Integumentary

Question 1

What are primary vs secondary lesions?

Answer 1

Primary lesions: Anything that is not normal of the skin. (mole, bruise)

Secondary lesions: A lesion that results from a lesion (scratching, crusting)

Question 2

Pressure ulcers

What are they?

Why do they commonly result?

Answer 2

• Sores that result from prolonged, unrelieved pressure
• Bone (tailbone, heel) presses on b.v. and causes decreased blood supply and necrosis

Question 3

What are these things that can cause pressure ulcers:

• Shearing
• Friction

Answer 3

• Shearing: Two surfaces move against each other (patient moves against mattress)
• Friction: Two surfaces rubbing against one another (both surfaces move: sheets)

Question 4

What are these stages of pressure ulcers:

• Stage 1
• Stage 2

Answer 4

Stage 1: Non-blanchable erythema intact skin

Stage 2: partial thinckness Skin loss involving epidermis/dermis

Question 5

What are these stages of pressure ulcers:

• Stage 3
• Stage 4

Answer 5

• Stage 3= Full thickness skin loss with loss of fatty tissue
• Stage 4: Full thickness skin loss with damage to muscle/ligaments/bones (appears silvery)

Question 6

What are these types of pressure ulcers:

• Suspected deep tissue injury
• Unstageable:

Answer 6

Deep tissue: Discolored intact skin (purple/maroon) (feels mushy)

Unstageable: Full tissue loss but covered by slough or eschar

Question 7

What are the preventative techniques for pressure ulcers:

Answer 7

• Skin assessment (every shift)
• Frequent Reposition/pressure reduction
• Elimination of moisture

Question 8

What are some risk factors of pressure ulcers:

Answer 8

• Malnutrition (lack of protein)
• Previous ulcers
• lack of movement

Question 9

What are these terms:

• Comedome
• Burrow

Answer 9

Comedome: Oil gland that gets plugged with dirt/debris

Burrow: Parasite that burrows through skin

Question 10

What are these terms:

• Petechiae
• Purpura
• Telangiectasia

Answer 10

Petechiae: Little red pinpoints from rupture capillary

Purpura: Large purble/blue skin from ruptured capillary

Telangiectasia: Dilated superficial blood vessels

Question 11

Pruritus

What is it/what is it caused by?

Answer 11

Pruritus: Itching caused by mediators like histamine

Question 12

Eczema:

What are these types of dermatitis:

What are the treatments

Answer 12

Inflammation/thickening of skin that cause bumps/pruritus

Treatment: Antihistamine

Question 13

What is alergic contact dermatitis:

Answer 13

Type 4 allergic reaction (T-cell mediated/delayed) that causes dermatitis from contact with allergen

(poison ivy)

Question 14

• What is irritant contact dermatitis?
• What is Atopic Dermatitis?

Answer 14

Irritant contact

Innate immune response from skin irritation (not an allergy)

Atopic Dermatitis:

Type 1 hypersensitivity (IgE antibodies) from asthma, allergies, etc…

Question 15

What is Stasis Dermatitis?

What are the treatments?

Answer 15

Inflammation of skin from venous stasis/edema

Treatments:

• Elevate legs
• Avoid standing still for long periods

Question 16

What is seborrheic dermatitis?

Answer 16

Inflammation of primarily scalp/face (can be anywhere)

• Scaly, dry flaky skin (dandruff or cradle cap)

Question 17

What is Psoriasis?

Answer 17

Chronic skin disorder that causes thick, silvery scales

• Skin growth rate is higher than falloff rate

Question 18

What is the difference in eczema and psoriasis?

