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Clinical Assessment > Skin, Hair, Nails > Flashcards

Skin, Hair, Nails Flashcards

(65 cards)

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1
Q

Two open ended questions about skin

A

“Have you noticed any changes in your skin? hair? nails?”

“Have you noticed any new sores, lumps, bumps or changes in your skin color?”

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2
Q

Parts to ROS

A

Skin, hair & nail changes, itching, rashes, sores, lumps, new moles or change in existing moles

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3
Q

Questions Regarding Lesion Timing

A
  • When did it start or 1st noticed?
  • Sudden or gradual onset?
  • Specify change: size, shape or color
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4
Q

Technique for PE of Skin

A
  • Inspection & palpation
  • Good lighting and magnifying lens
  • Disrobe pt relative to CC
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5
Q

Part of Physical Evaluation of Skin

A
  • Color (overall): erythema, pallor, yellow, cyanosis
  • Moisture: dryness, sweating, oiliness
  • Temperature
  • Texture
  • Mobility & Turgor (rapid or less than 2-3 sec)
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6
Q

Aggravating/Alleviating Factors for Skin Conditions

A 
What did skin come into contact with?
Chemical irritants?
-Changes in topical exposures 
(skin lotions, fabric softeners, soaps, wool, lanolin, make-up)
-New medications: topical or systemic
-Switch brand name to generic
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7
Q

Severity/Character of Skin Conditions

A
  • what did it look like when it first started compared to now? Has it spread, if so pattern? Does it hurt or itch?
  • Additional descriptors: scaling, crust, weeping, bleeding, delayed healing, odor
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8
Q

Environmental Triggers of Skin Conditions

A

when/where does the lesion appear

-sun, home, work, outside, near pets

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9
Q

Erythema

A

bright red all over

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10
Q

Pallor

A

Paleness caused by loss of hemoglobin, vasovagle reaction

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11
Q

Central Cyanosis

A
  • lips, tongue, mucous membranes; usually related to COPD, heart problems
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12
Q

Peripheral Cyanosis Causes

A
  • poor perfusion
  • blood not returning to heart quickly due to viscosity
  • connective tissue disorders
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13
Q

Terminology to Describe Texture of Skin

A

rough, smooth, dry, scaly

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14
Q

Location of Psoriasis

A
  • extensor surfaces

- elbows, knees, across chest, vulva

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15
Q

Location of Tinea versicolor

A

fungus with general distribution all over body

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16
Q

Location of Eczema

A
  • flexor surfaces
    children: cheeks, around mouth
    adults: hairline
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17
Q

Components Physical Evaluation of Lesions

A 
Size (bi-dimensional)
Location and Distribution
Color
Patterns and Shapes
Types (Primary and Secondary)
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18
Q

café-au-lait

A
  • uniform tan patch
  • one spot not a big concern
  • associated with neurofibromatosis
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19
Q

T. versicolor

A

Pigmented macules on body

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20
Q

heliotrope

A

purple, violet, lilac

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21
Q

Examples of patterns & shapes of lesions

A 
Linear or dermatomal
geographic
clustered
serpiginous
annular
arciform
targetoid
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22
Q

Linear

A

straight line

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23
Q

Dermatomal

A
  • straight line following specific nerve pattern

- shingles is most common

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24
Q

Clustered

A

lesions separate but grouped together

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25
Annular
ring/ round
26
Arciform
Arc
27
Targetoid
look like bullseye
28
Primary Lesions
Flat: macule, patch, Raised: papule, plaque, nodule/cyst, wheal, burrow Raised & fluid filled: vesicle, bulla, pustule
29
Primary Flat Lesions
Macule and Patch
30
Primary Raised Lesions
Papule, plaque, nodule/cyst, wheal, burrow
31
Primary Raised & fluid filled Lesions
vesicle, bulla, pustule
32
Secondary Lesions
Flat: Scale, crust, lichenification, scars/keloids Depressed: erosion, excoriation, fissure, ulcer
33
Secondary Flat Lesions
Scale, crust, lichenification, scars/keloids
34
Secondary Depressed Lesions
erosion, excoriation, fissure, ulcer
35
Lichenification
skin becomes thick and rough due to chronic scratching or itching; does not happen overnight
36
Scar vs. Keloid
Scar is superficial and filling in defect | Keloid goes beyond area of original injury and hypertrophies
37
Stage 1 Pressure Ulcers
- Erythema that fails to blanch | - in people who are bed ridden with limited mobility
38
Stage 2 Pressure Ulcers
Partial thickness skin loss
39
Stage 3 Pressure Ulcers
Full thickness skin loss & extends to underlying muscle but does not go through the muscle
40
Stage 4 Pressure Ulcers
Full thickness skin loss w/ damage to muscle & bone
41
Type of Lesions
Vascular and Purpuric
42
Types of Vascular Lesions
Spider angioma, spider vein, cherry angioma
43
Types of Purpuric Lesions
Petechia/purpura | Ecchymosis
44
Spider Angioma
- red - will not blanche - usually found above waist - commonly associated with liver disease
45
Spider Veins
- do not blanche with central pressure, but press on outer edges it may blanche - associated with lower extremities - typically people will also have varicose veins
46
Cherry Angioma
- bright fiery red, but benign | - very tiny
47
Nevi (moles)
- Congenital or acquired with malignant potential - Basal cell - Squamous cell - Melanoma
48
Basal Cell CA
Grow slowly, seldom metastasizes Most common: fair skin, 40+ y/o, common on face Early: red macule or papule Late: Depressed center, Firm elevated border, Translucent nodule w/telangiectasia
49
Squamous Cell CA
- Grows quicker than basal cell - Face, neck, back, tips of ears, hands - Most common: fair skinned, 60+ y/o - Firm, erythematous, Scale, crust
50
ABCDE's of Moles
``` Asymmetry Border Color Diameter Evolution ```
51
Causes of Hair Loss
Alopecia Trichotillomania Infection
52
Alopecia
- clearly delineated round or oval patches of hair loss | - various forms of balding
53
Compulsive pulling out of hair
Trichotillomania
54
Clubbing
- change in angle of nail due to bulbous swelling of the tissue at the nail base - seen in long term COPD or heart failure
55
Paronychia
- superficial infection of cuticles | - cuticles are red, swollen, and tender
56
Tinea Capitis
- ringworm | - round scaling patches of alopecia
57
Onycholysis
- painless separation of the whitened opaque nail plate from the pinker translucent nail bed - from fungal infection; manicuring, trauma, dishwashing detergents, psoriasis
58
Leukonychia
trauma to the nails causes white spots
59
Mees' Lines
-transverse white lines; usually due to repetitive manicuring
60
Beau's LInes
- transverse linear depression | - due to systemic illness
61
Pitting
punctate depressions of nail plate caused by defective layering of superficial nail plate
62
Geriatric Changes
Capillary fragility (Actinic purpura) Decreased turgor Long term sun-exposure
63
Patient Education
- Skin Cancer types (ABCDE for early recognition) - Modifiable Risk Factors: sun exposure, blistering sunburns - Non-modifiable: FHx, fair skin, changing or atypical nevi, hx dysplastic nevi - Monthly self exam > 50 y/o; Annually/PCP - Shaving: prevent cross contamination
64
Non-modifiable risk factors for skin cancer
FHx, fair skin, changing or atypical nevi, hx dysplastic nevi
65
Modifiable Risk Factors for Skin Cancer
sun exposure, blistering sunburns

Clinical Assessment (11 decks)

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