J Chapter 12: Skin

J Chapter 12: Skin

1. Struture and Function

   • Skin
     • Epidermis
       • Basal cell layer constantly regenerates new skin cells to replace damaged outer layer
       • Horny cell layer: outer layer of dead cells closely packed and often shed
       • Palm/soles have thicker epidermis
     • Dermis
       • Primarily composed of connective collagenated tissue
         • Allows reisistence to tearing
       • Innervated, vascularized, sensory receptors, lymph vessels
     • Subcutaneous
       • Adipose tissue: fat cells
         • Provides insulation and cushioning
     • Main Functions
       • Protection from environment
         • Prevents water loss and pathogen invasion
           • Perception to pain, temperature, pressure
             • Fingerprints for ID
               • Production of vitamin D
   • Hair
     • Composed of shaft and root (not visible), bulb matri
     • Two types
       • Vellus: baby hairs, grow all over body
       • Terminal: thick hair that grows on eyebrows, scalp, axillae, pubic region
     • Sebaceous glands
       • Produce sebum: decreases moisture loss of skin
     • Sweat Glands: Two types
       • Eccrine: excretes sweat, regulate body temp
       • Apocrine: Causes body odor, located in axillae, nipples, anogenital area
   • Nails

2. Elderly

   • Best indication of age, because we can see it directly
   • decreased sweat and sebaceous glands,
     • Causes dry skin
     • Higher risk for impaired body temperature regulation
   • Thinning of epidermis and dermis
     • Wrinkles, increased risk of tear injury
   • Loss of mobility
     • Increased risk for impaired skin integrity
   • Decreased melanocytes
     • Hair loss, grayiing/whitening of hair

3. Subjective Data

   • History of skin disease?
     • Known allergies, birthmarks
   • Change in skin pigmentation
     • Assess moles for neoplastic signs
     • Assess for pressure ulcers
   • Rashes/lesions
     • Describe location, character, warmth, duration
       • Does anyone close to you have the same rash
   • Hair loss
   • Change in nails
     • Note shape color, brittleness
       • Do you bite your nails
   • Environmental/Occupational Hazards
     • Dyes, toxic chemicals, radiation
     • Sun exposure, bug bites

4. Objective Data

   • color
     • Is it conistent with genetic background
     • widespread? local?
     • Pallor/flushing/cyanosis
   • Moisture
     • May indicated dehydration
   • Edema
     • 1/2/3/4+ indicates degree of pitting
   • Hair Distribution
     • Asians hair body diminished sometimes
     • vellus/terminal hair in appropriate places

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