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Internal Med > Integumentary System > Flashcards

Integumentary System Flashcards

1
Q

What is the largest organ of the body?

A

skin

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2
Q

How much BW does the skin consist of?

A

15-20%

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3
Q

Primary fxn of integumentary

A

protect underlying structures from external injury and harmful substances

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4
Q

Other fxns of the integumentary system

A

holding organs together

sensory perception

fluid balance

controlling temp

absorbing UV

metabolizing vit D

synthesizing epiderminal lipids

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5
Q

Primary lesion vs Secondary Lesion

A

Primary - first lesion to appear, visually recognizable

Secondary - when changes occur in primary lesion (scale, crust, erosion, ulcer, atrophy)

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6
Q

Signs and Symptoms of skin disease

A

rash, Pruritus (itching), urticaria (hives), blisters, xeroderma (dry skin)

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7
Q

Lab values to look for

A

prealbumin (indication of nutritional status(

glucose, hemoglobin, hematocrit (monitor wound healing)

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8
Q

What are some general changes with aging and the integumentary system?

A

gray hair, balding and loss of secondary hair, increased facial hair,

lax skin, vascular changes (decreased elasticity) dermal or epidermal degenerative changes and wrinkling

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9
Q

When does the most of the obvious chnages to the skin occur?

A

First during puberty because of HORMONES

then again in older adulthood

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10
Q

What integumentary change might women experience after menopause?

A

balding

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11
Q

The use of BC or pregnancy may result in what?

A

changes in hair growth an hyperpigmentation of the cheeks and forehead known as melasma or pregnancy mask

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12
Q

Structural and functional changes in the skin result in

A

diminished pain perception

increased vulnerability to injury

decreased vascularity

weakened inflammatory response

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13
Q

With again, blood vessels within the ___ are reduced in number and the walls are ____

A

reticular dermis (deeper layer of dermis)

thinned

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14
Q

The decrease in blood flow and thinner walls with aging contribute to what?

A

pale skin and impaired ability to thermoregulate = increased susceptibility of older individuals to hypothermia and hyperthermia

(get colder or hotter easier)

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15
Q

Why does the protective function of the skin diminish with aging?

A

diminished barrier function of the stratum corneum

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16
Q

When the stratum corneum becomes thinner, what does this make older adults more sensitive to?

A

skin becomes more translucent and paper thin, reacting more readily to minor changes in humidity, temperature, and other irritants

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17
Q

With aging, fewer melanocytes result in

A

decreased protection against UV radiation

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18
Q

With aging, a reduction in Langerhans cells represent what?

A

a loss of immune surveillance and increased risk of cancer

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19
Q

The epidermis is one of the body’s principal suppliers of _____

Therefore, aging contributes to _____ deficiency. What does this result in?

A

Vitamin D

Vitamin D deficiency

altered bone pass and osteoporosis

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20
Q

The skin is sensitive to

A

oxidation damage or process

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21
Q

Bacterial Infections

A

impetigo
cellulitis

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22
Q

Viral infections

A

Herpes Zoster
Warts (Verrucae)

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23
Q

Fungal Infections (Dermatophytosis)

A

Ringworm Tinea Corporis)

Athletes Foot (Tinea Pedis)

Yeast (candida)

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24
Q

Other Parasitic Infections

A

Scabies
Pediculosis

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25
Q

Benign Lesion

A

seborrheic keratosis

Nevi (moles)

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26
Q

Premalignant Lesions

A

actinic keratosis

Bowen disease

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27
Q

Malignant Nonmelanoma Carcinomas

A

basal cell carcinoma
squamous cell carcinoma

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28
Q

Other skin cancers

A

malignant melanoma

kaposi sarcoma

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29
Q

What skin disorders are associated with immune dysfunction?

A

psoriasis

lupus

system sclerosis

polymyositis and dermatomyositis

(know generally each)

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30
Q

Burn severity determined by

A

depth of injury and total body surface area (TBSA)

Depth determined - the temperature and source of energy and duration of exposure

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31
Q

TBSA Wallace
arms
head
anterior thorax
legs
genital

A

9% each arm
9% head
18% anterior thorax
18% each leg
1% genital

32
Q

Who is especially vulnerable to burns

A

children

(extremes of both ends - children and older adults)

33
Q

Thermal burns account for approx __ of all burn center admissions

A

75%

34
Q

4 types of burns

A

friction burns (road rash, turf burns)

chemical burns

electrical burns

radiation burns (prolonged UV exposure)

35
Q

General risk factors for burns

A

age, lack of smoke detectors, psychomotor disorders (impaired judgement/mobility/drug/alcohol), smoking, rural location, low SES, ocupation and fireworks

36
Q

Why are children at higher risk for burns?

