integumentary Flashcards

1
Q

congenital integument disorders

A

-birthmarks (vascular birthmarks and pigmented birthmarks)
-skin anomalies that present at birth or shortly thereafter
-most are harmless and shrink w age
-can sometimes be treated w laser therapy or surgery (moles)
-may be flat or raised, have regular or irregular borders, and are of diff colors

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2
Q

what are the 2 types of congenital integument disorders?

A

vascular birthmarks and pigmented birthmarks

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3
Q

macular stains (vascular)

A

-consist of blood vessels that have not formed correctly
-macular stains: also called salmon patches, angel kisses, and stork bites
-most common
-faint red marks often occurring on the forehead, eyelids, posterior neck, nose, upper lip, or posterior head
-most fade on their own by 2 years of age, although they may last into adulthood

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4
Q

hemanigiomas (vascular)

A

-“strawberries”
-bright red patch of extra blood vessels in the skin
-may be superficial or deep
-deep hemangioma may be bluish bc they involve deeper blood vessels
-grow during the first year of life and then usually recede
-most are benign, but can cause complications if they interfere w sight, feeding, breathing, or other bodily functions

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5
Q

port wine stain (vascular)

A

-discolorations that look like wine was spilled on the skin
-most often occur on face, neck, arms, and legs
-can be any size, but they grow only as the child grows
-tend to darken and thicken over time (bruise looking)
-will not resolve spontaneously
-those occurring near the eye should be assessed for possible complications

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6
Q

café au lait spots (pigmented)

A

-very common
-color of coffee w milk
-can be anywhere on the body and sometimes increase in number w age
-one spot alone is not usually a concern, but several spots larger than a quarter can be neurofibromatosis

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7
Q

mongolian spots (pigmented)

A

-flat, bluish-gray patches
-often found on the lower back or buttocks
-more common on those w darker skin tones
-usually fade, often completely, by school age w out treatment

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8
Q

albinism (disorders of melanin)

A

-recessive condition that results in little or no melanin production
-melanin deficits cause a lack of pigment in the skin, hair, and iris
-skin changes: color ranges from white to nearly the same as relatives
-hair changes: color can range from very white to brown; ppl of African or Asian descent may have hair color that is yellow, reddish, or brown
-eye changes: color ranges from light blue to brown; irises are semitranslucent; some eyes appear red

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9
Q

melanin

A

-pigment that provides color and protection
-plays a role in the development of the retina

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10
Q

what forms cause problems w eye development and function in melanin

A

-nystagmus
-near/farsighted
-photophobia

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11
Q

vitiligo (disorders of melanin)

A

-rare condition characterized by small patchy area of hypopigmentation
-occurs when the cells that produce melanin die or no longer form melanin, causing slowly enlarging, irregularly shaped white patches on the skin
-affects ppl of all races but may be more noticeable in those w dark skin tones
-may affect any area, but usually develops on sun-exposed areas first
-can start at any age, but often first appears btwn 10-30 yrs of age

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12
Q

cause of vitiligo

A

-the exact cause is unknown; causes may include autoimmune melanocyte destruction, reduced melanocyte survival , and primary melanocyte defects

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13
Q

skin changes w aging

A

-decreased sensations of pain. vibration, cold, heat, pressure, and touch
-increase the risk of injury including falls, decubitus ulcers, burns and hypothermia
-decreased elasticity, integrity, and moisture
-environmental factors, genetic makeup, and nutrition contribute to these changes, especially sun exposure
-blue-eyed, fair-skinned ppl show more of these changes
-sebaceous glands produce less sebum
-difficult to maintain skin moisture

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14
Q

skin changes w aging in the epidermis

A

-appears thin, pale, and translucent
-epidermis thins even though the number of cell layers remains unchanged
-melanocyte numbers decrease but increase in size

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15
Q

skin changes w aging in the dermis

A

-changes in the connective tissue reduce the skin’s strength and elasticity
-blood vessels become fragile, leading to bruising

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16
Q

skin changes w aging in the subcutaneous

A

-the subcutaneous fat layer thins
-increases risk of skin injury and reduces the ability to maintain body temp

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17
Q

dark spots/sun spots (skin changes w age)

A

-large pigmented spots (lentigos) may appear in sun-exposed areas

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18
Q

skin tags (skin changes w age)

A

-benign, flesh-colored masses
-usually occur on the neck
-most are painless, but can become inflamed in the presence of constant friction
-can be removed w surgery, cryotherapy, and cautery

