Integumentary System

Question 1

structures of integumentary system

Answer 1

skin
hair
nails
arrectores pilorum muscles 
glands 
- eccrine (sweat
- apocrine (smelly sweat)
- sebaceous (oil)
- ceruminous (ear wax)
- mammary

Question 2

epidermis

Answer 2

• migration of cells from deep to superficial (living to dead)
• waterproof barrier, protection, skin tone

Question 3

layers of skin

Answer 3

epidermis
dermis
subcutis

Question 4

dermis

Answer 4

• fibrous collage and elastic fibers
• support the epidermis
• provides pliability
• contains blood vessels, glands, nerves

Question 5

subcutis

Answer 5

• adipose cells

- mechanical an thermal protection

Question 6

hair

Answer 6

• covers body (except palms of hands and soles of feet and some parts of genitalia)
• originates form hair follicle in dermis
• bulb of follicle is contained in melanin (color)
• debase process may manifest in hair changes

Question 7

nails

Answer 7

• protective plate

- provides counterforce to finger pa for enhances fingertip sensation

Question 8

purpose of glands

Answer 8

sweat- help maintain body temp
sebaceous (oil)- inhibit bacteria, waterproofing, keep hair and nails from drying out
ceruminous- keep outer eardrum from drying out
mammary- produce milk

Question 9

relevant history for integumentary system

Answer 9

personal history of melanoma, burns, surgeries, changes in sweating

family history of melanoma

work environment and chemical exposures

drug and alcohol use

history of present illness

pain assessment

medical treatments and medications

Question 10

integumentary systems reiew

Answer 10

skin integrity
skin texture
skin color
scars

Question 11

systems review questions

Answer 11

do you have any cuts scrapes or open areas in the skin

do you have any soft tissue lumps or bumps
have you noticed any changes in hair growth

do you have any bruising, areas of discoloration, or changes in pigmentation

do you have any scars, injury or surgical

Question 12

after a positive response to systems review questions

Answer 12

observe
compare bilaterally
palpate locally
relevance to current condition?

Question 13

normal skin temperature

Answer 13

91*F

• not hot or cold to touch
• use back of hand

Question 14

skin texture

Answer 14

smooth, rough, bumpy, orange peel (enlarged pores), dry, oily, flaky

Question 15

skin turgor

Answer 15

ability of skin to return to original formation

- affected by hydration and age

Question 16

skin cancer

Answer 16

• 1 in 5 Americans

- 8.1 billion healthcare dollars annually

Question 17

what to look for in moles

Answer 17

asymmetry
border
coloration 
diameter
evolving

Question 18

nail changes

Answer 18

clubbing- pulmonary of inflammatory bowel disease
koilonychia- “spoon-shaped” nails (possible amenia
onchylosis (separation from bed)- possible hyperthyroidism
lines

Question 19

subungual melanomas

Answer 19

longitudinal linear lines

• normal findings on dark skinned people
• diagnostic problem in 50% of melanomas in dark skinned populations

Question 20

factors increasing likelihood of melanoma in patients with longitudinal pigmented bands

Answer 20

• new bands in light skinned populations
• sudden change in appearance of band
• single nail involvement
• pigmentation on skin around nail bed
• new pigmentation in old population
• band width of >3mm
• family history of melanoma or dysplastic nevi
• abnormal nail structure

Question 21

hair changes

Answer 21

hypothryoidism- dry, thinning, brittle, coarse hair

anorexia nervosa- dry skin, thinning hair

hair loss or color changes: anemia, medication, inflammatory processes, metabolic or nutritional deficits
abnormal growth: hormones imbalance

Question 22

hypertrophic scars

Answer 22

raised scar following cutaneous trauma, staying within the boundaries of the original wound

Question 23

keloid scars

Answer 23

raised scar beyond the boundaries of the original wound

- commonly a source of pain, hyperesthesia

Question 24

shingels

Answer 24

pain, itching, tingling before rash appears
fever, headaches, chills, upset stomach
1/10 develop postherpetic neuralgia for months to years after rash resolves
follows a dermatomal pattern
at greater risk if you had chickenpox already

Question 25

lyme disease

Answer 25

tick borne- bacterial infection
not contageous
headache, server fatigue, neck stiffness, joint pain
don’t always see the “bulls eye” at site of bite

Question 26

fungal infection

Answer 26

saprophytic- jock itch, ringworn, athletes foot
very contagious
gets in the flood: fungemia

Question 27

burns

Answer 27

superficial (first degree)- epidermis
partial (second degree)- through dermis
full (third degree)- through subcutaneous