Skin Assessment - Unit 2 Flashcards
What is some of the subjective data for health history questions?
Previous history of skin disease, change in pigmentation, change in mole (size or color), excessive dryness or moisture, excessive bruising, itching, hair loss, self care behaviors, etc.
Pruritus - def
Itching.
Objective Data - what do we look for?
Color (general pigmentation, widespread color change), temp, moisture, texture.
Skin Color - assess areas ___ exposed to sun and assess for ___ pigmentation.
NOT exposes/even pigmentation.
What is skin color influenced by?
Amount of melanin, oxygen content in blood, level of exposure to sun, etc.
Dark skin - large or little amounts of melanin?
Large amounts!
Light skin - large or little amounts of melanin?
Little!
Asian skin - large amount of carotene. T/F?
True!
What are some of the variations of the skin color/tone?
Pinkish tan to ruddy dark tan, light to dark brown, may have yellow or olive overtones, pink, tan, brown or black.
Dark skin people - normally have areas of lighter pigmentation on palms, nail beds & lips. T/F?
True!
Where are some good areas to asses changes in coloration for darker skinned people?
Under the tongue, buccal mucosa (cheek), conjunctivae (eyelids), sclera (white part of eyes)
Cyanosis - def
mottled blue color in skin.
Cyanosis - increased amount of ____ ___ causing inadequate tissue perfusion.
Unoxygenated hemoglobin.
Cyanosis - what color?
Blueish color!
Pallor - def and what causes it?
loss of color because there is an absence of oxygenated Hbg.
Light skin - pallor - lose __ tone.
Rosy
Pallor - skin with natural yellow tone becomes more…
Yellow, which is why it can be mistaken for jaundice.
Dark skin - pallor - loses healthy ___.
Glow.
Pallor - black skin - loses __ undertones and appears __ __ and ___.
Red/ash grey and dull.
Pallor - brown skin - appears ___ ____ and ___.
Yellow brown/dull.
Jaundice - yellow undertone caused by increased ___ in blood.
Bilirubin
Erythema (redness) - what is it?
Light skin = red, bright pink and with dark, it’s a purplish tint.
What is the normal temp of skin?
Warm.
Skin temp - varies depending on circulation and limbs? T/F?
True!
Skin moisture - usually __ with moisture in axilla, skin folds and in response to activity or anxiety/emotional state.
Dry!
Turgor (elasticity) - indicator of total body ___.
Hydration.
Turgor - “Tenting” test (Pinch-fold test) - use forehead for the test. T/F?
True!
Edema - def
fluid that accumulates in intercellular spaces - excess fluid not normally present.
Edema - looks ___ and __.
Puffy and tight.
Edema - assess ___, whether area remains _____ (or pitted), when press with finger.
Location/indented.
Scale for Describing Edema - 1+ 2+ 3+ 4+
1+ - Barely detectable, slight indentation (2mm) 2+ - Indentation of less than 5mm 3+ - Indentation of 5-10mm w/puffy, deeper pitting. 4+ - Indentation of more than 10mm - extremely deep pitting.
With edema, ask if it’s normal for the patient. T/F?
True!
Skin texture - smooth, soft and more coarse with aging. T/F?
True!
Thyroid problems can can skin dryness, and hyperthyroidism can cause velvet smooth skin. T/F?
True!
Lesions of skin - def
pathologic change in structure of the skin.
Assessment of lesions - what do we look for?
Color, elevation (flat or raised?), pattern or shape, border, size (in CM), location and distribution, and exudate (fluid = COCA - Color, Odor, Consistency, Amount)
What are these? (top left to bottom right.)
Annular, Confluent, Discrete, grouped, gyrate, target, linear, polycyclic, zosteriform.
What are these? (Top left to bottom right)
Sharp, Ill-defined, Circinate, Arciform, Annular, Iris, Serpiginous, Gyrate, Linear, Zosteriform
What are these distributions? (top left to bottom right.)
Localized, Generalized, Symmetric, Assymetric (Shingles?), Discrete, Grouped, Coalescing (Smaller and bigger lesions together), Clevage Plane
Primary Lesion - def
lesion that is a physical alteration of the skin and considered to be directly caused by the diease process which is characteristic and ocassionally specific. This could be a tumor or a papule, etc.
Secondary Lesion - def
lesion that changes of time or as a result of scratching, trauma, infection or changes caused by healing. Examples could be Scale, Crust, Erosion, etc.
