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PA: Exam 1 > 2. SESSION 2.1: Skin, Hair & Nails > Flashcards

2. SESSION 2.1: Skin, Hair & Nails Flashcards

1
Q

What are the eight functions of the skin?

A

1) Protection
2) Prevents penetration
3) Perception

4) Temperature regulation
5) Identification
6) Wound repair

7) Absorption and excretion
8) Synthesizes Vitamin D

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2
Q

Three layers of the skin and their general composition

A

1) Epidermis: Thin, outermost layer (Stratum corneum + Stratum germinativum)
2) Dermis - CT
3) Subcutaneous (adipose)

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3
Q

Differentiate between eccrine glands and apocrine glands.

A
  • Eccrine glands are saline sweat; mature by the time we are 2 years old.
  • Apocrine glands secrete more of a milky solution (around hair follicles). Mature after puberty, during sexual stimulation.
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4
Q

List four locations of apocrine sweat glands.

A
  • Ear canal
  • Axillae
  • Nipples
  • Ano-genital region
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5
Q

List four locations of eccrine sweat glands.

A
  • Forehead
  • Axillae
  • Palms
  • Soles
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6
Q

What objective data should you gather for the skin? (7)

A
  • Color: General pigmentation
  • Color: Widespread color change
  • Moisture
  • Temperature
  • Texture
  • Mobility and Turgor
  • Any lesions
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7
Q

What are five different types of widespread color change you might note?

A
  • Pallor
  • Erythema
  • Cyanosis
  • Jaundice
  • Increased pigmentation
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8
Q

What is Reynod’s Phenomenon / Reynod’s disease? What does the disease mean?

A
  • Change in pallor: Skin is pink and white.

- If it’s constant, it’s a disease, and is associated with CT diseases or anemia.

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9
Q

Jaundice is due to a rise of _________ in the blood.

A

Bilirubin

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10
Q

What are seven possible sources of jaundice?

A
  • Hepatitis
  • Really severe fatty liver
  • Malaria
  • Sickle cell disease
  • Gallstones blocking the bile duct
  • INH for TB can cause hepatitis from the medication
  • Cancer
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11
Q

Five signs of malignant melanoma

A

A: Asymmetry of eye
B: Border (eyes irregularly scalloped)
C: Color is mottled. Haphazard display of color.
D: Diameter: Unusually large (greater than the tip of a pencil earaser)
E: Evolving (change in size, shape, surface, shades of color, or symptoms.

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12
Q

MACULE:

  • Definition
  • Size
  • Examples (5)
A
  • A circumscribed, flat, nonpalpable change in skin color.
  • up to 1 cm
  • Freckles, flat nevi, hypopigmentation, petechiae, measles rash.
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13
Q

PATCH

  • Definition
  • Size
  • Examples (4)
A
  • A macule (nonpalpable change in skin color) larger than 1 cm
  • Mongolian spot, vitiligo, cafe au lait spot, chloasma, measles rash
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14
Q

PAPULE

  • Definition
  • Cause
  • Size
  • Examples (3)
A
  • A palpable, elevated, circumscribed, solid mass; caused by superficial thickening in the epidermis.
  • Up to .5 cm
  • Elevated nevus, lichen planus, molluscum, wart
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15
Q

PLAQUE

  • Definition
  • Size
  • Examples (3)
A
  • A flat, elevated surface larger than .5 cm, often formed by the coalescence of papules.
  • Psoriasis, lichen planus, xanthoma
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16
Q

NODULE

  • Definition
  • Size
  • Examples (3)
A
  • A solid, elevated, firm or soft mass larger than .5 cm. May be firmer and extended deeper into the dermis than a papule.
  • .5 to 1-2 cm
  • Xanthoma, fibroma, intradermal nevi
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17
Q

TUMOR

  • Definition
  • Size
  • Examples (2)
A
  • A solid, elevated firm or soft mass extending even deeper into dermis, may be benign or malignant.
  • Larger than 1-2 cm
  • Lipmoa, hemangioma
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18
Q

Wheal

  • Definition
  • Size
  • Examples (3)
A
  • A superficial, raised, erythematous, transient lesion with somewhat irregular borders due to localized edema (fluid held diffusely in the tissues.
  • Size varies.
  • Mosquito bite, allergic reaction, dermographism.
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19
Q

Urticaria

  • Definition
  • Size
  • Example
A
  • Wheals coalescing to form an extensive reaction; intensely pruritic.
  • Size varies.
  • HIVES.
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20
Q

Vesicle

  • Definition
  • Size
  • Examples (4)
A
  • A circumscribed, superficial elevated cavity containing free fluid; clear fluid flows if wall is ruptured.
  • Up to 2 cm.
  • Herpes simplex, early varicella (chx pox)
  • Herpes zoster (shingles)
  • Contact dermatitis
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21
Q

BULLA

  • Definition
  • Size
  • Examples (4)
A
  • A larger vesicle. Usually single chambered (unilocular; superficial in epidermis. It is thin-walled, so it ruptures easily.
  • Larger than 1cm
  • Friction blister, pemphigus, burns, contact dermatitis.
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22
Q

PUSTULE

  • Definition
  • Size
  • Examples (2)
A
  • A circumscribed, superficial, elevated cavity containing turbid fluid (pus)
  • Up to one cm
  • Impetigo, acne
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23
Q

CYST

  • Definition
  • Size
  • Examples (2)
A
  • An encapsulated, fluid- or pus-filled cavity in dermis or subcutaneous later, tensely elevating the skin.
  • Larger than 1cm
  • Sebaceous cyst, wen
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24
Q

ERYTHEMA

  • Definition
  • 4 causes
A
  • Redness due to excess blood in the surface capillaries

- due to fever, localized infection, embarrassment, or Carbon Monoxide poisoning.

