Integumentary System Quiz

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Questions and Answers

What is the primary composition of the epidermis?

Keratinized stratified squamous epithelium (correct)

Non-keratinized cuboidal epithelium

Loose connective tissue and fibroblasts

Collagen fibers and adipose tissue

Which layer of skin is typically described as 'thin skin'?

Plantar surface of the feet

Most areas of the body (correct)

Palmar surface of the hands

The eyelid area

Which of the following layers is absent in thin skin?

Stratum spinosum

Stratum granulosum

Stratum lucidum (correct)

Stratum corneum

What structures are found within the dermis?

Hair follicles and sweat glands Signup and view all the answers

Which statement best describes a disorder?

A disturbance in the function of a body part Signup and view all the answers

What is the location of the stratum lucidum?

Between the stratum corneum and stratum granulosum in thick skin Signup and view all the answers

Which best defines a 'condition' in terms of health?

A state of being in health or disease Signup and view all the answers

Which component is NOT found in the epidermis?

Blood vessels Signup and view all the answers

What is the primary component produced by fibroblasts that contributes to the structure of the dermis?

Collagenous fibers Signup and view all the answers

Which pigment is primarily responsible for skin color and is produced by melanocytes?

Melanin Signup and view all the answers

What is the defining characteristic of petechiae?

Round red or purple macule of 1-2 mm Signup and view all the answers

Which type of angioma is typically noted on the trunk and extremities?

Cherry Angioma Signup and view all the answers

What is a significant feature of telangiectasia?

It does not blanch with pressure Signup and view all the answers

In which area does acne vulgaris most commonly affect the skin?

Face Signup and view all the answers

What morphological feature differentiates ecchymoses from petechiae?

Ecchymoses vary in color and size Signup and view all the answers

What is a common cause associated with spider angiomas?

Liver disease and pregnancy Signup and view all the answers

What is primarily responsible for the production of sebum during puberty?

Androgens Signup and view all the answers

What causes the color of open comedones, also known as blackheads?

Accumulated sebum and skin debris Signup and view all the answers

Which of the following treatments is aimed at reducing sebaceous gland activity in acne management?

Hormone therapy Signup and view all the answers

What is the ultimate goal of therapy for acne management?

Prevention of scarring Signup and view all the answers

Which part of the body is most commonly affected by psoriasis?

Elbows and knees Signup and view all the answers

What is a primary characteristic of psoriasis lesions?

Red, raised patches covered with silvery scales Signup and view all the answers

What factors can trigger the onset of psoriasis?

Hormonal changes, trauma, and stress Signup and view all the answers

What type of treatment is not typically part of the standard management for acne?

Antifungal treatment Signup and view all the answers

What is the primary goal of psoriasis management?

To slow the turnover of epidermis and control disease cycles Signup and view all the answers

What characterizes psoriasis in terms of appearance on the skin?

White scaly patches with redness and inflammation Signup and view all the answers

Which area is NOT commonly affected by psoriasis?

Eyelids Signup and view all the answers

What is a primary underlying factor in the pathophysiology of psoriasis?

Immune system dysfunction Signup and view all the answers

Which substance is often added to baths to help manage psoriasis?

Olive oil Signup and view all the answers

What is the first symptom typically experienced by individuals with eczema?

Intense itching Signup and view all the answers

Which of the following is a common complication associated with psoriasis?

Asymmetric rheumatoid arthritis Signup and view all the answers

Eczema can lead to which of the following skin conditions?

Thickened and crusty skin Signup and view all the answers

What primarily causes inflammation in contact dermatitis?

Irritating substances or allergens Signup and view all the answers

Which statement about athlete's foot is true?

It can be spread through various surfaces. Signup and view all the answers

What are hives also known as?

Urticaria Signup and view all the answers

Which of the following is NOT a symptom of rosacea?

Cracking skin Signup and view all the answers

What is the main reason individuals with albinism need more protection from UV radiation?

They cannot produce melanin effectively. Signup and view all the answers

What is the primary goal of herpes zoster management?

