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Integumentary > Integ Basic Science PPT > Flashcards

Integ Basic Science PPT Flashcards

1
Q

What is the largest organ in the body?

A

The Skin; covers 25 square feet

15% of BW

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2
Q

More patients suffer from chronic wounds than what other diseases combined?

A

Alzheimer’s, Parkinson’s and cancer

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3
Q

Five main functions of the skin:

A
  1. Temperature: more skin loss will effect the body temp and the ability to regulate it
  2. Touch: Sensory
  3. Lymphatics: Absorb 60% of what is put on your skin, skin has own respiratory system, tattoos dye lymph nodes
  4. Protection: UV and trauma
  5. Vitamin D: from the sun is absorbed
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4
Q

Five Layers of the Epidermis

A

superficial to deep: corneum, lucidum, granulosum, spinosum, basal

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5
Q

What are basal and spinosum layer often referred to together?

A

Stratum Malpighi

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6
Q

Stratum Corneum

A

Protective layer
Outermost layer and turned over 30 days
comprised of 15-20 layers of non-nucleated keratinized cells

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7
Q

Stratum Lucidum

A

Transparent layer found mostly in the soles of the feet and palm of the hands
transitional layer: 1-5 layers thick

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8
Q

Stratum Granulosum

A

1-5 cells thick
waterproof barier to prevent fluid loss
synthesizes keratonyaline (keratin precursor)

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9
Q

Stratum Spinosum:

A

Prickle Cell layer
has desmosomes which terminate in spiny projections
help protect skin from abrasion
LANGERHAN’S cells provide antigens to T-lymphocytes

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10
Q

Stratum Germanitivum

A

single cell layer
give germinal cells that are needed for regeneration of epidermis
has melanocytes which give skin pigment

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11
Q

Basement Membrane

A

epidermal-dermal junction where the cells are responsible for mitotic growth and epidermal regeneration (30 days)

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12
Q

Rete Ridges or Rete Pegs

A

downward fingerlike projections in the epidermis

meets with upward projections that connect to anchor the dermis to the epidermis, should move as one in a healthy person

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13
Q

At what age do the Rete Ridges flatten?

A

In your 60s, causing the anchoring between the epidermis and the dermis to be diminished giving a higher chance for epidermis to detach from dermis
tears the uppermost layers of the skin

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14
Q

Two layers of the Dermis

A
  1. Papillary layer: Anchors dermis to epidermis

2. Reticular Layer: dense, deep accessory organs such as epidermal appendages (hair follices, lymph vessels) Vascular

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15
Q

Functional Components of the dermis

A 
hair follicles
nerve ending
lymph vessels
capillaries
collagen
elastin
sweat glands
sebaceous glands (controls pH)
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16
Q

The purpose of subcutaneous tissue

A

adipose or fat

connective and elastic tissue: insulate, support, cushion, and store energy

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17
Q

Dermatologic Exam

OSAP not SOAP

A 
Objective
Subjective
Assessment
Plan
Examine the patient and than take a detailed history
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18
Q

Use hands during an evaluation to feel for:

A

texture and consistency
assess for tenderness
flat or elevated

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19
Q

Blanching

A

when sitting we cross our legs, when we undo we have a red mark. If you push on the red mark it turns white and than back to red as the blood refills with capillary. This is blanching

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20
Q

Five places to make sure you dont forget to assess during an examination

A
  1. scalp
  2. mouth
  3. eyes
  4. nails
  5. hair
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21
Q

Primary Lesions

A

first to appear and their ID is the most important aspect of the dermatological physical examination

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22
Q

Secondary Lesions

A

are depressed and manifest below the plane of the skin

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23
Q

Flat (2)

A

macule/patch

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24
Q

Raised Smooth (4)

A

papule/plaque/cyst/nodule

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25
Q

Raised Scaly (2)

A

papule with scale/plaque with scale

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26
Q

Fluid Filled (3)

A

vesicle/bulla/pustule

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27
Q

Redness (3)

