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Bates' Guide To The Physical Exam (IPA emory) > Skin, Hair, & Nails > Flashcards

Skin, Hair, & Nails Flashcards

1
Q

3 layers of skin

A

epidermis, dermis, subcutaneous

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2
Q

4 Pigments of skin

A

melanin, carotene, oxyhemoglobin, deoxyhemoglobin

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3
Q

Anagen phase

A

(growing phase)
lasts 2-5 years
85-90% of scalp hair is in anagen
this % decreases with age & male pattern baldness

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4
Q

Catagen phase

A

short transitional phase lasting a few days

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5
Q

Telogen phase

A

(resting phase)
approx 3 months
Hair is shed in the telogen stage or when a new hair pushes it out during the next anagen.

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6
Q

Vellus Hair

A

short and fine

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7
Q

Terminal Hair

A

coarser, thicker, pigmented

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8
Q

2 layers of nail plate

A

Outermost layer: formed by proximal nail matrix
Innermost layer: formed by distal nail matrix, which can be seen as the lunula or white crescent of the proximal nail plate

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9
Q

Alopecia universalis

A

permanent total hair loss

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10
Q

Alopecia totalis

A

permanent hair loss of eyebrows and up

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11
Q

Alopecia areata

A

Round shaped areas of hair loss; usually stress-related

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12
Q

Erythema

A

Red hue, increased blood flow, “slapped cheeks” (cellulitis, rosacea)

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13
Q

Violaceous

A

Purpling of the skin

senile purpura, kaposi’s sarcoma, benign vascular collection (venous lake), dermatomyositis (heliotrope=purple eyelids)

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14
Q

Pallor

A

Pale appearance

anemia, arterial insufficiency, arterial occlusion

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15
Q

Peripheral Cyanosis

A

Blue color of hands, nails, feet

severe heart disease, venous obstruction, anxiety, cold room

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16
Q

Central Cyanosis

A

Blue color of lips, oral mucosa, tongue

advanced lung disease, COPD, congenital heart disease, hemoglobinopathies

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17
Q

Jaundice

A

Yellowing of skin (sclera affected)

liver disease, hemolysis of RBCs

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18
Q

Carotonemia

A

Yellowing of skin (sclera not affected)

diet high in yellow vegetables

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19
Q

Hyperpigmentation

A

Darkening of skin

tan, melasma, post-inflammatory change

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20
Q

Depigmentation

A

absence of any pigment
vitiligo, albinoism
Pigment cells destroyed, hairs will be white

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21
Q

Hypopigmentation

A

skin lighter than normal

post-inflammatory, like after eczema inflammation becomes controlled; will return with time;

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22
Q

Warm/Hot skin indicative of

A

Inflammation, fever

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23
Q

Cool/Cold skin indicative of

A

Decreased perfusion, cold exam room

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24
Q

Moist skin indicative of

A

Anxiety, hyperthyroidism, ↑ oil production

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25
Q

Dry skin indicative of

A

Hypothyroidism, xerosis

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26
Q

Most common cutaneous symptom

A

Pruritis

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27
Q

Pruritis: definition and indications

A

Itching

May be a symptom of skin disease (dry skin, eczema, contact dermatitis, parasitic) or systemic illness (anemia, thyroid disorder, liver/kidney dz, lymphoma)

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28
Q

Things to look for in a mole to diagnose melanoma

A

ABCDE: Asymmetry, Border irregularity, Color (blue/black mixed with white/red), Diameter (>6mm), Evolution

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29
Q

Name the Primary Lesions

A

Macule, Patch, Papule, Nodule, Plaque, Wheal, Vessicle, Bulla, pustule, cyst

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30
Q

Macule

A

FLAT, nonpalpable lesions with change in color

31
Q

Patch

A

FLAT, nonpalpable lesions with change in color >1 cm (vitiligo) 1°

32
Q

Papule

A

RAISED, palpable, solid lesions (no fluid)

33
Q

Nodule

A

RAISED, palpable, solid lesions (no fluid) >5mm (lipoma) 1°

34
Q

Plaque

A

RAISED, palpable, solid lesions (no fluid) Elevated area of confluent papules (psoriasis) 1°

35
Q

Wheal

A

RAISED, palpable, solid lesions (no fluid) Raised, edematous, evanescent (come and go) plaque (hive) 1°

36
Q

Vesicle

A

Papule that contains yellowy serous fluid;

37
Q

Bulla

A

Larger variant of a vesicle; >5mm (large blister) 1°

38
Q

Pustule

A

Papule that contains white purulent material (acne) 1°

39
Q

Cyst

A

Nodule that contains purulent or semisolid material (acne) 1°

40
Q

What is a primary lesion?

