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Health Status > Integumentary > Flashcards

Integumentary Flashcards

1
Q

What is the general purpose of the epidermis?

A

Outer most layer (only a max. Of 1.5mm thick)
Protects deeper layers from mechanical, thermal and chemical damage
Protects from pathogen and UV radiation

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2
Q

What are the main layers of the epidermis from superficial to deep?

A

Stratum corneum
Stratum granulosum
Stratum spinosum
Stratum basale

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3
Q

What is the stratum corneum?

A

Outer most layer of epidermis
Comprised of dead skin cells that continually shed and are replaced
Provides waterproofing

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4
Q

What is the stratum granulosum?

A

The second deepest epidermal layer
Comprised of granula cells which provide keratin
Gives structure and integrity

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5
Q

What is the stratum spinosum?

A

Between the granulosum and basale epidermal layers
Has several layers of cells that give support and strength

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6
Q

What is the stratum basale?

A

Deepest epidermal layer
New skin cells (keratinocytes) made here. Undergo keratinisation where they are hardened and pushed up as more new cells are produced
Melanocytes produce melanin

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7
Q

What produces skin tone variation?

A

The ratio of the different forms of melanin in the stratum basale

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8
Q

What is the purpose of keratin in skin?

A

Helps with fluid retention
Healing and repair
Gives shape and structure

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9
Q

Describe the dermis

A

Thick middle layer of skin
Has two layers: superficial papillary dermis and deep reticular dermis
Many capillary networks to provide oxygen and nutrients
Collagen and elastin provide shape and elasticity
Hair follicles, glands, erector pili muscles and nerve endings

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10
Q

Describe the hypodermis

A

Also called subcutaneous tissue (means tissue under the skin)
Comprised of loose connective tissue and adipose tissue
Connects skin to muscle, maintains temperature, adipose stores glucose that can be used for energy and helps with protection

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11
Q

What causes acne?

A

Hair follicle gets clogged with oil and dead skin cells
Influenced by high oil levels, hormones, genetics, bacteria and inflammation

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12
Q

What are the symptoms of acne?

A

Usually on face, black, chest and shoulders
Presents as whitehead, blackhead, pustule, cyst

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13
Q

What is the treatment for acne?

A

Refer to dermatologist or GP
Topical benzoyl peroxide or salicylic acid
Oral hormone, AB or isotretinoin

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14
Q

What causes psoriasis?

A

A chronic autoimmune disease causes mass skin cell production that accumulates on surface of skin

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15
Q

What are the symptoms of psoriasis?

A

Commonly on elbows, knees, scalp and back
Thick silver scales/red patches
Flares up when stressed, infection, injury, weather changes, some medication

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16
Q

What is the treatment for psoriasis?

A

Refer to dermatologist/GP
Topical and oral medication, light therapy

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17
Q

What is skin cancer?

A

Abnormal cell growth due to damaged cell DNA
Usually caused by prolonged UV radiation exposure
Can be BCC is stratum basale, SCC in keratinocytes or melanoma in melanocytes

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18
Q

What is the treatment for skin cancer?

A

Refer to dermatologist/GP
Needs a biopsy
Medication, radiation therapy or excision

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19
Q

How does the body produce and retain its own heat?

A

Heat is produced as a by product of metabolic processes
Skin helps to retain this heat, especially adipose tissue

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20
Q

What might cause the body to overheat?

A

Illness, exertion, hot environment, medication

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21
Q

How does the body thermoregulate when too hot?

A

Dilates capillary beds in the skin so more heat can be transferred out
Sweat is produced (salt and water fro eccrine glands in dermis). It is released onto the skin where heat is transferred into it and then gets evaporated off the body
Negative feedback loop

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22
Q

How does the body thermoregulate when too cold?

A

Constricts capillary networks in the skin so less heat is transferred out.
Activates erector pili muscles in the dermis to cause shivering - metabolic processes produce heat
Negative feedback loop

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23
Q

What is an apocrine gland?

A

Located in armpits and genital areas
Activated at puberty - hormone triggered
Responsible for body odour and pheromones
Specialised forms exist e.g. glands in ear makes earwax, ciliary gland in eye controls tears, mammary helps with milk production

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24
Q

What are eccrine glands?

A

Activate at birth
Produce sweat

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25
Q

What are the symptoms of hypothermia?

A

Shivering
Pale
Numb
Fatigued
Confused
Uncoordinated movement and speech
Severe cases: unconscious, ectopics, respiratory failure

26
Q

What is the treatment for hypothermia?

A

Move patient to warm area
Get patient dry
Insulate them
Start gentle re-warming (warm drink, warm blanket)
Transport to ED

27
Q

What are the 3 phases of hyperthermia?

A

Heat cramps: muscle cramp/spasm from dehydration and electrolyte imbalance
Heat exhaustion: weak, dizzy, nausea, headache, tachycardia
Heat stroke: temp above 40, confusion, agitation, ALOC, hot/dry skin - no sweat

28
Q

In general, how does skin provide sensory information?

A

There are receptors in the dermis specialised in pressure, touch, heat, vibration and pain which relay information back to the brain when activated. This allows differentiation of stimulus and position.
This mechanism diminishes with age

29
Q

What is vitamin D synthesis?

A

Occurs in the epidermis
UV radiation induces a reaction to convert pro vitamin D into vitamin D
Important for calcium regulation, cell signalling and DNA repair

30
Q

How does BSA and mass ratio affect thermoregulation?

