Nursing 104 Skin

Front 1

What are the layers of skin?

Back 1

epidermis, dermis, and subcutaneous

Front 2

What is the outmost layer of the epidermis called?

Back 2

stratum corneum

Front 3

What does the stratum corneum consist of?

Back 3

dead cells that are tightly packed together

Front 4

What does the stratum corneum do for us?

Back 4

protects and is a moisture barrier

Front 5

How often are the dead skin cells shed?

Back 5

every 4 weeks

Front 6

What is the lower layer of the epidermis called?

Back 6

stratum germinatavum

Front 7

What is another name for the stratum germinatavum?

Back 7

Basal cell layer

Front 8

What are the two specialized cells that are in the stratum germinatavum?

Back 8

-Melanocytes
-keratinocytes

Front 9

What do the melanocytes produce?

Back 9

melanin

Front 10

A pigment that gives our skin color and protects the body from UV rays

Back 10

melanin

Front 11

How is the production of melanin stimulated?

Back 11

sunlight and hormones

Front 12

Melanin production is dependent on what?

Back 12

heredity/race

Front 13

What do the keratinocytes produce?

Back 13

keratin

Front 14

What is the function of keratin?

Back 14

gives skin its waterproof coating

Front 15

What is the second layer of skin?

Back 15

Dermis

Front 16

What is the outer most section of the dermis?

Back 16

papillary layer

Front 17

What is the function of the papillary layer?

Back 17

makes us unique with our own finger prints and foot prints.

Front 18

What connects the epidermis to the dermis?

Back 18

the ridges in the papillary layer that make up our finger prints and foot prints

Front 19

What is the second layer of the dermis?

Back 19

reticular layer

Front 20

What is the reticular layer made up of?

Back 20

collagen and elastic fibers

Front 21

What does the elasticity of skin depend on?

Back 21

the amount and quality of the elastic fibers, which are scatter among the collagen fibers

Front 22

The reticular layer has what, which is for the exchange of oxygen and heat?

Back 22

capillaries and lymph vessels

Front 23

What do collagen and elastic fibers do for the skin?

Back 23

gives it flexibility and strength

Front 24

The reticular layer is rich in ________ ________ that transmit the sensation of touch, pressure, temperature, pain, and itch.

Back 24

Sensory nerves

Front 25

What appendages are present in the reticular layer?

Back 25

-hair follicles
-sebaceous glands
-sweat glands

Front 26

What is the innermost layer of skin?

Back 26

the subcutaneous layer

Front 27

What is the subcutaneous layer made up of?

Back 27

loose connective and adipose (fat) tissues.

Front 28

What does adipose tissue serve as?

Back 28

-an insulator
-shock absorber
-alternative energy source

Front 29

Fat distribution varies how?

Back 29

-age
-body area
-gender

Front 30

Many _______ _______ go through the fatty layer and extend into the dermal layer, forming the capillary networks that supply nutrients and remove waste.

Back 30

blood vessels

Front 31

Where doesn't hair grow?

Back 31

-lips
-umbilicus
-glans penis
-labia
-palms of the hands
-soles of the feet

Front 32

Where are the hair follicles located at?

Back 32

in the dermal layer but are actually extensions of the eipdermal layer

Front 33

What is around the hair follicle that elevates the hair so it resembles "goose bumps"?

Back 33

arrector pili

Front 34

Which is tougher: hair keratin or skin keratin?

Back 34

hair keratin

Front 35

How is hair color determined?

Back 35

genetically determined by a person's rate of melanin production

Front 36

Hair growth occurs in ______, with a growth phase followed by a resting phase?

Back 36

cycles

Front 37

The absence of hair may be caused by what?

Back 37

disease, treatment related to chemo or a result of heredity

Front 38

What is distributed over the entire skin surface except for the palms of the hands and soles of the feet?

Back 38

sebaceous glands

Front 39

What does sebaceous glands produce?

Back 39

sebum

Front 40

What is a mildly bacteriostatic, fat containing substance?

Back 40

sebum

Front 41

What does debum do for the skin?

Back 41

it lubricates and reduces water loss from the skin surface

Front 42

What are the two types of sweat glands?

Back 42

-eccrine
-apocrine

Front 43

Stimulation of sweat from what glands can cause the body to lose as much as 10-12 L of fluid a day?

Back 43

eccrine

Front 44

Which sweat gland is not associated with the hair follicle?

Back 44

eccrine

Front 45

an isotonic liquid secreted by the eccrine glands

Back 45

sweat

Front 46

Why is sweat important?

