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health assesment > module 3: skn, hair, nails > Flashcards

module 3: skn, hair, nails Flashcards

1
Q

when inspecting and palpating the hair, look for

A
  1. color
  2. texture
  3. ditribution
  4. lesions
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2
Q

when inspecting and palpating the nails, look for:

A
  • shape & contour (slightly curved/flat) → The profile sign (view of index finger at its profile and note angle of nail base) ~160 degrees
  • consistency: smooth and regular, not brittle or splitting
    -color: translucent to pink nail bed
  • Capillary refill: healthy color return takes 1-2 sec.
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3
Q

degree of normal, curved, and early clubbing nails.

A

normal: 160 degrees
curved nail: 160 degrees or less
ealy clubbing: flat 180 degrees

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4
Q

clubbing of nails occurs with:

A

congenital cyanotic heart disease, lung cancer, and pulmonary diseases

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5
Q

widespread color change of the skin

A

Pallor, erythema, cyanosis, jaundice

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6
Q

Pallor

A

(PALE) loss of color; red-pink tones from oxygenated
hemoglobin in the blood are lost

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7
Q

Erythema

A

intense redness of skin(infection/fever); due to excess blood in dilated superficial capillaries

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8
Q

cyanosis

A

bluish mottled color; signifies decreased perfusion
of oxygenated blood to the tissues

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9
Q

jaundice

A

yellowish skin color; indicates rising amounts of bilirubin in blood.
First place you’ll see? Soft and hard palate of mouth.

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10
Q

Danger signs or abnormal characteristics of pigmentd lesions: ABCDEF (ABNORMAL)

A

A - asymmery
B - border
C - color
D - diameter (measure in mm)
E - elevation and enlargement
F - funny looking

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11
Q

When inspecting and palpating the skin

A

-temp (palpate using back of both hands)/should be wam and equal bilaterally.
-moisture (dehydrated? Look in mouth)
- texture (smooth, even, firm)
- thickness
- edema
- mobility (ease of rise) or turgor (ability of skin to return/snap back to place
- vascularity or bruising
- lesions

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12
Q

Edema:

A

-pitting vs non pitting (on tibia bone/both side @ same time)

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13
Q

If edema is pitting, grade on scale

A
  • 1+ Mild pitting
  • 2+ Moderate pitting
  • 3+ Deep pitting (short time indentation)
  • 4+ Very deep pitting (long term indentation)
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14
Q

What are lesions?
Primary vs secondary

A

Traumatic/pathological changes, abnormal development
Primary: something you wake up with
Secondary: changed over time

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15
Q

If any lesions are present note:

A
  • Color
  • Elevation: flat/raised skin tag
  • Pattern or shape
  • Size: lesion in cm / mole in mm
  • Location and distribution on body
  • Any exudate: note color and odor
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16
Q

Common shapes/ configurations of lesions: refer to p228
ANNULAR

A

(Or circular) begins in center & spreads to periphery (outer limits or edge)
Ex: tinea corporis or ringworm, tinea versicolor, pityriasis rosea)

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17
Q

Common shapes/ configurations of lesions: refer to p228
CONFLUENT

A

Lesions run together/ touching
Ex: urticaria (hives)

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18
Q

Common shapes/ configurations of lesions: refer to p228
DISCRETE

A

Distinct, individual lesions that remain separate (ex: acrochordon or skin tags, acne)

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19
Q

Common shapes/ configurations of lesions: refer to p229
GROUPED

A

Cluster of lesions (ex: vesicles of contact dermatitis)

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20
Q

Common shapes/ configurations of lesions: refer to p229
LINEAR

A

A scratch, streak, line, or stripe.

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21
Q

Common shapes/ configurations of lesions: refer to p229
TARGET

A

Or iris, resembles iris of eye, concentric rings of color in lesions
Ex: erythema multiforme

22
Q

Common shapes/ configurations of lesions: refer to p229
ZOSTERIFORM

A

Linear arrangement along a unilateral nerve route
Ex: herpes zoster

23
Q

Primary skin lesions; refer to page 230
MACULE

A

Solely a color change, flat & circumscribed, of < 1 cm.
Ex: freckles, flat nevi, hypopigmentation, petechiae, measles, scarlet fever

24
Q

Primary skin lesions; refer to page 230
PATCH

A

Same as macule, but > 1 cm.
Ex: Mongolian spot, vitiligo, café au lait spot, chloasma, measles rash,

25
Q

Primary skin lesions; refer to page 230
PAPULE

A

Something you can feel (solid, elevated, circumscribed, < 1 cm diameter) caused by superficial thickening in epidermis.
Ex: elevated nevus (mole), lichen planus, molluscum, wart (verruca).

26
Q

Primary skin lesions; refer to page 230
PLAQUE

A

Papules coalesce to form surface elevation wider than 1 cm. A plateaulike, disk-shaped lesion.
Ex: psoriasis, lichen planus

27
Q

Primary skin lesions; refer to page 230
WHEAL

A

Superficial, raised, transient, and erythematous; slightly irregular shape from edema (fluid held diffusely in tissues)
Ex: mosquito bite, allergic reaction, dermographism

28
Q

Primary skin lesions; refer to page 230
VESICLE/BULLA

A

Vesicle: elevated cavity containing free fluid, up to 1 cm; a “blister.” Clear serum flows if wall is ruptured.
Ex: herpes simplex, early varicella (chickenpox), herpes zoster (shingles), contact dermatitis.
Bulla: > 1 cm diameter; usually single chambered (unilocular); superficial in epidermis; thin-walled and ruptures easily.
Ex: friction blister, pemphigus , burns, contact dermatitis

29
Q

Primary skin lesions; refer to page 231
Cyst

A

Encapsulated fluid-filled cavity in dermis or subcutaneous layer, tensely elevating skin.
Ex: sebaceous cyst, wen.

