Skin, Hair & Nail Assessment Flashcards
Stratum germinativum or basal cell layer
Stratum corneum or horny cell layer
Derivation of skin color
Epidermis (outer layer)
Connective tissue or collagen
Elastic tissue
Supportive layer—allows skin to stretch
Dermis
The dermis layer has what in it?
nerves
sensory receptors
blood vessels
lymphatic
subcutaneous layer has
Adipose tissue
Function of skin (10 things)
Protection from microbial and foreign substance invasion Prevents penetration Retain fluid and electrolytes Perception/ Sensation Temperature regulation Identification Communication/ express emotion Wound repair Absorption and excretion (sweat) Production of vitamin D
Skin color is determined by:
melanin
Carotine
how much blood volume is circling dermis
what variables affect skin color?
- Emotions
- Environment
- Physical
Inspecting skin (5 things)
- General pigmentation
- Vascularity (circulation of skin)
- Bruising
- Patici (small hemorrhages under the skin)
- Widespread color change
skin conditions noted for black individuals
- Keloids
- Pigmentary disorders
- Pseudofolliculitis
- Melasma
pale; indicates anemia, shock
pallor
blue tinge to skin or gray color in lips; indicates lack of oxygen, exposure to cold
cyanosis
yellow from increased serum bilirubin; indicates liver disease
Jaundice
red from increased cutaneous blood flow; indicates inflammation, fever, blushing
erythema
renal failure
uremia
increased carotene (yellow)
Carotenemia
Normal skin variations
birthmarks, freckles, moles (nevi), vitiligo, striae
Nevi
moles
small, flat macules
freckles
tan, reddish, or brown & flat
birthmarks
Objective data (5 things)
Temperature, moisture, texture, thickness, vascularity
Assessing skin mobility & turgor
Pinching up a large fold of skin on the anterior chest under the clavicle (or on the hand), forearm
is its ability to return to place promptly when released
turgor
is the skin’s ease of rising
mobility
normal angle of nail base
160
Curved nail
160
early clubbing
late
angle is 180
>180
How to evaluate swelling
Imprint the thumb firmly against ankle malleolus and tibia.
Normally the skin surface stays smooth.
If the pressure leaves a dent in the skin, pitting edema is present
Pitting edema scale
4 point grading scale
slight indentation, no perceptible swelling of the leg (2mm)
1+ mild pitting
indentation subsides rapidly (4mm)
2+ moderate pitting
indentation remains for a short time, leg looks swollen (6mm)
3+ deep pitting
indentation lasts a long time, leg is very swollen (8mm)
4+ very deep pitting
ABCDE
Asymmetry Border Colour Diameter Evolution
