Term
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Definition
The body's largest organ covering 20 square feet of surface area.
Has two layers the outer epidermis and inner dermis
Skin is the sentry that guards the body from environmental stresses |
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Term
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Definition
uniformly thin (except where exposed to friction) but tough
cells are bound tightly together into sheets that form a rugged protective barrier
avascular-nourished by blood vessels in the dermis below
startified into several zones: inner stratum germinativum and outer stratum corneum
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Term
Stratum germinativum
(basal cell layer) |
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Definition
forms the new skin cells, their major ingredient is the tough, fibrous protein keratin
melanocytes are interspersed in this layer and produce the pigment melanin (brown tones to skin and hair)
people have the same amount of melanocytes, the amount of melanin they produce varies with genetic, hormonal, and environmental influences. |
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Term
stratum corneum
(horny cell layer) |
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Definition
news cells migrate up from the basal layer and flatten
consists of dead keratinized cells that are interwoven and closely packed
they are constantly being desquamated (shed), completely replace every 4 weeks, avg 1 pound shed per year |
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Term
skin color derived from three sources |
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Definition
-mainly from the brown pigment melanin
-from orange-yellow tones of the pigment carotene
-red-purple tones in the underlying vascular bed
all people have varying shades of brown, yellow, and red
skin color is further modified by the thickness of the skin and by the presence of edema
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Term
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Definition
inner supportive layer consisting mostly of connective tissure, collagen-the tough, fibrous protein that enables the skin to resist tearing.
the dermis has resilient elastic tissue that allows the skin to stretch with body movements
nerves, sensory receptors, blood vessels, and lymphatics and appendages from the epidermis-hair follicles, sebaceous glands, and sweat glands are in the dermis
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Term
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Definition
adispose tissue, made up of lobes of fat cells
stores fat for energy, provides insulation for temperature control and aids protection by its soft cushioning effect
loose subq later gives the skin its increased mobility over structures underneath |
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Term
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Definition
these structures are fromed by a tubular invagination of the epidermis down into the underlying dermis
hair
sebaceous glands
sweat gland
nails |
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Term
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Definition
vestigial for humans
threads of keratin
hair shaft is the visible projecting part
root is below the surface embedded in the follicle
at the root the bulb matrix is expanded area where new cells are produced at a high rate
hair growth is cyclical-phases
arrector pili around the hair follicle which contract and elevate the hair so that it resembles "goose flesh"
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Term
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Definition
vellus hair-fine, faint, covers most of the body (except the palms and soles, the dorsa of the distal parts of the fingers, the umbilicus, the glans penis, and inside the labia)
terminal hair-the darker, thicker hair that grows on the scalp, eyebrows and, after puberty, on the axillae, pubic area, and the face and chest in the male |
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Term
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Definition
produce a protective lipid substance, sebum, which is secreted through the hair follicles. Sebum oils the skin and hair and forms an emulsion with water that retards water loss.
Dry skin results from the loss of water, not directly from loss of oil.
everywhere except palms and soles
most abundant is the scalp, forehad, face, and chin |
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Term
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Definition
eccrine glands-coiled tubes that open directly onto the skin surface and produce a dilute saline solution called sweat. Evaporation of sweat reduces body temperature, widely distributed and mature in 2 month old infant.
apocrine glands-produce a thick, milky secretion and open into the hair follicles. Mainly in axillae, anogenital area, nipples, and navel and are vestigial in humans. Bacterial flora on the skin surface react with apocrine glands to produce a characteristic musky body odor.
