Hair/Skin/Nails Flashcards
What are the three main components of the integumentary system?
1.Hair
2.Skin
3. Nails
What are the two different types of sweat glands?
Eccrine: sweat to reduce body temp. Open directly onto the sin
Apocrine: body odor. Open into follicles
What are the functions of the skin?
-Protection/Barrier
-Transmit sensation
-Temperature regulation
-Identifiction
-communication
-Wound repair
-Absorption/excretion
-vitamin D synthesis
-Immune response
How does vitamin D synthesis of the skin help the body?
Prevents osteoporosis, and rickets
What are the three layers of the skin? From superficial to deep?
1.Epidermis
2. Dermis
3. Subcutaneous
Describe what is in the epidermis
-Avascular
-Squamous cells
-Basal cells
-Melanocytes
Describe what’s in the dermis
-Collagen
-Nerves, sensory receptors, blood vessels, lymph
-Sweat and sebaceous glands
-Connective tissue
Describe what’s in the subcutaneous layer
-adipose tissue
-needed for cushioning and insulation
What are the two layers of the epidermis?
1.Outer layer
*AKA stratum corneum
*Composed of dead keratinized cells
2. Inner cellular layer
*Stratum basale and stratum spinosum
*Both melanin and keratin form from this layer
*relies on underlying dermis for nutrition
What separates the epidermis from cutaneous fat?
The dermis
What are the components of the dermis?
Elastin
*Provides resilience, strength
Collagen
*Strength and flexibility
Reticulin fibers
* supportive mesh
Sensory nerve
Autonomic nerve fibers
What connects the dermis to underlying organs?
Subcutaneous layer
What are the four pigments that skin color is dependent on?
1.Melanin
2. Carotene
3. Oxyhemoglobin
4. Deoxyhemoglobin
What are the aspects of melanin?
-Formed in the epidermis
-Brownish pigment of the skin
-Genetically determined
-Increased with exposure to sunlight
-Responsible for hair color
What are the aspects of carotene?
-Golden yellow pigment
-Exists in the subcutaneous fat
-Also found in heavily keratinized areas (palms and soles)
What is hemoglobin?
Carries the most oxygen of the blood
What are the two forms of hemoglobin?
1.Oxyhemoglobin
2.Deoxyhemoglobin
What are the aspects of oxyhemoglobin?
-bright red pigment
-predominates in the arteries and capillaries
*The increase in blood flow through the arteries to the capillaries causes a reddening of the skin
What are the aspects of Deoxyhemoglobin blood?
-Darker and somewhat bluer pigment
*Result of blood passing through the capillary bed
-Increase conc. Of Deoxyhemoglobin in cutaneous blood vessels gives the skin a bluish cast
What are the CNS causes of central cyanosis?
Intracranial hemorrhage
Drug overdose
Tonic-clonic seizure
What are the respiratory causes of central cyanosis?
Pneumonia
Bronchiolitis
Bronchospasm
Pulmonary hypertension
Pulmonary embolism
Hypoventilatino
Chronic obstructive pulmonary disease
What are the cardiovascular causes of central cyanosis?
Congential heart disease
Heart failure
valvular heart disease
Myocardial infarction
What are the “blood” causes of central cyanosis?
Polycythemia
Congenital cyanosis
What can cause peripheral cyanosis?
-all of the factors that can cause central cyanosis can cause peripheral cyanosis
Reduced CO
Cold exposure
Arterial obstruction
venous obstruction
What are the two types of hair?
1.Vellus
2.Terminal
What are the aspects of vellus hair?
-Short, fine, inconspicuous
-Unpigmented
- found at birth
What are the aspects of terminal hair?
-Course, thick, more conspicuous
-Pigmented
-Referred to as androgenic hair
What is the growth cycle of hair?
1.Anagen (growth)
2.Catagen (atrophy)
3.Telogen (rest)
Describe the nail plate
Firm rectangular, curvy
Describe the nail bed
What the nail plate is attached to and provides blood supply to nail plate
Describe the nail root
The 1/4 part of the nail plate that is covered by the proximal nail fold
Describe the lunula
Whiteish moon
Describe the cuticle (eponychium)
Extends from the proximal nail fold and functions as a seal
*protects the space between. The fold and the plate from external moisture
Describe the lateral nail folds
Covers the sides of the nail plate
What is schamroth’s sign?
If the distance between the proximal nail fold and nail plate is normally less than 180 degrees
*will create a window
What is clubbing?
If there is more than a 180 degrees of the nail plate
What is the hyponychium?
The skin under the free edge of the nail
What is the function of sebaceous glands?
-Produce a fatty substance secreted onto the skin surface
*through the hair follicles
-Keep the skin and hair from drying out
What are the function of eccrine glands?
-Help regulate body temperature by water secretion
*widely distributed
What are the functions of apocrine glands?
-The bacterial decomposition of apocrine sweat is responsible for adult body odor
*mainly in the Axillary and genital regions
What history should you have about the hair/skin/nails
-Previous history of skin disease
-changes in pigmentation
-excessive dryness or moisture
-Pruritis (Itching)
-Rash or lesion
-medications
-Tanning
-Wounds
-Hair loss
-change in nails
What type of changes should document about skin/hair/nails?
-Timing
-associated symptoms
-Location
-Alleviating/Aggravating
-Treatments
-Exposures
What are the three types of skin cancer?
