Chapters 12: Skin, Hair, Nails Flashcards
Epidermis
Outer highly differentiated layer composed of basal cell layer that forms new skin cells and outer horny cell layer of dead keratinized cells
Dermis
Inner supportive layer made up of connective tissue or collagen and elastic tissue
Function of the skin
Protection, Prevents penetration, Perception, Temperature regulations, Identification, Communication, Wound repair, Absorption and excretion, Production of Vitamin D
What can you tell from just looking at skin?
Hydration, Bruises, Scar, Liver issues, Age, Wight gain/loss, Sweating, Oxygenation
What can you tell from just looking at hair?
Grooming and hygiene, Nutritional status, Age based on graying, Genetics (i.e balding or early graying)
What can you tell from nails?
Cap refill, Clubbing from chronic hypoxia
Sebaceous glands
Produce a protective lipid substance called sebum (everywhere except palms and soles)
Sweat glands (2 TYPES)
Eccrine: coiled tubules that open directly onto the skin surface, produce a dilute saline saline called sweat
Apocrine: Produce a thick, milky secretions and open into the hair follicles (active during puberty)
Lanugo
Fine hairs on a newborn infant
Vernix caseosa
Thick cheesy substance made of sebum and shed epithelial cells
Mongolian spots
Darker discolored spots on an infant (hyperpigmentation on darker skinned babies)
Erythema Toxicum
Rash on infants (almost looks like chicken pox)
Milia
A cyst, a small, white bump that typically appears on the nose and cheeks
Stork bites
A common type of birth mark seen in a new born
Acrocyanosis
Bluish or purple coloring of the hands and feet caused by slow circulation
Physiologic Jaundice
Happens in a newborn 3-4 days after they are born and can disappera
Pathological Jaundice
Happens when baby is born
Ineffective thermoregulation in babies
Babies can’t shiver, make sure babies are swaddles
Carotenemia
yellow pigmentation of the skin (xanthoderma) and increased beta-carotene levels in the blood
Striae Gravidarum
Stretch marks
Chloasma
Changes pigmentation in face
Linea Nigra
Dark line down the abdomen
Palmar erythema
Redness in palms of hands
Vascular spider
Tiny veins
What to keep in mind with changes in adolescents
Sebaceous gland secretions increase, secondary sex characteristics, subcutaneous fat deposits increase
Senile purpura
Mild trauma leading to dark red discoloration spots
Keloids
Scars tat form at the site of a wound and grow beyond normal boundaries of wound
Pigmentary disorders
Dark or light spots
Pseudofolliculitis
razor bumps or ingrown hairs caused by shaving too closely with an electric or straight razor
Melasma
patchy tan to dark brown discoloration of the face “the mask of pregnancy”
Diaphoresis vs Dehydration
Diaphoresis = excess water Dehydration = not enough water
Reasons for edema
Due to cardiac problem, kidney disorder/disfunction, localized injury
What causes Jaundice
Increased serum bilirubin
Polycythemia
Increased red blood cells, capillary stasis
Carotemia
Inc. serum carotene from ingestion of large amounts of carotene rich foods
Café au lait spots
Caused by increased melanin pigment in basal cell layer
Pitting edema scale
1+ = 2mm depth 2+ = 4 mm depth 3+ = 6 mm depth 4+ = 8mm depth
Pressure ulcer stages
Stage 1: intact skin with non blanchable redness of a localized area
Stage 2: Partial thickness loss of dermia presenting as a shallow open ulcer with a res pink wound bed, without slough
Stage 3: Full thickness tissue loss, Subcutaneous fat may be visible but bone, tendon or muscles are not exposed. Maybe slough
Stage 4: Full thickeness tissue loss with exposed tendon or muscle. Slough or eschar may be present
Braden scale rating
9 or less = very high risk of pressure ulcer 10 - 12 = high risk 13 - 14 = Moderate risk 15 - 18 = Mild risk 19 - 23 = Generally not at risk
ABCDE Skin Assessment
Asymmetry, Border, Color, Diameter, Elevation/evolution
Annular or circular
circular spots, beginning in center and spreads to periphery (ringworm)
Confluent
abnormal shaped lesions that are spread out and touching (hives)
Discrete
small dots distinct and individual ( skin tags, acne, acrochordon)
Grouped
a cluster of lesions (contact dermatitis)
Gyrate
large, twisted and snake looking
Target or iris
Almost ringworm looking, raised on outer ring (Lyme Disease)
Linear
a scratch or streak
Zosteriform
bumps in a linear arrangement along a unilateral nerve route (herpes zoster- Shingles)
Polycyclic
annular lesions grow together (psoriasis)
Macules
Dark spots almost like freckles, flat
Papules
Raised discolored spots (mole)
Patches
macules that are larger than 1 cm (mongolian spots)
Plaques
papules coalesce to form surface elevation wider than 1 cm (psoriasis)
Nodules
Extremely elevated bumps that are discolored
Wheals
Spread out inflammation of the skin thats slightly elevated, not specifically round, usually misshapen (mosquito bite, allergic reaction)
Tumors
Larger than a few cm in diameter, firm or soft, deeper into dermis (lipoma, hemangioma)
Urticaria
Hives
Vessicles
Little bumps filled with clear fluid (chicken pox)
Cysts
Filled with cloudy white liquid
Bullas
Large bumps filled with fluid (a larger vesicle)
Pustules
filled with pus (pimples)
Crusts
Scab like
Scales
Dry patch of skin, feels like sandpaper
Fissures
Tear in the skin (Cheilosis - at corners of mouth caused by excess moisture; athletes foot)
Erosions
gradual breakdown of the epidermis, moist but no bleeding, heals without scar
Ulcers
Deep breakdown of the skin into dermis and below (pressure sore, chancre)
Excoriations
Self-inflicted abrasions like a bug bite, dermatitis, scabies, varicella
Scars
What is left after lesion is repaired, connective tissue, permanent fibrotic change
Lichenification
Prolonged intense scratching eventually thickens skin and produces tightly packed sets of papules
Purpuric lesions
Petechiae and Purpura
