Chapter 12; Skin, Hair, Nails. Exam 1.

Front 1

What are the three layers of the skin?

Back 1

epidermis, dermis, subcutaneous

Front 2

What are the appendages of the skin?

Back 2

-sweat glands
-sebaceous glands
-hair follicles
-nails

Front 3

Is the epidermis vascular or avascular?

Back 3

avascular

Front 4

Where does the epidermis get its nutrition?

Back 4

the dermis

Front 5

What are the two major areas of the epidermis?

Back 5

1. stratum germinatum-melanocytes and keratinocytes
2. stratum corneum-dead squamous cells containing keratin

Front 6

What is the structure of the dermis?

Back 6

vascular, connective tissue that supports the epidermis

Front 7

What two things does the dermis contain?

Back 7

1. sensory nerve fibers that transmit pain, touch and temp
2. autonomic motor nerves

Front 8

What is the structure of the subcutaneous tissue?

Back 8

loose connective tissue and adipose cells

Front 9

What isi the function of the subcutaneous tissue?

Back 9

insulation, shock absorption, calorie reserve

Front 10

What are the 6 functions of the skin?

Back 10

1. protects against microbes and minor trauma
2. slows fluid loss
3. excretes sweat, urea, lactic acid
4. provides sensory perception
5. helps regulate body temp
6. helps regulate blood pressure

Front 11

What six changes occur to the skin as a person ages?

Back 11

1. sebaceous and sweat gland activity decreases
2. epidermis thins and flattens
3.dermis vascularity and elasticity decreases *wrinkling
4. subcutaneous tissue lost
5. nails thicker, brittle, yellow, prone to splitting due to slow growth
6. hair turns gray

Front 12

What is vitiligo?

Back 12

absence of melanin pigment in patchy areas of white or light skin on parts of the body

Front 13

What is the mnemonic for abnormal characteristics of pigmented lesions?

Back 13

A-asymmetry
B-border
C-color variation
D-diameter
E-elevation or enlargement

Front 14

What are some collor changes that occur over the entire body?

Back 14

pallor (white)
erythema (red)
cyanosis (blue)
jaundice (yellow)

Front 15

What is pallor associated with?

Back 15

acute high stress states, cold, cigarette smoking, presence of edema, anemia, schock, arterial insufficiency

Front 16

What is erythema expected with?

Back 16

fever, local inflammation, emotional reactions, polycythemia, venous stasis, carbon monoxide poisoning, extravascular presence of red blood cells

(black ppl palpate for warmth)

Front 17

When might a person be cyanotic?

Back 17

hypoxemia that occurs with schokc, heart failure, chronic bronchitis, congenital heart disease, anemia

Front 18

What does jaundice indicate?

Back 18

rising amounts of bilirubin in the blood

Front 19

What might jaundice occur with?

Back 19

hepatitis, cirrhosis, sickle cell disease, transfusion reaction, hemolytic disease of the newborn

Front 20

What is the difference between a primary and secondary lesion?

Back 20

primary-lesion develops on previous unaltered skin

secondary-when a lesion changes over time or because of scratching or infection

Front 21

What characteristics are important to observe in lesions?

Back 21

1. color
2. elevation: flat, raised, pedunculated
3. pattern or shape: pattern may be characteristic of certain disease
4. size-in centimeters
5. location and distribution
6. any exudate;color and odor

Front 22

What hair changes accompany tinea capitiis?

Back 22

gray, scaly, well defined areas with broken hairs

Front 23

What occurs with hirsutism?

Back 23

excess body hair
-with females, indicates endocrine abnormalities

Front 24

Describe a macule and give an example.

Back 24

color change, flat, circumscribed, less than 1 cm. example is a freckle

Front 25

Describe a patch and give an example.

Back 25

same as a macule; color change, flat, circumscribed but greater than 1 cm
example is vitiligo, mongolian spot, cafe au lait spot, measles rash, CHLOASMA

Front 26

Describe a papule and give an example.

Back 26

something you can feel (solid, elevated, circumscribed, less than 1 cm diameter) that is caused by superficial thickening of the epidermis
example is a mole or WART

Front 27

Describe a plaque and give an example.

Back 27

papules coalesce to form surface elevation wider than 1 cm. plateau like, disk shaped lesion.
example is psoriasis, lichen planus

Front 28

Describe a nodule and give an example.