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19
Q

repairs itself more slowly

A

-wound healing may be up to four times longer
-contributes to decubitus ulcer formation and infections

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20
Q

inflammatory integument disorders

A

-contact dermatitis
-atopic dermatitis
-urticaria-hives
-psoriasis

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21
Q

contact dermatitis

A

-acute inflammatory reaction triggered by direct exposure to an irritant to allergen-producing substance
-not contagious or life threatening
-varies in severity depending on the substance, area affected, exposure extent, and individual sensitivity
-usually resolves in 2-4 weeks

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22
Q

irritant contact dermatitis

A

-causes: chemicals, plants, body fluids, rubber gloves, and soaps
-does not involve the immune system, but triggers the inflammatory response
-produces a reaction similar to a burn
-manifestations: erythema, edema, pain, pruritus, and vesicles

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23
Q

allergic contact dermatitis

A

-causes: metals, chemicals, adhesives, cosmetics, and plants
-sensitization occurs on the first exposure, and subsequent exposures produce a type IV cell-mediated hypersensitivity
-manifestations appears 24-48 hrs after exposure
-manifestations: pruritus, erythema, edema, and small vesicles

24
Q

atopic dermatitis

A

-“eczema”
-chronic inflammatory condition
-has an inherited tendency
-may be accompanied by asthma and allergic rhinitis
-most common in infants and usually resolves by early adulthood
-young children: face, scalp, hands, or feet
-older children and adults: knees and elbows
-characterized by remissions and exacerbations

25
Q

atopic dermatitis cause

A

-exact cause unknown, but may result from an immune system malfunction (similar to hypersensitivity reaction, [i.e., IgE eleveation present])

26
Q

atopic dermatitis complications

A

secondary bacterial skin infections, neurodermatitis (permanent scarring and discoloration from chronic scratiching), and eye problems (e.g., conjunctivitis)

26
Q

factors that trigger exacerbation for psoriasis

A

bacteria or viral infections in any location, dry air or dry skin, skin injuries, stress, too little or too much sunlight, and excessive alc consumption

26
Q

atopic dermatitis manifestations

A

-may be worsened by environmental factors like food allergens, airborne allergens, Staphylococcus aureus colonization on skin, topical products, sweating, and rough fabrics
-red to brownish-gray skin patches
-pruritus, which may be severe, especially at night
-vesicles
-thickened (lichenified), cracked, or scaly skin
-irritated, sensitive skin from scratching

26
Q

urticaria - hives

A

-raised erythematous skin lesions (welts)
-result of a type I hypersensitivity reaction often triggered by food (e.g., shellfish and nuts) and medicine (e.g. antibiotics)
-may also be a result of emotional stress, excessive perspiration, diseases (e.g., autoimmune conditions and leukemia), and infections (e.g., mononucleosis)
-occurs when histamine release is initiated by these conditions
-usually short-lived and harmless
-can impair breathing if around the face and progress to anaphylaxis and shock

26
Q

bacterial infections

A

-can be caused by any of the norm flora bacteria
-varies from mild to life-threatening
-Staphylococcus and Streptococcus genera are common culprits

27
Q

psoriasis

A

-chronic inflammatory condition that affects keratinocytes life cycle
-cellular proliferation is significantly increased, causing cells to build up too rapidly on the skin’s surface
-normally takes weeks, but occurs over 3-4 days w psoriasis
-buildup leads to thickening of the dermis and epidermis bc dead cells cannot shed fast enough

27
Q

infectious integumentary disorders

A

-skin infections are common
-organisms gain access through breach in skin or mucous membrane
-this triggers inflammatory responses
-can occur in any skin layer or structure
-may be acute or chronic and severity varies
-resolves w treatment

27
Q

psoriasis cause

A

-the exact cause is unknown, but it is thought to be multifactorial: environmental factors, trauma, infections, excessive alc use, meds, genetic factors, and immunologic factors plays a role

27
Q

how does psoriasis appear

A

-pt usually experiences remissions and exacerbations
-severity varies
-may also have arthritis – psoriatic arthritis
-may be severe in persons who have a weakened immune system
-begins as a small, red papule
-papules most often occur on the elbows, knees, and trunk but they can appear anywhere

28
Q

treatment for bacterial infections

A

organism-specific antibiotics, wound care, adequate hydration, surgical debridement, drainage

