Health Assessment 1

Front 1

Hemagioma

Back 1

strawberry, cavernous, salmon patch, port wine, Bright red, raised lesion 2-10cm irregular shaped macular patch, Does not blanch w/pressure, Present at birth, some disappear by age 3, Superficial or deep

Front 2

Strawberry mark (immature hemangioma)

Back 2

Bright red well-defined 2-3 cm, Does not blanch, Immature superficial capillaries, Present at birth or first few mos, usually disappears 5-7 yrs, Most common, neck and face, No treatment required

Front 3

Cavernous hemangioma (Mature)

Back 3

Reddish-blue, irregular shaped, solid, spongy mass blood vessels, May be present at birth, may enlarge during first 10-15 mos, Not involute spontaneously; deep capillaries

Front 4

Stork bites (Salmon Patches)

Back 4

common 30-50% newborns

Front 5

Port-Wine Stain (Nevus Flammeus) hemangioma

Back 5

Flat, irregular shaped lesion ranging in color from pale red to deep purple-red, Color deepens w/exertion, emotional response, or exposure to extremes of temperature, Present at birth, typically does not fade. Those on face associated with rare Sturge-Weber Syndrome (seizures, one sided paralysis or weakness, learning disabilities)

Front 6

Mongolian blue spot

Back 6

Benign flat congenital birthmark with wavy borders and irregular shape, Common Native Americans, Asian, Hispanic, East African

Front 7

Telangiectasias

Back 7

widely open (dilated) blood vessels in the outer layer of the skin

Front 8

Spider Angioma (arterial)

Back 8

Flat, bright red dot with tiny radiating blood vessels ranging in size from pinpoint to 2cm, Central pressure blanches legs, Liver disease, Vit B def, idiopathic origin, pregnancy

Front 9

Venous Lake (Star)

Back 9

Flat blue lesion with radiating, cascading or linear veins extending from center, Central pressure does not blanch legs

Front 10

Petechiae punctate hemorhages into skin

Back 10

Flat red or purple rounded, 1-3mm, Does not blanch. Thrombocytopenia, subacute bacterial endocarditis other septicemias

Front 11

Purpura extravasation of blood into skin; confluent patch petechiae & ecchymosis

Back 11

Flat, reddish blue, irregular shaped extensive patches of varying size >3mm, Does not blanch, Thrombocytopenia, scurvy, minor trauma (bumps in ankle)

Front 12

Ecchymosis

Back 12

(Bruise, Contussion) extravasation of blood into skin layer, Flat, irregular shaped lesion varying size with no pulsation, Does not blanch with pressure, Light skinned ... Red-blue or purple immediately w/in 24hrs, Blue to purple, Blue to green, Yellow, Brown to disappears, Dark skinned, Deep, dark purple initially

Front 13

Hematoma

Back 13

Raised, irregular shaped lesion similar to ecchymosis except it elevated the skin and looks like a swelling

Front 14

Macule

Back 14

<1cm, Flat circumscribed area, nonpalpable change in skin color, Freckles (lentigines), flat moles nevi, measles, petechiae, scarlet fever

Front 15

Patch

Back 15

>1cm, Flat nonpalpable, irregular shaped large macule, Mongolian spot, port-wine stains, vitiligo, chloasma, tinea versicolor

Front 16

Papule

Back 16

<1cm, Elevated firm, circumscribed area, palpable, Elevated mole, wart, lichen planus, basal cell CA, kaposi sarcoma

Front 17

Plaque

Back 17

>1cm, Elevated, firm rough lesion with flat top surface, palpable, psoriasis, seborrheic & actinic keratosis, lichen planus

Front 18

Nodule

Back 18

<2cm, Elevated firm, circumscribed lesion, solid, hard or soft palpable mass deeper in dermis than papule, Small lipoma, squamous cell carcinoma, fibroma, intradermal nevi

Front 19

Tumor

Back 19

>2cm, Elevated solid lesion may or may not be clearly demarcated, deeper in dermisLarge lipoma, carcinoma, hemangioma

Front 20

Vesicle

Back 20

<1cm, Elevated, circumscribed, superficial, thin translucent walls, not in dermis; filled w/serous fluid, Herpes simplex/zoster, early chickenpox, poison ivy, small burn blister

Front 21

Bulla

Back 21

>1cm, Vesicle larger than 1cm, Contact dermatitis, friction blister, large burn blister

Front 22

Wheal/Hive: raised, superficial temporary

Back 22

Elevated, reddish w/irregular border, diffuse fluid in tissue, cutaneous edema, solid, transient variable diameter,Insect bite, urticaria (hives), allergic reaction

Front 23

Pustule

Back 23

Elevated, superficial lesion puss-filled vesicle/bulla, circumscribed border, Acne, impetigo, carbuncles (large boils), folliculitis

Front 24

Cyst

Back 24

1cm or larger, Elevated, encapsulated, fluid-filled or semisolid mass from subcutaneous tissue or dermis, Sebaceous or epidermoid cysts; wen

