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midterm > ASSESSMENT OF THE SKIN, HAIR, AND NAILS > Flashcards

ASSESSMENT OF THE SKIN, HAIR, AND NAILS Flashcards

1
Q

is a physical barrier that protects the underlying tissues and
structures from microorganism, physical trauma, ultraviolet
radiation and dehydration.

A

SKIN

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2
Q

SKIN
composed of three layers:

A

o Epidermis
o Dermis
o Subcutaneous Tissue

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3
Q

EPIDERMIS
* the outer layer of skin.
* 4 distinct layers

A

stratum corneum
stratum lucidum
stratum granulosum
stratum germativum (stratum basale)

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4
Q

outermost layer; consists of dead, keratinized
cells that render the skin waterproof; replaced
every 3 to 4 weeks

A

stratum corneum

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5
Q

only layer that undergoes cell division;
contains melanin and keratinocyte (keratin-
forming cells)

A

stratum germativum (stratum basale)

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6
Q

the inner layer of the skin.

A

DERMIS

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7
Q

is a well-vascularized, connective tissue layer containing
collagen and elastic fibers, nerve endings, and lymph
vessels. It is also the origin of sebaceous glands, sweat
glands, and hair follicles

A

DERMIS

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8
Q

secrete an oily substance called sebum that
lubricates hair and skin and reduces water
loss through the skin.

A

Sebaceous Glands

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9
Q

are located over the entire
skin surface and secrete an odorless,
colorless fluid, the evaporation of which is vital
to the regulation of body temperature.

A

Sweat Glands
* Eccrine glands

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10
Q

are concentrated in the
axillae, perineum, and areolae of the breast
and are usually open through a hair follicle.

A

Sweat Glands
Apocrine glands

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11
Q

beneath the dermis , a loose connective tissue
containing fat cells, blood vessels, nerves, and the
remaining portions of sweat glands and hair follicles.

A

SUBCUTANEOUS TISSUE

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12
Q

(particularly scalp and eyebrows) is
longer, generally darker, and coarser than vellus
hair.

A

Terminal Hair

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12
Q

consists of layers of keratinized cells, found over much of
the body except for the lips, nipples, soles of the feet, palms
of the hands, labia minora, and penis.

A

HAIR

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12
Q

HAIR
Structures

A

o Follicle
o Bulb
o Shaft
o Root

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13
Q

located on the distal phalanges of fingers and toes, are
hard, transparent plates of keratinized epidermal cells that
grow from the cuticle

A

NAILS

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13
Q

o layer of clear skin located along the bottom edge of
your finger or toe.

A
  • Cuticle
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13
Q

is short, pale, fine, and
present over much of the body.

A

Vellus hair (peach fuzz)

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14
Q

o extends over the entire nailbed and has a pink tinge
as a result of the rich blood supply underneath.

A
  • Nail Body
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15
Q

o a paler, crescent shaped area.

A
  • Lunula
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16
Q

(loss of color) is seen in arterial insufficiency,
decreased blood supply, and anemia. Pallid tones vary from
pale to ashen without underlying pink.

A

Pallor

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16
Q

may cause white skin to appear blue-tinged,
especially in the perioral, nail bed, and conjunctival areas.
Dark skin may appear blue, dull, and lifeless in the same
areas.Cyanosis

A

Cyanosis

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17
Q

results from a cardiopulmonary problem,
whereas peripheral cyanosis may be a local problem
resulting from vasoconstriction.

A

Central cyanosis

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18
Q

in light- and dark-skinned people is characterized
by yellow skin tones, from pale to pumpkin, particularly in
the sclera, oral mucosa, palms, and soles.

A

Jaundice

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19
Q

is roughening and darkening of skin
in localized areas, especially the posterior neck.

A

Acanthosis nigricans

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20
Q

is a generalized loss of pigmentation.

A

Albinism

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21
Q

(skin redness and warmth) is seen in
inflammation, allergic reactions, or trauma.

A

Erythema

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22
Q

flat, small macules of pigment that appear
following sun exposure

A

Freckles –

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23
Q

raised papule with a depressed center.

A

Cutaneous tag,

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23
Q

(stretch marks)

A

Striae

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24
Q

– flat or raised tan/brownish marking up to 6
mm wide

A

Mole (nevus) –

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24
Q

small raised spots (1–5 mm wide)
typically seen with aging

A

Cherry angiomas,

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25
Q

warty or crusty pigmented lesion
* Scar

A

Seborrheic keratosis –

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26
Q

Granulation Tissue

A
  • Healthy granulation tissue has a moist,
    red and granular appearance.
  • Treatment aim of granulation tissue is
    to maintain a moist wound healing
    environment and protect from infection
    and trauma
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27
Q

Epithelial Tissue

A
  • Epithelial tissue has a pearly
    pink appearance.
  • Epithelia spread across the
    wound surface from the
    wound edge or islets from
    within the wound bed in
    superficial wounds.
  • Treatment aim for epithelial
    tissue is to provide protection
    and a moist wound healing environment.
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28
Q

Over-granulation Tissue

A
  • Granulation tissue has
    become proud of the
    surrounding wound bed.
  • Over-granulation can delay
    wound healing
  • Treatment aim for over-
    granulation is to apply local

pressure, remove occlusive
dressings and consider
corticosteroid or antimicrobial application.

