Chapter 13 - Skin, Hair, and Nails Flashcards
1
Q
Skin covers _____ m² of surface area on the average adult.
A
1.86
2
Q
What is the role of the skin?
A
-protection
-temperature regulation
-sensory perception
-identification
-communication
-wound repair
-absorption and excretion
3
Q
What is the outer layer of the skin called?
A
epidermis
4
Q
What is the inner supportive layer of the skin called?
A
dermis
5
Q
What is the 3rd deepest layer of the skin? What kind of tissue is it?
A
subcutaneous layer, adipose tissue
6
Q
Which of the 3 skin layers is the thinnest?
A
epidermis
7
Q
What is the role of the inner basal cell layer of the epidermis?
A
formation of new skin cells
8
Q
What is the main ingredient of skin cells?
A
keratin - a fibrous protein
9
Q
What is the role of melanin in the epidermis?
A
pigmentation
10
Q
What impacts changes in hair and skin colour? A) amount of melanin B) amount of melanocytes
A
A
11
Q
Above the basal layer is the _______ layer where new cells move up and flatten
A
horny cell layer
12
Q
What makes up the horny cell layer?
A
dead keratinized cells
13
Q
What does desquamated mean?
A
skin cells are being shed
14
Q
The epidermis is completely replaced every ___ weeks
A
4
15
Q
The epidermis is avascular meaning…
A
it does not have a blood supply
16
Q
Where do blood vessels supply the skin?
A
dermis
17
Q
What 3 things comprise skin colour?
A
- melanin (brown)
- carotene (yellow-orange)
- vascular bed (red-purple)
18
Q
What is the dermis made of?
A
-connective tissue - mainly collagen
-elastic tissue
-nerves
-sensory receptors
-blood vessels
-lymphatic vessels
19
Q
What is the role of collagen?
A
it is a tough protein that helps resist tearing
20
Q
Appendages such as hair follicles, sebaceous glands, and sweat glands originate in the ______
A
dermis
21
Q
What is the role of the subcutaneous layer?
A
-stores fat for energy
-insulation
-cushions
22
Q
The visible part of hair is called the _______
A
shaft
23
Q
What part of hair is embedded in the follicle?
A
root
24
Q
Where are new hair cells produced at the root?
A
bulb matrix
25
What is the muscle around the hair follicle that elevates the hair in response to cold or emotion?
arrector pili muscle
26
What is vellus hair?
fine hair that covers most of the body
27
What is terminal hair?
thicker hair that grows on scalp, eyebrows, axillae, pubic area, face & chest (males)
28
Where are the hairless parts on the body?
-palms
-soles
-dorsa of distal parts of fingers
-umbilicus
-glans penis
-inside labia
29
What do sebaceous glands produce?
sebum
30
What does sebum do?
oil and lubricate skin, delays water loss
31
Where are sebaceous glands not found?
-palms
-soles
32
Where are sebaceous glands most abundant?
-scalp
-forehead
-face
-chin
33
What are eccrine sweat glands?
coiled tubules that open DIRECTLY onto skin surface and produce sweat
34
At what age do mature sweat glands appear?
2 months
35
What are apocrine glands?
sweat glands that produce a thick MILKY secretion and open into HAIR follicles
36
Where are apocrine glands located?
-axillae
-anogenital area
-nipples
-navel
37
When do apocrine glands activate?
puberty
38
When do apocrine glands secrete?
emotional and sexual stimulation
39
When do eccrine glands secrete?
temp. regulation
40
What produces body odour?
bacteria + apocrine sweat
41
Apocrine gland functioning ____________ in older adults
decreases
42
What are hair and nails made of?
keratin
43
What makes nails pink?
underlying vascularized epithelial cells
44
What is the lanula?
white, opaque, semi-lunar area at proximal end of nail
45
What is the nail matrix?
area where new keratinized cells are formed
46
What does the cuticle do?
cover and protect nail matrix
47
What vitamin does the skin produce?
D
48
Vitamin D is made by UV light converting ____________
cholesterol
49
Hair follicles develop at ___ months gestation
3
50
What is lanugo?
fine hair on newborn infants
51
What kind of hair is lanugo replaced by?
vellus hair
52
What is vernix caseosa?
thick, cheesy substance made of sebum and dead skin cells present at birth
53
Newborn skin is _______ permeable than adult skin
more
54
Why are infants at greater risk for fluid loss?
their skin is more permeable
55
What is the cause of milia and cradle cap in some babes?
sebum on skin in first few weeks of life
56
What is different about temperature regulation in babies?
-eccrine glands don't sweat in response to heat
-skin can't contract and shiver to protect against cold
57
How does skin and hair change during puberty?