Relieve pain and avoid complications Signup and view all the answers

What do wheals refer to in the context of hives?

Red raised lesions with a flare Signup and view all the answers

Which treatment is considered effective for reducing inflammation in herpes zoster?

Triamcinolone injections Signup and view all the answers

Which group of professionals is commonly linked with dry skin due to occupational exposure?

Medical personnel Signup and view all the answers

What is a characteristic of a second-degree burn?

It leads to blistering and intense pain. Signup and view all the answers

Which of the following statements about skin grafting is true?

It involves the transplanting of skin and sometimes other tissue types. Signup and view all the answers

What typical environment contributes to the growth of the fungus causing athlete's foot?

Warm and moist environments Signup and view all the answers

What technique is recommended to avoid spreading the herpes zoster virus?

Practicing proper hand hygiene Signup and view all the answers

What is the most common form of skin cancer diagnosed annually?

Basal cell carcinoma Signup and view all the answers

How is a third-degree burn characterized?

It completely destroys the epidermis and dermis. Signup and view all the answers

What role does relaxation play in nursing management of herpes zoster?

It assists with pain management and promotes sleep. Signup and view all the answers

Study Notes

Integumentary System - Overview

The integumentary system is susceptible to various diseases, disorders, and injuries, ranging from minor infections to potentially fatal conditions like skin cancer and severe burns.
Common skin disorders and conditions are covered in the study notes.

Definitions

Disease: An abnormal condition in the body or mind that causes dysfunction or discomfort.
Disorder: A functional abnormality or disturbance.
Condition: A state of being, encompassing health, disease, or a specific medical state, such as a heart condition.

Objectives

Identify the structures and functions of the skin.
Differentiate the composition and function of skin layers (epidermis, dermis, and subcutaneous tissue).
Recognize common skin eruptions and manifestations linked to systemic diseases.
Describe general management approaches for patients with abnormal skin conditions.
Utilize the nursing process as a framework for patient care with skin disorders.

Layers of the Skin

The epidermis, dermis, and hypodermis comprise the skin.
Each layer has specific structural components and functions for overall skin health, protection, and sensation.

Layers of Epidermal Cells

The epidermis is keratinized stratified squamous epithelium.
It has four or five layers: stratum basale, stratum spinosum, stratum granulosum, and stratum corneum. Some areas have a fifth layer, stratum lucidum.
Thick skin has all five layers, while thin skin has four. Thick skin is found on the palms and soles.
The epidermis is avascular, meaning it lacks blood vessels.

Dermis

The dermis is the core of the integumentary system, distinct from the epidermis and hypodermis.
It contains blood vessels, nerves, hair follicles, and sweat glands.
The dermis is composed of two layers of connective tissue, creating a mesh of elastin and collagenous fibers. Fibroblasts produce these fibers.

Skin Pigmentation

Skin color is influenced by melanin, carotene, and hemoglobin.
Melanin, produced by melanocytes in the stratum basale of the epidermis, is transferred to keratinocytes via melanosomes.

Petechiae & Ecchymoses

Petechiae are small (1-2 mm) red or purple macules due to blood extravasation, often linked to bleeding tendencies or emboli.
Ecchymoses are larger than petechiae, round or irregular macular lesions with changing colors (black, yellow, green) due to blood extravasation. These are commonly associated with trauma or bleeding tendencies.

Angioma types

Cherry angiomas are round, red or purple papules often found on the trunk and extremities.
Spider angiomas are red or arteriole lesions, with a central body and radiating branches. These are frequently seen on the face, neck, arms, and trunk.

Telangiectasia (Venous Star)

Telangiectasia lesions vary in shape (spider-like or linear) and color (bluish or red).
They do not blanch when pressure is applied and are frequently noted on the legs and anterior chest. They are likely linked to superficial dilation of venous vessels/capillaries or increased venous pressure states (varicosities).