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29
Q

Un-healthy granulation Tissue

A
  • Granulation tissue which appears
    dark red or pale in colour or dull
    and dehydrated
  • Indication that the wound is
    poorly perfused or infected
  • Treatment aim for un-healthy
    granulation tissue is to reassess
    the patient holistically and treat
    the underlying cause of poor
    wound perfusion or wound infection.
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30
Q

Slough Tissue

A
  • Slough tissue is typically
    white/yellow in colour.
  • Slough is devitalised tissue
    which may delay wound healing
    and increase the risk of infection.
  • Treatment aim for slough is to
    debride, if clinically appropriate
    following a holistic assessment
    of the patient and wound.
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31
Q

Necrotic Tissue

A
  • Necrosis Can Be Black, Grey Or
    Tan In Colour. It Can Also Be
    Wet Or Dry.
  • Necrosis Is Cause By Ischemia
    And Cellular Death.
  • Necrosis May Delay Wound
    Healing And Increase The Risk
    Of Infection.
  • Treatment Aim For Necrosis Is
    To Debride, If Clinically
    Appropriate Following A Holistic
    Assessment Of The Patient And Wound.
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32
Q

PRESSURE ULCER STAGE
* Intact skin with nonblanchable redness of a localized area
usually over a bony prominence.
* Darkly pigmented skin may not have visible blanching; its
color may differ from the surrounding area.
* The area may be painful, firm, soft, warmer, or cooler as
compared to adjacent tissue.

A

STAGE I

33
Q

PRESSURE ULCER STAGE
* Partial thickness loss of dermis presenting as a shallow
open ulcer with a red-pink wound bed, without slough.
* May also present as an intact or open/ruptured, serum-filled
blister.
* Presents as a shiny or dry shallow ulcer without slough or
bruising; bruising indicates suspected deep tissue injury.

A

STAGE II

34
Q

PRESSURE ULCER STAGE
Full-thickness tissue loss.
* Subcutaneous fat may be visible
* but bone, tendon, or muscle is not exposed.
* Slough may be present but does not obscure the depth of
tissue loss.
* May include undermining and tunneling.
* The depth of a stage

A

STAGE III

35
Q

PRESSURE ULCER STAGE
Full-thickness tissue loss with exposed bone, tendon, or
muscle.
* Slough or eschar may be present on some parts of the
wound bed.
* Often includes undermining and tunneling. The depth varies
by anatomic location Stage IV ulcers can extend into
muscle and/or supporting structures (e.g., fascia, tendon, or
joint capsule), making osteomyelitis possible.
* Exposed bone/tendon is visible or directly palpable.

A

STAGE IIII

36
Q

PRESSURE ULCER STAGE
Full-thickness tissue loss in which the base of the ulcer is
* covered by slough (yellow, tan, gray, green, or brown) and/
* or eschar (tan, brown, or black) in the wound bed.
* The true depth, and therefore stage, cannot be
* determined until enough slough and/or eschar is removed
to expose the base of the wound
* Stable (dry, adherent, intact without erythema
* or fluctuance) eschar on the heels serves as “the body’s
natural (biological) cover” and should not be removed.

A

UNSTAGEABLE

37
Q

Small, flat, nonpalpable skin
color change (skin color may
be brown, white, tan, purple,
red).

A

Macule and Patch

38
Q

are less than 1 cm
with a circumscribed border

A
  • Macules
39
Q

are greater than 1
cm and may have an irregular
border.

A

Patches

40
Q

Elevated, solid, palpable
mass

A

Nodule, Tumor

41
Q

0.5–2 cm;
circumscribed

A
  • Nodule:
42
Q

1–2 cm; does not
always have sharp border

A

Tumor:

43
Q

Examples include freckles, flat
moles, petechiae, rubella (pictured below), vitiligo, port wine
stains, and ecchymosis.

A

Macule and Patch

44
Q

Examples keloid (pictured
below), lipoma, squamous
cell carcinoma, poorly absorbed injection, and
dermatofibroma.

A

Nodule:

45
Q

Examples include larger lipoma and carcinoma.

A

of tumors

46
Q

Circumscribed elevated,
palpable mass containing
serous fluid.

