Skin, Hair, and Nails (+Breast) Flashcards
intertriginous area
area where two skin areas may touch (e.g. axilla, nares, breasts)
what do the SOAP letters stand for?
Subjective, Objective, Assessment, Plan
list 5 examples of how the skin, hair, and nails can be examined to display external manifestations of diease
- genetic conditions and congenital disorders
- endocrine/metabolic disorders
- other systemic disease states
- infectons
- skin, hair, nails can provide clues to occupational/leisure activities and use of drugs
how much does the skin weigh?
approx. 6 pounds
list 4 functions of skin
- protects against heat, light, injury, infection
- regulates body temp
- stores water, fat, and vitamin D
- can sense painful and pleasant stimulation
name and describe the most superficial layer of the skin
epidermis
stratum corneum (horny layer)
cellular stratum
basal layer/basement membrane
how long does it take basal cells to migrate to stratum corneum?
4 weeks
the accessory organs of the skin are found in what skin layer?
dermis
name the middle layer of the skin
dermis
describe the cellular structure and function of the stratum corneum
continually shedding, dead keratinocytes, keratin (protein formed by dead cells) protects the skin from harmful substances
describe the cellular structure and function of the cellular stratum
contains melanocytes (produce pigment melanin- protect against harmful UV rays) and living keratinocytes (squamous cells- to become stratum corneum)
describe the cellular structure and function of the basal layer/basement membrane
contains basal cells (continually divide to create new keratinocytes that will be used to protect skin)
name the accessory structures found in the dermis
blood vessels, lymph vessels, hair follicles, sweat glands
describe the production, structure, and function of collagen in the dermis
dermis held together by collagen. collagen produced by fibroblasts (cells that give the skin its strength)
name the deepest layer of the skin
subcutis (subcutaneous layer)
discuss the structure and function of the subcutis
network of collagen and fat cells. helps conserve body head and cushioning organs
eccrine glands
sweat glands, open to surface and provide cooling mechanism thru. evaporation
apocrine glands
under the arms, in the groin, secretions produce littler or no odors, but mix w/ bacteria to result in characteristic odors
discuss the 3 regions of the hair follicle
- bulb (and suprabulb): bottom portion, base of follicle to insertion of erector pili muscle
- isthmus: middle portion, short section from insertion of erector pili to entrance of sebaceous gland duct
- infundibulum: upper portion, extends from the entrace of sebaceous gland duct to follicular orifice
discuss the 3 phases of the hair follicle life cycle
- anagen: longest, active growth phase, 3-4 years (84% of follicles on scalp)
- catagen: follicle dies, lasts approx. 2-3 weeks (1-2% of follicles on scalp)
- telogen: resting period after follicle dies, lasts 3 months (10-15% of follicles on scalp)
what is turgor and how do you test for it during a PE?
tension produced by fluid in the cells and tissues, tested by pinching skin on posterior forearm (NOT dorsal hand)
what affects turgor?
edema or dehydration decrease turgor
eponychium
covers and protects nail root (cuticle)
paronychium
protects nail from getting debris underneath, soft tissue surrounding nail
sebaceous gland
secrete sebum (lipid rich, prevents skin and hair from drying out)
pitting
psoriasis
koilonychia
AKA spooning, iron deficiency anemia
Beau lines
severe systemic illness
clubbing
inflammatory/immune diseases (COPD, hear disease)
cholasma
seen in women during pregnancy occasionally, darkening of skin on face
macule
flat, circumscribed, less than 0.5cm
patch
flat, circumscribed (like macule), larger than 0.5mc
papule
elevated, firm, circumscribed, less than 0.5cm
plaque
elevated, larger than 0.5cm
wheal
edematous, irregular shaped, hive, variable diameter, transient
nodule
elevated, firm, circumscribed lesions, deeper in dermis than a papule, 1-2cm in diamter
tumor
elevated, solid lesion, may or may not be clearly demarcated, deeper in dermis, >2cm in diameter
vesicle
elevated, circumscribed, superficial, not into dermis, filled with serous fluid less than 1cm in diameter
bullae
vesicle greater than 1cm
pustule
elevated, superficial lesion, similar to vesicle, but filled with purulent fluid
cyst
elevated, circumscribed encapsulated lesion, in dermis or subcutaneous layer, filled with liquid or semisolid material
telangiectasia
fine, irregular, red lines, produced by capillary dilation
lichenification
secondary lesion: rough, thickened epidermis, secondary to persistent rubbing, itching, or skin irritation
keloid
secondary lesion, irregularly shaped, elevated progressively enlarging scar
excoriation
secondary lesion, scratch
fissure
secondary lesion, linear crack or break from epidermis
erosion
secondary lesions, loss of part of the epidermis; depressed moist, glistening
ulcer
secondary lesion, loss of epidermis and dermis; caries in size
crust
secondary lesion, dried serum, blood, or purulent exudates
atrophy
secondary skin lesions, thinning of skin surface and loss of skin markings
peau d’orange
pitted or dimpled appearance of skin, texture looks like an orange peel, if found on the breast, concerning for carcinoma
leukonychia
white spots on nail plate from minor injury/trauma
woods lamp
to inspect skin for fungal infection
diascopy
determines if a lesion is vascular or avascular, pushing slide down on skin to see if blanching occurs
direct microscopy
skin scrapings, observed on microscope with KOH prep
name the 4 skin biopsy methods
- punch
- incisional
- excisional
- shave
what 2 tests are there for allergy testing?
- patch
2. prick
varicosities
varicose veins, twisted, enlarged, dilated, at skin surface
onycholysis
when the nail plate separates from the nail bed, starts at distal groove, often caused by onychomycosis
striae
pink-red, linear bands/streaks
leukonychia
white spots in the nail plate from minor trauma
peau d’orange breast
thickened skin of the breast with enlarged pores. indicates edema of breast caused by blocked lymph drainage following advanced breast malignancy.
mass in the breast
concerning if mass is unilateral, irregular in shape, stellate, hard/stoneline, nontender, and evolving in size.
pain of the breast
only 10% of cancers present with pain. there may be pain in the axilla if breast cancer has spread to lymph nodes.
nipple discharge
can be a sign of pituitary abnormalities such as adenomas
nipple retraction
retractions and dimpling occur with contraction of fibrotic tissue, may occur with breast cancer. a new retraction (unilateral) suggests malignancy.
be familiar with the lesion types and shapes discussed in skin, hair, nails lecture
quiz yourself using the pictures in the book (but remember that the macule is