integumentary system ch.13 Flashcards
1
Q
includes
A
skin nails hair mucous membranes glands
2
Q
functions
A
- protects the body from pathogen invasions
- regulates temperarure
- senses environmental changes
- maintains water balance
3
Q
skin layers
A
- hypodermis: inner
- dermis: middle
- epidermis: outer
4
Q
hypodermis
A
blood vessels
nerves
immune cells
5
Q
dermis
A
dense connecitve tissue, fatty tissue
6
Q
keratin
A
protein that strengths skin
7
Q
melanin
A
pigment that protects from ultraviolet rays
- allows u to tan
- as you get older you loose melatin
8
Q
sebaceous glands
A
produce sebum to moisturize and protect the skin
9
Q
sweat glands
A
eccrine glands
- secrete through skin pores in response to the sympathetic nervous system
apocrine glands
- open into hair follicles in the axillae, scalp, face, and external genitalia
10
Q
integumentary conditions
A
- result in impaired skin integrity
- result in risk for infection
11
Q
changes associated with aging: decreased sensations
A
of pain, vibration, cold, heat, pressure, and touch
- secondary to decreased blood flow to touch receptors
- decreased blood flow to the brain
- increase the risk of injury including falls, decubitus ulcers, burns, and hypothermia
12
Q
changes associated with aging: decreased elasticity, integrity, and moisture
A
- environmental factors, genetic makeup, and nutrition
- contribute to these changes, especially sun exposure
- blue eyed, fair skin people show more of these changes
13
Q
changes associated with aging: appearance
A
thin, pale, and translucent
- epidermis thins even though the number of cell layers remains unchanged
- melanocyte numbers decrease but increase in size
large pigmented spots (lentigos) may appear in sun exposed areas
changes in connective tissue reduce skin strength and elasticity
14
Q
changes associated with aging: dermis blood vessels
A
becomes fragile, leading to bruising, cherry angiomas, and other smilar conditons
15
Q
changes associated with aging: sebaceous glands
A
produce less sebum
- men experienc a minimal decrease, usually after the age of 80
- women gradually produce less sebum beginning after menopause
- difficult to maintain skin moisture
16
Q
changes associated with aging: subcutanous fat layer
A
thins
- increases risk of skin injury and reduces the ability to maintain body temperature
- changes the actions of some medications
17
Q
changes associated with aging: repairs
A
more slowley
- wound healing may be up to four times longer
- contributes to decubitus ulcer formation and infections
- the prescence of chronic diseases along with other changes with agin further delays healing
18
Q
urticaria
A
- raised erthematous skin lesions (welts)
- short lived and harmless
- can impair breathing is around the face and progress to anaphylaxis and shock
- diffuse welts that blanch and pruitus
19
Q
urticaria cause
A
- result of a type 1 hypersensitivity reaction often triggered by food and medicine
- emotional stress
- excessive perspiration, disease
- autoimmune conditons, and leukemia
- infections
- occurs when histamine release is initiated by these substances or conditions
20
Q
urticaria manifestations
A
welts that blanch and pruritus
21
Q
urticaria diagnosis
A
history
physical examination
allergy testing
skin biopsy
22
Q
urticaria treatment
A
- avoid hot baths or showers
- avoid further irritation
- antihistamines
- epinephrine
- corticosteroids
- maintain respiratory status
23
Q
infectious integumentary disorders
A
- skin infections are common
- organisms gain access through breach in skin or mucous membrane
- triggers inflammatory responses
- occur in any skin layer or structure
- may be acute or chronic and severity varies
- resolves with treatment
24
Q
bacterial infections
A
- can be caused by any of the normal flora bacteria
- varies from mild to life threatening
- staphylococcus and streptococcus genera are common culprits
25
bacterial infections: cellulitis
- occurs deep in the dermis and sub q tissue
- results from a direct invasion of pathogens through a break in skin, especially those breaches where contamination is likely, or spreads from an existing skin infection
- appears as a swollen , warm, tender area of erythema
26
cellulitis manifestations
indicators of infection
- fever
- leukocytosis
- malaise
- arthralgia
27
cellulitis complications
necrotizing fasciitis
septicema
septic shock
28
