Exam 3: Skin, hair, nails Flashcards
(120 cards)
1
Q
Skin is like a
A
window for viewing changes that take place within the body
2
Q
Inspect and palpate skin for
A
Color & presence of lesions Moisture Temperature Texture & thickness Turgor Vascularity Edema Pain response w/ palpation
3
Q
Chloasma
A
- Darker pigmentation on forehead, nose, and cheeks “mask of pregnancy”
- Usually fades after birth
4
Q
Linea Nigra
A
Darkened line from umbilicus to symphysis pubis
- Darkening of areola
- Usually fades after birth
5
Q
Normal/benign pregnancy skin variations
A
Chloasma
Linea nigra
6
Q
Normal or benign newborn skin markings
A
Milia
Mongolian spots
Erythema toxicum
Stork bike (nevus simplex)
7
Q
Milia
A
Unopened/clogged sebaceous glands that usually appear on nose and cheeks
8
Q
Mongolian spots
A
Normal in dark-skinned infants during 1st few years of life
9
Q
Erthema toxicum
A
Transient maculopapular rash; may be due to increased eosinophil activity
10
Q
Stork bite (nervous simplex)
A
Caused by dilation of small capillaries; regress spontaneously
11
Q
Sebaceous Glands in elderly
A
Decrease in size, number, and output
12
Q
Decreased output of the sweat glands cause
A
Senile Xerosis
Skin itches
Looks flaky and loose
13
Q
Senile Xerosis
A
Age related dry skin
14
Q
Age related skin changes
A
Paper-thin, transparent skin Wrinkles Actinic lentigo Cherry hemangiomas Skin tags
15
Q
Wrinkles
A
Decrease elastin and subcutaneous tissue
16
Q
Actinic lentigo: liver spots
A
Normal with aging
Cluster of melanocytes on dora of hands and forearms
17
Q
Cherry hemangiomas
A
Common and arise in middle-ages to older adults
18
Q
Cherry hemangioma is a
A
Vascular lesion
19
Q
Cherry hemangiomas usually located on
A
the trunk
20
Q
Cherry (senile) hemangiomas increase in what with age
A
Increase in size and number
21
Q
Are Cherry (senile) hemangiomas a concern?
A
No, they are benign
22
Q
Skin tags
A
Overgroths of normal skin that forms a stalk
23
Q
skin tags are frequently on
A
eyelids
cheeks and neck
axillae and trunk
24
Q
Skin tags are more common with
A
diabetes
25
Turgor indicates
Elasticity and overall hydration
26
turgor can be altered by
Water content
| Aging
27
How to check turgor
Pinch skin and release
28
If skin has normal elasticity and hydration, it will
Immediately return to its original state after pinching
29
Poor skin turgor is
tenting of the skin with a slow return to the original
30
Skin/mucous membrane color comes from
```
melanin
carotene
oxyhemoglobin
deoxyhemoglobin
bilirubin
```
31
Pallor
Observed most readily in the palms, nail beds, face, and conjunctiva
32
Pallor is caused by
```
Lowered Hgb content
fight or flight response
Medications
Cold
Shock
```
33
Red/erythema increased visibility of
Hgb
34
red/erythemic skin cause what with hand pressure
Blanches
35
Red/erythema is often related to
inflammation
36
is red/erythmea skin the same as burns?
No!
37
Blue/cyanosis is increased
Geoxyhemoglobin (Hhb=hypoxia/hypoxemia)
38
Blue/cyanosis often related to
cardio/pulmonary diseases or end of life
39
Jaundice
Excess bilirubin
40
Carotenoderma / Carotenemia:
(blood levels 4X normal)
| Eyes remain white!
41
Ephelides (freckles)
Small brown macule on sun exposed skin of fair skinned individuals
42
Cafe-au-lait
A light brown, oval macule (dark brown on brown or black skin) found anywhere on the body
43
Loss of pigmentation
Vitiligo
44
Vitiligo is
Congenital
| Autoimmune
45
Assessment methods for dark skin: Pallor
Use good lighting
| Mucous membranes ash-gray color: absence of underlying red tones that give skin a healthy glow
46
Assessment methods for dark skin: Cyanosis
Lips & tongue are grayish
| Palms, soles, conjunctivae, & nail beds have a bluish tinge
47
Assessment methods for dark skin: Erythema
How to assess for inflammation in a dark-skinned patient?
- Compare palpation with other areas of the body.
- Ask about pain in the area
- Palpate for edema/induration
- Moisten skin to look for redness
48
Ski lesions are grouped according to
fluid-filled versus solid, diameter, compare scaling versus flat, etc.
49
Flat lesion
| <0.5 cm diameter
Macule
50
Flat lesion
| >0.5 cm diameter
Patch
51
Elevated. fluid filled with pus, and regular
Pustules
52
Elevated, fluid filled with serous, <0.5 cm diameter
Vesicle
53
Elevated, fluid-filled with serous, > 0.5 cm in diameter
Bulla
54
elevated, edematous, and generally irregular/transiet
Hives !
