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Patient Assessment > Skin > Flashcards

Skin Flashcards

1
Q

Functions of Integumentary System

(hair, nails, glands)

A
  • protects underlying structures
  • provides sensory information: pain, temp, pressure
  • protects from UV rays
  • regulate body temperature
  • prevents dehydration
  • synthesizes vitamin D
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2
Q

Physical Exam of Integumentary System Includes

A

skin, hair, nails

mucous membranes: mouth, eyes, anus, genitals

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3
Q

Skin Exam Techniques Used

A
  • inspection
    • color and uniform appearance
    • thickness
    • symmetry
    • hygiene
    • lesions
    • odors
  • palpation
    • moisture (min perspiration or oiliness)
    • temperature (cool to warm; symmetrical)
    • texture (smooth, soft, even)
    • turgor (fullness produced by fluid in skin)
    • mobility
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4
Q

Skin Exam Equipment

A
  • pen light
  • centimeter ruler
  • magnifying glass or dermatoscope
  • Wood’s lamp
  • gloves
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5
Q

flat or slightly elevated, dark brown mole

A

junctional nevus - remove

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6
Q

slightly elevated brownish papule w/ indistinct border

A

compound nevus - remove

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7
Q

dome-shaped, raised, flesh to black colored mole

(can be pedunculated -stalk- or hair baring)

A

intradermal nevus - not necessary to remove

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8
Q

sharp oval or circular mole with depigmented ring surrounding

A

halo nevus - biopsy

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9
Q

sometimes present at birth and can cover large area

(hair growth can occur after several years)

A

hairy nevus - remove

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10
Q

Normal vs Dysplastic Nevi

A

color: uniform v. mixture of colors
shape: well defined borders v. irregular/notched borders
surface: smooth bump v. scaly/rough
size: <6mm v. >6mm
number: 10-4 v. >100
location: sun-exposed areas v. anywhere

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11
Q

ABC’s of Pigmented Lesions

A

A- asymmetry of shape

B- border irregular

C- color irregular

D- diameter > 6mm

E- evolving/changing

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12
Q

Risk factors of Melanoma

A
  • Previous hx
  • Family hx
  • Mole changes
  • UV exposure
  • Fair skin
  • Sun sensitivity
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13
Q

pigmented benign lesions on sun exposed areas of

immature keratinocytes

A

seborrheic keratosis

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14
Q

causes of skin color changes

A
  • striae (stretch marks)
  • freckles
  • birthmarks
  • melasma/chloasma- facial discoloration, “mask of pregnancy”
  • vitiligo- “geographic skin depigmentation”
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15
Q

Skin Color Meanings

A
  • brown: darkening of melanin pigment
    • generalized: pituitary, adrenal, liver disease
    • localized: nevi, neurofibromatosis
  • white: absence of melanin
    • generalized: albinism
    • localized: vitiligo
  • red: increased cutaneous blood flow
    • generalized: fever, viral xanthema, urticaria (hives)
    • localized: inflammation
  • yellow:
    • jaundice- liver disease
    • increased carotene pigmentation- hypothyroid, veggies
  • blue: hypoxia- VC and pulmonary disease
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16
Q

Vascular Discolorations

A
  • Non-blachable
    • purpura, petechiae, ecchymosis
  • Vasculature
    • spider angioma
    • venous star
    • telangiectasia (spider veins)
    • capillary hemangioma (extra vessels in skin)
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17
Q

Causes of Odors

A
  • rotten apples- Clostridium gas gangrene
  • mousy- Proteus infection
  • grapelike- Pseudomonas
  • stale beer- Tuberculous lymphadenopathy
  • putrid- anaerobic (scurvy)
  • feculent- intestinal obstruction, peritonitis
  • mousy/musty- phenylketonuria
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18
Q

Primary vs Secondary Lesion

A
  • primary- initial spontaneous manifestation or pathologic process
  • secondary- evolution or trauma to primary lesion
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19
Q

