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SKIN
SKIN
159
Medical
Graduate
11/24/2011

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Term
Epidermis:  outer--> inner
Definition
corneum, lucidum, granulosum, germinativum
Term
stratum corneum
Definition
consists of closely packed, dead squamous cells that contain the water proofing protein keratin.
Term
lies below the dermis and connects epidermis to dermis
Definition
basement membrane
Term
epidermis=
Definition
stratum corneum and cellular stratum
Term
keratin cells are formed
Definition
in the deepest sublayer of the cellular stratum, the stratum germinativum.
Term
keratin cells are synthesized here
Definition
celluar stratum
Term
richly vascularized connective tissue layer of the skin that supports and separates the epidermis from the cutanous adipose tissue
Definition
dermis
Term
stratum lucidum
Definition
only present in thicker skin of the palms and soles and lies just below the stratum corneum.
Term
protects the body against harmful environmental subtances and restricts water loss
Definition
stratum corneum
Term
keratinocytes mature as they make their way to the surface through the stratum spinosum and stratum granulosum to replace the cells in the
Definition
stratum corneum
Term
melanocytes can be found in the
Definition
stratum germinativum
Term
sensory nerve fibers located here form a complex network to provide sensations of pai, touch, and temperature.
Definition
dermis
Term
dermis is connected to underlying organs by this
Definition
hypodermis
Term
this layer contains autonomic nerves that innervate blood vessels, glands, and the arrectores pilorum muscles.
Definition
dermis
Term
subcutaneous layer that consists of loose connetive tissue filled with fatty cells.
Definition
hypodermis
Term
eccrine sweat glands are located
Definition
everywhere except, lip margins, eardrums, nail beds, inner surface of the prepuce and glans penis.
Term
these glands open directly onto the surafce of the skine and regulate body temperature through water secretion
Definition
eccrine sweat glands
Term
apocrine glands
Definition
specialized structures found only in the axillae, nipples, areolae, anogenital area, eyelids, and external ears.
Term
apocrine secretions
Definition
odorless (Body odor is produces by bacterial decomposition of apocrine sweat).
Term
sebum
Definition
lipid-rich substance that keeps the skin and hair from drying out.
Term
which is deeper, apocrine or eccrine
Definition
apocrine=larger and deeper than eccrine.
Term
hair is formed by what kind of cells that invaginate into the dermal layers
Definition
epidermal cells
Term
stimulated by sex hormones
Definition
sebaceous secretory activity.
Term
vellus hair
Definition
short, fine, soft and nonpigmented.
Term
loop of capillaries at base of follicle that supplies nourishment for growth. 
Definition
hair papilla
Term
terminal hair
Definition
coarser, longer, thicker, and usually pigmented.
Term
telogen
Definition
rest
Term
epidermal cells converted to hard plates of keratin
Definition
nails
Term
catagen
Definition
atrophy
Term
site of nail growth
Definition
nail matrix
Term
anagen
Definition
growth
Term
this is highly vascularized and lies beneath the nail plate, giving the nail its pink color.
Definition
nail bed
Term
stratum corneum layer of skin covering the nail root
Definition
cuticle
Term
soft tissue surrounding the nail border
Definition
paronychium
Term
skin of infants and children appears smoother than that of adults
Definition
partly because of the relative absence of coarse terminal hair and partly because the skin has not been subjected to years of exposure to the elements.
Term
mixture of sebum and cornified epidermis, covers infant's body at birth
Definition
vernix caesosa
Term
poorly developed in newborns, predisposing them to hypothermia
Definition
subcutaneous fat layer
Term
lanugo
Definition
Fine, silky hair, that which the newborn's body is covered in, particularly the shoulders and back. 
Term
most of newborn's head hair is shed by about
Definition
2-3 months
Term
after the newborn's head hair is shed (2-3 months after birth) it is replaced by
Definition
more permanent hair with a new texture and often a different color
Term
apocrine function is absent in newborns, giving the skin
Definition
a less oily texture and resulting in characteristic inoffensive perspiration.
Term
eccrine sweat glands begin to function
Definition
after the first month of life.
Term
during adolscence the apocrine sweat glands enlarge and become active causing
Definition
axillary sweating and sometimes body odor.
Term
sebaceous glands increase sebum (in adolescents) in response to
Definition
increased hormone levels, primarily androgens, giving the skin an oily appearance and predisposing the individual to acne. 
Term
coarse terminal appears in the axillae and pubic areas
Definition
of both males and females and on the faces of males.
Term
in pregnant women, increased blood flo to the skin, especially that of the hands and feet, results from
Definition
peripheral vasodilation and increased numbers of capillaries.
Term
this percentage of women have some degree of skin darkening beginning in early pregnancy
Definition
90%
Term
these three mechanisms assists in dissipating the excess heat caused by the increased metabolism during pregnancy
Definition

