Skin, Hair, & Nails Flashcards
what are some of the SKIN’S integral functions?
- PROTECTIVE BARRIER against foreign substances & trauma
- restricts BODY FLUID LOSS
- regulates BODY TEMP
- produces VITAMIN D
- provides SENSORY PERCEPTION
describe the A&P of the SKIN
EPIDERMIS:
- outermost layer (come lets get sub burnt)
DERMIS:
- connective tissue layer
- includes elastin, collagen, fibers, motor nerve fibers
HYPODERMIS:
- subcutaneous layer
- important for HEAT, INSULATION, SHOCK ABSORPTION, calorie reserve
what are some APPENDAGES OF THE SKIN?
- ECCRINE & APOCRINE SWEAT GLANDS
- SEBACEOUS GLANDS
- HAIR
- NAILS
describe ECCRINE GLANDS
direct opening on skin surface
describe APOCRINE GLANDS
- specialized structures found in axillae, nipples, areolae, eyelids, ears
- secrete OILY FLUID containing protein, CHO, & etc…
describe SEBACEOUS GLANDS
secretion of SEBUM - acts of lubricant & moisturizer for skin & hair
what are NAILS composed of?
keratin–very important for dexterity
describe what happens to A&P of the skin in OLDER ADULTS?
- decreased activity of GLANDS; = drier skin & less perspiration
- THINNING of the epidermis
- decreased COLLAGEN & ELASTICITY
- increased GRAY HAIR = decreased MELANOCYTES
- increased baldness
describe HISTORY OF PRESENT ILLNESS–SKIN
important to observe/ask;
- skin changes
- specific symptoms
- specific location
- recent exposures/travel history
- any medications?
- any trauma?
- any bites?
describe HISTORY OF PRESENT ILLNESS–HAIR?
important to observe/ask;
- changes in hair
- any symptoms?
- diet/nutrition?
- any infestations?
- any medications?
describe HISTORY OF PRESENT ILLNESS–NAILS?
important to observe/ask;
- changes in nails
- recent history
- any associated symptoms?
- exposure/occupations?
- medications?
what are some signs of history to observe within OLDER ADULTS?
- can have INCREASED or DECREASED SENSATION
- have many different factors of CHANGE in skin, hair, & nails
- have greater SUSCEPTIBILITY to SKIN INFECTIONS
- have DECREASED HEALING RESPONSES
- have greater SUSCEPTIBILITY TO FAILLS
- have greater MEDICATIONS **POLYPHARMACY
what do we PALPATE FOR on SKIN SURFACES? (5)
- MOISTURE
- TEMPERATURE
- TEXTURE
- TURGOR
- ELASTICITY
what do we INSPECT FOR on SKIN SURFACES?
- COLOR & UNIFORM APPERANCE
(ex. color is appropriate for ethicity) - any SKIN LESIONS/WOUNDS?
- THICKNESS
- SYMMETRY
- HYGIENE
- any ABNORMALITIES
what are areas that NEED EXTRA INSPECTION during skin examination?
- important to also check areas like SKIN FOLDS;
- larger breast under areas
- obese abdomen
- groin
(all of these areas are WARM & MOIST – susceptible for irritation/infection) - also checking FEET, TOENAILS, FINGERS, TOES
can rashes be soley on one part of the body?
NO, rashes can be various areas on the body–important to specify & clear if rashes are LOCALIZED or GENERALIZED
normal moisture of skin
should be MINIMAL / some oiliness
what surface of the hand do we use to PALPATE FOR TEMPERATURE? normal temperature of skin?
using the DORSAL SURFACE – more sensitized to temperature
- skin should be WATM – hands & feet can be slightly cooler
- want this temperature to be BILATERAL = normal circulatory status
normal texture of skin
should be SMOOTH, SOFT, & EVEN
normal TURGOR of the skin
- should immediately revert back to original position after pinching
if NOT (INTENTED); can be a sign of DEHYDRATION/PRESENT EDEMA
hypothermia
a medical emergency that occurs when the body’s temperature drops too low, usually due to exposure to cold temperatures for a prolonged period
hyperthermia
condition where the body’s temperature is higher than normal due to a failure of the body’s thermoregulation system
diaphoresis
sweating
what are some IMPORTANT CHARACTERISTICS of SKIN LESIONS to NOTE? (8)
- size
- shape
- color
- texture
- elevations/depressions
- blanching
- exudates
- location & distribution
what are our TYPES OF SKIN LESIONS
Macule
Patch
Papule
Plaque
Nodule
Tumor
Vesicle
Bulla
Pustule
Cyst
Wheal
bulla
fluid filled vesicle – BLISTER
cyst
elevated + circumscribed area of the skin filled with LIQUID or SEMISOLID FLUID
macule
FLAT + circumscribed AREA
- can be BROWN, RED, WHITE, or TAN
nodule
ELEVATED + FIRM + CIRCUMSCRIBED + PALPABLE area greater than 5 MM in diameter
- can involve all skin layers
papule
- TINY RAISED BUMP
- can often develop from EXCESS OIL and PORE CLOGGED
plaque
- elevated FLAT TOPPED FIRM ROUGH PATCH
pustule
- similar to a VESCILE but is filled with PUS
vesicle
elevated circumscribed superficial fluid-filled blister
wheal
elevated irregular shaped area of CUTANEOUS EDEMA
- often as SOLID, TRANSIENT & CHANGEABLE
- can be RED, PALE PINK or WHITE (HIVES)
describe VITILIGO
- type of LONG-TERM CONDITION often seen by skin patches that LOSE PIGMENT
- can affect inside of the mouth, hair, and nose
- more at RISK OF SKIN CANCER in NONPIGMENTED AREAS of their skin
what are PETECHIAE?
