Integumentary

Question 1

Components

Answer 1

Skin
Hair
Nails

Question 2

Function

Answer 2

Protective Barrier
Sensation
Regulation
Overall body homeostasis

Question 3

Why perform skin screen?

Answer 3

Inflammatory
Infectious
Immunological
Cancer

Question 4

Observation

Answer 4

Erythema; red streaks
Scar formation, lesion, wounds, callus, maceration
Dry skin, cuts, bruises, rashes, scars, hair follicles, nails
Non-healing trauma
Drainage
Edema/Swelling

Question 5

Palpation

Answer 5

Skin temp
Skin turgor
Pulses
Pitting/non-pitting edema
Tissue texture
Skin mobility & elasticity

Question 6

Skin lesions

Answer 6

Scleroderma: autoimmune, inflammation and over production of collagen

Poison Ivy: Contact dermatitis

Question 7

Changes in the skin and nail beds sign of…

Answer 7

Inflammation
Infection
Immunologic disorders
Organ dysfunction

Question 8

Clubbing of nails

Answer 8

Lung
Inflammatory bowel
CV
Liver disease
AIDS

Question 9

Yellow nail syndrome

Answer 9

Respiratory disease

Primary Lymphedema

Question 10

Screening Observations

Answer 10

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)

Question 11

Cyanosis

Answer 11

Peripheral

Central

Question 12

ABCDE

Answer 12

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

Question 13

DVT

Answer 13

Anatomy:
platelets form a plug
chemical reactions frow the clot
anti-clotting agents
break down of the clot

Aysomptomatic or symptomatic

Question 14

Edema

Answer 14

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

Question 15

Causes of peripheral edema

Answer 15

Trauma
Infection
Venous/Lympthatic
Wound
Obstruction of lymph nodes
Medications
Organ Pathology

Question 16

Red Flags

Answer 16

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

Question 17

Circumferential measurements

Answer 17

10 cm for LE
4 cm for UE
Figure 8 for ankle

Question 18

Role of lymphatic system…

Answer 18

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

Question 19

Pitting edema

Answer 19

insufficiency is occurring…

the more viscous… the more fibrotic (worsening)

Question 20

Causes of edema

Answer 20

CHF
Venous insufficiency
Lymphedema
Dependency

Question 21

Grading

Answer 21

0, absent
1+, minimal, lasts 10 secs
2+, moderate, lasts 20 secs
3+, severe, lasts 30 secs

Question 22

Descriptors

Answer 22

easily pits, some pitting, non-pitting
Brawny edema (between viscous/firm)
Skin mobility
Viscosity

Question 23

Evidence of water vs. CM

Answer 23

water displacement tends to be underestimate while CM overestimates

Question 24

Major concern…

Answer 24

Organ dysfunction
CHF
Liver
Kidney
Pulmonary edema w/ peripheral edema
Blood clot