Back 46

helps regulate body temperature

Front 47

Which sweat gland is in direct contact with the hair follicles?

Back 47

apocrine

Front 48

Where are most of the apocrine sweat glands found?

Back 48

axillae, nipple areola, and perineal and periumbilical body areas

Front 49

What causes the distinctive body odor?

Back 49

the interaction of skin bacteria with the secretions of the apocrine glands

Front 50

What grows at the ends of fingers and toes?

Back 50

nails

Front 51

What is the white, crescent shaped protion of the nail at the lower end of the nail plate called?

Back 51

the lunula

Front 52

What is the location of the nail matrix, where nail keratin is formed and nail growth begins?

Back 52

the lunula

Front 53

a layer of keratin at the nail fold that attaches the nail plate to the soft tissue of the nail fold

Back 53

the cuticle

Front 54

What features does the epidermis have that provide protection?

Back 54

-keratin-protection of skin surface
-barrier to external microorganisms
-mechanical strength

Front 55

What features does the dermis have that provide protection?

Back 55

-provides fibroblasts for wound healing
-mechanical strength: collagen, elastin

Front 56

What features do the subcutaneous tissue have that provide protection?

Back 56

-mechanical shock absorber
-energy reserve

Front 57

What features do the epidermis have that maintains homeostasis (water balance)?

Back 57

-waterproof exterior that prevents fluid, electrolyte losses

Front 58

What features do the dermis have that maintains homeostasis (water balance?)

Back 58

-lymph and vessels respond to injuring, inflammation, infection

Front 59

What features do the epidermis have the provide temperature regulation?

Back 59

-eccrine sweat glands allow dissipation of heat

Front 60

What features do the dermis have the provide temperature regulation?

Back 60

-cutaneous vasculature dilates/contracts to promote/inhibit heat loss

Front 61

What features do the subcutaneous tissues have the provide temperature regulation?

Back 61

-fat cells act as insulators and aid in heat retention

Front 62

What features does the epidermis have that makes it a sensory organ?

Back 62

-neuroreceptor system transmits a variety of stimuli

Front 63

What features does the dermis have that makes it a sensory organ?

Back 63

-encloses an extensive network of nerve endings for relaying info to the brain

Front 64

What features do the subcutaneous tissues have that make it a sensory organ?

Back 64

large pressure receptors

Front 65

What features does the epidermis have aids in vitamin synthesis?

Back 65

conversion of Vitamin D

Front 66

How does the epidermis affect psychosocial image?

Back 66

alterations with epidermal disease/trauma

Front 67

How does the dermis affect psychosocial image?

Back 67

alterations with dermal disease (scleroderma)

Front 68

How does the subcutaneous tissue affect psychosocial?

Back 68

alterations in body fat distribution

Front 69

a reddened area caused by increased amounts of oygenated blood in the dermal vasculature. Flushed appearance

Back 69

erythema

Front 70

localized red or purple discoloration caused by extravasation of blood into dermis and subcutaneous tissue

Back 70

ecchymosis (bruise)

Front 71

pinpoint, tiny and sharp circumscribed spots in the superficial layers of the epidermis

Back 71

petechiae

Front 72

skin changes produced by some causative factor. It appears in response to some change in the internal or eternal environment of the skin and is not altered by trauma

Back 72

Primary lesions-warts

Front 73

changes that result from alteration in the primary lesions, such as those caused by rubbing, scratching, medication, or involution. They either add to or take away from an existing primary lesion

Back 73

Secondary lesion-scar, stretch marks

Front 74

The pattern in which lesions are distributed over the body, whether local or generalized, and specific areas associated with the lesions

Back 74

Distribution pattern

Front 75

The size, shape, and arrangement of a lesion or groups of lesions.

Back 75

Configuration and arrangement

Front 76

Round (coin-shaped) lesions. Also known as discoid.

Back 76

Nummular lesion

Front 77

A linear shape to a lesion often occurs for some external reason such as scratching. Also striate

Back 77

Linear lesion

Front 78

Concentric rings like a dartboard. Also know as iris lesion

Back 78

Target lesion

Front 79

A rash that appears to be whirling in a circle

Back 79

gyrate rash

Front 80

lesions grouped in a circle like ringworm

Back 80

Annular

Front 81

an area of color change, flat, smooth, less than 1 cm

Back 81

Macule

Front 82

raised lesion like a mole

Back 82

Papule

Front 83

small blister less than 1/2 cm like chicken pox, burns

Back 83

Vesicle

Front 84

over growth of skin like psorasis wider than 1 cm

Back 84

Plaque

Front 85

raised area like hives, bug bite

Back 85

Wheal

Front 86

blister filled with pus like acne

Back 86

pustule

Front 87

crack in the skin

Back 87

fissure

Front 88

hyperkeratosis

Back 88

scale

Front 89

after a skin lesion is repaired, normal tissue is lost and replaced with connective tissue

