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Physical Diagnostics > Integumentary System > Flashcards

Integumentary System Flashcards

1
Q

Lesions may indicate….

A

autoimmune diseases, allergies, cancer, insect bites/stings, etc.

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2
Q

Thin skin has how many layers of cells? What about thick?

A

Thin skin has 4 layers of skin cells, while thick skin has 5 cell layers

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3
Q

Where is thick skin found?

A

in the palms of hands and soles of feet (contains keratinocytes)

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4
Q

Describe the process for shedding our skin cells?

A

Keratinocytes are in the basal layer (lowest level) of the epidermis and will move upwards, which takes approx 1 month. As the cells shift to the top layer of epidermis, they will lose their nuclei and organelles, and gain a protein called keratin. Once they reach the very top of epidermis, at this point the cells are dead and shed. This is called desquamation

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5
Q

Where are keratinocytes located?

A

in the basal layer of epidermis

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6
Q

How long does it take for our skin cells to shed?

A

about 1 month

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7
Q

What is the proper medical term for shedding?

A

desquamation

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8
Q

What other cell type is found in the basal layer of the epidermis, besides keratinocytes?

A

melanocytes

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9
Q

What are melanocytes?

A

cells that contain pigment called melanin and this gives us our skin color

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10
Q

Is the epidermis vascular or avascular?

A

avascular- it has no blood vessels

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11
Q

What happens if a sebaceous gland/duct is blocked?

A

acne

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12
Q

What does sebaceous gland do?

A

secretes sebum, which is an oil

it lubricates the skin/hair

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13
Q

What are the 3 layers of skin from most superficial to least?

A

1) epidermis
2) dermis
3) subcutaneous tissue

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14
Q

Is the dermis vascular or avascular?

A

HIGHLY VASCULAR

it has lots of blood vessels, and is mainly made up of connective tissue

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15
Q

What is the function of apocrine glands? How is their secretion induced? Where are these glands found?

A

Apocrine glands empty onto the hair follicles and is induced by stress

It is not a watery secretion like eccrine glands, but rather more milky

Apocrine glands are typically found in the axillary region and genitals

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16
Q

What is the function of eccrine glands? Where are these glands found?

A

Eccrine glands empty onto the surface of the skin and are our primary sweat glands

Sweat glands are all over the body and have watery secretion (evaporation allows the body to cool)

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17
Q

What does the dermis contain besides lots of blood vessels?

A

Glands!!! There are 3 types:

1) eccrine glands
2) apocrine glands
3) sebaceous glands

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18
Q

Humans have 2 types of hair. What are they and where are they located?

A

Vellus hair is our fine, thin hair that is found all over the body

Terminal hair is our thicker hair on the scalp, pubis, face, eyebrows, etc.

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19
Q

What is Lovibond’s angle and what is the normal range?

A

angle found between the proximal nail fold and the nail plate

Normally less than 160-165 degrees

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20
Q

What general assessment methods do you use on a derm exam?

A

inspection and palpation

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21
Q

What is a dermoscope?

A

It magnifies skin to look more closely, very similar to a magnifying glass

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22
Q

When doing a derm exam what do you assess?

hint: there are 5 things to inspect

A

1) color
2) moisture
3) turgor
4) texture
5) temp

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23
Q

What is hyperhidrosis

A

excessive sweating

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24
Q

What does turgor assess?

A

pt skin elasticity- if they are hydrated or not

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25
Q

What is normal skin turgor (elasticity)?

A

when pinched, skin springs back to previous state; may be slower in elders

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26
Q

What is a deviation from normal skin turgor (elasticity)?

A

Skin stays pinched, tented, or moves back super slowly (dehydration)

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27
Q

What does blanching mean in a medical setting?

A

It is when the skin becomes white/pale in appearance (could be because of palpation)

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28
Q

What is ecchymosis (bruising)?

A

It is the discoloration of the skin due to rupture of blood vessels below the skin

If you palpate skin, it will not blanch

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29
Q

What are ecchymoses?

A

This is the plural of ecchymosis (bruises). However, it is also more specific because there are 2 subcategories for ecchymoses
1) purpura
2) petechiae
If you palpate the skin here, it will NOT blanch

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30
Q

What is purpura?

