Integumentary System: Skin

Question 1

What is the function of the integumentary system?

Answer 1

• protection
• containment
• heat regulation
• sensation
• synthesis and storage

Question 2

What are the layers of the integumentary system?

Answer 2

• epidermis (superficial)
• dermis (deep)

Question 3

What are the layers of the fascia?

Answer 3

• superficial
• deep

Question 4

Describe the epidermis

Answer 4

• tough, keratin outer surface
• sheds every 25-45 days
• avascular
• afferent nerve endings (touch, pain, temperature)

Question 5

Describe the dermis

Answer 5

• deep layer of the skin
• dense, strong layer of collagen and elastic fibers
• contains tension lines
• contains hair follicular, arrector pili muscles, & sebaceous glands

Question 6

What are tension lines?

Answer 6

• created by collagen fibers
• dermis layer
• keeps skin taut (tight)

Question 7

Describe the arrector pili muscles

Answer 7

• contraction causes hair follicles to stand up straight
• flexed muscles create goosebumps
• flexed muscle compresses sebaceous glands & releases oil onto skin

Question 8

Describe the superficial fascia layer

Answer 8

• subcutaneous tissue
• contains loose connection tissue & fat (fat storage)
• between dermis & deep fascia
• contains sweat glands, blood vessels, lymph vessels, cutaneous nerves

Question 9

Describe the deep fascia layer

Answer 9

• dense, organized connective tissue
• contains NO fat
• covers all body parts deep to skin
• divides muscles via intermuscular septa

Question 10

What is the intermuscular septa?

Answer 10

divides skeletal muscles

Question 11

What does the deep fascia form?

Answer 11

• retinaculum (ex: flexor & extensor retinaculum)
• bursae (ex: subacrmial bursa)

Question 12

What are bursae?

Answer 12

fluid filled sacs

Question 13

What is Dupytren’s Contracture?

Answer 13

• contraction of the superficial fascia of the hand
• involves one or more digits
• may affect vessels (veins OR arteries)
• does NOT affect tendons

Question 14

How do you treat Dupytren’s Contracture?

Answer 14

• does NOT respond to conservative therapy
• treatment through steroid OR collagenase injections or open surgery

Question 15

How do surgeons work with tension lines during surgery?

Answer 15

• work parallel to tension lines to promote better healing & less scarring

Question 16

What happens if surgeons cut across tension lines?

Answer 16

• longer healing time
• can restrict movement and cause scarring (keloids)

Question 17

What are the burn classifications?

Answer 17

1. superficial burns
2. partial thickness burn
3. full thickness burn

Question 18

What skin layer do superficial burns affect?

Answer 18

superficial epidermis

Question 19

What skin layer do partial thickness burns affect?

Answer 19

• epidermis
• superficial dermis

Question 20

What skin layer do full thickness burns affect?

Answer 20

• epidermis
• dermis
• may include muscle and bone

Question 21

Define decubitus ulcers (pressure ulcers)

Answer 21

• also known as pressure ulcers
• type of skin damage that occurs when constant pressure if applied to an area for an extended amount of time
• can reduce blood flow to the affected area, leading to tissue damage and death

Question 22

What are the characteristics of a Stage 1 decubitus (pressure) ulcer?

Answer 22

• damage is limited to the epidermis
• skin is red, non-blancheable, and intact

Question 23

What are the characteristics of a Stage 2 decubitus (pressure) ulcer?

Answer 23

• produces an open wound, with partial thickness skin loss
• damage occurs to the epidermis & dermis
• wound is red & moist or a serous filled blister occurs

Question 24

What are the characteristics of a Stage 3 decubitus (pressure) ulcer?

Answer 24

• damage to the epidermis, dermis, subcutaneous layer
• bone, tendon, and muscles are not visible
• undermining and tunneling may occur
• tunneling: linear damage that only occurs in one direction that penetrates deeply underneath the skin
• undermining: damage underneath the wound edge that spans a wider area in multiple directions

Question 25

What are the characteristics of a Stage 4 decubitus (pressure) ulcer?

Answer 25

• full thickness skin loss
• damage to epidermis, dermis, subcutaenous layer, and deep fascia
• causes exposed bone, muscle, or tendon

Question 26

What is an unstageable pressure injury?

Answer 26

• depth of wound is unknown (wound base is covered in necrotic tissue)
• necrotic tissue could be black (escar tissue) or creamy & white/yellow (slough)

Question 27

What is a deep tissue injury (DTI)?

Answer 27

• intact or not intact skin at injury site
• purple or maroon discoloration or there may be a blood filled blister