Acne Vulgaris

Acne vulgaris is a common skin disease affecting a high percentage of individuals.
It's characterized by non-inflammatory pustules (comedones) and inflammatory pustules (nodules) in severe cases.
Acne typically affects areas with concentrated sebaceous follicles (face, upper chest, back).

Pathophysiology of Acne Vulgaris

Androgens stimulate sebaceous gland activity during puberty, increasing sebum production.
In acne-prone individuals, this stimulation triggers heightened sebum production, potentially causing sebum plugs in pilosebaceous ducts, creating acne.
Acne is not caused by accumulated dirt, but by a buildup of lipids, bacteria, and epithelial debris. Propionibacterium acnes bacteria break down sebum.

Management of Skin Disorders

Management goals encompass reducing bacterial colonies, decreasing sebaceous gland activity, preventing follicle plugging, reducing inflammation, minimizing scarring, and eliminating predisposing factors.
Treatments include topical creams, oral antibiotics, steroids, hormone therapy (e.g., estrogen) to manage excessive oil production, and surgical interventions.

Nursing Interventions for Skin Disorders

Patient education is critical, especially regarding skin care techniques and potential therapy-related issues.
Prevention of scarring is essential. Treatment strategies include long-term antibiotic therapy.

Psoriasis

Psoriasis is an immune system disorder causing red, inflamed skin with white scaly patches.
It commonly appears on the elbows, knees, scalp, and lower back.
It can be painful, itchy, and may bleed.
The primary cause is unknown but attributed to a combination of genetic makeup and environmental stimuli, including emotional stress.

Clinical Manifestation of Psoriasis

Psoriatic lesions appear as red, raised patches with silvery scales.
Scraping away scales exposes a dark red base, often with bleeding points.
Affected areas include the scalp, elbows, knees, lower back, genitalia, palms, soles, and nails.
Complications may include asymmetric rheumatoid arthritis of multiple joints

Management of Psoriasis

Managing psoriasis aims to slow skin cell turnover, resolve lesions, and control disease cycles.
A therapeutic strategy includes gentle scal removal through baths, oils, or coal tar preparations, alongside applications of emollient creams with alpha-hydroxy or salicylic acids.

Eczema

Eczema commonly causes dry, reddened skin with itching or burning.
Appearance and severity vary based on specific type.
Intense itching is a common first symptom. Blisters, oozing, and scaly skin can also occur. Repeated scratching leads to thickening and crusting.

Contact Dermatitis

Contact dermatitis is a skin inflammation due to contact with an irritant (often occupational related).
Symptoms include extreme itching, redness, swelling, cracking, weeping, crusting, and scaling.
Dry skin is a common underlying factor.

Tinea Pedis (Athlete's Foot)

Athlete's foot is a fungal skin infection of the feet. The condition thrives in warm, moist environments, and is often found in places with high foot traffic and humidity- (floors of gyms, locker rooms, pools, etc.)
Infection generally manifests as an itchy, scaly rash and can spread from person to person or surfaces.

Urticaria (Hives)

Urticaria, commonly recognized as hives, is characterized by red, itchy, raised areas of skin.
Variable shapes and sizes (from millimeters to several inches). Typically marked by welts (red lesions with a surrounding red "flare").
They can occur anywhere on the body (trunk, arms, legs)

Rosacea

Rosacea or (roz-ay-sha) is a common, benign skin disorder, affecting the face primarily.
Symptoms include red or pink patches, visible broken blood vessels, small red bumps, red cysts, and irritated eyes.
Many simply attribute these symptoms to blushing or sunburn.

Albinism

Albinism is a genetic disorder affecting skin, hair, and eye pigmentation.
The disorder is primarily attributable to the inadequate production of melanin (pigment) by melanocytes.
Affected individuals often have white or pale skin and hair.
Increased UV sensitivity and a higher predisposition to sunburns and skin cancer are common.

Vitiligo

Vitiligo is a pigmentation disorder where melanocytes are destroyed.
White patches appear on various body parts, including mucous membranes (mouth, nose) and retina.
Affected hair can also turn white.

