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Physical Assessment > Hair/Skin/Nails > Flashcards

Hair/Skin/Nails Flashcards

1
Q

What are the three main components of the integumentary system?

A

1.Hair
2.Skin
3. Nails

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2
Q

What are the two different types of sweat glands?

A

Eccrine: sweat to reduce body temp. Open directly onto the sin
Apocrine: body odor. Open into follicles

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3
Q

What are the functions of the skin?

A

-Protection/Barrier
-Transmit sensation
-Temperature regulation
-Identifiction
-communication
-Wound repair
-Absorption/excretion
-vitamin D synthesis
-Immune response

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4
Q

How does vitamin D synthesis of the skin help the body?

A

Prevents osteoporosis, and rickets

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5
Q

What are the three layers of the skin? From superficial to deep?

A

1.Epidermis
2. Dermis
3. Subcutaneous

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6
Q

Describe what is in the epidermis

A

-Avascular
-Squamous cells
-Basal cells
-Melanocytes

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7
Q

Describe what’s in the dermis

A

-Collagen
-Nerves, sensory receptors, blood vessels, lymph
-Sweat and sebaceous glands
-Connective tissue

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8
Q

Describe what’s in the subcutaneous layer

A

-adipose tissue
-needed for cushioning and insulation

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9
Q

What are the two layers of the epidermis?

A

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

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10
Q

What separates the epidermis from cutaneous fat?

A

The dermis

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11
Q

What are the components of the dermis?

A

Elastin
*Provides resilience, strength
Collagen
*Strength and flexibility
Reticulin fibers
* supportive mesh
Sensory nerve
Autonomic nerve fibers

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12
Q

What connects the dermis to underlying organs?

A

Subcutaneous layer

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13
Q

What are the four pigments that skin color is dependent on?

A

1.Melanin
2. Carotene
3. Oxyhemoglobin
4. Deoxyhemoglobin

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14
Q

What are the aspects of melanin?

A

-Formed in the epidermis
-Brownish pigment of the skin
-Genetically determined
-Increased with exposure to sunlight
-Responsible for hair color

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15
Q

What are the aspects of carotene?

A

-Golden yellow pigment
-Exists in the subcutaneous fat
-Also found in heavily keratinized areas (palms and soles)

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16
Q

What is hemoglobin?

A

Carries the most oxygen of the blood

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17
Q

What are the two forms of hemoglobin?

A

1.Oxyhemoglobin
2.Deoxyhemoglobin

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18
Q

What are the aspects of oxyhemoglobin?

A

-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

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19
Q

What are the aspects of Deoxyhemoglobin blood?

A

-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

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20
Q

What are the CNS causes of central cyanosis?

A

Intracranial hemorrhage
Drug overdose
Tonic-clonic seizure

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21
Q

What are the respiratory causes of central cyanosis?

A

Pneumonia
Bronchiolitis
Bronchospasm
Pulmonary hypertension
Pulmonary embolism
Hypoventilatino
Chronic obstructive pulmonary disease

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22
Q

What are the cardiovascular causes of central cyanosis?

A

Congential heart disease
Heart failure
valvular heart disease
Myocardial infarction

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23
Q

What are the “blood” causes of central cyanosis?

A

Polycythemia
Congenital cyanosis

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24
Q

What can cause peripheral cyanosis?

A

-all of the factors that can cause central cyanosis can cause peripheral cyanosis

Reduced CO
Cold exposure
Arterial obstruction
venous obstruction

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25
Q

What are the two types of hair?

A

1.Vellus
2.Terminal

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26
Q

What are the aspects of vellus hair?

A

-Short, fine, inconspicuous
-Unpigmented
- found at birth

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27
Q

What are the aspects of terminal hair?

A

-Course, thick, more conspicuous
-Pigmented
-Referred to as androgenic hair

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28
Q

What is the growth cycle of hair?

A

1.Anagen (growth)
2.Catagen (atrophy)
3.Telogen (rest)

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29
Q

Describe the nail plate

A

Firm rectangular, curvy

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30
Q

Describe the nail bed

A

What the nail plate is attached to and provides blood supply to nail plate

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31
Q

Describe the nail root

A

The 1/4 part of the nail plate that is covered by the proximal nail fold

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32
Q

Describe the lunula

A

Whiteish moon

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33
Q

Describe the cuticle (eponychium)

A

Extends from the proximal nail fold and functions as a seal
*protects the space between. The fold and the plate from external moisture

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34
Q

Describe the lateral nail folds

A

Covers the sides of the nail plate

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35
Q

What is schamroth’s sign?

A

If the distance between the proximal nail fold and nail plate is normally less than 180 degrees
*will create a window

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36
Q

What is clubbing?

A

If there is more than a 180 degrees of the nail plate

37
Q

What is the hyponychium?

A

The skin under the free edge of the nail

38
Q

What is the function of sebaceous glands?

A

-Produce a fatty substance secreted onto the skin surface
*through the hair follicles
-Keep the skin and hair from drying out

39
Q

What are the function of eccrine glands?

A

-Help regulate body temperature by water secretion
*widely distributed

40
Q

What are the functions of apocrine glands?

A

-The bacterial decomposition of apocrine sweat is responsible for adult body odor
*mainly in the Axillary and genital regions

41
Q

What history should you have about the hair/skin/nails

A

-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

42
Q

What type of changes should document about skin/hair/nails?

A

-Timing
-associated symptoms
-Location
-Alleviating/Aggravating
-Treatments
-Exposures

43
Q

What are the three types of skin cancer?

