Flashcards in Clinical evaluation tools Deck (136)
What is the rule of three?
Looking for a minimum of 3 indications that support your hypothesis.
What are the 3 main structures of a nail?
1. The nail plate
2. The nail bed
3. The cuticle
What 3 indications may nails give us?
1. overall vitality (strength & quality)
2. Occupations and hobbies
3. Nutritional status
What is paronychia and what may it indicate?
Nail infection around the nail. Caused by:
What can wicks or hangnails be due to?
Too little protein, lack of vit B and vit C.
What may nail dryness indicate?
Low EFAs, low vit A and D or low thyroid condition.
Excessive use of chemical detergent, irritants and hand washing may indicate?
Need for nervous system/adrenal support or may be due to occupational hazards.
What is clubbing (Schamroth's sign)?
Involves a softening of the nail bed with the loss of normal angle between nail bed and the fold. If you can see a diamond space between them (Schamroth's sign) then the nails are not clubbed.
What are 3 causes of clubbing?
1. Pulmonary and Cardiovascular (80%)
2. Gastrointestinal (5%)
3. Hyperthyroidism (1%)
What is koilonychia?
spoon shaped concave nails
Which age group does koilonychia normally appear in?
Children, usually resolves with aging.
What test can we perform to see if a nail is spooned?
Water drop test - if water doesn't slide off nail is spooned.
Name 3 conditions spooned nails can indicate?
1. Iron deficiency
2. diabetes mellitus
In Beau's nails the location and depth of transverse lines indicate what?
The approximate date and severity of the illness.
Name 3 illnesses producing Beau's lines?
1. Severe infection
2. Hypotension, shock
Along with transverse lines, what other appearance is there in Beau's lines?
Beau's Growth Arrest Line
Name 3 things thin brittle nails may indicate?
1. Metabolic bone disease
2. Thyroid disorder
3. Severe malnutrition and common mineral deficiency
Name 3 deficiencies associated with central longitudinal ridges?
1. Iron deficiency
2. Folic acid deficiency
3. Protein deficiency
Which nail is central nail canal normally present?
What 3 conditions are associated with central nail canal?
2. Repetitive trauma
3. Severe arterial disease
What type of deformity can appear with central nail canal?
Fir Tree deformity
What is the main cause of nail pitting?
Nail matrix inflammation due to psoriasis and eczema.
Can you describe nail beading?
The beads seem to drip down the nail like wax.
What condition is nail beading associated with?
Endocrine (diabetes mellitus, thyroid, addison's disease)
Name one condition to consider when nails look sandpapered and dull.
Identify 3 possible causes of nail thickening.
1. Slowed nail growth
2. Onychomycosis (fungal nail infection)
What is onycolysis?
Distal separation of the nail plate from the underlying nail bed.
Name 3 conditions associated with onycolysis?
3. Contact dermatitis
What should be investigated if lunula is absent from the thumbs?
Anaemia or malnutrition