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Unit 14 - Hair Skin and Nails
Test 4
112
Nursing
Undergraduate 3
04/21/2014

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Term
What is the body's largest organ system?
Definition
The skin
Term
What are the 2 basic layers of the skin?
Definition
Epidermis
Dermis
Term
What layer of cells forms the new skin cells of the epidermis?
Definition
Basal
Term
What kind of tissues are in the dermis
Definition
Connective, collagen, elastin
Term
What are the epidermal appendages?
Definition
Hair
Sebaceous glands
Sweat glands
Nails
Term
What is a eccrine gland?
Definition
the major sweat glands of the human body, found in virtually all skin.[4] They produce a clear, odorless substance, consisting primarily of water and NaCl (
Term
What is an apocrine gland?
Definition
Apocrine glands, on the other hand, produce a milky fluid that most commonly is secreted when you're under emotional stress. This fluid is odorless until it combines with bacteria found normally on your skin.
Term
What are the structures of a nail?
Definition
-Posterior nail fold
-Cuticle
-Lunula
-Lateral nail fold
-Nail plate
-Nail matrix
-Nail bed
Term
What is the fxn of skin?
Definition
Protection from environment
Prevents penetration
Perception
Temperature regulation
Identification
Communication
Wound repair
Absorption and excretion
Production of vitamin D
Term
What are some important HHQ to ask when assessing skin, hair and nails?
Definition
Past history of skin disease, allergies, hives, psoriasis, or eczema?
Change in pigmentation or color?
Change in mole size, shape, color, tenderness?
Excessive dryness or moisture?
Pruritus or skin itching?
Excessive bruising?
Rash or lesions?
Medications: prescription and over-the-counter?
Hair loss?
Change in nails’ shape, color, or brittleness?
Environmental or occupational hazards?
Self-care behaviors?
Term
What else should be asked of children and infants?
Definition
Does child have any birthmarks?
Any change in skin color as a newborn?
Physiologic jaundice?
Cyanosis?
Does child have any rash or sores?
Does child have diaper rash?
Does child have any burns or bruises?
Where?
How did it happen?
Has child been exposed to:
Contagious skin conditions: scabies, impetigo, lice?
Communicable diseases: measles, chicken pox, scarlet fever?
Toxic plants: poison ivy?
Does child have habits such as nailbiting or twisting hair?
What steps are taken to protect child from sun exposure?
Term
What else should be asked of adolescents?
Definition
Skin problems such as pimples, blackheads?
Term
What else should be asked of aging adults?
Definition
What changes have you noticed in your skin in last few years?
Any delay in wound healing?
Any change in feet: toenails; bunions, wearing shoes?
Falling: bruises, trauma?
History of diabetes or peripheral vascular disease?
Term
What should you focus on first when assessing the skin?
Definition
Scrutinize the outer skin surface first before you concentrate on underlying structures
Term
What should you do for areas with skin folds?
Definition
Separate intertriginous areas (areas with skinfolds) such as under large breasts, obese abdomen, and groin and inspect them thoroughly. They are perfect conditions for irritation and infection.
Term
Always inspect _______, _______, and between _______.
Definition
Feet, toenails and between toes.
Term
Should the skin be looked at in different sections or one entity?
Definition
1 entity.
Term
What should you do if someone has a rash?
Definition
check all areas of body as you cannot rely on the history that rash is in only one location
Term
What should you note when looking at skin COLOR?
Definition
color change over entire body skin, such as pallor (pale), erythema (red), cyanosis (blue), or jaundice (yellow)
Note if color change transient or due to pathology
Term
What influences skin color?
Definition
emotional states, temperature, cigarette smoking, prolonged elevation/dependent position of extremities, and prolonged inactivity
Term
What should you use to feel body temperature?
Definition
Use backs of hands to palpate person
Skin should be warm, and temperature equal bilaterally; warmth suggests normal circulatory status
Hands and feet may be slightly cooler in a cool environment
Term
What are the 2 states of irregular body temperature?
Definition
Hypothermia
Hyperthermia
Term
What are the 2 states of irregular body moisture?
Definition
Diaphoresis
Dehydration
Term
What are you feeling for when palpating the skin?
Definition
Texture
Thickness
Edema
Mobility and turgor
Vascularity or bruising
Term
What should raise concerns about physical abuse?
Definition
Multiple bruises at different stages of healing and excessive bruises above knees or elbows
Term
Where are needle marks visible?
Definition
may be visible on antecubital fossae, forearms, or on any available vein
Term
If there are lesions, what should be noted?
Definition
Color
Elevation
Pattern or shape
Size
Location and distribution on body
Any exudate: note color and odor
Use a Wood’s light (ultraviolet light filtered through special glass) to detect fluorescing lesions
Term
What should you note when inspecting/palpating the hair?
Definition
Color
Texture
Distribution
Lesions
Term
What should you note when palpating and inspecting the nails?
Definition
Shape
Contour
Consistency
COlor
Capillary Refill
Term
Where do you view the contour of the nail?