A

a type of ecchymoses that is greater than 1/2 cm

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31
Q

What is petechiae?

A

a type of ecchymoses that is less than 1/2 cm

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32
Q

What is the ABCDE method in terms of a derm exam?

A 
A= asymmetry
B= border
C= color
D= diameter
E= evolution
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33
Q

What is a concerning diameter for a mole/lesion?

A

larger than 6mm or 1/4 in (smaller than 6mm/1/4in is ok)

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34
Q

What social hx is super important to ask during a derm exam?

A

What is your occupation? Do you have any family medical history? Skin history in family or for yourself?

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35
Q

What does pruritus mean?

A

itchy

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36
Q

A pt may appear jaundice if they have been taking an excess amount of…

A

vitamin C

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37
Q

What does an annular configuration indicate?

A

circular lesion

38
Q

What is a common annular lesion?

A

Tinea corporis (ringworm)

39
Q

What is a common lesion that appears linear?

A

shingles

40
Q

What does circinate lesion mean?

A

round/coiled lesion

41
Q

What is a common grouped lesion?

A

herpes zoster (cold sores typically, or can be shingles), or herpes simplex

42
Q

What are the 2 types of nonpalpable/flat skin lesions?

A

macule and patch

43
Q

What characterizes a macule lesion? Examples?

A

smaller than 1 cm

Ex: freckles, moles

44
Q

What characterizes a patch lesion? Examples?

A

greater than 1 cm

Ex: vitiligo, cafe au lait spots, etc.

45
Q

What are the 5 types of palpable, solid mass lesions?

A

1) papule
2) nodule
3) tumor
4) plaque
5) wheal

46
Q

What characterizes a papule lesion? Examples?

A

smaller than 1 cm

Ex: nevus, wart

47
Q

What characterizes a nodule lesion? Examples?

A

1-2 cm

Ex: erythema nodosum

48
Q

What characterizes a tumor lesion? Examples?

A

greater than 2 cm

Ex: neoplasms

49
Q

What characterizes a plaque lesion? Example?

A

flat, elevated, superficial papule with surface area greater than height

Ex: psoriasis

50
Q

What characterizes a wheal lesion? Examples?

A

superficial area of cutaneous edema

ex: hives, insect bite

51
Q

What are the 3 types of palpable, fluid-filled lesions?

A

1) vesicle
2) bulla
3) pustule

52
Q

What characterizes a vesicle lesion? Examples?

A

smaller than 1 cm; filled with serous fluid

Ex: blister, herpes simplex

53
Q

What characterizes a bulla lesion? Examples?

A

greater than 1 cm; filled with serous fluid

Ex: blister

54
Q

What characterizes a pustule lesion? Examples?

A

similar to vesicle (smaller than 1 cm); filled with pus, centered within hair follicles

Ex: acne, impetigo

55
Q

What is serous fluid?

A

a clear fluid

56
Q

What are the 6 types of vascular skin lesions?

A

1) erythema
2) petechiae
3) purpura
4) ecchymosis
5) telangiectasia
6) spider angioma

57
Q

What characterizes erythema lesions?

A

pink or red discoloration of the skin, secondary to dilation of blood vessels, that blanches with pressure

58
Q

What characterizes petechiae lesions? Examples?

A

reddish-purple; non-blanching; smaller than 1/2 cm

Ex: intravascular defects

59
Q

What characterizes purpura lesions? Examples?

A

reddish-purple; non-blanching; greater than 1/2 cm

Ex: Intravascular defects

60
Q

What characterizes ecchymosis lesions? Examples?

A

reddish-purple; non-blanching; variable size

Ex: trauma, vasculitis

61
Q

What characterizes telangiectasia lesions? Examples?

A

fine, irregular dilated blood vessels

commonly known as spider veins

Ex: dilation of capillaries

62
Q

What characterizes spider angioma lesions? Examples?

A

central red body with radiating spider-like arms that blanch with pressure to the central area

Ex: liver disease, estrogens

63
Q

What are the 3 miscellaneous types of skin lesions?

A

1) scar
2) keloid
3) lichenification

64
Q

What characterizes scar lesions? Examples?

A

replacement of destroyed dermis by fibrous tissue; may be atrophic or hyperplastic

Ex: healed wound

65
Q

What characterizes keloid lesions? Examples?

