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H&P #1 > (6) Skin (Hair & Nails) > Flashcards

(6) Skin (Hair & Nails) Flashcards

1
Q

What are (6) functions of the skin?

A
  1. Maintain homeostasis
  2. Hold body fluids
  3. Protect underlying tissues
  4. Modulate body temperature
  5. Synthesize vitamin D
  6. Sense pain and pleasant stimuli
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2
Q

What are 3 layers of the skin?

A
  1. Epidermis
  2. Dermis
  3. Subcutaneous tissue
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3
Q

What is the most superficial layer of the skin?

A

Epidermis

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4
Q

What are the 2 layers within the epidermis?

A
  1. Outer horny layer of dead keratinized skin cells
  2. Inner cellular layer, where melanin (color protein) and keratin (structure protein) form
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5
Q

What are 2 characteristics of the epidermis?

A
  1. Lack blood vessels
  2. Relies on the dermis for nutrition
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6
Q

What skin layer “contains connective tissue, sebaceous glands, sweat glands, and hair follicles”?

A

Dermis

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7
Q

What are the 2 characteristics of the dermis?

A
  1. Well-supplied with blood vessels (help regulate body temperature)
  2. Well-supplied with nerve endings (sense pain, pleasure, touch, temperature)
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8
Q

What skin layer merges with the subcutaneous tissue?

A

Dermis

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9
Q

What skin layer “contains fat (adipose fat)”?

A

Subcutaneous tissue

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10
Q

What are the 3 functions of the subcutaneous tissue?

A
  1. Insulate
  2. Provides padding
  3. Stores energy
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11
Q

What are (5) factors that can influence skin color?

A
  1. Melanin
  2. Oxyhemoglobin
  3. Deoxyhemoglobin
  4. Carotene
  5. Bilirubin
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12
Q

What are (3) characteristics of Melanin?

A
  1. Brownish pigment
  2. Genetically determined
  3. Increased with sunlight exposure
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13
Q

What are the (2) characteristics of Oxyhemoglobin?

A
  1. Bright red pigment formed by the combination of hemoglobin and oxygen
  2. Present in O2 rich blood (increased blood flow cause red skin)
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14
Q

What are (2) characteristics of Deoxyhemoglobin?

A
  1. Blood that has already passed through capillary beds
  2. Hgb without O2 or someone with low O2 level (cyanosis)
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15
Q

What are (2) characteristics of Carotene?

A

1, Gold yellow pigment within subcutaneous fat and heavily keratinized area
2. Ingested through diet

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16
Q

What is the characteristic of Bilirubin?

A

Orange-yellow pigment formed in the liver by the breakdown of hemoglobin

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17
Q

What is the (3) functions of Hair?

A
  1. Insulate
  2. Protect
  3. Absorb
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18
Q

What is the function of the nails?

A

Protect distal ends of fingers and toes

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19
Q

What is the function of the Sebaceous glands?

A

Produce sebum via hair follicles and everywhere else EXCEPT your palms and soles

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20
Q

What are the (2) types of Sweat glands?

A
  1. Eccrine
  2. Apocrine
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21
Q

Where are Eccrine glands? What is the function?

A

Sweat glands widely distributed
- control body temperature

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22
Q

Where are Apocrine glands? What is the function?

A

Apocrine glands are in the axillary and genital regions
- responsible for odor

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23
Q

Define Nail Plate.

A

hard and translucent portion, composed of keratin

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24
Q

Define Nail Bed

A

adherent connective tissue that underlies the nail

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25
Q

Define Nail Fold

A

skin at base of nail and along nail plate

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26
Q

How long does it take for fingernails to fully grow out?

A

5 months

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27
Q

How long does it take for toenails to fully grow out?

A

12-18 months

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28
Q

What are the (2) forms of hair growth?

A
  1. Vellus hair (prepubertal stage)
  2. Terminal hair (adult stage)
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29
Q

Define Vellus Hair

What is an example of Vellus hair?