Active during puberty and with emotional and sexual stimulation |
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Term
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Definition
hard plates of keratin on the dorsal edges of the fingers and toes.
the lunula is the white opaque semilunar area at the proximal end of the nail. it lies over the nail matrix where new keratinized cells are formed |
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Term
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Definition
protection-minimizes injury from physical, chemical, thermal, and light wave sources
prevents penetration-is a barrier that stops invasion of microorganisms and loss of water and electrolytes within the body
perception-vast sensory suface
temperature regulation-sweat and subq
identification-everyone has unique characteristics
communication-emotions
wound repair-skin allows cell replacement of surface wounds
absorption and excretion-metabolic wastes, etc
production of vitamin D-ultraviolet light converts cholesterol into vitamin D |
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Term
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Definition
| hair follicles develop in the fetus at 3 months gestation. by midgestation most of the skin is covered with lanugo, the fine downy hair of the newborn infant. |
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Term
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Definition
| thick, cheesy substance made up of sebum and shed epithelial cells the newborn is covered in at birth |
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Definition
| sebaceous glands reduce in size until puberty, temperature regulation in ineffective. eccrine sweat glands do not secrete in response to heat until the first few months of life and then only minimally thoughout childhood, get cold easily and pigment system is inefficient at birth |
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Term
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Definition
linea nigra- the change in hormone levels results in increased pigment in the areolae and nipples, vulva, and sometimes in the midline of the abdomen, or in the face (chloasm
striae gravidarum-connective tissue develops increased fragility of the abdomen, breasts, or thighs |
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Term
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Definition
aging skin loses its elasticity, folds and sags, thin, lax, dry, and wrinkled
the stratum corneum thins and flattens, allows easier access to chemicals into the body
a loss of elastin, collagen, and subq fat occurs as well as a reduction and muscle tone.
sweat and sebaceous glands decrease in number and function (dry skin, temp reg) |
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Term
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Definition
| minor trauma may produce dark red discolored areas in the elderly |
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Term
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Definition
| the number of functioning melanocytes decrease, so the hair looks gray or white and feels thin and fine |
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Term
skin conditions found among blacks |
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Definition
keloids-scars that form at the site of a wound and grow beyond the normal boundaries of the wound
pigmentary disorders-areas of either postinflammatory hypopigmentation or hyperpigmentation that appear as dark or light spots
pseudofolliculitis-"razor bumps" or "ingrown hairs" caused by shaving too closely
melasma-the "mask of pregnancy" a patchy tan to dark brown discoloration of the face |
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Term
hair, skin, and nails
subjective data |
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Definition
previous history of skin disease (allergies, hives, psoriasis, eczema)
change in pigmentation
change in mole (size or color)
excessive dryness or moisture
pruritus
excessive bruising
rash or lesion
medications
hair loss
change in nails
environmental or occupational hazards
self-care behaviors |
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Term
previous history of skin disease |
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Definition
how was this treated
any family history of allergies or allergic skin problem
any know allergies to drugs, plants, animals
any birthmarks, tatoos |
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Term
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Definition
hyper-hypopigmentation
a generalized color change (all over or localized)
pallor, jaundice, cyanosis |
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Term
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Definition
any change in a mole: color, size, shape, sudden appearance of tenderness, bleeding, itching?-signs suggest neoplasm
any sore that do not heal |
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Term
excessive dryness of moisture |
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Definition
any change in the feel of your skin: temperature, moisture, texture
any excess dryness? is this seasonal or constant?
seborrhea-oily
xerosis-dry |
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Term
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Definition
any skin itching? is this mild (prickling, tingling) or intense (intolerable)
does it awaken you from sleep
where is the itching? when did it start?
any other skin pain or soreness? where? |
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Term
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Definition
any excess bruising? where on the body?
how did this happen?
how long have you had it? |
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Term
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Definition
any skin rash or lesion?
onset. when did you first notice it?
location. where did it start?
where did it spread
character or quality.describe the color
is it raised or flat? any crust, odor? does it feel tender or warm
duration. how long have you had it?
