Integumentary Flashcards
Components
Skin
Hair
Nails
Function
Protective Barrier
Sensation
Regulation
Overall body homeostasis
Why perform skin screen?
Inflammatory
Infectious
Immunological
Cancer
Observation
Erythema; red streaks
Scar formation, lesion, wounds, callus, maceration
Dry skin, cuts, bruises, rashes, scars, hair follicles, nails
Non-healing trauma
Drainage
Edema/Swelling
Palpation
Skin temp Skin turgor Pulses Pitting/non-pitting edema Tissue texture Skin mobility & elasticity
Skin lesions
Scleroderma: autoimmune, inflammation and over production of collagen
Poison Ivy: Contact dermatitis
Changes in the skin and nail beds sign of…
Inflammation
Infection
Immunologic disorders
Organ dysfunction
Clubbing of nails
Lung Inflammatory bowel CV Liver disease AIDS
Yellow nail syndrome
Respiratory disease
Primary Lymphedema
Screening Observations
Changes in the skin
Cyanosis
Jaundice
Pallor Skin Cancer
Changes in nails
Changes in hair
Change in sweating or dryness of the skin
Pruitis (itching)
Cyanosis
Peripheral
Central
ABCDE
Asymmetry - 1/2 is different than other half Border Irregularity - edges notched, uneven or blurred Color - uneven; shades of brown of brown, tan, black Diameter - 6 mm Evolution - changes over time
DVT
Anatomy: platelets form a plug chemical reactions frow the clot anti-clotting agents break down of the clot
Aysomptomatic or symptomatic
Edema
imbalance in Starling Law of Equilibrium
imbalance in filtration and resorption rate
results in excess fluid in the interstitial spaces/tissues
can be multifactorial cause
impedes healing regardless of etiology
location: localized, unilateral, bilateral, systemic
Causes of peripheral edema
Trauma Infection Venous/Lympthatic Wound Obstruction of lymph nodes Medications Organ Pathology
Red Flags
Bilateral edema of hands/feet
Sudden onset w/o traumatic event
Edema that occurs simultaneously w/ fever, sweats, chills
Progressive
Distal edema w/ SOB @ rest or exertion
Calf pain and edema after trauma
Edematous body part w/ red streaks
Edema that is warm/hot and painful to palpitate
Face/arm that is discolored of the chest/arm/face/loss of carotid pulses. dysphasia, wheezing, chest pain, headaches, dizziness
Total body edema or total quadrant edema
Circumferential measurements
10 cm for LE
4 cm for UE
Figure 8 for ankle
Role of lymphatic system…
protein molecules leave capillaries gets reabsorbed by the lymphatic, back to into the venous/heart to prevent peripheral edema
if there’s an obstruction there’s edema
Pitting edema
insufficiency is occurring…
the more viscous… the more fibrotic (worsening)
Causes of edema
CHF
Venous insufficiency
Lymphedema
Dependency
Grading
0, absent
1+, minimal, lasts 10 secs
2+, moderate, lasts 20 secs
3+, severe, lasts 30 secs
Descriptors
easily pits, some pitting, non-pitting
Brawny edema (between viscous/firm)
Skin mobility
Viscosity
Evidence of water vs. CM
water displacement tends to be underestimate while CM overestimates
Major concern…
Organ dysfunction CHF Liver Kidney Pulmonary edema w/ peripheral edema Blood clot