A

erythema
erythroderma
telangiectasis (spider veins)

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28
Q

Purpura (3)

A

ecchymoses (bruise: you can date a bruise based on color)
petechiae
palpable purpura

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29
Q

Thinning or Loss

A

atrophy
erosion
ulcer
fissure

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30
Q

Gangrene

A

tissue death, mostly to distal fingers

occlusion to vascular supply from a blunt force or trauma

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31
Q

Eschar

A

Areas of dead tissue

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32
Q

hyperpigmented

A

darker due to increased melanin

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33
Q

hypopigmented

A

lighter due to decreased melanin

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34
Q

Flat: Macule

A

flat area of color change
LESS that 0.5cm
hyper: freckles
hypo: sunspots

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35
Q

Flat: Patch

A

flat area of color change

GREATER than 0.5cm

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36
Q

Raised Smooth: Papule

A

Solid elevated body

LESS than0.5cm in diameter

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37
Q

Raised Smooth: Plaque

A

solid, FLAT top, elevated

GREATER than 0.5cm and broader than thick

38
Q

Raised Smooth: Cyst

A

closed cavity or sac.
Has fluid or semisolid material
epitherial or endothelial lining

39
Q

Raised Smooth: Nodule

A

Firm and well-defined
maybe dermal or subcutaneous
GREATER than 0.5

40
Q

Surface Change: Scale

A

further classifies: papules and plaques
may appear as flakes or plates
color is white or gray
change in stratum corneum

41
Q

Surface Change: Crust

A

Dried blood, serum, or purulent
maybe thick or thin
color based on fluid

42
Q

Fluid Filled: Vesicle

A

fluid filled cavity or elevation
forms within or just under epidermis
LESS than 0.5cm
ex: shingles

43
Q

Fluid Filled: BUlla

A

“blister”

GREATER than 0.5cm

44
Q

Fluid Filled: Pustule

A

circumscribed elevation than contains pus
less than 0.5 cm in diameter
white-yellow

45
Q

Redness: Erythema

A

blanchable redness

increased blood flow

46
Q

Redness: Erythroderma

A

blanchable redness

excessive scaling

47
Q

Redness: Telangiectasis

A

visible, dilation of small blood vessels

spiderveins

48
Q

Atrophy

A

thinning of epidermal, dermal, or subcutaneous tissue

49
Q

Erosion

A

localized loss of epidermal mucosal epithelium

50
Q

Ulcer:

A

circumscribed loss of epidermis and at least upper dermis
classified by:
depth: can extend from subcut, muscle, bone area
edge: clean, ragged, undermined
Tissue at base: necrotic, purulent or healthy granulation

51
Q

Fissure

A

A deep linear crack or cleavage

found in areas of thickened skin

52
Q

Gangrene

A

necrotic black tissue
may be wet or dry (dry is better than wet, wet is a medical emergeny)
caused by obstruction, diminution, or loss of blood supply

53
Q

Eschar

A

Scab… dead tissue
adherent, thick, dry crust
infection, trauma, or excoriating skin disease

54
Q

Morphologies can be characterized by:

A

Shape (individual lesions)

Configuration (multiple lesions)

55
Q

Purpura

A

hemorrhage into skin or mucous membrane

56
Q

Non-palpable Purpura: Ecchymoses:

A

flat discoloration of skin or mucous membranes (bruise)

color changes over time

57
Q

Non-palpable Purpura: Petechiae

A

Tiny 1-2mm (pinpoint spots)

color is red or purple

58
Q

Palpable Purpura

A

raised and palpable discoloration

due to: vasuclar inflammation and extravasation of RBC

59
Q

Wound Classification Color

A

Yellow: Slough
Red: beefy granulation
Black: Necrotic or eschar

60
Q

Wound Classificatio: Wagner Scale

A

Used to est the presence of depth and infection. Developed for the diagnosis and treatment of the dysvascular foot.
six grades: 0-5