setting. work or home, camping, pet, new food, drug, stress
alleviating and aggravating factors. home care
associated symptoms. itching, fever
what do you think rash/lesion means
coping strategies
any new increased stress |
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Term
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Definition
what medications do you take
prescriptions and over-the counter
recent change
how long on medication |
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Term
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Definition
a gradual or sudden onset? symmetrical? associated with fever, illness, increased stress
any unusual hair growth
any recent change in texture, appearance
alopecia-significant loss
hirsutism-shaggy or excessive hair |
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Term
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Definition
| any change in nails:shape, color, brittleness? do you tend to bite or chew |
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environmental or occupational hazards |
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Definition
any hazard-related problems with your occupation, dyes, chemicals
hobbies
sun exposure
recent bites by insects
recent exposure to plants, animals in yard work, camping |
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Term
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Definition
what do you do to care for your skin, hair, nails
cosmetics, soaps, chemicals
clip cuticles, nails, false nails
environment control for allergies
skin-self exam |
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Term
| additional history for infant child, adolescent, aging adult |
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Definition
infant-jaundice, cyanosis, abuse
adolescent-skin problems
aging adult-changes in last few years |
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Term
objective data
equipment needed |
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Definition
strong direct lighting
small centimeter ruler
penlight
gloves
needed for special procedures:
wood's light(filtered uv light)
magnifying glass, for minute lesions
materials for laboratory tests:(KOH), glass slide |
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Term
| inspect and palpate the skin |
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Definition
color
temperature
moisture
texture
thickness
edema
mobility and turgor
vascularity or bruising
lesions |
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Term
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Definition
general pigmentation-vitiligo, freckles(ephelides), mole(nevus)-<6mm,
junctional nevi-kids, macular only,
compound nevi-young adults-macular and papular
birthmarks
widespread color change
pallor
erythema
cyanosis
jaundice |
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Term
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Definition
| when red-pink tones from the oxygenated hemoglobin in the blood are lost, the skin takes on the color of connective tissue, which is mostly white. ashen gray color in dark skin |
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Term
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Definition
| intense redness of the skin from excess blood(hyperemia) in dilated superficial capillaries. fever, local inflammation, emotional reactions occurs with polycythemia, venous stasis, carbon monoxide poisoning, and the extravascular presence of red blood cells(ecchymosis) |
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Term
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Definition
| bluish mottled color hat signifies decreased perfusion; the tissues are not adequately perfused with oxygenated blood indicates hypoxemia and occurs with shock, heart failure, chronic bronchitis, and congenital heart disease |
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Term
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Definition
| bluish mottled color hat signifies decreased perfusion; the tissues are not adequately perfused with oxygenated blood indicates hypoxemia and occurs with shock, heart failure, chronic bronchitis, and congenital heart disease |
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Term
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Definition
| exhibited by a yellow color, indicating rising amounts of bilirubin in the blood. first noticed in the junction of the hard and soft palate in the mouth and in the sclera. occurs with hepatitis, cirrhosis, sickle-cell disease, transfusion reaction, and hemolytic disease of the newborn |
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Term
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Definition
hypothermia-accompanies central circulatory problem such as shock
hyperthermia-increased metabolic rate |
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Term
| diaphoresis and dehydration |
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Definition
profuse perspiration
dehydration the mucous membranes and lips look dry |
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Term
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Definition
fluid accumulating in the intercellular spaces
1+ mild pitting, slight indentation, no perceptible swelling
2+ moderate pitting, indentation subsides rapidly
3+ deep pitting, indentation remains for a short time, leg looks swollen
4+ very deep pitting, indentation lasts a long time. leg is very swollen
edema is most evident in dependent parts of the body
masks normal skin color, can obscure pathological conditions |
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Term
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Definition
| mobility is decreased with edema poor turgor is evident in severe dehydration or extreme weight loss scleroderma-hard skin, connective tissue disorder |
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Term
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Definition
| small <1-5mm, smooth, slightly raised bright red dots that commonly appear on the trunk in all adults over 30 year old |
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Term
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Definition
| color elevation:flat, raised, pedunculated pattern or shape size-cm location and distribution on body any exudate primary-when a lesion develops on previously unaltered skin secondary-when a lesion changes over time or changes because of a factor such as scratching or infection |
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Term
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Definition
red macules from dilated blood vessels will blanch
petechiae do not blanch
blu-green flourescence indicate fungal infection |
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Term
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Definition
color
texture