Back 89

scar

Front 90

thinning of the epidermis like stretch mark

Back 90

atrophic

Front 91

this is a inflammatory disorder. It is autoimmune disease. The cells replicate rapidly-8x's faster than normal

Back 91

Psoriosis

Front 92

Psoriasis has periods of exacerbation and remission.
Illness, hormones, stress, medications can worsen
Psoriatic arthritis can occur in the joints
no cure

Back 92

info

Front 93

pediculosis capitus

Back 93

head lice

Front 94

pediculosis corporis

Back 94

body lice

Front 95

pediculosis pubis

Back 95

pubic or crab lice

Front 96

sarcoptes scabiei

Back 96

scabies (mite)

Front 97

Tinea capitus

Back 97

ringworm of the scalp

Front 98

tinea corporis

Back 98

ringworm of the body

Front 99

tinea cruris

Back 99

jock itch

Front 100

tinea pedis

Back 100

Athlete's foot-most common

Front 101

infection of the hair shaft- staph infection is a common cause

Back 101

folliculitis

Front 102

infection of the entire hair shaft, only one

Back 102

furuncle

Front 103

infection of the entire hair shaft, a group of 2 or more

Back 103

carbuncles

Front 104

What does Herpes type I cause?

Back 104

cold sore

Front 105

What does Herpes type II cause?

Back 105

genital lesion

Front 106

What is another name for herpes zoster?

Back 106

shingles

Front 107

This is a benign growth cause by the papilloma virus

Back 107

warts

Front 108

What type of pustule is a closed comedone?

Back 108

a white head

Front 109

What type of pustule is a open comedone?

Back 109

a black head

Front 110

raw, red, painful, itchy skin are s/s of what type of dermatitis?

Back 110

contact

Front 111

What type of dermatitis is cradle cap and diaper rash?

Back 111

seborrheic

Front 112

This type of ulcers is caused by poor circulation and prolonged edema

Back 112

stasis ulcer
this is slow to heal if at all
irregular borders

Front 113

This type of burn consists of sunburn to fire, scalding, and contact with hot objects

Back 113

thermal burn-hot thermal most common

Front 114

This type of burn is a localized injury to the skin resulting from the formation of ice crystals in the skin tissues and cells

Back 114

Cold burn (frostbite)

Front 115

What factors contribute to getting frost bite?

Back 115

-age
-duration
-environmental temperature
-pre-existing medical conditions

Front 116

The environmental temperature (cold) causes the vessels to ________. As a result, blood flow is __________ to the area which limits the warming capability of the body to the external tissues.

Back 116

constrict
decreased

Front 117

What layers of skin does superficial frosbite involve?

Back 117

epidermis, dermis, and subcutaneous tissue

Front 118

What are some common sites for superficial frostbite?

Back 118

ears, nose, fingers, and toes

Front 119

What color can superficial frostbitten skin turn?

Back 119

pale yellow to blue or mottled

Front 120

This brostbite involves the skin layers, the subcutaneous tisse as well as muscle, bone, and tendon

Back 120

Deep frostbite

Front 121

What does the skin look like in deep frostbite?

Back 121

white, hard, and without feeling

Front 122

The tissue on a deep frostbite often develops _________.

Back 122

gangrene

Front 123

This burn results from acids, alkalis, and organic compounds.

Back 123

Chemical burns

Front 124

This substances tends to be more difficult to remove from the skin and as a result, they often cause a larger deeper burn than an acid wound.

Back 124

Alkaline

Front 125

Where are some Alkalis found?

Back 125

oven and drain cleaners, fertilizers, and heavy industrial cleaners.

Front 126

With chemical injuries, it is important to _______ the burning agent from the individual.

Back 126

remove

Front 127

Dry chemical should be brushed from the skin, clothing _______, and the skin _________ with large amounts of water.

Back 127

removed
flushed

Front 128

How long can tissue destruction continue for after the chemical injury?

Back 128

72 hours

Front 129

This type of burn is the result of intense heat generated by a current.

Back 129

electrical burn

Front 130

What factors determine the severity of an electrical burn?

