Exam II Integumentary Flashcards
1
Q
What does epidermis not have?
A
Blood vessels
2
Q
What is in the dermis?
A
BVs, all action - accessory organs, nerves, CT, collagen, immune cells, hair follicle
3
Q
What is in the Subcutaneous tissue?
A
Fat, CT, BVs, lymph.
4
Q
What purpose does the subcutaneous tissue serve?
A
Energy storage, cushioning, insulatoin
5
Q
What do sebaceous glands produce?
A
Sebum
6
Q
Two types of sweat glands
A
Apocrine and eccrine
7
Q
What’s the difference between apocrine and eccrine sweat glands?
A
Apocrine open into hair follicles, eccrine open to skin.
8
Q
Blood vessels in the skin dilate to dissipate heat? T/F
A
True
9
Q
4 different skin pigmentations
A
Melanin
Carotene
Oxyhemoglobin
Deoxyhemoglobin
10
Q
What purpose does melanin fulfill to the skin?
A
Genetics and sun exposure
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.
12
Q
What is the condition called when you have too much carotene in the body?
A
Carotenemia
13
Q
What does oxyhemoglobin do for the skin?
A
Gives it red color.
14
Q
What does deoxyhemoglobin do to the skin?
A
Without O2 is cyanotic
15
Q
What is deoxyhemoglobin?
A
Hemoglobin that has released it’s O2 into the body.
16
Q
What is oxyhemoglobin?
A
Combination of hemoglobin and O2
17
Q
What causes cyanosis?
A
Deoxyhemoglobin
18
Q
Where does cyanosis appear?
A
Fingertips toes, lips.
19
Q
What causes peripheral cyanosis?
A
Cold weather.
20
Q
What causes central cyanosis?
A
Oxygen not being perfused, systemic problem.
21
Q
2 types of hair
A
Terminal and vellus
22
Q
What is terminal hair?
A
Scalp, pubis. Facial and armpit hair stars as vellus and become terminal.
23
Q
What is vellus hair?
A
Born with this to keep us warm
24
Q
What do we check in the nail plate?
A
Capillary refill
25
Common or concerning symptoms in the skin
Rash
Nonhealing leasions
Moles
Growths
Lesions
Bruising (ecchymosis)
Hair loss
Nail changes
26
What to look for in color assessment
Change in pigmentation
Redness
Cyanosis or pallor
Jaundice
Conjunctive, palms, feet
Skin color
27
What is vitiligo
Hypopigmentation
28
What happens in vitiligo
Melanocytes dies
29
When does vitiligo set in?
10-30 years. Is progressive.
30
What is a cafe-au-lait spot?
Birth mark
31
What type of cells make a cafe-au-lait spot?
Melanocytes
32
What is tinea versicolor?
Fungal infection
33
What does tinea versicolor look like?
Hypopigmentation from yeast overgrowth.
34
How is tinea versicolor treated?
OTC Lotrimin
35
What is acanthosis nigricans?
Darkened color around neck, folds in wrists and legs, from high levels of insulin.
36
What is a precursor to acanthosis nigricans?
Obesity. Probably undiagnosed diabetes.
37
Check skin for what 56 things?
Moisture
Temperature
Texture
Mobility and turgor
Edema
Skin lesions
38
What is the skin lesion called a macule?
Flat colored spot on skin (freckle, flat mole) that you can't feel with eyes closed.
39
What is the skin lesions called a papule?
Small bump or pimple (acne)
40
What is the skin lesion called a vesicle?
Small blister containing serous fluid (eczema, chicken pox)
41
What is the skin lesion called a nevus?
Mole or birthmark
42
5 things to access about skin lesions
Color
Size
Elevation
Number
Texture
43
What is the skin lesions patterns or shapes called linear and what condition does it suggest?
In a straight line - poison ivy
44
What is the skin lesions patterns or shapes called geographic and what condition does it suggest?
Resembles a map
Inflammatory response to food/allergy on tongue
45
What is the skin lesions patterns or shapes called confluent and what condition does it suggest?
Run together - psoriasis
46
What is the skin lesions patterns or shapes called bullseye and what condition does it suggest?
Target - Lyme
47
What is the skin lesions patterns or shapes called clustered and what condition does it suggest?
Grouped
Eczema, inflammation, allergies, genetic, fold of arm, behind knees, groin,
48
What is a primary skin lesion?
Initial lesion/abnormal growth, occur as initial rx to internal or external environment
49
Which skin lesions are flat?
Macules or patches (birthmark)
50
Which skin lesions are fluid filled?
