Week 2 Integumentary System

Question 1

Name the 5 levels of consciousness and what each means

Answer 1

1. Alert - awake or easily woken
2. Lethargic - not fully alert, answers questions, falls asleep when not stimulated
3. obtunded - sleeps most times, difficult to wake (loud noise, vigorous shaking or pain needed) slow to respond and generally confused
4. Stupor - arouses only to painful stimuli, may respond with groan or brief eye-opening; little to no awareness of surroundings
5. coma - not responsive

Question 2

Name the order in which orientation deteriorates. What goes first? What goes last

Answer 2

1. time
2. place
3. familiar persons/situation
4. Last to go = self

Question 3

What is the difference between fatigue and weakness

Answer 3

Fatigue refers to sense of weariness or loss of energy. Nonspecific symptom with many causes

weakness denotes demonstrable loss of muscle power and suggests possible neuropathy or myopathy

Question 4

Give some examples of signs of cardiac or respiratory distress

Answer 4

Clutching chest, pallor, diaphoresis, labored breathing, SOB, tripod position

Question 5

Give some examples of signs of pain

Answer 5

facial expression, grimacing, crying

Question 6

Give examples of signs of anxiety or depression

Answer 6

Anxious face, fidgety movements, poor eye contact, flat affect, psychomotor slowing

Question 7

What is excessive or spontaneous bruising called

Answer 7

purpura

Question 8

What does old cart stand for?

Answer 8

• Onset
• Location
• Duration
• Characteristics
• Associated Manifestations
• Relief/Exacerbations
• Treatment

Question 9

Where would you look for jaundice in both light pigment and dark pigmented skin

Answer 9

light: skin, sclera, conjunctiva, underneath tongue

Dark: hard palate, conjunctiva

Question 10

Where would you see central cyanosis in both light and dark pigmented skin

Answer 10

Light: around mouth, lips, oral mucosa, tongue

Dark: under the tongue, hyperpigmentation around the mouth

Question 11

What are some external variables that influence skin color

Answer 11

• emotional states
• febrile
• cigarette smoking
• prolonged elevation/dependent position of extremities
• prolonged inactivity

Question 12

Where would you check for skin turgor

Answer 12

top of wrist and under the clavicle

Question 13

How do we rate edema? What does the scale look like

Answer 13

1+ = 2mm depression
2+ = 4mm depression
3+ = 6mm depression
4+ = 8mm depression

Question 14

What are examples of the different colors of exudate and what does each look like

Answer 14

Sanguineous - frank fresh blood

Serous - thin, clear, watery

Serosanguineous - mixture

Purulent - pus, white and viscous

Question 15

What lesion pattern of arrangement would ringworm or tinea corporis follow

Answer 15

annular or circular

Question 16

What lesion pattern of arrangement would herpes simplex or cold sores follow

Answer 16

grouped or clustered

Question 17

What lesion pattern of arrangement would contact dermatitis follow

Answer 17

linear

Question 18

What lesion pattern of arrangement would scabies follow

Answer 18

gyrate or snakelike

Question 19

What lesion pattern of arrangement would hives or urticaria follow

Answer 19

confluent or run together

Question 20

What lesion pattern of arrangement would lyme or erythema multiforme follow

Answer 20

target for lyme

iris for erythema multiforme

Question 21

What lesion pattern of arrangement would herpes zoster follow

Answer 21

nerve root distribution or dermatomal

Question 22

A macule is a skin lesion that is less than _____ cm and more than 1 cm is called a _____

Is this primary or secondary

Are these palpable or non palpable

Answer 22

macule= less than 1.0 cm

patch = more than 1.0 cm

Primary

These are not palpable

Question 23

A papule is ______ cm and more than 1 cm is called ____

Is this primary or secondary

Are these palpable or not?

What is an example

Answer 23

less than 1.0 cm = papule

more than 1.0 cm = plaque

primary skin lesions

These are both palpable but superficial

psoriasis

Question 24

A nodule is less than _____ cm. What does it look like?

Is this primary or secondary

Answer 24

5.0; marble like

primary

Question 25

A primary lesion that is fluid filled with clear, serous fluid is called a what

Answer 25

Vesicle

Question 26

A semi solid fluid filled primary lesion (Dr. Pimple popper example) is called a what

Answer 26

cyst

Question 27

A pus filled primary lesion is called a what

Answer 27

pustule

Question 28

Explain what crust is

Is it a primary or secondary lesion

Answer 28

Crust is when a blister or vesicle that pops

secondary

Question 29

Explain what a fissure is

Is it primary or secondary

Answer 29

a linear crack (smiling when lips are really dry)

Secondary

Question 30

Explain what an Erosion is

Is it primary or secondary

Answer 30

Shearing of the top epidermis (ulcers in the mouth) (sour patch kids) not linear

secondary

Question 31

What is considered an atrophic scar and why?

Answer 31

stretch marks; they go into and under the skin which is different than a normal scar

Question 32

What causes lichenification

Answer 32

Years of itching and scratching which causes leathery appearance of skin. Very tough (chronic eczema)

Question 33

Give an example of excoriation

Answer 33

a cat scratch

Question 34

What does the ABCDE acronym of skin cancer stand for

Answer 34

1. asymmetry
2. border irregularity
3. color
4. diameter
5. evolving

Question 35

What could cause non-pitting edema?

What is Brawny edema?

Answer 35

infection or trauma

Brawny = thickening, indurated, non-pitting; brawny color from chronic ischemia and lysed RBC