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40 Cards in this Set

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Integumentary System made up of:
Skin
Hair
Nails
Skin Functions (5)
Protection
Temp Regulation
Sensory Perception
Vitamin D
Barometer of emotions ("lycos")
Excretes impurities
Inspection of Skin
Color
Jaundice
yellowing

most evidentscholera and mucous membrance;

gall bladder or liver problem;

excess bilirubin (in sucutaneous fat);

types- conjugated: bound by enzyme (glucoroltransferase)and excreted thru bowels/urine

unconjugated: free flowing to skin, brain, and vital organs
Encepholapathy: too much b/r in brain; interferes with thinking; people w/ liver failure get this;

b/r def: end product of broken down red blood cells;

Inpsect posterior of hard pallette to confirm in dark skin patients
Inspection of Skin
Color
Cyanosis

Pallor
bluish discoloration around lips, nails, palms, ear lobes
Assoc with oxygination prob
See conjunctiva (eye), palms and soles in dark skin patients
----------------------------
Pallor: pale
in buccal
decreased peripheral circulation if pale shiny skin on lower extremeties
Erythema
may be burn
Petechiae (machule)
Red or purple spots caused by small hemorrages; in superficial blood vessels of skin

Affects circulation, vascularity

May indicate serious blood clotting disorder, liver disease, drug reaction
Ecchymoses
larger bruising
may be from blood thinning therapy
Inspection of Skin
Texture and Tone
-Turgor
palpate for moisture, temp, texture, turgor, mobility

Want smooth warm soft dry

Hypothyroidism: rough, dry, thick

Cold skin: in SHOCK and HYPOtension

Sun exposure makes skin course and tough may cause cataracts

Decreased turgor indicates hypothyroidism

Test by pinch right under clavicle (best); upper chest
If > 30 seconds to return to orig position, can indicate HYPO (dehydration)
Inspection of Skin
Skin symmetry
Moles (NEVI)
ABCD assessmemt of moles (for MELENOMA) CANCER THAT STARTS IN MOLES; AGGRESSIVE, FAST GROWING TYPE
A: Asymmetry - will not be symmetric

B: Borders will be irregular

C: Color will see variations

D: Diameter will be > 6mm (pencil eraser size)
Types of skin lesions
Macule
type of skin lesion
Flat, nonpalpable change in skin color; smaller than 1 cm
ex: freckle, petechiae
< 1 cm in diameter

Only on top layer (horny layer)
paltate
therapeutic touching of skin for inspection
Types of skin lesions:
Papule
small solid raised legion

could be mold

on top two layers (horney, grandular or luna)
Types of skin lesions:
Nodule
solid raised bump .5-.2cm

ex: wart,
swollen lymph node

tonsils another ex
measles ex
MMR immunizations

In 2nd and 3rd layers pushing top layer (horny layer) up
Inspection of Skin
Tumor
Broken tissue that forms abnormal mass (abnormal cells)

No useful function

Grows at expense of healthy tissue

Ex: Benign tumor or malignant tumor
Extends deep through subcutaneous tissue to hypothermus
Types of skin lesions
Wheal
Irregular shaped, elevated areas of superficial localized edema; usually itches; varies in size
EX: misquito bite, hives, allergic reaction

Top 2 layers
Types of skin lesions
Vesicle
small fluid filled blister
EX chicken pox, blue blister, poison ivy/oak

Between 1st and 2nd layers
Types of skin lesions
Pustule
elevation of skin filled with pus
EX acne
In first 2 layers
Types of Skin lesions
Ulcers
deep loss of skin surface that may extend to dermis and frequently bleeds and scars; varies in size
EX bed sore, spider bite
Describing Skin Lesions
Structure
macule, papule, pustule, etc
Describing Skin Lesions
size, shape, color, texture
---------------------------
Distribution
circumscribed-round
color: includes any mixtures
----------------------------
where are they on body
Describing Skin Lesions
Configuration
Annular - round in a circle like ringworm

Clustered - grouped together

Linear - in a line
Edema
Fluid retention in interstitial spaces

Abnormal buildup of fluid in the body
Edema
Generalized
swelling thoughout body
Edema
Localized
limited to particular part of body

COPD
Edema
Pitting
leaves indentation
Edema
Nonpitting
no indentation
Edema
Anasarca
massive generalized edema

eg kidney failure
Edema
Ascites
Extra fluid in abdominal cavity ("third space")
EX jaundice
Assessment of Pitting Edema
1+
Press for 5 seconds

Barely detectable - 2 mm
Assessment of Pitting Edema
2+
indents 2-4mm
Assessment of Pitting Edema
3+
3+ indents 5-6mm
Assessment of Pitting Edema
4+
indents >6mm
Assessing Hair
Hirsutism: abnormal hair in women

Thin hair: decreased thyrod function. EXCEPTION: genetics
Assessing Hair
Inspect hair for distribution
-Alopecia (hair loss)
-Hirsutism
-Male pattern baldness
Assessing Hair
Thickness/thinness

thiness may rep a decreased thyroid function (Exp: genetics)
Assessing Hair
Texture
silky and resilient, not dry and brittle (vitamin/mineral deficiency, decreased thyroid, dehydration)
Assessing Hair
Infestation (lice)
Assessing Nails
Normal findings:
smooth
pink
flat or slightly convex
nail base angle of 160 degrees
Assessing Nails
Blanch test
capillary refill < 3 seconds
Abnormal Nail Assessment
Clubbing -> 180 degrees
Fungus

Broadening and thickening of the fingers/toes with an increased lengthwise curvature of the tip of the nail; flattening between cuticle and nail (poor oxigination)
heart/lung disease related
ex: emphasema, COPD

Fungus: nail thickens and turns yellow, white or gray