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NURS 252 > Chapter 13 - Skin, Hair, and Nails > Flashcards

Chapter 13 - Skin, Hair, and Nails Flashcards

1
Q

Skin covers _____ m² of surface area on the average adult.

A

1.86

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2
Q

What is the role of the skin?

A

-protection
-temperature regulation
-sensory perception
-identification
-communication
-wound repair
-absorption and excretion

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3
Q

What is the outer layer of the skin called?

A

epidermis

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4
Q

What is the inner supportive layer of the skin called?

A

dermis

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5
Q

What is the 3rd deepest layer of the skin? What kind of tissue is it?

A

subcutaneous layer, adipose tissue

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6
Q

Which of the 3 skin layers is the thinnest?

A

epidermis

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7
Q

What is the role of the inner basal cell layer of the epidermis?

A

formation of new skin cells

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8
Q

What is the main ingredient of skin cells?

A

keratin - a fibrous protein

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9
Q

What is the role of melanin in the epidermis?

A

pigmentation

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10
Q

What impacts changes in hair and skin colour? A) amount of melanin B) amount of melanocytes

A

A

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11
Q

Above the basal layer is the _______ layer where new cells move up and flatten

A

horny cell layer

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12
Q

What makes up the horny cell layer?

A

dead keratinized cells

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13
Q

What does desquamated mean?

A

skin cells are being shed

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14
Q

The epidermis is completely replaced every ___ weeks

A

4

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15
Q

The epidermis is avascular meaning…

A

it does not have a blood supply

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16
Q

Where do blood vessels supply the skin?

A

dermis

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17
Q

What 3 things comprise skin colour?

A
  1. melanin (brown)
  2. carotene (yellow-orange)
  3. vascular bed (red-purple)
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18
Q

What is the dermis made of?

A

-connective tissue - mainly collagen
-elastic tissue
-nerves
-sensory receptors
-blood vessels
-lymphatic vessels

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19
Q

What is the role of collagen?

A

it is a tough protein that helps resist tearing

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20
Q

Appendages such as hair follicles, sebaceous glands, and sweat glands originate in the ______

A

dermis

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21
Q

What is the role of the subcutaneous layer?

A

-stores fat for energy
-insulation
-cushions

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22
Q

The visible part of hair is called the _______

A

shaft

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23
Q

What part of hair is embedded in the follicle?

A

root

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24
Q

Where are new hair cells produced at the root?

A

bulb matrix

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25
Q

What is the muscle around the hair follicle that elevates the hair in response to cold or emotion?

A

arrector pili muscle

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26
Q

What is vellus hair?

A

fine hair that covers most of the body

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27
Q

What is terminal hair?

A

thicker hair that grows on scalp, eyebrows, axillae, pubic area, face & chest (males)

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28
Q

Where are the hairless parts on the body?

A

-palms
-soles
-dorsa of distal parts of fingers
-umbilicus
-glans penis
-inside labia

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29
Q

What do sebaceous glands produce?

A

sebum

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30
Q

What does sebum do?

A

oil and lubricate skin, delays water loss

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31
Q

Where are sebaceous glands not found?

A

-palms
-soles

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32
Q

Where are sebaceous glands most abundant?

A

-scalp
-forehead
-face
-chin

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33
Q

What are eccrine sweat glands?

A

coiled tubules that open DIRECTLY onto skin surface and produce sweat

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34
Q

At what age do mature sweat glands appear?

A

2 months

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35
Q

What are apocrine glands?

A

sweat glands that produce a thick MILKY secretion and open into HAIR follicles

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36
Q

Where are apocrine glands located?

A

-axillae
-anogenital area
-nipples
-navel

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37
Q

When do apocrine glands activate?

A

puberty

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38
Q

When do apocrine glands secrete?

A

emotional and sexual stimulation

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39
Q

When do eccrine glands secrete?

A

temp. regulation

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40
Q

What produces body odour?

A

bacteria + apocrine sweat

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41
Q

Apocrine gland functioning ____________ in older adults

A

decreases

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42
Q

What are hair and nails made of?

A

keratin

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43
Q

What makes nails pink?

A

underlying vascularized epithelial cells

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44
Q

What is the lanula?

