Exam 2 (for health assessment) Flashcards
what is the epidermis
-the top most layer of the skin
-Basal cell layer (Bottom)
- Horny cell layer (Shed)
- Derivation of skin color: melanin in basal cell layer
what is the dermis of the skin what does it have
the second layer
– Connective tissue: collagen
- Elastic tissue
- Nerves, receptors, blood vessels, lymphatics; hair, sweat, sebaceous glands
what is the subcutaneous layer
the most bottom layer
it has adipose tissue
what iare the functions of the skin
- Protection: physical, chemical, thermal and light
- Prevents penetration & loss of fluids
- Perception: touch, pain, temperature, pressure
- Fluid balance–> keeps anything from penetrating
5 Temperature regulation via sweat & adipose layer - Identification
- Communication
- Wound repair
- Absorption and excretion (toxins)
- Production of Vitamin D
what is verniz caesosa
thick, cheesy substance make of sebum and shed epithelial cells)
-this is present at birth
what is terminal hair
-on the scalp; soft and patchy loss
what happens with the hair after the first few months of birth
replaced by fine veluus hair
what happens with hair at midgestation
most skin covered with lanugo (fine downy hair of newborn
when do fair follicles develop
develop in fetus at 3 mos’ gestation
how does you skin change when you get pregnant
-Increased pigment: areolae, nipples, vulva, midline of abdomen (Linea nigra), face (Chloasma)
-Hyperestrogenemia- vasuclar spiders & palmar erythema (this means too much estrogen on the blood flow)
-Connective tissue develops increased fragility
what is stria gravidarum
stretch marks
what happens to you metabolism when you are pregnant
peripheral vasculature dilates & seat and sebaceous glands increase secretion.
Fat deposits laid down as maternal reserves for nursing baby
what happens to skin in the aging adult
-everything atrophies!
Loses elasticity and Lost of collagen (increase risk of shearing, tearing injuries), and SQ fat occurs & reduction of muscle tone
-wrinkling
-Decreased number and function of sweat and sebaceous glands (greater risk for heat stroke)
- dry skin xerosis
-Decreased thermoregulation
-Skin vascularity diminishes while vascular fragility increases
-Life style factors increase risk for skin disease & breakdown too
what happens to the nails and hair as you age
Hair- graying, feels thin and fine. Hair distribution changes-decreases and loss; and the female may have some bristly facial hairs
-Nails grow more slowly, surface is lusterless. characterized by longitudinal ridges
what would be the subjective data of the skin
-history of skin disease (allergies, hives, psoriasis, eczema)
-Change in pigmentation hypo/hyperpigmentation
-Change in mole (size or color)
-Excessive dryness or moisture
-Pruritus (inching)
-Excessive bruising
-Rash or lesion (N,O,P)
- Medications
Hair loss alopecia
-Change in nails
-Environmental or occupational hazards
-Health Promotion and Disease Prevention
-Ask about tattoos, body piecing & scars
if an adolescent ask about any acne or blackheads
what subjective skin data do you collect from infants and children
-birthmarks?
-Jaundice? Cyanosis? Pallor? Erythema?
-rash (diaper) or sores?
-burns or bruises and how did they happen?
-has the child been exposed to scabies, impetigo, lice?
-have they been exposed to measles, chicken pox, scarlet fever?
-does the child bite their nails or twirl their hair
-does the child use sunscreen
what subjective data do you collect about the skin in aging adults
-What changes have you noticed in your skin in last few years?
-Any delay in wound healing?
-Skin pain or pruritis?
-Any change in feet: toenails; bunions, wearing shoes?
-Any falls?: bruises, trauma?
-History of diabetes or peripheral vascular disease?
-What do you do to care for your skin?
what preparation do you have to do when you are going to conduct a skin exam
-External variables that influence skin color: Emotions, Environment, Physical (position)
what equipment is needed when you are going to conduct a skin exam
-Strong direct lighting
-Small centimeter ruler
-Penlight
-Gloves!
