Skin Flashcards
Function of the Skin
HEPES Heat regulation Excretion & Absorption Protection Elimination Sensation
Perception- neurosensory end-organs for touch, pain, temperature, and pressure
Identification – finger print, facial features
Communication – emotions, nonverbal
Vitamin D production – UV light converts cholesterol into vitamin D at skin surface
Vernix Caseosa
Thick cheese-like substance present at birth
Lanugo
Fine hair present at birth
Infants Skin
Vernix Caseosa
Lanugo
Temp control ineffective
Skin more permeable (risk for fluid loss)
Linea nigra
Dark line down abdomen - occurs during pregnancy
Striae Gravidarum
Stretch Marks
Vellus Hair
fine, faint hair - covers most of the body, except the palms and soles
Terminal Hair
darker, thicker hair - grows on scalp, eyebrows &, after puberty, on the axillae, pubic area, & face & chest in the male.
Sebaceous Glands
produce sebum
protective lipid substance that lubricates the skin/hair & forms an emulsion with water that retards water loss from the skin.
Located mostly on the scalp, forehead, face, and chin
Eccrine Glands
Sweat glands
Secrete diluted saline solution
Distributed through the body & are mature by the time an infant is 2 months old.
Apocrine Glands
Sweat glands
Located mainly in the axillae, anogenital area, nipples, and navel.
Become active during puberty, and produce a thick, milky secretion and open into the hair follicles.
Bacterial flora from the skin surface react with apocrine sweat and produce the characteristic musty body odor
Primary Skin Lesions
vs.
Secondary Skin Lesions
Primary: develop on previously unaltered skin
Secondary: occur when a lesion changes over time or changes due to a factor such as scratching or infection
Leukonychia Striata
White linear mark that is normally visible through the nail
Mongolian spot
common variation of hyperpigmentation in black, Asian, Native American, and Hispanic newborns.
It is a blue-black to purple macular area at the sacrum or buttocks, but sometimes also occurs on the abdomen, thighs, shoulders, or arms. It gradually fades over the first year to adulthood.
Café au lait spot
large, round or oval patch of light brown pigmentation that is usually present at birth
Erythema toxicum
Common rash that appears in the first 3 to 4 days of life.
Consists of tiny punctate red macules and papules on the cheeks, trunk, chest, back, and buttocks.
Cause is unknown, and no treatment is needed
Cutis marmorata
transient mottling in the trunk and extremities in response to cool room temperatures. It forms a reticulated red or blue pattern over the skin
Physiologic jaundice
Yellowing of the skin, sclera, & mucous membranes.
Develops after the 3rd or 4th day of life.
Due to red blood cell hemolysis that occurs after birth.
When the hemoglobin of the destroyed red blood cells is metabolized by the liver & spleen, its pigment is converted to bilirubin.
Senile lentigines
small, flat brown macules that are not malignant
equire no treatment
Petechiae
tiny punctate hemorrhages, less than 2 mm, round, and discrete, dark red, purple, or brown
Ecchymosis
patch of capillary bleeding into the tissues (bruise)
Hematoma
Bruise that can be felt.
Skin is elevated and swollen
Measles (rubeola)
Red-purple maculopapular blotchy rash that appears on the 3rd or 4th day of illness
First behind the ears, face, neck, trunk, arms, and legs last.
Does not blanch, - Koplik’s spots may be present in the mouth
German measles (rubella)
Pink, papular rash (similar to measles but more pale)
Appears on the face 1st - then spreads.
No Koplik’s spots.
Chickenpox (varicella)
Small, tight shiny vesicles that erupt in succession over days - become pustules, then crusts.
Vesicles are highly pruritic
Appear on the trunk 1st - then face, arms, & legs.
Described as a “dewdrop on a rose petal.”
Edema Assessment
1 + Mild pitting, slight indentation, no noticeable swelling of the leg.
2 + Moderate pitting, indentation subsides rapidly.
3 + Deep pitting, indentation remains for a short time, leg looks swollen.
4 + Very deep pitting, indentation lasts a long time, leg is very swollen.
4 Stages of Ulcer development
- Stage I: Skin red but intact/unbroken. Localized redness. Skin will blanch (Dark skin appears darker but does not blanch).
- Stage II: Partial-thickness skin erosion w/ loss of epidermis or dermis. Ulcer looks shallow - like an abrasion or open blister with a red-pink wound bed.
- Stage III: Full-thickness pressure ulcer extending into the subcutaneous tissue - resembling a crater. May see subcutaneous fat but not muscle, bone, or tendon.
- Stage IV: Full-thickness pressure ulcer involves all skin layers - extends into supporting tissue. Exposes muscle, tendon or bone, and may show slough (stringy matter attached to wound bed) or eschar (black or brown necrotic tissue).
Macule
Flat lesion smaller than 1 cm.
Ex: freckle
(primary lesion)
Papule
Raised lesion smaller than 1 cm.
Ex: Molluscum
(primary lesion)
Plaque
United papules forming a surface larger than 1cm. Ex: Psoriasis
(primary lesion)
Nodule:
Hard soiled elevated lesion larger than 1cm. Ex: Dermatofibroma
(primary lesion)
Tumor
Large nodule.
Ex: Lipoma
(primary lesion)
Wheal
A plaque that is filled with fluid.
Ex: Dermographism
Vesicle
A blister smaller than 1cm.
Ex: Herpes Simplex
(primary lesion)
Pustule
An infected papule.
Ex: Acne Vulgaris
(primary lesion)
Crust
Dried body of serum, such as died pus or blood.
Ex: Impetigo
(secondary lesions)
Scale
Dry flakes of skin.
Ex: Seborrheic Dermatitis
(secondary lesions)
Fissure
Cracked skin.
Ex: Cheilosis
(secondary lesions)
Erosion
Depression in the skin.
Ex: Scratch
(secondary lesions)
Ulcer
A deep erosion in which the skin surface is destroyed.
Ex: Pressure Sore
(secondary lesions)
Koilonychia
Nail is thin, concaved, and has raised edges.
Paronychia
Nail fold is inflamed, red, and swollen.
Beau’s Line
Depression across the nail that looks like a furrow or groove.
Splinter Hemorrhages
Red-brown linear streaks and embolic lesions.
Clubbing
Inner edge of nail elevates and the distal phalanx looks rounder and wider.
Flattening of the angle between the nail & base.
Annular - rash
Circular.
Begins in center & spreads to periphery
Confluent - rash
Lesions run together
urticaria
Discrete - rash
Distinct, individual lesions that remain separate
acochordons
Gyrate - rash
Twisted, coiled, spiral, snakelike
Linear - rash
Scratch, streak, line, stripe
Zosteriform - rash
linear arrangement along a unilateral nerve route
herpes zoster
Grouped - rash
Cluster of lesions
Target - rash
resembles iris of eye.
Concentric rings of color in lesion
Polycyclic - rash
annular lesions grow together
psoriasis
Components of a nail examination include:
contour, consistency, and color
To determine if a dark skinned patient is pale, the nurse should assess the color of the…
conjunctivae
Normal angle of a nail is
160 degrees
