Tissue Integrity: Skin Assessment, Pressure Injuries, and Cutaneous Conditions

Vocabulary practice flashcards covering integumentary anatomy, physical assessment, pressure injury staging, clinical mnemonics, cellulitis, and skin neoplasms.

Sebum

An oily substance secreted by the sebaceous glands located at the root of each hair.

Schamroth sign

A physical assessment technique evaluating finger clubbing; the loss of the diamond-shaped window created when opposing dorsal nail surfaces are placed together indicates clubbing.

Pressure Injury

A localized damage to the skin and underlying tissue, typically occurring over a bony prominence as a result of intense or prolonged pressure, friction, and shear.

Shear

A mechanical force generated when skin sticks to a surface while underlying skeletal structures slide in the direction of body movement, resulting in bunched-up skin and reduced capillary blood flow.

Stage 1 Pressure Ulcer

Persistent, nonblanchable erythema of intact skin over a bony prominence.

Stage 2 Pressure Ulcer

Partial-thickness loss of skin with exposed dermis, which can present as a shallow open ulcer or an intact or ruptured serum-filled blister.

Stage 3 Pressure Ulcer

Full-thickness skin loss in which adipose (fat) tissue is visible within the ulcer, and slough or eschar may be present.

Stage 4 Pressure Ulcer

Full-thickness skin and tissue loss with directly visible or palpable cartilage, bone, muscle, tendon, or deeper structures.

Unstageable Pressure Ulcer

Full-thickness skin and tissue loss where the true depth and stage cannot be determined because the wound bed is obscured by slough or eschar.

Deep Tissue Pressure Injury (DTPI)

Localized, persistent nonblanchable deep red, maroon, or purple discoloration of intact or nonintact skin, or an area presenting with a dark wound bed or blood-filled blister.

Hydrocolloid dressing

An occlusive or semi-occlusive dressing designed to protect wounds and maintain a moist healing environment.

TIME framework

A systematic wound assessment tool representing: Tissue integrity (color, appearance, necrosis), Inflammation or infection (redness, warmth, swelling, discharge), Moisture (dry, moist, or macerated), and Edge of wound.

DIDN'T HEAL

A mnemonic identifying systemic and local factors that impair wound healing: Diabetes, Infection, Drugs, Nutritional problems, Tissue necrosis, Hypoxia, Extensive tension, Another wound, and Low temperatures (cold).

Braden Scale

A clinical assessment tool used to predict pressure sore risk by evaluating six categories: Sensory Perception, Moisture, Activity, Mobility, Nutrition, and Friction & Shear.

Cellulitis

An acute bacterial infection affecting the deeper dermal and subcutaneous layers of the skin, typically triggered by microbial entry through a cutaneous break.

Malignant Melanoma

A highly aggressive cancer arising from melanocytic transformation triggered by DNA damage (especially UV radiation), notable for irregular borders, rapid evolution, and high metastatic potential.

ABCDE criteria

A clinical diagnostic guide for evaluating pigmented skin lesions for melanoma: Asymmetry, Border irregularity, Color variegation, Diameter greater than $6\,\text{mm}$ ($1/4\,\text{inch}$), and Evolution over time.

Biotherapy (monoclonal antibodies)

An immunological cancer treatment that stimulates host T cells to produce a targeted antitumor immune response against malignant cells.

Basal Cell Carcinoma (BCC)

The most common form of skin cancer; an epidermal malignancy originating in basal cells due to sun-induced DNA damage, characterized by slow growth, pearly translucent lesions, and rare metastasis.

Mohs Micrographic Surgery

A specialized surgical technique involving progressive excision and immediate microscopic examination of thin tissue margins until all cancer cells are removed, preserving maximal healthy tissue.

Sebum

An oily substance secreted by the sebaceous glands located at each hair root.

Schamroth Sign

A clinical assessment technique for detecting finger clubbing; in normal fingers, opposing nail beds form a diamond-shaped window, which is lost when clubbing is present.

Pressure Injury

A localized tissue injury, typically occurring over a bony prominence, that results in damage to the underlying tissue.

Shear Force

A mechanical force generated when skin and superficial tissues remain stationary against an external surface while deeper skeletal tissues slide downward, causing skin stretching, distortion, and vascular compromise.

Stage 1 Pressure Injury

Intact skin presenting with a localized area of persistent, nonblanchable erythema.

Stage 2 Pressure Injury

Partial-thickness skin loss with exposed dermis, which may present as an intact or ruptured serum- or serosanguinous-filled blister.

Hydrocolloid Dressing

An occlusive or semi-occlusive wound dressing designed to maintain a moist healing environment for wound recovery.

Stage 3 Pressure Injury

Full-thickness skin loss in which adipose tissue is visible, with slough and/or eschar potentially present in the wound bed.

Stage 4 Pressure Injury

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

Deep Tissue Pressure Injury (DTPI)

Persistent, nonblanchable deep red, maroon, or purple discoloration of intact or non-intact skin, or an epidermal separation revealing a dark wound bed or blood-filled blister.

Unstageable Pressure Injury

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

TIME Assessment Framework

A structured wound evaluation tool consisting of Tissue integrity (wound color, appearance, necrosis), Inflammation/infection (erythema, warmth, swelling, exudate), Moisture (dry, moist, macerated), and Edge of wound.

DIDN'T HEAL

A mnemonic identifying factors that impair wound healing: Diabetes, Infection, Drugs, Nutritional problems, Tissue necrosis, Hypoxia, Extensive tension, Another wound, and Low temperatures (cold).

Braden Scale

A standardized clinical risk prediction tool assessing six subscales: Sensory Perception, Moisture, Activity, Mobility, Nutrition, and Friction & Shear, where lower scores indicate higher pressure sore risk.

Cellulitis

An acute bacterial infection involving the deeper layers of the skin and underlying subcutaneous tissue, usually triggered by a break in skin integrity.

Malignant Melanoma

An aggressive, irregular skin malignancy caused primarily by UV-induced DNA damage that metastasizes rapidly and is associated with increased morbidity and mortality.

ABCDE Criteria

A clinical guideline for identifying malignant melanoma: Asymmetry (mismatched halves), Border irregularity, Color variegation (two or more colors), Diameter ($>6\,\text{mm}$ or $\frac{1}{4}\,\text{inch}$), and Evolution (changes in size, shape, color, or traits).

Biotherapy (Monoclonal Antibodies)

An oncologic targeted therapy that utilizes monoclonal antibodies to stimulate T cells to generate an antitumor immune response.

Basal Cell Carcinoma (BCC)

The most common form of skin cancer; originates from epidermal basal cells, grows slowly, rarely metastasizes, and often presents as pearly, translucent papules or nodules.

Mohs Micrographic Surgery

A specialized surgical technique that excises cutaneous malignancy through microscopically controlled margins until all cancerous cells are verified removed.