28
Q

folliculitis

A

-involving the hair follicles
-characterized by tender, swollen areas that form around hair follicles,
-often on the neck, breasts, and face

29
Q

furuncles

A

-begin in the hair follicles and then spread into the surrounding dermis
-most commonly occur on the face, neck, axillae, groin, buttocks, and back
-start as a firm, red, painful nodule that develops into a large, painful mass, which freq drains large amts of purulent exudate
-carbuncles refer to clusters of furuncles

30
Q

impetigo

A

-common and highly contagious
-can occur w out an apparent skin breach, but typically arises from a break in the skin
-lesions usually begin as small vesicles that enlarge and rupture, forming the characteristic honey-colored crust
-typically caused by staphylococci, which produce a toxin that attacks collagen and promotes spread

31
Q

cellulitis

A

-occurs deep in the dermis and subcutaneous tissue
-usually results from a direct invasion of pathogens through a break in the skin, or spreads from an existing skin infection
-appears as a swollen, warm, tender area of erythema
-complications: necrotizing fasciitis, septicemia, and septic shock

32
Q

necrotizing fasciitis

A

-rare, serious infection
-can aggressively destroy skin, fat, muscle, and other tissue
-typically results from a highly virulent strain of gram-pos, group A, beta-hemolytic Streptococcus that invades through a minor cut or scrape
-the bacteria release harmful toxins that directly destroy the tissue, disrupt blood flow, and break down the tissue

33
Q

HSV -1 (viral infections)

A

-cold sores/lesions
-typically affects the lips, mouth, and face
-usually begins in childhood
-can involve the eyes, leading to conjunctivitis
-can result in meningoencephalitis
-transmitted by contact w infected saliva
-the primary infection may be asymptomatic

34
Q

verrucae (viral infections)

A

-warts caused by a number of human papillomaviruses
-can develop at any age and often resolve spontaneously
-transmitted through direct skin contact btwn ppl or w in the same person
-the human papillomavirus replicates in the skin cells, causing irregular thickening
-varying color, shape, and texture depending on type

35
Q

shingles

A

-“herpes zoster”
-varicella-zoster virus
-caused by the varicella-zoster virus
-appears in adulthood yrs after a primary infection of varicella in childhood
-the virus lies dormant on a cranial nerve or a spinal nerve dermatome until it is activated yrs later
-the virus affects this nerve only, giving the condition its typical unilateral manifestations

36
Q

shingles manifestations & complications

A

manifestations: -pain, paresthesia,
-a red or silvery vesicular rash that develops in a line over the area innervated by the affected nerve (one side of the head or torso),
-extremely sensitive skin
-the rash may persist for weeks to months.
complications: neuralgia and blindness

37
Q

pressure injuries

A

-soft-tissue injuries that occur as a result of unrelieved mechanical pressure
-results in areas of necrosis and ulceration where the tissue is compressed btwn bony prominences and external hard surfaces
-most common sites for these injuries are the sacrum, ischial tuberosities, trochanters, malleoli, and heels, though can develop anywhere
-An injury can develop in 1–2 hours if pressure is not relieved

38
Q

pressure injuries risk factors

A

advancing age, impaired circulation and tissue perfusion, immobilization, malnutrition, decreased sensation, and incontinence

39
Q

pressure injury complications

A

challenging mitigating factors;
ulcers can become infected with hospital-acquired, antibiotic-resistant organisms
osteomyelitis
cellulitis
tissue calcification
bacteremia

40
Q

pressure injury treatment

A

effort to reduce pressure,
care for the wound, minimize infection,
pain management, antibiotics,
negative-pressure therapy
surgical closure, or skin grafts

41
Q

Healing typical takes weeks; ____________________________

A

prevention is critical

42
Q

pressure injuries stage 1

A

Stage I: Skin is intact, nonblanchable erythema is present

43
Q

pressure injury stage 2

A

Stage II: Erosion or blister with or without true ulcerations, no exposed subcutaneous tissue

44
Q

pressure injury stage 3

A

full-thickness skin loss w damage to subcutaneous tissue down to the underlying fascia

45
Q

pressure injury stage 4

A

full-thickness kin loss w extensive destruction, tissue necrosis, and damage to exposed supporting structures

45
Q

deep tissue injury

A

skin may or may not be intact, and underlying tissue is damaged

46
Q

unstageable

A

full thickness skin and tissue loss in which the extent of damage cannot be determined bc it is hidden by slough or eschar