Jarvis Chapter 12 Skin, Hair and Nails Flashcards
Linear or oval patch of hair loss along hair line from HAIR ROLLERS , TIGHT BRAIDING, tight ponytail, barrettes
Traumatic Alopecia
Rounded, patchy hair loss on scalp.Usually seen in FARMERS ; highly contagious, may be transmitted by another person, by domestic animals, or from soil.
Tineas Capitis
Sudden appearance of a sharply circumscribed, ROUND or oval balding patch, usually with SMOOTH, soft, hairless skin underneath.
Alopecia areata
Regrowth occurs after illness or discontinuation of toxin. Mainly ocuur due to Chemo treatment.
Toxic Alopecia
Considered an AIDS-defining illness, this can occur at any stage of HIV infection
Sarcoma Caposi
Traumatic sel-induce hair loss usually the result of compulsive twisting or plucking.
Trichotillomania
Head Lice
Pediculosis Capitis
Multiple pustules, “whiteheads,” with hair visible at CENTER and erythematous base. Usually on arms, legs, face, and buttocks
Folliculitis
Red, swollen, tender inflammation of the nails folds.
Paronychia
Acute version is usually a bacterial infection; chronic version is most often a fungal infection from a break in the cuticle in those who perform “WET” work.
Paronychia
A depression across the nail that extends down to the nail bed. Occurs with any trauma that temporarily impairs nail formation, such as acute illness, toxic reaction, or local trauma
Beau’s line
Red-brown linear STREAKS, embolic lesions, occur with subacute bacterial ENDOCARDITIS; also may occur with minor trauma
Splinter hemorrhages
Inner edge of nail elevates; nail bed angle is GREATER than 180 degrees.
Clubbing of the nails.
This is a slow, persistent fungal infection of fingernails and, more often, toenails, common in older adults.- Apearing in the NAIL PLATES
Onycholysis
The inner basal cell layer of the epidermis that forms new skin cells. made up of keratin, the fibrous protein, melanin is interspersed along this layer
Stratum germinativum
the outer horny layer of the epidermis formed by the migrated, flattened cells of the basal layer. this layer consists of dead keratinized cells that are interwoven and closely packed.
Stratum corneum
Protion of hair that is below the surface, embedded in the follicle
Root
Located in the expanded areas where the new cells are produced at a high rate
Bulb matrix
Fine, faint hair that covers most of the body
Vellus
Darker, thicker hair that grows on the scalp and eyebrows and, after puberty, on the acillae, pubic area, and the face and chest in male
Terminal hair
Oils and lubricates the skin and hair and forms an emulsion with water that retards water loss from the skin.
Sebum
Coiled tubules that open directly onto the skin surface and produce a dilute saline solution called sweat.
Eccrine glands
Producers of a thick, milky secretion that opens directly into the hair follicles. located in the axillae, anogenital area, nipple, and naval
Apocrine glands
Become active during puberty, and are stimulated with emotion and sexual stimulation
Apocrine glands
White opaque semilunar area at the proximal end of the nail.
Lanula
Fine downy hair of the newborn
Lanugo
Thick, cheesy substance present at birth that is made up of sebum and shed epithelial cells
Vernix Caseosa
An increased pigment in the areolae and nipples, vulva, and sometimes in the midline of the abdoment because of the change in hormone levels in pregnant women
Linea nigra
Increased pigmentation in the face because of a change in hormone levels in pregnant women also know as the “mask of pregnancy”
Chloasma
A dark red discolored area found in elderly because of their decreasing vascularity and increasing fragility of skin
Senile purpura
Itching
Pruritus
Complete absennce of melanin pigment in patchy areas of white or light skin on the face, neck, hands, feet, body folds, and around orifices
Vitiligo
ephilides
Freckels
Mole
Nevus
Profuse perspiration
Diaphoresis
A common variation in about half of newborns that causes yellowing of the skin, sclera, and mucus membranes
Physiological Jaundice
Caused by increased sebaceous gland activity in adolescence, can include milder open/closed comedones (white and black heads),
Acne
Lesions that are raised, thickened aras of pigmentation that look crusted, scaly, and warty. there are many different forms, caused by/no relation to the amount of sun exposure, malignant or benign. common in older adults
Keratoses
Acrochordons
Skin tags
Raised yellow papules that have a central dpression. common on oler men’s foreheads, nose, or cheeks
Sebacceous hyperplasia
3 layers of the skin
- Epidermis
- Dermis
- Subcutaneus
Dermis is most made out of?