Flat primary lesions - def
circumscribed, flat non-palpable changes in skin color - they are well defined and have definite boundaries or limits. (Think about a birth mark!)
Macule - def
flat, discolored lesion with no elevation - <1 CM in size.
Patch - def
flat, nonpalpable, irregular - >1CM in size.
Vitiligo - def (this is a patch!)
autoimmune disorder - destruction of melanocytes (melanin producing cells). It looks like a dark person has been bleached!
Raised Primary Lesions - def
palpable, elevated solid masses.
Types of Raised Primary Lesions (info on them!)
Papule
Plaque
Nodule
Tumor
Wheal
Papule - elevated pinpoint lesion, < than 1 CM. Solid, raised.
Plaque - groupes of papules, >1 CM and do not extend into lower skin layers. Can be silvery!
Nodule - elevated, solid, hard or soft, palpable masss extending deeper into dermis than a papule - 1-2CM in diamter. Could be a swollen lymph node!
Tumor - >2 CM in diameter - solid mass larger than a nodule.
Wheal - elevated transient with a variable diameter; superficial localized skin edema.
Tumor does mean neoplasm. T/F?
False - tumor doesn’t mean neoplasm. Neoplasm = cancerous.
Fluid filled primary lesions - def
circumscribed, superficial elevations of the skin formed by free fluid in a cavity within the skin layers.
Types of Primary Lesions w/fluid. (info!)
Vesicle, Bulla, Pustule, Cyst
Vesicle - fluid filled papule <1CM. Think chickenpox!
Bulla - >1CM, fluid filled - larger than a vesicle. Large fluid filled blisters!
Pustule - elevated, pus filled vesicle or bulla.
Cyst - encapsulated, may or may not be elevated - fluid filled or semi solid mass.
What are these primary lesions? (Top left to bottom right.)
Macule, papule, plaque, vescicle, bulla, pustule, wheal, nodule/tumor.
Secondary lesions - Type - info
Scales, Crusts, Excoriation, Fissures
Scales - flakes of dead epidermis - epidermal thickening.
Crusts - covering formed from serum, blood or pus drying on the skin - dried serum.
Excoriation - injury to surface of skin causd by trauma such as scratching or abrasion - linear loss of epidermis (erosion pertains to loss of epidermis, not linear.)
Fissures - linear cracks with sharp edges extending into dermis - a crack or slip!!!
Kawasake’s Disease - serious viral infection. T/F? It also affects the heart.
True!
More secondary lesions -
Ulcers, Scar, Atrophy, Striae, Lichenification
Ulcers - lesion formed by loss of epidermic and extending into deeper tissues. Loss of epidermis and dermis!
Scar - area of connective tissue left after lesion or wound is healed - it is a thickening, fibrous tissue.
Atrophy - translucent, dry, paper like, sometimes wrinkled skin surface as result of thinning or wasting of skin due to loss of collagen and elastin - loss of substance/thinning.
Striae - long line, appearing like scars related to stretching of subcutaneous skin.
Lichenification - thickening with skin line accentuation.
Keloid - a type of scar. T/F?
Yes, it’s excess scar tissue and icnreased cartilage pudction. Reddish, darkened, etc. It can happen with a piercing!
What are these secondary lesions? (Top left to bottom right)
Scale, crust, fissure, erosion, ulcer, lichenification, epidermal atrophy, dermal atrophy.
Vascular Skin Lesions - def
lesions pertaining to blood vessels
Vascular Skin Lesions- info
Ecchymosis
Hemangioma
Hematoma
Petechiae
Purpura
Ecchymosis - accumulation of extravascular blood in dermis or subcutaneous tissue.
Hemangioma - cherry red, raised lesions that blanch with pressure.
Hematoma - localized, deep collection of blood beneath subcutaneous tissue.
Petechiae - hemmorhagic pinpoint spots.
Purpura - flat, irregularly shaped extensive patches of varying size.
Ecchymosis - red, large patch, irregular edge, changing colors. T/F?
True!
Petechiae - info
small lesions, could be liver disease, septicemia, clotting disorder. It’s a minor hemmorhage.
Purpura - info
inflammation of blood vessels caused by disease or severe allergic reactions. These are purple dots.
Purpura and Petechiae - these do blahce. T/F?
FALSE- they do not!
Senile purpura - what is it?
Steroid Purpura - what is it?
Senile - in older people, probably not on clotting meds.
Steroid - decreasing tissue mass from steroids - muscle mass wasted away.
