Integumentary

Question 1

Functions of skin

Answer 1

Protection
Regulation of body temp
Sensory organ 
Excretion organ
Maintain fluid balance 
Produce and absorbs vitamin D

Question 2

Layers of skin

Answer 2

Epidermis- superficial layer stratified epithelial cells

Dermis- elastic connective tissue; nerves , hair follicles, glands arteries , veins, capillaries

Subcutaneous: adipose tissues blood vessels; heat insulating layer

Question 3

Components of Health Assessment

Answer 3

Health history : subjective info

Physical assessment: objective info

Question 4

Types of health assessments

Answer 4

Comprehensive: annual physical head to toe exam

Ongoing partial: follow up on identified problem

Focused: focus on brand new problem

Emergency

Question 5

Assessment techniques

Answer 5

1. Inspection
   2.Auscultation
   Pitch: high vs low
   Loudness: soft vs loud
   Quality : swish, gurgle
   Duration: short med long
2. Palpation : feeling
3. Percussion:
   flat- when over a bone or muscle;
   Dull- over fluid or mass;
   Resonant-over air(lungs) ;
   hyper resonant- too much air (Copd)
   Tympanic: percussion in abdomen

Question 6

Braden scale

Answer 6

Identifies patients at risk for skin breakdown

Sensory perception
Moisture 
Activity
Mobility
Nutrition 
Friction and shear 
Low score= high risk

Question 7

Normal inspection findings in skin

Answer 7

Color/vascularity

Skin integrity

Question 8

Cyanosis

Answer 8

Blue gray discoloration due to low oxygen, cold environment, cardiac or respiratory disease

Ears lips of mouth hands and feet, nail beds

Question 9

Ecchymosis

Answer 9

Collection of blood in subcutaneous tissues purple bruises

Question 10

Erythema

Answer 10

Redness
Facial area
Sunburn, inflammation, fever, trauma, allergic reactions

Question 11

Jaundice

Answer 11

Yellow,

Liver and gall bladder disease

Question 12

Pallor

Answer 12

Face and lips
Due to anemia( decrease hemoglobin)

Shock (decreased blood volume)

Question 13

Petechiae

Answer 13

Small hemorrhagic spots caused by capillary bleeding

Question 14

Moles

Answer 14

A-sssymety 
B- border
C- color
d- diameter
E- elevation

Question 15

Palpation of skin

Answer 15

Normal findings: warm temp; dry moisture; smooth texture, elastic

Abnormal: dehydration: poor skin turgor, dry skin ; edema : fluid accumulation; pitting edema

Question 16

Pressure ulcers

Answer 16

Stage 1: epidermis layer; no skin breakdown color changes

Stage 2: epidermis/dermis; skin breakdown

Stage 3: subcutaneous layer; chemical debridement

Stage 4: muscle/ bone/tendon surgical debridement

Question 17

Common skin lesions

Answer 17

Primary:
Freckles, petechiae: flat non palpable w skin color changes
Moles warts, lipomas, mosquito bites: palpable elevated

Secondary:
Erosions, ulcers, fissures: loss of skin surface
Crust, scale: material on skin surface

Miscellaneous
Atrophy: thinking of skin; due to loss of circulation

Excoriation: scratching of epidermis layer

Scar: fibrous tissue

Keloid : fibrous tissue with lumpy bumping

Question 18

Skin assessment in older adult

Answer 18

Decreased skin elasticity 
Dryness and scaling of skin
Balding
Hair loses pigmentation 
Skin pigmentation 
Nail thickening