Integumentary System Overview for NPTE Exam

Integumentary System

Largest body organ, 15-20% of body weight.

Primary Function

Protection, insulation, sensory, fluid balance, temperature control.

Epidermis

Outer skin layer containing keratinocytes and melanocytes.

Dermis

Inner skin layer with collagen and blood vessels.

Keratinocytes

Cells producing keratin, a protective protein.

Melanocytes

Cells responsible for skin pigmentation.

Langerhans Cells

Immune cells in the epidermis.

Basal Cells

Cells in the epidermis that regenerate skin.

Venous Insufficiency

Inadequate drainage of venous blood, causing edema.

Arterial Insufficiency

Lack of adequate blood flow to body regions.

Clinical Presentation

Signs and symptoms observed during patient assessment.

Pressure Ulcers

Wounds over bony areas, staged by depth.

Meissner Corpuscles

Sensory receptors for light touch and pressure.

Krause End Bulbs

Receptors for cold sensation in the skin.

Pacinian Corpuscles

Receptors for deep pressure and vibration sensation.

Ruffini Endings

Receptors for skin stretch and sustained pressure.

Hemosiderin Staining

Brown discoloration due to iron deposition.

Granulation Tissue

New connective tissue formed during wound healing.

Pitting Edema

Swelling that leaves an indentation when pressed.

Hyperkeratosis

Thickening of the outer skin layer.

Plan of Care

Strategy for patient treatment and rehabilitation.

Differential Diagnosis

Process of distinguishing between different conditions.

Stage 1 Pressure Injury

Reddened area that does not disappear.

Stage 2 Pressure Injury

Involves first two skin layers, superficial.

Stage 3 Pressure Injury

Subcutaneous fat may be visible.

Stage 4 Pressure Injury

Extends down to and includes bone.

Unstageable Pressure Injury

Wound base obscured by necrotic tissue.

Diabetic Ulcers

Located on weight-bearing surfaces of the foot.

Venous Insufficiency Ulcers

Found proximal to medial malleolus, edematous.

Arterial Ulcers

Located on lateral malleolus or distal toes.

Pressure Ulcers

Result from unrelieved external pressure.

Herpes Zoster Symptoms

Initial pain and paresthesia in affected dermatome.

Herpes Zoster Rash

Presents as unilateral, raised, pink with silvery appearance.

Contact Precautions

Used for herpes simplex virus type 1.

Airborne Precautions

Required for herpes zoster (shingles).

Localized Skin Edema

Irregular areas indicating possible wheals.

Macerated Wound

Identified by white, friable, overhydrated skin.

Causes of Maceration

Uncontrolled drainage, perspiration, or incontinence.

Transparent Films

Used for very mild exudate wounds.

Hydrogel Dressing

Appropriate for minimal exudate wounds.

Hydrocolloid Dressing

Used for minimal to moderate exudate.

Foam Dressings

Suitable for moderate exudate wounds.

Calcium Alginates

Used for heavy exudate wounds.

Hydrofiber Dressings

Max capacity for heavy exudate management.

Debridement

Removal of nonviable tissue from a wound.

Selective Debridement

Only nonviable tissues are removed.

Sharp Debridement

Use of scalpel, scissors, and forceps.

Enzymatic Debridement

Topical application to remove nonviable tissue.

Autolytic Debridement

Body's mechanisms remove nonviable tissue.

Nonselective Debridement

Both viable and nonviable tissues are removed.

Wet to Dry Dressings

Moistened gauze applied to necrotic tissue.

Wound Irrigation

Pressurized fluid removes necrotic tissue.

Hydrotherapy

Whirlpool agitation for wound debridement.

Red Yellow Black System

Color-coded system for wound assessment.

Superficial Burn

Affects epidermis; heals in 5 days.

Superficial Partial Thickness Burn

Involves epidermis and some dermis; heals in 10-14 days.

Deep Partial Thickness Burn

Involves epidermis and dermis; heals in 3 weeks.

Full Thickness Burn

Involves all skin layers; requires surgical intervention.

Subdermal Burn

Involves all skin layers and subcutaneous tissue.

Hypertrophic Scar

Thick fibrous tissue within original wound borders.

Keloid Scar

Excessive scar tissue beyond original wound margins.

Rule of Nines

Estimates burn surface area based on body regions.

Burn Depth

Classification based on tissue involvement and healing.

Capillary Refill

Time taken for color to return after pressure.

Necrosis

Death of tissue due to lack of blood supply.

Granulation Tissue

New connective tissue and blood vessels in healing.