Skin Flashcards
1
Q
Roles of Integumentary System(6)
A
- provides barrier
- regulates body temperature
- synthesize Vitamin D
- sensory perception
- excretion of metabolic wastes
- wound repair
ALSO: identity, non-verbal communication?!?
2
Q
Layers of the skin (3)
A
- Epidermis (No blood vessels)
- —– a. stratum corneum
- ——b. stratum germinativum - Dermis (blood vessels, connective tissue, sebaceous glands, hair follicles)
- Subcutaneous
3
Q
Pigments (4)
A
- Melanin
- carotene
- Oxyhemeglobin
- Deoxyhemeglobin
4
Q
Jaundice
A
deposition of (too much) bilirubin
Yellowish color
Easiest to see in sclera, nails, palms and soles of feet
5
Q
Cyanosis
A
Bluish Color
lack of oxygen (central)
lack of blood flow ( peripheral)
6
Q
Vellus
A
Short fine baby fuzz hair, inconspicuous, unpigmented
7
Q
Terminal hair
A
Coarser, thicker, conspicuous, pigmented
8
Q
Sebaceous Glands
A
Produce sebum, lubricates skin and hair, reduces water loss through skin
9
Q
Sweat glands ( 2 Types)
A
eccrine- widely distributed, open to surface, help control body temp
Apocrine- in axillary or genital areas, stimulated by emotional stress- Body odor
10
Q
Health Hx Questions
A
- History of skin disease
- Diabetes or peripheral vascular disease?
- allergies or food sensitivities
- Burns or sun burns
- Corticosteroids/medications
- Family Hx
11
Q
erythemia
A
Redness of skin
12
Q
ecchymosis
A
Bruising of the skin
13
Q
caratonemia
A
Orange tint form too much carrots
14
Q
Vitiligo
A
loss of skin color
15
Q
Mobility vs. Turgor
A
Mobility- the ease at which it picks up
Turgor- speed with which it returns into place
16
Q
Edema
A
Localized- Injury
Systemic- puffy tight skin
Pitting- Interstitial fluid mobile
17
Q
Pitting Edema Scale
A
1+ - 2mm
2+- 4mm
3+- 6mm
4+ - 8mm
18
Q
What Vitamins/Minerals needed for Collagen formation
A
Vitamin C
Zinc
Copper
19
Q
Non-pitting edema
A
Local infection or trauma ; Brawny edema
20
Q
Macules
A
Sm flat mole < 1 cm
21
Q
Papules
A
Raise mole <1 cm
22
Q
Patches
A
Flat lesion, discoloration, > 1 cm,
23
Q
Plaques
A
elevated, superficial, solid lesion, > 1 cm in diameter.
24
Q
Nodules
A
Small Solid Tumor
25
Wheals
edemas of the skin, raised red, that appear suddenly - often related to allergic reactions
26
uticaria
Hives
27
Vesicles
filled with serous fluid, superficial blisters < 1/2 cm
28
cysts
semi solid, or liquid, goes into dermis
29
Bullas
filled with serous fluid, superficial blisters > 1/2 cm
30
Erosion
The partial loss of the epithelium, with the basement membrane left intact
31
Excoriation
Scratch to the skin
32
Fissure
cracks to the skin, like in eczema
33
Ulcer
A skin ulcer is a sore on the skin. Skin ulcers often form when blood circulation is impaired. Bed sores
34
Stages of Bed Sores ( 4)
Stage 1 - epidermis
stage 2- dermis
stage 3 - subcutaneous tissue, fat
stage 4- muscle & bone
35
Who is at risk for bed sores
IMMOBILE PATIENTS
| INCONTINENT PATIENTS
36
```
Braden Scale (6 risk factors)
whats good/whats bad
```
six major risk factors:
1. sensory perception
2. moisture
3. activity
4. mobility
5. nutrition
6. Friction/Sheer.
lower the score, the more likely the patient will develop a pressure ulcer.
