Integumentary system

engulf foreign substances when skin is injured

• sun exposure is the single most important factor leading to skin degeneration
• other changes such as decrease in collagen or hyper/hypo pegmentation

integrity (moisture, skin lesions, edema) and assisting with hygiene

• A: asymmetry
• B: border irregularity
• C: color variation
• D: diameter greater than 6mm
• E: evolving or changing in any feature (shape, size, color, elevation, itching, bleeding, crusting)

• Pearly papule 
• Irregular borders-waxy-asymmetrical
• Basal cell carcinoma

• squamous cell carcinoma
• red, crusty, asymmetrical, lesion.

• actinic keratosis
• macule 
• black, crusty, bleeding, scabby,

• Actinic Keratosis
• (premalignant lesion squamous cell CA)Small macule/papule with dry, rough, yellow or brown scale

• Squamous Cell Carcinoma
• Firm, nodular lesion with crusty or ulcerated top
• Indurated margins
• May be attached to underlying tissue w/deep invasion

• Basal Cell Carcinoma
• Pearly papule, central crater, waxy borders, telangiectasias

• Basal Cell Carcinoma
• Pearly papule, central crater, waxy borders, telangiectasias

• common disorder
• most are allergic immune responses
• S&S: severe itching, lesions with indistinct borders, different distribution patterns

• superficial infection of the folicle
• Bacterial: staph
• Rash that is raised, red, may have small pustules

• Deep infection of the follicle
• Bacterial: Staph/strep
• small, tender, red nodules, develop pus overtime

collection of furuncles with many heads

• bacterial skin infection of the deeper connective tissue
• can be secondary to a wound
• staph and strep very common.

• are infecting fungi that live in soil, on animals and humans. 
• Spreads via direct contact and some can survive for a limited time on items fomites

• Grows easily in moist, warm environments
• is a common superficial fungal infection.
• Risk factors: immunosuppressed patients, long-term antibiotic therapy, DM, Obesity, hot-humid climates

• Type 1: oral-cold sores
• Type 2: Genital herpes
• Dormant in nerve ganglia
• Reactivated by stress
• Outbreak 3-10 days, Virus sheds for 3-5 days
• Tingling or burning prior to presentation
• Herpatic whitlow-Herpes infection on fingertips of healthcare workers easily transmitted to patients.

• reactivation of varicella zosters in root ganglia leading to shingles-similar lesions to herpes-they follow nerve pathways.
• Neuralgia: severe pain after lesions have disappeared.

• red, papular rash on the trunk
• commonly related to viruses

• Sun/UV exposure
• Monthly self-skin examinations
• regular skin hygiene-clean and dry
• childbearing women should know risks associated with drugs for skin

to check for abrasions and ulcerations

to assess for color blindness

• imbalance between production and outflow of aqueous humor. If IOP becomes too high it compresses retinal blood vessels and photoreceptors.
• treatments-eye drops, apply pressure to lacrimal ducts to prevent systemic absorption.

20/200 or less

mechanical problem with moving the sound waves through the outer ear to the middle ear.  Common causes include cerumen impaction, infection, destruction of the ossicles.

problem with the inner ear sensing sound waves.  Usually due to destruction of cilia within the ear canals

hearing loss due to damage of the vestibulo nerve, usually from ototoxic drugs

hearing loss with age

Avoid foods high in caffeine or salt, manage stress, anxiety, migraines, allergies,

disorder of the inner ear that leads to vertigo