How to Describe Lesions

A
  • characteristics (name or describe)
  • exudates
  • configuration
  • location
  • distribution
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20
Q

primary lesion: flat, <0.5cm

A

macule

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21
Q

primary lesion: flat, >0.5cm

A

patch

22
Q

primary lesion: solid, elevated, <0.5cm

A

papule

23
Q

primary lesion: solid, elevated, >0.5cm

A

plaque

24
Q

white to pink edematous papule or plaque lasting < 24h

A

wheal

25
Q

primary lesion: dermal or subcutaneous solid, elevated, >0.5cm

A

nodule

26
Q

primary lesion: fluid/blood filled blister <0.5cm

A

vesicle

27
Q

primary lesion: fluid/blood filled blister >0.5cm

A

bulla

28
Q

primary lesion: cavity filled with pus <0.5cm

A

pustule

29
Q

primary lesion: cavity filled with pus or keratin >0.5cm

A

cyst

30
Q

secondary lesion: loose or adherent flake

A

scale

31
Q

secondary lesion: yellow, brown, black or green deposit of serum, blood or pus

A

crust

32
Q

secondary lesion: thickening of epidermis

A

lichenification

33
Q

secondary lesion: deep crack in skin

A

lesion

34
Q

secondary lesion: localized loss of superficial epidermis

A

erosion / excoriation

35
Q

secondary lesion: epidermal defect due to loss of tissue

A

ulcer

36
Q

secondary lesion: black, hard, crust of necrosis

A

eschar

37
Q

secondary lesion: depression/surface change due to diminution

A

atrophy

38
Q

secondary lesion: depressed or elevated connective tissue

A

scar

39
Q

Describing Lesion Characteristics

(if not using primary/secondary names)

A
  • size
  • shape
  • color
  • texture
  • elevation/depression
  • attachment at base:
    • peunculated, sessile, verrucous
40
Q

Describing Exudates

A
  • color
  • odor
  • amount
  • consistency
41
Q

Describing Lesion Configuration

A
  • annular (ring)
  • grouped
  • linear
  • aciform (needle-shaped)
  • diffuse
42
Q

Describing Lesion Location/Distribution

A
  • localized / generalized
  • symmetric / assymetric
  • discrete / grouped
  • coalescing
  • body region
43
Q

Inflammatory & Infectious Conditions

A
  • acne
  • eczematous dermatitis
  • folliculitis
  • furuncle/carbuncle
  • cellulitis
  • tinea (fungal) infections
  • pityriasis rosea (herald patch, christmas tree)
  • psoriasis
  • rosacea (rhinophyma)
  • herpes simplex
  • herpes zoster
  • erythema migrans (lyme disease)
  • erythema multiforme (target lesions hand, white tongue- immunologic/Steven-Johnson’s syndrome)
  • scabies
  • bed bugs
44
Q

Cutaneous Reactions

A
  • drug eruptions (morbiliform rash)
  • acanthosis nigricans (thickening on back of neck
45
Q

Pre-malignant/malignant Lesions

A
  • actinic keratosis (pre)
  • basal cell carcinoma- pearly/translucent/shiny nodule
  • squamous cell carcinoma- scaly red patch w/ central depression
  • malignant melanoma
  • kaposi sarcoma
46
Q

Hair/Scalp PE Techniques

A
  • Inspection
    • color, distribution, quantity
  • Palpation
    • texture, scalp
47
Q

Nail PE Techniques

A
  • Inspection:
    • color, length, configuration, symmetry, cleanliness
48
Q

Nail color associated conditions

A
  • pigment deposits- normal in dark skin people
  • yellow- psoriasis, fungal infections
  • diffuse darkening- candida, hyperbilirubinemia
  • greenish black- pseudomonas
  • single blue or black- melanoma, trauma
  • general blue- cyanosis
  • splinter hemorrhage- endocarditis, vasculitis
  • leukonychia punctate- cuticle manipulation, matrix trauma
49
Q

Nail plate associated conditions

A
  • ridging (longitudinal lines)- lichen planus
  • beau lines- injury, infection, nutrition
  • mee’s bands- hodgkins, CHF, carbon monoxide poisoning
  • lindsay’s nails- renal disease
  • terry’s nails- hepatic failure, cirrhosis
  • depressions- syphilis, high fever, PVD, DM
  • pitting- psoriasis
  • clubbing- CV disorder, cirrhosis, colitis, thyroid, respiratory
    • 160 degrees normal, >180 degrees abnormal
  • kollonychia (spoon)- Fe deficiency, Plummer-Vinson
50
Q

infection between nail fold and plate

A

paronychia

51
Q

fungal infection of nail

A

onychomycosis

52
Q

loosing of nail from bed

A

onycholysis

Patient Assessment (7 decks)

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