Integumentary

Question 1

Layers of the skin

Answer 1

epidermis: keratinocytes; melanocytes, langerhans cells, merkel cells
dermis: collagen, elastin, reticulin, fibroblasts, mast cells, macrophages
subcutaneous: adipose tissue

Question 2

How does the skin regulate heat loss?

Answer 2

1. variations in skin blood flow thru opening and closing of arteriovenous anastomoses (vasodilation & constriction) - controlled by SNS
2. evaporative heat loss of sweat

Question 3

What composes fingernails and toenails?

Answer 3

1. proximal nail fold
2. eponychium (cuticle)
3. matrix where nail grows & nail root
4. hyponychium (nail bed)
5. nail plate
6. paronychium (lateral nail fold)

Question 4

What do sebaceous glands secrete?

Answer 4

sebum - lipids; oils the skin and hair and prevents drying
androgens stimulate growth of sebaceous glands (enlargement = puberty)

Question 5

what do eccrine glands secrete?

Answer 5

sweat
important in thermoregulation and cooling of the body thru evaporation

Question 6

What do apocrine glands secrete?

Answer 6

sweat
produce more sweat than eccrine glands

Question 7

What changes occur to the skin due to aging?

Answer 7

-thinner, drier, wrinkled, less elastic, changes in pigmentation
-number of capillary loops shorten and decrease
-fewer melanocytes and langerhans cells
-sebaceous & sweat glands atrophy
-temp regulation compromised
-reduced sensory perception, decreased pressure & touch receptors, decreased nerve endings
-protective functions of skin decreased (increased infection & delayed wound healing)

Question 8

primary skin lesions

Answer 8

papule
plaque
vesicle
bullae

Question 9

secondary skin lesions

Answer 9

ulcer
fissure
scale

Question 10

pressure injuries

Answer 10

localized damage to skin & underlying soft tissue usually over bony prominence or medical device
-from pressure, heat, or combo of both

Question 11

stage 1 pressure injury

Answer 11

non-blanchable erythema of intact skin

Question 12

stage 2 pressure injury

Answer 12

partial-thickness skin loss with exposed dermis

Question 13

stage 3 pressure injury

Answer 13

full-thickness skin loss

Question 14

stage 4 pressure injury

Answer 14

full-thickness skin and tissue loss

Question 15

unstageable pressure injury

Answer 15

obscured full-thickness skin and tissue loss

Question 16

deep tissue pressure injury

Answer 16

persistent non-blanchable deep red, maroon or purple discoloration

Question 17

nonmelanoma skin cancer

Answer 17

basal cell carcinoma & squamous cell carcinoma
most prevalent

Question 18

melanoma skin cancer

Answer 18

most serious and most common cause of death

Question 19

basal cell skin cancer

Answer 19

surface epithelial tumor
depressed centers with rolled borders
most common cancer
UV radiation exposure & arsenic in food or water, radiation

Question 20

squamous cell skin cancer

Answer 20

tumor of the epidermis
firm with granular surface that bleeds easily
second most common
2 types: in situ and invasive
assoc. w lip cancer too

Question 21

melanoma

Answer 21

malignant tumor originating from transformation of melanocytes
most serious; incidence increases w age
UV radiation exposure, light skin, pesticide exposure

Question 22

melanoma warning signs

Answer 22

asymmetry
border
color variation
diameter > 6 mm
elevation or evolving

Question 23

frostbite

Answer 23

skin injury from exposure to extreme cold temps
burning rxn caused by alternating cycles of vasoconstriction & dilation
inflammation and reperfusion
common area: fingers, toes, ears, nose, cheeks
mild: pallor, pain, red, discomfort
severe: white, yellowish, waxy texure, numbness & no sensation of pain

Question 24

superficial (1st degree) burn

Answer 24

epidermis
warm, erythematous, painful, blanching, dry w/o blisters

Question 25

partial-thickness (2nd degree) burn

Answer 25

involves epidermis and penetrates dermis wet, weeping, erythematous, painful, blistering or sloughing 2 types: superficial partial-thickness injury: blanching, more painful deep partial-thickness: nonbleaching, less painful, pink or pallor

Question 26

full-thickness (3rd degree)

Answer 26

penetrates to the subcutaneous tissue, affecting all dermal layers dry, leathery, waxy, nonblanching, eschar

Question 27

acute phase of burn

Answer 27

hypovolemia & edema fluid resuscitation monitor urine output

Question 28

long term phase of burn

Answer 28

heightened metabolic activity transmembrane cellular damage loss of skin barrier immunologic response

Question 29

paronychia

Answer 29

acute or chronic inflammation of the lateral and/or proximal nail fold

Question 30

onychomycosis

Answer 30

chronic infection of toenails or fingernails

Question 31

impetigo *

Answer 31

-common & highly contagious bacterial infection -direct & indirect transmission -usually caused by Strep pyogenes -incidence is high in hot, humid climates -CM: small vesicles w honey colored rust, lesions on face around nose and mouth, hands and other exposed areas

Question 32

staphylococcal scalded-skin syndrome

Answer 32

caused by toxin-producing group of staphylococcous infants to children <5 y/o CM: large sheets of top layer of skin peel away, fluid filled blisters, fever, malaise or irritability, severe pain

Question 33

molloscum contagiosum

Answer 33

poxvirus skin to skin, fomite, autoinoculation transmissions virus encourages epidermal cell proliferation and blocks immune response CM: discrete, slightly umbilicated, dome-shaped, waxy or pearl-like papules

Question 34

rubella

Answer 34

ribonucleic acid (RNA) virus CM: faint maculopapular rash on face, spreading to the trunk and extremities, sparing palms and soles of feet, itchy lasting 3 days vaccination: MMR treatment: rest and fluids

Question 35

measles (rubeola)

Answer 35

-direct contact w infectious droplets or airborne spread -CM: prodrome: high fever, malaise, cough, conjunctivitis, cough, enlarged lymph nodes, runny nose, koplik spots (mouth lesions), erythematous maculopapular rash (head and spreads over trunk and extremities) prevention: vaccination

Question 36

roseola *

Answer 36

human herpes virus CM: fever lasting 3-5 days, erythematous, nonpruritic macular rash that lasts 24-48 hrs & develops over trunk, neck, and arms no treatment required

Question 37

hand, foot, and mouth disease

Answer 37

coxsackievirus droplet transmission CM: fever, mouth sores, vesicular rash (hand & feet)

Question 38

scabies

Answer 38

transmitted by contact CM: severe itching (worse at night), rash - papules, pustules, burrows

Question 39

lice

Answer 39

head, body, or pubic area transmitted by direct contact

Question 40

cutaneous hemangioma (birth marks)

Answer 40

benign tumors; endothelial cell proliferation superficial: strawberry hemangioma deep: cavernous hemangioma