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41 Cards in this Set

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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.
epidermis
inner, basal cell skin layer that forms new skin cells. major ingredient is tough, fibrous protein keratin.
stratum germinativum
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.
stratum corneum
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.
dermis
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.
subcutaneous layer
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.
pallor
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).
erythema
bluish mottled color that signifies decreased perfusion; tissues are not adequately perfused with oxygenated blood.
cyanosis
exhibited by a yellow color, indicating rising amounts of bilirubin in blood.
jaundice
skin's ability to return to place promptly when released
turgor
what are the normal findings when assessing nails, nail beds and circulation?
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)
danger signs: abnormal characteristics of pigmented lecions are summarized in the mnemonic ABCDE: A
asymmetry of pigmented lesion (one that is not regularly round or oval)
danger signs: abnormal characteristics of pigmented lecions are summarized in the mnemonic ABCDE: B
border irregularity (notching, scalloping, ragged edges or poorly defined margins)
danger signs: abnormal characteristics of pigmented lecions are summarized in the mnemonic ABCDE: C
color variation (areas of broen, tan, black, blue, red, white or combination)
danger signs: abnormal characteristics of pigmented lecions are summarized in the mnemonic ABCDE: D
diameter greater than 6 mm (size of a pencil eraser)
danger signs: abnormal characteristics of pigmented lecions are summarized in the mnemonic ABCDE: E
elevation and enlargement
solely a color change, flat and circumscribed, of less than 1 cm (freckles, flat nevi, hypopigmentation, petechiae, measles, scarlet fever)
macule
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)
papule
solid, elevated, hard or soft, larger than 1 cm. may extend deeper into dermis than papule (xanthoma, fibroma, intradermal nevi)
nodule
superficial, raised, transient and erythematous; slightly irregular shape due to edema (fluid hel diffusely in tissues). ex: mosquito bite, allergic reaction, dermographism
wheal
wheals coalesce to form extensive reaction, intensely pruritic.
urticaria (hives)
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
vesicle
turbid fluid (pus) in the cavity. circumscribed and elevated. ex: impetigo, acne
pustule
deeper depression extending into dermis, irregular shape; may bleed; leaves scar when heals. ex: stasis ulcer, pressure sore, chancre
ulcer
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.
petechiae
edema with mild pitting, slight indentation, no perceptible swelling of leg
1+
edema with moderate pitting, indentation subsides rapidly
2+
edema with deep pitting, indentation remains for a short time, leg looks swollen
3+
edema with very deep pitting, indentation lasts a long time, leg is very swollen
4+
what are the effects of aging on all skin layers?
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
circular, begins in center and spreads to periphery, e.g., tinea corporis or ringworm, tinea versicolor, pityriasis.
annular
lesions run together, e.g., urticaria (hives)
confluent
distinct, individual lesions that remain separate, e.g., molluscum
discrete
clusters of lesions, e.g., vesicles of contact dermatitis
grouped
twisted, coiled spiral, snakelike
gyrate
iris, resembles iris of eye, concentric rings of color in lesions, e.g., erythema multiforme
target
a scratch, streak, line or stripe
linear
annular lesions grow together, e.g., lichen planus, psoriasis
polycyclic
linear arrangement along a nerve route, e.g., herpes zoster
zosteriform
what are normal lymph node findings?
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.
where in body are sites accessible?
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