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Comprehensive Health Assessments > Chapter 9: Hair, Skin, Nails > Flashcards

Chapter 9: Hair, Skin, Nails Flashcards

1
Q

Bulla

A

fluid-filled sac or lesion that appears when fluid is trapped under a thin layer of the skin
- blister
- vesicle like > 1 cm in diameter

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2
Q

Clubbing

A

condition affective the fingers and toes in which proliferation of distal tissues, especially the nail beds, results in thickening and widening of the extremities of the digits; the nails are abnormally curved and shiny
- when angle of the nail beds is >180 degrees

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3
Q

Confluent

A

skin lesions that become merged, forming a patch;
- lesions that are not discrete, or distinct one from the other

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4
Q

Cyanosis

A

bluish discolorations of the skin, mucous membranes, tongue, lips, or nail beds
- due to an increased concentration of reduced hemoglobin in the circulation

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5
Q

Ecchymosis

A

subcutaneous extravasation of blood within the tissues, which results in discoloration of the skin from the blood in the tissues
- aka bruising

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6
Q

Erythema

A

a common but nonspecific sign of skin irritation, injury, or inflammation caused by dilation of superficial blood vessels in the skin
- a reddening of the tissue

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7
Q

Jaundice

A

condition that causes the skin and whites of the eyes to turn yellow

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8
Q

Keloid

A

excess growth of scar tissue where the skin has healed

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9
Q

Leukonychia

A

abnormal nail matrix keratinization causing nail plate parakeratosis; also known as white nails

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10
Q

Linear

A

abnormal lesions that form in a line

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11
Q

Macule

A

small, flat, nonpalpable skin color change, less than 1 cm with a circumscribed border
- like a freckle or port-wine stain

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12
Q

Nevi

A

congenital, raised, pigmented growth, e.g, a mole
- uniform color
- typically less then 5 mm in diameter
- 10-40 usually above waist or on sun-exposed areas
- clearly defined border

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13
Q

Nodule

A

a primary skin lesion that is solid, elevated, hard/soft
- greater than 1 cm in diameter

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14
Q

Pallor

A

loss of the pinkish tones of the skin due to the lack of blood flow to the surface of the skin

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15
Q

Papule

A

palpable skin lesions less than 1 cm in diameter

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16
Q

Patch

A

greater then 1 cm, may have irregular border

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17
Q

Petechiae

A

tiny, purple spots on the skin
- blood vessels that have popped

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18
Q

Plaque

A

papules that join to form surface elevation wider than 1 cm

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19
Q

Pustule

A

vesicle-like filled with purulent fluid
- aka a pimple

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20
Q

Rash

A

area of irritated or swollen skin; often itchy, red, painful, irritated

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21
Q

Scar

A

area of fibrous tissue that replaces normal skin after an injury

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22
Q

Striae

A

asymmetric, raised, red linear streaks (striae rubrae) that tend to flatten and lighten over time
- commonly called stretch marks

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23
Q

Turgor

A

skin elasticity; the ability of skin to change shape and return to normal

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24
Q

Vesicle

A

small, fluid-filled sacs that can appear on your skin; fluid may be clear, white, yellow, or mixed with blood
-<1 cm in diameter
- blisters

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25
Q

Zosteriform

A

distribution of cutaneous lesions that follow a nerve; a unilateral girdle-like distribution
- can be caused by shingles or herpes

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26
Q

What is vitiligo ?

A

development of unpigmented patch(s)
- hypopigmentation
- most common in dark skinned individuals
- thought to be auto-immune disorder (melanocytes are destroyed)
- not born with but you develop it over time

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27
Q

What is Albinism ?

A

genetic absence of melanocytes
- hypopigmentation

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28
Q

What is Melasma ?

A

darkening of the color across the nose and the cheeks, and the upper lip
- hyperpigmentation
- more common in women
- usually on face
- associated with hormonal changes
- worsened with exposure to sunlight
- aka chloasma “mask of pregnancy”; tends to fade a few months after delivery
- harmless

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29
Q

What is Hemosiderin Staining ?

A

staining of the legs caused by chronic venous insufficiency
- hyperpigmentation
- blood pools under the skin
- poor venous return from legs with back-up of fluid and red blood cells from capillaries into interstitial tissues
- Risk factors: advanced age, obesity, previous blood clots, injuries, or surgery to legs

30
Q

What is Urticaria/Hives/Wheals ?

A

a skin rash caused by allergy to food, medication, or environmental irritant
- usually acute
- itchy and raised skin
- can be treated with antihistamines (benadryl)
- can be hard to see in darker skin

31
Q

What do we use to compare normal moles to possible melanomas ?

