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Pathology in Integum

Pathology in the integumentary system

Burns tissue damage and cell death caused by intense heat in the form of chemical, thermal, UV radiation, or electrical agents
one of the most serious threats to skin Burn
leading cause of death among burn victims Infection; Dead skin is breeding ground for bacteria; heat/water loss causes electrolyte imbalance which causes kidney failure and lose ability to protect against infection
Characteristics of Burns that Threaten life Dehydration, Electrolyte imbalance, Inadequate circulation, Suppresses immune system, Infection, Open to environment, body temp regulation
Rule of Nines Determines what percentage of the body surface area is burned, Estimates fluid loss; Divides body into 11 areas of 9% plus 1 area of 1%
Parts of the Rules of Nine (1)head 9%, (2) right arm 9%, (3) left arm 9%, front of trunk (counts as two) 18%, back of trunk (counts as two) 18%, right leg (counts as two) 18%, left leg (counts as two) 18%, genitals = 1%
What percentage makes up the head 9%
What percentage makes up each arm 9%
What percentage makes up each side of the trunk 18% front and back, each count as two, 36% total
What percentage makes up each leg 18% both legs together make up 36%
What percentage makes up the genitals 1%
Burns are classified according to severity & depth
Critical burns more than 25% is second degree, or more than 10% is third degree, or burns to face, hands, and/or feet
facial burns associated with inhalation burns & can cause respiratory damage & swelling; limits gas exchange
First degree burn red and swollen skin, only the epidermis is damaged; Temporary discomfort; Partial thickness burn; Sunburn; Regeneration of skin possible
Second degree burn Injury to epidermis and upper level of dermis, skin gets Red, swollen, blisters, and painful; Partial thickness burn; Regeneration of skin possible
Third degree burn Destroys entire thickness of skin “full thickness burn”; Gray-white, black color with nerves destroyed (Not painful); Regeneration not possible; Must receive skin graft
Skin Cancer Most common type of cancer (CA); 1 in 5 Americans have skin CA at some point in their life
Greatest risk factor of skin cancer over-exposure to sunlight (UV radiation)
Ways to Prevent skin cancer Wear sunscreen & protective clothing; limit sun exposure; Annual skin checks with dermatologist
Basal Cell Carcinoma (BCC) Cells of stratum basale effected, Shiny, dome-shaped pearly beaded edge, Rarely metastasize (spread), slow growing, only at sun-exposed areas, requires surgical removal, easy to cure
Most common type of skin CA Basal Cell carcinoma (BCC)
Least malignant type of skin cancer Basal Cell carcinoma
Squamous Cell Carcinoma Arises from stratum spinosum, Scaly, shallow ulcer with firm raised border, Metastasizes to lymph nodes, Rapid growth, Sun induced, Surgically removed, Good chance of complete cure
Metastatic (Malignant) Melanoma Cancer of melanocytes, Arises from pigmented mole, Metastasizes to lymph nodes or blood vessels, Rapid Spreading of brown/black patch, Extensive surgical excision, 50% chance of survival, even if removed it can grow back
Which skin cancer can develop into brain cancer Metastatic (Malignant) Melanoma
Examination of Pigmented Areas ABCDE; Asymmetry, border irregularity, color, diameter, elevation
Asymmetry(examining for skin cancer) two sides of pigment in mole or spot do not match(examining for skin cancer)
border irregularity(examining for skin cancer) borders of lesions are not smooth, have indentions(examining for skin cancer)
Color(examining for skin cancer) the pigmented area contains different colors(examining for skin cancer)
Diameter (examining for skin cancer) spot is >6 mm across (examining for skin cancer)
Elevation(examining for skin cancer) changes in the height of skin surface(examining for skin cancer)
Pressure Ulcer decubitus ulcers; Ischemic necrosis formed from prolonged external pressure over bony prominences; Tissue lacks oxygen (because no bloodflow) for long time
Necrosis tissue death
Common areas for pressure ulcers Sacrum, heels, ischium, hips
Risk factors of Pressure ulcers Decreased ability to move, Decreased sensation (paralyzed), Decreased body fat and muscle tissue (just skin on bone), Decreased cognition, Incontinence, Amount of pressure distributed over surface area
Incontinence Inability to control one’s bowels
Contact Dermatitis Itching, redness, & swelling, May have blisters; Acute or chronic skin inflammation
Allergic responses causing contact dermatitis Poison ivy, Latex, Soaps
Psoriasis Chronic condition, auto-immune disorder that attacks tissues; Overproduction of cells Dry, scaly, cracking, red lesions that Itch and burn, Disfiguring and painful
What is psoriasis triggered by stress, trauma, hormones, infections
Scabies Transmissible parasitic infection; Mite burrows into stratum corneum and burrow eggs; Larva congregate around hair follicles; Associated with very poor hygiene
Athlete’s foot “tinea pedis” itchy red, peeling condition of the sin between the toes, from fungal infection
Boils and carbuncles inflammation of hair follicles and sebaceous glands caused by bacterial infection (staphylococcus aureus)
Cold Sores (fever blisters) fluid-filled blisters that itch and sting, caused by herpes simplex infection
Port Wine Stain Also called Hemangioma, Birthmark, Very large w/ lots of vascular supply (blood vessels) so it looks very red; Hyperplasia vascular lesion of skin and subcutaneous tissue; Flat, Pink-red-purple
Keloid Scarring Excessive proliferation of connective tissue during healing of open skin that causes a Large thick scar on skin surface that looks Shiny, smooth, dome-like, no prevention, can be corrected with pressure guard
Keloid Scarring is More common among those with darker skin, Blacks, Middle eastern
Albinism Rare, Inherited disorder, auto-somal recessive trait, Have melanocytes but Missing enzyme that makes melanocytes produce melanin, causes Pale skin, white hair, and light eyes (blue)
Vitiligo Loss of brown pigment from areas of skin (depigmentation) that look like Irregular white patches caused from Melanocytes that die or are unable to function; Unknown causes either Auto-immune, Genetic, Stress, Viral
Allopecia Hair loss also called Male pattern baldness
Created by: alechsu



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