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NRS121: Pathophysiology & Pharmacology > Module 2: Integumentary System health Changes > Flashcards

Module 2: Integumentary System health Changes Flashcards

1
Q

The skin has three layers- what are they?

A
  1. Epidermis
  2. Dermis
  3. Subcutaneous layer

Module 2, lecture 1, integumentary system

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2
Q

What is the largest organ of the body?

A

The skin- this includes (hair and nails).

Has the largest surface area.

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3
Q

List the causes of cellular injury- give examples.

A
  • physical agents (radiation, including ultraviolet rad), trauma, pressure/blunt force and penetrating, burns etc.
  • Chemical agents- (acids, toxins, TIC’s and TIM’s, plant toxins
  • Environmental changes - (hyper/hypothermia, dry and wet conditions)
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4
Q

Pathophysiology in the integementary system can be catagorized into 4 groups. What are they?

A
  1. Neoplasia and cancers;
  2. Inflammatory conditions;
  3. Traumatic conditions; and
  4. Vascular disorders.
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5
Q

What are skin lesions?

A

A pathalogical or traumatic breach of the normal skin.

  • skin has abnormal appearance compared to skin around it.
  • Primary skin lesions are those that develope as a direct result of the disease process, and appear as ‘normal’ lesions.
  • Secondary lesions- evolve from primary lesions or develope as a consequence of the persons activities, & appearance has changed over time.
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6
Q

What are Primary skin lesions?

A

Lesions that develope as a direct result if the disease process, and appear as ‘original lesions’

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7
Q

What are ‘Secondary lesions’?

A

Lesions that evolve from primary lesions or develope as a consequence of thr persons wctivities (sun-damage), and have an appearance that has changed over time.

Have the boarders changed? Is it raised? Has the colour changed etc.

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8
Q

What is ‘Morphology’?

A

The form, structure snd physical appearance of the lesion.

The morphology indicated the pathophysiology of the lesion.

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9
Q

Primary lesion morphology includes what?

A
  1. Macule - a flat, circumscribed area that is a change in the colour of the skin; less than 1cm in diameter.
  2. Papule - an elevated circumscribed area less than 1cm in diameter.
  3. Patch - a flat, non palpable, irregular- shaped macule more than 1cm in diameter.

Circumscribed means there is a clearly defined edge.

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10
Q

Primary lesion morphology.

Describe a ‘Plaque’

A

Elevated, firm and rough lesion with a flat too surface grater than 1cm in diameter.

Think ciriasis.

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11
Q

Primary lesion Morphology.

Describe a ‘wheal’

A

An elevated, irregular shaped area if cutaneous oedema: solid, transient; variable diameter

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12
Q

Promary lesion morphology

Define a ‘Nodule’

A

An elevated, firm, circumscribed lesion, deeper in dermis than a papule, 1-2cm in diameter.

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13
Q

Primary lesion morphology

Define a ‘Tumor’

A

Tumour- elevated solid lesion; may be clearly demarcated; deeper in dermis; greater than 2cms in diameter

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14
Q

Primary lesion morphology

Define a ‘vesicle’

A

Elevated, circumscribed, superficial, does not extend to the dermis, filled with serous fluid; less than 1cm in diameter

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15
Q

Primary lesion morphology.

Define a ‘Bulla’

A

A vesicle greater than 1cm in diameter

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16
Q

Primary lesion morphology-

Define a ‘pustule’

A

Elevated, superficial, similar to vescicle but filled with purulent fluid (acne)

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17
Q

Primary lesion morphology

Define a ‘cyst’

A

Elevated, corcumscribed, encapsulated lesion; in dermis or subcutaneous layer; filled with liquid or fiberous material

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18
Q

Primary lesion morphology.

Define a ‘Telangiectasia’

A

Fine, irregular red lines produced by capilary dilations. Think if your leg :(

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19
Q

Secondary lesion morphology

Define a ‘sacle’

A

Heaped up, keeatinised cells, flaky skin, irregular shape, thick or thin, dry or oily, variation in size

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20
Q

Secondary lesion morphology

Describe a ‘Lichenification’

A

Rough, thickened epidermis, secondary persistent rubbing, itching or skin irritation; often involves flexor surface or extremity.

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21
Q

Secondary lesion morphology

Describe a ‘keloid’

A

Irregular shaped, elevated, progressively enlarging scar, grows beyond the boundaries of the wound; caused by excessive collagen formation during healing

22
Q

Secondary lesion morphology

Describe a ‘scar’

A

Thin to thick fibrous tissue that replaces normal skin following an injury or laceration to the dermis

23
Q

Secondary lesion morphology

Describe ‘Excoriation’

A

Loss of the epidermis; linear, hollowed-out, crusted

24
Q

Secondary lesion morphology

Describe a ‘Fissure’

A

Linesr crack or break from the epidermis to the dermis; may be moist or dry

25
Q

Secondary lesion morphology

‘Erosion’

A

Loss of part of the epidermis, moist, glistening, follows rupture of a vescicle or bulla

26
Q

Secondary lesion morphology

‘Ulcer’

A

Loss of epidermis and dermis, concave; varies in size

27
Q

Secondary lesion morphology

‘Atrophy’

A

Thinning of the skin surface and loss of skin markings

28
Q

What are the highest prevalance ofnskin cancers in Australia?

A

Basal cell carcinoma

Squamous cell carcinoma

Melanoma

29
Q

Cancer is _______and ________proliferation of cells, specifically ____________ tumours or ___________.

A

Uncontrolled, rapid, malignant, neoplasms

30
Q

Neoplasia and neoplasm means…

A

‘New formation’ and ‘ abnormal growth’

31
Q

Define ‘metastasis’

A

When malignant tumours grow rapidly and invade local structures and tissues and spread to distant sites through lymphatic and blood vessels.

