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Physical Assessment > 12 - Skin, hair, + nails > Flashcards

12 - Skin, hair, + nails Flashcards

(74 cards)

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1
Q

skin, hair, and nails make up the…

A

integumentary system

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2
Q

assessment of the integumentary system can reveal the status of the pt’s…

A
  • hydration
  • nutrition
  • airway clearance
  • thermoregulation
  • tissue perfusion
  • activity
  • sleep/rest
  • level of stress
  • self-care ability
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3
Q

major fx of skin

A
  • perceive touch, temp, pain
  • protect against mechncl, chmcl, thrml, solar damage
  • protect against water + electrlt loss
  • reg body temp
  • repair surface sounds
  • synth vit D
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4
Q

4-5 layers of the epidermis (deep to superficial)

A
  • stratum basale
  • stratum spinosum
  • stratum granulosum
  • stratum lucidum
  • stratum corneum
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5
Q

stratum basale mostly consist of…

A

keratin (fibrous, tough protein)

25% melanocytes (produce melanin)

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6
Q

T/F certain ethnicities have more melanocytes than others

A

FALSE

everyone has the same amt of melanocytes but produce different amt of MELANIN

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7
Q

2 types of fibers that make up the dermis

A

collagen (tough, resistant to tears)

elastic fibers

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8
Q

the dermis is richly supplied with…

A
  • nerves,
  • blood vssls,
  • hair follicl,
  • sweat glnd,
  • oil glnd,
  • sensory receptors
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9
Q

hypodermis aka

A

subcutaneous tissue

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10
Q

cutaneous glands are formed in the ____ and push deep into the ____

A
  • stratum basale

- dermis

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11
Q

fx of cutaneous glands

A
  • excrete uric acid, urea, ammonia, Na, K
  • perspiratn/evaporatn
  • protect against bactrl grwth
  • soften, lubcrt, waterprf
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12
Q

2 types of sweat

A 
1 eccrine (most numerous, clear persprtn)
2 apocrine (axillary/anogenital regions, secrete H2O, fatty acids, protein, into hair follicles. smells when mixes w bacteria)
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13
Q

sebaceous glands

A

oil glands

-found all over body except palms, soles of feet

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14
Q

vellus vs terminal hair

A

vellus: pale, most of the body
terminal: brow, scalp, pubic region, axillae, legs, face/chest of males

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15
Q

trichotillomania

A

compulsive twisting/plucking of hair

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16
Q

prolonged immersion of hands in water may lead to…

A

paronychia

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17
Q

ruddy (red-blue tone) is bc of an incr in hemoglobin + stasis of blood in capillaries that can be caused by…

A

polycythemia

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18
Q

carotenemia can be seen in…

A
  • pt w overdigestion of carotene containing foods
  • anorexia nervosa
  • endocrine disorders (DM, myexedema, hypo-pituitarism)
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19
Q

uremia (pale yellow ton) can be due to the retention of ____ and may be caused by ______

A
  • urinary chromogens

- chronic renal disease

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20
Q

what are some cues that the pt may be experiencing impending shock?

A
  • pallor
  • drop in BP
  • incr pulse + resp
  • anxiety
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21
Q

when cyanosis is noted, always assess ___+___

A

VS + LOC

-cyanosis/pallor can indicate low plasma oxygen

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22
Q

when assessing temp, palpate the ___ first and move ___

A

foregeah/face first

then move inferiorly

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23
Q

what can cause diaphoresis

A
  • exertion
  • fever
  • pain
  • emo stress
  • metabolic disorders like hyperthyroidism
  • impending medical crisis like MI
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24
Q

