Chapter 13, 22 Flashcards
In this skin disorder, there are patchy depigmentation from destruction of melanocytes
vitiligo
In pallor, anemia has decreased____ and shock has decreased_____
anemia= decreased hematocrit
shock= decreased perfusion, vasoconstriction
Describe how the skin disorder for both light skin & dark skin will look like in a patient with vitiligo.
patchy milky-white spots, often symmetric bilaterally
In this skin disorder, there is total absence of pigment melanin throughout the integument
albinism
In local artery insufficiency, describe how the dark skin would be.
dark skin= ashen gray, dull & cool to palpation
In this disorder, there is an increase amount of unoxygenated hemoglobin; Chronic heart and lung disease cause arterial desaturation
cyanosis
*REMEMBER DUSKY BLUE
What is the skin disorder jaundice?
Increased serum bilirubin from liver inflammation or hemolytic disease such as after severe burns, some infections
Where do you check for jaundice in a dark skin patient? Where is best noted to know they have jaundice?
Check sclera for yellow near limbus
Best noted= hard & soft palate; the PALMS
In carbon monoxide poisoning, what color would you see in a light & dark skin patient?
light skin= BRIGHT cherry red
dark skin= cherry red
This patient has a bronzed appearance, tan like, especially around the nipples, perineum, genitalia, and pressure points like inner thighs, buttocks, elbow, axillae
addison’s disease
This disorder is tan to light brown, irregularly shaped, oval patch with well-defined borders on the skin
cafe au lait spots
This disorder has yellow-orange in forehead, palms and soles, nasolabial folds, but no yellowing in sclera or mucous membranes
Carotenemia
Where are the findings of carotenemia in a dark skin patient?
Yellow-orange tinge in palms and soles
This primary skin lesion is a plateau like, disk-shaped lesion
plaque
This primary skin lesion is like a blister. Examples would include: herpes simplex, chickenpox, herpes zoster (shingles), contact dermatitis
vesicle
This primary skin lesion is an encapsulated fluid-filled cavity in dermis or subcutaneous layer, tensely elevating skin.
cyst
This primary skin lesion has wheals coalesce to form extensive reaction and is intensely pruritic.
Urticaria or hives
This primary skin lesion has a solely a color change and its flat
macule
This primary skin lesion is solid, elevated, hard or soft, larger than 1 cm. May extend deeper into dermis than papule
nodule
This primary skin lesion something you can feel and its caused by superficial thickening in epidermis
papule
This primary skin lesion Larger than a few centimeters in diameter, firm or soft, deeper into dermis & may be benign or malignant;
tumor
What are examples of tumors?
lipoma & hemangioma
This primary skin lesions are like macules but are larger than 1 cm.
patch
What are some examples of patches?
mongolian spot, vitiligo, café au lait spot, chloasma, measles rash.
This primary skin lesion is superficial, raised, transient, and erythematous; slightly irregular shape from edema
wheal
ex. mosquito bites, allergic reaction
This primary skin lesion has turbid fluid (pus) in the cavity. Circumscribed and elevated. Examples: impetigo, acne.
pustule
This primary skin lesion is usually single chambered (unilocular); superficial in epidermis; thin-walled and ruptures easily.
bulla
This secondary skin lesion is described as thickened, dried-out exudate left when vesicles/pustules that burst or dry up;
crust
This secondary skin lesion is described as desiccated flakes of skin, dry or greasy
scale
What skin lesion is colored silvery or white, from shedding of dead excess keratin cells? Give an example of this
scale
ex. psorasis, eczema
What skin lesion can be colored red-yellow, honey, or yellow? Give an example.
crust
ex. impetigo
This skin disorder have examples like cheilosis—at corners of mouth caused by excess moisture; athlete’s foot.
fissure
This skin disorder looks smooth, rubbery, shiny and “clawlike”; feels smooth and firm.
keloid
How does a scaphoid abdomen look like?
abdomen caves in; abnormally sunken abdominal wall
How does a protuberant abdomen look like?
bulging; abdomen is distended
These types of bowel sounds are diminished, absent, signals decreased motility
hypoactive bowel sounds
These types of bowel sounds are loud, gurgling sounds that signals increased motility
hyperactive bowel sounds
Whats the term name for stomach growling?
borborygmus
What is hepatomegaly?
enlarged liver
Characteristics associated with Cullen sign?
bluish periumbilical color occurs with intraperitoneal bleeding
What does a positive Murphy sign indicate?
inspiratory arrest
What does shifting dullness test for?
the second test for ascites; the note of percussion will change from tympany to dull if fluid is present
Which diseases might cause an enlarged spleen?
Mononucleosis, trauma, leukemia, lymphoma, portal hypertension, and HIV
What causes costovertebral angle tenderness?
Sharp pain occurs with inflammation of the kidney or perinephric area
What does a systolic bruit indicate?
pulsatile blowing sound and occurs with stenosis or occlusion of an artery
What is indicated by rebound tenderness?
Blumberg sign
Peritoneal inflammation= appendicitis
What causes costovertebral angle tenderness?
Sharp pain occurs with inflammation of the kidney or perinephric area
Discomfort at the angle formed on each side of the trunk by the junction of the last rib with the lumbar vertebrae; associated with kidney pain. When percussing the abdomen.
