Ch 23 Integumentary System

Front 1

epidermis

Back 1

this avascular superficial layer of the skin

made up of an outer dead cornified portion and a deep living portion

replaced every 28 days

Front 2

two major types of epidermal cells

Back 2

melanocytes 5%
keratinocytes 90%

Front 3

melanocytes

Back 3

contained in deep basal layer (stratum germinativum) of epidermis

Front 4

keratinocytes

Back 4

synthesized from epidermal cells in the basal layer

upward movement of keratinocytes from the basement membrane to the stratum corneum takes approx 4 weeks

Front 5

dermis

Back 5

connective tissue below the epidermis

1-4mm thick

2 layers

Front 6

two layers of dermis

Back 6

papillary layer and reticular layer

Front 7

papillary layer

Back 7

folded into ridges, or papillae, which extend into the upper epidermal layer

Front 8

reticular layer

Back 8

collagen and elastic and reticular fibers

mechanical strength

Front 9

subcutaneous tissue

Back 9

not part of the skin

lies below the dermis

stores lipids
regulates temperature
provides shock absorption

Front 10

skin appendages

Back 10

hair, nails, glands: (sebaceous, apocrine,eccrine)

hair and nails form from specialized keratine that becomes hardened

Front 11

sebaceous glands

Back 11

secretes sebum, which is eptied into the hair follicles

Front 12

aprocrine sweat glands

Back 12

located in the axillae, breast areolae, umbilical and anogenital areas, external auditorry canals and eyelidds

Front 13

Eccrine sweat glands

Back 13

widely distributed over the body except in a few areas, such as the lips

Front 14

funtions of integumentary system

Back 14

protection from external environment
thermal regulation
maintains fluid balance
sensory perception
insulation

Front 15

gerontologic considerations

Back 15

influenced by heredity, sun exposure, hygiene practices, nuttrition, health

decreased turgor
thinning
dryness
wrinkles
vascular lesions
increased skin fragility
benign neoplasms

Front 16

decreased subQ fat leads to

Back 16

risk of trauma
hypothermia
skin shearing, leading to pressure ulcers

Front 17

alopecia

Back 17

partial or complete lack of hair

Front 18

important health history

Back 18

past health history
medications
surgery or other treatments

Front 19

past health history

Back 19

food sensitivities, pet/drug allergies, skin reactions to insect bites, sun exposure

Front 20

Medications and skin

Back 20

vitamins, hormones, antibiotics, corticosteroids, antimetabolites .... call cause side effects that are manifested in the skin

Front 21

Surgery or other treatments

Back 21

surgical procedures, including cosmetic, biopsies, treatments for specific skin problems, radiation therapy, tanning booth use, laser resurfacing, peels

Front 22

functional health patterns

Back 22

health perception/management
nutritional/metabolic
elimination
activity-exercise
sleep-rest
cognitive-perceptual
self-perception
role-relationship
sex-reproductive
copiing-stress tolerance

Front 23

macule

Back 23

circumscribed, flat area with a change in skin color

less than 1cm or 0.5cm

freckles, petechiae, meaasles, flat mole (nevus)

large is a "patch"

Front 24

PAPULE

Back 24

elevated, solid lesion
1cm 0.5cm in diameter

wart, elevated moles

nodules 2cm
tumors more than 2cm

Front 25

vesicle

Back 25

circumscribed, superficial collection of serous fluid
less than 1cm/0.5 cm

varicella, herpes zoster, second degree burn

bulla - bigger than 1cm

Front 26

plaque

Back 26

curcumscribed, elevated superficial, solid lesion
greater than 1cm

psoriasis, seborrheic and active keratoses

Front 27

wheal

Back 27

firm, edematous, irregularly shaped area, diamter variable

insect bite, urticaria

dips down a little
usually related to an allergic reaction

Front 28

pustule

Back 28

elevated, superficial lesion filled with urulent fluid

acne, impetigo, cyst

Front 29

fissure

Back 29

linear crack or break from the epidermis to dermis, dry or moist

athlet's foot, cracks at corner of mouth

Front 30

scale

Back 30

excess, dead epidermal cells produced by abnormal keratinization and shedding

flaking of skin after drug rxn or scarlet fever

Front 31

scar

Back 31

abnormal formation of connective tissue that replaces normal skin

Front 32

ulcer

Back 32

loss of the epidermis and dermis
crater-like
irregular shape

pressure ulcer, chancre

Front 33

atrophy

Back 33

decression in skin resulting from thinning of the epidermis or dermis

aged skin, striae

Front 34

excoriation

Back 34

area in which epidermis is missing, exposing the dermis

scabies, abrasion, or scratch

Front 35

annular

Back 35

ring shaped

Front 36

gyrate

Back 36

spiral shaped

Front 37

iris lesions

Back 37

bull's eyes

Front 38

linear

Back 38

in a line

Front 39

nummular, discoid

Back 39

coinlike

Front 40

polymorphous

Back 40

occuring in several forms

Front 41

punctate

Back 41

marked by points and dots

Front 42

serpiginous

Back 42

snakelike

Front 43

for darker skin, areas easier to assess are:

Back 43

lips, mucous membranes, nail beds, protected areas

Front 44

psuedofolliculitis

Back 44

inflammatory response to ingrown haris that is thought to occur after shaving closely, characterized by pustules and papules

Front 45

keloid

Back 45

overgrowth of collagenous tissue at site of skin injury

Front 46

mongolian spots

Back 46

benign bluish-black macules

Front 47

main diagnostic techniques related to skin problems:

Back 47

inspection of the individual lesion

careful history related to the problem

Front 48

punch biopsy

Back 48

special punch biopsy instrument of appropriate size used, instrument rotated to appropriate level to include dermis and some fat

suturing may or may not be done

Front 49

excisional biopsy

Back 49

useful when good cosmetic results and entire removal desired

skin closed with subq and skin sutures

Front 50

incisional biopsy

Back 50

wedge-shaped incision made in lesion too large for excisional biopsy. useful when larger specimen than shave biopsy is needed

Front 51

shave biopsy

Back 51

single-edge razor blade used to shave off superficial lesions or small sample of a large lesion

provides full-thickness specimen of stratum corneum

Front 52

KOH test

Back 52

hair, scales, or nails examined for superficial fungal infection

specimen is put on slide and 10-20% KOH added

Front 53

Tzanck test

Back 53

wright's and Giemsas stain

fluid and cells from vesicles examined to diagnose herpes infections

Front 54

Culture

Back 54

test identifieds fungal, bacterial, viral microbes

Front 55

Fungi Culture

Back 55

scraping of swab of skin

Front 56

Bacterial culture

Back 56

material obtained from intact pustules, bullae, or abscesses

Front 57

viral culture

Back 57

vesicle/bulla scraped and exudate taken from center of lesion

Front 58

mineral oil slides

Back 58

to check for infestations

Front 59

woods's lamp

Back 59

exam of skin with long-wave uv light causes specific substances to fluoresce (fungal infections, vitiligo, Pseudomonas organisms)

Front 60

Patch test

Back 60

used to determine whether a pt is alergic to any testing material