Lecture 10 - Integumentary and Face Flashcards
What is the largest organ in the body?
The skin
How does the skin aid in temperature regulation?
The skin can aid in heat loss through sweat glands and with heat storage through subcutaneous insulation.
What vitamin does the skin produce?
Vitamin D when exposed to sunlight.
What is eczema?
Inflammation of the skin - most often in folds of skin
What is Psoriasis?
Chronic and recurrent thickening of skin that is exacerbated by scratching
What is rosacea?
Flushing due to blushing, heat
What is cellulitis?
Infection of the skin
What are Xerosis and Seborrhea?
Dry skin; Oily skin
What is photosensitivity?
Being more sensitive to sunlight and susceptible to burns - side effect of many medications.
When assessing a rash on a patient, what important information should be collected?
How the rash started or where it began.
When doing a skin assessment, which order should information be collected in?
Least to most invasive - start with hands and nails, move to more invasive areas, finish with toes and feet.
What things should be notes when assessing the colour and temperature of skin?
- Pigmentation
–> Skin tone, freckles, moles, birthmarks - Color change
–> Pallar, erythema (rash), cyanosis, jaundice - Temperature
–> Should be even bilaterally
Where is moisture normal on the skin?
On the face, axilla, and hands.
How do the skin, hair, and nails change in older adults?
Skin
–> Thins, atrophy of subcutaneous fat
–> Loss of muscle tone
Hair
–> Grey/white, fine or thin
–> Male pattern baldness may present
–> Female facial hair may present due to decreased estrogen
Nails
–> Growth rate decreases, toenails thicken
What is skin mobility and turgor and how is it tested?
Mobility - Skin’s ease of rising
Turgor - Elasticity of skin
Gently lift pinch large fold of skin under clavicle
What is a good way to check for dehydration?
Testing skin turgor
What is the normal angle of the nailbed?
160°
(any more is considered curve, 180° could be considered early clubbing)
Which six things should be notes when describing lesions?
Color, elevation, pattern or shape, size, location, distribution
When describing the shape of lesion, what do the following words mean?
Annular
Target
Linear
Gyrate
Annular - circular
Target - Also called iris (eye shaped)
Linear - straight line
Gyrate - curved/twisted line(s)
See slide 13, lecture 10
When describing the pattern/distribution of lesions, what do the following words mean?
Polycyclic
Grouped
Discrete
Zosteriform
Confluent
Polycyclic - Annular lesions that grow together
Grouped - Clusters of lesions
Discrete - Distinct, individual lesions that remain separate
Zosteriform - Linear arrangement along nerve route
Confluent - Lesions that merge together
See slide 14, Lecture 10
What are the ABCDEs of self screening moles of cancer?
A - Asymmetry
B - Borders (uneven)
C - Colour (two or more shades)
D - Diameter (0.6 cm/0.25’’ +)
E - Evolution (always suspicious)
What causes a pressure (decubutis) ulcer?
Prolonged pressure on the skin distorts capillaries and occludes blood flow and O2 delivery.
What are some risk factors for pressure ulcers?
Impaired mobility or LoC, decreased sensory perception.
Poor nutrition
Shearing injury
Old age - skin thinning, moisture from incontinence.
What are the stages of a pressure ulcer?
- Skin appears red but unbroken. Blanches in response to pressure.
- Partial thickness loss of epidermis/dermis, red woundbed.
- Full thickness crater, subcutaneous fat might be visible.
- Full thickness pressure injury involving all skin layers and extending into supporting tissue. Muscle, tendon and bone might be visible.
What is the range of the Braden scale? What do different scores indicate?
6-23.
15-18 - At risk
13-14 - Moderate risk
10-12 - High risk
9> - Very high risk
What is the Braden Scale?
A scale used to predict the risk of a patient developing pressure sores.
How long does it take a stage 1 pressure ulcer to develop?
2 hours
What should you palpate for when assessing the face?
Any deformities, lumps, or tenderness.
Also palpate temporal artery and TMJ.
The ability to make facial expressions is the role of which Cranial Nerve?
CN VII
What kinds of things should be inspected on the head?
General size and shape of skull, note any deformities or lumps
What kinds of things should be inspected when assessing the face?
Facial structure symmetry, eyes should not sink or protrude.
Also note of twitching/tics and the ability to make facial expressions (CN VII)
What should be inspected/palpated when assessing the neck?
Symmetry of all structures, note obvious pulsations.
Also observe ROM and test CN XI by resisting movement of neck.
What kind of headache has the shortest duration?
Cluster
What kind of headache is chronic and genetic in nature?
Migraine
Secondary headaches can be associated with which conditions?
Head trauma
Vascular disorders
Substance use or withdrawal
Systemic infection
Metabolic problems (hypoglycemia)
Problems with skull, neck, eyes, ears, nose, teeth, moth
Neuralgia or Occipital neuralgia headaches
What is Scotoma?
Blind spots in vision