A

Short, fine, unpigmented, (not super visible) inconspicuous

“Peach Fuzz”

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30
Q

Define Terminal Hair

A

Course, thicker, pigmented, visible (conspicuous)

During puberty, the increase in androgenic hormone levels causes vellus hair to be replaced with terminal hair.

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31
Q

Where can Terminal hair be found?

A

pubic or axillary hair, scalp hair, eyebrow hair

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32
Q

What type of individuals are at high risk for skin cancer?

A

Fair skinned people

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33
Q

What is the least common type of skin cancer?

A

Melanoma BUT it is the MOST DEADLY

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34
Q

What are (2) ways to prevent/reduce skin cancer? What is the best defense to avoid skin cancer?

A
  1. Avoid UV radiation and tanning beds**
  2. Regular use of sunscreen (use at least 30 SPF and broad spectrum protection, water resistant, re-application)
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35
Q

Describe the ABCDEs for evaluating nevi/moles:

A
  1. Asymmetry
  2. Border irregularity
  3. Color variations
  4. Diameter >6mm “larger than a pencil eraser”
  5. Evolution “elevation, bleeding, crusting”
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36
Q

What are (5) skin color (pigmentation) characteristics?

A
  1. Hypopigmentation
  2. Depigmentation
  3. Hyperpigmentation
  4. Erythema
  5. Blanchable vs. Non-Blanchable
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37
Q

Define hypopigmentation:

A

Decreased pigment of the skin

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38
Q

Define Depigmentation:

What is an example of Depigmentation?

A

Loss of pigment of the skin

Example: vitiligo

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39
Q

Define Erythema:

A

Redness of the skin

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40
Q

What are the (2) causes of Erythema?

A
  1. Increased blood flow to the capillaries
  2. Inflammation, infection of the skin (sunburn, acne, insect bite, medication rxn, etc.)
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41
Q

Define blanchable and non-blanchable skin:

A

Blanchable: site turns white with touch
Non-blanchable: skin does not turn white when touched with a finger (no change in color)

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42
Q

Define Primary Lesions:

A

A single area of altered skin that is caused by a disease process.

May be solitary or multiple.

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43
Q

What are (12) types of Primary Lesions?

A
  1. Macule
  2. Patch
  3. Papule
  4. Plaque
  5. Nodule
  6. Tumor
  7. Cyst
  8. Vesicle
  9. Bulla
  10. Wheal
  11. Pustule
  12. Abscess
    - Furuncle
    - Carbuncle
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44
Q

What best describes a “small <1cm, flat, non-palpable” lesion?

Primary or secondary lesion?

What is an example of this lesion?

A

Macule

Primary

Example: Freckle

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45
Q

What best describes a “large >1cm, flat, non-palpable” lesion?

Primary or secondary lesion?

What are examples of this lesion?

A

Patch

Primary

Example: vitiligo, cafe au lait, hemangioma (port wine stain, seen in infants)

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46
Q

What best describes a “small <1cm, solid, palpable” lesion?

Primary or secondary lesion?

What are examples of this lesion?

A

Papule

Primary

Example: mole, nevus, wart, insect bite

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47
Q

What best describes a “large >1cm, solid, palpable” lesion?

Primary or secondary lesion?

What are examples of this lesion?

A

Plaque

Primary

Example: psoriasis, tinea corporis “ringworm”, eczema

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48
Q

What best describes “solid elevation of the skin >1 cm extends into the deeper skin layers”?

Primary or secondary lesion?

What are examples of this lesion?

A

Nodule

Primary

Example: BCC, large wart, dermatofibroma, lipoma

49
Q

What best describes “any mass or large nodule that can be benign or malignant”?

Primary or secondary lesion?

A

Tumor

Primary

50
Q

What best describes a “nodule filled with liquid or semi-solid”?

Primary or secondary lesion? Examples?

A

Cyst

Primary

Example: epidermal inclusion cyst, sebaceous cyst

Epidermal inclusion cyst - subcutaneous cyst releasing whitish yellow substance with foul odor

51
Q

What best describes a “small <1cm, circumscribed elevation, with serous (clear) fluid”?

Primary or secondary lesion?

What are examples in this lesion?