-epidermis thickens, toughens, darkens
-skin is better lubricated
-accelerated hair growth
-increased apocrine gland secretion
-more active sebaceous glands
-subcutaneous fat deposits increase
-coarse pubic and axillary hair develops
58
How does the skin change during pregnancy?
increased pigmentation in areolae, nipples, vulva, midline of abdomen, face
59
Linea Nigra
midline of abdomen darkens during pregnancy
60
Cholasma
hyperpigmentation during pregnancy
61
What are striae gravidarum?
stretch marks on abdomen, breasts, thighs
62
During pregnancy sweat and sebaceous glands _______ secretion
increase
63
What are fat deposits used for during pregnancy?
maternal reserves for nursing baby
64
What happens to aging skin?
-elasticity lost
-folds
-sags
-thins
-dries
65
Loss of ________ increases risk for shearing and tearing injuries
collagen
66
Why are older adults at greatest risk for heat stroke?
sweat glands decreased response to heat
67
What are senile purpura?
dark red discoloured areas produced by minor trauma in older adults
68
The incidence of melanoma is ____x higher among individual with lighter skin
20
69
What is alcohol flush syndrome?
genetic condition characterized by redness, flushing, splotchy neck when alcohol is ingested
70
Alcohol flush syndrome occurs in 90% of individuals of ___________ decent and 50% of individuals of _________ decent
Indigenous, Asian
71
Pruritus
itching
72
What risk to tattoos pose?
Hepatitis C exposure
73
Hyperpigmentation
increase in colour
74
Hypopigmentation
loss of pigmentation
75
Pallor
paleness
76
Jaundice
yellowing usually caused by liver complications
77
Cyanosis
blue colour usually of oxygen depletion
78
Seborrhea
oily
79
Xerosis
dry
80
What is something to consider with multiple cuts or bruises?
abuse, frequent falls causes by neurological or cardiovascular origin, alcoholism or substance abuse
81
What are some medications that can cause an allergic skin reaction?
-aspirin
-antibiotics
-barbiturates
-some tonics
82
What are some meds that can increase sun sensitivity and produce a burn response?
-sulphonamides
-thiazide diuretics
-oral hypoglycaemic agents
-tetracycline
83
What are some medications that can cause hyperpigmentation?
-antimalarials
-antineoplastic agents
-hormones
-metals
-tetracycline
84
Alopecia
significant hair loss
85
Hirsutism
growth of male-pattern hair in women after puberty
86
Who is at most risk for developing skin cancer from prolonged UV exposure?
-have history of skin cancer
-younger than 18
-fair skinned
-have freckles or moles
-family history of skin cancer
-using medications that increase sensitivity to UV rays
-have a weakened immune system
-have a CDKN2A gene mutation
87
Use sunscreen with an SPF of ___ or higher and apply 20 mins before exposure and every __ to __ hours
30; 2-3hrs
88
Why are tanning beds more dangerous than the sun?
2-3x more UVA light exposure which is a known melanoma risk
89
Borrelia burgdorferi is the bacteria that causes ___________
Lyme disease
90
When is "tick season"?
late spring and summer
91
How can you accustom the patient to your touch at the start of the physical examination?
assess their hands and fingernails
92
Ephelides
freckles
93
Is it skin cancer? ABCDE
A - asymmetry
B - borders (defines or rugged)
C - colour
D - diameter (>1cm)
E - elevation (flat or raised)
93
Nevus
mole
94
Erythema
redness
95
Local Pallor
blood flow restriction, edema
96
Central Pallor
shock or anemia
97
Local Cyanosis
cold or anxiety
98
Central Cyanosis
cardiopulmonary condition
99
Local Jaundic
-sclera
-hard palate
-mucus membranes
100
Central Jaundice
liver issue
101
Carotenemia
jaundice in babies from eating orange foods
102
How does pallor appear in dark-skinned people?
-absence of underlying red tones
-loss of lustre
-lips
-nail beds
-ashen gray
103
What is the preffered site of assessing pallor in dark-skinned people?
palpebral conjunctiva and nail beds
104
Local Erythema
fever, local inflammation, blushing
105
How do you observe cyanosis in dark-skinned patients?
other signs such as changes in LOC or signs of respiratory distress
106
What does jaundice indicate?
rising amount of bilirubin in blood
107
Diaphoresis
profuse perspiration
108
What part of your hand do you use to assess temperature?
dorsal surface
109
How do you check for edema?
imprint your thumbs firmly against the ankle malleolus or tibia, if your pressure leaves a dent then edema is present
110
Grade 1 Edema
mild pitting, slight indentation, no perceptible swelling of the leg
111
Grade 2 Edema
moderate pitting, indentation subsides rapidly
112
Grade 3 Edema
deep pitting, indentation remains for a short time, swelling of the leg
113
Grade 4 Edema
very deep pitting, lasts a long time
114
How do you assess skin mobility and turgor?
grasp skin between thumb and index finger or under clavicle and the skin returns to place
115
What are cherry angiomas?
small (1-5mm), smooth, slightly raised bright red spots
116
Who commonly has cherry angiomas?
adults >30yoa
117
Are cherry angiomas concerning?
no
118
Ecchymosis
bruising
119
What tool is used for wound prevention?
