mole) that you can’t feel with eyes closed.

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39
Q

What is the skin lesions called a papule?

A

Small bump or pimple (acne)

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40
Q

What is the skin lesion called a vesicle?

A

Small blister containing serous fluid (eczema, chicken pox)

41
Q

What is the skin lesion called a nevus?

A

Mole or birthmark

42
Q

5 things to access about skin lesions

A

Color
Size
Elevation
Number
Texture

43
Q

What is the skin lesions patterns or shapes called linear and what condition does it suggest?

A

In a straight line - poison ivy

44
Q

What is the skin lesions patterns or shapes called geographic and what condition does it suggest?

A

Resembles a map
Inflammatory response to food/allergy on tongue

45
Q

What is the skin lesions patterns or shapes called confluent and what condition does it suggest?

A

Run together - psoriasis

46
Q

What is the skin lesions patterns or shapes called bullseye and what condition does it suggest?

A

Target - Lyme

47
Q

What is the skin lesions patterns or shapes called clustered and what condition does it suggest?

A

Grouped
Eczema, inflammation, allergies, genetic, fold of arm, behind knees, groin,

48
Q

What is a primary skin lesion?

A

Initial lesion/abnormal growth, occur as initial rx to internal or external environment

49
Q

Which skin lesions are flat?

A

Macules or patches (birthmark)

50
Q

Which skin lesions are fluid filled?

A

Vesicles, bullae, pustules, burrows.

51
Q

What skin lesions are solid masses?

A

Nodules, cyst, papules, wheals, plaques are palpable, solid or fluid filled.

52
Q

What are secondary skin lesions?

A

Arise from primary skin lesions.
Brought about by modification of the primary lesion.
Skin around lesion is becoming abnormal.

53
Q

What are types of secondary skin lesions?

A

Scales, crusts, excoriations, erosions, ulcers, fissures, scars, lichenification, keloids, crack or split.

54
Q

What is a vascular lesion?

A

Common abnormalities of the skin and underlying tissues.

55
Q

What are types of vascular lesions?

A

Spider angioma, spider veins, cherry angioma

56
Q

What is a purpuric lesion?

A

Discoloration of the skin or mucous membranes produced by small bleeding vessels near the skin surface

57
Q

With vascular or purpuric lesions is there something probably going on with patient?

A

Purpuric

58
Q

Types of purpuric lesions

A

Petechia, purpura, ecchymosis

59
Q

What condition can cause petechia?

A

Pulmonary embolism

60
Q

What condition can cause purpura?

A

Vascular insufficiency

61
Q

What condition can cause ecchymosis?

A

Bruising, blood coag issue, trauma, injury

62
Q

What is a pressure injury?

A

Soft tissue undergoes pressure in combination with shear and/or friction. Common on bony prominences.

63
Q

What two internal pressures cause pressure injuries?

A

Friction and shear

64
Q

What is the Braden scale used for?

A

Grade pressure injuries

65
Q

What are the highest and lowest Braden scores?

A

6 - 22

66
Q

What Braden score is a red flag?

A

18 and over

67
Q

How often should you turn a patient?

A

Every 2 hours

68
Q

How long does it take to cause a pressure injury?

A

1-2 hours

69
Q

What is metholexin?

A

Cushion adhesive put on patient undergoing surgery who will be lying in one position for an extended period of time.

70
Q

What is stage 1 of pressure injuries and how to test?

A

Skin is unbroken but inflamed, non-blanchable from damaged blood flow.

71
Q

How do you treat a stage 1 pressure injury?

A

Put on methylex and keep on for up to 3 days.

72
Q

What is a stage 2 pressure injury and how do you know?

A

Epidermis is open. See dermis through epidermis.

73
Q

How do you treat a stage 2 pressure injury?

A

Cover with methylex, turn every 2 hours.

74
Q

What is a stage 3 pressure injury?

A

BVs can’t feed tissue. Necrosis. See fat through epidermis. Tissue has been compromised.

75
Q

How do you treat a stage 3 pressure injury?

A

Call wound care nurse. Plastic surgery might be required.

76
Q

What is a stage 4 pressure injury?

A

Blood flow to muscle, tendon compromised. Full tissue thickness damaged.

77
Q

How do you treat a stage 4 pressure injury?

A

Plastic surgery gets involved. Need graft.

78
Q

What is an unstageable pressure injury?

A

Sometimes is not getting blood flow but can’t tell what stage. Deep tissue injury.

79
Q

How do you treat an unstageable pressure injury?

A

Maybe methylex and turn 1-2 hours to see if that corrects it.

80
Q

What is eschar?

A

Dark, black leathery top of wound of pressure injury.

81
Q

If you see eschar on pressure injury, what stage?

A

Can’t tell.

82
Q

How do you treat eschar on pressure injuries?

A

Topical will sometimes dissolve or surgery

83
Q

What is slough in pressure injuries?

A

Bacteria, WBC, serous fluid that gets thick, mucous.

84
Q

How do you treat slough in pressure injuries?

A

Clean to see what stage.

85
Q

Loss of hair on legs can indicate what?

A

Peripheral artery disease

86
Q

Changes in pubic or axilla hair indicates what?

A

Possible hormonal problems.

87
Q

What is alopecia areata?

A

Round/oval patches of hair loss in young adults and children with no scaling or inflammation. LIfelong.

88
Q

Trichotilomania

A

Hair loss from plucking/pulling. Shafts broken of various lengths, can render shaft worthless.

89
Q

Tinea Capitis

A

Ringworm. Scaling patches of alopecia. Caused by fungal infection. Treat with Lotrimin.

90
Q

Paronychia

A

Tear on cubicle that becomes infected.

91
Q

Clubbing of nails

A

COPD

92
Q

Onycholysis

A

Nail plate pulls aways from plate, trauma, diabetes, anemia, fungal.

93
Q

Terry nails

A

Nail plate turns white.
Diabetes, congestive heart failure, liver disease, endocrine or electrolyte disturbances.

94
Q

Leukonychia

A

White spots from vigorous manicuring

95
Q

Two types of skin cancer

A

Melanoma and Merkel cell carcinoma

96
Q

What is melanoma?

A

Skin cancer arising from melanocytes in epidermis, high rate of metastasis

97
Q

What is Merkel cell carcinoma?

A

Mistaken for insect bite, patients over 50

98
Q

Malignant melanoma risk factors

A

Asymmetry
Border (uneven)
Color (dark or multi colored
Diameter (> 6mm)
Evolving (change in shape, size, color)

Health Assessment (7 decks)

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