Chapter 13: Skin, Hair, and Nails Flashcards
Alopecia
Baldness; hair loss
Annular
Circular shape to skin lesion
Bulla
Elevated cavity containing free fluid larger than 1 cm in diameter
Confluent
Skin lesions that run together
Crust
Thick, dried-out exudate left on skin when vesicles or pustules burst or dry up
Cyanosis
Dusky blue color to skin or mucous membranes as a result of increased amount of non-oxygenated hemoglobin
Erosion
Scooped-out, shallow depression in skin
Erythema
Intense redness of the skin due to excess blood in dilated superficial capillaries, as in fever or inflammation
Excoriation
Self-inflicted abrasion on skin due to scratching
Fissure
Linear crack in skin extending into dermis
Furuncle
Boil; suppurative inflammatory skin lesion due to infected hair follicle
Hemangioma
Skin lesion due to benign proliferation of blood vessels in the dermis
Iris
Target shape of skin lesion
Jaundice
Yellow color to skin, palate, and sclera due to excess bilirubin in the blood
Keloid
Hypertrophic scar, elevated beyond site of original injury
Lichenification
Tightly packed set of papules that thickens skin; caused by prolonged intense scratching
Lipoma
Benign fatty tumor
Maceration
Softening of tissue by soaking
Macule
Flat skin lesion with only a color change
Nevus
Mole; circumscribed in the skin lesion due to excess melanocytes
Nodule
Elevated skin lesion large than 1 cm in diameter
Pallor
Excessively pale, whitish-pink color to lightly pigmented skin
Papule
Palpable skin lesion smaller than 1 cm in diameter
Plaque
Skin lesion in which papules coalesce or come together
Pruritus
Itching
Purpura
Red-purple skin lesion due to blood in tissues from breaks in blood vessels
Pustule
Elevated cavity containing thick, turbid fluid
Scale
Compact desiccated flakes of skin from shedding of dead skin cells
Telangiectasia
Skin lesion due to permanently enlarged and dilated blood vessels that are visible
Ulcer
Sloughing of necrotic inflammatory tissue that causes a deep depression in skin, extending into dermis
Vesicle
Elevated cavity containing free fluid up to 1 cm in diameter
Wheal
Raised red skin lesion due to interstitial fluid
Zosteriform
Linear shape of skin lesion along a nerve route
List the 3 layers associated with the skin and describe the contents of each layer.
Epidermis - outer layer
- Horny cell layer: flattened cells from basal cell layer
- Dead keratinized cells
- Completely replaced every 4 weeks
- Basal cell layer: forms new skin cells
- Melanocytes produce melanin
Dermis - middle layer
- Made mostly of collagen (connective tissue)
- Location of: nerves, sensory receptors, blood vessels, and lymphatics
- Appendages of epidermis: hair follicles, sebaceous glands, sweat glands
Subcutaneous layer - deepest
- Adipose tissue
- Provides energy, insulation, and protection
- Increases skin mobility
Differentiate among sebaceous, eccrine, and apocrine glands
Sebacous: produces protective lipid substance (sebum); helps prevents water loss; secreted through hair follicles
Sweat glands:
- Eccrine: tubules that open directly on skin and produce sweat
- Apocrine: produces thick, milky secretion onto hair follicles; located in axillae, angogenital, nipple, and naval regions; activated during puberty, decresaed function with age
List at least 5 functions of the skin
- Protection (physical, chemical, thermal, UV)
- Prevents penetration (mircoorganisms, loss of water and electrolytes)
- Perception (sensory)
- Temperature regulation (sweat and heat storage)
- Indentification
- Communication
- Wound repair
- Absorption and secretion
- Production of vitamin D
Describe the appearance of pallor in both light-skinned and dark-skinned persons.
