Skin, Hair, and Nails

Question 1

What is the ROS question for skin, hair, and nails?

Answer 1

Any changes with your skin, hair, or nails? Any discolorations, lumps, or rashes?

Question 2

What’s one important thing when looking comprehensively at the skin?

Answer 2

Blisters

Question 3

What do we look for on inspection of the skin?

Answer 3

Color and patterns of color changes

Question 4

What do we assess a red color for?

Answer 4

Oxyhemoglobin and the pallor in its absence

Question 5

What does pallor result from?

Answer 5

Decreased redness in anemia and decreased blood flow seen in fainting or arterial occlusion

Question 6

Where is central cyanosis best assessed?

Answer 6

Lips, oral mucosa, and tongue

Question 7

What can cause central cyanosis?

Answer 7

1. Advanced lung disease
2. Congenital heart disease
3. Hemoglobinopathies

Question 8

What is cyanosis of the nails, hands, and feet cause by?

Answer 8

Peripheral in origin

Question 9

What simple thing could cause peripheral cyanosis?

Answer 9

Anxiety or a cold examining room

Question 10

What is the cyanosis of HF usually?

Answer 10

Peripheral, reflecting deoxygenation with impaired circulation

Question 11

What should we look for in the sclera?

Answer 11

Yellow color of jaundice

Question 12

What does jaundice suggest?

Answer 12

Liver disease or excessive hemolysis

Question 13

What does NOT affect the sclera?

Answer 13

Yellow color that accompanies high levels of carotene (palms, soles, and face)

Question 14

What are changes in pigmentation caused by?

Answer 14

Widespread increase in melanin by Addison’s disease

Question 15

What is Addison’s?

Answer 15

Hypofunction of the adrenal cortex

Question 16

What does Cafe-Au-Lait Spot suggest?

Answer 16

Neurofibromatosis

Question 17

What is Tinea Versicolor common in?

Answer 17

Common superficial fungai infection of the skin

Question 18

What is Vitiligo?

Answer 18

Depigmented macules appear on the face, hands, feet, and other regions

Question 19

What is cyanosis?

Answer 19

Bluish color that is visible on toenails and toes

Question 20

What is Carotenemia?

Answer 20

Yellowish with pink palm but does NOT affect sclera (jaundice does)

Question 21

What is Erythema?

Answer 21

Red hue, increased blood flow

Question 22

Waht is hellotrope?

Answer 22

Violaceous patches over the eyelids in the collaten vascular disease dermatomyositis

Question 23

Define Lesions

Answer 23

Any of various pathological or traumatic changes in bodily organ or tissue, including tumors, ulcers, sores, and wounds

Question 24

What are the 3 basic lesion descriptions?

Answer 24

1. Flat
2. Solid
3. Fluid filled

Question 25

What is a scale?

Answer 25

A thin flake of dead exfoliated epidermis

Question 26

What is crust?

Answer 26

The dried residue of skin exudates such as serum, pus, or blood

Question 27

What is Lichenification?

Answer 27

Visible and palpable thickening of epidermis and roughening of the skin

Question 28

What are scars?

Answer 28

Increased connective tissue that arises from injury or disease

Question 29

What are keloids?

Answer 29

Hypertrophic scarring that extends beyong the borders of the initiating injury

Question 30

What are 3 secondary depressed skin lesions?

Answer 30

1. Erosion 2. Excoriation 3. Fissure

Question 31

Erosion

Answer 31

Nonscarring loss of the superficial epidermis, surface is moist but does not bleed

Question 32

Excoriation

Answer 32

Linear or punctate errosions caused by scratching

Question 33

Fissue

Answer 33

A linear crack in the skin often resulting from dryness

Question 34

Ulcer

Answer 34

Deeper loss of epidermis and dermis, may bleed or scar

Question 35

Difference between Petechia and Ecchymosis

Answer 35

Ecchymosis more purple

Question 36

What is specific about Basal Cell Carcinoma?

Answer 36

Grows slowing and almost never metastasizes

Question 37

When does Squamos Cell Carcinoma usually appear?

Answer 37

Sun-exposed skin of fair skinned adults older than 60

Question 38

How do we palpate the skin for temp?

Answer 38

Backs of fingers

Question 39

Where do we have generalized warmth in fever?

Answer 39

Hyperthyroidism (coolness in hypo)

Question 40

What do we note when looking at the hair?

Answer 40

Quantity, distribution, and texture

Question 41

Define Alopecia

Answer 41

Hair loss (diffuse, patchy, or total)

Question 42

What happens to the hair in hypothyroidism?

Answer 42

Sparse hair

Question 43

What happens to the hair in hyperthyroidism?

Answer 43

Fine, silky hair

Question 44

What is mobility of the skin?

Answer 44

How easily you can lift it

Question 45

What is turor of the skin?

Answer 45

How quickly it returns to place

Question 46

What is decreased mobility of the skin seen?

Answer 46

Edema

Question 47

When is decreased turgor seen?

Answer 47

Dehydration

Question 48

What do we look for in the nails?

Answer 48

Color, shape, and any lesions

Question 49

What are 6 things related to nails?

Answer 49

1. Clubbing of the fingers 2. Terry's nails 3. Transverse White Bands (Mee's Lines) 4. Transverse Linear Depressions (Beau's Lines) 5. Onycholysis 6. White Spots (leuhonychia)

Question 50

Finger Clubbing

Answer 50

Vasodilation, congenital HF

Question 51

Terry's Nails

Answer 51

Decreased vascularity

Question 52

Mee's Lines

Answer 52

Disrupted matrix of proximal nail

Question 53

Beau's Lines

Answer 53

Transverse depressions of nail plates, usually bilateral

Question 54

Onycholysis

Answer 54

Trauma from excess manicuring

Question 55

White Spots

Answer 55

Nonuniform white spots, could be from excess manicuring