32
Q

Define ‘benign’ tumours

A

Slow growing, encapsulated, maintain cell differentiation and do not invade/ metastasise.

33
Q

Define ‘malignant tumours’

A

Grow rapidly, lack differentiation (anaplasia) snd organisation, are not encapsulated, invade local structures & can metastisize.

34
Q

Cancer fundamentals.

Uncrontrolled growth in cancer is due to what’

A

Mutations - particularly in the genes that nirmally regulare the cell cycle.

35
Q

Cancer fundamentals.

What do ‘Proto-oncogenes’ do?

A

Encode proteins that regulate when cells progress through the cell cycle to mitosis.

  • a mutated proto-oncogene is a ‘ONCOGENE’, protein becomes too active & accelerates cell division.
36
Q

Cancer fundamentals.

Tmuor supressor genes do what?

A

Encode proteins that stop the cell cycle and check for mistakes, correcting them is possible OR starting ‘apoptosis’.

  • a mutated tumour supressor gene can’t stop the cycle and it will progress without checking.
37
Q

Cancer fundamentals.

Cell cycle

A

Biointeractive.org

Bioninja.org

38
Q

Cancer fundamentals.

Describe ‘basal cell carcinoma’ (BCC)

A
  • Most common skin cancer
  • arises from dividing cells at ‘basal layer’ of the epidermis
  • repeated exposure to solar UV radiation, especially ultraviolet B
  • exposure during childhood & tennage years
  • both UVA & UVB damage DNA
    • UVB is absorbed by DNA, causing damage to genes
    • UVA causes DNA damage by generating O2, breaking DNA molecule
    • alterations in tumour supressor genes for BCC.
39
Q

Cancer fundamentals.

BCC- list defining features

A
  • slow growing tumours- rarely metastisize
  • most frequent on body, face, head, neck & shoulders
  • three common growth patterns each with unique clinical features.
    1. Superficial- common. Lesions are flat, erythematous, scaling macules with colour change. If untreated will enlarge
    2. Nodular - common in elderly. Begin as pink nodule, elarged, becomes ulcer surrounded by a raised, rolled pearly boarder.
    3. Morphoeic- sclerosing (hardens) growth oattern, pale scar that feels hard on palpation.
40
Q

What is the treatment for BCC?

A
  • complete surgical excision with 4-5mm margin
  • highly aggressive - mohs surgery, margins examined
  • non-aggressive = cryotherapy
41
Q

Cancer fundamentals.

Squamous Cell Carcinoma (SCC)

Define the characteristics

A
  • second most common cancer
  • arises from keratinocytes in outer later of epidermis
  • may arise from skin or other sites lined by squamous epithelium eg. Oesophagus, bucal musosa, vagina
  • precurser lesions, invasive & may metastisize
  • aetiology- cumulativr sun exposure
  • treatment similar to BCC
42
Q

Cancer fundamentals.

SCC pre-cancerous = what disease?

A

Bowen’s disease.

  • abnormal keratinocytes confined to the epidermis.
  • lesions are full thickness of the epidermis, well-demarcated, erythematous scaly patches io to several centimetrrs in diameter.
    Most common on hands, face, ears etc.
  • will progress to invasive disease. Development of lump of bleeding may indicate lesion progression to invasive SCC.
43
Q

Cancer fundamentals.

Describe ‘Melanoma’ characteristics.

A

Highest incidence of melanoma in australia.

  • arises from melanocytes, pigment cells producing melanin.
  • rapid progression with high rates if metastasis.
  • cause involves both environmental and genetic factors.
  • intemittent exposure to UV rad, individuals with bad sunburn, fair hair/skin etc higher risk
44
Q

Describe the pathophysiology of melanoma

A

Environmental factor > genetic alteration > change to melanocyte > clinical appearance

45
Q

Describe the various Types of dermatitis and their pathophysiology.

A

Dermatitis - eczema
Exogenous-
Endrogenous-

Learning objectives
Module 2, Lecture 2

46
Q

Desscribe the oathophysiology of acne

A

Learning objectives

Module 2, Lecture 2

47
Q

Dermatitis is the i flammation of the ‘dermis’. It is caused my eczema - which is…

A

The most common inflammatory condition of the skin.

Learning objectives
Module 2, Lecture 2

48
Q

Dermatitis is of what aetiology?

A

Exogenous - irritant contact dermatitis & allergic contact dermatitis and;

Endogenous - atopic dermatitis and seborrhoeic dermatitis.

Learning objectives
Module 2, Lecture 2- slide 4

49
Q

Acute dermatitis is associated with what symptoms?

A

Puritis - itchy skin
Erythema -
Vescicles -
Scales -

Learning objectives
Module 2, Lecture 2

50
Q

Chronic dermatitis manifestations include;

A

Pruritis
Dryness of the skin,
Skin thickening
Hyperpigmentation and sometimes fissures.

51
Q

What is ‘seborrhoeic dermatitis’

A

Malassezia yeasts, affects areas rich in sebaceous glands eg. Scalp (cradle cap/ dandruff), eyebrows, nasolabial folds, behind the ears, axille, chest.

Scaly white or yellow plaques, treated with shampoos containing sulphur, salcylic acid, zinc purithione or tar.

52
Q

List the characteristics of ‘irritant contact dermatitis’

A
  • most common in nurses- affecting hands, occupational skin disorder.
  • non-allergenic inflammatory response to chemical or phsyical agents, from either one or many exposures.
  • common trigger substances- water, soap, detergents, oils, acids and rubber.
  • environmental factors such as UV, heat, low humidity = > seramine production.
  • friction etc

NRS121: Pathophysiology & Pharmacology (7 decks)

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