Skin, Hair, & Nail Flashcards
General Survey
Physical appearance
Body structure
Mobility
Behavior
is objective or subjective
Objective
Skin - Physical Exam Inspect & Palpate
- soft & smooth vs. rough, thin vs. thick
- Elastcity and Movement
- Veiny- muscle/fitness overuse
- Discoloration of skin due to increase of blood (bruising)
- Swelling by excess fluid
Turgor, edema, ecchymosis, texture, mobility, vascularity
Texture Turgor & Mobility Vascularity Ecchymosis Edema
Inspect & Palpate 1. Cool/ cold warm/hot how do you check it 2 ? -excess sweating -lack of water in body
Dehydration, temp, moisure, diaphoresis
temperature
back of hand
moisture
diaphoresis
dehydration
? normal for ethnicity such as bruising and lesions
Color
Uniform , calluses?
Clavicle, hand, forearm?
0-4+
mobility/turgor, edema, thickness
thickness
mobility, turgor
edema
Edema Dout
1. No pitting edema?
2.severe Pitting edema ?mm last long than _?
3. Moderate pitting edema ?mm disappears _?
4. Mild Pitting edema ? mm disappears rapidly
5. Moderately severe edema ? mm last more than ? min
4+, 2+, 0+, 1+, 3+
6, 4, 8, 2,
10- 15 sec, 2, 1 min
0+ 4+, 8mm-2min 2+, 4mm-10-15 sec 1+, 2mm 3+, 6mm-1
Capillary Refill
1.Genty depress nailbed for?
If normal it will return in?
If not what should u expect?
2,1,3 sec
hypoxia, anemia or cardiac insufficiency.
1 sec
2-3
hypoxia, anemia or cardiac insufficiency.
< 1 cm diameter, may be in epidermis, dermis, or subcutaneous tissue. Has palpable depth.
Wheal, Nodules, Abcess, Vesicle, Pustule, Cyst, Bulla
Pri Or Sec.
Nodule
Pri
< 1 cm diameter, filled with clear fluid
Wheal, Nodules, Abcess, Vesicle, Pustule, Cyst, Bulla
Vesicle
Pri
> 1 cm diameter, filled with clear fluid
Wheal, Nodules, Abcess, Vesicle, Pustule, Cyst, Bulla
Bulla
Pri
filled with pus (dead cells and debris)
Wheal, Nodules, Abcess, Vesicle, Pustule, Cyst, Bulla
Pustule
Pri
pustule that becomes infected (red, irritated)
Wheal, Nodules, Abcess, Vesicle, Pustule, Cyst, Bulla
Abscess
Pri
in upper epidermis (very superficial)
Wheal, Nodules, Abcess, Vesicle, Pustule, Cyst, Bulla
Wheal
Pri
fully encapsulated fluid or semi-solid material. May also contain air. Feels hard.
Wheal, Nodules, Abcess, Vesicle, Pustule, Cyst, Bulla
Cyst
Pri
evolve from primary lesions, may be from infection or external force like scratching
Primary or Secondary Lesion
Secondary Lesion
flakes or plates from desquamated layers of stratum corneum (top layer of epidermis)
Skin opening, Excoriation, scale, crust
Primary or Secondary Lesion
Scale
Secondary Lesion
Open lesion
Skin opening, Excoriation, scale, crust
Primary or Secondary Lesion
Skin opening
Secondary Lesion
skin abraded from scratching or rubbing (mechanical)
Skin opening, Excoriation, scale, crust
Primary or Secondary Lesion
Excoriation
Secondary Lesion
from dried plasma or exudates on skin (can wipe off)
Skin opening, Thickening Keloid or Lichenification , Excoriation, Ulceration, Scale, Crust, Fissure, Erosion
Primary or Secondary Lesion
Crust
Secondary Lesion
slightly depressed areas in which part or all of epidermis has been lost (infection or chemical)
Skin opening, Thickening Keloid or Lichenification , Excoriation, Ulceration, Scale, Crust, Fissure, Erosion
Primary or Secondary Lesion
Erosion
Secondary Lesion
linear cleavage, extends into dermis
Skin opening, Thickening Keloid or Lichenification , Excoriation, Ulceration, Scale, Crust, Fissure, Erosion
Primary or Secondary Lesion
Fissure
Secondary Lesion
involves necrosis of tissue, has varying depth (sometimes subcutaneous)
Skin opening, Thickening Keloid or Lichenification , Excoriation, Ulceration, Scale, Crust, Fissure, Erosion
Primary or Secondary Lesion
Ulceration
Secondary Lesion
excessive scarring (ask the patient what happened at that spot)
Skin opening, Thickening Keloid or Lichenification , Excoriation, Ulceration, Scale, Crust, Fissure, Erosion
Primary or Secondary Lesion
Keloid
Secondary Lesion
thickening of epidermis with exaggerated wrinkling, usually from chronic rubbing or scratching
Skin opening, Thickening Keloid or Lichenification , Excoriation, Ulceration, Scale, Crust, Fissure, Erosion
Primary or Secondary Lesion
Lichenification
Secondary Lesion
Non-blanching or Blanch with pressure
- Petechiae-
- Cherry angioma-
- Capillary/ strawberry hemangioma-
- Purpura-
- Ecchymosis-
- Spider angioma/ telangiectasia:-
- Port wine stain:-
- Non
- Branch
- Branch
- Non
- Non
- Branch
- Non
tiny red spots, 1-3 mm, from increased pressure on capillaries
Purpura, Port wine, Ecchymosis, Perechiae
Petechiae
more than 3 mm, tend to be redder than ecchymosis
Purpura, Port wine, Ecchymosis, Perechiae
Purpura
bruising. Bluegreenyellowbrown
Purpura, Port wine, Ecchymosis, Perechiae
Ecchymosis
Gorbachev
Purpura, Port wine, Ecchymosis, Perechiae
Port Wine
red, spider veins
Capillary/ strawberry hemangioma, Spider angioma, Cherry angioma
Spider angioma
benign red tumor, usually on head and neck, appears by 6 months of age, almost always disappears by age 10
Capillary/ strawberry hemangioma, Spider angioma, Cherry angioma
Capillary/ strawberry hemangioma
red or brown, < 3mm, more likely with aging.
