Module 4: Hair, Skin, & Nails Flashcards
What are some of the major functions of the skin to help keep the body in homeostasis?
Provide boundaries for body fluid, protects underlying tissues from microorganisms, harmful substances, and radiation, modulates body temperature, synthesizes vit. D.
T or F: The skin is the heaviest single organ in the body.
True…16% of body weight.
What are the 3 layers of the skin?
Epidermis, dermis, subcutaneous tissue.
What are the hair, nails, and sebaceous and sweat glands in regards to the skin?
Appendages.
What are some terms to describe hair?
Vellus hair - short, fine, less pigmentation.
Terminal hair - coarser, pigmented (scalp/eyebrows)
What is the function of the nails?
Protect distal ends of fingers/toes.
Where are sebaceous glands?
Present on all surfaces except palms/soles!! They produce a fatty substance secreted onto skin surface through hair follicles.
What are the two types of sweat glands?
Eccrine and Apocrine
What do eccrine glands do?
They help control body temperature. They’re widely distributed and open directly onto the skin surface.
Where are apocrine glands found?
They’re found in the axilla and groin and are stimulated by emotional stress.
What are some common or concerning symptoms regarding hair, skin, nails?
Hair loss, rash, and moles.
What are the most common cancers in the US?
Skin cancers with the most prevalent being hands, neck, and head.
What are some types of skin cancer?
Basal cell carcinoma, squamous cell carcinoma, and melanoma.
What are the characteristics of basal cell?
Comprises 80% of skin cancers. Shiny and translucent, they grow slowly and rawly metastasize.
What are the characteristics of squamous cell?
Comprises 16% of skin cancers. Crusted, scaly, and ulcerated, they can metastasize.
What are the characteristics of melanoma?
Comprises 4% of skin cancers. Rapidly increasing in frequency, they spread rapidly.
What are the HARRM risk factors for Melanoma?
First, not sure what HARRM is (might come across it when reading)….. History of previous melanoma, Age > 50, regular dermatologist absent, mole changing, and male gender.
Other risk factors for Melanoma:
- ≥50 common moles
- ≥1-4 atypical or unusual moles (especially if dysplastic)
- Red or light hair
- Actinic lentigines, macular brown or tan spots (usually on sun exposed areas)
- Heavy sun exposure (especially severe childhood sunburns)
- Light eye or skin color (especially freckles/burns easily)
- Family history of melanoma
What are the ABCDE’s of melanoma?
A for asymmetry
B for irregular borders, especially ragged, notched, or blurred
C for variation or change in color, especially blue or black
D for diameter ≥6 mm or different from other moles, especially changing, itching, or bleeding
E for elevation or enlargementA for asymmetry
Techniques for skin exam:
- Make sure the patient wears a gown
- Drape appropriately to facilitate close inspection of hair, anterior and posterior surfaces of body, palms and soles, and webspaces
- Inspect entire skin surface in good light
Preferably in natural light (or artificial light that resembles natural)
Artificial light often distorts colors
What do you look for when inspecting and palpating the skin?
Color, moisture, temperature, texture, mobility and turgor, and lesions.
T or F: A patient often notices a change in color before a physician.
True.
When examining color:
- Look for increased pigmentation, loss of pigmentation
- Look for redness, pallor, cyanosis, and yellowing
- Red color of oxyhemoglobin best assessed at fingertips, lips, and mucous membranes
- In dark-skinned people, palms and soles
- For central cyanosis, look in lips, oral mucosa, and tongue
- Jaundice - sclera
Additional items to note when examining the skin include:
1. Moisture Dryness, sweating, and oiliness 2. Temperature Use back of fingertips Identify warmth or coolness of skin 3. Texture Roughness or smoothness 4. Mobility and turgor Lift fold of skin and note ease with which it lifts up (mobility) and speed with which it returns to place (turgor)
When looking a lesion, it is good to note what?
Anatomic location and distribution, patterns and shapes, type of lesion (macules, papules, nevi and vesicles), and color.
What should you do when you see a skin lesion?
Look is up in a well-illustrated textbook of dermatology.To arrive at a dermatologic diagnosis, consider the type of lesions, location, and distribution, along with the patient’s history and physical.
T or F: When inspecting the hair, note the quantity, distribution, and texture.
True.
When inspecting the nails:
Inspect and palpate fingernails/toenails, note color and shape, note lesions, longitudinal bands of pigment may be a normal finding in people with darker skin.
What to examine with a bed bound patient:
People confined to bed are particularly susceptible to skin damage and ulceration. Pressure sores result when sustained compression obliterates arteriolar and capillary blood flow to the skin.
Assess these patients by carefully inspecting the skin that overlies the sacrum, buttocks, greater trochanters, knees, and heels. Roll patient onto one side to see sacrum and buttocks.
How should you record your findings?
Initially you may use sentences to describe findings; later you will use phrases:
Examples:
“Color good. Skin warm and moist. Nails without clubbing or cyanosis. No suspicious nevi. No rash, petechiae, or ecchymoses.”
“Marked facial pallor, with circumoral cyanosis. Palms cold and moist. Cyanosis in nailbeds of fingers and toes. One raised blue-black nevus, 1x2 cm, with irregular border on right forearm. No rash.”
Jaundice:
Jaundice that appears within the first 24 hours after both is likely to be pathologic jaundice due to hemolytic disease of newborn. Jaundice that persists beyond 2-3 weeks should raise suspicions of biliary obstruction or liver disease.
What can be misdiagnosed as ecchymosis, raising corn of intentional injury.
Mongolian Spots
Are benign skin lesions and rashes common in childhood?
YES
Dermatological problems result from a number of mechanisms including:
inflammatory, infectious, immunological, and environmental, (traumatic and exposure induced).
Examination involves the classification of __________ features.
Morphological. Analyze as follows: location, distribution, primary or secondary, shape, margins, pigmentation, texture and consistency, size.
Fever is common in viral rashes.
True. Fever and rash is not life threatening. However, fever, irritability, hypotension, and a macular or petechial rash may indicate meningoccemia.
What is associated with an allergic reaction?
Angioedema of the extremities, face, lips, tongue, and/or airway; cough; wheezing; shortness of breath; or heart palpitations.
What is toxic epidermal necrolysis?
Also called Stevens-Johnson Syndrome, is a tender, morbiliform erythematous rash accompanied by fever, conjunctivitis, oral ulcers, and diarrhea. It is usually drug induced.