Answer 18

Eczema

is thought to be environmental

Inflamed skin

Psoriasis

Autoimmune

Buildup of skin

Question 19

What is Vasiculobullous diseases:

• Pemphigus
• Erytema multiforme

Answer 19

• Pemphigus= Painful blisters
• Erythema multiforme= Bullseye lesions that can pop and increase risk for infection

Question 20

What are these types of bacterial infections:

• Folliculitis
• Curbuncles
• Impetigo

Answer 20

Folliculitis: Single infected hair follicle

Carbuncle: Group of infected hair follicles

Impetigo: Skin infection that causes honey, crusted lesions

Question 21

What are these types of fungal infections:

Tinea

Candidiasis

Answer 21

Tinea: Fungal infection of skin

Candidiasis: Uncontrolled growth of fungus (yeast infection)

Question 22

What are these viral infections:

• Herpes simplex
• Herpes zoster/varicella
• Warts

Answer 22

Herpes: Chronic sores of mouth/genitals

Herpes zoster/varicella: Virus that causes scaly skin lesions (chicken pox)

Warts: benign tumor caused by human papillomavirus

Question 23

What are these types of insect infestations:

Scabies

Pediculosis

Answer 23

Scabies: Insect that burrows through the skin

Pediculosis: Infestation of the hair (lice/crabs)

Question 24

What is Urticaria?

What are the treatments?

Answer 24

Circumscribed area of raised/red skin (hives)

Most resolve without treatment

Question 25

What is this benign tumor: **seborrheic keratosis**?

Answer 25

Darkened, skin growth on older adults.

Question 26

What is Actinic keratosis?

Answer 26

Pre-malignant crusty, scaly lesion

Question 27

What are nevi?

Answer 27

Moles: Increased deposits of melanin

Question 28

Basal cell carcinoma What is it? Growth rate/metastasis?

Answer 28

Skin cancer of deeper layer of epidermis (crusty looking) Grows slowly, metastasis is rare

Question 29

_Squamous cell carcinoma_ What is it? Can it metastasize?

Answer 29

Tumor of epidermis Often either pre-invasive (in-situ) or will be invasive

Question 30

What are first degree burns? What are the signs?

Answer 30

Burn of the epidermis only. Loal pain/erythema

Question 31

What are second degree burns? What are the signs?

Answer 31

Burn of the epidermis as well as dermis. * Most painful type of burn * Blisters will form

Question 32

What are third degree burns? What are the signs?

Answer 32

Burn that involves epidermis, dermis, and subcutaneous tissue. * Charred/blackened/white skin * No pain (nerves destroyed)

Question 33

Burns that go around extremeties increase the risk for:

Answer 33

Contractures: Elastic skin is replaced with **scar** tissue that is **not stretchy** (joint loses movement)

Question 34

How do you estimate percentage of body that is burned?

Answer 34

Question 35

What happens **internally** when someone gets a major burn?

Answer 35

Fluid/electrolyte/protein are lost into tissues (**edema**) * Blood pressure drops * Hypovolemia Liver enlarges * Blood clotting factors increase

Question 36

What is **burn shock**?

Answer 36

Shock= massive blood/fluid loss Burn shock= Burn victims have **decreased cardiac output** (less blood to organs)

Question 37

What changes of the blood contents occur with burn victims?

Answer 37

WBCs and Hct counts increase (do not leak out) Hyperglycemia (enlarged liver)

Question 38

What happens to the metabolism of a burn victim? What occurs in response?

Answer 38

Metabolism increases: * Core body temperature increases (fever) * Hypercapnea (too much CO2)

Question 39

What are the secondary risks for burn victims?

Answer 39

* Fluid loss from skin (sweating) and lungs (increased RR) * Increased infections (skin breakdown)

Question 40

What are stomach ulcers that occur in burn victims?

Answer 40

**Curling ulcers** (stress that occurs internally)

Question 41

* What is frostbite? * What injuries result from it?

Answer 41

* Skin tissue freezes through exposure to extreme cold. * Inflammation and reperfusion (damage caused by blood return)

Question 42

What are the 3 stages of frotbite?

Answer 42

**_Frostnip_** Skin turns red **_Superficial Frostbite_** Skin turns white/blisters **_Deep frostbite_** Skin turns black/all layers of skin

Question 43

* Loss of hair is known as:

Answer 43

Alopecia

Question 44

Abnormal growth of hair is known as:

Answer 44

Hirsutism

Question 45

* What is paronychia? * What is onychomycosis?

Answer 45

Parnychia: Infection of cuticle Onchomycosis: Fungal infection of nail