integumentary system skin and glands hair nails
TRANSCRIPT
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Integumentary System
Skin and Glands Hair Nails
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HistoryIntegumentary System
Previous skin history Changes in pigmentation Moles, any changes Excessive dryness or moisture Itching (pruritus) Excessive bruising Rash or lesions Medications Hair loss Nail changes
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Skin
Color General pigmentation (skin tone)
Vitiligo-absence of pigment Freckles
Small, flat macules, brown Mole
Proliferation of melanocytes, macular or papular
Tan to brown Birthmarks
Tan to brown in color
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Widespread color changes
Pallor (white)Unnatural paleness d/t constriction of
cutaneous vesselsAnemia, Shock
Erythema (redness)Excess blood in superficial capillaries d/t
vasodilatationFever or localized inflammation
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Cyanosis (blue)Decreased perfusionShock, heart failure, bronchitis, congenital ht
dx Jaundice (yellow)
Excess bilirubin in the bloodCirrhosis, sickle-cell anemia, transfusion
reactions
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Temperature and Moisture
Temperature Use back of hand Hypothermia
CoolnessSurgery, immobilized extremity, shock
HyperthermiaIncreased metabolic rate
Hyperthyroidism, fever, heavy exercise, trauma, infection, sunburn
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Moisture Diaphoresis- excessive perspiration Dehydration-dry, parched and cracked lips
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Texture and Thickness
Texture Character of the skin’s surface. It is not normally
uniform throughout. Elbow vs. cheek Hyperthyroidism-velvet Hypothyroidism-rough,dry, and flaky
Thickness Thin over body Thick over palms & soles
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Mobility & Turgor
Mobility = rise of skin Turgor = return of skin, the elasticity of skin.
It may be diminished by edema or dehydration. The skin normally loses elasticity with age Elderly – chest Infants – abdomen Adult/teen - arms
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Vascularity or Bruising
Vascularity or Bruising Petechiae
Tiny purple or redspots d/t minute hemorrhages in the dermis
Cherry angiomasSmall, smooth, raised red dots on trunk in
adults over 30 Bruising (ecchymosis) Tattoos
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Hair
2 Types Terminal Hair
Long, coarse, thick. Found on scalp, axilla and pubic areas. Vellus Hair
Small, soft, tiny hairs. Covering entire body except hands, soles of feet and penis
Color Texture Distribution Condition of scalp
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Common Hair Abnormalities
Hirsutism Male pattern growth in women, especially the
face Alopecia - Balding Excessively oily hair
Associated with androgen hormone stimulation
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Dry brittle hair Associated with aging and excessive use
of shampoo, etc Dry coarse discolored hair
Suspect poor nutrition Decreased hair on the extremities
Arterial insufficiency
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Nails
Shape & contour Normally transparent, smooth, convex with white tips
Strength/Thickness Can be a nutritional indicator
Color – determined by vascularity of nailbed Linear pigmentation
Pigment bands normal in dark skinned individuals Leukonychia striata
Markings from trauma, picking at cuticles Capillary refill Clubbing
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Note if bite their nails If nails are dirty, clean Well trimmed or groomed