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507 assessment integ


epidermis restricts water loss, is AVASCULAR
dermis VASCULAR, sensory/ ANS fibers
hypodermis subcutaneous, insulation/shock absorber. less SQ will give pink clear skin like pediatrics
apocrine sweat glands begin to function at 3 months less oily, with no offensive odor
sebaceous glands can cause seborrheic dermatitis
apocrine glands at puberty enlarge, become active---increased axillary sweating---onset of body odor
sebaceous glands at puberty increase sebum in response to hormones, primarily androgen---skin appears oily---acne prone
assess skin bwo color---odor---lesions (primary/secondary)---indications of abuse
assess nails bwo color---length/condition---ridges/depressions---nail bed angle/clubbing >180 degrees
causes of clubbing most common lung ca---CV---cirrhosis---Grave's (hyperthyroid)
palpate skin to determine temp (inc/dec disease states)---moisture (most on soles, palms, intertriginous areas)---texture---turgor (indicates hydration status bwo tenting)
capillary refill normal <3 seconds
Examples of primary lesions macule---patch---papule---plaque---nodule---pustule---vesicle---bulla---wheal
examples of secondary lesions scale---crust---erosion---ulcers---fissures---excoriation---scar---atrophic scare---lichenification---keloid
example of atrophy scar
how do we describe lesions size---shape---color---texture---exudate---tenderness---surface relationship (raised/flat/depressed)---blanchin/pulsation---pattern/configuration/distribution
how do we describe pattern configuration of lesions (page 240) round/oval---discrete---grouped---confuluent---linear---annular/circular---arciform---iris---reticular---gyrate---polycyclic---
how do we describe the distribution of skin lesions (page 243) diffuse/generalized---scattered---localized---regional---torso---extensor/flexor surfaces---dermatome---interiginous (folds)---sun exposed areas
see power point for visuals --- macule flat, circumscribed <1 cm
patch (large macule) flat, irregular > 1 cm
papule (solid, elevation of skin, no visible fluid) elevated, firm, curcumscribed < 1 cm
plaque (broad raised area on skin) elevated, firm, rough, flat top > 1 cm
nodule (slightly elevated lesion, larger than papules) elevated, solid > 0.5 cm . . .deeper than paule
pustule (small elevation containing purulent material) filled with pus
vesicle (small fluid filled blister) superficial, filled with serous fluid, circumscribed < 1.0 cm
bulla (fluid-filled blister) >5 cm otherwise same as vesicle
wheat (raised, pruritic) elevated, irregular borders, edematous
secondary lesion - ulcer - big one to know, only takes 20 minutes of pressure to start process characterized by loss of epidermis or dermis---concave---size varies
2 types of ulcers decubiti---stasis ulcers
2- excoriation superficial loss/abrasion
2- fissure (chapped hands, athlete's foot) linear break in skin with defined border
2- erosion (abrasion, fragile skin, candidiasis) superficial loss of epidermis
lichenification (contact dermatitis, eczema) thickening & scaling
keloid (excess collagen) hypertrophic scarring
scar replacement CT formation
atrophy (arterial insufficiency, topical corticosteroids) thinning of skin, transparent
types of vascular lesions - 6 (pg. 231) echhymosis---petechia/purpura---venous star---telangiectasis---spider angioma---cherry angioma
purpuric lesions include ecchymosis---petechiae/purpura characteristics non-blanchable---variable size ---bwo vascular wall destruction (trauma, vasculitis)
petechia vs. purpura both non-blanchable intravascular defects. -----petechiae < 0.5cm----purpura > 0.5cm
ABCD signs of melanoma asymmetry---border irregularity---color changes/varigations---diameter > 5mm
child-related skin lesions mongolian dark spots---port-wine spots---hemangiomas---milia (white spots)
older adult skin lesions senile lentigines (falt, brown macules)----seborrheic keratosis (dark, wart-like)---acatinic karatosis (red, scaly, pre-malignant)---skin tags
expected findings skin normal color/turgor---warm/dry---no open wounds/lesions---hair/scalp without lesions/infestations---nail beds pink/smooth/160 degree base angle---nail folds without redenss/induration---capillary refill < 3 seconds
Created by: lorrelaws