What are abnormal findings associated with palpation?
Muscle guarding, rigidity, large masses, tenderness
Involuntary rigidity is a constant, board-like hardness of the muscles
What stage of pressure ulcer/injury is associated with redness but the skin is not broken?
stage 1- non blanchable
What stage of pressure ulcer/injury is described as loss of the epidermis and the dermis is exposed?
stage 2- partial thickness skin loss
What stage of pressure ulcer/injury can see the subcutaneous fat but the muscle, bone or tendon isn’t exposed?
stage 3- full thickness skin loss
What stage of pressure ulcer/injury exposes the muscle, bone, or tendon?
stage 4-full thickness skin & tissue loss
If you ask a patient about any changes in appetite and weight, what disorder is it referring to?
anorexia
What is dysphagia?
difficulty swallowing
occurs with disorders of the throat or esophagus
Food intolerance is associated with? What is pyrosis?
Lactase deficiency resulting in bloating or excessive gas after taking milk products
Pyrosis is heartburn
Black tarry stools are associated with
GI bleeding
Non tarry black stools are associated with
Iron medications
Gray stools are associated with
hepatitis
Red blood stools occur with
GI bleeding or localized bleeding around the anus (ex: hemorrhoids).
abnormalities are indicated in the presence of dullness on percussion
occurs over a distended bladder, adipose tissue, fluid or a mass
abnormalities are indicated in the presence of hyperresonance on percussion
present with gaseous distention
This term is defined as scooped out but shallow depression. Superficial; epidermis lost; moist but no bleeding; heals without scar
erosion
This term is defined when the surface of the skin has deeper depression extending into dermis, irregular shape; may bleed; leaves scar when heals
ulcer
This term is self-inflicted abrasion; superficial; sometimes crusted; scratches from intense itching.
excoriation
Examples include: insect bites, scabies, dermatitis, varicella.
excoriation
normal tissue is lost and replaced with connective tissue (collagen).
scar
This describes when skin level is depressed with loss of tissue; a thinning of the epidermis. Example includes striae.
atrophic scar
Prolonged, intense scratching eventually thickens skin and produces tightly packed sets of papules
AND looks like surface of moss
Lichenification
What areas can you find keloids?
Found in ear lobes, back of neck, scalp, chest, and back; may occur months to years after initial trauma
This type of pressure injury is begins in the muscle closest to the bone; common skin sites are coccyx, sacrum, buttocks, heels
Deep tissue pressure injury
Describe the appearance of a patient with brown skin and has pallor would look like.
Brown skin→ appears yellow-brown, dull
Describe the appearance of a patient with black skin and has pallor would look like.
black skin → appears ashen gray, dull
Describe how light skin and dark skin patients would look like with albinism.
light skin= Whitish pink
dark skin= tan, cream, white
In dark skinned patients with cyanosis, how would their skin look like?
Dark but dull, lifeless; only severe cyanosis is apparent in skin
What areas would you check for cyanosis in dark patients?
Check conjunctivae, oral mucosa, nail beds
How would patients with light skin & dark skin that have hyperemia would look like?
light skin= red, bright pink
dark skin= purplish tinge; palpate for increased warmth with inflammation, taut skin, and hardening of deep tissues
How would patients with light skin & dark skin that have polycythemia would look like?
light skin= Ruddy blue in face, oral mucosa, conjunctiva, hands, and feet
dark skin= redness in lips
Describe light skin patients with carotenemia.
Yellow-orange in forehead, palms and soles, nasolabial folds, but no yellowing in sclera or mucous membranes
Define uremia.
Describe light skin patients with uremia.
Renal failure causes retained urochrome pigments in the blood
Orange-green or gray overlying pallor of anemia; may also have ecchymoses and purpura
What skin condition is caused by increased melanin pigment in basal cell layer?
cafe au lait spots
Examples: elevated nevus (mole), lichen planus, molluscum, wart (verruca) are this type of skin lesion.
papule
Examples: xanthoma, fibroma, intradermal nevi are this type of skin lesion.
nodule
Examples: friction blister, pemphigus, burns, contact dermatitis are this type of skin lesion
bulla
psoriasis and lichen planus are examples of what skin lesion?
plaque
This type pressure injury shows epidermis may separate, revealing dark wound or blood-filled blister.
Deep tissue pressure injury (DTPI)
What causes pulsation of the aorta?
widened pulse pressure, (hypertension, aortic insufficiency, thyrotoxicosis) and abdominal aortic aneurysm
signs and symptoms of abdominal pain
knees flexed up, facial grimacing, and rapid, uneven respirations
If you are palpating a patient to find out if they have an enlarged spleen, what quadrant would you palpate?
Left Upper Quadrant (LUQ)
If you are palpating a patient to find out if they have an enlarged liver, what quadrant would you palpate?
Right Upper Quadrant (RUQ)
An abnormal finding for a patient with Murphy sign would indicate if pain is present?
In a person with inflammation of the gallbladder (cholecystitis)
When performing an abdominal assessment, what are the steps in order?
Inspection
Auscultation
Percussion
Palpation (LAST)
