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Physical Assessment > Physical Assessment: Skin Exam > Flashcards

Physical Assessment: Skin Exam Flashcards

(65 cards)

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1
Q

Skin: Three Layers

A

Epidermis
Dermis
Subcutaneous Layer

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2
Q

Epidermis: 5 Layers

A 
Stratum Corneum
Stratum Luciderm
Stratum granulosum
Stratum Spinosum
Stratum Basale
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3
Q

Dermis: Composition and Function

A

composition: living cells
Two Functions:
Perspiration
Supply Epidermis with nutrient rich blood

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4
Q

Dermis: Two layers

A

Papillary

Reticular

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5
Q

Subcutaneous Tissue: Composition and Function

A

Composition: Fat and loose CT
Function: Stabilizes skin
-insulates, stores energy, shock absorption

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6
Q

Skin: Changes with age

A

Looses vascularity
Blood vessels become thin
Skin becomes thinner, pale and translucent
Decrease in elasticity

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7
Q

Physical Assessment of skin

A 
Color
Temperature
Dry/moist
Legions?
Skin folds (intertriginous)
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8
Q

Lesions: 3 types

A

Primary
Secondary
Vascular/ Purpuric

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9
Q

Primary Legions: Non palpable (2)

A

Macule: < 1cm (freckles)
Patch: > 1cm (birthmark)

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10
Q

Primary Legions: Palpable (3)

A

Papule: < 1cm
Plaque: often a collection of papules, >1cm
Nodule: Marble like, >0.5cm (deep and firm)

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11
Q

Primary Legions: With Fluid (3)

A

Vesicle: 1cm, serous fluid
Bulla: >1cm, serous fluid
Pustule: inside is pus (infection)

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12
Q

Primary Legions: Wheal

A

Irregular, superficial area of edema

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13
Q

Secondary Legions: 4 types involving skin loss

A

Crust: serum/pus/blood dried on skin
Erosion: chicken pox scar
Ulcer: deep, loss of epidermis and dermis, may go to bone
Fissure: Linear crack, only epidermal and dermal layer

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14
Q

Secondary Legions: Vascular vs Purpuric
Purpuric = think purple (bruise)
Vascular = think (think tiny veins)

A 
Purpuric: Outside vessels
-petechiae
-ecchymosis
Vascular: Within vessels
-telangiectasia
-spider vein
-spider angioma
-cherry angioma
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15
Q

Petechia

A

(purpuric) 1-3mm, red/purple. Non-blanching

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16
Q

Ecchymosis

A

(purpuric) >3mm, purple, non-blanching

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17
Q

Telangiectasia

A

(vascular) small, dilated blood vessels, blanching, 0.5-1mm: encompasses spider vein and spider angioma

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18
Q

Spider Angioma: size and location

A

(vascular) <2cm, face, arms and trunk

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19
Q

Spider Vein: Size and location

A

(vascular) Small to several inches, mostly on legs, chest.

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20
Q

Cherry angioma

A

(vascular) 1-3mm, trunk and extremities

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21
Q

Lesions: Arrangements (5)

A 
clustered
linear (line)
annular (in a ring)
arciform (in an arc)
dermatomal (covering a skin band that corresponds to a nerve root)
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22
Q

Skin Tumors: 6 types

A 
Actinic Keratosis
Seborrheic Keratosis
Basal Cell Carcinoma
Squamous Cell Carcinoma
Benign Nevus (Lentigo)
Malignant Melanoma
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23
Q

Actinic keratosis

A

tumor: superficial hyperkeratonic papules, often multiple

1/1000 develop into squamous cell carcinoma

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24
Q

Seborrheic Keratosis

A

tumor: benign, white-yellow or brown raised papules. Typically multiple.

