Integument Flashcards
What are the lesions?
Anything on slide 3
Secondary lesions can only occur from primary ones
True/False
True
Pressure Ulcers (Slide 6)
Ulcers occur from prolonged unrelieved pressure, especially in bony areas. Especially happens in people who are on prolonged bedrest where there is pressure on blood vessels quite the blood flow making the area necrosed. May experience discomfort
Friction vs Shearing forces
Two things rubbing against each
Shearing: one surface is moving the other isn’t; the patient being moved up and down in bed causing wear on the skin
Moisture
harbors bacteria, can lead to skin breakdown
Stages of pressure ulcers
Stage 1: erythema the skin is red, press on it and it stays red means this(no break in the skin)
Stage 2: top layer of skin is gone; a fluid filled blister that ruptures, superficial; area where the skin is gone
Stage 3: fatty tissue present in the wound
Stage 4: muscle is seen, bone is seen, ligament(silvery, light)
Suspected deep tissue injury
the area that is discolored if it is pressed, the tissue feels mushy, skin will eventually break open; characterized by a discolored (purple or maroon)intact skin or blood-filled blister
‘Unstageable’ Stage of pressure ulcer
full-thickness tissue loss with base of ulcer covered by slough or eschar, or both
Slough:
Eschar: black coating that is really hard and leathery and cant be removed (usually seen on the heel)
-these can be present on top of any of the stages of the pressure ulcer
Preventative techniques of pressure ulcers
- Conducting Frequent skin assessments
- Repositioning: Min of 2 hours a patient should be repositioned
- Pressure Reduction, removal, and distribution
- Elimination of Moisture: especially for patients that are incontinent
Risk factors for pressure ulcers
Don’t memorize but just look at pg 1055
Ischemia
Malnutrition
Causes of pressure ulcers
- impaired perfusion, lack of adequate blood flow
- adequate amt of proteins, vitamins, and other things vital for the body is key for skin integrity
Pg 1059, Table 41-4
Comedone:
Burrow: caused by a parasite
Petechiae: ruptured capillaries(b.v), causing red dots to form
Purpura: really large bruise, purple in color, >.5cm in diameter
Telangiectasia: dilated superficial blood vessels
Pruritis
Itching, this is just a symptom of of something
*chronic itching can result in infections and scarring due to persistent scratching
What’s the most common cause of itching(pruritus)?
*Histamine; released by mast cells *
What is the most common symptom of primary skin disorders?
Pruritus
Dermatitis
Causing inflammation of the skin
Eczema
the most common inflammatory disorder of the skin
Characterized by: tiny little bumps that are extremely itchy, lesions with indistinct borders, epidermal changes
**When chronic, the skin becomes thickened, leathery, and hyperpigmented from recurrent irritation and scratching
Allergic Contact Dermatitis
-delayed hypersensitivity type IV reaction, caused by T-cell mediated or delayed hypersensitivity
Ex. Poison Ivy
Characterized by fluid filled bumps
What are the manifestations of Allergic contact dermatitis?
Erythema, Swelling, Pruritus, Vesicular lesions
Irritant Contact Dermatitis
-when the skin becomes ‘irritated’ when it comes into contact with something that they may not be allergic to but is causing a response to the skin
Could be detergent, jewelry, fabric softner, etc
Atopic Dermatitis
Type 1 hypersensitivity reaction; it is an allergic dermatitis but is not caused by what the skin comes in contact with(physical) but instead mast cells releasing histamine and high levels of eosinophils(IgE antibodies(; allergies)
Stasis dermatitis
always occurs in the legs as a result of venous stasis (blood in the veins that just accumulates and doesn’t move)
Characterized by a rusty, brown color. Eventually the area can break open resulting in a sore
Treatment for Stasis Dermatitis
- Elevate legs as much as possible
- Avoid tight clothes around legs
- Don’t stand for long periods of time
- Antibiotics (acute lesions)
What is Seborrheic dermatitis?
dandruff further classified by age group, can be on the head or any part of the body really
- Chronic inflammation of the skin
- Inflammation of the skin involving the scalp, eyebrows, eyelids, nasolabial folds, and ear canals
- Scaly, white, or yellowish plaques
- Starts in infancy and lasts to old age
- Remission/exacerbations
- Treatment:
- Topical steroid
What is psoriasis(Papulosquamous Disorders)? very common
- A skin disorder that is somewhat of an autoimmune problem (the body is doing it to itself)?
- with autoimmune problems, you’ll always have remissions and exacerbations
- the top of the lesion is **white, silvery and scaly ** plaques
- the epidermal skin cells turnover is too fast
Vasiculobullous diseases
blister that ruptures
-Pemphigus: painful blister
-Erythema multiforme: blistering skin(the blisters pop; putting patient at risk high risk for infection) disorder
Ex stevens Johnson’s syndrome
what are the 3 different Types of Infections
- Bacterial: cellulitis, necrotizing fasciitis, erysipelas, impetigo
- Fungal: tinea(ring worm infection that is contagious, characterized by “round” reddish lesions); diff types 41-10, candidiasis(yeast infection when its in the mouth its called thrush
- Viral: Herpes simplex, Herpes Zoster(can only get if you have previously had chickenpox) and varicella(chickenpox), warts
Insect Bites
Scabies: mite that burrows under the skin
Pediculosis:
