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HOSA Pathophysiology > Integumentary > Flashcards

Integumentary Flashcards

1
Q

Skin is the __________ organ of the body in surface area and weight

A

Largest

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2
Q

Dermatology

A

The medical specialty concerning the diagnosing and treatment of skin disorders

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3
Q

What are the two layers of skin called

A

Epidermis and dermis

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4
Q

Epidermis

A

Consists of 5 layers varying in thickness;
Does not contain blood vessels or nerves;
Contains melanocytes

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5
Q

What are the 5 layers of the epidermis in order from the innermost layer to the outermost layer?

A

stratum basale, stratum spinosum, stratum granulosum, stratum lucidum, and stratum corneum

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6
Q

Stratum Basale

A

The innermost layer of the epedermis;
new squamous epithelial cells form through mitosis in this layer;
only layer where mitosis occurs;
from this layer, the epithelial cells are then moved upward forming each layer of the epidermis

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7
Q

Stratum Corneum

A

outermost layer of the epidermis that consists of many layers of dead, flat, keratinized cells that are sloughed from the surface after being formed in the basale layer

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8
Q

Melanin

A

specialized pigment-producing cells, dark pigment;
this cell production depends on genes and environmental factors (sun exposure or ultraviolet light)

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9
Q

Keratin

A

a protein found in skin, hair, and nails which is deposited into the epithelial cells;
prevents loss of body fluid through the skin and entry of excessive water into the body

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10
Q

Albinism

A

recessive trait leading to a lack of melanin production;
person has white skin and hair and lacks pigment in the iris of the eye;
must avoid sun exposure

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11
Q

Vitilgo

A

Small areas of hypopigmentation

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12
Q

Melasma or Chloasma

A

Patches of darker skin

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13
Q

Carotene

A

additional pigment that gives a yellow color to the skin

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14
Q

Dermis

A

thick layer of connective tissue that includes elastic and collagen fibers and varies in thickness over body;
contains nerves and blood vessels;
contains sensory receptors for pressure or texture, pain, heat or cold

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15
Q

Embedded in the skin are appendages or accessory structures, which are

A

Hair follicles, sweat and sebaceous glands, and nails

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16
Q

Hair follicles

A

lined by epidermis, the stratum basale produces the hair;
Smooth muscle is attached to it (arrector pili which is controlled by sympathetic nerves) which create goose bumps

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17
Q

Sebaceous glands

A

Produce an oily secretion, sebum, which keeps hair/skin soft

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18
Q

Sweat glands (two types)

A

Eccrine (merocrine) glands located all over body and secrete sweat through pores in response to increased heat or emotional stress (SNS control)
Apocrine glands located in the axillae, scalp, face, and external genitalia, & the ducts of glands open into hair follicles

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19
Q

Beneath the dermis is the _____________ or _____________, which consists of connective tissue, fat cells, macrophages, fibroblasts, blood vessels, nerves, and base of many appendages

A

subcutaneous tissue, hypodermis

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20
Q

5 functions of the skin

A
  1. first line of defense against invasion by microorganisms and other foreign material
  2. prevents excessive fluid loss
  3. controlling body temperature using 2 mechanisms: cutaneous vasodilation (increases peripheral blood flow), and increased secretion and evaporation of sweat
  4. sensory perception which is a defense against environmental hazards, as a learning tool, and as a means of communicating emotions
  5. synthesis and activation of vitamin D on exposure to small amounts of ultraviolet light
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21
Q

Macule

A

Freckle; small, flat, circumscribed lesion of a different color than the normal skin

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22
Q

Papule

A

Insect bite; small, firm, elevated lesion; epidermal and papillary

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23
Q

Nodule

A

Cyst; elevated palpable lesion; varies in size; extends into the subcutaneous layer

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24
Q

Pustule

A

Acne; elevated lesion erythematous lesion, usually containing purulent exudate (pus)

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25
Q

Vesicle

A

elevated, thin-walled lesion containing clear fluid (blister)

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26
Q

Plaque

A

large, slightly elevated lesion with flat surface, often topped by scale

27
Q

Crust

A

dry, rough surface or dried exudate or blood

28
Q

Lichenification

A

thick, dry, rough surface (leather-like)

29
Q

Keloid

A

raised, irregular, and increasing mass of collagen resulting from excessive scar tissue formation

30
Q

Fissure

A

small, deep, linear crack or tear in skin

31
Q

Ulcer

A

cavity with loss of tissue from the epidermis and dermis, often weeping or bleeding

32
Q

Erosion

A

Shallow, moist cavity in epidermis

33
Q

Comedone

A

mass of sebum, keratin, and debris blocking the opening of a hair follicle

34
Q

Pruritis

A

release of histamine in hypersensitivity response;
associated with allergic responses, chemical irritation due to insect bites, or infestations by parasites;
common manifestations include redness and itchiness

35
Q

Contact Dermatitis

A

caused by exposure to an allergen, direct chemical, or mechanical irritation

36
Q

Allergic Dermatitis

A

manifestations such as a prutitic rash develop at the site a few hours after exposure to that allergen; indicated by pruritic, erythematous, and edematous area, covered with vesicles

37
Q

Urticaria

A

results from type I hypersensitivity, commonly caused by ingested substances; release of histamine causes eruption of hard, raised erythematous lesions (hives)

38
Q

Atopic Dermatitis

A

inherited tendency toward allergic conditions; chronic inflammation; eosinophilia and increased serum IgE levels indicate allergenic basis for this; infants = moist, red, vesicular, and covered with crusts; adults = dry and scaling with lichenification; topical glucocorticoids are helpful

39
Q

Psoriasis

A

chronic inflammatory skin disorder; results from abnormal activation of T cells and increase in cytokines which then lead to excessive proliferation of keratinocytes and symptoms of disease; rate of cellular proliferation is greatly increased which leads to thickening of dermis and epidermis; treatments reducing cell proliferation include glucocorticoids, tar preparations, antimetabolite methotrexate

40
Q

Pemphigus

A

autoimmune disorder; autoantibodies disrupt cohesion between epidermal cells causing blisters to form; systemic glucocorticoids such as prednisone and immunosuppressants are used; 3 forms (pemphigus vulgaris, pemphigus foliaceus, and pemphigus erythematosus)

41
Q

Scleroderma

A

skin disorder that can be systemic and affect viscera;
cause is not known but increase collagen deposition is observed in all cases, which reduces blood flow to skin or internal organs; inflammation and fibrosis can occur; cutaneous form can decrease microcirculation resulting in renal failure, intestinal obstruction, or respiratory failure

42
Q

Bacterial Infections

A

often caused by resident flora, or secondary infections

43
Q

Staphylococcal infection

A

Acne

44
Q

Cellulitis (erysipelas)

A

infection of dermis and subcutaneous tissue, can be secondary to injury, furuncle, or ulcer; causative organism is Staphylococcus auereus or Streptococcus; frequently occurs in lower trunks in individuals with restricted circulation, or those immunocompromised;
systemic antibiotics usually necessary along with analgesics for pain

45
Q

Furuncles

A

infection by S. aureus which begins in hair follicle;
squeezing boils can spread infection by autoinoculation, cause cellulitis;
compression of these in nasal area may lead to thrombi or infection spreading to the brain

46
Q

Carbuncles

A

collection of furuncles that form a large infected mass

47
Q

Pus

A

composed of leukocytes (WBC), cellular debris from dead blood cells and bacteria and a thin protein rich fluid component

48
Q

Impetigo

A

Staphylococcus aureus is highly contagious in neonates, older children infection results from S. aureus but can be caused by group A beta-hemolytic streptococci;
spread by direct contact;
topical antibiotics can be used in early stages, but systemic administration of these drugs is necessary if the lesions are extensive

49
Q

Acute Necrotizing Fasciitis

A

flesh eating disease; rapid tissue invasion resulting from reduced blood supply to tissue and secretion of protease enzymes that destroy tissue; results from virulent strain of gram-positive, group A, beta-hemolytic Streptococcus; symptoms similar to cellulitis;
can treat with aggressive antimicrobial therapy, fluid replacement, excision of all infected tissue, high oxygen flow in hyperbaric chambers, possibly amputation

50
Q

Leprosy (Hansen’s disease)

A

caused by bacterium Mycobacterium leprae;
problem in Africa, Asia, South Pacific, and South America;
not highly contagious, extended contact with source is required for infection;
affect skin, mucous membranes, and peripheral nerves;
can treat with antibiotics

51
Q

Herpes simplex

A

cold sores; can be asymptomatic; reinfection can be caused by common cold, sun exposure, or stress; acute stage can by reduced by topical application of antiviral drugs (acyclovir, Zovirax); contagious through direct contact with fluid from lesion

52
Q

Verrucae

A

warts; caused by human papillomavirus (HPV); infection spreads by viral shedding of the surface skin; tend to persist even with treatment; local treatments including laser, freezing with liquid nitrogen, and topical medications with ASA compounds

53
Q

Fungal Infections (mycoses)

A

diagnosed from scrapings of skin processed with potassium hydroxide, microscopic examination, culturing of samples; fungi live off the dead, keratinized cells of the epidermis (dermatophytes)

54
Q

Tinea capitis

A

infection of scalp common in school-aged kids; can result from Microsporum canis transmitted from dogs or cats, or by Trichophyton tonsurans by humans; oral antifungals such as griseofulvin

55
Q

Tinea corporis

A

infection of the body (ringworm);
topical antifungals such as tolnaftate or ketoconazole

56
Q

Tinea pedis

A

athlete’s foot; Trichophyton mentagrophytes or Trichophyton rubrum;
organisms may be normal flora;
spreads easily from lesions under conditions of excessive warmth and moisture;
topical tolnaftate is effective

57
Q

Tinea unguium

A

onychomycosis; infection of the nails, particularly toenails; nail thickens and cracks

58
Q

Pediculosis

A

pediculus humanus corporis is the body louse, pediculus pubis is the pubic louse, and pediculus humanus capitis is the head louse; topical permethrin, malathion, or pyrethrin is used to treat lice

58
Q

Scabies

A

invasion by a mite, Sarcoptes scabiei; topical treatment with lindane is effective

59
Q

Kerotoses

A

benign lesions that are usually associated with aging or skin damage; Seborrheic keratoses result from proliferation of basal cells leading to oval elevation;
Actinic keratoses occur on skin exposed to UV radiation and commonly arise in fair skins, can develop into squamous cell carcinoma

60
Q

Reducing the risk of skin cancer

A
  1. reducing sun exposure at midday and early afternoon
  2. cover up with clothing, remain in shade, wear broad-brimmed hats to protect face and neck
  3. apply sunscreen to protect from UVA and UVB rays
  4. protect infants and children from exposure and sun damage
61
Q

Squamous cell carcinoma

A

similar to common basal cell carcinoma; excellent prognosis when lesion is removed in a reasonable time;
sun exposure is contributing factor; smokers have higher incidence of this tumor in the lower lip;
invasive type of this cancer arises from premalignant conditions such as leukoplakia;
develops as scaly, slightly elevated, reddish lesion with irregular border and central ulceration

62
Q

Malignant melanoma

A

develops from melanocytes in basal layer and is increasing in incidence;
development depends on genetic factors, exposure to UV radiation, and hormonal influences; arise from melanocytes in the basal layer of the epidermis or from a nevus (mole);
often appears as multicolored lesion with irregular border, grow quickly extending into tissues and metastasize into regional lymph nodes;
after surgical removal of lesion, additional radiation and chemotherapy can provide a 5-year survival rate

63
Q

Kaposi’s Sarcoma

A

rare type of skin cancer;
association with human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS); occurred in older men originating from Eastern Europe or Mediterranean area before HIV pandemic;
can affect the viscera and skin; Herpesvirus #8 forms part of the etiology; arise from endothelium in small blood vessels, form large, irregularly shaped plaques or nodules;
combination of radiation, chemotherapy, surgery, and biologic therapy are common treatments

HOSA Pathophysiology (10 decks)

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