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25
Basal Cell Carcinoma
tumor: although malignant, almost never metastasizes. | Begins as a macule, often on face
26
Squamous Cell Carcinoma
REDDER Macule, firm elevated border. Begin small, white legion. Slow growth at first, rapid and spread later on.
27
Benign Nevus
the common mole
28
Malignant Melanoma: ABCD
``` most aggressive and life threatening A: asymmetry B: Irregular borders C: Variation in Color D: Diameter: >6mm ```
29
Skin Color: Cafe-Au-Lait Spot
Macule, irregular borders, 0.5-1.5 cm, benign.
30
Skin Color: Tinea Versicolor
hypo/hyper pigmented area of skin, found on trunk, neck, and upper arms. Pale, reddish, or tan
31
Skin Color: Vitiligo
Depigmented macules on hands, feet, extensor surfaces. Caused by a loss/lack of melanin
32
Skin Color: Cyanosis
Bluish color of nail beds, fingers, oral mucosa.
33
Skin Color: Jaundice
Yellow discoloration, also sclera
34
Skin Color: Carotenemia
Yellow palms, not jaundice, associated with a diet of yellow vegetables such as carrots, etc. Sclera remains white
35
Skin Color: Erythema
Red hue, "Slapped cheeks"
36
Skin Color: Heliotrope
Violaceous patches over the eyelids
37
Skin Texture: Lichenification
thickening of skin
38
Skin Texture: Atrophy
Thinning of skin
39
Skin Texture: Scar
raised regenerative skin growth
40
Skin Texture: Keloid
excessive growth in healing of a legion
41
Skin Texture: Excoriation
linear loss of epidermis
42
Striae
"stretch marks" associated with rapid growth
43
Legions: Distribution Classification | EXTENT
isolated, localized, regionalized, generalized, universal
44
Skin Breakdown: 5 forms
``` Decubitus Ulcer Decubiti Bedsore Pressure Sore Dermal Ulcer ```
45
Pressure Ulcer: 4 stages
Stage 1: Unbalanceable, redness Stage 2: Skin forms blister or sore Stage 3: Crater, full thickness skin loss Stage 4: Full thickness, damage to underlying structures (muscle etc.)
46
Pressure Sores: Three ways
1: sustained compression 2: shearing forces (sliding/transferring) 3: friction and moisture
47
Hair Loss: Alopecia Areata
hair loss, in round or oval patches. Thought to be autoimmune. NO SCALING
48
Hair Loss: Trichotillomania
Hair loss from pulling/twisting hair
49
Hair Loss: Tinea Capitis (ringworm)
Round scaling patches of alopecia. Hairs are broken off close to surface of scalp.
50
Nails: Paronychia
Infection of the lateral and proximal nail folds. Due to Staphylococcus Aureus or Streptococcus.
51
Nails: Clubbing
Bulbous swelling. Due to hypoxia or genetics
52
Nails: Onycholysis
``` Spontaneous separation of nail at distal margin due to loss of supporting structures. Due to Trauma Psoriasis Fungal infection Onychmyosis ```
53
Nails: Terry's Nails
``` Nail plate turns white. Due to Liver disease Cirrhosis Heart Failure Diabetes ```
54
Nails: Leukonychia
White spots due to trauma
55
Nails: Mee's Lines
``` Transverse white bands, run parallel to lanula Due to: Arsenic poisoning Heart Failure Hodgkin's Disease Chemotherapy CO poisoning Leprosy ```
56
Nails: Beau's Lines
``` Transverse Depressions Due to: Severe illness trauma Cold exposure (w/ Reynaud's disease) ```
57
Nails: Pitting
``` Depressions Due to: Psoriasis Reiter's syndrome Sarcoidosis Alopecia areata Localized atopic or chemical dermatitis ```
58
Nails: Anatomical Components
``` Lunula, Nail plate, Cuticle, Lateral nail fold, proximal nail fold, Free Edge Nail bed, Nail root, Distal Phalanx Cross section of nail plate. ```
59
Nails: Paronychia
infection of nail bed, spreads to entire nail
60
Nails: Herpetic Whitlow
infection caused by herpes virus, contagious
61
Asteatosis
Dry skin Common in geriatrics Flaky, rough
62
Skin Exam: Palpation
Temperature/Moisture: hot or cold, wet or dry Texture: smooth or rough Turgor: elasticity Edema: swelling
63
Inspection and Palpation of Skin Checklist
``` Location Pattern (Configuration) Size, Shape Mobility Consistency Color Exudate (Drainage) ```
64
Legion: Distribution Classification | PATTERN
``` symmetrical, exposed areas, areas of pressure, intertriginous area, follicular localization, random ```
65
Legion: Distribution Classification | CHARACTERISTIC PATTERN
acne, syphilis, erythema mulitform, many more

Physical Assessment (2 decks)

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