Assessing The Skin

ASSESSING THE SKIN, HAIR AND NAILS
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Content
STRUCTURE AND FUNCTION Skin Hair Nails NURSING ASSESSMENT Collecting Subjective Data Nursing History Collecting Objective Data Physical Assessment Validation and Documentation of Findings ANALYSIS OF DATA Diagnostic Reasoning
Functional Review of the Integumentary System

Protector and barrier between internal organs and external environment
Barrier against foreign body intrusions - against invading bacteria and foreign matter
Transmits sensation nerve receptors - allows for feelings of temperature, pain, light touch and pressure
Functions of the Skin

Regulates body temperature - regulates heat loss Helps regulate fluid balance absorbs water prevents excessive water & electrolyte loss slow loss up to 600 ml daily by evaporation Immune Response Function - inflammatory process Vitamin production exposure to UV light allows for the conversion of substances necessary for synthesizing vitamin D Necessary to prevent osteoporosis, rickets
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Mrs. Mahdia Samaha Kony 6/20/2012
Epidermis
Covers, protects, and waterproofs. Contains four main layers: Stratum corneum: Keratinized layer. Prevents loss or entry of water; protects against pathogens and chemicals. Stratum lucidum: Found only on palms of hands and soles of feet; protects against UV sunrays to prevent sunburn. 1.Stratum granulosum 2.Stratum germinativum. The innermost layer of epidermis, is the only layer that undergoes cell division & contains melanin & keratin-forming cells.
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Epidermis
The epidermis, hair, nail, dental enamel, & horny tissues are composed of keratin. It is replaced every 3-4 weeks. Skin color depends on: 1. The amount of melanin & carotene" yellow pigment" contained in the skin 2. The volume of blood containing hemoglobin 3. The oxygen-binding pigment that circulates in the dermis.
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Dermis
Contains collagen, reticular, and elastic fibers. Adds strength and elasticity to skin. Contains papillary layer, reticular layer, sweat glands, sebaceous glands, cholesterol, and arterioles. Papillary Layer: Contains capillaries that supply the stratum germinativum; also contains nerve endings, touch receptors, and fingerprint pattern; double layer on hands and feet. Reticular Layer: Contains connective tissue with collagen and elastic fibers, blood and lymphatic vessels, nerves, free nerve endings, fat cells, sebaceous glands and hair roots, deep pressure receptors, and smooth muscle fibers.
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Dermis
Sweat Glands (Sudoriferous):Most numerous on palms of hands and soles of feet. Two types are eccrine and apocrine glands. Eccrine Glands: Respond to external temperature and psychological stress. Found over most of body but most numerous on palms of hands and soles of feet; secrete sweat, which helps regulate body temperature and, to a lesser degree, excretes wastes such as urea.
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Dermis
Apocrine or Odoriferous Glands: Found in axilla and genital area. Respond to stress; secrete pheromones, a substance with a barely perceptible odor; when apocrine secretions react with bacteria, body odor results. Ceruminous glands are a type of apocrine gland found in the external ear canal. They secrete cerumen, which prevents drying of the ear drum and traps foreign substances.
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Sebaceous Glands: Produce sebum, which lubricates and protects skin and hair. Cholesterol: Converts to vitamin D when exposed to UV lights. Arterioles: Dilate when hot to increase heat loss and constrict when cold to conserve heat. Constrict in response to stressful situations to shunt blood to vital organs.
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Hypodermis/Subcutaneous
Connective Tissue: Connects skin to muscles; contains white blood cells. Adipose Tissue: Contains stored energy, cushions bony prominences, provides insulation.
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The Hair
The hair is also made up of keratinized cells. 1. Vellus, which is short, pale,and fine hair, is located over all of the body. 2. Terminal hairs, which are dark and coarse, are found on the scalp, brows, and, after puberty, on the legs, axillae, and perineum. Hair provides protection by covering thescalp and filtering dust and debris away from the nose, ears, and eyes.
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The Nails
Nails are made up of hard, keratinized cells and grow from a nail root under the cuticle. The nail bed, or epithelial layer of skin: vascular supply gives the nail a pink color The lunula, the proximal part of the nail. The nailbeds . The purpose of the nails is to protect the distal portions of the digits and aid in picking up objects
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Mrs. Mahdia Samaha Kony
6/20/2012
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6/20/2012
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Relationship of the Integumentary System to Other Systems

ENDOCRINE Thyroid affects growth and texture of skin, hair and nails. Hormones stimulate sebaceous glands. Sex hormones affect hair growth and distribution, fat and subcutaneous tissue distribution and activity of apocrine sweat glands. Adrenal hormones affect dermal blood supply and mobilize lipids from adipocytes.
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URINARY Kidneys remove waste and maintain normal pH. Skin helps eliminate water and waste. Skin prevents excess fluid loss. DIGESTIVE Skin synthesizes vitamin D for calcium and phosphorous absorption. Supplies nutrients while skin stores lipids.
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CARDIOVASCULAR Mast cell stimulation produces localized changes in blood flow and capillary permeability. CV system provides nutrients and removes wastes. Delivers hormones and lymphocytes. Provides heat for skin temperature. SKELETAL Skin synthesizes vitamin D needed for calcium and phosphorus absorption. Skeletal system provides a framework for skin.
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LYMPHATIC/IMMUNE Skin is first line of defense. Langerhan cells and macrophages resist infection. Mast cells trigger inflammatory responses. Lymphatic system protects skin by sending more macrophages and lymphocytes when needed. RESPIRATORY Provides oxygen to and removes carbon dioxide from integumentary system. Color of skin and nails can reflect changes in respiratory system.
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MUSCULAR Skin synthesizes vitamin D needed for calcium absorption for muscle contraction. Gives shape to and supports skin. Contraction of facial muscles allows communication through expressions. NEUROLOGICAL Sensory receptors in dermis to touch, temperature, pressure, vibration and pain. Provides communication with external environment. Controls blood flow and sweating through thermoregulation.
6/20/2012
NURSING ASSESSMENT
COLLECTING SUBJECTIVE DATA

Assessing The Skin

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ASSESSING THE SKIN, HAIR AND NAILS

Functional Review of the Integumentary System

Functions of the Skin

Mrs. Mahdia Samaha Kony

Mrs. Mahdia Samaha Kony

Relationship of the Integumentary System to Other Systems

Relationship of the Integumentary System to Other Systems

Relationship of the Integumentary System to Other Systems

Relationship of the Integumentary System to Other Systems

Relationship of the Integumentary System to Other Systems

Mrs. Mahdia Samaha Kony

COLLECTING SUBJECTIVE DATA

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