Integumentary System Assessment and Dermatological Conditions

Comprehensive vocabulary flashcards reviewing skin structures, functions, risk assessment scales, pressure injury stages, and dermatological conditions.

Epidermis

The outermost layer of the skin composed of keratinized stratified squamous epithelium, divided into four distinct sublayers.

Stratum Corneum

The outermost sublayer of the epidermis consisting of dead, keratinized cells that form a protective barrier.

Stratum Germinativum

The innermost sublayer of the epidermis where active cell division occurs and melanin is produced.

Dermis

The inner layer of skin composed of connective tissue containing collagen, elastic fibers, nerve endings, thermoreceptors, hair follicles, and sweat glands.

Dermal Papillae

Projections of dermal connective tissue connecting the dermis to the epidermis that create the visible ridges or swirls in fingerprints and toe prints.

Eccrine Sweat Glands

Sweat glands distributed across the entire skin surface that secrete an odorless, colorless fluid for evaporative cooling to regulate body temperature.

Apocrine Sweat Glands

Sweat glands located in hairy regions (axillae, perineum, areolae) that secrete milky sweat that produces odor upon interacting with skin bacteria.

Subcutaneous Layer

The fatty layer of tissue below the dermis responsible for energy storage, insulation, heat regulation, and structural protection.

Arrector Pili Muscle

Smooth muscle attached to the hair follicle root that contracts in response to cold temperatures or emotional stimuli, pulling hair upright and decreasing skin surface area.

Vellus Hair

Short, fine, pale hair that covers the majority of the human body.

Terminal Hair

Coarse, thick, pigmented hair influenced by hormones, found on the scalp, beard, armpits, and pubic area.

Lunula

The white, crescent-shaped area located at the base of the nail plate.

Melanoma

The most serious and potentially fatal type of skin cancer originating in melanocytes; susceptible populations include African Americans, Asians, and Hispanics.

Basal Cell Carcinoma (BCC)

The most common type of non-melanocyte skin cancer, originating in the basal layer of the epidermis, and more common in Whites.

Squamous Cell Carcinoma (SCC)

A common type of non-melanocyte skin cancer arising from epidermal squamous cells, occurring more frequently in darker skin types.

Actinic Keratosis

A rough, scaly patch on the skin caused by years of sun exposure that serves as a precancerous lesion for skin cancer.

Xeroderma Pigmentosum

A genetic disorder characterized by a severely decreased ability to repair DNA damage caused by exposure to ultraviolet ($\text{UV}$) light.

ABCDE Mnemonic

A clinical framework used to assess suspicious skin lesions for signs of melanoma: Asymmetry, Border, Color, Diameter, and Evolution (or Elevation).

MRSA Bundle Approach

An evidence-based infection control protocol consisting of nasal swabbing/testing for colonization, contact precautions, strict hand hygiene, and a facility-wide culture of safety.

Braden Scale

An assessment instrument used to evaluate pressure injury risk across six subscales (sensory perception, moisture, activity, mobility, nutrition, friction/shear) with scores ranging from $6$ to $23$.

PUSH Tool Scale

A standardized clinical scale used to track pressure ulcer healing by scoring wound dimensions (length $\times$ width), exudate quantity, and tissue category.

Stage 1 Pressure Injury

Localized intact skin presenting with nonblanchable erythema, which may be painful, firm, soft, warmer, or cooler compared to adjacent tissue.

Stage 2 Pressure Injury

Partial-thickness skin loss with exposed dermis, presenting as a shallow open ulcer with a red-pink wound bed without slough or as an intact or ruptured serum-filled blister.

Stage 3 Pressure Injury

Full-thickness loss of skin in which adipose (fat) tissue is visible in the ulcer, but fascia, muscle, tendon, ligament, cartilage, or bone are not exposed.

Stage 4 Pressure Injury

Full-thickness skin and tissue loss with directly exposed or palpable bone, tendon, ligament, cartilage, or muscle.

Unstageable Pressure Injury

Full-thickness skin and tissue loss in which the extent of tissue damage within the ulcer base cannot be confirmed because it is obscured by slough or eschar.

Common Pressure Injury Anatomical Sites

Anatomical locations over bony prominences susceptible to prolonged pressure breakdown, including the sacrum, ischium, heels, occiput, scapulae, trochanters, and malleoli.

Acanthosis Nigricans

A hyperpigmented, velvety cutaneous condition localized to flexural areas such as the neck folds and axillae, commonly associated with insulin resistance.

Schamroth Sign

A physical assessment technique for finger clubbing, evaluated by placing opposing fingernails together to observe for the disappearance of the normal diamond-shaped window.

Leukonychia

White discoloration, spots, or transverse lines appearing on the nail plate.

Tinea Capitis

A superficial fungal infection (ringworm) of the scalp hair follicles resulting in scaly patches, inflammation, and localized alopecia.

Primary Skin Lesions

Initial skin alterations directly produced by an underlying disease process, including macules, patches, papules, plaques, nodules, tumors, vesicles, bullae, wheals, pustules, and cysts.

Secondary Skin Lesions

Cutaneous changes resulting from the progression, trauma, or evolution of primary skin lesions, including erosions, ulcers, scars, and fissures.

Vascular Skin Lesions

Lesions involving cutaneous blood vessels or extravasation of blood, including petechiae, ecchymoses, hematomas, cherry angiomas, spider angiomas, and telangiectasias.

Longitudinal Ridging

Vertical ridges extending along the length of the nail plate, commonly encountered as a normal finding in aging nails.

Half-and-Half Nails

A nail change where the proximal portion of the nail bed is white and the distal portion is dark red or brown, classically associated with chronic renal failure.

Koilonychia

A nail deformity where the nail plate becomes flattened and concave with raised edges (spoon-shaped nail), often caused by iron deficiency anemia.

Paronychia

An infection or inflammation of the soft tissue folds surrounding the nail margin.