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Physical Assessment > 12 - Skin, hair, + nails > Flashcards

12 - Skin, hair, + nails Flashcards

1
Q

skin, hair, and nails make up the…

A

integumentary system

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2
Q

assessment of the integumentary system can reveal the status of the pt’s…

A
  • hydration
  • nutrition
  • airway clearance
  • thermoregulation
  • tissue perfusion
  • activity
  • sleep/rest
  • level of stress
  • self-care ability
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3
Q

major fx of skin

A
  • perceive touch, temp, pain
  • protect against mechncl, chmcl, thrml, solar damage
  • protect against water + electrlt loss
  • reg body temp
  • repair surface sounds
  • synth vit D
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4
Q

4-5 layers of the epidermis (deep to superficial)

A
  • stratum basale
  • stratum spinosum
  • stratum granulosum
  • stratum lucidum
  • stratum corneum
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5
Q

stratum basale mostly consist of…

A

keratin (fibrous, tough protein)

25% melanocytes (produce melanin)

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6
Q

T/F certain ethnicities have more melanocytes than others

A

FALSE

everyone has the same amt of melanocytes but produce different amt of MELANIN

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7
Q

2 types of fibers that make up the dermis

A

collagen (tough, resistant to tears)

elastic fibers

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8
Q

the dermis is richly supplied with…

A
  • nerves,
  • blood vssls,
  • hair follicl,
  • sweat glnd,
  • oil glnd,
  • sensory receptors
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9
Q

hypodermis aka

A

subcutaneous tissue

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10
Q

cutaneous glands are formed in the ____ and push deep into the ____

A
  • stratum basale

- dermis

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11
Q

fx of cutaneous glands

A
  • excrete uric acid, urea, ammonia, Na, K
  • perspiratn/evaporatn
  • protect against bactrl grwth
  • soften, lubcrt, waterprf
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12
Q

2 types of sweat

A 
1 eccrine (most numerous, clear persprtn)
2 apocrine (axillary/anogenital regions, secrete H2O, fatty acids, protein, into hair follicles. smells when mixes w bacteria)
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13
Q

sebaceous glands

A

oil glands

-found all over body except palms, soles of feet

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14
Q

vellus vs terminal hair

A

vellus: pale, most of the body
terminal: brow, scalp, pubic region, axillae, legs, face/chest of males

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15
Q

trichotillomania

A

compulsive twisting/plucking of hair

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16
Q

prolonged immersion of hands in water may lead to…

A

paronychia

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17
Q

ruddy (red-blue tone) is bc of an incr in hemoglobin + stasis of blood in capillaries that can be caused by…

A

polycythemia

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18
Q

carotenemia can be seen in…

A
  • pt w overdigestion of carotene containing foods
  • anorexia nervosa
  • endocrine disorders (DM, myexedema, hypo-pituitarism)
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19
Q

uremia (pale yellow ton) can be due to the retention of ____ and may be caused by ______

A
  • urinary chromogens

- chronic renal disease

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20
Q

what are some cues that the pt may be experiencing impending shock?

A
  • pallor
  • drop in BP
  • incr pulse + resp
  • anxiety
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21
Q

when cyanosis is noted, always assess ___+___

A

VS + LOC

-cyanosis/pallor can indicate low plasma oxygen

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22
Q

when assessing temp, palpate the ___ first and move ___

A

foregeah/face first

then move inferiorly

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23
Q

what can cause diaphoresis

A
  • exertion
  • fever
  • pain
  • emo stress
  • metabolic disorders like hyperthyroidism
  • impending medical crisis like MI
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24
Q

dry skin over lower legs may indicate…

A

vascular insufficiency

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25
Q

dry lips + mucus membranes may indicate

A

systemic dehydration

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26
Q

hyper vs hypo thyroids on skin

A

hyper: excessively smooth + velvety skin
hypo: rough scaly skin

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27
Q

turgor

A

elasticity + ability of skin to return to normal

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28
Q

primary vs secondary lesions

A

P: dvlps on previously unaltered skin
S: lesions that change over time or bc of scratching, abrasion, or infection

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29
Q

localized hot red swollen painful areas indicate the presence of inflammation + possibly infection.
This is CI for…