61
Q

Burn Classification: Traditional (not used anymore)

A

First, Second, and Third

62
Q

American Burn Association Classification

A

Superficial
Partial-thickness (superficial partial, deep partial)
Full Thickness

63
Q

Platelets

A

promote hemostasis, initiate wound healing cascade

64
Q

Neutrophils

A

remove damaged tissue, bacteria, foreign debris; produce elastase and colagenase

65
Q

Mast Cells

A

promote fibroblast proliferation

66
Q

Macrophages

A

removed damaged tissue, bacteriam foregin debrism degrade matrix; release chemotactic and mitogenic factors for fibroblasts

67
Q

Fibroblasts

A

synthesize and deposit extracellular matrix components; important for wound contraction (transition into myofibroblasts

68
Q

Keratinocytes

A

promote epithelialization

69
Q

Endothelial cells

A

promote neovascularization

70
Q

Exogenous

A

external or environmental factors

71
Q

Endogenous

A

Internal Factors or conditions of the patient

72
Q

Iatrogenic

A

things that are done to or with the patient. Excessive cleasing of wound with cytotoxic cleansers

73
Q

Medications that delay wound healing

A 
steroids
immunosuppressive agents
antineoplastic drugs
anticoagulants
antiprostaglandins
chemo
radiation
74
Q

Signs and Symptoms of dehydration

A 
eyes that appear sunken
dry skin
loose skin
dry mouth/tounge
fever
nausea
vomiting
weakenss
lack of appetite 
constipation
low BP
dark urine
75
Q

Skin Lesions affect hydration

A

patients loose a lot of fluids and protein through a wound

76
Q

With increased protein why must you increase hydration?

A

when protein is increased, adequate fluid must be provided so the kidneys can handle the extra nitrogen load and prevent the possibility of dehydration

77
Q

Calories and maintaining weight

A

sedentary adult to maintain weight 20-25kcals/kg

patient with wounds should have 30-45kcals/kgbw

78
Q

Vitamin C

A

enhances leukocyte, macrophage activation, fibroblast and collagen synthesis

79
Q

Vitamin A

A

Facilitates macrophage entry into the wound/ enhances angiogenesis
should nto exceed 200% of the RDA due to toxicity

80
Q

Zinc

A

essential mineral fro RNA/DNA

81
Q

Copper

A

Formation of RBC

82
Q

DERMATOLOGICAL

A

D: describe integrity, skin intact or resents with injury
E: Ethnicity, note skin tone/color
R: review sensory status, intact or altered
M: moisture, dry or moist to touch
A: atrophic changes, shiny, hairless
T: turgor/texture
O: observe nail composition and hair
L: look and feel for edema, color, and temp
O: observe skin folds
G: gerontodermatological changes: aging
I: inquire about allergies and past medical history
C: Callus: high pressur or repetitive trauma
A: Assess vascular status
L: lesions rashes, scars, bruising, hemosiderin

83
Q

Population of non-Caucasions in the US?

Projection in 2050?

A

29% now

2050: 48%

84
Q

Black People: Stratum Corneum

A

more layers of corneal cells, more compact and robust, has fewer ceramides (essential lipids)

85
Q

Black Skin Care, whats bigger?

A

pores, sweat glands, and sebaceous glands, more sebum and have a lower pH (acidic)

86
Q

Futcher’s (voigt’s) line

A

sharp demarcation between darkly pigmented and lightlt pigmented skin the upper extremity, follows spinal nerve

87
Q

Midline hypopigmentation

A

lighter skin color over the sternum

lessens with age

88
Q

Nail Pigmentation

A

diffuse nail pigmentation, linear dark bands on the nail

89
Q

Oral pigmentation

A

oral mucosa appears blue to blue-gray

gums may be different colors

90
Q

Palmar changes

A

creases maybe lyperpigmented

91
Q

Dermatosis Papulosa Nigra

A

Brown to black papules, family history, more common in females

Morgan Freeman

Integumentary (1 decks)

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