Impetigo

Impetigo is a contagious skin infection characterized by sores that form honey-colored scabs—especially on the face.
The sores are not painful but can feel tender and may itch.
Commonly affects children (2-6 years) and is more likely to occur in summer & fall.

Boils

A boil, or skin abscess, is a localized bacterial infection within the skin.
It is often characterized by a reddened, tender area that becomes firm and hard over time.
The central area of the abscess softens, forming pus which is composed of white blood cells, bacteria, and proteins.

Carbuncles

Carbuncles are a serious version of abscesses—with multiple adjacent lesions.
They're characterized by deep-seated infections, multiple, red, swollen skin areas.
Antibiotics are often not particularly helpful for treating abscesses. Management typically involves hot packs and lancing (draining) the abscess when softened.

Ringworm

Ringworm is not caused by a worm but a fungal infection. 
The condition is marked by distinctive, round lesions, often with a ring-like appearance. 
Typically presents as a ring-shaped, red skin infection with peeling skin or blisters

Warts

Warts are localized skin growths frequently associated with human papillomavirus (HPV) infections, although it is not always contagious.
Often appear as irregular bumps (papules) and can be in isolated parts of the body, like hands or feet.
They tend not to spread to other areas over time.

Keloids

Keloids are over-grown scars, characterized by raised, shiny, dome-shaped structures.
These scars may vary in shade from slightly pink to red and are firm to the touch.

MRSA Staph Infection

MRSA (methicillin-resistant Staphylococcus aureus) is a highly contagious bacterial infection commonly found in medical settings.
It typically appears as noticeable skin lesion or bumps that often become inflamed and may show pus, or develop abscesses.

Gangrene

Gangrene is the death of tissue due to a lack of blood supply.
This loss of circulation causes extensive damage to any tissue which can ultimately lead to tissue death.
The two types of gangrene—dry and wet—have distinct characteristics.  Dry gangrene is gradual, marked by numbness, discoloration (mummification), while the wet type is rapid, exhibiting swelling, pus, foul odor, and blackening.

Harlequin Type Ichthyosis

Harlequin type ichthyosis is a rare genetic skin disorder. It's characterized by significant thickening of the skin's keratin layer in infants.
Affected individuals will have massive, diamond-shaped scales and a reddish skin tone; other appendages may be abnormally contracted (eyes, ears, mouth). -The serious drying effect causes significant limitations to mobility. 
Impaired skin integrity predisposes these infants to bacterial infections and can be fatal

Scleroderma

Scleroderma is an autoimmune disease primarily affecting the connective tissues. It triggers the body's immune system to attack its own tissues. -This inflammation leads to the formation of scar-like tissue (fibrosis), causing swelling and hardening in the skin and other organs.

Alopecia Areata

Alopecia areata is a condition marked by sudden hair loss, which usually begins on the scalp and may spread elsewhere.  A precise cause is still unknown, but current evidence suggests an immune system assault on hair follicles.

Herpes Zoster (Shingles)

Herpes zoster is an infection caused by reactivation of the varicella-zoster virus (VZV), the same virus that causes chickenpox.  - It typically manifests as a painful rash characterized by blisters and often confined to a narrow area of the body (face or torso)—typically along a nerve pathway.

Burns

Burns are injuries to skin tissues caused by heat, chemicals, or electricity.
Burn severity is graded—first-degree (superficial), second-degree (partial-thickness), and third-degree (full-thickness).
The severity strongly influences the patient's overall prognosis.
Skin grafting procedures may be needed to repair damage.

Skin Cancer

Skin cancer is a common type of cancer, most commonly, associated with too much sun exposure.
The most prevalent forms are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), although melanoma is more severe and requires more extensive medical intervention.
The most common cancer is BCC, followed by SCC. Melanoma is more serious.

Basal Cell Carcinoma

Basal cell carcinoma (BCC) is the most prevalent form of skin cancer, often appearing as a small, dome-shaped bump with a pearly white discoloration. Blood vessels may be visible on its surface or can appear as pimple-like lesions. -It's typically found on exposed areas.