Definition
view index finger at its profile and note angle of nail base; it should be about 160 degrees
Term
How do you check capillary refill?
Definition
Depress nail edge to blanch and then release, noting return of color; indicates status of peripheral circulation
Color return is normally instant
Term
What is sluggish capillary refill
Definition
longer than 1-2 seconds
Term
What should be taught about suspicious lesions?
Definition
A - Asymmetrical
B - Border
C - Color
D - Diameter
E - Elevation/Enlargement
Term
What is an annular/circular lesion?
Definition
Begins in center and spreads to periphery.

RINGWORM, TINEA CAPITIS
Term
What is confluent lesions?
Definition
Lesions run together
Term
What is discrete?
Definition
Distincit, individual lesions that remain separate
Term
What is gyrate?
Definition
Twisted, coiled, spiral, snakelike
Term
What is grouped?
Definition
Cluster of lesions
Term
What is linear?
Definition
Scratch, streak line, or stripe.
Term
What is target?
Definition
Iris. Resembles an iris of an eye. Concentric rings of color in the lesions.
Term
What is zostiform?
Definition
Linear arrangement along a unilateral nerve route

HERPES ZOSTER AKA SHINGLES
Term
What is polycyclic?
Definition
Annular lesions grow together
Term
What is a macule?
Definition
Color change. Flat, circumscribed, less than 1 cm.
Term
What is a papule?
Definition
Solid, elevated, circular, circumscribed, less than 1 cm.
Term
What is a patch?
Definition
Macules that are larger than 1 cm
Term
What is plaque?
Definition
Papules coalesce to form surface elevation wider than 1 cm.
Term
What is a nodule?
Definition
Solid, elevated, hard or soft, larger than 1 cm.
Term
What is a wheal?
Definition
Superficial, raised, transient, and erythematous, slightly irregular shape due to edema.
Term
What is a tumor?
Definition
larger than a few centimeters, firm or soft, deeper into dermis. can be benign or malignant.
Term
What is a urticaria/hive?
Definition
Wheals coalesce to form extensive reaction
Term
What is a vesicle?
Definition
Elevated cavity containing free fluid up to 1 cm. Clear serum flows if busted.
Term
What is a cyst?
Definition
Encapsulated fluid-filled cavity in dermis/subq layer tensely elevating skin.
Term
What is a bullas?
Definition
Larger than 1 cm in diameter, usually single chambered, superficial in epidermis, it is thin walled so it ruptures easily.
Term
What is a pustule?
Definition
Turbid fluid in the cavity. Circumscribed and elevated. Acne.
Term
What is crust?
Definition
Thickened, dried out exudate left when vesicles/pustules burst or dry up. Color can be red/brown, honey, yellow, depending on the fluids ingredients.
Term
What is scales?
Definition
Compact, desiccated flakes of dry or greasy skin silvery or white from shedding of dead skin cells
Term
What is a fissure?
Definition
Linear crack with abrupt edges, extends into dermis, dry or moist.
Term
What is an erosion?
Definition
Scooped out but shallow depression. Superficial epidermis lost but no bleeding heals w.o scar
Term
What is an ulcer?
Definition
Deeper depression extending into dermis. Irregular shape may bleed leaves scar
Term
What is an excoriation?
Definition
Self inflicted abrasion, superficial, sometimes caused by intense scratching
Term
What is a scar?
Definition
After a lesion is repaired normal tissue is lost and replaced with connective tissue.
Term
What is an atrophic scar?
Definition
The resulting skin level is depressed with a loss of tissue, thinning of the epidermis.
Term
What is lichenification?
Definition
Prolonged intense scratching eventually thickens skin and produces tightly packed sets of papules
Term
What is a keloid?
Definition
Hypertrophic scar that is elevated by excess scar tissue which is invasive beyond the site of original injury.
Term
What is a port wine stain?
Definition
A large flat macula patch covering the scalp or face. Cranial nerve 5. dark red/bluish or purplish and intensifies with crying, exertion, or exposure to heat.cold.
Term
What is a strawberry mark?
Definition
Raised bright red area with well defined borders about 3 cm in diameter. Does not blanch with pressure
Term
What is cavernous hemangioma?
Definition
Reddish blue irregular shaped solid and spongey mass of blood vessels.
Term
What is telangiectasia?
Definition
Spider veins. Caused by vascular dilation. Permenantly enlarged and dilated blood vessels that are visible on skins surface.
Term
What is spider/star angioma?
Definition
Fiery red star-shaped marking with a solid circular center.
Term
What is venous lake?
Definition
Blue/purple dilation of venues and capillaries in a star shaped linear or flaring pattern.
Term
What is petechiae?
Definition
Tiny punctuate hemorrhages 1-3 mm round and dark red, purple, or brown in color .
Term
What is purpura?
Definition
Confluent and extensive patch of petechiae and ecchymosis > 3 mm flat, red to purple, macular hemorrhage.