30
Q

Primary skin lesions; refer to page 231
PUSTULE

A

Turbid fluid (pus) in cavity/ bacterial infection of skin. Circumscribed and elevated.
Ex: impetigo, acne

31
Q

Secondary skin lesions; refer to page 231
CRUST

A

Thickened/ dried up exudate (ex:after popping pimple)
Ex: impetigo (dry, honey-colored), weeping eczematous dermatitis, scab after abrasion.

32
Q

Secondary skin lesions; refer to page 231
SCALE

A

Compact, desiccated flakes of skin, dry or greasy, silvery or white, from shedding or dead cells.
Ex: after scarlet fever or drug reaction, psoriasis, eczema, etc.

33
Q

Secondary skin lesions; refer to page 232
FISSURE

A

Earthquake/linear crack in dermis w/ abrupt edges. (Dry or moist)
Ex: cheilosis: @ corners of mouth caused my excess moisture ; athletes foot

34
Q

Secondary Skin Lesions; refer to pg 232
EROSION

A

Scooped-out but shallow depression. Superficial; epidermis lost; moist but no bleeding; heals w/o scar bc erosion does not extend into dermis.

35
Q

Secondary Skin Lesions; refer to pg 232
ULCER

A

deeper depression extending into dermis, irregular shape; leaves scar when heals.
Ex: stasis ulcer, pressure injury, chancre

36
Q

Secondary Skin Lesions; refer to pg 232
SCAR

A

After a skin lesion is repaired, normal tissue is lost and replaced with CT (connective tissue) aka collagen. This is a permanent fibrotic change.
Ex: healed area of surgery or injury , acne.

37
Q

Secondary Skin Lesions; refer to pg 232
ATROPHIC SCAR

A

The resulting skin level is depressed with loss of tissue; a thinning of the epidermis
Ex: striae

38
Q

Secondary Skin Lesions; refer to pg 232
KELOID:

A

Skin trying to heal, lots of collagen. Looks smooth, rubbery, shiny, and “clawlike”; feels smooth & firm.
Found in earlobes, back of neck, scalp, chest, and back; may occur months-years after initial trauma.

39
Q

Vascular lesions:
HEMANGIOMAS

A

Caused by a benign proliferation of blood vessels in dermis

40
Q

Vascular lesions: Hemangiomas
PORT-WINE STAIN

A

Flat, purple birthmark on face or scalp (frequently along distribution of cranial nerve V).
*intensifies w/ crying, exertion, or exposure to heat or cold.

41
Q

Vascular lesions: Hemangiomas
STRAWBERRY MARK (INFANTILE HEMANGIOMA)

A

2-3 cm in diameter.Raised bright red area w/ well-defined borders.
Vascular veins: infants

42
Q

Vascular lesions: Hemangiomas
CHERRY ANGIOMA

A

Red spots/ papules (age)

43
Q

Vascular lesions: Hemangiomas
TELANGIECTASES

A

A fiery red, star-shaped marking w/ a solid circular center.
Develops on face, neck, or chest; may be associated with pregnancy, chronic liver disease, or estrogen therapy or may be normal

44
Q

Vascular lesions: Purpuric lesions (caused by blood flowing out of breaks in the vessels, RBCS & blood pigments are deposited in tissues (extra vascular)
PETECHIAE

A

Tiny hemorrhages (1-3mm) round & discrete
- prolonged straining or thrombocytopenia (not a lot of platelets)

45
Q

Vascular lesions: Purpuric lesions (caused by blood flowing out of breaks in the vessels, RBCS & blood pigments are deposited in tissues (extra vascular)
PURPURA

A

CONFLUENT and extensive patch of petechiae and ecchymoses; >3mm, flat, red to purple macular hemorrhage.
Seen is disorders such as thrombocytopenia, coagulation disorders, &scurvy

46
Q

Vascular lesions: Purpuric lesions (caused by blood flowing out of breaks in the vessels, RBCS & blood pigments are deposited in tissues (extra vascular)
ECCHYMOSIS

A

A purplish patch resulting from extravasation of blood into the skin, > 3mm in diameter.
NOT CAUSED BY BLUNT FORCE TRAUMA
Ex: hitting a table

47
Q

Vascular lesions: Purpuric lesions (caused by blood flowing out of breaks in the vessels, RBCS & blood pigments are deposited in tissues (extra vascular)
CONTUSION (bruise)

A

Mechanical injury results in hemorrhage into tissues. Skin is intact.
Ex: punch/car accident (be mindful of abuse)

48
Q

How is a contusion (bruise) different from petechiae, ecchymosis, and purpura?

A

B/c these 3 are not caused by blunt force trauma.

49
Q

Is there are any lesions present on your pt, you should note:

A
  1. Color
  2. Elevation
  3. Pattern/shape
  4. Size: cm measurement
  5. Location and distribution on body
  6. Any exudate: note color and odor
50
Q

Braden scale (6 sub-scales)

A

Scale for predicting pressure score risk: how much @ risk for pressure ulcer
1. Sensory perception (can they feel? Are they limited?)
2. Moisture: incontinent
3. Activity: if they’re only in bed/chair, they’re @ greater risk.
4. Mobility
5. Nutrition: high risk yo getting a pressure ulcer
6. Friction and shear: bone/skin rub together —> injury

51
Q

Braden scale: the lower the score… vs the higher the score

A

Lower score = grater risk
Higher score = less risk

health assesment (3 decks)

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