Skin, Hair and Nails

Question 1

Skin Facts

Answer 1

Largest organ in the body, skin conditions as part of chronic health conditions (ex diabetes and obesity)
weights appx. 6 lbs
protective shield regulates body temp
stores water, fat, vit D
pain receptors

Question 2

Skin as an External Manifestation of Disease

Answer 2

• genetic syndromes and congenital disorders
• endocrine / metabolic disorders
• systemic diseases
• infections

Question 3

3 sublayers of epidermis

Answer 3

stratum corneum
cellular stratum
basal layer

Question 4

stratum corneum

Answer 4

horny layer

continually shedding dead keratinocytes. keratin protein formed from dead cells protects outer skin surface

Question 5

cellular stratum

Answer 5

contains melanocytes, pigment and living keratinocytes (squamous cells)

Question 6

basal layer of skin

Answer 6

inner layer of epidermis. contains basal cells that continually divide, forming new keratinocytes. migrate upward over 4 weeks

Question 7

dermis

Answer 7

middle layer of skin. contains blood vessels, lymph vessels, hair follicles, sweat glands, sensory and autonomic motor nerves.
held together by collagen made by fibroblasts.

Question 8

subcutis

Answer 8

deepest layer of skin. network of collagen an fat. conserves body heat. shock absorber.

Question 9

eccrine glands

Answer 9

sweat glands, open onto surface of skin, evaporative cooling

Question 10

apocrine glands

Answer 10

under arms and groin. secrete little or no odors alone, but bacteria accumulated in nearby hair can result in characteristic odors

Question 11

3 segments of hair follicle

Answer 11

bulb, isthmus, infundibulum

Question 12

Bulb and suprabulb

Answer 12

base of follicle to the insertion of the erector pili

Question 13

isthmus

Answer 13

short section of hair follicle that extends from insertion of erector pili to entrance of sebaceous gland duct

Question 14

ifundibulum

Answer 14

upper segment of hair follicle. entrance of sebaceous gland duct to follicular orifice.

Question 15

3 phases of follicular life cycle

Answer 15

anagen phase
catagen phase
telogen phase
…ACT!

Question 16

anagen phase

Answer 16

active growth, 3-4 years, 84% of scalp follicles are in anagen

Question 17

catagen phase

Answer 17

follicular regression. 2-3 weeks. 1-2% of follicles.

Question 18

telogen phase

Answer 18

resting period. 3 months. 10-15% of hair follicles.

Question 19

nail facts

Answer 19

keratinized structure. 
0.1mm growth per day
6 months to regrow
dominant hand grows faster
men faster than women

Question 20

anatomy of the nail

Answer 20

hyponychium, nail plate, lanula, eponychium, dorsal root

Question 21

Physical Exam of Skin

Answer 21

color, moistness, temp, texture, turgor, mucous membranes

Question 22

Examining dermatological lesions

Answer 22

location and distribution, lesion type (primary vs. secondary), lesion arrangement, cutaneous color changes)

Question 23

Skin lesion distribution

Answer 23

sun exposed vs. covered by clothing
flexural vs. extensor
stocking an glove
face shoulders back = acne
truncal

Question 24

primary lesion definition

Answer 24

skin lesion as it first appears

Question 25

types of primary lesions

Answer 25

macule (patch) papule (plaque)
wheals
vesicle (bullae)
pustules

Question 26

macule

Answer 26

circumscribed flat discoloration

Question 27

papule

Answer 27

elevated solid lesion up to 0.5cm

Question 28

plaques

Answer 28

circumscribed elevated superficial solid lesion geater than 0.5cm, confluence of papules

Question 29

wheals

Answer 29

firm edamatous plaque resulting from infiltration of the dermis with fluid (hives)

Question 30

vesicle and bullae

Answer 30

circumscribed collection of free fluid 0.5cm

ex. chicken pox, herpes

Question 31

pustules

Answer 31

circumscribed collection of leukocytes and free fluid ex. follicuitis, impetigo

Question 32

secondary lesion

Answer 32

transformed primary lesions

Question 33

types of secondary lesions

Answer 33

scales -excess dead epidermal cells
atrophy -depression in the skin resulting in thinning
erosion
fissure

Question 34

arrangement of skin lesions

Answer 34

annular = circle
arcuate = curve
circinate = C shaped
confluent = blotch
discoid = disk
grouped= grape clusters
iris = circle with nucleus
reticulated = spider web
serpignous = snake like
telangiectatic = looks like nerve cells

Question 35

nail exam

Answer 35

shape
color
abnormalities: pigment, pitting (psoriasis), spooning (Fe deficiency), clubbing (lung diseases)

Question 36

hair exam

Answer 36

quantity and distribution
color
texture
presence of abnormalities

Question 37

diagnostic techniques to evaluate skin hair and nail disorders

Answer 37

woods light - fungus
diascopy - using glass to depress and blanche skin
direct microscopy - observing a skin scraping
biopsy - punch, incisional, excisional, shave
patch and prick - allergy testing

Question 38

HPDP - Skin Cancer

Answer 38

SCC and BCC are most commonly occuring skin cancers
Malignant Melanoma is most rapidly increasing malignancy
Skin cancer diagnoses are more than all other cancers combined