A

Initial presenting lesion that has NOT been altered by trauma, manipulation, scratching or natural regression over time

41
Q

What is a secondary lesion?

A

Created by scratching, scrubbing, infection or natural regression of lesion with time (scale).

42
Q

TELANGIECTASIA

A

Small dilated blood vessel (rosacea); will blanch 1°

43
Q

Petechiae

A

Reddish purple discoloration caused by extravasation of blood;

44
Q

Purpura

A

Reddish purple discoloration caused by extravasation of blood; >5mm (bruise) 1°

45
Q

Comedo

A

Follicular collection of sebum & keratin (whitehead/blackhead) 1°

46
Q

Burrow

A

Linear tunnel of epidermis produced by a parasite (scabies) 1°

47
Q

Abscess

A

Circumscribed collection of pus associated with infection 1°

48
Q

Furuncle

A

Acute, deep seated, hot, tender nodule or abscess (inflamed hair follicle) 1°

49
Q

Carbuncle

A

Deeper infection comprised of interconnecting abscesses (multiple furuncles) 1°

50
Q

Name the secondary lesions

A

Crust, Erosion, Ulcer, Fissure, Excoriation, Scar, Scale

51
Q

Crust

A

Dried residue of serum, pus or blood (scab) 2°

52
Q

Erosion

A

Loss of superficial epidermis, heals without scarring (popped blister) 2°

53
Q

Ulcer

A

Deeper loss of epidermis & dermis (bed sore) 2°

54
Q

Fissure

A

Vertical crack or split in the epidermis & dermis (after primary lesion, like with athlete’s foot between toes) 2°

55
Q

Excoriation

A

Linear erosion induced by scratching (pickers!) 2°

56
Q

Scar

A

Collection of new fibrous connective tissue (keloid) 2°

57
Q

Scale

A

Thick stratum corneum or flaking of skin (dandruff)
Overproduction of oil in the scalp can cause overgrowth of yeast in the skin. This causes inflammation, which causes skin to peel. 2°

58
Q

Linear

A

Pattern of lesions in a linear fashion

59
Q

Annular

A

Pattern of lesions: round area with central clearing

60
Q

Arcuate

A

Pattern of lesions: arc like

61
Q

Gyrate

A

Pattern of lesions: like a worm crawling around AKA serpiginous

62
Q

Reticular

A

Pattern of lesions: lacy patches

63
Q

Confluent

A

Pattern of lesions: everything is colliding everywhere

64
Q

Generalized

A

Pattern of lesions: head to toe

65
Q

Dermatomal

A

Pattern of lesions: along one dermatome/nerve root. Unilateral. Can see in midline and off to one side.

Ex: shingles and HSV (If bilateral, rule these out)

66
Q

Grouped

A

Pattern of lesions: just like it sounds. Grouped together lesions. Grouped vesicles are almost always some type of herpes virus

67
Q

Pitting

A

Change affecting nails: Small pinpoint depressions; psoriasis

68
Q

Splitting

A

Change affecting nails: Frequent hand washing, trauma, artificial nails, etc.

69
Q

Dystrophy

A

Change affecting nails: Resulting from inflammation of skin overlying matrix or invasion of fungus (subungal debris)

70
Q

Thickening

A

Change affecting nails: Psoriasis, onychomycosis (fungus)

71
Q

Separation of nail bed

A

Change affecting nails: Trauma

72
Q

Detachment of cuticle

A

Change affecting nails: Allows moisture & bacteria to invade in a normally sealed off environment, causing soft tissue swelling around the nail (paronychia)

73
Q

Ridging of nails

A

Change affecting nails: Severe illness, trauma, or fever may cause temporary arrest of nail growth, resulting in horizontal grooving (Beau’s lines); longitudinal grooving (lichen planus).

74
Q

Discoloration

A

Change affecting nails:
Trauma (bruising/hematoma)
Blue nails (drugs like minocycline or anti-malarials)
Green nails (pseudomonas bacteria)
Gray linear streak: deposition of lead
Splinter hemorrhages: reddish-black linear streaks of nail (trauma, endocarditis)

Bates' Guide To The Physical Exam (IPA emory) (4 decks)

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