Week 6 Flashcards
What do you look for during a general nervous system screen?
Tremors, facial asymmetries, muscle wasting, gait, balance, pupils, gross movement patterns
What is the #1 type of cancer in terms of incidence?
Skin cancer
What layer of the skin has no blood supply?
Which has a blood supply?
Epidermis
Dermis
What types of cells are at risk for abnormal growth?
Squamous, basal cells, melanocytes
Regarding basal/squamous cells: What are the risk factors for malignancies?
-Older age
-fair complexion/light skin
-family history
-history of malignancy
-immunosuppression
-radiation therapy
*Has a better prognosis
Regarding malignancies: what are the risk factors for melanoma?
-15 years old or older
-family history
-fair complexion with UV light exposure
-presence of many moles (about 1/3rd have melanoma)
-history of burn scars, chronic skin ulcers, melanoma/basal cell carcinoma
*More common through genetics
Explain the acronym HARMM- Risk factors for melanoma
H: history of previous melanoma (highest increased risk if present)
A: age >50 years
R: regular dermatologist absent
M: mole changing
M: male gender
Describe the acronym ABCD- For melanoma (Malignant)
A: asymmetry
B: borders (irregular, blurry)
C: color (multiple variants, black)
D: Diameter (>6 mm)
*In the book, they mentioned an E (evolving/changing)
Describe the ABCDs for benign skin lesion
Symmetrical
Border (smooth, distinct)
Color (one color; tends not to be black)
Diameter (<6mm; height of pencil eraser)
Evolving (maybe)
What is the most common site for skin cancers for: colored and light/white skin individuals?
Colored: LEs, soles of feet
Light/white: head, face, ears, neck, hands
Common characteristics of basal cell carcinoma?
Depressed center, raised/formed border
*80% of skin cancers
Common characteristics of squamous cell cancer?
Scaly, crusty nodules, plaques
Skin characteristics for Benign vs Malignant cancerous lesions
Benign
-<6mm
-uniform color
-distinct/smooth borders
-symmetric shape
-soft/firm consistency
-no friability
-seldom ulceration
-mobile
-slow rate of change of color/shape/size/etc.
Malignant
->6mm
-varied/black color
-irregular/indistinct borders
-asymmetric shape
-firm/hard consistency
-often friability/ulceration
-mobile/nonmobile
-slow or rapid changes
Abnormal skin color changes: White, pale (pallor)
Physiological changes & causes
Physiological changes: Absence of pigment, blood abnormality, diversion of blood flow
Causes: albinism, anemia, lack of sunlight, vasospasm, syncope
Abnormal skin color changes: Cyanosis (blue)
Physiological changes & causes
PC: decreased oxygen in blood (increased deoxyhemoglobin)
Causes: high blood iron levels, cold exposure, oxidation of hemoglobin, cerebrospinal disease
Abnormal skin color changes: Jaundice (yellow)
Physiological changes & causes
PC: excess bilirubin (2-2.5 mg/100ml), excess bile pigment, high levels of carotene (carotenemia) and metals
Causes: liver disease, gallbladder blockage of bile duct, hepatitis, high vitamin A/carotene food levels
Abnormal skin color changes: Gray
Physiological changes & causes
PC: disturbance of adrenocortical hormones
Causes: increased iron (bronze/gray); increased silver (blue/gray)
Abnormal skin color changes: hyperpigmentation (brown)
Physiological change & causes
PC: disturbance of adrenocortical hormones
Causes: adrenal or pituitary glands, Addison’s disease
What is the least predictive of a malignant skin lesion?
Asymmetry
Borders
Color
Diameter
Diameter
Peripheral vs central cyanosis
Peripheral: results from a decrease or slowing of cutaneous blood flow *tends to dissipate with local warming
Central: inadequate pulmonary gas exchange causing low arterial oxygen levels
Follow-up questions if atypical characteristics are observed regarding a skin lesion?
-have you noticed this skin lesion before?
-has it recently changed size/color/shape/surface appearance?
-has a physician looked at it? If so, what did they say about it?
What is strabismus?
Misalignment of the two eyes (one eye focused on the PT while the other is not)
What is ptosis and what CN is affected?
Drooping of the upper eyelid; CN 3 Oculomotor
What are clubbing of the finger nails associated with? (What conditions)
-CF
-chronic hypoxia
-lung cancer