Braden Scale
120
Seborrhea
dandruff
121
Nails should curve at about _____ degrees from cuticle to nail bed
160
122
What is clubbing?
in turning of nails, a sign of COPD due to decreased O2
123
What is a mongolian spot?
hyperpigmentation, macular area on buttocks in newborns of Indigenous, African, East Indian, or Hispanic descent
124
What is a cafe au lait spot?
large patch of light brown pigmentation
125
What is erythema toxicum?
rash that appear in first 3-4 day of life, of tiny red macules, cause unknown no Tx needed
126
Acrocyanosis
-bluish colour around the lips, on hands, fingernails, feet, and toenails
-lasts a few hours
-disappears with warming
127
Cutis marmorata
transient (short-term) mottling (blotchy red marbling) in response to cool room temperatures
128
Physiological jaundice (newborns)
-occurs in 50% of newborns
-due to increased hemolysis creating bilirubin
129
Carotenemia doesn't yellow the ________ or mucous membranes
sclera
130
What causes carotenemia?
ingestion of a large amount of foods containing carotene
131
What are milia?
white papules on face caused by sebum that resolve in a few weeks
132
Where do you test mobility and turgor in an infant?
over the abdomen
133
What is a storkbite?
a flat irregular shaped red or pink patch found on forehead, eyelid, upper lip, or back of neck that is present at birth and usually fades in the first year
134
dark-skinned newborns have _______ lanugo than light-skinned newborns
more
135
What are striae?
jagged linear "stretch marks" on pregnant women that occur in half of pregnancies
136
Vascular spiders
occur in 2/3 of pregnancies
137
Senile lentigines
small, flat, brown macules that appear on older adults usually after sun exposure and are not malignant or requiring treatment
138
What are keratoses?
raised, thickened lesions of pigmentation that look scaly and warty and are uncommon to be cancerous
139
Actinic Keratosis
less common, scaly plaques that become raised and rough and are premalignant
140
Acrochordons
skin tags
141
Sebaceous hyperplasia
raised yellow papules with a central depression common in older men
142
Skin tenting
skin turgor decreased and so it stands by itself
143
What are the components of the Braden scale?
-sensory perception
-moisture
-activity
-mobility
-nutrition
-friction and shear
144
How does CO posioning appear in light-skin people?
bright cherry red in face and upper torso
145
How does CO poisoning appear in dark-skin people?
cherry red in nail bed, lips, and oral mucosa
146
Where is jaundice in dark-skinned people most noted?
hard and soft palate, palms
147
What are annular lesions?
circular lesions that begin in centre and spread to periphery
148
What is an example of annular lesions?
tinea corporis (ringworm)
149
What are confluent lesions?
lesions that merge together
150
What is an example of confluent lesions?
urticaria (hives)
151
What are discrete lesions?
distinct, individual lesions that remain separate
152
What is an example of a discrete lesion?
molluscum
153
What are grouped lesions?
clusters of lesions
154
What is an example of grouped lesions?
vesicles of contact dermatitis
155
What are gyrate lesions?
twisted, coiled, spiral, snakelike lesions
156
What is another name for target lesions?
iris lesions
157
What are target lesions?
concentric rings of colour in the lesions
158
What is an example of target lesions?
erythema multiforme
159
What are linear lesions?
a scratch, streak, line, or stripe
160
What are polycyclic lesions?
annular lesions that grow together
161
What is an example of polycyclic lesions?
-lichen planus
-psoriasis
162
What are zosteriform lesions?
linear arrangement along a nerve route
163
What is an example of zosteriform lesions?
herpes zoster
164
Macule, patch, nodule, tumour, vesicle, bulla, papules, plaque, wheal, urticaria, cyst, and pustule are all ____________ lesions
primary
165
What is a macule lesion?
-a colour change
-flat and circumscribed
-<1cm diameter
166
What are some examples of macules?
freckles, flat nevi, petechiae, measles
167
Papule
168
What is a patch lesion?
macules >1cm diameter
169
What are some examples of patch lesions?
vitiligo, cafe au lait
170
Plaque
171
What is a nodule lesion?
a solid, elevated, hard or soft, >1cm diammeter
172
What are some examples of nodules?
xanthoma, fibroma
173
Wheal
174
What is a tumour lesion?
-larger than a few cm
-firm or soft
-can be malignant or benign
175
Urticaria
176
What is a vesicle lesion?
-aka blister
-contains free fluid
-elevated
177
What is an example of a vesicle lesion?
-herpes simplex
-early varicella
178
Cyst
179
What is a bulla lesions?
-single chambered
-superficial in epidermis
->1cm diameter
-thin walled
180
What is a bulla example?
friction blister, burn
181
What is a pustule lesion?
-cavity filled with pus
-circumscribed
-elevated
182
What is an example of a pustule?
acne
183
Crust, scale, fissure, erosion, ulcer, excoriation, scar, atrophic scar, lichenification, and keloid are all ______________ lesions
secondary
184
Look over pictures of other lesions