A

elevated, enlarging scar growing beyond boundaries of wound

Ex: burn scars

66
Q

What characterizes lichenification lesions? Examples?

A

roughening or thickening of epidermis; accentuated skin markings

Ex: atopic dermatitis

67
Q

What type of lesion are warts? Where are they found?

A

found all over the body, but most commonly hands and feet

warts are classified as nodular, plantar, or papular lesions

68
Q

What are plantar warts?

A

nodular wart that has been pushed in through walking (found on feet), and is extremely painful

Once removed, it leaves a gap in foot from how intrusive it was

69
Q

Characteristics of squamous cell carcinoma

A

present in epidermis, may invade dermis

cancer of keratinocytes

May have a nodular or patch presentation

70
Q

Characteristics of basal cell carcinoma

A

most common skin malignancy

starts in the basal layer of the epidermis and may invade into the dermis

it has elevated margins around the lesions, and the center looks ulcerated

71
Q

Can you confirm a skin lesion diagnosis with just observation?

A

no, to be sure you need to biopsy lesion

72
Q

Characteristics of malignant melanoma

A

derived from melanocytes

worst prognosis because it replicates really fast compared to the other skin cancers

95% survival rate for 5 years if there is an early diagnosis

there are 4 types of malignant melanoma

73
Q

What are the 4 types of malignant melanoma?

A

1) superficial spreading
2) nodular
3) acral lentiginous
4) lentigo maligna

74
Q

What is superficial spreading?

A

this is the most common type of malignant melanoma

it looks like a patch with uneven borders/colors

75
Q

Characteristics of NODULAR malignant melanoma

A

2nd most common malignant melanoma

black, brown, or blue in color

grows super quickly

76
Q

Characteristics of acral lentiginous melanoma

A

most common in Asian and African American descent

found commonly under nails (subungual), on the palms of hands, soles of feet, and oral mucosa

none of the regions that have lesions are sun exposed (not all skin cancers are because of the sun)

77
Q

Characteristics of lentigo maligna melanoma

A

more common in elderly

has a linear configuration

typically in sun-exposed areas of the body, fairly common to be seen on the face

78
Q

Characteristics of contact dermatitis

A

vesicle lesions

allergy to latex gloves would cause contact dermatitis

79
Q

Characteristics of psoriasis

A

plaque-like lesions

anywhere on the body (common on scalp)

80
Q

What are the 2 types of tinea?

A

tinea corporis and tinea pedis

81
Q

Characteristics of tinea

A

virus/fungal infection

common with Florida humidity

ex: annular configuration (ringworm)

fungal nails are extremely common

82
Q

What is tinea corporis?

A

tinea that is found anywhere on the body

83
Q

What is tinea pedis?

A

tinea that is found on the feet

84
Q

Characteristics of shingles (herpes zoster)

A

linear configuration

vesicle lesions

very painful, follows the nerve roots

shingles is caused from chicken pox

85
Q

Characteristics of acne lesions

A

pustular or papular lesions

86
Q

Characteristics of vitiligo lesions

A

depigmented patches and macular lesions

87
Q

Characteristics of insect bites

A

bites from mosquitos, fleas, ants, bed bugs, etc.

papular or wheal lesions

lesions in burrows are common

88
Q

What are burrows (scabies)?

A

lesions that are anywhere in dark regions of the body, such as popliteal region, between the fingers and toes, axillary region, etc.

89
Q

When examining hair what should you be taking note of?

A

examine the texture, distribution, density, and quantity

90
Q

What are common problems with the hair?

A

male pattern baldness

alopecia (circular lesions that forms and causes balding, typically from stress)

psoriasis is commonly found on the scalp and may be mistaken for dandruff (this is good to catch early because psoriasis can cause arthritis and other problems)

lice

91
Q

What does it mean if there’s a lack of the Lovibond’s angle in the nail?

A

“flood nails”

can be caused by injury, but if there is more than one nail that is affected then it may indicate respiratory illness, cardiovascular disease, etc.

92
Q

Which disease causes the pinning of nails (looks like little dot indents)?

A

psoriasis, this may be the first sign before there is even skin lesions

Physical Diagnostics (13 decks)

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