Chapter 23: Med Surg Flashcards

1
Q

epidermis

A

thin, superficial layer of skin; 0.05-0.1 mm thickness and nourished by blood vessels in dermis; regenerates every 28 days

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2
Q

melanocytes

A

contained in deep basal layer (germinativum) of the epidermis; contain melanin (gives skin and hair color) and protects from UV

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3
Q

keratinocytes

A

synthesized from epidermal cells in basal layer, they move to surface of epidermis to die and form corneum (horny cell layer); protective barrier

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4
Q

dermis

A

1-4 mm thickness, 2 layers: papillae forms fingerprints and footprints and reticular layer forms collagen

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5
Q

collagen

A

forms the greatest part of the dermis and responsible for strength; composed of fibroblasts which are important for wound healing

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6
Q

subcutaneous tissue

A

not part of skin, provides insulation, provides shock absorption

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7
Q

sebaceous glands

A

prevent skin and hair from drying; abundant on face, scalp, upper chest, and back, not palms and soles

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8
Q

apocrine sweat glands

A

located in the axillae, breast, tummy, external auditory canals, and eyelids; thick milky substance and become odorous at puberty

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9
Q

eccrine sweat glands

A

widely distributed except on lips; cools the body from evaporation and excretes waste products through the pores of the skin

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10
Q

insensible perspiration

A

600-900 mL/day lost and helps maintain homeostasis through fluid and electrolyte balance

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11
Q

gerontologic differences with skin

A

decreased extracellular water and sebaceous glands, increased capillary fragility which causes bruising, increased melanocytes in basal layer which cause solar lentigines, decreased estrogen causing baldness, increased keratin causing longitudinal ridging of nails

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12
Q

actinic keratoses

A

areas of chronic sun exposure, increased risk for BCC & SCC

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13
Q

normal nails

A

160 degrees

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14
Q

intertriginous

A

skin surfaces overlap and rub on each other

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15
Q

primary skin lesions

A

occur on previously unaltered skin

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16
Q

secondary skin lesions

A

change with time or occur because of factors such as scratching or infection

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17
Q

macule

A

circumscribed, flat discoloration < 0.5 cm: freckles, petechiae

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18
Q

papule

A

elevated solid lesion up to 0.5 cm: wart, BCC

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19
Q

vesicle

A

defined collection of (serous or free fluid up to 0.5 cm: chicken pox, 2nd degree burn

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20
Q

plaque

A

circumscribed, elevated solid lesion formed by confluence of papules: psoriasis and keratoses

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21
Q

wheal

A

firm plaque caused by fluid in dermis: insect bite

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22
Q

pustule

A

circumscribed collection of leukocytes and free (purulent) fluid: acne, impetigo

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23
Q

fissure

A

linear loss of epidermis to dermis: athlete’s foot or cracks at corner of mouth

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24
Q

scale

A

excess dead epidermal cells: flaking of skin

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25
Q

scar

A

abnormal formation of connective tissue that replaces normal skin

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26
Q

ulcer

A

irregular, crater-like loss of the epidermis and dermis: pressure ulcer and chancre

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27
Q

atrophy

A

depression in skin resulting from thinning of the epidermis or dermis: aged skin, striae

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28
Q

excoriation

A

epidermis is missing and exposed dermis: abrasion or scratch

29
Q

angioma

A

benign tumor of blood or lymph vessels: increased with age, liver disease, pregnancy

30
Q

ecchymosis for dark skin

A

purple to brownish black

31
Q

erythema for dark skin

A

deeper brown to purple with increased skin temperature

32
Q

pallor for dark skin

A

underlying red tone in brown or black is absent, light African americans have yellowish brown skin, dark skinned may have ashen gray

33
Q

petechiae

A

small, reddish pinpoints best observed on tummy and butt < 1-2 mm in extravascular tissue

34
Q

petechiae for dark skin

A

difficult to see, may be evident in the buccal mucosa of mouth or conjunctiva of eye

35
Q

rash for dark skin

A

feel!! aka palpate

36
Q

purpura

A

bleeding disorder caused by ecchymosis or petechiae

37
Q

if a lesion blances and then refills, redness is r/t

A

dilated blood vessels

38
Q

if the lesion does not blanch and remains discolors it’s r/t

A

subq or intradermal bleeding or nonvascular lesion

39
Q

asymmetric lesion

A

unilateral distribution

40
Q

confluent lesion

A

merges together

41
Q

diffuse lesion

A

wide distribution

42
Q

discrete lesion

A

separate from other lesions

43
Q

symmetric lesion

A

bilateral distribution

44
Q

zosteriform lesion

A

bandlike distribution along a dermatome area

45
Q

increased localized temperature

A

seen with burns and local inflammation

46
Q

increased generalized temperature

A

fever

47
Q

carotenemia

A

yellow discoloration of skin, not eyes, most visible on palms and soles: veggies containing carotene can cause this (carrots, squash)

48
Q

comedo

A

acne

49
Q

cyst

A

sac containing fluid or semisolid material: caused by obstruction of duct or parasitic infection

50
Q

hematoma

A

extravasation of blood: trauma and bleeding disorders

51
Q

hirtuism

A

excess hair: abnormality of adrenal glands, decrease in estrogen

52
Q

lichenification

A

thickening of skin: caused by excessive scratching rubbing or irritation

53
Q

mole

A

nevus aka overgrowth of melanocytes

54
Q

telangiectasia

A

visibly dilated, superficial, cutaneous small blood vessels, found on face and thighs: aging acne, alcoholism, liver failure, radiation, sun exposure

55
Q

vitiligo

A

complete absence of melanin: autoimmune, thyroid disease

56
Q

punch biopsy

A

use a punch instrument to obtain dermis and some fat for full thickness diagnostic purposes; place in Michel’s fixative not formalin

57
Q

excisional biopsy

A

entire lesion removed with good cosmetic results, closed with sutures

58
Q

incisional biopsy

A

wedge-shaped incision made, used when excisional or punch is not an option due to large specimen needed

59
Q

shave biopsy

A

single-edged razor blade used to shave off superficial lesion, thin specimen

60
Q

potassium hydroxide (KOH)

A

hair, scales, or nails examined for superficial fungal infection

61
Q

Tzanck test (Wright’s and Giemsa’s stain)

A

fluid and cells from vesicles examined; used for herpes; sterile

62
Q

fungi culture

A

scraping or swab of skin performed

63
Q

bacteria culture

A

material obtained from intact pustules, bullae, or abcesses

64
Q

virus culture

A

vesicle/bulla and exudate taken from base of lesion

65
Q

mineral oil slides

A

checks for infestations, scrapings are placed on slide with mineral

66
Q

immunofluorescent studies

A

skin tissue and serum examined due to some diseases having specific, abnormal antibody proteins

67
Q

wood’s lamp (black light)

A

identifies pseudomonas organisms, fungal infections, and vitiligo

68
Q

patch test

A

determines what patient is allergic to by applying potential allergen on back; instruct patient to return in 48-72 hrs to remove allergens and evaluation @ 96 hr