A

A: asymmetry (not round or oval)
B: border (poorly defined or irregular)
C: color (uneven, variegated)
D: diameter (greater than 6 mm)
E: evolving (changing, getting bigger, darker, etc)
F: feeling (itching, burning, tingling, etc)

32
Q

What is important about melanomas on darker skin ?

A
  • less common on darker skin (increased melanocytes help protect against sun)
  • melanoma often diagnosed later in darker skin
  • black people are more likely to die from melanoma than white people
33
Q

What is Basal Cell Carcinoma (BCC) ?

A
  • most common skin cancer
  • affects light-skinned individuals between 40-80
  • locally invasive, can grow quite large but rarely metastasizes (does not spread)
  • most common in males then females
  • grows slowly
  • nodular pigmented lesions with depressed center and rolled borders and/or central ulceration in areas of sun or UV light exposure
34
Q

What is Squamous Cell Carcinoma (SCC) ?

A
  • 2nd most common skin cancer
  • invasive cancer of head, neck from sun or UV light exposure
  • most common if >50 with blue eyes, and childhood freckling
  • men more affected
  • can be more aggressive than BCC
  • lesion is soft, mobile and slightly elevated with surrounding redness
35
Q

What is Congenital Dermal Melanocytosis ?

A

irregular/oval patch on sacrum and buttocks, bluish/greenish or bruised looking
- common in asians and african darker skinned children
- usually disappears by age 1-2 yrs
- link with inherited disorders of metabolism

36
Q

What is Cafe Au-Lait Spots ?

A

large round/oval patch
- flat, pigmented birthmark
- light brown in color (coffee with milk)
- occasionally associated with neurofibromatosis (tumor growth in nervous system)
- usually present at birth but can develop in first few years of life

37
Q

What is Nevus Simplex ?

A

small, red or pink spot seen on back of neck (nape), forehead, eyelids
-aka “stork bite”
- can be caused by telangiectasis (permanent dilation of small blood vessels)
- can also be caused by flat capillary hemangioma (abnormal growth of blood vessels)
- usually disappears by 5 yrs
- vascular

38
Q

What are some abnormal birthmarks ?

A
  • Nevus Flammeus
  • Infantile (Strawberry) Hemangioma
  • Cavernous Hemangioma
39
Q

What is Nevus Flammeus ?

A

large macule usually on the face along the 5th cranial nerve
- aka port-wine stain
- does not disappear (often start pinkish and become red/purple)
- bluish/purple capillary areas
- caused by a mutation of a specific gene
- treatment: laser (not always effective)

40
Q

What is Strawberry (Infantile) Hemangioma ?

A

a slightly raised skin growth
- red (in pale babies) with sharp demarcation line
- may be 2-3 cm diameter as they grow
- usually disappear by age 5
- may require laser treatment

41
Q

What is Cavernous Hemangioma ?

A

mass that forms from collection of malformed reddish or bluish blood vessels
- may continue to grow until 10-15 months of age
- should be assessed frequently but often shrink and go away
- could affect eyesight or breathing
- treatment: surgery, depends on location, symptoms, Hx (history) of bleeding from lesion

42
Q

What is Diaphoresis ?

A

excess moisture; abnormal in absence of strenuous activity
- causes are hyperthermia, extreme anxiety, shock, hyperthyroidism

43
Q

What is Alopecia Areata ?

A

chronic inflammatory disease of hair follicles
- multiple round patches of hair loss
- unknown cause: believe autoimmune disorder, metabolic disease and stressful events
- poorly developed shaft breaks and grows back in 3-4 months (some may suffer total scalp hair loss)

44
Q

What are melanomas ?

A
  • most serious form of skin cancer
  • responsible for majority of skin cancer related deaths
  • typically arise from nevi
  • ABCDEF assessment
  • lesion may have flaking, scaling, be brown, tan, brown, pink or purple with mixed pigmentation
45
Q

What is Onychomycosis ?

A

fungal infection of nail plate caused by tinea unguium
- occurs in up to 18% of population in given areas
- nail plate turns yellow or white as debris accumulates
- nail eventually separates from nail bed and nail plate splits and crumbles

46
Q

What is Paronychia ?

A

acute or chronic infection of cuticle
- usually caused by staph or strep but candida may also be causative organism
- rapid onset of very painful inflammation at base of nail abscess may form
- frequent exposure to moisture is risk factor
- inflammation develops slowly usually starting at nail base and works along side of nails

47
Q

What are Ecchymosis ?