Squamous Cell Carcinoma

Squamous cell carcinoma (SCC) is the second most common form of skin cancer. It presents as a firm, red nodule or a flat lesion with a scaly crust. Areas on the body will be affected. -The lesions are typically found on sun-exposed skin.

Melanoma

Melanoma is a highly malignant form of skin cancer. Often appears as an asymmetrical, multi-colored (irregular border), mole.
Early detection is crucial as it can rapidly spread. A popular method to remember the signs and symptoms of melanoma is the mnemonic "ABCD" (Asymmetrical, Border, Color, Diameter) -Melanoma arises from melanocytes often within existing moles or a new lesion.

Moh's Surgery

Mohs surgery is a state-of-the-art surgical procedure to treat various skin cancers.  It enables the precise removal of the cancerous layer(s) of skin in a timely, and less harmful manner. -This technique leaves surrounding healthy tissue intact.

Integumentary System Assessment

A thorough assessment of integumentary patient should incorporate a detailed history of skin condition, general assessment, specific skin evaluations, and consideration of skin’s sensory role; knowledge appraisal pertaining to the person's skin condition is also important.

Primary Skin Lesions

These lesions represent initial disease expressions.  Lesions include descriptions of flat marks, elevated 'spots' (papules and nodules), raised and flat topped structures (plaques), irregular shaped areas indicative of edema (wheals), and circumscribed fluid-filled blisters (vesicles and bullae); Pus filled lesions (pustules) are also included

Secondary Skin Lesions

 These are skin modifications occurring over time owing to disease progression, manual manipulation or treatment. -The skin lesions can include thick layers of hardened and dry scales (scaly), dried exudates (crusts), and skin injuries (excoriation, lichenification) based on the lesion itself. 

Management of Integumentary Patients

Patient care involves assessing the patient's suffering and responding to the medication appropriately.  Education on hygiene, drug regimens and management strategies is offered for the patient. -Counseling and other types of support may also be required

Dengue - Overview

Dengue is a viral infection transmitted by Aedes mosquitoes (daytime biters). 
It's more prevalent in tropical/subtropical regions.
Dengue symptoms can range from mild to severe, sometimes resulting in death. - Prevention and support strategies are crucial for patients with dengue or those at high risk -Treatment strategies are limited, with emphasis on pain management, and supportive care; Blood transfusions for patients with depleted platelets are sometimes required.

Dengue - Causes

Mosquito bites, Mother to Unborn child, Medical Item Sharing, Blood transfusion.

Dengue - Symptoms

Symptoms include high fever, severe headache, pain behind eyes, muscle/joint pain, nausea, vomiting, swollen glands, and rash; The illness typically comes after a mosquito bite (4-10 days later) and can initially be mistaken for other viral infections; Severe dengue can present with a repetition of these symptoms after recovery from the original illness.

Diagnostics & Treatment of Dengue

Specific treatment for dengue is non-existent. Management focuses on supportive care: rest, hydration, and pain relief (acetaminophen). Avoid non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin). -Consult a physician if symptoms worsen or prolonged

Dengue - Platelets

Dengue fever can cause severe drops in platelet counts. -Normal platelet range is approximately 150,000 - 450,000/µL. Severe dengue may result in lower levels, even less than 10,000/µL, which is considered a form of thrombocytopenia and significantly alters blood clotting and leads to serious risks of bleeding. - This condition demands medical intervention 
Platelet transfusions can assist in cases with extremely low counts.

Dengue - How to Increase Platelet Count

Blood transfusion is critical in enhancing severe cases with low platelet levels. 
Diet enhancements such as eating foods that contain iron, fruits, dairy and other beneficial nutrients, are encouraged.

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Description

Test your knowledge on the integumentary system, focusing on skin structure, disorders, and conditions. Questions cover various layers of skin, the role of different cells, and common skin conditions. This quiz is essential for anyone studying human anatomy or dermatology.