skin, hair, nails Flashcards

1
Q

anatomy of the skin

A

epidermis, dermis, subcutaneous

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2
Q

types of hair

A

vellus, terminal

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3
Q

what is hair made of?

A

keratin, dead cells

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4
Q

nails

A

hard plate of keratin, protects fingers and toes, angle of nail bed should be 160 degrees

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5
Q

ROS, health history questions

A

past history of skin disease? excessive dryness? rash or lesions? change in nails? etc.

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6
Q

inspection of skin

A

general pigmentation of skin, expected v. unexpected findings

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7
Q

pallor

A

pale or grey or yellow brown, caused by anemia or circulatory issues

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8
Q

erythema

A

may appear red or purple, caused by inflammation

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9
Q

cyanosis

A

blue or purple undertones, caused by lack of oxygen

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10
Q

jaundice

A

yellowish skin, caused by bilirubin

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11
Q

petechia

A

small round reddish dots, caused by bleeding under skin

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12
Q

palpation of skin

A

temperature, moisture, texture, edema, turgor

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13
Q

turgor

A

pinch large fold of skin below clavicle, should return promptly when released, reflects elasticity and hydration

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14
Q

edema

A

fluid in the extremities, push with your thumb, note how long it stays (1-4 scale)

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15
Q

expected skin findings

A

skin is smooth, intact, uniformly dry, warm, instant return with skin turgor

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16
Q

expected variations of skin

A

acne, wrinkles, scars, older people may have more elastic skin

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17
Q

unexpected findings of skin

A

velvet skin, roughness or flaky, diaphoresis, skin lesions, hypothermia, hyperthermia, skin tenting, edema

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18
Q

vitiligo

A

acquired skin condition that is loss of pigment in skin

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19
Q

primary skin lesions

A

macules, papules, patches, plaques, nodules, wheals, tumors, urticaria, vesicles, cysts, bullas, pustules

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20
Q

macules

A

solely a color change, flat, less than 1 cm

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21
Q

papules

A

felt and caused by superficial thickening of the epidermis

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22
Q

patches

A

macules that are larger than 1 cm

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23
Q

plaques

A

papules coalescing to form surface elevation wider than 1 cm

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24
Q

nodules

A

solid, elevated, hard or soft, greater than 1 cm that may extend deeper into dermis than papule

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25
Q

wheals

A

superficial, raised, transient and erythematous, irregular in shape due to edema

26
Q

tumors

A

larger in diameter, firm or soft, deeper into dermis, may be benign or malignant

27
Q

urticaria

A

wheals coalesce to form extensive pruritic reaction

28
Q

vesicles

A

elevated cavity containing fluid up to 1 cm

29
Q

cysts

A

encapsulated fluid filled cavity

30
Q

bullas

A

larger than 1 cm, usually single chamber, superficial in dermis and ruptures easily

31
Q

pustules

A

pus in cavity that is circumscribed and elevated

32
Q

secondary skin lesions

A

debris on skin surfaces, break in continuity of skin surface

33
Q

crust

A

thickened, dried out exudate

34
Q

scale

A

compact flakes of desiccated skin from shedding of dead excess keratin cells

35
Q

fissures

A

linear crack with abrupt edges extending into dermis

36
Q

erosions

A

scooped out but shallow depression

37
Q

ulcers

A

deeper depression extending into dermis with irregular shape, may bleed, leaves scar

38
Q

excoriations

A

self inflicted abrasion that is superficial

39
Q

scars

A

permanent fibrotic change after healing

40
Q

keloids

A

benign excess of scar tissue beyond original injury

41
Q

how to document skin lesions

A

color, elevation, pattern or shape, size, location and distributions, exudate

42
Q

locations and distributions of lesions

A

annular, confluent, linear, grouped, zosteriform, target

43
Q

annular/circular lesions

A

begins in center and spreads to periphery

44
Q

confluent lesions

A

lesions run together

45
Q

discrete lesions

A

distinct and separate

46
Q

grouped lesions

A

cluster of lesions

47
Q

gyrate lesions

A

twisted, coiled, or snakelike

48
Q

target or iris lesions

A

resembles iris of eyes, concentric rings

49
Q

linear lesions

A

scratch, streak, line, or stripe

50
Q

polycyclic lesions

A

annular lesions grow together

51
Q

zosteriform lesions

A

linear arrangement following a unilateral nerve route

52
Q

pressure injuries stages

A

stage I - non blanchable erythema
stage 2 - partial thickness skin loss
stage 3 - full thickness skin loss
stage 4 - full thickness skin and tissue loss

53
Q

risk factors for pressure ulcers

A

reduced sensory perception, moisture, reduced mobility, malnutrition, friction and shear, thin fragile skin

54
Q

what to inspect in hair

A

color, texture, distribution, lesions

55
Q

inspecting and palpating nails

A

profile signs, curved, clubbing, consistency, color, cap refil

56
Q

capillary refill

A

should take less than 3 seconds

57
Q

unexpected conditions of the nails

A

paronychia, beau line, splinter hemorrages, onychomycosis, late clubbing, pitting, color variations, delayed cap refill

58
Q

acral lentiginous melanoma

A

skin cancer under the nail

59
Q

ABCDE of skin cancer

A

asymmetry, borders, color variation, diameter greater than 6 mm, elevation/evolution, funny looking

60
Q

red flags for skin

A

ABCDE of melanoma, sore that does not heal, skin changes over bony prominences, discoloration, new onset rash, expanding redness and heat around wound

61
Q

unexpected hair conditions

A

AIDS related kaposi sarcoma; toxic alopecia; tinea capitis; traction alopecia; cradle cap, pediculosis capitis (lice), folliculitis barbae (razor bumps), hirsutism, furuncel and abscess

62
Q
A