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Dillion Ch 10

Assessing the Integumentary System

QuestionAnswer
Skin Largest organ system Provides clues about general health Reflects changes in the environment
Skin Reflects changes in the environment because the integumentary system cells reproduce rapidly and maybe warning signs of health problems
Epidermis Protects against the environment Restricts water loss Is avascular
Dermis Vascular Sensory fibers Autonomic nerve fibers
Hypodermis Subcutaneous tissue Insulation, shock absorber
Functions of Skin Protection Perception Thermal regulation Identification Communication Absorption Excretion Production of Vitamin D
Stratum corneum closely packed dead squamous cells containing keratin (waterproofing)
Stratum lucidum additional layer present only in thicker skin of palms and soles
Cellular stratum Cell synthesis of both keratinocytes and melaninocytes are made in the BASAL cell layer
Dermis CT, Papillae project into epidermis to provide nourishment Autonomic nerve fibers innervate BVs, glands, arrectores “goose bumps” (tiny “hair erector” muscles, due to fear/cold) Collegen, elastin, reticulin fibers provide strength, stability, resillence
Hypodermis ( subcutaneous tissue) Loose connective tissue filled with fatty cells Reserve for calories
The Integumentary System is also related to these Other Systems Respiratory, Digestive, Cardiovascular, Neurological, Urinary
Central Cyanosis Occurs when O2 saturation is <80% and results in diffuse changes in the skin and mucous membranes.
Peripheral Cyanosis Occurs in response to decreased cardiac output, evident in nail beds and lips, also may be evident when an individual is chilled.
Jaundice A yellowish discoloration of the skin that often results when bile excretion is impaired, due to a dysfunctional liver that causes bile build up.
Lesions, ulcerations, and necrosis May develop as a result of alteration in the cardiovascular system, can lead to the development of these
Pruritis Caused by toxin build up - responsible for itching of the skin.
Infant Skin Smooth, pinker/redder skin, partially due to less subcutaneous tissue
IApocrine sweat glands begin to function around 3 months: less oily, no offensive odor
Sebum secretion (sebaceous glands) can cause seborrheic dermatitis
Physiologic jaundice Yellowish staining of the skin and whites of the newborn's eyes (sclerae) by pigment of bile (bilirubin). In newborn babies a degree of jaundice is normal.
Seborrheic dermatitis is also known as cradle cap
Apocrine Glands, Adolescent Skin Changes Enlarge and become active, Increased axillary sweating Onset of body odor
Sebaceous Glands, Adolescent Skin Changes Increase sebum production in response to hormone levels-primarily androgen Skin takes on oily appearance Predisposition to acne
Sebaceous and apocrine gland activity in Older Adults Diminishes Skin is drier Less perspiration produced
Epidermis activity in Older Adults thins and flattens and becomes wrinkled
Dermis activity in Older Adults becomes less elastic, looses collagen and becomes less vascular
Nail growth in Older Adults Nail growth slows & nails become thicker, brittle, hard, yellowish, prone to splitting
Age spots, keratotic lesions in Older Adults increased melanocytes
Graying of hair decrease in melanocytes
Hair thinning in Older Adults axillary, pubic, scalp
Assessment findings of Actinic Keratosis Typically less than 1 cm in diameter Generally on sun-exposed areas of the face, head, neck and hands
Assessment findings of Seborrheic Keratosis Sharply demarcated lesions Brown to black pigmentation Rough, dry surface Elevation, with pasted or stuck-on appearance Surrounding skin generally normal Incidence increases with age Generally found on trunk, although potentially can occur anywhere
What determines skin color? Genetic factors determine the skin color. The greater amount of melanin, the darker the skin color.
Expected findings of an infants skin Smooth, pinker/redder, partially due to less subcutaneous tissue
Primary skin lesions (9 listed): Macule, Patch, Papule, Plaque, Nodule, Pustule, Vesicle, Bulla, Wheal
Describe a Macule Flat, distinct colored area, <1 cm, nonpalpable
Describe a Patch Flat, distinct colored ara, >1 cm, nonpalpable
Describe a Papule Solid, elevation of skin/raised, no visible fluid, <1 cm, superficial
Describe a Plaque Broad, raised area of the skin
Describe a Nodule Slightly elevated lesion/palpable, larger than papules, <2 cm, solid with depth into dermis
Describe a Pustule Small elevation, containing purulent material (pus filled)
Describe a Vesicle Small fluid filled blister <1 cm, palpable
Describe a Bulla Fluid filled blister >5 mm in diameter, palpable
Describe a Wheal Raised, superficial, temporary
Signs of Melanoma on the skin A - Asymmetry, B - Border irregularity/bleeding, C - Color changes or multiple colors, D - Diameter >5 mm
Age-related skin lesions of older adults -Senile lentigines: flat brown macules -Seborrheic keratois: dark, wart-like -Acatinic keratosis: red, scaly, pre-malignant -Skin tags
Created by: MEPN 2013