Other systems
❖Integumentary system
➢ Layers of skin
■ Epidermis
● Protection
Dermis
● Regulate temp
● Papillary and reticular layers
● Supply blood vessels and nerve endings, sweat glands, hair
follicles
■ Hypodermis
● Adipose tissue and collagen
● Shock absorber
➢ Structures of skin
■ Merkel cells
● Epidermis
● Sensation of light touch
■ Pacinian corpuscles
● Nerve receptors located in dermis
● Respond to deep pressure and vibration
➢ Ulcers
■ Arterial ulcers
● Minimal drainage
● Lower one third of leg toes, dorsal foot, lateral malleolus
● Smooth edges
● Deep
■ Venous insufficiency ulcers
● Elevate legs above heart when resting or sleeping
● Compression to control edema
● Irregular shape, proximal medial malleolus (gator area), shallow
● Moderate heavy exudate
●
■ Neuropathic ulcers
● Protective sensation (monofilament testing)
◆ 5.07 or 10gm = protective sensation
➢Wound classification
■ Superficial
● Epidermis is intact
● Non blistering sunburn
■ Partial thickness
● Extends to epidermis and possibly dermis
, ● Blisters, skin tears, abrasions
■ Full thickness
● Dermis
■ Subcutaneous
● Fat and muscles or tendon and bone
➢ Pressure injury staging
■ 1
● Non blanchable and intact skin
● Superficial wound
■ 2
■ 3 - subcutaneous fat
■ 4 - muscle bone
■ Unstageable
● Unable to see due to eschar
➢ Wagner ulcer scale (diabetic foot)
■ 0- pre ulcerative lesion
■ 1- superficial ulcer not involving subcutaneous tissue
■ 2 - deep ulcer with subcutaneous tissue, potential bone exposure
■ 3- deep ulcer, osteomyelitis
■ 4- gangrene digit
■ 5- gangrene with disarticulation
➢ Wound terminology
■ Desiccated
● Drying out or dehydration of a wound
■ Desquamation
● Peeling or shedding of outer layer of epidermis
● Scales
■ Ecchymosis
● Discoloration below intact sin resulting from trauma to underlying
blood vessels and blood seeping into tissues
● Bruise
■ Turgor
● Speed in which the skin resumes normal appearance after being
pinched slightly
● Elasticity
● Decreases with age
➢ Integ pathology
■ Onychomycosis
● Fungal infection affecting toenail and nail beds
■ Psoriasis - plaque
● Chronic autoimmune disease of skin
● Patches on surface of skin
■ Tinea pedis
● Athletes foot
, ● Superficial fungal infection
● Direct contact is contagious
●
❖Metabolic and Endocrine System
➢ Metabolic system pathology
■ Phenylketonuria
● Intellectual and behavioral disability
● Elevation of serum phenylketonuria
● Autosomal recessive, caucasians
■ Tay sachs disease
● Lysosomal storage disorder
◆ Deficiency of hexosaminidase A
◆ Autosomal recessive inherited trait, jewish
◆ Intellectual disability, paralysis, die by age 5
■ Wilson's disease
● Cant metabolize copper
● Autosomal recessive inherited trait
● Liver, kidney, brain cornea
➢ Acid base metabolic disorders
■ Metabolic alkalosis
● Abnormal loss of acids
● Increase in bicarbonate
● pH above 7.45
● Compensate with hypoventilation
■ Metabolic acidosis
● pH drops below 7.35
● Accumulation of acid
● Compensate by hyperventilating
➢ Metabolic bone disease
■ Osteomalacia
■ Low bone mass conditions
● Cushing's syndrome
● Osteomalacia
● Hyperthyroidism
● Hyperparathyroidism
● Celiac disease
● RA
● Osteogenesis imperfecta
■ Osteoporosis
■ Padget disease
● Heightened osteoclast activity
● Excessive bone formation
❖Integumentary system
➢ Layers of skin
■ Epidermis
● Protection
Dermis
● Regulate temp
● Papillary and reticular layers
● Supply blood vessels and nerve endings, sweat glands, hair
follicles
■ Hypodermis
● Adipose tissue and collagen
● Shock absorber
➢ Structures of skin
■ Merkel cells
● Epidermis
● Sensation of light touch
■ Pacinian corpuscles
● Nerve receptors located in dermis
● Respond to deep pressure and vibration
➢ Ulcers
■ Arterial ulcers
● Minimal drainage
● Lower one third of leg toes, dorsal foot, lateral malleolus
● Smooth edges
● Deep
■ Venous insufficiency ulcers
● Elevate legs above heart when resting or sleeping
● Compression to control edema
● Irregular shape, proximal medial malleolus (gator area), shallow
● Moderate heavy exudate
●
■ Neuropathic ulcers
● Protective sensation (monofilament testing)
◆ 5.07 or 10gm = protective sensation
➢Wound classification
■ Superficial
● Epidermis is intact
● Non blistering sunburn
■ Partial thickness
● Extends to epidermis and possibly dermis
, ● Blisters, skin tears, abrasions
■ Full thickness
● Dermis
■ Subcutaneous
● Fat and muscles or tendon and bone
➢ Pressure injury staging
■ 1
● Non blanchable and intact skin
● Superficial wound
■ 2
■ 3 - subcutaneous fat
■ 4 - muscle bone
■ Unstageable
● Unable to see due to eschar
➢ Wagner ulcer scale (diabetic foot)
■ 0- pre ulcerative lesion
■ 1- superficial ulcer not involving subcutaneous tissue
■ 2 - deep ulcer with subcutaneous tissue, potential bone exposure
■ 3- deep ulcer, osteomyelitis
■ 4- gangrene digit
■ 5- gangrene with disarticulation
➢ Wound terminology
■ Desiccated
● Drying out or dehydration of a wound
■ Desquamation
● Peeling or shedding of outer layer of epidermis
● Scales
■ Ecchymosis
● Discoloration below intact sin resulting from trauma to underlying
blood vessels and blood seeping into tissues
● Bruise
■ Turgor
● Speed in which the skin resumes normal appearance after being
pinched slightly
● Elasticity
● Decreases with age
➢ Integ pathology
■ Onychomycosis
● Fungal infection affecting toenail and nail beds
■ Psoriasis - plaque
● Chronic autoimmune disease of skin
● Patches on surface of skin
■ Tinea pedis
● Athletes foot
, ● Superficial fungal infection
● Direct contact is contagious
●
❖Metabolic and Endocrine System
➢ Metabolic system pathology
■ Phenylketonuria
● Intellectual and behavioral disability
● Elevation of serum phenylketonuria
● Autosomal recessive, caucasians
■ Tay sachs disease
● Lysosomal storage disorder
◆ Deficiency of hexosaminidase A
◆ Autosomal recessive inherited trait, jewish
◆ Intellectual disability, paralysis, die by age 5
■ Wilson's disease
● Cant metabolize copper
● Autosomal recessive inherited trait
● Liver, kidney, brain cornea
➢ Acid base metabolic disorders
■ Metabolic alkalosis
● Abnormal loss of acids
● Increase in bicarbonate
● pH above 7.45
● Compensate with hypoventilation
■ Metabolic acidosis
● pH drops below 7.35
● Accumulation of acid
● Compensate by hyperventilating
➢ Metabolic bone disease
■ Osteomalacia
■ Low bone mass conditions
● Cushing's syndrome
● Osteomalacia
● Hyperthyroidism
● Hyperparathyroidism
● Celiac disease
● RA
● Osteogenesis imperfecta
■ Osteoporosis
■ Padget disease
● Heightened osteoclast activity
● Excessive bone formation