Back 28

a nodule is solid, elevated, hard or soft, larger than 1 cm. extends deeper into the dermis than a papule.
example: fibroma, xanthoma,INTRADERMAL NEVI

Front 29

Describe a tumor and give an example.

Back 29

larger than a few cm, firm or soft, deeper into dermis, benign or malignant
example: LIPOMA

Front 30

Describe a wheal and give an example.

Back 30

superficial, raised, transient, erythematous, irregular shape due to edema
example:

-mosquito bite

-OFTEN FROM ALLERGIC REACTION!!!!!, -dermographism

Front 31

Describe urticaria

Back 31

wheals that join to form an extensive reaction; extensively pruritic

EX: HIVES

Front 32

Describe a vesicle and give an example.

Back 32

elevated cavity containing free fluid, up to 1 cm, blister
example: herpes simplex, early VARICELLA, herpes zoster

Front 33

Describe a bulla and give an example.

Back 33

larger than 1 cm diameter, superficial in epidermis, ruptures easily
example: burn, friction BLISTER

Front 34

Describe a cyst and give an example

Back 34

encapsulated fluid filled cavity in dermis or subcutaneous layer
example: SEBACEOUS CYST, wen

Front 35

Describe a pustule and give an example.

Back 35

turbid fluid in the cavity, circumscribed and elevated
example: ACNE, IMPETIGO

Front 36

Describe a crust and give an example.

Back 36

dried exudate when vesicles or pustules burst. yellow, honey

example SCAB AFTER ABRASION or impetigo, weeping. IMPETIGO AFTER RUPTURED

Front 37

Describe a scale and give an example.

Back 37

raised piling of keratinized cells
example: eczema, DRY SKIN, dermattis, PSORIASIS

Front 38

Describe a fissure and give an example.

Back 38

linear split through epidermis to dermis
example: athletes foot, or corners of mouth (cheilosis)

Front 39

Describe erosion and give an example.

Back 39

depressed, moist, superficial, heals without scar

Front 40

Describe an ulcer and give an example.

Back 40

an ulcer is a deeper depression extending into the dermis, irregular shape, may bleed, leaves scar when heals
example: PRESSURE ULCER, stasis ulcer, sore chancre

Front 41

Describe excoriation and give an example

Back 41

self inflicted abrasion, superficial, scratches from intense itching
example: abrasion or scratch, SCRATCHING OF INSECT BITE

Front 42

Whatis a scar and give an example

Back 42

normal tissue is lost and replaced with connective tissue
example: HEALED AREA OF SURGERY, injury or acne

Front 43

Describe lichenification and give an example

Back 43

prolonged, intense scratching that eventually thickens skin and produces tightly packed set of papules; looks like moss

Front 44

Describe an atrophic scar and give an example.

Back 44

skin level is depressed with loss of tissue, thinning of epidermis.
example: striae

Front 45

What is a hypertrophic scar that is raised beyond the borders of a wound?

Back 45

keloid

Front 46

What are the four stages of a pressure ulcer?

Back 46

stage 1: intact skin is red but unbroken
stage 2:partial thickness skin erosion with loss of epidermis/dermis (looks like popped bilster)
stage 3: full thickness pressure ulcer that extends to subcutaneous tissue; resembles a crater
stage 4:full thickness pressure ulcer involving all skin layers and extends into supporting tissue. (bone)

Front 47

Keloid

Back 47

-skin is elevated by excess scar tissue; looks smooth, rubbery "clawlike". higher incidence with blacks

EX: HYPERTROPHIC SCAR

Front 48

What are the 3 vascular lesions?

Back 48

1. Port-wine satin (large flat macular patch on scalp or face, frequently along CN V)

2. strawberry mark (immature hemangioma)

3. carvenous hemagioma (mature)

Front 49

What are the 2 Telangiectases?

Back 49

1) spider or Star Angioma

2) Venous Lake

Front 50

What are the 2 Pupuric Lesions

Back 50

1) Petechiae (will not blanch)

2) Pupura

Front 51

Petechiae

Back 51

-(will not blanch) (tiny punctate hemmorhages, 1 to 3mm, round & discrete dark red purple or brown

-may indicated abnormal clotting factors

-w/ dark skin look for areas like abdomen, and forearm (if too dark then you can see them)

Front 52

Purpura

Back 52

confluent and extensive patch of petechiae and echymoses GREATER than 3mm flat, red to purple