Back 130

-the amount of voltage
-the pathway of the current
-the surface area in contact with the current
-the length of time that contact is made
-thickness of the skin at the area of contact (areas with fat and bone are more protected than vital organs)

Front 131

What is one of the biggest problems initially with electrical burn?

Back 131

difficulty assessing the level of injury

Front 132

What is the #1 complication of a burn?

Back 132

infection

Front 133

What type of burn:
damage to only the top layer of the skin. Healing occurs in 3-5 days and no scarring

Back 133

Superficial burn

Front 134

What type of burn:
entire epidermis and first 1/3 of dermis are destroyed. Healing in 10-21 days

Back 134

Superficial Partial Thickness burn

Front 135

What type of burn:
extends deeper into the dermis. Takes 3-6 weeks to heal and has scar formation

Back 135

Deep Partial Thickness burn

Front 136

What type of burn:
reaches through the entire dermis and sometimes into the subcutaneous fat. The skin cannot heal on its own. Take weeks to months to heal with grafting required and scar formation

Back 136

Full thickness burns

Front 137

human skin obtained from cadavers

Back 137

homografts

Front 138

patient's own skin taken from another area (non-injury)

Back 138

Autografts

Front 139

skin obtained from another species (usually pigskin)

Back 139

Xenografts (heterografts)

Front 140

derived from placenta

Back 140

amniotic membrane

Front 141

grown from small specimens of epidermal cells from unbruned area of pt's body

Back 141

cultured skin

Front 142

an uncontrolled growth of abnormal skin cells

Back 142

skin cancer

Front 143

abnormal growth of cells in the lowest layer of the epidermis and is the most common type of skin cancer

Back 143

basal cell carcinoma
*least deadly, looks like open sores, can be a shiny nodule, pearly, or translucent, white, or red

Front 144

this a highly aggressive skin cancer that is found in the middle layer of the epidermis

Back 144

squamous cell carcinoma
*metastasizes easily, has irregular borders

Front 145

this occurs in the cells that produce pigment and is less common than squamous or basal cell carcinoma, but is more dangerous

Back 145

melanoma
*the leading cause of death from skin disease

Front 146

FYI: skin cancers are sometimes classified as either melanoma or nonmelanoma. Basal cell and squamous cell carcinomas are the most common nonmelanoma skin cancers.

Back 146

info

Front 147

TorF:
Skin cancer is the least common form of cancer in the United States.

Back 147

False

Front 148

What are some known risk factors for skin cancer?

Back 148

-complexion
-genetics
-age
-sun exposure and sunburns
-smoking

Front 149

What is ABCDE?

Back 149

-Asymmetry-one half of the abnormal skin area is different than the other half
-Borders-irregular borders
-Color-varies from one area to another with shades of tan, drown, or black (sometimes white, red, blue)
-Diameter-usually (but not always) larger than 6 mm in size
-Evolving-any skin growth that bleeds or will not heal or changes in character

Front 150

Large moles that are not cancerous

Back 150

Nevus

Front 151

What are some ways to prevent skin damage from the sun?

Back 151

-protect your skin from the sun when you can
-try to avoid exposure between 10 am and 4 pm
-use sunscreen with an SPF of at least 30
-apply sunscreen during winter months as well

Front 152

this is a pre-malignant form of squamous cell carcinoma with a typical lesion being irregularly shaped

Back 152

Actinic keratosis

Front 153

actinic keratosis lesion may be flat or elevated, and often has a rough, wart-like appearance. What is the cause?

Back 153

sun damage

Front 154

What are the most common areas that squamous cell ca occur?

Back 154

areas frequently exposed to the sun, such as rim of the ear, lower lip, face, bald scalp, neck, hands, arms and legs

Front 155

What are some telltale signs of sun damage?

Back 155

wrinkling, changes in pigmentation, and loss of elasticity

Front 156

This skin carcinoma typically appear as a persistent thick, rough, scaly patch that can bleed if bumped. They often look like warts and sometimes appear as open sores with a raised border and a crusted surface over an elevated pebbly base

Back 156

Squamous cell CA

Front 157

This skin CA occurs on parts of the body excessively exposed to the sun-especially the face, ears, neck, scalp, shoulders, and back.

Back 157

Basal cell CA

Front 158

Who has the highest risk for Basal Cell CA?

Back 158

fair skin, blond or red hair, and blue, green, or grey eyes

Front 159

Anyone who has more than ____ moles is at greater risk for melanoma.

Back 159

100

Front 160

The new method of sight detection for skin lesions that could be melanomas. These melanomas look different compared to surrounding moles.

Back 160

"The Ugly Duckling"