Connective Tissue or Collagen
Subcutaneous layer is made out of ?
Adipose tissue
Wrinkling occour due to?
Loss of collagen, elastin, subcutaneous far, and a reduction of muscle tone
subjective data about skin
- skin disease in family?
- change in pigmentation?
- change in mole?
- excessive dryness or moisture- seasonal or constant?
- pruritus?
- excessive bruising?
- rash or lesion
8 medications - hair loss
10.change in nails - environmental or occupational hazards
hypopigmentation
Loss od color
hyperpigmentation
Increase of color
Oily
Seborrhea
Dry
Xerosis
Hair Loss
Alopecia
Hirsutism
Excessive hair
ABCDE
- asymmetry
- border irregularity
- color variation
- diameter greater than 6mm
- elevation or enlargement
Pallor
White, pale color
Red
Erythema
Blue
Cyanosis
Cyanosis indicates,
Hypoxemia, and occurs with shock, heart failure, chronic bronchitis, and congenital heart disease
Lack of oxygen in the blood
Hypoxia
Accompanies central circulatory problems such as shock
General Hypothermia
Occurs in peripheral arterial insufficiency and Raynauds disease
Localized Hypothermia
Skin feels smoother and softer like velvet
Hyperthyroidism
skin feels rough, dry and flaky
Hypothyroidism
Very thin, shiny skin, occurs with arterial insuffeciency
Atrophic
4 point scale for edema
- Mild, slight indentation
- Moderate pitting, indentation subsides rapidly
- Deep pitting, remains for a short time, leg looks swollen
- Very deep pitting, lasts a long time, leg very swollen.
Consider local or peripheral cause ( deep vein thrombosis- dvt)
Unilateral edema
Generalized all over the whole body…central problem such as heart or kidney failure.
Bilateral edema
Skin ability to return to place promptly when released. evident in dehydration or extreme weight loss
Turgor
Literally hard skin
Scleroderma
Traumatic or pathologic changes in perviously normal skin
Primary lesion
When a legion changes over time because of a factor such as scratching or infection.
Secondary lesion
Lesion documentation
- color
- elevation
- pattern
- size
- location
- exudate - note color or odor
Hypertrophic scar, skin level is elevated by excess scar tissue most seen in african americans.
Keloids
Tiny punctuate hemorrhages 1-3mm, round and discrete; caused by bleeding in superficial capillaries, will not blanch
Petechiae
Purplish patch resulting from extravasation of blood into the skin >3mm
Ecchymosis
Confluent and extensive patch of petechiae and ecchymosis
Purpura
Atopic Dermatitis
Eczema
Erythemous papules and vesicles, weeping and oozing, crusts
Atopic dermatitis
Red purple maculopapular blotchy rash; rash appears first behind the ears and spreads over face, then neck, trunk, arms, legs; looks coppery and will not blanch; Koplik spots in mouth (bluish, white red based elevations)
Measles
Pink, papular rash (paler than measles), first appears on face and spreads; neck lymphadenopathy, no Koplik spots
Rubella
German Measles
Rubella
Small tight vesicles first appear on trunk then spread to face, arms, legs; “dewdrop on rose petal”; vesicles erupt and become pustules and crusts
Chickenpox
Chickenpox
Varicella
Local inflammatory reaction to irritant/allergy; erythema first, then swelling, wheals/urticaria, maculopapular vesicles, scales; pruritis
Primary contact dermatitis
“Althlete’s foot”, fungal infection, first appears are small vesicles between toes, sides of feet, grows scaly and hard
Tineas Pedis
Cold Sores
Labial herpes simplex
Herpes simplex virus (HSV); skin tingling and sensitivity; lesions erupts with tight vesicles followed by pustules and then produces acute gingivostomatitis with many shallow, painful ulcers; upper lip, oral mucosa
Labial herpes simplex
Fine scaling round patches of pink, tan white than do not tan in sunlight, caused by a superficial fungal infection
Tinea versicolor
Herpes Zoster
Shingles
Small, group vesicles emerge along route of cutaneous sensory nerve, then pustules, and crusts; caused by varicella zoster virus (reactivating chicken pox); acute appearance, unilateral, does not cross midline
Herpes Zoster
Vascular tumor, multiple patch state early lesions are faint pink on the temple and beard area
HIV related Sarcoma Caposi
Prolonged, intense scratching eventually thickens the skin and produces tightly packed sets of papules; looks like surface of moss (or lichen)
Lichenification
Scaly plaques that are red-tan in color and tend to increase size and roughness overtime.
