Chapter 7: Integumentary System

What is the integumentary system?

The skin and its associated structures; skin is the largest organ in the body.

What percentage of body weight does the skin make up?

15–20% of total body weight.

What are the three primary layers of the skin?

Epidermis, dermis, and subcutaneous tissue.

What is the primary function of the skin?

Protection

What are skin lesions?

Abnormal changes or areas on the skin.

What are the two classifications of skin lesions?

Primary and secondary lesions.

What is a primary skin lesion?

The first lesion to appear on the skin with a visually recognizable structure.

What is a secondary skin lesion?

A change that occurs in an existing primary lesion.

What commonly causes birthmarks?

A nevus (mole), caused by an overgrowth of one or more normal components of the skin.

What are Mongolian spots?

Blue/black macules that are a type of birthmark.

Where are Mongolian spots commonly found?

Over the lumbosacral area.

In which populations are Mongolian spots commonly found?

Native American, African American, and Asian infants.

What are common causes of skin lesions?

Injurious agents, infections, medications, trauma, hereditary factors, allergens, radiotherapy, systemic conditions, burns, and neoplasms.

What does pruritus mean?

Itching.

What does bullous mean?

Blistering or formation of bullae.

What does urticaria mean?

Hives.

What does xeroderma mean?

Dry skin.

What are examples of unusual skin findings?

Moles, cysts, and swelling.

What should a PTA monitor when observing skin lesions?

Location, size, color, temperature, moisture, ulceration, texture, thickness, mobility, edema, turgor, odor, and tenderness.

What should a PTA document about a skin lesion's pattern?

The pattern and arrangement of the lesions.

Why is a rash on the breast important to recognize?

It may indicate Paget's disease.

What should a PTA do when noticing suspicious skin changes?

Remain alert, document specific findings, and report concerns appropriately.

What precautions should a PTA take with aging skin?

Avoid shear and friction, use extreme caution with electrical and thermal modalities, and avoid adhesives.

What happens to pain perception as skin ages?

Pain perception decreases.

How does aging affect skin injury risk?

Increases vulnerability to injury.

How does aging affect skin vascularity?

Decreases vascularity.

How does aging affect the inflammatory response?

Weakens the inflammatory response.

What are visible skin changes associated with aging?

Lax skin, vascular changes, wrinkling, and diminished barrier function.

What is the stratum corneum?

The outermost layer of the epidermis.

What happens to the stratum corneum with aging?

Its barrier function diminishes.

What should a PTA monitor in aging skin?

Appearance, wounds, minor cuts, moles, vascular changes, and loss of collagen.

What is eczema/dermatitis?

Superficial inflammation of the skin caused by irritant exposure or allergic sensitization.

What are the three stages of dermatitis?

Acute, subacute, and chronic.

What are common signs and symptoms of eczema/dermatitis?

Dryness, sensitivity, redness, inflammation, severe itching, dark patches, rough or scaly skin, oozing, crusting, and swelling.

Is there a cure for eczema/dermatitis?

No cure, but it can be controlled with proper management.

How is eczema/dermatitis managed?

Personal hygiene, moisturizing, avoiding irritants, and topical pharmacology.

What is atopic dermatitis?

A chronic inflammatory skin disease.

What is xerosis?

Abnormally dry skin.

What is the exact cause of atopic dermatitis?

Unknown.

When does atopic dermatitis commonly begin?

Infancy.

What are the major symptoms of atopic dermatitis?

Xerosis and pruritus.

How is atopic dermatitis managed?

Daily skin care and moisturizing; there is no cure.

What should a PTA teach a patient with atopic dermatitis?

Daily skin care and moisturizing.

What topical products should be avoided with atopic dermatitis?

Topical agents containing alcohol.

What should a PTA monitor when using ultrasound gel or creams on atopic skin?

Use carefully and observe for skin reactions.

What is contact dermatitis?

Acute or chronic skin inflammation caused by exposure to a chemical, mechanical, physical, or biologic agent.

What are common contact dermatitis sensitizers?

Nickel, chromates, wool fats, and rubber additives.

What are the main signs of contact dermatitis?

Intense pruritus, erythema, and edema.