Front 25

Vernix Caseosa

Back 25

The thick cheesy substance on a newborn, Sebum and Epithelial Cells

Front 26

Lanugo

Back 26

Fine downy hair on a baby

Front 27

Apocrine vs Eccrine glands

Back 27

Apocrine - Thick milky secretions - smells, pheromones Eccrine - Sweat

Front 28

Linea Nigra

Back 28

Darker midline on a pregnant woman's body

Front 29

Striae Gravidarum

Back 29

Stretch Marks

Front 30

Vellus

Back 30

Fine faint hair covers most of body, except palms, soles, dorsal surface distal fingers, umbilicus, glans penis and inside labia

Front 31

Cyanosis

Back 31

Bluish - 02 less than 80%

Front 32

Peripheral cyanosis: decreased CO evident in nailbeds & lips, clubbing of nails chronic hypoxia

Back 32

Decreased CO - chronic hypoxia, evident in nailbeds/lips

Front 33

Skin Variations in Children

Back 33

Physiological jaundice, Shed hair then replaced, Cradle Cap, Mongolian spots

Front 34

Seborrheic Dermatitis

Back 34

Cradle cap - thick yellow crusted lesions

Front 35

Skin worries in adolescents

Back 35

Acne, Apocrine glands enlarge and function, Body Hair

Front 36

Skin variations in pregnant women

Back 36

Hyperpigmentation, Linea Negra

Front 37

Skin Variations in Menopause

Back 37

Hot flashes, Skin flushing, Increased facial hair, Skin tags

Front 38

Skin variations in older adults

Back 38

Skin atrophies, Decrease sebum/sweat, Dry, flat skin, Decrease elasticity, Lesions more common

Front 39

Skin differences on dark-skinned African Americans

Back 39

Oral mucosa assess subtle color changes, Keloids Mongolian spot

Front 40

Asian skin differences

Back 40

Oral mucosa assess jaundice than skin, Mongolian spot . Less facial hair

Front 41

What are some health promotion tips you can give for the integumentary system?

Back 41

Care habits: soap, cleansers, toners, detergent, bathe or shower, SPF: 15 minimum, Tattoos & piercing: risk infection, HBV & HCV, scar tissue, Self skin exam, ABCDE melanoma

Front 42

What are the ABCDE of melanoma

Back 42

A - Asymmetry B - Borders C - Color D - Diameter E - Elevation

Front 43

Pruritis

Back 43

Itchy skin

Front 44

inspection of hair

Back 44

Color, Quantity, Distribution, Condition of scalp, lesions or pediculosis

Front 45

Inspection of nails

Back 45

Color, Condition, Angle of Attachment, Abnormalities

Front 46

Clubbing

Back 46

Occurs with congenital cyanotic heart disease and neoplastic and pulmonary disease. > 180 degrees. inner edge of nail elevates. Accompanied by spongy nails.

Front 47

Spooning

Back 47

Koilonychia. Affects color, shape, texture, thickness of nails. Iron deficiency

Front 48

Onychomycosis/Tinea unguium

Back 48

Fungal infection of nail bed. common in older adults. causes change in color, nail crumbling.

Front 49

Splinter Hemorrhage

Back 49

Narrow, red brown lines of blood under nails. Tiny clots. Associated with heart valves (endocartitis). Tiny clots damage small capillaries.

Front 50

Pitting

Back 50

Depressions caused by nail matrix inflammation. Result of psoriasis, alopecia areata, eczema, lichen plansus.

Front 51

Palpation of the skin

Back 51

Temperature, Turgor, Texture, Moisture, Surface characteristics of any lesions

Front 52

Temperature of skin

Back 52

hot dry (fever), cool moist (hypotension, circulatory compromise)

Front 53

Turgor of skin

Back 53

Use dorsal side of hand. Skin turgor is "brisk" or "poor"

Front 54

Texture of skin

Back 54

thick, flaky (hypothyroid). Thin, smooth (hyperthyroid)

Front 55

Moisture of skin

Back 55

Dry, cool (hypothyroid). Moist, oily, warm (hyperthyroidism)

Front 56

Palpation of Hair and Nails

Back 56

Scalp mobility, scalp tenderness (masses), texture of hair and nails, capillary refill

Front 57

Capillary refill

Back 57

<2sec (brisk) WNL (within normal limits)

Front 58

Brown linear streaks may indicate in nails...

Back 58

melanoma

Front 59

Cyanotic nail beds

Back 59

sluggish color return. cardiovascular or respiratory dysfunction.

Front 60

Paronychia

Back 60

red, swollen, tender inflammation of the nail folds. Usually bacterial infection.