1) peripheral vasodilation

2) increased number of capillaries

3) acceleration of sweat and sebaceous gland activity

Term
the skin of older adults becomes drier with less perspiration produced due to
Definition
a decreae in sebaceous and sweat gland activity
Term
the epidermis folds and assumes a wrinkled appearance in older adults because
Definition
the dermis becomes less elastic, loses collagen, and elastic fibers, and shrinks.  This causes the epidermis to fold and assume a wrinkled appearance.
Term
the joints and bony prominences of older adults have a sharp and angular appearance due to
Definition
a decrease in subcutaneous tissue, particularly in the extremities.
Term
grey hair results from a decrease in the number of
Definition
functioning melanocytes
Term
transitions from vellus to terminal hair occurs in the hair of
Definition
the nares and the tragus of men's ears.
Term
increased risk of developing melanoma
Definition
those with fair skin and light eyes
Term
those with fair skin, freckled, ruddy complexions
Definition
are at high risk of developing basal cell carcinoma
Term
daylight produces the best illumination for
Definition
determining color variations, particularly jaundice
Term
how long before sun exposure should one apply sunscreen
Definition
15-20 minutes
Term
reapply sunscreen after swimming and how long after exposure
Definition
reapply 2-3 hours after exposure
Term
tangential lighting is helpful in
Definition
assessing contour
Term
pay careful attention to intertriginous surfaces, especially in
Definition
older adults and bedridden patients
Term
inspect the skin and mucous membranes (especially oral) for
Definition
odor and uniform appearane, thickness, symmetry, hygiene and the presence of any lesions
Term
coining
Definition
coin dipped in mentholated oil is vigorously rubbed across the skin in a prescribed manner, casing a mild dermabrasion.
Term
cupping
Definition
series of small, heated glasses are placed on the skin, forming a suction that leaves a red or purpuric circular mark
Term
(skin thickness varies over the body) with the thinnest skin on the
Definition
eyelids and the thickest at areas of pressure or rubbing, most notably the soles, palms, and elbows.
Term
corns are found
Definition
in pressure points
Term
soft corns
Definition
caused by the pressure of a bony prominence against softer tissue --> appear as whitish thickenings, commonly between the 4th and 5th toes
Term
hard corns
Definition
sharply dilineated and have a conical appearance
Term
hard corns occur
Definition
most often over bony prominences where pressure is exerted, such as from shoes pressing on the interphalangeal joints at the toes.
Term
less well demaracted than corns and usually are not tender
Definition
calluses
Term
skin color may be masked by
Definition
cosmetics and tanning agents
Term
nevi occur most often
Definition
in lighter-skined individuals than in darker-skinned individuals
Term
Wood's lamp
Definition
used to view fluorescing, hypopigmented or hyperpigmented lesions
Term
occur on the upper back in men and on the legs in women
Definition
dysplastic nevi
Term
border more irregular, lesions tend to e larger, often greater than 6mm
Definition
melanoma
Term
dysplastic nevi (atypical moles) occur predominantly
Definition
on the trunk
Term
normal mole
Definition
usually less than 6mm, uniformly tan or brown, clearly defined border
Term
dysplastic mole
Definition
mixture of tan, bron, black and red/pink, irregular borders, often larger than 6mm and sometimes larger than 10mm
Term
a bluish hie of the lips and gums can be a normal finding in persons with
Definition
dark skin
Term
discolorations produced by injuries
Definition
ecchymoses
Term
discolorations produced by mechanisms other than injury
Definition

