skin hair and nais Flashcards
the skins main function
Largest organ of the body.
Provides a physical barrier that protects the underlying tissues and
organs from microorganisms, physical trauma, ultraviolet radiation
(UVR), and dehydration.
Assists in temperature maintenance & fluid and electrolyte balance.
Absorption, excretion, sensation, immunity, and vitamin D synthesis.
Provides individual identity to a person’s appearance.
layers of the skin
epidermis, dermis, subcutaenous layer
epidermis
top layer of the skin, contain melanin and is replaced every 3-4 weeks
dermis
Inner layer of the skin
◦ Contains sebaceous glands, hair follicles and sweat glands
◦ Sebaceous glands – secrete oily substance to waterproof skin and hair. Located everywhere except soles and palms
◦ Sweat glands:
sweat glands
◦ Eccrine – primary function for sweat and thermoregulation – all over the body
◦ Apocrine – axillae, perineum, areolae / non-functional until puberty
subcutaneous layer
contains fat, blood vessels, nerves, remaining sweat glands
◦ Stores fat an energy reserve
◦ Serves as cushion protection for body
◦ Provides insulation
function of the hair
◦ Composed of keratin
◦ Develops within the hair follicle
◦ Hair protects the skin and provides thermoregulation
◦ Two types of hair
vellus hair
peach fuzz
terminal hair
longer darker hair - initiates in puberty
nails function
◦ Composed of keratin
◦ Provides protection to fingers and toes
what would you assess for in skin?
◦ Any skin problems? – rashes, lesions, dryness, oiliness, discolorations, bruising, swelling
◦ Any birthmarks or moles looking different? Always establish a baseline.
◦ Sweating changes?
pruritis
pruritis = itching
◦ Any dryness? Is it seasonal?
◦ Xerosis – dryness
◦ Seborrhea - oily
my cat is very itchy
rash or lesions
◦ Character?
◦ Itching may signal an allergic reaction
hair loss or growth
◦ Gradual or sudden?
◦ Hirsutism – unusual growth
Change in nails – coloration or shape?
o Bacterial infections may cause green, black or brown nail discoloration
o Nail changes may be seen in malnutrition
personal health history
◦ Sunburns as a child? May link to increase in skin cancer
◦ Recent hospitalizations or surgeries?
◦ Females: hormone therapy or menstruation can cause skin changes
◦ Reactions to foods or environment?
family health history
◦ Familial skin conditions or skin cancer?
◦ Recent illnesses in the household? Chickenpox / Measles are contagious and can demonstrate skin lesions
lifestyle and health practices
o Sunbathing and tanning? Can increase skin cancer risk.
o Occupational risks of exposure to chemicals?
o Body piercings and tattoos – increase risk of Hepatitis C / infection
o Daily routine for skin and nail care
benign pigmented areas include
◦ Freckles (macules) on sun exposed skin
◦ Nevi (moles)
◦ Birthmarks
abnormal findings
oPallor – paleness
oCyanosis – blue hue
oJaundice – yellow tone
pallor
◦ Pale, white color caused by decrease of blood flow (vasoconstriction) or anemia
◦ Shock or arterial insufficiency
erythema
◦ Redness due to increased blood flow (vasodilation)
◦ Fever, inflammatory process, allergic reaction
cyanosis
◦ Bluish, purplish hue due to decreased perfusion of tissues
◦ Hypoxemia due to heart failure or shock
◦ Central cyanosis can be seen in the oral mucosa
jaundice
◦ Yellow, orange hue due to jaundice (increased bilirubin in blood)
◦ Due to liver problems such as hepatitis, cirrhosis
vitiligo
absence of melanin in patchy areas – usually a
benign finding
albinism
generalized loss of pigmentation all over
pallor in different skin tones
◦ Brown skinned people will be more yellow. Black skinned people will be more gray
◦ Palpebral conjunctiva and nail beds should be observed
erythema in different skin tones
◦ Difficult to observe
◦ If fever suspected, check skin for warmth. If edema, check skin for tightness
cyanosis in different
◦ Darker skinned people have normal bluish tone on lips
◦ Palms, but not clearly evident, other clinical signs should be observed
jaundice in different skin tones
◦ Hard and soft palate must be observed in addition to sclera of eyes
◦ Dark urine may also present
skin assessment
Temperature, texture and thickness
◦ Check skin with back of hand
◦ Hyperthyroidism may cause increase of temp
Moisture
◦ Diaphoresis may occur during fever or exercise
◦ Dehydration can be observed by dry mucous membranes in mouth and cracked skin
Mobility and Turgor
◦ Mobility is ease of skin rising when pinched. Turgor is returning back to its place. Use 2 fingers to pinch the skin over the clavicle. Recoil should be immediate.
◦ Slow turgor can be indicative of dehydration. “Tenting” if severe dehydration. (May not be a good assessment tool in elderly)
lesions
◦ A lesion is any traumatic or pathological change in skin
◦ Describe using ABCDE, also noting location and exudate
◦ Roll nodule gently between fingers to assess depth
◦ Ultraviolet light is used if fungal infection suspected (Wood’s light) – positive findings would be a blue-green fluorescent
annular
◦ Circular, beginning in center and spreading to
periphery (ringworm)
