What do melanocytes do?
Gives color to the skin and hair
Protects the body from UV sunlight
What do keratinocytes do?
Move to surface as they mature --> flatten and die to form outer skin layer
Protective barrier function
What creates fingerprints?
The papillary layer of the dermis
What does collagen do?
Creates the mechanical strength of the skin
What type of cell creates collagen?
Is the subcutaneous tissue part of the skin?
What does the subcutaneous tissue do?
Attaches skin to underlying tissues such as muscle + bone
Where do nails "grow from"?
How long does it take a lost fingernail to regenerate?
3 - 6 months
How long does it take a lost toenail to regenerate?
12 months +
What are melanonychea striata?
Pigmented longitudinal bands
Commonly occur in the nail bed of approximately 90% of dark skinned people
What are the two major types of glands associated with the skin?
Sebaceous and Sweat
What are the two types of sweat glands?
Apocrine and Eccrine
What do apocrine sweat glands do and where are they located?
In the axillae, breast areolae, umbilical and anogenital areas
Secrete a thick millky substance of unknown composition that becomes odoriferous by skin's bacteria
What do eccrine sweat glands do and where are they located?
All over the body
What are the functions of the sweat glands?
Cool the body
Excrete waste products
Moisturize surface cells
What are some common skin changes in the aging adult?
Increased skin fragility
What are actinic keratoses?
Premalignant cutaneous lesions
Seen in older adults on areas of chronic sun exposure
Especially in those with fair complexion and light eyes
What can the decrease in subcutaneous tissue seen in older adults contribute to?
Increased risk of traumatic injury
Skin shearing --> pressure ulcers
What systemic problem might jaundice indicate?
What systemic problem might delayed wound healing indicate?
What systemic problem might cyanosis indicate?
What systemic problem might pallor indicate?
What are some common areas/questions to ask during the integumentary system assessment?
Health-Perception/Health Management --> Daily hygiene practices
Nutritional/Metabolic --> Dietary changes
Elimination --> Dehydration, edema, pruritus
Activity/Exercise --> Environmental hazards in work/activities
Sleep/Rest --> Skin condition keep you up/disturb sleep
Cognitive/Perceptual --> Perception of heat, cold, pain, touch
Self-Perception/Self-Concept --> Feel about self because of skin
Role/Relationship --> Skin changed relationships/roles
Sexuality/Reproductive --> Skin changed sexuality/Medications for skin affect reproduction
Coping/Stress Tolerance --> Role of stress in creating/exacerbating skin conditions
Value/Beliefs --> Culture/religious beliefs influence perception or treatments
What is a macule?
Circumscribed, flat area w/change in skin color less than .5 cm
What is a patch?
Circumscribed, flat area w/change in skin color more than .5 cm
What is a papule?
Elevated, solid lesion less than .5 cm
What is a nodule?
Elevated, solid lesion more than .5 cm
What is a vesicle?
Circumscribed, superficial collection of serous fluid less than .5 cm
What is a plaque?
Circumscribed, elevated, superficial, solid lesion more than .5 cm
What is a wheal?
Firm, edematous, irregularly shaped area
What is a Pustule?
Elevated, superficial lesion, filled with purulent fluid
What is a fissure?
Linear crack or break, dry or moist
Cracks in corner of mouth
What is a scale?
Excess, dead epidermal cells
Flaking of skin after drug reaction or sunburn
What is a scar?
Abnormal formation of connective tissue that replaces normal skin
What is an ulcer?
Loss of epidermis and extending into dermis; crater-like; irregular shape
What is an atrophy?
Depression in skin resulting from thinning of epidermis or dermis
What is an excoriation?
Area in which epidermis is missing, exposing the dermis
What does cyanosis look like?
What does cyanosis look like in the darker skinned person?
Ashen or gray color
What does ecchymosis look like?
What does ecchymosis look like in the darker skinned person?
Purple to brownish black
What does erythema look like?
What does erythema look like in the darker skinned person?
Deeper brown or purple skin tone
What does jaundice look like?
Yellowish coler of skin, sclera
What does jaundice look like in the darker skinned person?