petechiae when smaller than .5 cm in diameter

purpura when larger than .5 cm in diameter

Term
localized redness
Definition
inflammatory process
Term
pale shiny skin of the lower extremities
Definition
may reflect hanges that occur with systemic diseases such as diabetes mellitus and cardiovascular disease
Term
telangiectasis
Definition
permanently dilated, small blood vessels consisting of venules, capillaries, or arterioles
Term
spider angiomas
Definition
arterial, and when blanched, will refull in a very organized way, from the center out and evenly in all directions
Term
capillary spiders
Definition
little masses of venules, and when blanched will refill in an erratic, not-at-all organized way.
Term
pituitary, adrenal, liver disease
Definition
generalized darkening of melanin pigment
Term
dampest areas
Definition
palms, scalp, forehead, axillae
Term
vitiligo
Definition
localized absence of melanin
Term
tuberculosis lymphadenitis (scrufola)
Definition
stale beer
Term
increased carotene pigmentation (yellow)
Definition
hypothyroidism, increased intake of vegetables containing carotene
Term
nevi, neurofibromatosis, albinism, vitiligo
Definition
(white) absence of melanin
Term
should evidence minimal dampnes
Definition
intertriginous areas
Term
albinism
Definition
general absence of melanin
Term
anaerobic infection; scurvy
Definition
putrid
Term
rotten apple
Definition
clostridium gas gangrene
Term
proteus infection
Definition
mousy
Term
phenylketonuria
Definition
mousy, musty
Term
pseudomonas infection (espcially burns)
Definition
grapelike
Term
hyperkeratoses, especially of the palms and soles
Definition
may be the sign of a systemic disorder such as arsenic or other toxic exposure
Term
the peak hours for harmful UV radiation
Definition
10am-4pm
Term
genetically predisposed men often display a gardual symmetric hair loss on the scalp during adulthood as a response to
Definition
androgens
Term
fluid-filled lesions will
Definition
transilluminate with a red glow. 
Term
solid lesions
Definition
will not transiluminate
Term
turgor will be altered if the patient is
Definition
substantially dehydrated or if edema is present
Term
turgor is decreased in a dehydrated patient as evidenced by
Definition
the pinched skin's failing to spring back to place after release
Term
scleroderma
Definition
affects skin mobility
Term
wood's lamp
Definition
can be used to evaluate epidermal hypopigmented or hyperpigmented lesions and to distinguish fluorescing lesions
Term
indicative of the presence of some types of fungal infection
Definition
yellow-green fluorescence
Term
secondary lesions
Definition
those that result from later evolution of or external trauma to a primary lesion
Term
primary lesion
Definition
occur as initial spontaneous manifestations of a pathologic process
Term
asymmetric hair loss may indicate
Definition
a pathologic condition
Term
hirsutism
Definition
growth of terminal hair in a male distribution pattern on the face, body and pubic area
Term
hirsutism
Definition
growth of terminal hair in a male distribution pattern on the face, body and pubic area
Term
peeling nails (from the plate splitting into layers) are usually found in individuals whose
Definition
hands are subject to repeated water immersion
Term
yellowing of nails
Definition
psoriasis, fungal infections, chronic respiratory disease
Term
proximal subungal fungal infection
Definition
associated with HIV infection
Term
diffuse darkening of the nails
Definition
may arise frm antimalarial drug therapy, candidal infection, hyperbilrubinemia, and chronic trauma (tight-fitting shoes).
Term
single blue or black nail may indicate
Definition
melanoma, or bruising/bleeding from trauma
Term
green-black discoloration (nails)
Definition
pseudomonas (may be confused with similar discoloration caused by injury tothe nail bed) subungal hematoma