Vesicles, bullae, pustules, burrows.
51
What skin lesions are solid masses?
Nodules, cyst, papules, wheals, plaques are palpable, solid or fluid filled.
52
What are secondary skin lesions?
Arise from primary skin lesions.
Brought about by modification of the primary lesion.
Skin around lesion is becoming abnormal.
53
What are types of secondary skin lesions?
Scales, crusts, excoriations, erosions, ulcers, fissures, scars, lichenification, keloids, crack or split.
54
What is a vascular lesion?
Common abnormalities of the skin and underlying tissues.
55
What are types of vascular lesions?
Spider angioma, spider veins, cherry angioma
56
What is a purpuric lesion?
Discoloration of the skin or mucous membranes produced by small bleeding vessels near the skin surface
57
With vascular or purpuric lesions is there something probably going on with patient?
Purpuric
58
Types of purpuric lesions
Petechia, purpura, ecchymosis
59
What condition can cause petechia?
Pulmonary embolism
60
What condition can cause purpura?
Vascular insufficiency
61
What condition can cause ecchymosis?
Bruising, blood coag issue, trauma, injury
62
What is a pressure injury?
Soft tissue undergoes pressure in combination with shear and/or friction. Common on bony prominences.
63
What two internal pressures cause pressure injuries?
Friction and shear
64
What is the Braden scale used for?
Grade pressure injuries
65
What are the highest and lowest Braden scores?
6 - 22
66
What Braden score is a red flag?
18 and over
67
How often should you turn a patient?
Every 2 hours
68
How long does it take to cause a pressure injury?
1-2 hours
69
What is metholexin?
Cushion adhesive put on patient undergoing surgery who will be lying in one position for an extended period of time.
70
What is stage 1 of pressure injuries and how to test?
Skin is unbroken but inflamed, non-blanchable from damaged blood flow.
71
How do you treat a stage 1 pressure injury?
Put on methylex and keep on for up to 3 days.
72
What is a stage 2 pressure injury and how do you know?
Epidermis is open. See dermis through epidermis.
73
How do you treat a stage 2 pressure injury?
Cover with methylex, turn every 2 hours.
74
What is a stage 3 pressure injury?
BVs can't feed tissue. Necrosis. See fat through epidermis. Tissue has been compromised.
75
How do you treat a stage 3 pressure injury?
Call wound care nurse. Plastic surgery might be required.
76
What is a stage 4 pressure injury?
Blood flow to muscle, tendon compromised. Full tissue thickness damaged.
77
How do you treat a stage 4 pressure injury?
Plastic surgery gets involved. Need graft.
78
What is an unstageable pressure injury?
Sometimes is not getting blood flow but can't tell what stage. Deep tissue injury.
79
How do you treat an unstageable pressure injury?
Maybe methylex and turn 1-2 hours to see if that corrects it.
80
What is eschar?
Dark, black leathery top of wound of pressure injury.
81
If you see eschar on pressure injury, what stage?
Can't tell.
82
How do you treat eschar on pressure injuries?
Topical will sometimes dissolve or surgery
83
What is slough in pressure injuries?
Bacteria, WBC, serous fluid that gets thick, mucous.
84
How do you treat slough in pressure injuries?
Clean to see what stage.
85
Loss of hair on legs can indicate what?
Peripheral artery disease
86
Changes in pubic or axilla hair indicates what?
Possible hormonal problems.
87
What is alopecia areata?
Round/oval patches of hair loss in young adults and children with no scaling or inflammation. LIfelong.
88
Trichotilomania
Hair loss from plucking/pulling. Shafts broken of various lengths, can render shaft worthless.
89
Tinea Capitis
Ringworm. Scaling patches of alopecia. Caused by fungal infection. Treat with Lotrimin.
90
Paronychia
Tear on cubicle that becomes infected.
91
Clubbing of nails
COPD
92
Onycholysis
Nail plate pulls aways from plate, trauma, diabetes, anemia, fungal.
93
Terry nails
Nail plate turns white.
Diabetes, congestive heart failure, liver disease, endocrine or electrolyte disturbances.
94
Leukonychia
White spots from vigorous manicuring
95
Two types of skin cancer
Melanoma and Merkel cell carcinoma
96
What is melanoma?
Skin cancer arising from melanocytes in epidermis, high rate of metastasis
97
What is Merkel cell carcinoma?
Mistaken for insect bite, patients over 50
98
Malignant melanoma risk factors
Asymmetry
Border (uneven)
Color (dark or multi colored
Diameter (> 6mm)
Evolving (change in shape, size, color)