A

white, opaque, semi-lunar area at proximal end of nail

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45
Q

What is the nail matrix?

A

area where new keratinized cells are formed

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46
Q

What does the cuticle do?

A

cover and protect nail matrix

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47
Q

What vitamin does the skin produce?

A

D

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48
Q

Vitamin D is made by UV light converting ____________

A

cholesterol

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49
Q

Hair follicles develop at ___ months gestation

A

3

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50
Q

What is lanugo?

A

fine hair on newborn infants

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51
Q

What kind of hair is lanugo replaced by?

A

vellus hair

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52
Q

What is vernix caseosa?

A

thick, cheesy substance made of sebum and dead skin cells present at birth

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53
Q

Newborn skin is _______ permeable than adult skin

A

more

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54
Q

Why are infants at greater risk for fluid loss?

A

their skin is more permeable

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55
Q

What is the cause of milia and cradle cap in some babes?

A

sebum on skin in first few weeks of life

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56
Q

What is different about temperature regulation in babies?

A

-eccrine glands don’t sweat in response to heat
-skin can’t contract and shiver to protect against cold

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57
Q

How does skin and hair change during puberty?

A

-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

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58
Q

How does the skin change during pregnancy?

A

increased pigmentation in areolae, nipples, vulva, midline of abdomen, face

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59
Q

Linea Nigra

A

midline of abdomen darkens during pregnancy

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60
Q

Cholasma

A

hyperpigmentation during pregnancy

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61
Q

What are striae gravidarum?

A

stretch marks on abdomen, breasts, thighs

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62
Q

During pregnancy sweat and sebaceous glands _______ secretion

A

increase

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63
Q

What are fat deposits used for during pregnancy?

A

maternal reserves for nursing baby

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64
Q

What happens to aging skin?

A

-elasticity lost
-folds
-sags
-thins
-dries

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65
Q

Loss of ________ increases risk for shearing and tearing injuries

A

collagen

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66
Q

Why are older adults at greatest risk for heat stroke?

A

sweat glands decreased response to heat

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67
Q

What are senile purpura?

A

dark red discoloured areas produced by minor trauma in older adults

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68
Q

The incidence of melanoma is ____x higher among individual with lighter skin

A

20

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69
Q

What is alcohol flush syndrome?

A

genetic condition characterized by redness, flushing, splotchy neck when alcohol is ingested

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70
Q

Alcohol flush syndrome occurs in 90% of individuals of ___________ decent and 50% of individuals of _________ decent

A

Indigenous, Asian

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71
Q

Pruritus

A

itching

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72
Q

What risk to tattoos pose?

A

Hepatitis C exposure

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73
Q

Hyperpigmentation

A

increase in colour

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74
Q

Hypopigmentation

A

loss of pigmentation

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75
Q

Pallor

A

paleness

76
Q

Jaundice

A

yellowing usually caused by liver complications

77
Q

Cyanosis

A

blue colour usually of oxygen depletion

78
Q

Seborrhea

A

oily

79
Q

Xerosis

A

dry

80
Q

What is something to consider with multiple cuts or bruises?

A

abuse, frequent falls causes by neurological or cardiovascular origin, alcoholism or substance abuse

81
Q

What are some medications that can cause an allergic skin reaction?

A

-aspirin
-antibiotics
-barbiturates
-some tonics

82
Q

What are some meds that can increase sun sensitivity and produce a burn response?

A

-sulphonamides
-thiazide diuretics
-oral hypoglycaemic agents
-tetracycline

83
Q

What are some medications that can cause hyperpigmentation?

A

-antimalarials
-antineoplastic agents
-hormones
-metals
-tetracycline

84
Q

Alopecia

A

significant hair loss

85
Q

Hirsutism

A

growth of male-pattern hair in women after puberty

86
Q

Who is at most risk for developing skin cancer from prolonged UV exposure?

A

-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
Q

Use sunscreen with an SPF of ___ or higher and apply 20 mins before exposure and every __ to __ hours

A

30; 2-3hrs

88
Q

Why are tanning beds more dangerous than the sun?

A

2-3x more UVA light exposure which is a known melanoma risk

89
Q

Borrelia burgdorferi is the bacteria that causes ___________

A

Lyme disease

90
Q

When is “tick season”?