A

Vesicle

Primary

Example: chicken pox, small blister, HSV

52
Q

What best describes a “large >1cm, circumscribed elevation, with serous (clear) fluid”?

Primary or secondary lesion?

What are examples of this lesion?

A

Bulla

Primary

Example: severe sunburn, poison ivy

53
Q

What best describes a “round or flat-topped elevation, pale red, lasts a few hours, papule or plaque (solid and palpable)”?

Primary or secondary lesion?

What are examples of this lesion?

A

Wheal

Primary

Example: hives, mosquito bite

54
Q

What best describe “small circumscribed elevation of the epidermis filled with purulent fluid”?

Primary or secondary lesion?

What are examples of this lesion?

A

Pustule

Primary

Example: folliculitis, acne pimple

55
Q

What best describes a “circumscribed collection of pus appearing as a localized infection, associated with tissue destruction”?

Primary or secondary lesion?

A

Abscess

Primary

56
Q

What type of abscess is “an acute, deep-seated, red, hot, tender abscess that involves a hair follicle (folliculitis)”?

What type of abscess is a “deeper infection comprised of interconnecting abscesses arising in several contiguous hair follicles”?

A

Furuncle

multiple furuncle: Carbuncle

57
Q

Define Secondary Lesions:

A

Modification of a primary lesion from evolution, traumatic injury, or external factors.

58
Q

What are (11) Secondary Lesions?

A
  1. Erosion
  2. Ulcer
  3. Fissure
  4. Crust
  5. Scale
  6. Lichenification
  7. Scar
  8. Epidermal atrophy
  9. Dermal atrophy
  10. Excoriation
  11. Keloid
59
Q

What best describes a “loss of superficial epidermis, moist surface, with no bleeding”?

Primary or secondary lesion?

What are examples with this lesion?

A

Erosion

Secondary

Example: skinning your knee, candidiasis

60
Q

What best describes a “deeper loss of epidermis and dermis”?

Primary or secondary lesion?

What are examples with this lesion?

A

Ulcer

Secondary

Example: bed sores, stasis ulcer

61
Q

What best describes a “linear loss of epidermis and dermis, with sharp defined vertical walls”?

Primary or secondary lesion?

What are examples with this lesion?

A

Fissure

Secondary

Example: tinea pedis “athlete’s foot”, eczema (fingertips)

62
Q

What best describes “dried residue of serum, pus, blood”?

Primary or secondary lesion?

What are examples with this lesion?

A

Crust

Secondary

Example: impetigo (caused by Staph), scab

63
Q

What best describes a “thin flake of exfoliated epidermis”?

Primary or secondary lesion?

What are examples with this lesion?

A

Scale

Secondary

Example: dandruff, dry skin

64
Q

What best describes “thickening of the epidermis, increased visibility of normal skin lines that is induced by scratching”?

Primary or secondary lesion?

What are examples with this lesion?

A

Lichenification

Secondary

Examples: chronic atopic dermatitis

65
Q

What best describes a “replacement of destroyed tissue with fibrous tissue”?

Primary or secondary lesion?

A

Scar

Secondary

66
Q

What best describes “thin, transparent epidermis”?

Primary or secondary lesion?

What are examples with this lesion?

A

Epidermal Atrophy

Secondary

Example: aging

67
Q

What best describes a “decreased papillary or reticular support that results in a depression”?

Primary or secondary lesion?

What are examples with this lesion?

A

Dermal Atrophy

Secondary

Example: striae “stretch marks”

68
Q

What best describes a “superficial linear or punctate marks secondary to scratching”?

Primary or secondary lesion?

A

Excoriation

Secondary

69
Q

What best describes a “firm, nodular hypertrophic scar tissue that extend beyond the area of injury”?

Primary or secondary lesion?

A

Keloid

Secondary

70
Q

What best describes “blackheads made of keratin and sebaceous material”?

A

Comedo

71
Q

What best describes “permanent dilation of superficial blood vessels”?

What are examples of this lesion?

A

Telangiectasia

Example: spider veins, rosacea, face of alcoholics

72
Q

What best describes a hyperpigmentation, melanin deposition with “mask of pregnancy”?

