Assessing the Integumentary System
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| Skin | Largest organ system
Provides clues about general health
Reflects changes in the environment
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| Skin | Reflects changes in the environment because the integumentary system cells reproduce rapidly and maybe warning signs of health problems
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| Epidermis | Protects against the environment
Restricts water loss
Is avascular
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| Dermis | Vascular
Sensory fibers
Autonomic nerve fibers
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| Hypodermis | Subcutaneous tissue
Insulation, shock absorber
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| Functions of Skin | Protection
Perception
Thermal regulation
Identification
Communication
Absorption
Excretion
Production of Vitamin D
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| Stratum corneum | closely packed dead squamous cells containing keratin (waterproofing)
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| Stratum lucidum | additional layer present only in thicker skin of palms and soles
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| Cellular stratum | Cell synthesis of both keratinocytes and melaninocytes are made in the BASAL cell layer
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| 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
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| Hypodermis ( subcutaneous tissue) | Loose connective tissue filled with fatty cells
Reserve for calories
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| The Integumentary System is also related to these Other Systems | Respiratory, Digestive, Cardiovascular, Neurological, Urinary
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| Central Cyanosis | Occurs when O2 saturation is <80% and results in diffuse changes in the skin and mucous membranes.
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| Peripheral Cyanosis | Occurs in response to decreased cardiac output, evident in nail beds and lips, also may be evident when an individual is chilled.
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| 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.
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| Lesions, ulcerations, and necrosis | May develop as a result of alteration in the cardiovascular system, can lead to the development of these
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| Pruritis | Caused by toxin build up - responsible for itching of the skin.
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| Infant Skin | Smooth, pinker/redder skin, partially due to less subcutaneous tissue
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| IApocrine sweat glands begin to function around | 3 months:
less oily, no offensive odor
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| Sebum secretion (sebaceous glands) can cause | seborrheic dermatitis
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| 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.
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| Seborrheic dermatitis is also known as | cradle cap
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| Apocrine Glands, Adolescent Skin Changes | Enlarge and become active,
Increased axillary sweating
Onset of body odor
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| Sebaceous Glands, Adolescent Skin Changes | Increase sebum production in response to hormone levels-primarily androgen
Skin takes on oily appearance
Predisposition to acne
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| Sebaceous and apocrine gland activity in Older Adults | Diminishes
Skin is drier
Less perspiration produced
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| Epidermis activity in Older Adults | thins and flattens and becomes wrinkled
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| Dermis activity in Older Adults | becomes less elastic, looses collagen and becomes less vascular
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| Nail growth in Older Adults | Nail growth slows & nails become thicker, brittle, hard, yellowish, prone to splitting
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| Age spots, keratotic lesions in Older Adults | increased melanocytes
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| Graying of hair | decrease in melanocytes
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| Hair thinning in Older Adults | axillary, pubic, scalp
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| Assessment findings of Actinic Keratosis | Typically less than 1 cm in diameter
Generally on sun-exposed areas of the face, head, neck and hands
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| 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
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| What determines skin color? | Genetic factors determine the skin color. The greater amount of melanin, the darker the skin color.
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| Expected findings of an infants skin | Smooth, pinker/redder, partially due to less subcutaneous tissue
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| Primary skin lesions (9 listed): | Macule, Patch, Papule, Plaque, Nodule, Pustule, Vesicle, Bulla, Wheal
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| Describe a Macule | Flat, distinct colored area, <1 cm, nonpalpable
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| Describe a Patch | Flat, distinct colored ara, >1 cm, nonpalpable
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| Describe a Papule | Solid, elevation of skin/raised, no visible fluid, <1 cm, superficial
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| Describe a Plaque | Broad, raised area of the skin
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| Describe a Nodule | Slightly elevated lesion/palpable, larger than papules, <2 cm, solid with depth into dermis
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| Describe a Pustule | Small elevation, containing purulent material (pus filled)
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| Describe a Vesicle | Small fluid filled blister <1 cm, palpable
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| Describe a Bulla | Fluid filled blister >5 mm in diameter, palpable
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| Describe a Wheal | Raised, superficial, temporary
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| Signs of Melanoma on the skin | A - Asymmetry, B - Border irregularity/bleeding, C - Color changes or multiple colors, D - Diameter >5 mm
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| 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
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Created by:
MEPN 2013
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