A

late spring and summer

91
Q

How can you accustom the patient to your touch at the start of the physical examination?

A

assess their hands and fingernails

92
Q

Ephelides

A

freckles

93
Q

Is it skin cancer? ABCDE

A

A - asymmetry
B - borders (defines or rugged)
C - colour
D - diameter (>1cm)
E - elevation (flat or raised)

93
Q

Nevus

A

mole

94
Q

Erythema

A

redness

95
Q

Local Pallor

A

blood flow restriction, edema

96
Q

Central Pallor

A

shock or anemia

97
Q

Local Cyanosis

A

cold or anxiety

98
Q

Central Cyanosis

A

cardiopulmonary condition

99
Q

Local Jaundic

A

-sclera
-hard palate
-mucus membranes

100
Q

Central Jaundice

A

liver issue

101
Q

Carotenemia

A

jaundice in babies from eating orange foods

102
Q

How does pallor appear in dark-skinned people?

A

-absence of underlying red tones
-loss of lustre
-lips
-nail beds
-ashen gray

103
Q

What is the preffered site of assessing pallor in dark-skinned people?

A

palpebral conjunctiva and nail beds

104
Q

Local Erythema

A

fever, local inflammation, blushing

105
Q

How do you observe cyanosis in dark-skinned patients?

A

other signs such as changes in LOC or signs of respiratory distress

106
Q

What does jaundice indicate?

A

rising amount of bilirubin in blood

107
Q

Diaphoresis

A

profuse perspiration

108
Q

What part of your hand do you use to assess temperature?

A

dorsal surface

109
Q

How do you check for edema?

A

imprint your thumbs firmly against the ankle malleolus or tibia, if your pressure leaves a dent then edema is present

110
Q

Grade 1 Edema

A

mild pitting, slight indentation, no perceptible swelling of the leg

111
Q

Grade 2 Edema

A

moderate pitting, indentation subsides rapidly

112
Q

Grade 3 Edema

A

deep pitting, indentation remains for a short time, swelling of the leg

113
Q

Grade 4 Edema

A

very deep pitting, lasts a long time

114
Q

How do you assess skin mobility and turgor?

A

grasp skin between thumb and index finger or under clavicle and the skin returns to place

115
Q

What are cherry angiomas?

A

small (1-5mm), smooth, slightly raised bright red spots

116
Q

Who commonly has cherry angiomas?

A

adults >30yoa

117
Q

Are cherry angiomas concerning?

A

no

118
Q

Ecchymosis

A

bruising

119
Q

What tool is used for wound prevention?

A

Braden Scale

120
Q

Seborrhea

A

dandruff

121
Q

Nails should curve at about _____ degrees from cuticle to nail bed

A

160

122
Q

What is clubbing?

A

in turning of nails, a sign of COPD due to decreased O2

123
Q

What is a mongolian spot?

A

hyperpigmentation, macular area on buttocks in newborns of Indigenous, African, East Indian, or Hispanic descent

124
Q

What is a cafe au lait spot?

A

large patch of light brown pigmentation

125
Q

What is erythema toxicum?

A

rash that appear in first 3-4 day of life, of tiny red macules, cause unknown no Tx needed

126
Q

Acrocyanosis

A

-bluish colour around the lips, on hands, fingernails, feet, and toenails
-lasts a few hours
-disappears with warming

127
Q

Cutis marmorata

A

transient (short-term) mottling (blotchy red marbling) in response to cool room temperatures

128
Q

Physiological jaundice (newborns)

A

-occurs in 50% of newborns
-due to increased hemolysis creating bilirubin

129
Q

Carotenemia doesn’t yellow the ________ or mucous membranes

A

sclera

130
Q

What causes carotenemia?

A

ingestion of a large amount of foods containing carotene

131
Q

What are milia?

A

white papules on face caused by sebum that resolve in a few weeks

132
Q

Where do you test mobility and turgor in an infant?

A

over the abdomen

133
Q

What is a storkbite?

A

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
Q

dark-skinned newborns have _______ lanugo than light-skinned newborns

A

more

135
Q

What are striae?

