Integumentary

• The integumentary system, consisting of the skin, hair, and nails, is the largest organ of the body and the easiest of all systems to assess.
• The skin, hair, and nails provide clues about general health, reflect changes in environment, and signal internal ailments stemming from other organs.
• Changes in the skin, hair, and nails may be an early warning of a developing health problem.
• The skin provides a barrier protecting the body from injury, penetration by microorganisms, loss of water and electrolytes, and dehydration.
• The skin regulates body temperature.
• The skin synthesizes vitamin D.
• The skin allows sensory perception via end sensory organs for touch, pain, temperature and pressure.
• The skin provides nonverbal communication such as posture, facial movements or vasomotor responses such as blushing.
• The skin allows wound repair through replacement of surface injuries.
• Fingernails well manicured with clear enamel.
• Nailbeds pink without clubbing.
• Cuticles smooth; no detachment of nail plate.
• The skin allows excretion of metabolic waste, such as electrolytes, minerals, sugar or uric acid.
• Toenails clean and well trimmed.
• Nails form 160-degree angle at base; are hard, smooth, and immobile.
• Old appendectomy scar right lower abdomen, 4 inches long, thin, and white.
• Sprinkling of freckles noted across nose and cheeks.
• Normal distribution of hair on scalp and perineum.
• The skin is composed of three layers: the epidermis, dermis, and subcutaneous tissue.
• The epidermis is the outer layer of skin, composed of four distinct layers: the stratum corneum, stratum lucidum, stratum granulosum, and stratum germinativum.
• The stratum corneum is the outermost layer of the epidermis, composed of dead, keratinized cells that render the skin waterproof.
• The stratum lucidum is the innermost layer of the epidermis, containing melanin (brown pigment) and keratin-forming cells.
• Skin color depends on the amount of melanin and carotene (yellow pigment) contained in the skin and the volume of blood containing hemoglobin, the oxygen-binding pigment that circulates in the dermis.
• The dermis is the inner layer of the skin, connected to the epidermis by means of papillae, and is a well vascularized connective tissue layer containing collagen and elastic fibers, nerve endings, and lymph vessels.
• The dermis is also the origin of hair follicles, sebaceous glands, and sweat glands.
• Sebaceous glands develop from hair follicles and are present over most of the body, excluding the soles and palms, secreting an oily substance called sebum that lubricates hair and skin and reduces water loss through the skin.
• Sebum also has some fungicidal and bactericidal effects.
• There is normally a 160-degree angle between the nail base and the skin.
• Nails extend over the entire nailbed and have a pink tinge as a result of the rich blood supply underneath.
• Past health history questions may include skin diseases such as melanoma, eczema, or psoriasis, diabetes or peripheral vascular disease, allergies or food sensitivities, severe sun burn, use of corticosteroid medications for more than 2 weeks, and immunizations.
• Oncholysis is a painless separation of the whitened opaque nail plate from the pinker translucent nail bed, caused by trauma from excess manicuring, psoriasis, fungal infection.
• Validation and Documentation of Findings involves validating normal and abnormal findings with the client, other health care workers, or your instructors, and documenting the skin, hair, and nail assessment data that you have collected on the appropriate form your school or agency uses.
• Vellus Hair is short, pale, and fine and is present over much of the body.
• The nails protect the distal ends of the fingers and toes.
• Nails are hard and basically immobile in dark-skinned clients and older clients.
• The appendages consist of layers of keratinized cells found over much of the body except for the lips, nipples, soles of the feet, palms of the hands, labia minora, and penis.
• Nails are hard and firmly attached to the nailbed in healthy individuals.
• At the base of the nail is the lunula, a paler, crescent-shaped area.
• Transverse Linear Depressions (Beau Lines) are transverse depressions of the nail plates, usually bilateral resulting from temporary disruption of proximal nail growth, seen in severe illness, trauma and cold exposure if Reynaud disease is present.
• Eccrine glands are located over the entire skin surface and secrete an odorless, colorless fluid, the evaporation of which is vital to the regulation of body temperature.