Plan 4 Physiological role of the skin Anatomical and physiological features of the skin Inspection of the skin Color of skin Subcutaneus fat layer
The skin is the outer cover of the human body, the barrier between the body environment and the external environment involved in metabolic processes, thermoregulation, etc.
- respiratory function: in a newborn it is 8 times stronger than in an adult; secretory function - vitamins are formed in the skin pigment-forming function - melanin production the skin is the organ of the senses excretory function - underdeveloped at an early age, in an adult emits up to 1,300 ml of sweat Physiologi cal role of the skin.
Anatomical and physiological features of the skin. The skin consists of two layers: the epidermis (basal, granular and horny layers) and dermis. Features: -the thickness of different layers of the -skin of children is 2-3 times less than that -of the elders; - in the basal layer of the epidermis of the newborn is not enough melanin (skin lighter, including in Africans); -the granular layer of the newborn is weakly expressed, there is no keratogialin (this - explains the transparency and pink color of the skin); the stratum corneum is thin, friable, saturated with water; a weakly developed membrane separating the epidermis and dermis, as a result of which epidermolysis is possible - easy formation of blisters in places of pressure, on mucous membranes; - the dermis in children has a predominantly cellular structure, in adults - fibrous. By the age of 6, the histological structure of the skin is approaching the composition of an adult rights.
Sebaceous glands The sebaceous glands begin to function even in the prenatal period, their secret forms a curdled grease covering the surface of the fetal skin. Lubricant protects the skin from the effects of amniotic fluid and facilitates the passage of the fetus through the birth canal. Sebaceous glands actively function in the first year of life, then their secretion decreases, but again intensifies in the puberty period. In teenagers they are often clogged with horny plugs, which leads to the development of acne. Sweat glands At the time of birth, the eccrine sweat glands are not fully formed, their excretory ducts are not sufficiently developed and closed by epithelial cells. Sweating begins at the age of 3-4 weeks. During the first 3-4 months, the glands do not function fully. The threshold is reduced. By 5-7 years the glands are fully formed,and adequate sweating occurs in 7-8y Hair Primary hair before birth or soon after it is replaced by gun. The skin, especially on the shoulders and back, is covered with gun hair (lanugo), which is much more noticeable in preterm Eyebrows and eyelashes are poorly developed, in the future their growth increases. The development of hair during puberty ends. Nails The nails of full-term newborns are well developed and reach the fingertips. In the first days of life the growth of nails is temporarily delayed and the so-called physiological trait is formed on the nail plate.
Inspection The child is examined, if possible, in natural daylight. Skin covers are examined sequentially from the top down: the scalp, neck, natural folds, inguinal and gluteal regions, palms, soles, interdigital between the ducks. On examination, evaluate: skin color and its uniformity; humidity; purity (absence of hysteria or other pathological elements, for example, hemorrhages); the state of the vascular system of the skin, in particular localization and the severity of the venous pattern; Integrity of skin integument; the condition of the appendages of the skin (hair and nails).
Color of skin Yellowness (icteric) Redness (hyperemia) Pale skin Pale skin is more often due to a violation of the blood composition - true anemia. It may be asso- ciated with vasospasm - pseudoanemia. The main difference is the color of the mucous membranes: with true anemia the mu- cous membranes become pale. It is carried out in a warm, bright room, in the side transmitted light. Children of an early age are stripped entirely, the elders - gradually, during the course of the examination. The color of the skin of a healthy child is pale pink or swarthy. Redness (hyperemia) of the skin under phy- siological conditions occurs with neurogenic disorders, the action of low temperature, mecha-nical irritation. Patho- logical hyperemia occurs with fever, erythrocytosis. Yellowness (icteric) of the skin and sclera can be of an alimentary nature - (eating a lot of food or drugs containing colorants - carrots, tangerines, acrichine). In that The palms and soles turn yellow, then the skin of the face and body.
Cyanosis (cyanosis) occurs when the level of oxyhemoglobin falls below 95%, is typical for respiratory and cardiovascular diseases. Total cyanosis - captures the entire surface of the body; regional cyanosis: perioral - around the mouth, cyanosis of nasolabial 8 triangles; acrocyanosis (cyanosis of the distal parts of the body) - tip of the nose, earlobes, lips, tip of the tongue, hands and feet. Much rarer in children can be found dirty-brown color, occurs against the background of long-term chronic diseases (tuberculosis, etc.). When examining the skin, it is necessary to pay attention to the development of the venous network. A pronounced venous pattern in the form of a jellyfish head can appear with stagnant phenomena in the portal vein system. Skin vessels can to form vascular asterisks - are characteristic for chronic liver diseases. It is possible to reveal in the folds of the skin hyperemia.
localization; quantity; color (white, pink, brown, etc.); the size; form; presence or absence of a clear edge; consistency (soft, hard); tenderness in palpation. In describing the elements of the rash, you must specify:
Primary elements of the rash Vesicula Urtica Macula Pustula Papula Tuberculum Bulla
Secondary elements of the rash Erosio Vesicula Squama Cicatrix Crusta Excoriatio Fissure
SFL - distribution of subcutaneous fat after birth is uneven; in the newborn, and especially in the second month of life, it is well developed in all parts of the body, except the abdomen, where there is an intensive growth to half a year. - subcutaneous fat layer in infants in relation to to the mass of the body is relatively larger than that of an adult; this up to 5-7 years in children there is almost no fat tissue in the thoracic and abdominal cavities, retroperitoneal space, which makes it easy to shift internal organs. in the thoracic period of life in the fat layer, embryonic tissue retains its hemopoietic function.
With the skin turgor all you have to do is pinch the skin on the back of your hand for about ten second and then release it. If it snaps right back into shape youre okay, but if it takes a few seconds youre showing signs of dehydration. Its a fairly simple test, but you should first try it ahead of time when you know you are well hydrated so you can see what your skin is like normally. Skin elasticity varies greatly from person to person so its best to have something more personal to compare it to.
Method for determining the thickness of the subcutaneous fat layer at the angle of the scapula and on the abdomen
definition of tissue turgor Decrease in turgor is a sign of the pastose type of paratrophy, significant hypotrophy, Down's disease, atrophy, paresis, paralysis, prolonged inflammatory process
References: Captain Propaedeutics of Childhood Illnesses with Child Care_Capitan TV_2006 Propaedeutics of childhood illnesses А.В.Mazuryn dehydrated-what-are-the-symptoms-of-dehydration/ dehydrated-what-are-the-symptoms-of-dehydration/ Propaedeutics of childhood diseases - Geppe N.A year Keltsev VA - Propaedeutics of childhood diseases, 2011 year