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25
Q

CYANOSIS

  • What it it?
  • What do you look for?
A
  • Lack of oxygen due to decreased profusion of oxygenated blood for whatever reason.
  • We look to see if it’s local or generalized.
  • Anemic person may not look blue, but might not have enough Hb carrying oxygen.
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26
Q

______ is the name of the condition where skin lacks pigment – like Michael Jackson had.

A

Vitiligo

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27
Q

Darkening on the neck, probably due to increased insulin resistance on its way to diabetes.

A

Acanthosis Nigricans

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28
Q

3 possible causes of pallor

A
  • Anxiety
  • Fear
  • Anemia
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29
Q

3 possible causes of Jaundice

A
  • Chirrhosis
  • Sickle Cell
  • Hepatitis
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30
Q

Cause of Cyanosis

A

Hypoxemia

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31
Q

A birth mark called _______________ refers to a flat, harmless color change that WILL fade away.

A

Mongolian Spots

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32
Q

Name and describe the two types of acne.

A
  • Comedonal: Whitehead or blackhead. Pore is clogged.

- Pustular: Pimples. More than just a clogged pore.

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33
Q

Name five skin changes that occurs in older adults

A
  • More wrinkling
  • Senile purpura
  • Dry skin (xerosis)
  • Senile lentigines
  • Skin takes about 4x longer to heal.
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34
Q

SENILE PURPURA

  • Definition
  • Size
  • Appearance
A
  • Purple bruises on forearms - benign
  • .3-1cm
  • Purple, does not blanch.
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35
Q

_____ is a fancy word for dry skin.

A

Xerosis

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36
Q

_______ are “liver spots” - flat, brown clusters of melanoma due to sun use. Normal variation.

A

Senile lentigines

37
Q

Six things you inspect for in a skin exam.

A
  • Termperature
  • Moisture
  • Texture
  • Thickness
  • Edema
  • Mobility and turgor
38
Q

__________ refers to “too much moisture”

A

Diaphoresis

39
Q

What happens to the skin in hypothyroidism?

A

Rough, scaly, thick skin

40
Q

What happens to the skin in hyperthyroidism?

A

Smooth, dried or moist.

41
Q

Five possible causes for edema

A
  • Deep venous thrombosis (DVT)
  • Chronic venous insufficiency
  • Lymphedema
  • Orthostatic edema
  • Congestive heart failure
42
Q

How is Edema graded?

A

1+, 2+, 3+ or 4+

43
Q

With edema, if you leave a dent when you push with your thumb, it is called _______

A

PITTING.

44
Q

What is mobility? What does “normal” look like?

A
  • Skin’s sense of rising
  • Reflects elasticity
  • Normal rises easily
45
Q

What is turgor?

A

Ability to return to place promptly when released. Reflects elasticity and moisture content.

46
Q

What is tenting?

A

Due to dehydration: When pinched skin takes its time going back to normal.

47
Q

What four components do you note when assessing a wound?

A
  • Type
  • Appearance
  • Dressing
  • Drainage
48
Q

_________ refers to “chafing”

A

excoriation

49
Q

_______ refers to a black wound

A

Eschar

50
Q

ECCHYMOSES

  • Definition
  • Size
  • Appearance
A
  • A small hemmorrhagic spot on the skin or mucus membrane where blood escaped into tissues from ruptured vessels.
  • 1 cm (larger than a petechia)
  • Non-elevated, rounded or irregular blue or purplish patch.
51
Q

_________ refers to serous with a little bit of blood tinting

A

Serosanguinous

52
Q

____________ refers to puss drainage

A

Purulent

53
Q

____________ refers to itchy

A

pruritis

54
Q

A diagnosis of lesions is based on (1), (2) and (3).

A

1) Distribution of lesions
2) Their morphology
3) Their configuration

55
Q

What are we referring to when we talk about the morphology of a lesion?

A

Primary verses secondary.
PRIMARY: Developed on its own (ex hives from poison ivy)
SECONDARY: Result of primary lesion (ex skin tears from itching the hives)

56
Q

Visual features to note when looking at a lesion

A
  • Color
  • Sharpness of edge
  • Surface contour (dome, pedunculated, flat, spire-like etc)
  • Geometric shape or configuration
57
Q

A _______ refers to a long stalk or tissue, so a _________ lesion refers to a mass that is supported by a little stalk on the skin.