What does erythema mean?

Redness of the skin.

What does edema mean?

Swelling.

How is contact dermatitis diagnosed?

History, physical examination, and patch testing.

Who should evaluate suspected contact dermatitis?

A physician.

What is the primary treatment approach for contact dermatitis?

Avoid the irritant.

What are other contact dermatitis treatments?

Moisturizers; prescribed topical anesthetics or steroids.

What should a PTA avoid with contact dermatitis?

Modalities, alcohol-based lubricants, and antibacterial soaps without a rinsing agent.

What is rosacea?

A chronic facial skin disorder commonly affecting middle-aged and older adults.

What are the signs of rosacea?

Redness of the cheeks, nose, and chin; may include papules, pustules, and oily skin.

What can trigger rosacea flare-ups?

Sun, hot weather, and humidity.

Is rosacea a temporary condition?

No, it is persistent.

What causes fungal skin infections?

Fungi that invade the stratum corneum, hair, and nails.

Where do superficial fungal infections live?

On the skin rather than inside it.

What happens to fungal infections without treatment?

They can spread.

What are two common types of tinea infections?

Tinea corporis and tinea pedis.

What is tinea corporis?

A fungal skin infection characterized by ring-shaped pigmented patches.

Does tinea corporis have an association with worms?

No.

What do tinea corporis lesions look like?

Ring-shaped pigmented patches covered with vesicles or scales that often itch.

How is tinea corporis transmitted?

Person to person, animal to person, or contaminated object to person.

How is tinea corporis diagnosed?

Laboratory examination of affected skin.

How is tinea corporis treated?

Keep skin clean and dry; use prescribed antifungal powder or topical agents.

What is tinea pedis?

A fungal infection of the feet, commonly called athlete's foot.

What are the signs of tinea pedis?

Erythema, peeling skin, and itching between the toes.

Where can tinea pedis spread?

From between the toes to the sole of the foot.

What may occur with severe tinea pedis?

Strong odor.

How is tinea pedis treated?

Clean, dry socks, proper footwear, thorough washing and drying between toes, and antifungal cream or powder.

What are risk factors associated with tinea pedis in the slides?

History of antibiotic use and yeast infections.

What should patients with fungal infections avoid sharing?

Hair care products, clothes, towels, and linens.

What should patients with fungal infections avoid doing near the infected site?

Shaving body hair closely.

What is a PTA's role with fungal infections?

Educate patients on hygiene and preventing transmission.

What causes parasitic skin infections?

Contact with insects and animals.

Why do insects puncture the skin?

To suck blood, inject venom, or lay eggs.

Why can insect substances cause allergic reactions?

Substances deposited by insects are foreign to the host and may cause allergic sensitivity.

What is scabies?

A highly contagious skin eruption caused by mites.

What causes scabies?

A female mite burrows into the skin and deposits eggs that hatch into larvae.

How is scabies transmitted?

Skin-to-skin contact or contact with contaminated objects.

Where can scabies spread rapidly?

Households, nursing homes, and institutions.

What is the main symptom of scabies?

Intense pruritus.

Where is the scabies mite usually found?

In the burrow.

How is scabies diagnosed?

Removing a mite from a burrow and examining it under a microscope.

How is scabies treated?

Scabicides, including permethrin and ivermectin.

What is the PTA's role in preventing scabies transmission?

Good handwashing and appropriate protective equipment.

What protective equipment should a PTA wear with close scabies contact according to the slides?

Gloves, gown, cap, and booties.

What type of room should a patient with scabies occupy?

A private room for isolation.

What should happen to linens and towels used by a patient with scabies?

They should be isolated after use until the person is noninfectious.

What should happen to a treatment table used by a patient with scabies?

Thoroughly disinfect it after each session.

Who else may need scabies treatment?

Household members and others in close contact with the affected person.

How long can itching persist after scabies treatment?

One to two weeks.

What is pediculosis?

An infestation by parasites affecting the head, body, or genital area.

How is pediculosis transmitted?

Person to person or through contaminated objects

Who is commonly affected by pediculosis?

School-aged children, people in overcrowded surroundings, and older adults with poor personal hygiene.

What are nits?

Lice eggs.