lab7 - 7 The Integumentary System Objectives In this...

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40 7 The Integumentary System Objectives In this chapter we will study the importance of the integumentary system in a physical examination; terms describing the most common skin lesions; some diagnostic tests for skin disorders; the rule of nines used to evaluate burn patients; pressure ulcers, allergic contact dermatitis, and infections and infestations of the skin and hair; diagnostic signs in the nails; and acne vulgaris. Diagnosing Skin Disorders The skin is the largest, most visible, and most vulnerable of the body organs. Many illnesses cause visible changes in the skin—not only disorders of the skin itself, but also internal disorders such as anemia, lung disease, heart disease, hepatitis, dehydration, and hormone imbalances that affect the skin. Inspection of the integumentary system is one of the major elements of a comprehensive physical examination. The clinician notes the condition of the facial skin, studies the patient’s hands, and palpates the hair and nails, looking especially for abnormal colors, excessive dryness or oiliness, temperature, texture, turgor (how easily a pinch of skin returns to its normal, flat appearance), and the type and distribution of any lesions that are present. The clinician may be the first to notice lesions such as skin cancer in areas that the patient cannot see—for example, behind the ears and on the back. When a patient complains of a skin irritation or lesion, the history should include information on potentially harmful substances with which the patient has come in contact—for example, cleaning solvents or poison ivy. Table 7.1 describes many of the most commonly seen skin lesions. The diagnosis of skin disorders is often complicated by overlapping or nonspecific symptoms such as itching and pain. Pruritis (itching) may result from such diverse causes as eczema, infestation with lice, a food allergy, or a systemic disease such as iron deficiency or thyroid trouble. Pain may result from pruritis and the excessive scratching that it stimulates, or it may arise independently from another disease altogether. Specific skin tests, including the following, can help narrow down the diagnosis: Patch (scratch) test In this procedure, a known allergen (a substance that causes an allergy) is applied to the skin surface or introduced into the skin by scratch or injection. After 1 or 2 days, the site is examined for inflammation (redness and swelling). If inflammation occurs, it indicates that the patient is allergic to that substance. Skin biopsy A sample of skin is taken (by scraping or shaving the surface) and then microscopically examined. An abnormal histological appearance may be diagnostic of the various forms of skin cancer, among other disorders. Shave biopsy (skin scrapings)
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This note was uploaded on 11/16/2011 for the course SCIENCE Anatomy an taught by Professor Tory during the Spring '11 term at Kennesaw.

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lab7 - 7 The Integumentary System Objectives In this...

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