A

palpations

-do not palpate. slightest disturbance may spread the infection to deeper layers

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30
Q

a presence of more than ___ moles is a risk factor for skin cancer

A

50

31
Q

ABCDE of melanoma screening

A 
A asymmetry
B border irregularity
C color variegation
D diameter >6mm
E evolving changes
32
Q

evolving changes include…

A
  • size
  • shape
  • symptoms (itch, tender)
  • surface (bleeding)
  • shades of color
33
Q

when hair loss occurs in women, it is thought to be caused by…

A

an imbalance in adrenal hormones

34
Q

alopecia areata

A

patchy hair loss

35
Q

pediculosis capitis

A

head lice

36
Q

schamroth technique

A

used to assess clubbing

  • nails normally form a diamond shape opening
  • tips of nails dont touch
37
Q

types of primary lesions

A 
1 macule/patch
2 papule/plaque
3 nodule/tumor
4 vesicle/bulla
5 pustule
6 wheal
7 cyst
38
Q

macule/patches

A

-flat
-nonpalpable
-change in skin color
M: less than 1cm
P: larger than 1cm, may have irreg border

39
Q

macule examples

A

freckles, measles, petechiae

40
Q

patch examples

A
  • mongolian spots
  • port wine stains
  • vitiligo
  • chloasma
41
Q

papule/plaque

A

-elevated
-solid palpable mass
-circumscribed border
PPL: smaller than 0.5cm
PLQ: groups of papules

42
Q

papule examples

A
  • elevated moles
  • warts
  • lichen planus
43
Q

patch examples

A
  • psoriasis

- keratosis

44
Q

nodule/tumor

A

-elevated
-solid
-palpable mass
-extends into the dermis
N: smaller than 2cm
T: larger than 2 cm

45
Q

nodule example

A
  • small lipoma
  • squamous cell carcinoma
  • fibroma
  • intradermal nevi
46
Q

tumor examples

A
  • large lipoma
  • carcinoma
  • hemangioma
47
Q

vesicle/bulla

A

-elevated
-fluid filled
-round/oval
-palpable
-thin transluscent wall
V:smaller than 0.5cm
B: larger

48
Q

vesicle examples

A
  • herpes simplex/zoster
  • early chickenpox
  • poison ivy
  • small burn/blisters
49
Q

bullae examples

A
  • contact dermatitis
  • friction blisters
  • burn blisters
50
Q

pustule

A
  • elevated

- pus filled

51
Q

pustule examples

A
  • acne
  • impetigo
  • carbuncle (large boils)
52
Q

wheal

A
  • elevated
  • often reddish w irreg border
  • caused by diffuse fluid in tissues
53
Q

wheal examples

A
  • insect bites

- hives

54
Q

cyst

A
  • elevated
  • fluid filled or semisolid mass
  • originate in subcutaneous or dermis
  • 1cm or larger
55
Q

cyst examples

A

sebaceous cyst

-epidermoid cyst

56
Q

9 types of secondary lesions

A 
1 atrophy
2 crust
3 erosion
4 fissure
5 keloid
6 lichenification
7 scales
8 scar
9 ulcers
57
Q

atrophy

A

transluscent, dry, paperlike

-thinning/wasting bc loss of collagen + elastic

58
Q

atrophy example

A

striae + aged skin

59
Q

crust

A
60
Q

large crusts are called…

A

scabs

61
Q

crust examples

A
  • eczema
  • impetigo
  • herpes
  • scabs following abrasion
62
Q

erosion

A

wearing away of superficial epidermis causing a moist, shallow depression

63
Q

erosion ex

A
  • scratch marks

- ruptured vesicles

64
Q

fissure

A

linear crack w sharp edges extending into the dermis

65
Q

fissure ex

A
  • cracks at corners of mouth or in hands

- athletes foot

66
Q

keloid

A

elevated, irregular, darkened area of excess scar tissue

-fr excessive collagen formation during healing

67
Q

lichenification

A

rough, thickened, hardened area of epidermis

-fr chronic irritation like scratching or rubbing

68
Q

lichenification ex

A

chronic dermatitis

69
Q

scales

A

shedding flakes of greasy, keratinized skin tissue

-white, grey, or silver

70
Q

scales ex

A

-dry skin
-dandruff
psoriasis
-eczema

71
Q

4 Vascular Lesions

A

1 hemangioma
2 hematoma
3 petechiae
4 ecchymosis

72
Q

hemangioma

A
  • bright red raised lesions
  • 2-10 cm
  • unblanchable
  • present at birth
  • disappears by age 10
73
Q

clubbing has a nail angle greater than ____

A

160 degrees

74
Q

onycholysis

A

fungal nail infection

-causes nails to thicken + lift

Physical Assessment (20 decks)

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