LS2 Integumentary

outer layer of skin that consists of an outer dead portion, and an inner, living cellular portion

Only layer of epidermis (inner) able to undergo cell division and reproduce itself.

process by which the stratum germinativum gets its nutrition and blood supply, enabling it to repair itself

outermost layer of epidermis

consists of dead cells that have been filled with a protein called keratin, making them dry, tough, and somewhat waterproof

specialized cells that release melanin

black or dark brown pigment occuring naturally in the hair, skin, iris, and choroid of the eye

responsible for color of skin

irregular patches of concentrations of melanin

aka corium and true skin

contains glands and hair follicles, thickest in palms and soles, filled with interstitual fluid

gives stregnth to the dermis layer

small fingerlike projections that project into the lower epidermal layer, without it, the epidermal layer would not be able to survive

aka superficial fascia

layer beneath dermis, connects skin to muscle, composed of adipose tissue and loose connective tissue, provides shape and contour

Stores water and fat, insulates the body, protects organs, provides a pathway for nerves and blood vessles

sweat glands

excrete sweat, which contains water, salt, urea, uric acid, ammonia, sugar, lactic acid, and ascorbic acid

modified sudoriferous glands, secrete cerumen

located in external ear canal

waxlike substance, protects the ear canal from foreign substances.

secretes sebum through hair follicles

lubricates the skin and hair, inhibits bacteria growth

part of the root of a nail, exposed and looks like a white crescent

muscle tissue surrounding the hair follice, contracts due to cold, or fight or flight response causing piloerection or "gooseflesh"

symptom of itching

broadening of the fingertips, indicates decreased oxygen

• P-Provative/Palliative
• what provokes/helps the condition
• Q-Quality/Quantity
• characteristics of the skin/how many
• R-Region
• S-Severity of signs and symptoms
• T-Time its been present

flat, round, less than 1 cm in diameter

ex: freckles, flat moles (nevi), petechiae, measles, scarlet fever

elevated, firm, less than 1 cm in diameter

ex: wart (verruca), elevated moles, lichen planus

flat, nonpalpable, irregularly shaped macule more than 1 cm in diameter

ex: vitiligo, port-wine stains, mongolian spots, cafe-au-lait spot

elevated, firm, rough lesion with flat top surface greater than 1 cm in diameter

ex: psoriasis, seborrheic and actinic keratoses

elevated irregularly shaped area of cutaneous edema; solid, transient; variable diameter

ex: insect bite, urticaria, allergic reaction

elevated, firm lesion; deeper in dermis than papule, 1 to 2 cm diameter

ex: erythema nodosum, lipomas

elevated and solid lesion, greater than 2 cm

ex: neoplasms, benign tumor, lipoma, hemangioma

elevated, superficial, not into dermis, fillied with serous fluid; less than 1 cm diameter

ex: varicella (chicken pox), herpes zoster (shingles)

vesicle greater than 1 cm in diameter

ex: blister, pemphigus bulgaris

elevated, superficial lesion, similar to vesicle but filled with purulent fluid (pus)

ex: impetigo, acne

elevated, encapsulated lesion, in dermis or subq layer, filled with liquid or semisolid material

ex: sebaceous cyst, cystic acne

fine, irregular red lines produced by capillary dilation

ex: telangiectasia in rosacea

heaped-up keratinized cells; flaky skin, irregular, thick or thin, dry or oily, variation in size

ex: flaking of skin with seborrheic dermatitis following scarlet fever, flaking of skin following drug reaction, dry skin

rough, thickened epidermis secondary to persistent rubbing, itching, or skin irritation, often involves flexor (joint) surface of extremity

ex: chronic dermatitis

irregularly shaped, elevated, preogessively enlarging scar; grows beyond boundaries of wound; caused by excessive collagen formation during healing

ex: keloid formation following surgery

thin to thick fibrous tissue that replaces normal skin following injury or laceration to the dermis

ex: healed wound or surgical incision

loss of epidermis; linear hollowed-out crusted area

ex: abrasion or scratch, scabies

linear crack or break from the epidermis to dermis; may be moist or dry

ex: athletes foot, cracks at corner of mouth

loss of part of the epidermis; depressed, moist, glistening; follows rupture of a vesicle or bulla

ex: varicella, variola after rupture

loss of epidermis and dermis; concave, varies in size

ex: pressure sores, stasis ulcers

dried serum, blood, or pus; slightly elevated

ex: scab on avrasion, eczema

thinning of skin surface and loss of skin markings; skin translucent and paperlike

ex: striae, aged skin

• A-is the mole Asymmetrical?
• B-are the Borders irregular?
• C-is the Color uneven or irregular?
• D-has the Diameter of the growth changed recently?
• E-has the surface area become Elevated?

palm, sole of feet, underside of forearms, abdomen, and buttocks

mucous membranes, lips, nailbeds, and conjunctivae of the lower eyelids

palpate for warmth and induration

• caused by herpesvirus hominis
• Symptoms seen in both types: fatigue, pruritus, burning pain, exudate after lesions rupture, usually present 2-3 weeks, most painful during 1st week

Type 1: most common, causes common cold sore, associated with febrile conditions. no cure; usually occurs during acute illness/infection

Type 2: causes lesions in genital area, known as genital herpes, flu like symptoms occur 3-4 days after vesicles erupt (headache, myalgia (muscle pain), fever, anorexia)

Transmission: direct contact with open lesion, in type 2, primarily by sexual contact

acyclovir (Zovirax)

antiviral that alters course of the disease

warm compresses to relieve pain and pruritis, keep lesions dry and avoid direct contact, analgesics, teach proper skin care and medical asepsis, and more

shingles

causes spinal ganglia, rash generally in thoracic region following a peripheral nerve pathway, pain is burning and knife-like, tenderness and pruritus in affected area

greatest risk occurs during weakened immune system

shingles: anagesics, often times opioid analgesics, steroids or corticosteriods for inflammation and edema, lotions for pruritus ( Kenalog, Lidex), oral and IV antiviral agent acyclovir (Zovirax)

shingles: aimed at relieving pain pruritus, prevention of secondary complications, anxiety, teaching on controlling pain, applying meds and wet dressings, asepsis, preventing secondary infections, proper diet and vit C to promote healing