A

jagged linear “stretch marks” on pregnant women that occur in half of pregnancies

136
Q

Vascular spiders

A

occur in 2/3 of pregnancies

137
Q

Senile lentigines

A

small, flat, brown macules that appear on older adults usually after sun exposure and are not malignant or requiring treatment

138
Q

What are keratoses?

A

raised, thickened lesions of pigmentation that look scaly and warty and are uncommon to be cancerous

139
Q

Actinic Keratosis

A

less common, scaly plaques that become raised and rough and are premalignant

140
Q

Acrochordons

A

skin tags

141
Q

Sebaceous hyperplasia

A

raised yellow papules with a central depression common in older men

142
Q

Skin tenting

A

skin turgor decreased and so it stands by itself

143
Q

What are the components of the Braden scale?

A

-sensory perception
-moisture
-activity
-mobility
-nutrition
-friction and shear

144
Q

How does CO posioning appear in light-skin people?

A

bright cherry red in face and upper torso

145
Q

How does CO poisoning appear in dark-skin people?

A

cherry red in nail bed, lips, and oral mucosa

146
Q

Where is jaundice in dark-skinned people most noted?

A

hard and soft palate, palms

147
Q

What are annular lesions?

A

circular lesions that begin in centre and spread to periphery

148
Q

What is an example of annular lesions?

A

tinea corporis (ringworm)

149
Q

What are confluent lesions?

A

lesions that merge together

150
Q

What is an example of confluent lesions?

A

urticaria (hives)

151
Q

What are discrete lesions?

A

distinct, individual lesions that remain separate

152
Q

What is an example of a discrete lesion?

A

molluscum

153
Q

What are grouped lesions?

A

clusters of lesions

154
Q

What is an example of grouped lesions?

A

vesicles of contact dermatitis

155
Q

What are gyrate lesions?

A

twisted, coiled, spiral, snakelike lesions

156
Q

What is another name for target lesions?

A

iris lesions

157
Q

What are target lesions?

A

concentric rings of colour in the lesions

158
Q

What is an example of target lesions?

A

erythema multiforme

159
Q

What are linear lesions?

A

a scratch, streak, line, or stripe

160
Q

What are polycyclic lesions?

A

annular lesions that grow together

161
Q

What is an example of polycyclic lesions?

A

-lichen planus
-psoriasis

162
Q

What are zosteriform lesions?

A

linear arrangement along a nerve route

163
Q

What is an example of zosteriform lesions?

A

herpes zoster

164
Q

Macule, patch, nodule, tumour, vesicle, bulla, papules, plaque, wheal, urticaria, cyst, and pustule are all ____________ lesions

A

primary

165
Q

What is a macule lesion?

A

-a colour change
-flat and circumscribed
-<1cm diameter

166
Q

What are some examples of macules?

A

freckles, flat nevi, petechiae, measles

167
Q

Papule

A
168
Q

What is a patch lesion?

A

macules >1cm diameter

169
Q

What are some examples of patch lesions?

A

vitiligo, cafe au lait

170
Q

Plaque

A
171
Q

What is a nodule lesion?

A

a solid, elevated, hard or soft, >1cm diammeter

172
Q

What are some examples of nodules?

A

xanthoma, fibroma

173
Q

Wheal

A
174
Q

What is a tumour lesion?

A

-larger than a few cm
-firm or soft
-can be malignant or benign

175
Q

Urticaria

A
176
Q

What is a vesicle lesion?

A

-aka blister
-contains free fluid
-elevated

177
Q

What is an example of a vesicle lesion?

A

-herpes simplex
-early varicella

178
Q

Cyst

A
179
Q

What is a bulla lesions?

A

-single chambered
-superficial in epidermis
->1cm diameter
-thin walled

180
Q

What is a bulla example?

A

friction blister, burn

181
Q

What is a pustule lesion?

A

-cavity filled with pus
-circumscribed
-elevated

182
Q

What is an example of a pustule?

A

acne

183
Q

Crust, scale, fissure, erosion, ulcer, excoriation, scar, atrophic scar, lichenification, and keloid are all ______________ lesions

A

secondary

184
Q

Look over pictures of other lesions

A

NURS 252 (11 decks)

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