chapter 11 Flashcards
Turgor
Skin turgor is the skin’s ability to change shape and return to normal (elasticity)
- it usually decreases with age as the skin loses collagen and elastin fibers.
tenting might decrease in a patient who is dehydrated.
Cultural and Environmental Factors
- job depending on socioeconomic status and living situation.
- skin color
- calluses
Skin cancers
- basal cell carcinoma
- squamous cell carcinoma
- malignant melanoma
- kaposi’s sarcoma
-basal cell carcinoma
- least malignant type of cancer.
- proliferation of the cells of the stratum basale into the dermis and subcutaneous tissue.
- begin as shiny papules that develop central ulcers with rounded, pearly edges.
- caused by exposure to the sun.
-squamous cell carcinoma
- arises from the cells of the stratum spinosum.
- starts as a reddened, scaly papule and then forms a shallow ulcer with a clearly delineated, elevated border.
- commonly appears on the scalp, ears, back of the hands, and lower lip and is thought to be caused by exposure to the sun. it grows rapidly. MOST AGGRESSIVE
-malignant melanoma
- least common, but most serious
- spreads rapidly to lymph and blood vessels
- pigmentation from black to brown to blue or red.
- irregular with notched boarders and the diameter is greater than 6mm.
-kaposi’s sarcoma
- malignant tumor of the epidermis and internal epithelial tissues
- lesions are typically soft, blue to purple and painless
- COMMON IN PEOPLE WITH HIV, AIDS.
nail clubbing
in clubbing , the nail appears more convex and wide. the nail angle is greater than 160 degrees. it occurs in chronic respiratory and cardiac conditions in which oxygen is compromised.
spoon nails
concavity and thinning of the nails, spoon nails are commonly a congenital condition
capillary refill
blanching when pressing the nail that last a few seconds.
petechiae
flat; red or purple rounded freckles
approximately 1 to 3 mm in diameter.
difficult to detect on dark skin and do not blanch.
-cause: minute hemorrhages resulting from fragile capillaries. vitamin C or K deficiency.
hematoma
- raised, irregular shaped lesion similar to an ecchymosis except that it elevated the skin and looks like a swelling.
- causes- a leakage of blood into the skin and subcutaneous tissue as a result or trauma or surgical incision.
hemangioma
- bright red
- raised lesion about 2 to 10 cm in diameter.
- does not blanch with pressure.
- usually present at birth (typically disappears by age 10)
- cause: a cluster of immature capillaries.
nodules and tumors,
- elevated solid hard or soft palpable masses extending deeper into the dermis than a purple.
tumor: irregular, larger than 2cm
nodule: have circumscribed boarders and are .5 to 2 cm.
scales
shedding flakes of greasy, keratinized skin tissue. color may be white, gray, or silver,
configuration and shapes of lesion
Annular-Circular shape (Tinea Corporis, pityriasis rosea)
Confluent-run together (Urticaria)
Discrete-Separate and dicreate (molluscum)
Grouped-appear in clusters (purpural lesions)
Gyrate-coiled or twisted
Targetp-concentric circles of color (Erythema multiforme)
Linear-appear as a line (scratches)
Polycyclic- circular but united (Psosiasis )
Zosteriform Arranged in a linear manner a long a nerve route (herpes Zoster)
herpes simplex
a viral infection that causes characteristic lesions on the lips and oral mucosa.
lesions progress from vesicles to pustules and then crust. also occurs in the genitals.
Nails:
- clubbing,
- beaus lines, oster
- vertical lines,
- older adult,
- Spoon nails,
- splinter hemorrhages
Hair abnormalities:
lice, alopecia, tinea capitis, behaviors that affect hair
Variations in skin colors
melanin
lice
???
alopecia
sudden loss of hair un round balding patch on the scalp.
-no known cause
tinea capitis
patchy white hair loss on the head with pustules on the skin
it is highly contagious of fungal type; transmitted from soil, from animal, or from person to person.
behaviors that affect hair
lack of hygiene
contact dermatitis.
inflammation of the skin due to an allergy to a substance that comes into contact with the skin, such as clothing, jewelry, plants, chemicals, or cosmetics.
progresses from redness to hives, vesicles, or scales accompanied by intense itching.
Psoriasis
thickening of the skin in dry, silvery, scaly patches. it occurs with overproduction of skin cells, resulting in buildup of cells faster than they can be shed.
Changes in skin, hair and nails during pregnancy
-pigmentation increases (nipples, areola, vulva, and perianal.
-Chloasma (hyperpigmented patches) “mask pregnancy”
-linea niegra runs from umbilicus to the pubic area.
-striae gravidarum -stretch marks
Hairs matures quicker and falls off. grows back by 6 to 15 months postpartum.
sebaceous cells become more active worsening acne.
Cancer.
malignant tumor that spreads quickly, taking over the lymph and metastasize.
Impetigo
bacterial skin infection that usually appears on the skin around the nose and mouth. it is contagious and common in children. it may begin as a barely perceptible patch of blisters that breaks, exposing red, weeping area beneath.
shingles
eruption of dormant herpes zoster virus, it invades the body during a chicken pox attack.
measles
highly contagious viral disease that causes a rash of red to purple macules or papules.
begins on face and spreads down. does not blanch
eczema
internally provoked inflammation of the skin causing reddens papules and vesicles that ooze, weep, and progress to form crust.
usually located in the scalp, face, elbows, knees, forearms, torso, and wrist.
hirsutism
excess body hair in females on the face, chest, abdomen, arms, and legs, following the male pattern.
cause: endocrine and metabolic dysfunction.
Primary lesion types and configuration (describing lesions)
Macule and patch papule and plaque nodule and tumor vesicle and bulla wheal pustule cyst
macule and patch
flat, non-palpable changes in the skin color.
papule and plaque
elevated, solid palpable masses with a circumscribed boarder.
vesicle and bulla
fluid- filled, round or ovalshaped masses with thin translucent walls and circumscribed boarders.
wheal
elevated often reddish area with an irregular border caused by diffuse fluid in tissues rather than free fluid in a cavity as in vesicles (insect bite)
pustule
elevated pus-filled vesicle or bulla with a circumscribed border.
cyst
an elevated encapsulated, fluid-filled or semisolid mass originating in the subcutaneous tissue or dermis, usually 1 cm or larger.