- Pallor - white appearance
- stress/anxiety, edema, cold, smokers, anemia, shock, arterial insufficiency
- Powerful peripheral vasoconstriction
- Sympathetic stimulation
- Erythema - red appearance
- Excess blood (hyperemia) in dilated superficial cappillaries
- Polyeythemia, venous stasis, carbon monoxide poisoning, extra vascular presence of rbc (Petechiae, venous ecchymosis, hematomas), fever, inflammation, emotional reaction
- Cyanosis - blue appearance
- Decreased perfusion (high levels of deoxygenated blood)
- Shock, cardiac arrest, heart failure, chronic bronchitis; congenital heart failure, anemia, polyrythemia
- Jaundice - yellow appearance
- Increased amounts of bilirubim in the blood
- Hepatitis, cirrhosis, sickle-cell disease, transfusion reaction, and hemolytic disease
- Accompanied by light/gray colored stool and dark golden urine
Describe the appearance of erythema in both light-skinned and dark-skinned persons.
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Describe the appearance of cyanosis in both light-skinned and dark-skinned persons.
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Describe the appearance of jaundice in both light-skinned and dark-skinned persons.
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State common causes of pallor, erythema, cyanosis, and jaundice.
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List causes of change in skin temperature, texture, moisture, mobility, and turgor.
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The white linear markings that are usually visible through the nail and on the pink nail bed are termed: _____.
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Describe a Mongolian spot on an infant’s skin.
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Describe a Cafe au lait spot on an infant’s skin.
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Describe an erythema toxicum on an infant’s skin.
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Describe a cutis marmorata on an infant’s skin.
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Describe a physiologic jaundice on an infant’s skin.
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Describe a milia on an infant’s skin.
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Describe lentigines on an aging adult’s skin.
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Describe seborrheic keratosis on an aging adult’s skin.
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Describe actinic keratosis on an aging adult’s skin.
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Describe acrochordons (skin tags) on an aging adult’s skin.
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Describe sebaceous hyperplasia on an aging adult’s skin.
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Differentiate among these purpuric lesions: petechiae, bruise, hematoma.
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Differentiate among the appearance of the skin rash of these childhood illnesses: measles (rubeola), German measles (rubella), chickenpox (varicella).
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List and describe the 4 stages of pressure injury development.
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Define and give an example of the primary skin lesion: macule.
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Define and give an example of the primary skin lesion: papule.
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Define and give an example of the primary skin lesion: plaque.
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Define and give an example of the primary skin lesion: nodule.
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Define and give an example of the primary skin lesion: tumor.
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Define and give an example of the primary skin lesion: wheal.
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Define and give an example of the primary skin lesion: vesicle.
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Define and give an example of the primary skin lesion: pustule.
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Define and give an example of the secondary skin lesion: crust
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Define and give an example of the secondary skin lesion: scale.
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Define and give an example of the secondary skin lesion: fissure.
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Define and give an example of the secondary skin lesion: erosion.
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Define and give an example of the secondary skin lesion: ulcer.
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Define and give an example of the secondary skin lesion: crust
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Define and give an example of the secondary skin lesion: scale
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Define and give an example of the secondary skin lesion: fissure
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Define and give an example of the secondary skin lesion: erosion
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Define and give an example of the secondary skin lesion: ulcer
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What is label A pointing to?
Edge of nail
What is label B pointing to?
Nail Plate
What is label C pointing to?
Lateral nail fold
What is label D pointing to?
Lunula
What is label E pointing to?
Cuticle
What is label F pointing to?
Proximal nail fold
What is label G pointing to?
Nail root
What is label H pointing to?
Nail matrix
What is label I pointing to?
Tendon
What is label J pointing to?
Nail bed
What is label K pointing to?
Bone
What is label A pointing to?
Epidermis
What is label B pointing to?
Dermis
What is label C pointing to?
Hypodermis (superficial fascia)
What is label D pointing to?
Hair root
What is label E pointing to?
Hair follicle
What is label F pointing to?