dry skin over lower legs may indicate…

A

vascular insufficiency

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25
dry lips + mucus membranes may indicate
systemic dehydration
26
hyper vs hypo thyroids on skin
hyper: excessively smooth + velvety skin hypo: rough scaly skin
27
turgor
elasticity + ability of skin to return to normal
28
primary vs secondary lesions
P: dvlps on previously unaltered skin S: lesions that change over time or bc of scratching, abrasion, or infection
29
localized hot red swollen painful areas indicate the presence of inflammation + possibly infection. This is CI for...
palpations -do not palpate. slightest disturbance may spread the infection to deeper layers
30
a presence of more than ___ moles is a risk factor for skin cancer
50
31
ABCDE of melanoma screening
``` A asymmetry B border irregularity C color variegation D diameter >6mm E evolving changes ```
32
evolving changes include...
- size - shape - symptoms (itch, tender) - surface (bleeding) - shades of color
33
when hair loss occurs in women, it is thought to be caused by...
an imbalance in adrenal hormones
34
alopecia areata
patchy hair loss
35
pediculosis capitis
head lice
36
schamroth technique
used to assess clubbing - nails normally form a diamond shape opening - tips of nails dont touch
37
types of primary lesions
``` 1 macule/patch 2 papule/plaque 3 nodule/tumor 4 vesicle/bulla 5 pustule 6 wheal 7 cyst ```
38
macule/patches
-flat -nonpalpable -change in skin color M: less than 1cm P: larger than 1cm, may have irreg border
39
macule examples
freckles, measles, petechiae
40
patch examples
- mongolian spots - port wine stains - vitiligo - chloasma
41
papule/plaque
-elevated -solid palpable mass -circumscribed border PPL: smaller than 0.5cm PLQ: groups of papules
42
papule examples
- elevated moles - warts - lichen planus
43
patch examples
- psoriasis | - keratosis
44
nodule/tumor
-elevated -solid -palpable mass -extends into the dermis N: smaller than 2cm T: larger than 2 cm
45
nodule example
- small lipoma - squamous cell carcinoma - fibroma - intradermal nevi
46
tumor examples
- large lipoma - carcinoma - hemangioma
47
vesicle/bulla
-elevated -fluid filled -round/oval -palpable -thin transluscent wall V:smaller than 0.5cm B: larger
48
vesicle examples
- herpes simplex/zoster - early chickenpox - poison ivy - small burn/blisters
49
bullae examples
- contact dermatitis - friction blisters - burn blisters
50
pustule
- elevated | - pus filled
51
pustule examples
- acne - impetigo - carbuncle (large boils)
52
wheal
- elevated - often reddish w irreg border - caused by diffuse fluid in tissues
53
wheal examples
- insect bites | - hives
54
cyst
- elevated - fluid filled or semisolid mass - originate in subcutaneous or dermis - 1cm or larger
55
cyst examples
sebaceous cyst | -epidermoid cyst
56
9 types of secondary lesions
``` 1 atrophy 2 crust 3 erosion 4 fissure 5 keloid 6 lichenification 7 scales 8 scar 9 ulcers ```
57
atrophy
transluscent, dry, paperlike | -thinning/wasting bc loss of collagen + elastic
58
atrophy example
striae + aged skin
59
crust
dry blood, serum, or pus on skin surface fr burst vesicles or pustules -
60
large crusts are called...
scabs
61
crust examples
- eczema - impetigo - herpes - scabs following abrasion
62
erosion
wearing away of superficial epidermis causing a moist, shallow depression
63
erosion ex
- scratch marks | - ruptured vesicles
64
fissure
linear crack w sharp edges extending into the dermis
65
fissure ex
- cracks at corners of mouth or in hands | - athletes foot
66
keloid
elevated, irregular, darkened area of excess scar tissue | -fr excessive collagen formation during healing
67
lichenification
rough, thickened, hardened area of epidermis | -fr chronic irritation like scratching or rubbing
68
lichenification ex
chronic dermatitis
69
scales
shedding flakes of greasy, keratinized skin tissue | -white, grey, or silver
70
scales ex
-dry skin -dandruff psoriasis -eczema
71
4 Vascular Lesions
1 hemangioma 2 hematoma 3 petechiae 4 ecchymosis
72
hemangioma
- bright red raised lesions - 2-10 cm - unblanchable - present at birth - disappears by age 10
73
clubbing has a nail angle greater than ____
160 degrees
74
onycholysis
fungal nail infection | -causes nails to thicken + lift

Physical Assessment (20 decks)

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