Components of integumentary system skin, hair, nails, glands Comprises the protective coating that guards the body from injury Largest and most visible organ
Functions of integumentary system protect underlying body tissues from external environment
Provides a barrier against bacterial and viral ...
NUR 308 Exam 3 Test Questions and
Correct Answers
Components of integumentary system ✅skin, hair, nails, glands
Comprises the protective coating that guards the body from injury
Largest and most visible organ
Functions of integumentary system ✅protect underlying body tissues from external
environment
Provides a barrier against bacterial and viral invasion
Sensory perception-pain, hot, cold, pressure
Heat regulation by responding to changes in internal and external temperature
Skin cancers ✅most commonly diagnosed cancers
-early detection and treatment can lead to good prognosis
Teach to self examine
-asymmetry
-border
-color
-diameter (<6mm)
-evolving
Skin cancer epidemiology ✅two groups: melanoma, nonmelanoma
Uv damage to dna increases with extended time in the sun and is a major contributing
factor to the development of skin cancers
Non-melanoma skin cancer ✅basal cell carcinoma and squamous cell carcinoma
Basal cell carcinomas are the most common form (75%)
Melanoma ✅men are diagnosed at a higher rate
Most common cancer in women 25-29
Melanoma account for <2% of all cancers but vast majority of skin cancer deaths
Skin cancer pathophysiology ✅uv radiation from sunlight is composed of uva and uvb
Uva rays penetrate deeper into skin, damage disrupts cellular membranes
,Uvb rays do not penetrate deeply into skin, cause sunburns and direct damage to dna
Uv radiation is absorbed by dna of epidermal cells and mediates immune supression
Actinic keratosis ✅a precancerous skin growth that occurs on sun-damaged skin,
papules and plaques (2cm)
Most common form of precancerous lesions
Treatment cyrosurgery, 5 fu topical chemo, surgical removal
Can turn into squamous cell carcinoma
Basal cell carcinoma ✅most common and least severe type of skin cancer
Occurs in middle/older age
Usually not metastatic but can become locally invasive
Malignant melanoma ✅most serious form of skin cancer; often characterized by black
or dark brown patches on the skin that may appear uneven in texture, jagged, or raised.
Environmental and genetic links
Treatment
Excisional biospy only
,May require chemo/interferon or radiation
Malignant melanoma clinical manifestations ✅appearance can follow the abcde rule
Stages depend on thickness and depth
Report increase in size, change in shape/color
Body distribution: anywhere
Common on legs and backs of women and trunk, head, neck in men
Maliginant melanoma statistics ✅once in other organs, palliative care only
-incurable, 7.5 survival after diagnosis
5 year survival rate of 91%, 10 year survival rate 89%
Malignant skin neoplasms risk factors ✅exposure to uv radiation
Extended exposure-greater risk
Genetic factors
History of chronic sun exposure
Outdoor jobs
Indoor tanning booths
Fair skin
-blonde/red hair
-blue/green eyes
Darker skinned individuals still carry a risk
Malignant melanoma treatment ✅excision with a 5mm margin of unaffected tissue and
biopsy, including a sentinel lymph node biospy
Outcome depends on staging
Tumors confined to epidermis have better prognosis
Immunotherapy:
-interferon alpha and interleukin-2 provide treatment option with modest benefits
-stimulate the antitumor response of immune system and inhibit tumor growth
Skin cancer treatment: surgical excision and curettage/electrodesiccation ✅cancers
with well defined margins, high cure rate
Appropriate for low risk smaller lesions
Pt receives local anesthetic, sharp curette used to scrape away friable tumor until base
is felt
Minimal damage to surrounding tissue
, Skin cancer treatment: mohs micrographic surgery ✅gold standard for treatment of
non melanoma skin cancers
Highly specialized surgical approach completed only by specifically trained surgeons
Horizontal sections of tumor are excised, leaving a minimal margin of normal tissue
Skin cancer treatment: photodynamic therapy ✅noninvasive, exposes tumor to light
source, reacts to topical photosensitizing agent
Up to 20% of patients experience severe pain during procedure
May experience burning, itching, crusting at site post op
Advantageous for poor surgical candidates or for those who have large or multiple
lesions that can be treated at one time
Skin cancer treatment: cryotherapy ✅liquid nitrogen used to freeze vasculature leading
to cell death and tissue destruction.
As the tissue thaws, patients experience increased tenderness.
May have blistering and sloughing (white, yellow, tan or green)
Skin discoloration may last up to a year
Minimal scarring
Skin cancer treatment: radiotherapy ✅external beam radiation delivered in fractionated
doses from an x-ray machine.
Contraindicated on previously irradiated areas and some non-melanoma skin cancers.
Appropriate for patients who are poor surgical candidates
For aggressive squamous cell carcinoma, radiotherapy is an additional treatment
following surgical excision.
Skin cancer treatment: topical chemo ✅5-fluorouracil is used in the treatment of
multiple actinic keratoses or for superficial widespread basal cell carcinoma that would
take multiple surgical procedures
Therapy occurs over several weeks; lesions become inflamed, begin to crust, drain, and
eventually erode away.
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