A

Melasma

73
Q

What best describes melanin deposition along linea alba in pregnancy?

A

Linea Nigra

74
Q

What best describes “clear to red papules that result from obstruction of eccrine sweat duct; known as heat rash”?

Example?

A

Miliaria; newborns and infants who are bundled or placed in warm environments

75
Q

What best describes “hyperpigmented lesions that may vary in color from light brown to dark brown with smooth or irregular borders; known as “coffee with milk”?

A

Cafe-Au-Lait

76
Q

List the (6) benign lesions:

A
  1. Cherry angiomas
  2. Solar lentigines
  3. Seborrheic keratosis
  4. Pilar cyst
  5. Dermatofibroma
  6. Lipoma
77
Q

What best describes “benign cherry red papules, proliferation of blood vessels, no link to CA”?

A

Cherry angiomas

78
Q

What best describes “benign patch of darkened skin, common”?

What is an example of this lesion?

A

Solar lentigines

Example: sun spots “sun induced freckles”

79
Q

What best describes common, benign, “stuck-on appearance”?

A

Seborrheic keratosis

80
Q

What best describes “cyst from hair follicle, usually on the scalp”?

A

Pilar/Trichilemmal Cyst

81
Q

What best describes “benign fibrous tumor, common on lower legs”?

A

Dermatofibroma

82
Q

What best describes benign “knot of fatty tissue, anywhere on body”?

A

Lipoma

83
Q

What best describes “deeper bleeding beneath the skin”?

What kind of lesion is this?

A

ecchymosis “bruise”

Purpuric lesion

84
Q

What best describes “minute hemorrhagic spots on skin. Pinpoint to pin size head, non-blanchable, circumscribed deposit of blood (<5mm)”?

What kind of lesion is this?
Determine the cause:

A

Petechiae

Purpuric lesion

Caused by: vasculitis and gonococcemia

85
Q

What best describes “spontaneous bleeding into the skin, circumscribed deposit of blood >0.5 cm, common in elderly patients”?

What kind of lesion is this?
Determine the cause:

A

Purpura

Purpuric lesion

Caused by: low platelets, bleeding disorder

86
Q

What are (3) cancerous lesions?

A
  1. Actinic Keratosis (pre-cancer)
  2. Squamous cell carcinoma (2nd most common skin cancer)
  3. Basal cell carcinoma (most common skin cancer)
87
Q

What best describes “crusty scaly growth that develops from years of sun exposure; also known as solar keratoses”?

A

Actinic Keratosis

88
Q

What best describes “pink lesions typically on fair skin, darker lesions on dark skin, low epidermis”?

A

Basal Cell Carcinoma

89
Q

What are (8) types of Configurations?

A
  1. Annular
  2. Target
  3. Linear
  4. Serpiginous
  5. Geographic
  6. Verruca
  7. Vegetative
  8. Imbricated
90
Q

What best describes “ring-shaped lesions”?

What is an example of this configuration?

A

Annular configuration

Example: tinea corporis “ringworm”

91
Q

What best describes “series of concentric rings”?

What is an example of this configuration?

A

Target configuration

Example: lyme disease

92
Q

What describes “lesions in a linear or band-like configuration appear in the form of a line or stripe”?

What is an example of this configuration?

A

Linear configuration

Example: lacerations

93
Q

What best describes “shape or spread of lesions in a serpentine or snake-like configuration”?

What is an example of this configuration?

A

Serpiginous Configurations

Example: larva migrans “hookworm”

94
Q

What best describes “map-like configurations”?

A

Geographic configurations

95
Q

What type of configuration is best described: “a local growth of the epidermis caused by a virus”?

A

Verruca (wart)

96
Q

What type of configuration best describes: “capable of growth”?

A

Vegetative configurations

97
Q

What type of configuration best describes: “having regularly arranged, overlapping edges”?

A

Imbricated

98
Q

What best describes “a production of tissue necrosis that develop at body-support interfaces over bony prominences as a result of external compression of the skin, shear forces, and friction”?

A

Decubitus ulcer “pressure sores”

99
Q

What Decubitus Ulcer Stage is being described?