-For special procedures:
-Wood’s light, Magnifying glass
-Materials for laboratory tests: KOH, glass slide
descrbie inspection and palpation when it comes to conducting a skin exam
-color (general pigmentation and tone)
-is pallor, erythema, cyanosis, jaundice, ashen present
-make note of any moles, freckles and birthmarks
-dark skinned people have areas of lighter pigmentation on the palms, nail beds, and lips
-Healthy dark brown 4 (fair white 2) tone with even pigmentation and consistent with genetic background. No concerning moles or lesions
-are there any needle marks, tattoos, scars etc
what is type 1 on the Fitzpatrick skin type scale
light
-pale white skin
-always burns and never tans
what is type 2 on the Fitzpatrick skin type scale
white and fair
-usually burns and it tans with difficulty
what is type 3 on the Fitzpatrick skin type scale
-medium, white to olive
-burns mildly and tans gradually
what is type 4 on the Fitzpatrick skin type scale
-olive, moderate brown
-rarely burns and tans with ease
what is the type 5 on the Fitzpatrick skin type scale
-brown and dark brown
-very rarely burns and it tans very easily
what is type 6 on the Fitzpatrick skin type scale
-black, very dark brown to black
-never burns and it tans very easily
what do calluses do
they increase pressure
what is edema
swelling caused by too much fluid in the body tissues
-you can see how severe it is based on how deep the indentation is
-this is apart of palpating the skin and inspecting it
what does mobility and turgor
-reflects elasticity
–this is apart of palpating the skin and inspecting it
what is ecchymosis
bruising
how do you assess lesions
-Color
-Elevation
-Pattern or shape
-Size in cm
-Location and distribution on body
-Exudate? describe (color, consistency, amount, odor)
-Palpate lesions
-Wear gloves
-Note surrounding skin-temp, scales come off, bleed?
-Blanching?
-if there is fluorescence that means that there is fungal or yeast infection
–this is apart of palpating the skin and inspecting it
how do you inspect or palpate hair
give an example of how you would chart your findings
-Color
-Texture
-Distribution (Head and body)
-Lesions
e.g Hair is brown, fine, straight, and shiny with even distribution in relation to age, sex and race. Scalp and hair clean, free or lesions or pest
how do you inspect and palpate nails
give an example of how you would chart your findings
-Shape and Contour
-Profile Sign-clubbing?
-Consistency
-Color (linear pigmentation, leukonychia striata, melanoma)
-Capillary Refill Time (CRT)
e.g Nails are clean and slightly curved. Nail folds and edges are smooth and rounded. Surface is smooth and regular without splitting or markings. Nail bed is even, pale pink, base firm, with convex angle < 160. No clubbing, capillary refill less than 3 seconds
what is clubbing
the angle of the nail and bed and the nail bed itself
what is a cafe au lati spot
light brown spot
-present in infants
what is Cutis marmorata
-rare deep purple net like birth mark on babies
this is temporarty cyanotic conditon
Acrocyanosis
-hand and feet of the infant being blue
what is Erythema toxicum
-found in infants
-they look like little pimples but dont pop them
what is Carotenemia
yellow pigmentation of the skin
what is milia
-benign and transient subepidermal keratin cysts that present as small firm white papules in various numbers most commonly distributed on the face,
what are comedones
-balck heads or white heads
what is the Linea nigra
the black line you get from your belly button to the pubic bone
what is Chloasma
dark skin patches on the face and sunexposed areas that you get during pregnancy
what are vascualr spiders
-looks like a spider web
-dilation of end vasculature under the skin
what are Variscosities
-these are varicose veins
-veins become enlarged, dilated, and overfilled with blood
what would see during a skin exam of and aging adult
-senile lentigines (live spots)
-benign proliferation of immature keratinocytes
- waxy or scaly and slightly raised
what is Xerosis and what does it cause
dry skin
-common as you age
-sweat and sebaceous glands, puritus and the skin is flaky and loose
-common when you age
what are Acrochordons
-skin tags
what is sebaceous hyperplasia
acne for old people
