Health Assessment

Front 1

skin layer that is thin but tough. its cells are bound tightly together into sheets that form a rugged protective barrier. it is stratified into several zones.

Back 1

epidermis

Front 2

inner, basal cell skin layer that forms new skin cells. major ingredient is tough, fibrous protein keratin.

Back 2

stratum germinativum

Front 3

from basal layer the new cells migrate up and flatten into the ______ ____ skin layer. this outer horney cell layer consists of dead keratinized cells that are interwoven and closely packed. cells are constantly being shed or desquamated, and are replaced with new cells from below.

Back 3

stratum corneum

Front 4

inner supportive skin layer consisting mostly of connective tissue (collagen). this is the tough, fibrous protein that enables skin to resist tearing. also has resilient elastic tissue that allows skin to stretch with body movements. nerves, sensory receptors, blood vessels and lymphatice lie here. appendages from the epidermis-such as hair follicles, sebaceous glands and sweat glands-are embedded here.

Back 4

dermis

Front 5

adipose tissue which is made up of lobules of fat cells. stores fat for energy, provides insulation for temp control and aids in protection by its soft cushioning effect. loose layer gives skin its increased mobility over structures underneath.

Back 5

subcutaneous layer

Front 6

When the red-pink tones from the oxygenated hemoglobin in blood are lost, the skin takes on the color of connective tissue (collagen), which is mostly white. Common in acute high-stress states, such as anxiety or fear, due to powerful peripheral vasoconstriction from sympathetic nervous system stimulation. Skin also looks pale with vasoconstriction from exposure to cold and cigarette smoking in the presence of edema.

Back 6

pallor

Front 7

intense redness of skin due to excess blood (hyperemia) in dilated superficial capillaries. this sign is expected with fever, local inflammation or with emotional reactions such as blushing in vascular flush areas (cheeks, neck and upper chest).

Back 7

erythema

Front 8

bluish mottled color that signifies decreased perfusion; tissues are not adequately perfused with oxygenated blood.

Back 8

cyanosis

Front 9

exhibited by a yellow color, indicating rising amounts of bilirubin in blood.

Back 9

jaundice

Front 10

skin's ability to return to place promptly when released

Back 10

turgor

Front 11

what are the normal findings when assessing nails, nail beds and circulation?

Back 11

angle of nail bed sheould be 160 degrees or less; capillary refill less than 2 seconds; nails may have slight curve, linear pigmentation and leukonychia striate (white hairline linear markings from trauma or picking at cuticle)

Front 12

danger signs: abnormal characteristics of pigmented lecions are summarized in the mnemonic ABCDE: A

Back 12

asymmetry of pigmented lesion (one that is not regularly round or oval)

Front 13

danger signs: abnormal characteristics of pigmented lecions are summarized in the mnemonic ABCDE: B

Back 13

border irregularity (notching, scalloping, ragged edges or poorly defined margins)

Front 14

danger signs: abnormal characteristics of pigmented lecions are summarized in the mnemonic ABCDE: C

Back 14

color variation (areas of broen, tan, black, blue, red, white or combination)

Front 15

danger signs: abnormal characteristics of pigmented lecions are summarized in the mnemonic ABCDE: D

Back 15

diameter greater than 6 mm (size of a pencil eraser)

Front 16

danger signs: abnormal characteristics of pigmented lecions are summarized in the mnemonic ABCDE: E

Back 16

elevation and enlargement

Front 17

solely a color change, flat and circumscribed, of less than 1 cm (freckles, flat nevi, hypopigmentation, petechiae, measles, scarlet fever)

Back 17

macule

Front 18

something you can feel, i.e., solid, elevated, circumscribed, less than 1 cm diameter, due to superficial thickening in epidermis (elevated nevus-mole, lichen planus, molluscum, wart-verruca)

Back 18

papule

Front 19

solid, elevated, hard or soft, larger than 1 cm. may extend deeper into dermis than papule (xanthoma, fibroma, intradermal nevi)

Back 19

nodule

Front 20

superficial, raised, transient and erythematous; slightly irregular shape due to edema (fluid hel diffusely in tissues). ex: mosquito bite, allergic reaction, dermographism

Back 20

wheal

Front 21

wheals coalesce to form extensive reaction, intensely pruritic.

Back 21

urticaria (hives)

Front 22

elevated cavity containing free fluid, up to 1 cm. clear serum flows if wall is ruptured. ex: herpers simples. early varicella (chickenpoxO, herpes zoster (shingles), contact dermatitis

Back 22

vesicle

Front 23

turbid fluid (pus) in the cavity. circumscribed and elevated. ex: impetigo, acne

Back 23

pustule

Front 24

deeper depression extending into dermis, irregular shape; may bleed; leaves scar when heals. ex: stasis ulcer, pressure sore, chancre

Back 24

ulcer

Front 25

tiny punctate hemorrhages, less than 2 mm, round and discrete, dark red, purple or brown in color. due to bleeding from sjperficial capillaries; will not blanch. may indicate abnormal clotting factors.

Back 25

petechiae

Front 26

edema with mild pitting, slight indentation, no perceptible swelling of leg

Back 26

1+

Front 27

edema with moderate pitting, indentation subsides rapidly

Back 27

2+

Front 28

edema with deep pitting, indentation remains for a short time, leg looks swollen

Back 28

3+

Front 29

edema with very deep pitting, indentation lasts a long time, leg is very swollen

Back 29

4+

Front 30

what are the effects of aging on all skin layers?

Back 30

slow atrophy
decrease elasticity
skin folds and sags
thin, lac, dry, wrinkled
stratum corneum thins and flattens
sweat and sebaceous glands decrease in number and function
speckled and uneven coloring
more pigment changes

Front 31

circular, begins in center and spreads to periphery, e.g., tinea corporis or ringworm, tinea versicolor, pityriasis.

Back 31

annular

Front 32

lesions run together, e.g., urticaria (hives)

Back 32

confluent

Front 33

distinct, individual lesions that remain separate, e.g., molluscum

Back 33

discrete

Front 34

clusters of lesions, e.g., vesicles of contact dermatitis

Back 34

grouped

Front 35

twisted, coiled spiral, snakelike

Back 35

gyrate

Front 36

iris, resembles iris of eye, concentric rings of color in lesions, e.g., erythema multiforme

Back 36

target

Front 37

a scratch, streak, line or stripe

Back 37

linear

Front 38

annular lesions grow together, e.g., lichen planus, psoriasis

Back 38

polycyclic

Front 39

linear arrangement along a nerve route, e.g., herpes zoster

Back 39

zosteriform

Front 40

what are normal lymph node findings?

Back 40

salivary glands are not palpable. cervical nodes often are palpable in healthey person, although this palpability decreases with age. normal nodes feel movable, discrete, soft and nontender.

Front 41

where in body are sites accessible?

Back 41

1 preauricular
2 submandibular
3 submental
4 deep cervical chain
5 posterior auricular
6 occipital
7 jugulodigastric
8 superficial cervical
9 posterior cervical
10 supraclavicular