A
  1. Basal cell carcinoma
  2. Squamous cell carcinoma
  3. Melanoma
44
Q

What are the characteristics of basal cell carcinoma?

A

-arise in the basal layer
*immature cells
-Pearly white and translucent
-grow slowly
-rarely metastasize
-Arise in sun-exposed areas
-Rolled borders

45
Q

What are the characteristics of squamous cell carcinoma?

A

-Arises from the spinous layer of epidermis
*mature cells
-Can metastasize
-Usually arise in sun-exposed areas
-Rough surface
-flat, reddish patches

46
Q

What are the characteristics of melanoma?

A

-Arises from the pigment-producing melanocytes in the epidermis
-Associated with sun-exposure
-Spread rapidly
-most lethal
-Highest mortality white men

47
Q

What is the HARMM method for risk factors of melanoma?

A

History of previous melanoma
Age of 50
Regular dermatologist absent
Mole changing
Male gender

48
Q

What are some risk factors of melanoma

A

-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

49
Q

What are the screening guidelines for skin cancer?

A

American Academy of dermatology
* Monthly self examinations
American cancer society
*regular skin exams for high risk people

50
Q

What are the ABCDE of melanomas?

A

A: Asymmetry
B: irregular order
C: change in color
D; diameters >6 mm
E: evolution

51
Q

What are the two categories of sunscreen?

A
  1. Physical blockers
  2. Light absorbing chemical sunscreens
52
Q

What are physical blockers of suncreen?

A

-Contains minerals like zinc oxide or titanium dioxide
-thick,paste-like ointments that block all solar rays

53
Q

What are light absorbing chemical sunscreens?

A

-Rated by SPF (sun protecting factor)
- SPF is a ratio of the number of minutes for treated versus skin for reddening

54
Q

What does UV-A cause?

A

Photoaging

55
Q

What is Uv-C

A

The most carcinogenic ray blocked in the atmosphere by ozone

56
Q

What equipment do you need for the skin exam?

A

-Centimeter rules
-Wood’s lamp
-Flashlight to transilluminate
-Handheld magnifying lens
-materials for microscopic exam

57
Q

What falls under inspection for the skin examination?

A

Color
Uniformity
Thickness
Hygiene
Lesions

58
Q

What falls under Palpation for the skin exam?

A

Moisture
Temperature
texture
Turgor
Mobility

59
Q

What is skin type I?

A

Always burns easily, never tans

60
Q

What is skin type II

A

burns easily, tans slightly

61
Q

What is skin type III?

A

Sometimes burns, then tans gradually and moderately

62
Q

What is skin type IV

A

Burns initially, always tans well

63
Q

What is skin type V

A

Burns rarely, tans deeply

64
Q

What is skin type VI

A

Almost never burns, deeply pigmented

65
Q

Where can jaundice appear on the body?

A

Lips, hard palate, undersurface of tongue, tympanic membrane, skin, sclera

66
Q

What is carotenemia?

A

Yellow/organize level that accompanies high levels of carotene
*look at palms, soles, and face

67
Q

What does turgor assess?

A

-Assessment of the state of hydration
*normal: skin quickly retracts back
*dehydration: skin will remain tented longer and slowly return

68
Q

What are the flat, non palpable skin lesions with a change in color?

A

Macule
*up to 1cm
Patch
*1cm or larger
*can be irregular

69
Q

What are the palpable (elevated) skin lesions?

A

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

70
Q

What are the palpable elevations with fluid-filled cavities?

A

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

71
Q

What are secondary skin lesions?

A

Scale
Crust
Lichenification
Scars
Keloids
Erosion
Excoriation
Fissure
Ulcer
Atrophy

72
Q

What is the difference between a primary skin lesion and a secondary skin lesion?

A

The secondary skin lesion happens as a result of the primary lesion

73
Q

Describe a scale

A

A thin flake of dead exfoliated epidermis

74
Q

Describe a crust

A

Hard, rough, dried residue of skin exudates such as serum, pus, or blood

75
Q

Describe lichenification

A

Visible and palpable thickening of the epidermis and roughening of the skin

76
Q

Describe a scar

A

Connective tissue that arises from injury or disease

77
Q

Describe a keloid

A

Hypertrophic scarring that extends beyond the borders of initiating injury

78
Q

Describe erosion

A

Nonscarring loss of the superficial epidermis; surface is moist but does not bleed

79
Q

Describe excoriation

A

Linear or punctuate erosions caused by scratching

80
Q

Describe fissure

A

A linear crack in the skin

81
Q

Describe ulcer

A

A deeper loss of epidermis and dermis, may bleed and scar

82
Q

Describe atrophy

A

Thinning of skin surface and loss of skin markings, translucent and paper like

83
Q

What is the medial term for nail spooning?

A

Koilonychia

84
Q

What is hirsutism?

A

Excessive hair growth on unexpected areas of the body

85
Q

What is tines capitus?

A

A fungal infection of the scalp by a mold-like fungi

86
Q

What is trichotillomania?

A

A compulsive desire to pull out ones own hair

87
Q

What is paronychia?

A

Infection of the tissue folds around the nails

88
Q

What is Tinea Unguium

A

A nail fungus causing thickened, brittle, crumbly or ragged nails

89
Q

What is onycholysis

A

A fungal nail infection which can affect the toenails and or fingernails
*sometimes under the nail

Physical Assessment (12 decks)

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