- tiny PUNCTATE HEMORRHAGE
- around 1 -3 mm ROUND
- often is DARK RED, PURPLE, or BROWN
- important to observe; can be a sign of SEPSIS/SEPTICEMIAS
what are the ABCDE’s of SKIN CANCER?
A - ASYMMETRY
B - BORDER
C - COLOR
D - DIAMETER
E - ELEVATION & ENLARGEMENT
how do we INSPECT & PALPATE THE HAIR?
INSPECTION:
- looking at patient’s texture, color, distribution & quantity
PALPATION:
- texture
- lesions
what are some important characteristics to note about NAILS during our physical exam?
- looking at PIGMENTATION
- any SURFACE CHANGES (riding, beading, pitting, peeling)
- REDNESS
- PAIN/SWELLING/EXUDATE
- firmness/thickness
- how well does the nail adhere to the bed?
why do we utilize the technique of CAPILLARY REFILL?
- allows to see the CIRCULATORY STATUS WITHIN THE EXTREMITIES – this causes BLANCHING
- should be normally 2 - 3 seconds
- any longer; sign of DEHYDRATION & POOR CIRCULATION
define ECZEMATOUS DERMATITIS
this is the MOST COMMON INFLAMMATORY SKIN DISORDER
what are the types of ECZEMATOUS DERMATITIS?
- IRRITANT CONTACT DERMATITIS
- ALLERGIC CONTACT DERMATITIS
- ATOPIC DERMATITIS
folliculitis
- INFLAMMATION & INFECTION of the hair follicle & surrounding dermis
furuncle (boil)
a DEEP-SEATED INFECTION of the PILOSEBACEOUS UNIT
cellulitis
- a DIFFUSE + ACUTE INFECTION of the SKIN & SUBQ TISSUE
- this is often LOCALIZED
- an INFLAMMATORY PROCESS
- sometimes can mark the affected area to indicate process of healing/medication results
definition of SKIN CANCER
out-of-control growth of abnormal cells
in the epidermis, the outermost skin layer,
caused by unrepaired DNA damage that
triggers mutations
difference between BENIGN vs. MALIGNANT
BENIGN
- not cancerous; does not spread
MALIGNANT;
- cancerous; does spread
tinea (dermatophytosis)
- group of NONCANDIDAL FUNGAL INFECTIONS – often involving the STRTUM CORNEUM, NAILS or HAIR
- just a fancy name for RINGWORM :) !
psoriasis
- a CHRONIC & RECURRENT DISEASE of a KERATINOCYTE PROLIFERATION
- often GENETIC
rosacea
type of CHRONIC INFLAMMATORY SKIN DISORDER often characterized by REDNESS/SWELLING/PIMPLES around the nose & cheeks
herpes zoster (shingles)
- type of VARICELLA-ZOSTER VIRAL INFECTION
- very painful as it runs through the NERVE LINE
herpes simplex definition
It’san infection spread through saliva that can cause painful blisters and ulcers.Usually on or around the mouth but can also be on genitalia.
difference between HSV-1 & HSV-2
TYPE ONE is associated with an ORAL INFECTION & TYPE TWO is associated with a genital infection
what are some major symptoms of HERPES SIMPLEX 1 & key findings in the physical exam?
SYMPTOMS:
- fever
- pain
- swollen lymph nodes
- mouth blisters
Vesicular Lesions: Small, painful blisters, often in clusters.
Crusting: Sores may crust over as they heal.
Swollen Lymph Nodes: Tenderness in neck lymph nodes.
what are the TICK-BORNE DISEASES that can lead to MULTISYSTEMIC FAILURE?
- LYME DISEASE
- ROCKY MOUNTAIN SPOTTED FEVER
- COLORADO TICK FEVER
**all must be treated as soon as possible
alopecia areata
a SUDDEN RAPID COIN-SHAPED LOSS of HAIR usually from the scalp or face
scarring alopecia
replacement of hair follicles with SCAR TISSUE
traction alopecia
hair loss that is the result of PROLONGED TIGHTLY PULLED HAIRSTYLES
hirsutism
- growth of TERMINAL HAIR in WOMEN in the male distribution pattern on the FACE, BODY, and pubic areas
- can be a sign of VIRILIZATION (type of ENDOCRINE DISORDER)
nevi
also known as MOLES
- often seen on more light skinned patients & are strongly associated with sun exposure
paronchyia
inflammation of the PARONYCHIUM
onychomycosis
a FUNGAL INFECTION of the nail
- often has a yellow discoloration & vertical ridging
ANONYCHIA
complete absence of a nail
- can occur as a congenital condition
ingrown nails
nails begin to pierce into the LATERAL NAIL FOLD and grow into the dermis
nail avulsion
part or all of a nail is torn away or removed from the nail bed
subungual hematoma
trauma to the nail plate that is SEVERE ENOUGH to cause IMMEDIATE BLEEDING & PAIN
onycholysis
loosening of the NAIL PLATE from the bed that begins at the distal groove
nail clubbing definition
change within the NAIL STRUCTURE
- more UPSIDE DOWN SPOON LIKE + SPONGE LIKE
- FINGERS ENLARGE & CURVED NAILS over the span of many years
why does NAIL CLUBBING OCCUR?
this is due to LOW OXYGEN LEVELS WITHIN THE BLOOD
- can be signs of lung diseases; COPD, LUNG CANCER, CYSTIC FIBROSIS etc…
kolioonychia
- aka SPOON NAILS
- sign of HYPOCHROMIC ANEMIA; IRON-DEFICIENCY ANEMIA/SYPHILIS
- more CONCAVE IN SHAPE