Eccrine sweat gland
What is label G pointing to?
Hair shaft
What is label H pointing to?
Pore
What is label I pointing to?
Dermal papillae (papillary layer of dermis)
What is label J pointing to?
Meissner’s corpuscle
What is label K pointing to?
Free nerve ending
What is label L pointing to?
Reticular layer of dermis
What is label M pointing to?
Sebaceous (oil) gland
What is label O pointing to?
Arrector pili muscle
What is label P pointing to?
Sensory nerve fiber
What is label Q pointing to?
Eccrine sweat gland
What is label R pointing to?
Pacinian corpuscle
What is label S pointing to?
Artery
What is label T pointing to?
Vein
What is label U pointing to?
Adipose tissue
What is label V pointing to?
Hair follicle receptor (root hair plexus)
Select the best description of the secretion of the eccrine glands.
a. Thick, milky
b. Dilute saline solution
c. Protective lipid substance
d. Keratin
b. Dilute saline solution
To assess for early jaundice, you will assess:
a. Sclera and hard palate
b. Nail beds
c. Lips
d. All visible skin surfaces
a. Sclera and hard palate
Checking for skin temperature is best accomplished by using:
a. The palmer surface of the hands
b. The ventral surface of the hands
c. The fingertips
d. The dorsal surface of the hands
d. The dorsal surface of the hands
Assessing a patient’s skin turgor is done to assess which clinical finding?
a. Edema
b. Dehydration
c. Vitiligo
d. Scleroderma
b. Dehydration
You note a lesion during a skin assessment. Which is the best way to document this finding?
a. Raised, irregular lesion the size of a quarter, located on dorsum of left hand.
b. Open lesion with no drainage or odor, approximately 1/4 inch in diameter
c. Pedunculated lesion below left scapula with consistent red color and no drainage or odor
d. Dark brown raised lesion, with irregular border, on dorsum of right foot, 3 cm in size, with no drainage
d. Dark brown raised lesion, with irregular border, on dorsum of right foot, 3 cm in size, with no drainage
You examine the nail beds of a patient. Which finding indicates a normal angle?
a. 60 degrees
b. 100 degrees
c. 160 degrees
d. 180 degrees
c. 160 degrees
You are assessing capillary refill. The room is warm. Which finding would be considered normal?
a. Less than or equal to 1 second
b. Greater than 2 seconds
c. 2-3 seconds
d. Time is not significant as long as color returns
a. Less than or equal to 1 second
During a routine visit, M.B., age 78, asks about small, round, flat, brown macules on the hands. What is your best response after assessing the areas?
a. “These are the result of sun exposure and do not require treatment.”
b. “These are related to exposure to the sun. They may become cancerous.”
c. “These are the skin tags that occur with aging. No treatment is required.”
d. “I’m glad you brought this to my attention. I will arrange for a biopsy.”
a. “These are the result of sun exposure and do not require treatment.”
