Wound Care

Skin Assessment and Documentation 327
— Behavioral: cold or heat are unpleasant sensations and
people will add or delete clothing or seek a change in the
environment.
— Physiological: brain centers maintain core body temperature
close to 98.6°F.
— Slight elevations in core temperature cause dilation of
dermal vessels which causes sweating.
Dilation dissipates heat into the environment especially
from hands, feet, nose, lips, and ears. The sweating
delivers fluid to the skin surface where it evaporates
taking off 580 calories per gram.
— Decreases in core body temperature
Cause generalized vasoconstriction and blood is shunted
away from the skin thereby reducing heat loss.
This signals the adrenal glands to increase the metabolic
rate of cells and generates heat.
The brain centers activate the shivering response that
further increases body heat production.
Senses
— Dermis contains free and encapsulated nerve endings.
Free nerve endings translate sense of heat, cold, pain,
and itchiness.
Encapsulated nerve endings translate mechanical forces
into sense of touch and pressure.
Appendages: hair follicles, sweat glands
Pilosebaceous apparatus is made up of the hair follicle
and sebaceous gland.
Hair
Hormonal and genetic variations create the individual
differences for type, density, rate of growth, color, distribution,
pattern, and changes over time.
— Two types of hair:
Terminal: scalp hair
Vellus: fine, soft hair in “hairless” areas of the body.