Term
wilson disease
Definition
inherited disorder of copper metabolism (blue nails)
Term
blue nails
Definition
Wilson disease (inherited disorder of copper metabolism), silver poisoning, medication side effects
Term
separation of the nail plate from the bed produces
Definition
a white, yellow, or green tinge on the nonadherent portion of the nail
Term
anonychia
Definition
complete absence of the nail (may be congenital)
Term
longitudinal white streaks or transverse white bands
Definition
systemic disorder (need to be distinguished from white spots=cuticle manipulation, mild trauma)
Term
splinter hemorrhages
Definition
longitudinal red or brown streaks (endocarditis, vasculitis, severe psoriasis, minor injury to proximal nail fold)
Term
nail will grow out and assume normal appearance
Definition
in about 6 months
Term
depressions that occur in all the nails are usually
Definition
a response to systemic disease (syphillis, high fever disorders, peripheral vascular disease, uncontrolled diabetes mellitus)
Term
pain in the area of a nail groove
Definition
may be secondary to ischemia
Term
nail base angle should measure
Definition
160 degrees
Term
curvature is most common
Definition
in the toenails and is thought to be caused by shoe compression
Term
pitting
Definition
most commonly seen with psoriasis
Term
clubbing
Definition
angle of nail base increases and approaches or exceeds 180 degrees
Term
thickening of the nail
Definition
tight-fitting shoes, chronic trauma, fungal infections
Term
clubbing associated with
Definition
a variety of respiratory diseases and cardiovascular diseases, cirrhosis, colitis and thyroid disease.
Term
boggy nail accompanies
Definition
clubbing
Term
faun tail nevus
Definition
lumbosacral hair tuft overlying spinal column (spina bifida occulta)
Term
less subcutaneous fat the
Definition
redder and more transparent the skin
Term
acrocyanosis
Definition
cyanosis of the hands and feet
Term
cutis marmorata
Definition
transient mottling when infant is exposed to decreaed temperature
Term
physiologic jaundice
Definition
mild degree in 50% of newborns, starts after 1st day, persists 8-10 days (but maybe 3-4 weeks)
Term
salmon patches (stork bites)
Definition
flat, deep pink localized areas usually seen on the mid-forehead, eyelids, upper lip and back of neck
Term
mongolian spots
Definition
irregular areas of deep blue pigmentation, usually in the sacral and gluteal regions (african, native american, asian, latin)
Term
erythema toxicum
Definition
pink papular rash with vesicles superimposed on thorax, back, buttocs, and abdomen; may appear in 24-48 hours and resolves after several days
Term
supernumerary nipples
Definition
may be associated with renal abnormalities.  congenital accessory nipples with or without glandular tissue, located along the mammary line
Term
NF-1, neurofibromatosis diagnosis includes
Definition
6 or more cafe-au-lait macules more than 5 mm in greatest diameter in prepubescent individuals or more than 15 mm in greatest diameter after puberty.
Term
milia
Definition
small whitish, discrete papules on the face (commonly found during 1st 2-3 months of life)
Term
striae gravidarum
Definition
stretch marks, may apear over the abdomen, thighs and breasts during the 2nd trimester of pregnancy (fade but never really disappear)
Term
acne vulgaris
Definition
may be aggravted during the 1st trimester but often improves in the 3rd trimester
Term
cutaneous tags
Definition
acrochordan= small, soft tags of skin, usually appearing on the neck and upper chest
Term
in older adults, turgor
Definition
 may not be a reliabe or valid estimate of hydration status
Term
purpura, particularly dorsal surfaces or hands and lower arm that get tapped or bumped
Definition
is commonly seen in older adults on aspirin therapy
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