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NURS 307 > Chapter 12: Skin, Hair and Nails > Flashcards

Chapter 12: Skin, Hair and Nails Flashcards

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1
Q

Epidermis

A

outermost layer, thin but tough, replaced every 4 weeks.

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2
Q

Basal Cell Layer (Stratum Germinativum)

A
  1. Forms new skin
  2. Major Ingredients: Keratin (tough fibrous protein), Melanin (brown tones to the skin and hair), Carotene Pigment (orange tones)
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3
Q

Stratum Corneum

A

horny cell layer consists of dead keratinized cells

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4
Q

Dermis

A

inner supportive layer, consists of connective tissue (collagen), nerves, sensory receptors, blood vessels, lymphatics, hair follicles, sebaceous glands, and sweat glands

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5
Q

Subcutaneous

A

adipose (fat) tissue

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6
Q

Parts of the Skin

A

A. Epidermis
B. Dermis
C. Subcutaneous
D. Appendages

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7
Q

Appendages of the skin include

A

hair, sebaceous glands, sweat glands, nails

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8
Q

Hair

A

shaft, root, bulb matrix.

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9
Q

Vellus hair

A

fine hair all over body

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10
Q

Terminal hair

A

scalp, eyebrows

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11
Q

Sebaceous glands

A

produce sebum

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12
Q

Sweat glands: 2 Types

A

Eccrine and Apocrine

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13
Q

Eccrine Glands

A

produces sweat (diluted saline solution) active at 2 months of age

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14
Q

Apocrine Glands

A

produce thick milky secretions, activated in puberty

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15
Q

Nails

A

hard plates of keratin

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16
Q

What are the functions of the skin?

A
  1. Protection
  2. Barrier
  3. Perception
  4. Temperature Regulation
  5. Identification
  6. Communication
  7. Wound Repair
  8. Absorption and excretion
  9. Production of Vitamin D
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17
Q

Functions of the Skin: Protection

A

minimizes injury from physical, chemical, thermal, and light-wave sources

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18
Q

Functions of the Skin: Barrier

A

stops invasion of microorganisms, loss of water and electrolytes from the body

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19
Q

Functions of the Skin: Perception

A

has a vast sensory surface holding the neurosensory end-organs for touch, pain, temperature and pressure

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20
Q

Functions of the Skin: Temperature Regulation

A

allows heat dissipation through sweat glands and heat storage through subcutaneous insulation

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21
Q

Functions of the Skin: Identification

A

people identify one another by unique combinations of facial characteristics, hair, skin color, and even fingerprints.

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22
Q

Functions of the Skin: Communication

A

emotions are expressed in the sign of language of the face and body posture. Vascular mechanisms such as blushing or blanching also signal emotional states.

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23
Q

Functions of the Skin: Wound Repair

A

skin allows cell replacement of surface wounds

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24
Q

Functions of the Skin: Absorption and excretion

A

skin allows limited excretion of some metabolic wastes, by-products of cellular decomposition such as minerals, sugars, amino acids, cholesterol, uric acid and urea