A

Vesicle and Bulla

47
Q

Bullas are___ than 0.5 cm

A

greater

47
Q

Vesicles are____ than 0.5 cm

A

less

48
Q

Examples include
herpes simplex/zoster,
varicella, poison ivy, and
second-degree burn

A

of vesicles

49
Q

Examples include pemphigus, contact dermatitis,
large burn blisters, poison ivy, and bullous impetigo.

A

of bulla

50
Q

Elevated mass with transient borders
that is often irregular

A

Wheal

51
Q

Caused by movement of serous fluid
into the dermis; it does not contain
free fluid in a cavity (e.g., vesicle).

A

Wheal

52
Q

Examples include urticaria (hives,
pictured below) and insect bites

A

Wheal

53
Q

Pus-filled vesicle or bulla.

A

Pustule

54
Q

Examples include acne, impetigo,
furuncles, and carbuncles.

A

Pustule

55
Q

Encapsulated fluid-filled or
semisolid mass that is located
in the subcutaneous tissue or
dermis.

A

Cyst

56
Q

Cyst Examples include

A

sebaceous
cyst and epidermoid cyst

57
Q

Loss of superficial
epidermis that does not
extend to the dermis.

A

Erosion

58
Q

It is a depressed, moist
area. Examples include
rupture vesicle, scratch
mark, and aphthous
ulcer (aphthous
stomatitis, commonly called a canker sore,

A

Erosion

59
Q

Skin loss extending past
epidermis, with necrotic
tissue loss.

A

Ulcer

60
Q

Skin mark left after healing of
wound or lesion that represents
replacement by connective
tissue of the injured tissue.

A

Scar (Cicatrix)

61
Q

Linear crack in the skin that
may extend to the dermis
and may be painful.

A

FISSURE

62
Q

Examples include chapped
lips or hands and athlete’s
foot.

A

Fissure

63
Q

Round red or purple macule that
is 1–2 mm in size.

It is secondary to blood
extravasation and associated
with bleeding tendencies or
emboli to skin.

A

Petechia

64
Q

Round or irregular macular
lesion that is larger than
petechial lesion.

A

Ecchymosis

65
Q

A localized collection of blood
creating an elevated
ecchymosis.

A

Hematoma

66
Q

Papular and round, red or
purple lesion found on the
trunk or extremities.

A

Cherry Angioma

67
Q

Red arteriole lesion with a
central body with radiating
branches.
* It is usually noted on the
face, neck, arms, and trunk.

A

Spider angioma

68
Q

ABCDE:

A

o A for asymmetrical
o B for borders that are irregular (uneven or notched)
o C for color variations
o D for diameter exceeding 1/8 to 1/4 of an inch
o E for elevated, not flat.

69
Q

Straight line, as in a scratch or streak.

A

Linear configuration

70
Q

Linear configuration An example is

A

dermatographism.

71
Q

Circular lesions

A

Annular Clustered configuration

72
Q

Clustered configuration An example is

A

herpes simplex

73
Q
  • Individual and distinct lesions
A

Discrete configuration

74
Q

Discrete configuration * An example is

A

multiple nevi

75
Q
  • Coin-shaped lesions
A

Nummular configuration

76
Q

Nummular configuration An example is

A

nummular eczema

77
Q
  • Smaller lesions run together to form larger lesion.
A

Confluent configuration

78
Q

Confluent configuration An example is

A

tinea versicolor

79
Q

COMMON NAIL DISORDERS
Parallel ridges running lengthwise.
* May be seen in the elderly and some young people with no
known etiology.

A

Longitudinal ridging

80
Q

COMMON NAIL DISORDERS
Nails that are half white on the upper proximal half and pink
on the distal half.
* May be seen in chronic renal disease.

A

Half-and-Half Nails

81
Q

COMMON NAIL DISORDERS
Seen with psoriasis.

A

Pitting

82
Q

COMMON NAIL DISORDERS
Spoon-shaped nails that may be seen with trauma to
cuticles or nail folds or in iron deficiency anemia, endocrine
or cardiac disease).

A

Koilonychia

83
Q

COMMON NAIL DISORDERS
Yellow nails grow slow and are curved.
* May be seen in AIDS and respiratory syndromes.

A

Yellow Nail Syndrome

84
Q

COMMON NAIL DISORDERS
* Local infection in nails

A

Paronychia

85
Q

Elevated, palpable, solid
mass.

A

Papule and Plaque

86
Q

Examples of
include elevated nevi, warts, and lichen planus.

A

papules

87
Q

Examples of include psoriasis (psoriasis vulgaris
pictured below) and actinic keratosis.

A

plaques

88
Q

Bluish or red lesion with
varying shape (spider-like or
linear) found on the legs and
anterior chest.

A

Telangiectasis (Venous Star)

midterm (33 decks)

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