- Basal cell carcinoma
- Squamous cell carcinoma
- Melanoma
What are the characteristics of basal cell carcinoma?
-arise in the basal layer
*immature cells
-Pearly white and translucent
-grow slowly
-rarely metastasize
-Arise in sun-exposed areas
-Rolled borders
What are the characteristics of squamous cell carcinoma?
-Arises from the spinous layer of epidermis
*mature cells
-Can metastasize
-Usually arise in sun-exposed areas
-Rough surface
-flat, reddish patches
What are the characteristics of melanoma?
-Arises from the pigment-producing melanocytes in the epidermis
-Associated with sun-exposure
-Spread rapidly
-most lethal
-Highest mortality white men
What is the HARMM method for risk factors of melanoma?
History of previous melanoma
Age of 50
Regular dermatologist absent
Mole changing
Male gender
What are some risk factors of melanoma
-1 to 4 atypical or unusual moles
-red or light hair
-solar lentigines (sun spots)
-Severe blistering sunburns in childhood
-Immunosupression from HIV or chemotherapy
-FH
What are the screening guidelines for skin cancer?
American Academy of dermatology
* Monthly self examinations
American cancer society
*regular skin exams for high risk people
What are the ABCDE of melanomas?
A: Asymmetry
B: irregular order
C: change in color
D; diameters >6 mm
E: evolution
What are the two categories of sunscreen?
- Physical blockers
- Light absorbing chemical sunscreens
What are physical blockers of suncreen?
-Contains minerals like zinc oxide or titanium dioxide
-thick,paste-like ointments that block all solar rays
What are light absorbing chemical sunscreens?
-Rated by SPF (sun protecting factor)
- SPF is a ratio of the number of minutes for treated versus skin for reddening
What does UV-A cause?
Photoaging
What is Uv-C
The most carcinogenic ray blocked in the atmosphere by ozone
What equipment do you need for the skin exam?
-Centimeter rules
-Wood’s lamp
-Flashlight to transilluminate
-Handheld magnifying lens
-materials for microscopic exam
What falls under inspection for the skin examination?
Color
Uniformity
Thickness
Hygiene
Lesions
What falls under Palpation for the skin exam?
Moisture
Temperature
texture
Turgor
Mobility
What is skin type I?
Always burns easily, never tans
What is skin type II
burns easily, tans slightly
What is skin type III?
Sometimes burns, then tans gradually and moderately
What is skin type IV
Burns initially, always tans well
What is skin type V
Burns rarely, tans deeply
What is skin type VI
Almost never burns, deeply pigmented
Where can jaundice appear on the body?
Lips, hard palate, undersurface of tongue, tympanic membrane, skin, sclera
What is carotenemia?
Yellow/organize level that accompanies high levels of carotene
*look at palms, soles, and face
What does turgor assess?
-Assessment of the state of hydration
*normal: skin quickly retracts back
*dehydration: skin will remain tented longer and slowly return
What are the flat, non palpable skin lesions with a change in color?
Macule
*up to 1cm
Patch
*1cm or larger
*can be irregular
What are the palpable (elevated) skin lesions?
1.Papule
*up to 1cm
*firm
2. Plaque
*1cm or larger
*flat-top surface
3. nodule
*larger than 0.5cm
*deeper and firmer than a papule
*marble-like/knot-like
4. Cyst
*Type of nodule (with fluid)
5. Wheal
*transient
*Somewhat irregular
What are the palpable elevations with fluid-filled cavities?
1.Vesicle (blister)
*superficial
*up to 1cm
*fluid with serous fluid (Clear)
2. Bulla
*1cm or larger
*Filled with serous fluid
3. Pustule
*vesicle/bulla
*filled with purulent material
4. Burrow
*Slightly raised tunnel
*common in finger webs
What are secondary skin lesions?
Scale
Crust
Lichenification
Scars
Keloids
Erosion
Excoriation
Fissure
Ulcer
Atrophy
What is the difference between a primary skin lesion and a secondary skin lesion?
The secondary skin lesion happens as a result of the primary lesion
Describe a scale
A thin flake of dead exfoliated epidermis
Describe a crust
Hard, rough, dried residue of skin exudates such as serum, pus, or blood
Describe lichenification
Visible and palpable thickening of the epidermis and roughening of the skin
Describe a scar
Connective tissue that arises from injury or disease
Describe a keloid
Hypertrophic scarring that extends beyond the borders of initiating injury
Describe erosion
Nonscarring loss of the superficial epidermis; surface is moist but does not bleed
Describe excoriation
Linear or punctuate erosions caused by scratching
Describe fissure
A linear crack in the skin
Describe ulcer
A deeper loss of epidermis and dermis, may bleed and scar
Describe atrophy
Thinning of skin surface and loss of skin markings, translucent and paper like
What is the medial term for nail spooning?
Koilonychia
What is hirsutism?
Excessive hair growth on unexpected areas of the body
What is tines capitus?
A fungal infection of the scalp by a mold-like fungi
What is trichotillomania?
A compulsive desire to pull out ones own hair
What is paronychia?
Infection of the tissue folds around the nails
What is Tinea Unguium
A nail fungus causing thickened, brittle, crumbly or ragged nails
What is onycholysis
A fungal nail infection which can affect the toenails and or fingernails
*sometimes under the nail
