Lecture 9 Skin hair and nails

Question 1

EPidermis

Answer 1

• Upon the dermis
• Thin, tough, outer layer (made of epithelial tissue)
• Avascular (eg. Papercuts don’t bleed)
• Produces skin color based on:
  o Pigments (carotene = orange, melanin = brown)
  o Vascular bed below = red
• Stratified (Made up of many layers)

Question 2

o Stratum germinativum

Answer 2

(stratum means layer and germ means sprout, therefore forming new cells) = base layer

 forms new cells – constantly reproducing
 contains keratin (tough protein) and melanin (skin pigment)
 forms epidermal ridges (lead to fingerprints)

Question 3

o stratum corneum

Answer 3

exposed, top portion (made of multiple layers
 tough layer, made of 25-30 layers of flattened, dead cells

 keratinized
replaced every 4 weeks

Question 4

Types of Hair

Answer 4

Vellus (covers most of body)
o	 Terminal (thicker, head/face and other regions at puberty

o Hair growth is cyclical

Question 5

• Sebaceous glands

Answer 5

associated with hair, secrete sebum = oil glands

Question 6

Eccrine Gland

Answer 6

everywhere”, reduces body temp
 Forehead, palms and soles have largest number of eccrine sweat glands
 Made up of 99% water
 Its function is to cool the skin, we make as much as 600 ml of sweat a day

Question 7

Apocrine gland

Answer 7

associated with hair follicles, active after puberty, emotional stress
 Found in the axilla, groin and around the nipples
 Thick, milky type of secretion

Question 8

• Pruritus

Answer 8

itching

Question 9

ABCDE

Answer 9

	A – asymmetry
	B – border
	C – colour
	D – Diameter
	E – elevation and enlargement

Question 10

Edema Scale

Answer 10

o 1+: Mild pitting (slight indentation, no noticeable leg swelling)
o 2+: Moderate pitting (indentation subsides rapidly)
o 3+: Deep pitting (indentation remains for short time and leg looks swollen)
o 4+: Very deep pitting (indentation lasts a long time, leg is very swollen)

Question 11

• Nails – inspect and palpate

Answer 11

o Shape and contour (slightly curved or flat)
o Profile sign (should be 160°- or less)
o Consistency (smooth, uniform thickness)
o Colour (clear, pink nail bed underneath)
o Capillary refill (normal is 1 - 2 seconds) (squeezing finger tips)

Question 12

o Carcinomas

o Melanomas

Answer 12

o	Carcinomas (basal & squamous cell)- less likely to metastasize
o	Melanomas- most deadly

Question 13

Burns and degrees

Answer 13

o 1st degree- involves only epidermis
 sunburn
o 2nd degree- epidermis + dermis
 Blister – like
o 3rd degree- epidermis, dermis + subcutaneous
 Full thickness burn, destroys
 Destroys nerves cells (less painful due to lack of)
 Loss of fluid can lead to shock, dehydration, infection

Question 14

Pressure Ulcer Stages

Answer 14

 Stage I- Intact skin (reddened area)
 Stage II- Partial-thickness (loss of epidermis ± dermis)
• blister
 Stage III- Full-thickness (into subcutaneous layer)
 Stage IV- Full-thickness with exposed bone, tendon or muscle

Question 15

• Braden Scale Scores

Answer 15

 15-16 – mild risk
 13-14 = moderate risk
 10-12 = high risk
 < 10 = very high risk

o	Assesses:
	Sensory Perception
	Moisture
	Activity
	Mobility
	Nutrition
	Friction and Shear