18< risk
12< HIGH RISK
Asses upon admission and again 48-72 hours
37
Assessing moles for cancer
| ABCDE-EFG
```
Asymmetry of one side to the other
Borders-irregular=bad
Change in color
Diameter >6 mm =bad
Evolving over time
-
Elevated
Firm to palpation
Growing progressively
```
38
Pruritus
Itching
39
Reactive hyperemia
is the transient increase in organ blood flow that occurs after a period of ischemia (ex: arterial occlusion)
40
linear
in a line
41
Geographic
scalloped boarders, resembling the boarders of a map
42
gyrate
ring
43
target
multiple rings- bullseye
44
zosteriform
follows nerve root
45
annular
ring like arrangement
46
discrete
separate distinct lesions, not joined to one another
47
Arciform
Arch shape
48
serpiginous
(of a skin lesion or ulcerated region) having a wavy margin.
49
Paronychia
infection of the skin folds around the nails
50
Leukonychia
transverse white lines, commonly known as Mees lines in the nails
51
Seborrheic kerotosis -Older adults
A noncancerous skin condition that appears as a waxy brown, black, or tan growth.
52
Angle of nail base
160*
53
Clubbing nails
Angle of nail base is > 160*
heart and lung diseases
peripheral vascular disease
54
Classification of wounds (5)
1. Open/Closed
2. acute/chronic
3. clean/contaminated/Infected
4. superficial/partial or Full thickness
5. Penetrating
55
Primary Intention
edges are approximated
| examples: Surgical incisions, paper cuts, and small cutaneous wounds usually heal by primary closure. - Minimal scarring
56
Secondary intention
wound edges not approximated
tissue loss
heals from inner layer to surface
***requires a granulation tissue matrix to be built to fill the wound defect.***
57
Tertiary intention
granulating tissue brought together
| delayed closure of wound edges
58
Regeneration
In epidermal wounds
| NO scar
59
Partial Thickness wound repair (3)
1. inflammatory response ( vasodilation, redness, swelling, moderate amount of serous exudate
2. Reproduction, migration and reestablishment of epidermal layers
3. reestablishment of epithelial layers
60
Full thickness wound repair (4)
1. Hemostasis- control blood loos, establish bacterial control, seal defect
2. Inflammatory response- vasodilation, exudate
3. proliferative healing- granulated tissue, contraction of wound, surface repair
4. remodeling- final stage, scar tissue
61
Important labs for Wounds
```
WBC- too low =bad
Hemoglobin level
blood coagulation
serum protein analysis, pre-albumin
wound C&S
Tissue biopsy
```
62
Serous fluid
clear/slightly yellowish tinged fluid, excreted by serous membranes
63
purulent
puss drainage
64
serosanguineous
serous fluid + Blood
65
sanguineous (hemmorhagic)
Blood drainage
66
Penrose Drain
A Penrose drain is a soft, flexible rubber tube used as a surgical drain, to prevent the buildup of fluid in a surgical site.
lies under a dressing, at time of placement a pin or clip is place through the train to prevent it from slipping further into the wound,
67
Jackson -Pratt Drain
(also called a JP Drain) is a closed-suction medical device that is commonly used as a post-operative drain for collecting bodily fluids from surgical sites. The device consists of an internal drain connected to a grenade-shaped bulb via plastic tubing.
68
Color Guide for wound care
Red- Protect
yellow- Cleanse
Black - Debride
69
INtrinsic factors for pressure ulcer development
```
Immobility
impaired sensation
malnourishment
aging
fever
```
70
Extrinsic factors
Friction
pressure
shearing
exposure to moisture
71
WOCN
Wound ostomy continence Nurse
72
How to prevent Bed sore ( position)
30 * lateral position
73
Debriding syringe information
35mL ; 19 gauge Angiocath
74
Avoiding skin trauma
```
smooth, firm surfaces
semi fowlers position
frequent weight shifts
exercise and ambulation
reposition q2 hrs
```
mattresses beds, wedges and pillows