A

Peduncle, Pedunculated

58
Q

What is crust? What causes it (3)

A
  • Thickened, dried residue of burst vesicles, pustules or blood.
  • Eczema, impetigo, crust phase of herpes simplex virus.
59
Q

____________ is more commonly known as “athlete’s foot.”

A

Tinea pedis.

60
Q

What are fissures?

- 3 characteristics

A
  • A linear crack with abrupt edges
  • Extends into the dermis
  • Can be dry or moist
61
Q

Four causes of fissures.

A
  • Cheilosis (fissures on side of mouth in wintertime)
  • Athlete’s foot
  • Anal fissure
  • Renal failure (esp if patchy fissures are on skin of arms and abdomen
62
Q

What is erosion? 4 characteristics.

A
  • A superficial, circumscribed loss of epidermis.
  • Leaves a scooped-out but shallow depression
  • Moist but no bleeding
  • Heals without a scar because it does not extend into the dermis.
63
Q

What is an ulcer?

  • Definition
  • 3 examples
A
  • A circumscribed depression extending into the dermis. Irregular shape, may bleed, leaves a scar.
  • Statis ulcer, pressure sore, chancre (syphilis sore)
64
Q

Excoriation (def, 5 examples)

A
  • A superficial scratch mark

- Scratch from foreign body, insect bites, scabies, dermatitis, varicella

65
Q

What is a scar?

A

A replacement of destroyed normal skin tissue by fibrous connective tissue. A permanent change.

66
Q

_________ is a depressed skin level resulting from loss of tissue. A thinning of the epidermis with loss of normal skin furrows, resulting in shiny, transluscent skin. (3 examples)

A

ATROPHY.

Striae, senile skin, arterial insufficiency.

67
Q

LICHENIFICATION

  • Definition
  • Results from…
  • Appearance
  • Two examples
A
  • Thickening and roughening of the skin usually as a result of intense scratching
  • Results from a tightly packed set of papules
  • Increased visibility of the superficial skin markings
  • Ex: Long standing eczema, atopic dermatitis
68
Q

_________ is a hypertrophic scar. What causes it?

A
  • Keloid

- Elevation by an excess scar tissue, which is invasive beyond the site of the original injury.

69
Q

An ANNULAR lesion is

A

CIRCULAR

70
Q

CONFLUENT lesions are

A

CLOSE TOGETHER

71
Q

A DISCRETE lesion is

A

OFF BY ITSELF

72
Q

What is an example of GROUPED lesions?

A

POISON IVY

73
Q

A GYRATE lesion

A

makes sort of a snake-like loop

74
Q

What is an example of a TARGET lesion?

A

Lyme’s

75
Q

a LINEAR configuration of lesions is

A

A STRAIGHT LINE

76
Q

a POLYCYCLIC configuration of lesions is

A

GROUPED ANNULAR (Circular)

77
Q

A ZOSTERIFORM lesion is grouped

A

along a dermatome. Like Herpes Zoster.

78
Q

PETECHIAE

  • Definition
  • Size
  • Appearance
A
  • Pin-sized macules of blood in the skin
  • < 3 mm
  • Color = red
79
Q

CAMPBELL DE MORGAN SPOTS

  • Definition
  • Other name
  • Appearance
A
  • Benign angiomas common on the trunks of the middle-aged and elderly
  • Cherry angioma
  • Small bright red papules of no consequence
80
Q

SPIDER ANGIOMA

  • Definition
  • If diagnosis is in doubt…
  • If …. then check ….
  • May be normal _____________
  • May erupt ____________
A
  • Stellate telengiectases that look like spiders with legs radiating from a central, often palpable, feeding vessle.
  • If diagnosis in doubt, press on center with a slide and lesion will disappear
  • If many on trunk, check liver function.
  • May be normal in faces of children
  • May erupt during pregnancy.
81
Q

Telangiectasia

  • Refers to…
  • 3 possible appearances
  • Can be caused by… (drug)
A
  • Refers to permanently dilated and visible vessles in the skin
  • They can appear as linear, punctuate, or stellate-crimson (star shaped) purple markings
  • Can be caused by Nifedipine (BP med)
82
Q

Angiomas

A

Benign turmors

83
Q

Port Wine Stain

  • Medical Term
  • Caused by…
  • Appearance
  • Location on body
A
  • Nevus Flammeus
  • Caused by dilated dermal capillaries
  • Pale, pink to purple macules
  • Mostly on face and trunk
84
Q

Basal cell carcinoma on the forehead (4 facts)

A
  • Most common malignancy
  • Locally invasive and destructive
  • Slow growing, rarely metastasized
  • Almost translucent, dome-shaped papule with overlying telangiectasias
85
Q

What to look for when inspecting / palpating the hair (4)

A
  • Color
  • Texture
  • Distribution
  • Lesions
86
Q

What to look for when inspecting and palpating the nails (3)

A
  • Shape / contour
  • Consistency
  • Color
87
Q

Alopecia

A

Losing hair

88
Q

Alopecia Areata

A

Losing hair in just one area (most likely immunological phenomenon)

89
Q

____________ is excessive hairiness on women in those parts of the body where terminal hair does not usually occur or is minimal.

A

HIRSUTISM

PA: Exam 1 (10 decks)

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