Actinic Keratosis (senile or solar)
Raised yellow papules with a central depresion.
Sebaceous Hyperplasia
Intact skin appears red but unbroken.
Stage I pressure ulcer
Completely replaced every 4 weeks
Epidermis
Skin Subjective data
- Past history of skin disease
- Change in pigmentation
- Change in mole
- Excessive dryness or moisture
- Pruritus
- Excessive brusing
- Rash or lesion
- Medications
- Hair loss
- Change in nails
- Environmental hazards
- Self-care behaviors
Which skin lesion in older adults is precancerus.
Actinic Keratosis
Partial thickness skin erosion with loss of epidermis or also dermis.
Stage II pressure Ulcer
Function of the skin
- Protection
- Prevents penetration
- Perception
- Temperature regulation
- Identification
- Communication
- Wound repair
- Absorption and excretion
- Production of vitamin D
Dry skin, aging, drug reactions, allergies, obstructive jaundice, Uremia, lice.
Pruritus
Single- chambered superficial lesion containing free fluid grater than 1cm in diameter.
Bullae
Most common skin problem in adolescences.
Acne
Thin but tough
Epidermis
Outer layer of the skin
Epidermis
White spots on the nail plate
Leukonychia
smooth, slighly raised bright red dots that commomnly appear on the trunk in all older than 30 year.
Cherry angioma
Elevated cavity containing free fluid less than 1 cm in diameter
Vesicle
Raised lesions that appear crusted, scaly and warty.
Seborrheic Keratosis
Inner supportive layer of the skin
Dermis
Five common skin lesions in older adults
- Senile lentigines
- Seborrheic Keratosis
- Acrochordons
- Actinic Keratosis
- Sebbaceous Hyperplasia
Full thickness pressure ulce extending to the subcutaneos tissue and resembling a crater
Stage III pressure ulcer
Bilateral edema (generalized)
Anasarca
The cells are bound tightly together into sheet that form a rugged protective barrier.
Epidermis
Raised lesion
Papule
Flat lesions
Macule
Visible projecting part of the hair
Shaft
Hepatitis, cirrhosis, sicke-cell disease, transfusion reaction, hemolyc disease of the newborn
Jaundice
Full thickness pressure ulcer involves all skin layers, expose muscles, tendon and/or bones.
Stage IV pressure ulcer
When hair follicles develop in the fetus?
@ 3 month’s gestation
Treads of keratin
Hair
Components of nail examination
- Countour
- Consistency
- Color
Fluid accumulating in the intercellular spaces
Edema
Skin ability to raise
Mobility
Increase in the quantity of blood flow to a body part.
Hyperemia
3 sources of skin color
- Brown- melanin
- Yellow/orange - Carotene
- Red/purple - underlying vascular bed.
Skin Cancer Risk
- Sunburn
- Tanning
- Ultraviolet exposure (sun/tanning)
- Asbesto
- Cigarettes
In the aging adult the underlying dermis thin and flattens whih cause?
Wrinkling
In the aging adult which substance loss increase the risk for shering and tearing lesions?
Collagen
In the aging adult which glands decrease in numbers and funtion leaving dry skin?
Sweat gland and Sebaceous gland
What put the aging adult at risk for heat stroke?
Decrease response on the sweat glands.
In the aging adult vascularity of the skin diminished while __________
Vascular fragility increase.
In the aging adult subsequent cell replacement slow imparing?
Wound healing
Dehydraion s/s
- Mocous mmbrane is dry
- Lips look parched and cracked
- Extreme skin dryness
- Poor turgor
- Delay capillary refill
- Tachypnea
- Depressed and sunken fontanels
- Cachetic Apperance
Best place to access for pallor in a non- caucasian patient
Membrane mucous, conjuntiva