55
Hives are
Whelts/ wheals
56
Annular:
Circular, ring-like, raised, border around normal skin
57
Circunate
Circular
58
Circumscribed
Well-define borders
59
Clustered
Grouped together
60
Coalesced
Lesions that merged together
61
Diffuse
Wide-spread/generalized
62
Linear
Straight line
63
Universal
All over with no "normal" skin
64
Ecchymosis
Larger area of bleeding associated with injury
| --- may be caused by drugs, low platelets, clotting disorders
65
Purpuric lesions
Less vessels burst without trauma/injury
66
Purpura & petechiae
Often due to low platelets or clotting disorders causing increased capillary fragility
67
Purpura & Petechiae are
- Non-blanching (do not fade w/pressure)
- petechiae 1-3mm, flat, pinpoint
- Purpura generally larger than petechiae
68
Tattooing medical complications are rare, but mainly related to
pigment ingredients, but include viral, bacterial, fungal, and diseases
69
Piercing medical complications are common:
Metal-induced contact allergic dermatitis, broken teeth, anesthetic risks & infections of all types
70
Malignant moles are typically
Asymmetrical
Uneven borders
Two or more shades
Larger than 1/4 inch
71
Skin malignancies
Basal cell carcinoma
Squamous cell carcinoma
Melanoma
72
Nails protects
Vital ends of fingers and toes
73
Nail plate
Pink color from vascular nail bed beneath
74
Nail matrix
Site of growth; protected by cuticle
75
Lunula
White crescent-shaped area that extends beyond cuticle; the visible portion of the nail matrix
76
Dystrophic nails may occur with a
Serious systemic illness or local skin disease involving the epidermal keratinocytes
77
variations in color, texture, & grooming of the nails are influenced by
factors unrelated to disease, such as occupation, personal preferences, or customs
78
Color of the nail plate depends on
```
Thickness
Transparency
Amount of red blood cells
Arterial blood flow
Pigment deposits
```
79
Cgnages in nail color can be caused by
Chemical damage that occurs with some occupations or with long-term use of nail polish
80
Regardless of skin color, the healthy nail
Blanched (lightens) with pressure
81
To differentiate between color changes from the underlying vascular supply problems & those resulting from pigment deposition assess capillary refill
Vascular alterations
| Pigment alterations
82
Vascular alterations
Color will change as pressure it applied and returns to the original state when released
83
Noting the rate of return of color for vascular alterations:
Indicates the status of the peripheral circulation
84
Pigment alterations
color remains unchanged with or without pressure
85
Clubbing
Bulbous swelling of soft tissue of terminal phalanx of the digit
86
Clubbing is associated with
Pulmonary, cardiovascular, infectious, neoplastic, and other disorders
87
Schamroth
Loss of diamond shape formed when right and left thumbs are opposed in person
-- positive sign means abnormal clubbing
88
Beau Lines
Transverse, band-like depressions in nail
89
Beau Lines etiology
Damage to matrix
90
Beau lines can occur after
- Severe, sudden, acute, sometimes febrile illness;
| - Severe reactions to drugs/cytotoxic drugs (e.g. chemotherapy, as in top photo)
91
Onycholysis
- Detachment of nail from its bed at distal &/or lateral attachments
92
Etiology of onycholysis
idiopathic, mechanical or chemical damage; also associated with psoriasis
93
Onychomycosis
Invasion of the nail by fungus
| -affects up to 14% of population with increasing prevalence among older individuals
94
Age-related nail changes
- Gradual thickening of the nail plate
- Longitudinal ridges
- Yellowish gray discoloration
95
what is responsible for forming hairs
Cells of the germinal matrix responsible
96
Cells of the germinal matrix undergoes repeated
Mitosis, push upward in the follicle, and become keratinized to form a hair
97
As long as the cells of the germinal matrix remain alive,
hair regenerates even though it is cut, plucked, or otherwise removed
98
A common type of baldness occurs when two requirements are met:
genes for baldness + male sex hormones (androgens)
99
When the right combination of these causative factors exist (genes for baldness + male sex hormones)
Androgenic alopecia or
| Male pattern baldness inevitably results
100
Sudden or marked changes in hair characteristics may reflect
an underlying disease process
101
Intense itching/scratching for hair
Examine the scalp & pubis for lice and nits
102
Nits
Lice eggs
103
Inspect scalp for
Scaling, redness, open areas, crusting, tenderness
104
Dandruff
Collection or patchy or diffuse white/gray scales on the surface of the scalp
105
Flaking from dandruff causes people to mistakenly think the scalp is
too dry, however, it is excessive oil production
106
Pediculosis
Infestation with any of several kinds of lice
107
Types of lice encountered most frequently
Pediculus humanus capitis
Pediculus humanus corporis
Phthirus pubis
108
Pediculus humanus capitis
Head louse
109
Pediculus humanus corporis
Body louse
110
Phthirus pubis
Pubic or crab louse
111
louse (lice) requires
BLOOD
112
infestation of louse causes
Pruritus (result of sensitization to louse saliva)
113
Scratching from lice can result in
secondary bacterial infections
114
Head lice reside on the
Scalp, lay nits (eggs) on hair
115
The head louse can be found infesting people from
All socioeconomic groups
116
Can lice be acquired through contact with pets or other animals?
No!
117
Hirsutism
Condition of male-pattern hair growth in women
118
Hirsutism may arise
from excess male hormones called androgens, primarily testosterone
119
Hair of older individuals looks gray or white due to
decrease in number of functional melanocytes
120
Although gradual hair loss occurs with aging, sudden asymmetric or patchy hair loss at any age
is of concern