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25
Functions of the Skin: Production of vitamin D
the skin is the surface on which UV light converts cholesterol into vitamin D
26
Cultural Considerations
A. Darker Pigment B. Scarring C. Hair
27
Cultural Considerations: Darker Pigment
(native americans and african americans) lower incidence of skin cancer
28
Cultural Considerations: Scarring
Darker pigmented population, especially african americans increased incidence of keloids.
29
Cultural Considerations: Hair
various texture: african americans tend to be more dry and coarse, while asians tend to have straight and silky hair
30
Types of Lesions
A. Primary Lesions B. Secondary Lesions C. Vascular Lesions
31
Primary Lesions
Macule, patch, papule, plaque, nodule, tumor, wheal, urticaria, vesicle, bulla, cyst, pustule
32
Secondary Lesions
Crust, scale, fissure, erosion, ulcer, excoriation, scar, atrophic scar, lichenification, keloid
33
Vascular Lesions
Pupura, petechiae, contusion, ecchymosis, hemangioma
34
macule
color change, flat, <1cm (freckle, measles)
35
patch
flat, macule that is >1cm (mangolian spot, cafe au lait)
36
papule
elevated, solid lesion <1cm, lesion you can feel (mole, wart)
37
plaque
papule >1cm in width, surface elevation wider than 1cm (psoriasis)
38
nodule
solid, elevated, hard or soft >1cm, extends deeper into dermis (intradermal nevi)
39
tumor
>2cm, firm or soft mass (lipoma, hemangioma)
40
wheal
superficial, erythematous, raised lesion - slightly irregular shaped (insect bite, hive)
41
urticaria
hives. multiple wheal like lesions, very itchy - various sizes.
42
vesicle
fluid filled, elevated lesion <1cm (herpes, chicken pox, small blister)
43
bulla
>1cm vesicle (burn, blister, bullous impetigo)
44
cyst
fluid filled cavity extending to dermis or subcutaneous layer (sebaceous cyst)
45
pustule
pus filled lesion (acne, pimple)
46
crust
thickened, dried out exudate left when vesicles/pustules burst or dry up (impetigo)
47
scale
flakes of skin, silvery or white (psoriasis, eczema, seborrhea dermatitis)
48
fissure
linear crack with abrupt edges (athletes foot, cracks in the corners of mouth)
49
erosion
shallow depression on epidermis, does not extend to dermis, usually no scar (superficial abrasion)
50
ulcer
deep depression into dermis, irregular shape, leaves scar usually (decubitus ulcer)
51
excoriation
self-inflicted abrasion, superficial crusting secondary scratching (scabies, insect bites, dermatitis, varicella)
52
scar
healed lesion, normal tissue is replaced with collagen/connective tissue
53
atrophic scar
skin level depressed with loss of tissue, thinning of epidermis
54
lichenification
prolonged intense scratching eventually thickens skin
55
keloid
elevated scar, feels smooth and rubbery. Benign excess scar tissue, increased incidence in darker pigmentation populations.
56
purpura
>3 mm red/purple patch, flat macular hemorrhage
57
petechiae
1-3 mm tiny, pinpoint, round hemorrhages, tiny flat blood spots ranging in color - red, purple or brown (abnormal clotting, sepsis)
58
contusion
bruise, flat macular lesion of various colors depending on stage of bruise. Injury results in hemorrhage into tissues.
59
ecchymosis
a purplish patch resulting from blood into the skin >3 mm
60
hemangioma
reddish/blue, solid, spongy collection of benign blood vessels
61
What are the color variations?
1. pallor 2. erythema 3. cyanosis 4. jaundice
62
pallor
pale, white
63
erythema
redness
64
cyanosis
bluish, mottled color
65
jaundice
yellow color
66
History/Subjective Data
1. history of skin disease: treatments, skin allergies, birthmarks, tattoos, piercings 2. change in skin color/pigmentation - general or localized 3. changes in moles, skin lesions, freckles, sores, etc. 4. changes in skin texture: excessive dryness or moisture 5. pruritis 6. excessive bruising 7. rash/lesions 8. medications 9. hair loss - pattern, location, change in hair texture, color 10. change in nail texture, color, or shape 11. environmental/occupational hazards/exposures - excessive sun exposure 12. self-care behaviors - skin self-examination, type of skin care products, etc.
67
Exam/Objective Data
Inspect and Palpate: 1. color/general pigmentation 2. temperature 3. excessive moisture/dryness 4. texture 5. edema 6. skin mobility/skin turgor 7. vascular lesions/bruising 8. intactness 9. lesions 10. IV's/Drainage tubes, etc. 11. Hair/Scalp 12. Nails
68
Excessive Moisture/Dryness
1. diaphoresis- profuse perspiration | 2. dehydration- mucous membranes dry, lips cracked
69
Edema
a. 1+ mild pitting: slight indentation, no visible swelling b. 2+ moderate pitting: indentation subsides rapidly c. 3+ deep pitting: indentation remains for a short time, swollen appearance d. 4+ very deep pitting: indentation lasts a long time, very swollen
70
When doing exam/objective data, with lesions note:
note location, color, size, symmetry, pattern, shape, elevated or flat, odor, drainage or discharge
71
Common Skin Abnormalities
impetigo, eczema, candidiasis, varicella, tinea corporis, tinea pedis, tinea capitis, allergic drug reaction, psoriasis, herpes zoster/shingles, melanoma, kaposi's sarcoma, seborrheic dermatitis, alopecia areata, pediculosis capitis, folliculitis, nail clubbing, hirsutism and decubitus ulcer (stage I-IV)
72
Subjective Data Health History Questions R/T Skin
- past history of skin disease, allergies, hives, psoriasis, or eczema? - changes in pigmentation or color, size, shape, tenderness - excessive dryness or moisture? - pruritus or skin itching? - Excessive bruising? How did it happen? - rash or lesions? When did it start? Where? How has it spread? - medications: prescription and over the counter - hair loss - change in nails' shape, color, or brittleness - environmental or occupational hazards? - self-care behaviors
73
With a rash
Check all areas of the body as you cannot rely on the history that rash is only in one place
74
Checking for temperature
- Use backs of hands to palpate person - Skin should be warm and temperature equal bilaterally (warmth suggests normal circulatory status) - Hands and feet may be slightly cooler in a cool environment (hypothermia and hyperthermia)
75
Vascularity and Bruising
- multiple bruises at different stages of healing and excessive bruises above knees or elbows should raise concern about physical abuse - needle marks or tracks from intravenous injection of street drugs may be visible on ante cubical forsake, forearms or on any available vein.
76
With IV's/drainage tubes
Note location, describe site - including color, surrounding tissue (soft, hard, tender, hot, etc.) and drainage.
77
ABCDE Skin Assessment
A (asymmetry) B (border): is it smooth? Concerning if it's irregular or jagged. C (color): is it red, white, blue, black? D (diameter): concerning if it's greater than 6 mm E (elevation and enlargement): has it gotten bigger? Did it go from flat to raised?
78
When inspecting and palpating nails
Note shape, contour (nl 160'), consistency/texture, color, check cap refill)
79
Shapes and configurations of lesions
- annular or circular - confluence - discrete - grouped - gyrate - target or iris - linear - polycyclic - zosteriform

NURS 307 (29 decks)

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