Yellowish-green most obvious in sclera (not to be confused with yellow eye pigmentation, which may be evident in dark-skinned people)
What does pallor look like?
What does pallor look like in the dark skinned person?
Underlying red tone absent
What does petechia look like?
Small, reddish-purple pinpoint lesions
What does petechia look like in the dark skinned person?
Difficult to see
What color does melanin produce?
What color does carotene produce?
What color does oxyhemoglobin produce?
What color does reduced hemoglobin produce?
Where is the best place to get a view of the truest skin color?
In photo-protected areas such as the buttocks
What does confluent mean?
What does discrete mean?
Separate from other lesions
What does grouped mean?
Cluster of lesions
What does solitary mean?
A single lesion
What does zosteriform mean?
Bandlike distribution along a dermatome area
What is an angioma?
Benign tumor of blood or lymph vessels
What is purpura?
Bleeding disorder caused by ecchymosis or petechiae
What is causing the redness of a lesion if it blanches on direct pressure and then refills?
Dilated blood vessels
What is causing the redness of a lesion if it does not blanch and the discoloration remains?
Subcutaneous or intradermal bleeding or
Presence of a nonvascular lesion
What should be recorded if lesions are found?
What should be inspected regarding the skin?
Signs of breakdown
What should be inspected regarding hair?
What should be inspected regarding nails?
What should be noted during palpation of the skin?
What is carotenemia/carotenosis?
Yellow discoloration of skin w/ no yellowing of sclerae
What is comedo/acne lesion?
Enlarged hair follicle plugged w/ sebum, bacteria, and skin cells
What is a cyst?
Sac containing fluid or semisolid material
What is a hematoma?
Extravasation of blood of sufficient size to cause visible swelling
What is hirsutism?
Male distribution of hair in women
What is intertrigo?
Dermatitis of overlying surfaces of the skin
What is lichenification?
Thickening of the skin
What is a mole/nevus?
Benign overgrowth of melanocytes
What is telangiectasia?
Visibly dilated, superficial, cutaneous small blood vessels
Commonly on face and thighs
What is varicosity?
Increased prominence of superficial veins
What is vitiligo?
Complete absence of melanin/pigment resulting in chalky white patch
What is dermatosis papulosa nigra?
Small, pigmented wartlike papules commonly found on the face in darker skinned people
What is Naevus of Ota?
Slate-gray or blue-gray birthmark located on forehead or face around the eye of darker skinned people
What is traction alopecia?
Hair loss from hair rollers or tight braiding in darker skinned people
What is pseudofolliculitis?
Inflammatory response to ingrown hairs
Occurs after shaving too closely in the beard area
Pustules and papules
When is a biopsy done?
When a malignancy is suspected or
A specific diagnosis is questionable
What is a punch biopsy?
Provides full-thickness skin for diagnostic purposes
Includes dermis and some fat
What is an excisional biopsy?
Used when good cosmetic results and/or entire lesion removal is desired
Skin closed with sutures
What is an incisional biopsy?
A wedge shaped incision made in lesion too large for excisional biopsy
Useful when larger specimen than shave or punch biopsy is needed
What is a shave biopsy?
Single-edged razor blad used to shave off superficial lesions or small samples of large lesions
The primary function of the skin is:
Age-related changes in the skin include:
Loss of collagen
Thicker, brittle nails
When assessing the activity-exercise pattern in relation to the skin, the nurse questions the patient regarding:
Protection against sun exposure
During the physical examination of a patient's skin, the nurse would:
Pinch up a fold of skin to assess for turgor
The nurse assessed the skin lesions as circumscribed, superficial, elevated, solid, and greater than .5 cm in diameter. They would be called:
To assess the skin for temperature and moisture, the most appropriate technique for the nurse to use is:
Individuals with dark skin are more likely to develop:
On inspection of the patient's skin, the nurse notes hypertrophied scarring at the site of a prior injury to the skin. This assessment abnormality is called:
Diagnostic testing is recommended for skin lesions when:
A more definitive diagnosis is needed.