Front 61

Beau's Line

Back 61

transverse furrow or groove. Depression across the nail that extends down to the nail bed. occurs with trauma , acute illness

Front 62

splinter hemorrhages

Back 62

red brown linear streaks, embolic lesions, occur with subacute bacterial endocarditis or minor trauma

Front 63

Annular/Circular Lesion

Back 63

Circular shape, separated. Examples: Tinea corporis, sarcoidosis, pityriasis rosea

Front 64

Confluent Lesion

Back 64

Lesions run together. Examples: Uticaria (hives), rubella

Front 65

Discrete Lesion

Back 65

Lesions separate and discrete. Example: Moles

Front 66

Grouped Lesions

Back 66

Appear in clusters. Examples: Purpural lesions, herpes simplex

Front 67

Gyrate/Serpiginous Lesions

Back 67

Coiled, twisted, snakelike or wavy. Examples: Larva, dermatosis, nematode (round worm)

Front 68

Target/Iris Lesions

Back 68

Target symbol. Examples: Erythema, lyme disease

Front 69

Linear Lesions

Back 69

In line. Example: Scratches, herpes zoster (along nerve), poison ivy

Front 70

Polycyclic Lesions

Back 70

Interlocking circles. Example: Psoriasis

Front 71

Zosteriform Lesions

Back 71

Linear along nerve route. Example: Herpes zoster

Front 72

What are the six stages of pressure ulcers (starting at 0)

Back 72

0 - no redness or breakdown. 1 - Erythema only. Does not blanch, no breakage in skin. 2 - Break in skin such as blisters or abrasions. 3 - Break in skin exposing subcutaneous tissue. 4 - Break in skin extending through tissue and subcutaneous layers, exposing muscle or bone. 5 - Dark necrotic tissue (do not use this until necrotic tissue sloughs, then do staging)

Front 73

Extrinsic risk factors of ulcers are:

Back 73

Pressure, shear, friction, moisture, heat

Front 74

When do you check the skin for ulcers?

Back 74

Upon admission. Every time you interact with a pt (turn every two hours), when bathing

Front 75

What does the Braden Scale measure? Patients with a score of less than __ are most at risk. What are the six categories of measurement?

Back 75

The risk assessment for developing an ulcer. 16. Six categories are sensory perception, moisture, activity, mobility, nutrition, friction/shear

Front 76

How do you measure pressure ulcers?

Back 76

Length: 12:00-6:00 (widest part), Width: 3:00-9:00, Depth: with a qtip inserted into ulcer

Front 77

MEASURE for pressure ulcers stands for?

Back 77

M - Measure/Staging. E - Exudate (fluid), A - Appearance, S: Suffering, U - Undermining, R - Reevaluate, E - Edge

Front 78

Hirsutism

Back 78

Shaggy or excessive hair

Front 79

Lichenification

Back 79

Rough, thickening epidermis, secondary to persistent, rubbing, itching or skin irritation, Flexor surface of, extremity, Chronic dermatitis

Front 80

Scales

Back 80

Heaped up keratinized cells; flaky skin; irregular; thick or thin; dry or oily; variation in size, Color maybe white, gray or silver, Dry skin, dandruff, psoriasis, eczema

Front 81

Crust

Back 81

Dried serum, blood or purulent exudates; slightly, elevated; size varies, Brown, red, black, tan or straw colored, Scab, eczema, impetigo, herpes

Front 82

Scar

Back 82

Thin to thick fibrous tissue replaces normal skin following injury or laceration to dermi, Healed wound or surgical incision, New scars red/purple; old silver/white

Front 83

Keloid

Back 83

Irregular shaped, elevated progressively enlarging scar, Grows beyond boundaries of wound, Caused by excessive collagen formation during healing, Keloid from ear-piercing or surgery

Front 84

Excoriation

Back 84

abrasion or other loss that does not extend beyond superficial epidermis, Atopic dermatitis, excoriation (scratch marks), insect bite, scabies, statis dermititis

Front 85

Erosion

Back 85

loss of superficial epidermis, Loss of part of epidermis; depressed, moist glistening, Follows rupture of vesicle/bulla, Ruptured vesicles, abrasion, candidiasis erosion

Front 86

Fissure

Back 86

linear break in skin w/well defined borders, may extend into dermis, Linear crack or break from epidermis to dermis, May be moist or dry, Athlete’s foot, cracks at corner of mouth (cheilitis) or hands

Front 87

Ulcer

Back 87

irregulary shaped loss extending to or through dermis: may be necrotic, Loss of epidermis & dermis, Concave; size varies, Decubiti, stasis ulcer, chancres

Front 88

Atrophy

Back 88

thinning of skin w/transparent appearance & loss of markings, Thinning of skin surface, loss of skin marking, Skin translucent and paper-like, Straie, aged skin, topical corticosteroids

Front 89

Pre-cancerous

Back 89

actinic keratosis becomes squamous cell CA redflat

Front 90

Basal Cell Carcinoma

Back 90

most common, 80% slow growing common sun exposed parts of body. Raised, reddish, pearly nodule is the most common appearance of basal cell carcinoma, but it may also appear as a pink or red scar or area of irritated skin. Do not metastasize

Front 91

Squamous Cell Carcinoma

Back 91

16% sun exposed areas appearance is similar to a chronic ulcerated area of the skin or a crusty or scaly skin lesion; metastasize to other parts of body

Front 92

Melanoma

Back 92

deadliest only 4% spreads to lymph nodes and internal organs, usually > 6mm, ABCDE

Front 93

Kaposi Sarcoma

Back 93

Jewish/Mediterranean (primarily Italian) people with HIV are more susceptible to getting this