A

A low mass:high BSA means heat is exchanged rapidly = get cold quickly and get hot quickly
(e.g. a baby)
A high mass:low BSA means heat is exchanged slowly = increased disease states and fevers
(e.g. an obese person)

31
Q

What is the rule of nines?

A

A method of calculating BSA
Head: 4.5% each side
Chest/back: 9% each side
Abdomen/lower back: 9% each side
Arms: 4.5% each side
Legs: 9% each side
Groin: 1%

32
Q

What is folliculitis?

A

Bacterial infection on skin causing inflamed hair follicles. Usually in shaved areas, where clothes rub or high sweat zones
SX: Red, itchy, painful pustules
TX: warm compress, good hygiene, topical/oral AB

33
Q

What is cellulitis?

A

A bacterial infection in the deep skin layers and tissue. Usually staph or strep.
Commonly occurs in legs and more common in DM and those with reduced circulation
SX: red, swollen, warm, painful
TX: ABs and wound care

34
Q

What is dermatophytosis?

A

Ringworm. A fungal infection affecting the skin, scalp or nails
SX: red, circular rash with a raised edge and clear centre, itchy, scaly
TX: antifungal

35
Q

What is tinea pedis?

A

Athletes foot.
SX: red, itchy/burn, peeling, fissures, blisters
TX: good hygiene, antifungals

36
Q

What is candidiasis?

A

Fungal infection - oral/vaginal
SX oral: white patches, pain, bleeding
TX: antifungal

37
Q

What is molluscum contagiosum?

A

A viral skin infection
SX: round, firm, painless bumps
TR: highly transmissible via contact

38
Q

What is varicellar zoster?

A

Viral infection causing chicken pox
SX: itchy, blister-like rash, fever, fatigue etc
TR: highly transmissible via droplet

39
Q

What us herpes zoster?

A

Viral infection causing shingles. Chicken pox virus stays dormant in ganglia and can reactivate later in life (usually if patient is susceptible)
SX: painful, blistering rash in a cluster along a dermatone

40
Q

What is measles?

A

A viral infection
SX: flu SX + blotchy, red rash. Can start as small white spot with blue/white centre inside the cheeks.
TR: droplet and contact

41
Q

What is scabies?

A

Sarcoptes mite burrows in the skin
SX: intense itch, rash, commonly on wrist, elbow, fingers, waist and genitals
TR: contact
TX: permethrin, benzoyl benzoate, hygiene

42
Q

What is pediculosis?

A

Lice affecting hair, body or pubic area
SX: itching, visible lice
TR: contact
TX: OTC medications and hygiene

43
Q

What are ticks?

A

Parasite attaches to skin
SX: red, itch, swelling, painless, flu SX
TX: remove with tool/tweezer

44
Q

What is the management of people with skin issues?

A

Refer to GP unless systemic symptoms are present

45
Q

What is allergic contact dermatitis?

A

Immune system reacts to an allergen which comes into contact with skin
SX: red, itch, swell, blister, dry, scale

46
Q

What is irritant contact dermatitis?

A

Direct irritation on the skin without an immune response

47
Q

What is atopic eczema/dermatitis?

A

Irritated skin
Acute SX: red, oedema, scaly
Chronic SX: scratching causes dry, hard, thick areas
TX: avoid allergen, steroid, AH, moisturiser, care routines

48
Q

What do we need to consider with paediatric skin?

A

High BSA:mass ratio = rapid heat loss/gain
Different BSA calculation is required because of big head (18%)
Skin cells are smaller + less collagen so reduced strength and cushioning
Skin is less acidic so more prone to infection

49
Q

What do we need to consider with geriatric skin?

A

Skin layers are less tightly adhered = sagging and lines
Hypodermis thin = less protection
Reduced healing and skin integrity
Less blood vessels and nerves = reduced thermoregulation and sensation

50
Q

What is a pressure injury?

A

Localised damage to skin and tissue from prolonged, continual pressure
Compressive and shearing forces on the skin
Circulation gets impaired which reduces oxygen and nutrients to the skin
4 stages

51
Q

What are the 4 stages of a pressure injury?

A

1: area is red + warm, burn/itch/pain
2: area may be open, scraped or blistered, discoloured, painful
3: area is pitted/cratered
4: large wound involving underlying structures

52
Q

What is the TX for a pressure injury?

A

Transport if severe otherwise refer to GP or utilise own care network
Relieve the pressure
May need debridement, wound care, grafting, nutrition support

53
Q

What causes burns?

A

Heat
Electricity
Radiation
Chemical

54
Q

What is a first degree burn?

A

Epidermis only
SX: red, mild-moderate pain, minor swelling

55
Q

What is a second degree burn?

A

Superficial: slightly extends into dermis
Deep: extends well through the dermis
SX: blistered, painful, red/mottled, swelling, oozing

56
Q

What is a third degree burn?

A

All layers and structures beneath are affected
SX: white/charred area, can be painless, dry, leathery

57
Q

What other symptoms can be present with burns?

A

Shock (tachypnea, tachycardia, weak pulse, pale/clammy)
SOB if inhaled
Swelling = reduced ROM
Infection

58
Q

What is the TX for a first degree burn?

A

Cold running water for 20 minutes
Apply dressing
OTC analgesia and topicals
Refer to GP/pharm if needed

59
Q

What is the TX for a second degree burn?

A

Cooling
Analgesia
Wound cleaning and dressing

60
Q

What is the TX for a third degree burn?

A

Transport to ED with paramedic support

Health Status (15 decks)

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