Term
What is pattern injury/
Definition
A bruise or wound whose shape suggests an instrument or weapon that caused it. (belt, broom, cigarette etc.)
Term
What is a hematoma?
Definition
A bruise you can feel, elevates skin and is seen as swelling. Occurs w. petechiae and purpura may occur on the face w/ prolonged crying.
Term
What is contusion?
Definition
Mechanical injury results in a hemorrhage into tissues.
Term
Why is a contusion different then echymosis?
Definition
Contusion is caused by TRAUMA, ecchymosis is nOT!
Term
What is diaper dermatitis?
Definition
red moist maculopapular patch with poorly defined borders in diaper area extending along inguinal and gluteal folds.
Term
What is interigo?
Definition
Scalding red moist patches with sharply demarcated borders some loose scales.
Term
What is impetigo?
Definition
Moist, thin roofed vesicles with thing erythmatous base.
Term
What is atopic dermatitis?
Definition
Eczema. Erthymatous papules and vesicles with weeping, oozing, and crusts.
Term
What is measles?
Definition
Red-purple maculopapular blotchy rash that appears on the 3/4 day of illness. On face first then spreads to trunk. Koplik's spots in mouth
Term
What is german measles?
Definition
Pink, papular rash that first appears on face then spreads. There is lymphadenopathy and absence of koplick's spots.
Term
What is chicken pox?
Definition
Small, tight, vesicles first appear on trunk and then spread to arms and legs.
Term
What is primary contact dermatitis?
Definition
Local inflammatory reaction to an irritant in the environment or an allergy.
Term
What is an allergic drug rxn?
Definition
Erythmatous and symmetric rash that is usually generalized
Term
What is tinea corporis
Definition
Ringworm of the body. scales on chest, abdomen, back of arms forming multiple circular lesions w/ clear centers
Term
What is tinea pedis?
Definition
Ringworm of foot. Atheletes foot. Fungal infection that first appears as small vesicles between toes, sides of feet, and soles then grows scaly and hard.
Term
What is psoriasis?
Definition
scaly, erythmatous patch with silvery scales on top. Usually on scalp, elbows, knees, lower back, and anogenital area.
Term
What is tinea versicolor?
Definition
Fine scaling round patches of pink, tan, or white that do not tan in the sun
Term
What is labial herpes simplex?
Definition
Cold sores. Tight vesicles followed by pustules and then cullers.
Term
What is shingles?
Definition
Small grouped vesicles emerge along routes of cutaneous sensory nerves then pustules, then crusts.
Term
What is erythema migraines of lyme?
Definition
Bull's eye red macular papular rash. Radiates from tick bite.
Term
What are the malignant skin lesions?
Definition
Basal cell carcinoma
Squamous cell carcinoma
Malignant melanoma
Metastic malignant melanoma
Term
What is Kaposi's sarcoma?
Definition
AIDS related lesion.
A vascular tumor is most common tumor in persons infected with HIV
Considered an AIDS-defining illness
Can occur at any stage of HIV infection
Term
What is seborrheic dermatitis?
Definition
Thick yellow white greasy adherent scales with mild erythema on scalp and forehead very common in infancy
Term
What is tinea capitis?
Definition
Rounded patchy hair loss on scalp leaving broken off hairs, pustules, and scales on skin.
Term
What is toxic alopecia?
Definition
Patchy, asymmetric balding that accompanies severe illness or use of chemotherapy where growing hairs are lost and resting hairs are spared.
Term
What is alopecia areata?
Definition
Sudden appeared of sharply circumscribed round and balding patch.
Term
What is traumatic alopecia?
Definition
Linear oval patch of hair loss along hair line, a part of scattered distribution caused by trauma from hair rollers etc.
Term
What is trichotillomania?
Definition
Traumatic self induced hair loss caused by twisting/plucking
Term
What is pediculosis capitis?
Definition
Irching of scalp caused by nits.
Term
What is folliculitis?
Definition
Superficial infection of the hair follicles
Term
What is hirsutism?
Definition
Excess body hair in females forming male sexual astern
Term
What is a furuncle/abcess?
Definition
Red swollen hard tender pus filled lesion caused by acute localized bacterial infection
Term
What is scabies?
Definition
Intensely prutitic contagion caused by scabies mite.
Term
What is paronychia?
Definition
Red swollen tender inflammation of the nail folds.
Term
What is beau's line?
Definition
Transverse furrow/groove
Term
What is splinter hemorrhage?
Definition
Red brown linear streaks that occur with subacute bacterial endocarditis
Term
What is late clubbing?
Definition
Inner edges of nails elevates, nail bed angle is greater than 180 degrees.
Term
What is onycholysis?
Definition
Slow persistant fungal infection of fingernails and toe nails in older adults. Cuases change in color texture thickness and crumbling/breaking
Term
What is pitting?
Definition
Sharply defined and crumbling of the nails with distant attachment often occurring w/ psoriasis
Term
What is habit-tic dystrophy?
Definition
Depression down middle of the nail or multiple ridges caused by continuous picking of cuticle by another finger of the same hand
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