An area of thin, shiny skin with decreased visibility of normal skin markings is most likely:
a. Lichenification
b. Plaque
c. Atrophy
d. Keloid
c. Atrophy
Flattening of the angle between the nail and its base is:
a. Found in subacute bacterial endocarditis
b. A description of spoon-shaped nails
c. Related to calcium deficiency
d. Described as clubbing
h
A configuration of individual lesions arranged in circles or arcs, as occurs with ringworm, is described as a:
a. Linear lesion
b. Clustered lesion
c. Annular lesion
d. Gyrate lesion
k
The “A” in the ABCDEF rule for skin cancer stands for:
a. Accuracy
b. Appearance
c. Asymmetry
d. Attenuated
k
A risk factor for melanoma is:
a. Brown eyes
b. Darkly pigmented skin
c. Skin that freckles or burns before tanning
d. Use of sunscreen products
k
Herpes zoster infection (shingles) is characterized by:
a. A bacterial cause
b. Lesion on only one side of body; does not cross midline
c. Absence of pain or edema
d. Pustular, umbilicated lesion
l
The basal cell layer is part of the:
a. Epidermis
b. Dermis
c. Subcutaneous layer
k
The part of the skin that aids protection by cushioning is part of the:
a. Epidermis
b. Dermis
c. Subcutaneous layer
m
Collagen is part of the:
a. Epidermis
b. Dermis
c. Subcutaneous layer
d
Adipose tissue is part of the:
a. Epidermis
b. Dermis
c. Subcutaneous layer
d
The skin layer that is uniformly thin is part of the:
a. Epidermis
b. Dermis
c. Subcutaneous layer
d
The stratum corneum is part of the:
a. Epidermis
b. Dermis
c. Subcutaneous layer
d
The elastic tissue is part of the:
a. Epidermis
b. Dermis
c. Subcutaneous layer
d
Pallor:
a. Intense redness of the skin due to excess blood in the dilated superficial capillaries
b. Bluish mottled color that signifies decreased perfusion
c. Absence of red-pink tones from the oxygenated hemoglobin in blood
d. Increase in bilirubin in the blood causing a yellow color in the skin
l
Erythema:
a. Intense redness of the skin due to excess blood in the dilated superficial capillaries
b. Bluish mottled color that signifies decreased perfusion
c. Absence of red-pink tones from the oxygenated hemoglobin in blood
d. Increase in bilirubin in the blood causing a yellow color in the skin
v
Cyanosis:
a. Intense redness of the skin due to excess blood in the dilated superficial capillaries
b. Bluish mottled color that signifies decreased perfusion
c. Absence of red-pink tones from the oxygenated hemoglobin in blood
d. Increase in bilirubin in the blood causing a yellow color in the skin
h
Jaundice:
a. Intense redness of the skin due to excess blood in the dilated superficial capillaries
b. Bluish mottled color that signifies decreased perfusion
c. Absence of red-pink tones from the oxygenated hemoglobin in blood
d. Increase in bilirubin in the blood causing a yellow color in the skin
s
Tiny, punctate red macules and papules on the cheeks, trunk, chest, back, and buttocks
a. Harlequin
b. Erythema toxicum
c. Acrocyanosis
d. Physiologic jaundice
e. Carotenemia
f. Cafe au lait spot
g. Cutis marmorata
l
Lower half of body turns red, upper half blanches.
a. Harlequin
b. Erythema toxicum
c. Acrocyanosis
d. Physiologic jaundice
e. Carotenemia
f. Cafe au lait spot
g. Cutis marmorata
k
Transient mottling on trunk and extremities.
a. Harlequin
b. Erythema toxicum
c. Acrocyanosis
d. Physiologic jaundice
e. Carotenemia
f. Cafe au lait spot
g. Cutis marmorata
k
Bluish color arround the lips, hand, fingernails, feet, and toenails.
a. Harlequin
b. Erythema toxicum
c. Acrocyanosis
d. Physiologic jaundice
e. Carotenemia
f. Cafe au lait spot
g. Cutis marmorata
k
Large, round, or oval patch of light brown; usually present at birth.
a. Harlequin
b. Erythema toxicum
c. Acrocyanosis
d. Physiologic jaundice
e. Carotenemia
f. Cafe au lait spot
g. Cutis marmorata
k
Yellowing of skin, sclera, and mucous membranes due to increased numbers of red blood cells hemolyzed after birth.
a. Harlequin
b. Erythema toxicum
c. Acrocyanosis
d. Physiologic jaundice
e. Carotenemia
f. Cafe au lait spot
g. Cutis marmorata
k
Yellow-orange color in light-skinned persons from large amounts of foods containing carotene.
a. Harlequin
b. Erythema toxicum
c. Acrocyanosis
d. Physiologic jaundice
e. Carotenemia
f. Cafe au lait spot
g. Cutis marmorata
k
