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60 Cards in this Set
- Front
- Back
epidermis
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this avascular superficial layer of the skin
made up of an outer dead cornified portion and a deep living portion replaced every 28 days |
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two major types of epidermal cells
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melanocytes 5%
keratinocytes 90% |
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melanocytes
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contained in deep basal layer (stratum germinativum) of epidermis
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keratinocytes
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synthesized from epidermal cells in the basal layer
upward movement of keratinocytes from the basement membrane to the stratum corneum takes approx 4 weeks |
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dermis
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connective tissue below the epidermis
1-4mm thick 2 layers |
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two layers of dermis
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papillary layer and reticular layer
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papillary layer
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folded into ridges, or papillae, which extend into the upper epidermal layer
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reticular layer
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collagen and elastic and reticular fibers
mechanical strength |
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subcutaneous tissue
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not part of the skin
lies below the dermis stores lipids regulates temperature provides shock absorption |
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skin appendages
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hair, nails, glands: (sebaceous, apocrine,eccrine)
hair and nails form from specialized keratine that becomes hardened |
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sebaceous glands
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secretes sebum, which is eptied into the hair follicles
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aprocrine sweat glands
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located in the axillae, breast areolae, umbilical and anogenital areas, external auditorry canals and eyelidds
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Eccrine sweat glands
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widely distributed over the body except in a few areas, such as the lips
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funtions of integumentary system
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protection from external environment
thermal regulation maintains fluid balance sensory perception insulation |
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gerontologic considerations
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influenced by heredity, sun exposure, hygiene practices, nuttrition, health
decreased turgor thinning dryness wrinkles vascular lesions increased skin fragility benign neoplasms |
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decreased subQ fat leads to
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risk of trauma
hypothermia skin shearing, leading to pressure ulcers |
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alopecia
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partial or complete lack of hair
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important health history
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past health history
medications surgery or other treatments |
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past health history
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food sensitivities, pet/drug allergies, skin reactions to insect bites, sun exposure
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Medications and skin
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vitamins, hormones, antibiotics, corticosteroids, antimetabolites .... call cause side effects that are manifested in the skin
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Surgery or other treatments
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surgical procedures, including cosmetic, biopsies, treatments for specific skin problems, radiation therapy, tanning booth use, laser resurfacing, peels
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functional health patterns
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health perception/management
nutritional/metabolic elimination activity-exercise sleep-rest cognitive-perceptual self-perception role-relationship sex-reproductive copiing-stress tolerance |
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macule
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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" |
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PAPULE
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elevated, solid lesion
1cm 0.5cm in diameter wart, elevated moles nodules 2cm tumors more than 2cm |
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vesicle
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circumscribed, superficial collection of serous fluid
less than 1cm/0.5 cm varicella, herpes zoster, second degree burn bulla - bigger than 1cm |
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plaque
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curcumscribed, elevated superficial, solid lesion
greater than 1cm psoriasis, seborrheic and active keratoses |
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wheal
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firm, edematous, irregularly shaped area, diamter variable
insect bite, urticaria dips down a little usually related to an allergic reaction |
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pustule
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elevated, superficial lesion filled with urulent fluid
acne, impetigo, cyst |
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fissure
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linear crack or break from the epidermis to dermis, dry or moist
athlet's foot, cracks at corner of mouth |
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scale
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excess, dead epidermal cells produced by abnormal keratinization and shedding
flaking of skin after drug rxn or scarlet fever |
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scar
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abnormal formation of connective tissue that replaces normal skin
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ulcer
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loss of the epidermis and dermis
crater-like irregular shape pressure ulcer, chancre |
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atrophy
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decression in skin resulting from thinning of the epidermis or dermis
aged skin, striae |
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excoriation
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area in which epidermis is missing, exposing the dermis
scabies, abrasion, or scratch |
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annular
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ring shaped
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gyrate
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spiral shaped
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iris lesions
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bull's eyes
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linear
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in a line
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nummular, discoid
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coinlike
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polymorphous
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occuring in several forms
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punctate
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marked by points and dots
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serpiginous
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snakelike
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for darker skin, areas easier to assess are:
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lips, mucous membranes, nail beds, protected areas
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psuedofolliculitis
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inflammatory response to ingrown haris that is thought to occur after shaving closely, characterized by pustules and papules
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keloid
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overgrowth of collagenous tissue at site of skin injury
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mongolian spots
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benign bluish-black macules
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main diagnostic techniques related to skin problems:
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inspection of the individual lesion
careful history related to the problem |
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punch biopsy
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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 |
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excisional biopsy
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useful when good cosmetic results and entire removal desired
skin closed with subq and skin sutures |
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incisional biopsy
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wedge-shaped incision made in lesion too large for excisional biopsy. useful when larger specimen than shave biopsy is needed
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shave biopsy
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single-edge razor blade used to shave off superficial lesions or small sample of a large lesion
provides full-thickness specimen of stratum corneum |
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KOH test
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hair, scales, or nails examined for superficial fungal infection
specimen is put on slide and 10-20% KOH added |
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Tzanck test
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wright's and Giemsas stain
fluid and cells from vesicles examined to diagnose herpes infections |
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Culture
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test identifieds fungal, bacterial, viral microbes
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Fungi Culture
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scraping of swab of skin
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Bacterial culture
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material obtained from intact pustules, bullae, or abscesses
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viral culture
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vesicle/bulla scraped and exudate taken from center of lesion
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mineral oil slides
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to check for infestations
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woods's lamp
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exam of skin with long-wave uv light causes specific substances to fluoresce (fungal infections, vitiligo, Pseudomonas organisms)
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Patch test
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used to determine whether a pt is alergic to any testing material
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