A

inadequate supervision and abuse with scald injuries

37
Q

Cardiovascular response due to burns

A

increased vascular permeability

body edema

decreased circulating intravascular blood volume

heart rate increases (catecholamines)

cardiac output decreases (then normal than increases 24 hours after)

38
Q

Renal and GI response to burns

A

shunting blood from kidneys and intestine

oliguria (decreased urine output) and intestinal paralytic ileus

39
Q

Immune System response to burns

A

immunosuppressed

increased risk of infection and life-threatening sepsis

40
Q

How do electrical burns occur?

A

electricity travels through body resulting in internal damage and protentional multisystem injury

41
Q

T/F Entrance wounds of electrical burns are larger more exploitive than exit wounds

A

F Exit wounds larger

42
Q

T/F Alternating current i smore dangerous than direct current

A

true

AC associated with cardiopulmonary arrest, ventricular fib, tetanic muscle contractions

43
Q

Which chemicals burn deeper- acids or alkaline?

A

Alkaline - continue to burn until neutralized

44
Q

T/F Burn location influence injury severity

A

T

burns of the hands and joints can result in permanent physical and vocational disability

45
Q

How is pain with full thickness burns versus partial-thickness injuries?

A

full-thickness - nerve endings destroyed, painless skin

superficial partial thickness injuries - nerve endings intact and exposed

46
Q

What happens with peripheral nerve regeneration?

A

increased pain with healing

47
Q

What is the most common and life-threatening complication of burn injuries?

A

infection

those with extensive injuries or difficult wound closure more at risk

48
Q

Inhalation injury may lead to

A

respiratory, pneumonia and sepsis

49
Q

Hypertrophic scarring

A

result of burns

associated with considerable morbidity and potential lifelong disfiguration

50
Q

Emergent phase of burn care

A

fluid resuscitation, ventilatory management, assessment of burn, early wound management

51
Q

Acute phase of burn management

A

burn wound management and infection prevention

debridement and skin grafting

PT**

52
Q

Rehab phase

A

return to max independence and function

53
Q

What type of grafts exist?

A

autografts (for full thickness burn)

allografts - cadaver

xenografts - pig skin

biosynthetic grafts

54
Q

What 3 main factors determine prognosis of bruh injury

A

TBSA, age, inhalation

55
Q

What phase of burn care are PTs involved in?

A

acute and rehab

56
Q

Diabetic ulcers

A

aka neuropathic ulcers, can occur in anyone with loss of sensation

57
Q

What system is used to classify neuropathic ulcers

A

Wagner system

SINBAD score (site, ischemia, neuropathy, bacterial infection, area, depth

58
Q

What are common sites of pressure ulcers?

A

bony prominences

heels, sacrum, ischial tuberosities, greater trochanters, elbows, scapular or under medical devices

59
Q

Stage 1 pressure injury

A

nonblanchable erythema of intact skin

60
Q

stage 2 pressure injury

A

partial thickness skin loss with exposed dermis

61
Q

stage 3 pressure injury

A

full-thickness skin loss

62
Q

stage 4 pressure injury

A

full thickness skin and tissue loss

63
Q

unstageable pressure injury

A

obscured full thickness skin and tissue loss

64
Q

Deep pressure injury

A

persistent nonblanchable deep red, maroon, pr purple discoloration

65
Q

What does it mean that a pressure injury can not be back staged?

A

once its classified as a 2 or 3 or 4 it will stay that level until its resolved

66
Q

What are the primary factors that cause a pressure injury

A

interface pressure (externally) or pressure with shearing forces

67
Q

What are some intrinsic factors that cause pressure wounds

A
68
Q

What are some extrinsic factors that cause pressure wounds

A
69
Q

What do pressure injuries develop? (Pathogenesis)

A

constant pressure = compresses capillaries an occludes BF causing ischemia and tissue necrosis

necrotic tissue predisposes bacterial invasion and subsequent infection, preventing healthy granulation

70
Q

What pressure wound location is often large and undermined?

A

sacral because the tissue mass over the sacrum is thin and erodes easily

71
Q

Who is at greater risk for infection/sepsis progression after a pressure injury or burn

A

immunosuppressed or diabetics

they can mount an inflammatory response to the infection

72
Q

Evidence of an infection

A

erythema, heat, swelling, pain, purulence, delayed healing, foul odor

73
Q

Is necrotic tissue painful?

A

No, its dead so no sensation but surrounding skin might be painful

74
Q

What might the PT do to assist with pressure injuries?

A

establish safe and effective turning schedules

75
Q

when should you reposition a high risk patient when in bed, sitting and if they can move independently?

A

in bed - 2 hours
sitting - 1 hour
move independently - 15 min

76
Q

the bed should be elevated no higher than ___ when the patient is supine

A

30 degrees

Internal Med (25 decks)

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