Assessment of Skin, Hair and Nails (exam 1) Flashcards
What is the largest organ of the body?
skin
Then skin is a site of metabolic activity. What does it do?
activated vitamin D
Which layer of skin is the site of vitamin D activation?
epidermis (doesn’t have its own blood supply)
What is the main component of dermal tissue?
collagen
Which layer of skin contains capillaries, lymph, vessels and sensory nerves?
dermis
What are the pigment producing cells of the skin called?
melanocytes
What are the 3 layers of the epidermis?
stratum coreum (outer) stratum granulosum (middle) basal layer (inner)
What is the time frame for epidermis regeneration?
28-45 days
Which layer of skin is made up of fat, smooth and areolar tissue? What is the purpose of this layer?
subcutaneous layer (heat insulator, shock absorber, nutritional depot)
What are the main 2 components of the dermis?
collagen and elastic fibers
Dermis: Collagen is produced by ___ cells.
fibroblast
What all is contained in the dermis?
- blood vessels
- sweat and sebaceous glands
- hair follicles
- nerves to skin
- sensory fibers
- capillaries
- mast cells-ready to attack foreign things (secretion, phagoctosis, production of fibroblasts)
Which layer of the skin contains the mast cells?
dermis
Name this skin layer: vitamin D activated here, temperature regulation, transmits sensations, homeostasis.
epidermis
Skin cells: ___ provides skin color and ___ helps regenerate skin.
melanocytes, keratinocytes
Nail Anatomy: Where is keratin produced and new growth of a nail begins?
lunula (white part of cuticle)
What is the purpose of sebaceous glands?
sebum provides lubrication and waterproofing of skin
What are the 2 types of sweat glands?
eccrine (over the entire skin surface), apocrine (axillae, nipple aerolae, periumbillicus, perineal ares)*** causes odor
What are some health problems we should assess for that can cause skin damage?
- liver problems (jaundice)
- kidney problems (itching)
- diabetes (less blood supply)
- COPD (clubbing)
- anemia (paleness)
What is the rubric for assessing skin lesion (moles)?
A- asymmetry of shape B- border irregularity C- color variation within one lesion D- diameter greater than 6 mm E- evolving or changing features
When we inspect skin, what signs are we looking for?
- edema
- moisture
- vascular changes
What are some age-related changes we should look for during skin assessments? (epidermis)
- skin transparency and fragile
- delayed wound healing
- skin hyperplasia and skin cancers
- increased risk for infection
- increased risk or sun burn
- changes in pigment (liver spots, age spots)
- increased risk of shearing forces (blisters, purpura, pressure related problems)
What are some age-related changes we should look for during skin assessments? (dermis)
- increased susceptibility to dry skin
- increased risk for heat stroke and hypothermia
- paper thin, transparent skin/ increased trauma risk
- decreased tone and elasticity
- reduced sensory perception
- cherry hemangiomas
What are some age-related changes we should look for during skin assessments? (subcutaneous)
- increased risk for hypothermia and pressure injury
What are some age-related changes we should look for during hair assessments?
- increased hair thinning
2. gradual loss of hair color (graying)
What are some age-related changes we should look for during nail assessments?
- increased risk for fungal infections
- longitudinal nail ridges
- toenails thicken and may overhang the toes
What are some age-related changes we should look for during glands assessments?
- increased size of nasal pores, large comedones
- increased susceptibility to dry skin
- decreased perspiration with decreased cooling effect
What is petechiae (small reddish purple lesion) a sign of?
increased capillary fragility and venous stasis
Lesions (moles): A ___ is a flat rash. A ___ is a raised rash.
macular, papular
How do we assess skin temperature?
with the back of the hand
What is Paronychia?
swelling around the nail bed
Diagnostic test: What does KOH (Potassium Hydroxide) test assess for?
fungal infections
Diagnostic test: What is the benefit of a KOH test?
can be done quickly in physician’s office (doesn’t identify specific fungus, just if it is a fungus or not)
Diagnosis test: What C and S test assess for?
bacterial infections (requires uprooting/getting underneath top)
Diagnostic test: What test assess for viral infections on skin?
Tzanck Smear (they will do a gram stain)
Diagnostic test: which test allows examination of pigment changes in light skinned patients?
Wood’s light examination
Skin Biopsy: What are the different types of skin biopsy?
- excisional
- incisional
- shave
- punch
Which type of skin biopsy is when the lesion is removed with margin of normal skin down to adipose tissue?
excisional
Which type of skin biopsy is when there is a cross section wedge of tissue through center of lesion?
incisional
Which type of skin biopsy is where there is a horizontal shave of the skin lesion with only superficial portion of the dermis?
shave
Which type of skin biopsy is used to sample possible cancers, tumors, or inflammatory skin conditions?
punch
Which ethnic group has the highest incidence of melanoma?
whites
Evaporation of the water contained in the sweat from eccrine glands can cause the body to lose ___ of fluid a day.
10-12L
Untreated dandruff can lead to _____.
hair loss
During hair assessments we inspect and palpate for…..
- cleanliness
- distribution
- quantity
- quality
Excessive growth of body hair
hirsutism
Hirsutism is a manfestation of…..
hormonal imbalance
During a nail assessment we assess for….
- dystrophy
- color of nail plate
- shape changes
- thickness, consistency, lesions
- acute and chronic parnoychia
During skin assessments of darker skin patients assess for….
- pallor (oral mucosa)
- cyanosis
- inflammation
- jaundice
- skin bleeding