distribution-tinea capitis, endocrine (genital hair)
lesions-lice |
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Term
inspect and palpate the nails
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Definition
shape and contour
-profile sign: clubbing
consistency
color-brown linear streaks can indicate melanoma
-capillary refill |
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Term
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Definition
| white hairline markings in the nail from trauma or picking at the cuticle |
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Term
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Definition
| common variation of hyperpigmentation in black, asian, american indian, and hispanic newborns. It is a blue-black to purple macular area at the sacrum or buttocks, but sometime occur on abdomen, thighs, shoulders, or arms |
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Term
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Definition
a large round or oval patch of light brown pigmentation, which is usually present at birth
6 or more each more than 1.5 cm are diagnostic of neirofibromatosis |
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Term
skin color change in neonates |
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Definition
-beefy red flush for first 24 hours due to vasomotor instability
-harlequin color change-when baby is side lying and lower half of body turns red and upper half blanches
-erythema toxicum- rash that appears in the first 3-4 days of life sometimes called the "fleabite" rash |
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Term
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Definition
| a newborn may have bluish color around the lips, hands and fingernails, and feet and toenails. may last for a few hours |
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Term
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Definition
transient mottling in the trunk and extremities in response to cooler room temperatures in newborn. forms a reticulated red or blue pattern over the skin.
persistant cutis marmorata occurs with down syndrome |
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Term
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Definition
| about half of newborns. A yellowing of the skin, sclera, and mucous membranes develops after 3-4 days because of increased numbers of red blood cells that hemolyze after birth. After 1st day may indicate hemolytic disease, after 2 weeks may indicate biliary tract obstruction |
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Term
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Definition
| a yellow-orange color in light-skinned persons but no yellowing in the sclera or mucous membrances. too much carotene |
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Term
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Definition
| tiny white papules on the cheeks, forehead, and across the nose and chin caused by sebum that occludes the opening of the follicles |
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Term
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Definition
| salmon patch-is a flat, irregularly shaped red or pink patch found on the forehead, eyelid, or upper lip but most commonly at the back of the neck |
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Term
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Definition
| liver spots, small, flat, brown macules |
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Term
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Definition
raised, thickened areas of pigmentation that look crusted, scaly, and warty.
looks dark, greasy, and "stuck on"-trunk, face, and hands-not cancerous |
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Term
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Definition
| red-tan scaly plaques that increase over the years to become raised and roughened. premalignant and may develop into squamous cell carcinoma |
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Term
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Definition
| skin tags, overgrowth of normal skin that form a stalk |
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Term
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Definition
| raised yellow papules with a central depression. forehead, nose, cheeks. have a pebbly look. |
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Term
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Definition
solely a color change, flat and circumscribed of less that 1 cm
ex: freckles, flat nevi |
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Term
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Definition
| macules that are larger that 1 cm |
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Term
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Definition
something you can feel. solid, elevated, circumscribed, less that 1cm
ex- elevated nevi |
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Term
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Definition
papules coalesce to form surface elevation wider that 1cm
ex: psoriasis |
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Term
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Definition
solid, elevated, hard or soft, larger than 1 cm. may extend deeper into dermis that papule
ex: xanthoma, fibroma |
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Term
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Definition
| larger than a few centimeters in diameter, firm or soft, deeper into dermis; may be malignant or benign |
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Definition
superficial, raised, and erythematous; slightly irregular shape due to edema
ex: mosquito bite, allergic reaction |
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Term
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Definition
| wheals coalesce to form extensive reaction, intensely pruritic |
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Term
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Definition
encapsulated fluid-filled cavity in dermis or subq layer, tensely elevating skin.
ex: sebaceous cyst, wen |
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Term
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Definition
elevated cavity containing free fluid, up to 1 cm, a blister. clear serum flows if wall is ruptured
ex; herpes |
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Term
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Definition
larger than 1cm, usually single chambered, superficial in epidermis'
ex: friction blister |
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Term
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Definition
turbid fluid (pus) in the cavity, circumscribed and elevated
ex: impetigo, acne |
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