A

bruises; discoloration of skin caused by blood seeping into tissue as result of trauma
- 1-2 days: purple to deep black
- 3-6 days: green to brown
- 6-15 days: tan to yellow (fading)
- look for patterns such as loop pattern (cord hitting)

48
Q

What are signs of abuse in older adult skin ?

A
  • bruising
  • lacerations
  • fractures inconsistent with functional ability
  • pressure ulcers
  • dehydration
  • poor hygiene
49
Q

What does a stage 1 ulcer look like ?

A

intact non-blanchable (doesn’t change color with pressure) redness
-no slough

50
Q

What does a stage 2 ulcer look like ?

A

partial-thickness shallow open ulcer with pink wound bed
- no slough (layer on skin that covers wound and must be removed for healing to begin) or bruising
- may also appear as bulla (blister)

51
Q

What does a stage 3 ulcer look like ?

A

full-thickness skin loss
- subcutaneous fat may be visible
- no bone, tendon or muscles exposed
- slough may be present
- wound may have undermining and tunneling
- depth depends on location r/t varied anatomic skin depths

52
Q

What does a stage 4 ulcer look like ?

A

full thickness
- bone, tendon or muscle are exposed
- slough or eschar (dead tissue) may be present in wound bed
- undermining and tunneling often present
- depth depends on location

53
Q

What are examples of hypopigmentation ?

A
  • vitiligo
  • albinism
54
Q

What are examples of hyperpigmentation ?

A
  • melasma
  • hemosiderin staining
55
Q

What is the significance of hot/warm skin ?

A
  • hyperthyroidism
  • localization= inflammation, infection, traumatic injury, or thermal injury
56
Q

What is the significance of cold/cool skin ?

A
  • localization= poor peripheral perfusion
  • shock or hypothermia
57
Q

What can cause excessive skin thickness ?

A

diabetes
- can cause abnormal collagen resulting from hyperglycemia

58
Q

What can cause decreased skin thickness ?

A
  • hyperthyroidism
  • arterial insufficiency and aging
59
Q

What can cause dull, coarse and brittle hair ?

A
  • nutritional deficiencies
  • hypothyroidism
  • exposure to chemicals
60
Q

What can cause alopecia ?

A
  • autoimmune disorders
  • anemic conditions
  • nutritional deficiencies
  • radiation or antineoplastic treatments
61
Q

What is Hirsutism ?

A

hair growth in women with an increase in hair on face, body, and pubic area
- caused by an increase in male hormones

62
Q

What is a deep tissue injury ?

A

type or pressure ulcer that damages the underlying tissue, skin, fat and muscle tissue
- restrict blood flow causes non-blanching

63
Q

How would cyanosis look like in a pale and dark skinned individual ?

A

Pale: grayish-blue tone
- seen in nail beds, earlobes, lips, mucous membranes, and feet
Dark: ashen-grey tone
- best seen in conjunctiva of eyes, oral mucous membranes

64
Q

Where are the best places to see jaundice in dark-skinned individuals ?

A
  • sclera, palms of hands and soles of feet
65
Q

How does pallor look like in dark-skinned individuals ?

A
  • appears lighter then normal
  • light-skinned AA: yellowish-brown skin
  • dark-skinned AA: appear ashen
66
Q

How does petechiae appear in dark-skinned individuals ?

A
  • hard to see
  • best seen in buccal mucous of mouth, or sclera of eye
  • may look like blackish spots instead of reddish or purple
67
Q

How do rashes appear on dark-skinned individuals ?

A
  • not easily seen but can be felt with light palpation
68
Q

What is Milia ?

A

small papules on checks, nose, chin and forehead
- usually disappears by 3rd week of life
- common primary lesion in newborn/infants

69
Q

What is Erythemia Toxicum ?

A

common rash in newborns/infants
- erythematous macules, papules and pustules
- lasts a few days, gone within 2 weeks and will go away on its own

70
Q

What is lanugo ?

A

silky body hair found on premature babies
- commonly on scalp, ears, shoulders, and back

71
Q

What is the most serious form of skin cancer ?

A

melanoma

72
Q

What is Congenital Dermal Melanocytosis ?

A

irregular/oval patch on sacrum and buttocks
- caused by increased melanocytes
- bluish/greenish, or bruised looking
- aka mongolian spot
- usually disappear by age 1-2
- common in asian and AA dark skinned kids
- linked with inherited disorders of metabolism

Comprehensive Health Assessments (13 decks)

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