“intact skin with signs of impending ulceration; blanchable erythema, may be warm and indurated”

A

Stage I

100
Q

What Decubitus Ulcer Stage is being described?

“partial-thickness loss of skin involving epidermis & possibly dermis, may present as an abrasion, blister, or superficial ulceration, NON-BLANCHABLE”

A

Stage II

101
Q

What Decubitus Ulcer Stage is being described?

“full-thickness loss of skin and subcutaneous tissue but not through the underlying fascia, may present as crater with/without undermining of adjacent tissue”

A

Stage III

102
Q

What Decubitus Ulcer Stage is being described?

“full-thickness loss of skin and subcutaneous tissue and extension into muscle, bone, tendon, or joint capsule, may present with osteomyelitis, dislocations or pathologic fx”?

A

Stage IV

103
Q

What describes “distal enlargement and broadening of the fingertips, more convex nail plate, proximal nail feels spongy”?

Determine the cause:

A

Clubbing

Caused by:
1. Chronic hypoxia
2. Lung cancer

104
Q

What best describes “tiny pin-point indentations to the nails; punctate depressions of the nail plate”?

Determine conditions associated with this finding:

A

Pitting nails

Caused by:
1. psoriasis
2. alopecia areata
3. eczema
4. lichen planus “thickened skin”
5. imperfect nail plate formation

105
Q

What best describes “linear elevation of the nail, normally during aging”?

A

Longitudinal ridging

106
Q

What best describes “ridge that crosses from one side of the nail to another, known as Beau’s Lines”?

Determine the cause:

A

Transverse Ridging

Caused by:
recent illness or a shock to the body, such as a heart attack

107
Q

What best describes “curving transverse white bands that cross the nail”?

Determine the cause:

A

Mee’s Lines

Caused by:
1. Arsenic poisoning
2. Carbon monoxide poisoning
3. Chemotherapy
4. Heart failure
5. Hodgkin’s disease
6. Leprosy

108
Q

What best describes “nail plate turns white with ground-glass appearance, a distal band of reddish brown”?

Determine the cause:

A

Terry’s Nails

Caused by:
1. Liver disease
2. CHF
3. DM

109
Q

What are (4) types of Alopecia?

A
  1. Male pattern alopecia
  2. Alopecia Areata
  3. Alopecia Totalis
  4. Alopecia Universalis
110
Q

What best describes “hair loss typically results in a receding hair line and baldness on the top of the head”?

A

Male Pattern Alopecia

111
Q

What best describes “round bald patches appear suddenly, most often affecting the scalp”?

A

Alopecia Areata

112
Q

What best describes “complete loss of scalp hair”?

A

Alopecia Totalis

113
Q

What best describes “hair loss from the entire body, including eyelashes and eyebrows”?

A

Alopecia Universalis

114
Q

Which of the following is most important when examining a patient’s skin?

A. Comforting the patient
B. Warming the hands
C. Complete exposure of skin
D. Maintaining a sterile environment

A

C. Complete exposure of skin

115
Q

Which of the following layers of skin contains the blood vessels and connective tissue?
A. Subcutaneous tissue
B. Dermis
C. Stratum spinosum
D. Epidermis

A

B. Dermis

116
Q

Which of the following would be considered a secondary lesion?

A. Fissures (eczema)
B. Nodule (basal cell carcinoma)
C. Plaque (psoriasis)
D. Vesicles (varicella zoster)

A

A. Fissures (eczema)

117
Q

Describe expected age-related changes of the integumentary structures:

A
  1. thinner and fragile skin (rubbing or pulling can cause skin tears)
  2. fragile blood vessels can break easily
  3. lose protective fat layer of the skin, dryer skin
  4. less able to sense touch, pressure, vibration, heat, cold
  5. pigment changes in the hair and skin
118
Q

List the ROS of the Skin:

A
  1. sores
  2. lumps
  3. rashes
  4. pruritus
  5. easy bruising
  6. texture change (excessive moistness or dryness)
  7. color change, hair/nails
  8. hair loss
  9. moles of concern

H&P #1 (8 decks)

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