viral infectons: herpes zoster (shingles)
- caused by the varicella-zoster virus
- appears in adulthood years after primary infection of varicella in childhood
- virus lies dormant on a cranial nerve or a spinal nerve dermatone untill it is activated years later
- virus affects this nerve only, giving the condition its typical unilateral manifestations
29
herpes zoster (shingles) manifesations
- pain
- paresthesia
- red or silvery vesticaulr rash develops in a line over the area innervated by the affected nerve (may last for weeks or months)
- extremely sensitive skin
- pruritis
30
herpes zoster (shingles) complications
neuralgia and blindness
31
herpes zoster (shingles) treatment
antivirals
antidepressants
anticonvulsants
vaccines
32
pressure injuries
- soft tissue injuries that result of unrelieved mechanical pressure
- results in areas of necorsis and ulceration where the tissue is compressed between bony prominences and extrernal hard surfaces
- can develop in 1-2 hours if pressure is not relieved
- classification using a stagng system but not all injuries follow a linear progression
33
pressure injuries common sites
```
sacrum
ischial tuberosities
trochanters
malleoli
heels
can develop anywhere
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34
pressure injuries risk factors
```
advancing age
impaired circulation
tissue perfusion
immobilization
malnutriton
decreased sensation
incontinence
```
35
stage 1
skin is intact, nonblanchable erthema is present
36
stage 2
erosion or blister with or without true ulcerations, no exposed sub c tissue
37
stage 3
full thickness skin loss with damage to sub q tissue down to the underlying fascia
38
stage 4
full thickness skin loss with extensive destruction, tissue necrosis, and damage to exposed supporting structures
39
deep tiisue injury
skin may or may not be intact
| underlying tissue is damaged
40
unstageable
full thickness skin tissue loss in which the extent of damage cannot be determined because it is hidden by slough or eschar
41
pressure injuries complications
challenging mitigating factors
- ulcers can become infected with hospital acquired
- antibitoic resistant organism
- sinus tracts
- osteomyelitis
- cellutitis
- tissue calcifcation
- bactermia
- meningitis
- endocaridits
- squamous cell carcinoma
42
pressure injuries diagnosis
physical examination
| additional test depending upon the stage
43
pressure injuries treatment
```
reduce pressure
care for wound
minimize infection
support nutritional needs
pain management
antibiotics
negative pressure therapy
topical recombinant growth factors
electrical stimulation therapy
therapeutic ultrasonography
surgical closure
skin grafts
```
44
pressure injuries healing
take weeks, prevention is critical
several scales developed to assess risk:
- norton scale
- braden scale
45
skin cancer
- abnormal growth of skin cells
- most frequently occurring cancer in us
- usually on arms and neck
- early detection is crucial to positive outcomes
46
skin cancer risk factors
- uv exposure
- natural or artifical
- most prevalent in males, caucasians, those with fair complaxtion, and those with a family history
47
skin cancer: basal cell carcinoma
- most common
- develops from abnormal growth of cells in the lowest layer of the epidermis
- rarely metastasizes
48
skin cancer: squamous cell carcinoma
involves changes in the squamous cells, found in the middle layer of the epidermis
49
skin cancer: melanoma
- develops in the melanocytes
- least common type but most serious
- often metastasizes to other areas
50
skin cancer suspicious features
- asymmetry
- border irregularity
- color variations
- diameter larger than 6mm
- any skin growth that bleeds or will not heal
- any skin grwoth that changes in appearance over time
51
ABCDE
A: asymmetry: moles have assymetrical apperance
B: border: a mole that has blury and or jagged edges
C: color: mole that has more than one color
D: diameter: moles with a diameter larger than a pencil eraser
E: evolution: a mole that has gone through sudden changes in size, shape, or color
52
skin cancer diagnosis
history
physical examination
biopsy
53
skin cancer prevention
limiting or advoiding exposure to uv light
54
skin cancer treatment
```
cryosurgery
excision surgery
laser therapy
Mohs surgery
examining each layer under microscope
curettage
electrodesiccation
electric needle to destroy any cells
radiation therapy
chemo
```
