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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
What is normal skin turgor (elasticity)?
when pinched, skin springs back to previous state; may be slower in elders
26
What is a deviation from normal skin turgor (elasticity)?
Skin stays pinched, tented, or moves back super slowly (dehydration)
27
What does blanching mean in a medical setting?
It is when the skin becomes white/pale in appearance (could be because of palpation)
28
What is ecchymosis (bruising)?
It is the discoloration of the skin due to rupture of blood vessels below the skin If you palpate skin, it will not blanch
29
What are ecchymoses?
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
30
What is purpura?
a type of ecchymoses that is greater than 1/2 cm
31
What is petechiae?
a type of ecchymoses that is less than 1/2 cm
32
What is the ABCDE method in terms of a derm exam?
``` A= asymmetry B= border C= color D= diameter E= evolution ```
33
What is a concerning diameter for a mole/lesion?
larger than 6mm or 1/4 in (smaller than 6mm/1/4in is ok)
34
What social hx is super important to ask during a derm exam?
What is your occupation? Do you have any family medical history? Skin history in family or for yourself?
35
What does pruritus mean?
itchy
36
A pt may appear jaundice if they have been taking an excess amount of...
vitamin C
37
What does an annular configuration indicate?
circular lesion
38
What is a common annular lesion?
Tinea corporis (ringworm)
39
What is a common lesion that appears linear?
shingles
40
What does circinate lesion mean?
round/coiled lesion
41
What is a common grouped lesion?
herpes zoster (cold sores typically, or can be shingles), or herpes simplex
42
What are the 2 types of nonpalpable/flat skin lesions?
macule and patch
43
What characterizes a macule lesion? Examples?
smaller than 1 cm Ex: freckles, moles
44
What characterizes a patch lesion? Examples?
greater than 1 cm Ex: vitiligo, cafe au lait spots, etc.
45
What are the 5 types of palpable, solid mass lesions?
1) papule 2) nodule 3) tumor 4) plaque 5) wheal
46
What characterizes a papule lesion? Examples?
smaller than 1 cm Ex: nevus, wart
47
What characterizes a nodule lesion? Examples?
1-2 cm Ex: erythema nodosum
48
What characterizes a tumor lesion? Examples?
greater than 2 cm Ex: neoplasms
49
What characterizes a plaque lesion? Example?
flat, elevated, superficial papule with surface area greater than height Ex: psoriasis
50
What characterizes a wheal lesion? Examples?
superficial area of cutaneous edema ex: hives, insect bite
51
What are the 3 types of palpable, fluid-filled lesions?
1) vesicle 2) bulla 3) pustule
52
What characterizes a vesicle lesion? Examples?
smaller than 1 cm; filled with serous fluid Ex: blister, herpes simplex
53
What characterizes a bulla lesion? Examples?
greater than 1 cm; filled with serous fluid Ex: blister
54
What characterizes a pustule lesion? Examples?
similar to vesicle (smaller than 1 cm); filled with pus, centered within hair follicles Ex: acne, impetigo
55
What is serous fluid?
a clear fluid
56
What are the 6 types of vascular skin lesions?
1) erythema 2) petechiae 3) purpura 4) ecchymosis 5) telangiectasia 6) spider angioma
57
What characterizes erythema lesions?
pink or red discoloration of the skin, secondary to dilation of blood vessels, that blanches with pressure
58
What characterizes petechiae lesions? Examples?
reddish-purple; non-blanching; smaller than 1/2 cm Ex: intravascular defects
59
What characterizes purpura lesions? Examples?
reddish-purple; non-blanching; greater than 1/2 cm Ex: Intravascular defects
60
What characterizes ecchymosis lesions? Examples?
reddish-purple; non-blanching; variable size Ex: trauma, vasculitis
61
What characterizes telangiectasia lesions? Examples?
fine, irregular dilated blood vessels commonly known as spider veins Ex: dilation of capillaries
62
What characterizes spider angioma lesions? Examples?
central red body with radiating spider-like arms that blanch with pressure to the central area Ex: liver disease, estrogens
63
What are the 3 miscellaneous types of skin lesions?
1) scar 2) keloid 3) lichenification
64
What characterizes scar lesions? Examples?
replacement of destroyed dermis by fibrous tissue; may be atrophic or hyperplastic Ex: healed wound
65
What characterizes keloid lesions? Examples?
elevated, enlarging scar growing beyond boundaries of wound Ex: burn scars
66
What characterizes lichenification lesions? Examples?
roughening or thickening of epidermis; accentuated skin markings Ex: atopic dermatitis
67
What type of lesion are warts? Where are they found?
found all over the body, but most commonly hands and feet warts are classified as nodular, plantar, or papular lesions
68
What are plantar warts?
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
Characteristics of squamous cell carcinoma
present in epidermis, may invade dermis cancer of keratinocytes May have a nodular or patch presentation
70
Characteristics of basal cell carcinoma
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
Can you confirm a skin lesion diagnosis with just observation?
no, to be sure you need to biopsy lesion
72
Characteristics of malignant melanoma
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
What are the 4 types of malignant melanoma?
1) superficial spreading 2) nodular 3) acral lentiginous 4) lentigo maligna
74
What is superficial spreading?
this is the most common type of malignant melanoma it looks like a patch with uneven borders/colors
75
Characteristics of NODULAR malignant melanoma
2nd most common malignant melanoma black, brown, or blue in color grows super quickly
76
Characteristics of acral lentiginous melanoma
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
Characteristics of lentigo maligna melanoma
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
Characteristics of contact dermatitis
vesicle lesions allergy to latex gloves would cause contact dermatitis
79
Characteristics of psoriasis
plaque-like lesions anywhere on the body (common on scalp)
80
What are the 2 types of tinea?
tinea corporis and tinea pedis
81
Characteristics of tinea
virus/fungal infection common with Florida humidity ex: annular configuration (ringworm) fungal nails are extremely common
82
What is tinea corporis?
tinea that is found anywhere on the body
83
What is tinea pedis?
tinea that is found on the feet
84
Characteristics of shingles (herpes zoster)
linear configuration vesicle lesions very painful, follows the nerve roots shingles is caused from chicken pox
85
Characteristics of acne lesions
pustular or papular lesions
86
Characteristics of vitiligo lesions
depigmented patches and macular lesions
87
Characteristics of insect bites
bites from mosquitos, fleas, ants, bed bugs, etc. papular or wheal lesions lesions in burrows are common
88
What are burrows (scabies)?
lesions that are anywhere in dark regions of the body, such as popliteal region, between the fingers and toes, axillary region, etc.
89
When examining hair what should you be taking note of?
examine the texture, distribution, density, and quantity
90
What are common problems with the hair?
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
What does it mean if there's a lack of the Lovibond's angle in the nail?
"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
Which disease causes the pinning of nails (looks like little dot indents)?
psoriasis, this may be the first sign before there is even skin lesions

Physical Diagnostics (13 decks)

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