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IntegumentaryDisorders

IntegumentaryDisorders

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Published by: dlneisha61 on Mar 19, 2009
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01/30/2013

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INTEGUMENTARY DISORDERS
Structures & Functions of Skin & Appendages
Epidermis
Stratum Corneum
(outer layer of dead keratinized cells) flat scale likecells called squamous cells
Stratum Germinativum
(basal cell layer)– cells migrate from basal layerupward to corneum and sheds
Structures & Functions of Skin & Appendages
Dermis
Papillary layer-
upper thin layer
Reticular layer
- deep thick layer
1
 
Fibroblast cells-
Primary cell type fround in the
 
dermis
Subcutaneous Tissue (fat) -
 
below the dermis an is not part of theskin.
 
Skin (epidermal) Appendages
– down growths of epidermis intodermis; develop from epidermis- Hair & Hair Follicles- Nails- Glands:
Sebaceous glands
– secret sebum which is emptied into the hair follicles- prevents skin from drying
Apocrine Glands
-
 
sweat glands secrete milky substance that becomesodoriferous when altered by skin surface bacteria 
Eccrine Glands-
widely distributed over the body, except in a few areas,such as the lips.
-
These glands function to cool the body by evaporation, toexcrete waste products, and moisturize surface cells
Function of Skin:
A.
Protection
B.
Homeostasis
 C.
Thermoregulation 
D.
Sensory Reception
E.
Aesthetic functions
- include the mirrowring of various emotions such asanger or embarrassment, as well as displaying te individualidentity of a person.
Effects of Aging on the Skin
2
 
Adolescence
surge of hormones (androgens) lead to maturation of hairfollicles, sebaceous glands, apocrine and eccrine units. Sweat, odor, acne,Pigmented nevi (freckles)
Adult
– male baldness, facial hair on women, sebaceous cysts, skin tags
Older Adulthood
– thinner skin; more sensitive to minor changes in humidity,temperature, wrinkles due to weakened collagen;
Lentigines
(liver spots – havenothing to do with liver) black or brown flat lesions can appear anywhere, but onface and dorsum of hand from prolonged sun exposure. (“Aging” pigment– leftover from broken-down cells)
Assessment of the Integumentary System
A. HistoryB. Physical Exam
Good lighting (natural lighting), privacy, moderate room temp, expose sectionat a time, pt comfortable
Systematic –
proceed head-to-toe; compare symmetrical parts; performgeneral inspection then lesion specific exam
Inspect general color & pigmentation, vascularity or bruising, presence oflesions or discoloration
Vascularity ( angioma, petechiae, purpura)
Lesion –
color, size, distribution, location, shape recorded; also configuration(pattern) and distribution (arrangement); note odor
Refer to Table 22-7 & 22-8, pg. 483
Tattoos, needle-track marks
Lesion Configuration
Annular
- ring-shaped
Gyrate
- Ring-Spiral-shaped
Iris lesions
- Concentric rings or “bull’s eyes”
Linear
- In a line
Nummular, discoid
- Coinlike
Polymorphous
- Occurring in several forms
Punctuate
- Marked by points or dots
Serpiginous
- Snakelike
3

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