Anatomy and Physiology

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Skin functions
Psychosocial- display, body image Protection barrier Homeostasis: fluid & temperature Excretion Synthesis Sensory perception
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Protection of the skin
physical damage, trauma and infection immune function inflammation and repair
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Temperature regulation
heat loss by radiation, conduction, convection and evaporation
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Sensation
Pain: superficial (acute) pain, deep (chronic) pain Itch: mechanical (movement), chemical (histamine; kinins; bile salts) Touch and pressure
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Endocrine (Vit D. production)
Vit D. regulates calcium and phorporous levels 7-dehydrocholestrol (in skin cells) + sunlight = cholecalceiferol. Once in the liver and kidneys this is converted into Vit D.
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Psychosocial
bonding touch body image
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Sexual function
changes in puberty changes due to arousal
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Structures supporting key functions
Protective barrier Homeostasis: fluid temperature Excretion Synthesis Sensory perception Communication/ relating Epidermis & dermis Microvasculature , extracellular spaces Vessels, sweat,hair Sweat glands Vit D Epidermis (UV) Sensory nerves, me
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Layers of the skin
pidermis dermis hypodermis (superficial fascia/subcutaneous tissue)
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Epidermis
No blood vessels 0.1 mm (eyelids) - 1mm (palms/soles) 4 - 5 sub-sections (from top to bottom) stratum corneum (horny layer) s. lucidum* s.granulosum; s. spinosum; s.basale (germinative layer)
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Dermis
Dermal papillae interlocks with epidermis Vascular Connective tissue Semifluid matrix Protein fibres: collagen; reticulin and elastin Ground substance
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Changing skin: intrinsic factors
Biological process: eg: microcirculation Genetic predisposition Hormones (e.g. menopause) Illness
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Changing skin: extrinsic factors
Photo damage (UV exposure) Smoking Pollutants Irritants and allergens Heating/low humidity Overwashing Therapeutic treatments (e.g. diuretics; radiotherapy; corticosteroids) Nutrition
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Skin Appendages: part of Integumentary system- nails
Nails: emerge from specialised epithelial cells from the nail root, growing out over the nail bed and become keratinised Nail cuticle: fold of tissue covering the nail root Nail body: the part we see Tissue is very vascularised under the nail Have a
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Skin Appendages: part of Integumentary system- hair
Composed of the fibrous protein-keratin like nails) as they move away from the growth base (follicle) Key structures are the shaft (dead cells) - which extends down to the dermis to the follicle- from where the hair grows Sebaceous gland- sebum Key f
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Body surface area affected due to rash or burn
Clinicians estimate the extent of the body area affected by a rash or burn Rule of nines: percentage body area for different regions Head and neck: 9% Each upper limb 9% Each lower limb 9% Trunk-front 18%, back & buttocks 18% Perineum 1% Varie
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Disrupted barrier integrity
due to inflammation (infection, immune response) and trauma
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Disrupted homeostatic control
dryness due to disease, ageing, burns
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Disrupted circulation
due to pressure effects, poor nutrition, lymphoedema
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Disrupted skin chemistry (pH) and flora
due to chemicals and pathogens
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Categorisation of skin conditions
[Dry skin or xerosis] Chronic inflammatory dermatoses Rashes Acne and rosacea Infections Infestations & insect bites/strings Benign & malignant lesions (lumps & bumps) Hair/scalp disorders Nail disorders Leg ulcers Blistering diseases Urticaria Press
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Dry skin and the Skin Barrier
Dry skin = xerosis: is common Disruption to skin barrier with loss of integrity Loss of skin moisture and oils (sebum) Sometimes easier to feel than see Observations that may be associated: scaling, erythema, soreness, roughness Disease: disruption t
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Common skin conditions causing dry skin
Atopic eczema Asteatotic eczema Ichthyoses (inherited) Psoriasis
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Atopic Eczema
In children it presents in 3 forms: 1. Infantile eczema - begins at 2-6 months generally spontaneous remission by 3 years 2. Childhood - may follow infantile, occurs at 2 to 3 years old, and 90% will manifest by 5 years old 3. Preadolescent and
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Goals of management are to
Relieve pruritis Hydrate the skin Reduce inflammation Prevent or control secondary infection
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Pressure Ulcers
Pressure ulcer localised injury to skin or underlying tissue usually over a bony prominence, due to pressure or pressure associated with shear (EPUPAP 2014) Severity may range from superficial affecting skin surface to deep, affecting muscle and expo
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Grade 1 Pressure Ulcers
Intact skin, non-blanchable redness over a bony prominence. Darkly pigmented skin may not have visible blanching; colour may differ from surrounding area. May be painful, firm, soft, warmer or cooler as compared to adjacent tissue.
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Grade 2 Pressure Ulcers
Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough. May also present as an intact or open blister.
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Grade 3 Pressure Ulcers
Full thickness tissue loss, subcutaneous fat may be visible but bone, tendon or muscle are not exposed.
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Grade 4 Pressure Ulcers
Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present. Often includes undermining and tunnelling. At risk of osteomyelitis
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Other cards in this set

Card 2

Front

Protection of the skin

Back

physical damage, trauma and infection immune function inflammation and repair

Card 3

Front

Temperature regulation

Back

Preview of the front of card 3

Card 4

Front

Sensation

Back

Preview of the front of card 4

Card 5

Front

Endocrine (Vit D. production)

Back

Preview of the front of card 5
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