Capillary/ strawberry hemangioma, Spider angioma, Cherry angioma
Cherry angioma
Non blanching and Blanch with pressure is what lesion
Skin or Vascular
Vascular
one lesion, or lesions that are separated
Zosteriform, Annular, Grouped, Reticular, Arciform, Confluent, Discrete, Grouped
Discreet
lesions are clumped together
Zosteriform, Annular, Grouped, Reticular, Arciform, Confluent, Discrete, Grouped
Grouped
lesions run together
Zosteriform, Annular, Grouped, Reticular, Arciform, Confluent, Discrete, Grouped
Confluent
ring-shaped (circular, lighter in the center)
Zosteriform, Annular, Grouped, Reticular, Arciform, Confluent, Discrete, Grouped
Annular
Lesions form in a line
Zosteriform, Annular, Grouped, Reticular, Arciform, Confluent, Discrete, Grouped ,linear
Linear
follows dermatome pattern
Zosteriform, Annular, Grouped, Reticular, Arciform, Confluent, Discrete, Grouped
Zosteriform
incomplete circle or arch
Zosteriform, Annular, Grouped, Reticular, Arciform, Confluent, Discrete, Grouped
Arctifrom
lacy, net-like
Zosteriform, Annular, Grouped, Reticular, Arciform, Confluent, Discrete, Grouped
Reticular
Hemangiomas- 3
- Spider or star angioma
- Ecchymosis
- Purpura
- Port-wine stain
- Petechiae
- Pattern injury
- Cavernous hemangioma
- Strawberry mark
- Venous lake
- Hematoma
Post wine stain
Strawberry Mark
Cavernous hemangioma
Telangiectases-2
- Spider or star angioma
- Ecchymosis
- Purpura
- Port-wine stain
- Petechiae
- Pattern injury
- Cavernous hemangioma
- Strawberry mark
- Venous lake
- Hematoma
Spider or star angioma
Venous lake
Purpuric Lesions-2
- Spider or star angioma
- Ecchymosis
- Purpura
- Port-wine stain
- Petechiae
- Pattern injury
- Cavernous hemangioma
- Strawberry mark
- Venous lake
- Hematoma
Purpura
Petechiae
Lesions due to trauma or abuse-3
- Spider or star angioma
- Ecchymosis
- Purpura
- Port-wine stain
- Petechiae
- Pattern injury
- Cavernous hemangioma
- Strawberry mark
- Venous lake
- Hematoma
Pattern injury
Hematoma
Ecchymosis
Hemangiomas
Port-wine stain (?)
Strawberry mark (?)
Cavernous hemangioma (?)
Immature, Nevus flammeus, or Mature
Nervus flammeus
Immature
Mature
physical changes caused directly by disease process)
Primary or Secondary lesions
Primary
Flat/nonpalpable-
Flat/palpable-
Patch Plaque, Papule, Macule
Patch
Macule
Plaque
papule
Macule. ? Patch ? Papule ? Plaque ? < 1 cm diameter or > 1 cm diameter
< 1 cm diameter
> 1 cm diameter
< 1 cm diameter
> 1 cm diameter
Is it normal or adnormal for nails
Digital clubling
Touching
DC abnormal
Touching Normal
Normal nail, curved nail, or Early Clubbing
160 0r less-
160-
180-
curved
normal
early clubbing
Nail growth slows b/c of increase or decrease peripheral circulation?
decrease
Male Baldness-
Alopecia-
Chemo-
Trichotilomania-
Medication,Genetics, Pulling out hair, Stress
Genetic
Stress
Medication
Pulling out hair
can a person either over/under nutrition
yes
Low body weight Loss of muscle mass Compromised immune function Electrolyte abnormalities Low energy
Over or undernutrition
undernutrition
Tube feeding
Total parenteral nutrition
is Special diets or Nutrition support
Nutrition support
Nutrition Assessment is
Objective, subjective, Factual, Historical
Subjective Historical
systematic measurement of the size, shape, and composition of the human body. BMI
Laboratory tests or Anthropometric data
Anthropometric data
Laboratory tests require ?
Glucose or Albumnemia
Albumnemia
is a sign of kidney disease and means that you have too much albumin in your urine. Albumin is a protein found in the blood. ?
Glocuse or Albumnemia
Albumnemia
What are the four componests of Nutrition Assessment
Objective , subjective, skin,, physical, Standard or Albumnemia data, laboratory tests, factual, or historical
Historical Subjective Albumnemia data physical exam Laboratory test
Which is needed for infants and older Height Weight Head circumference BMI Body composition Waist/Hip ratio
everything for infant
minus HC for older
Underweight: ?
Optimal: ?
Overweight: ?
Obese: ?
Severely obese:?
18.5 to 25, 17.7 to 18.4, 30.1 – 40, >40.1, 25.1 – 30
17.7 to 18.4
18.5 to 25
25.1 – 30
30.1 – 40
>40.1