Skin, Hair, Nails

Front 1

Dermis

Back 1

Inner, supportive layer of skin consisting mainly of connective tissue (collagen). Is elastic and resists tearing. Contains nerves, sensory receptors, blood vessels and lymphatics. Epidermal appendages are embedded here (hair follicles, sebaceous and sweat glands)

Front 2

Epidermis

Back 2

thin, tough, outer highly differentiated layer of skin. Cells are bound tightly to form a rugged protective barrier. It is completely replaced every 4 weeks. Thin except on surfaces that experience high amounts of friction. It is avascular Contains the basal cell layer, horny cell layer,

Front 3

Subcutaneous

Back 3

Fatty adipose tissue. Stores energy, provides insulation for temp control, aids in protection (cushioning). The looseness provides skin mobility around organs and bone.

Front 4

Arrector Pili

Back 4

Muscles that control hair follicles. Contraction makes hair stand up to give goose bumps.

Front 5

Eccrine gland

Back 5

Coiled tubes that open to sin surface and produce sweat. Widely distributed on body and fully matured by 2mo. old.

Front 6

Apocrine gland

Back 6

Produce a thick milky secretion and open to the hair follicle. Bacteria on skin reacts with it causing body odor. Mainly in axillae, anogenital areas, nipples, navel and are vestigial. Activate at puberty and secrete during emotional or sexual stimulation. Function decrease with aging adult.

Front 7

Purpura

Back 7

red-purple coloring of skin from breaks in blood vessels caused by trauma. Seen often in elderly.

Front 8

Keloid

Back 8

hypertrophic scars, scars that are elevated beyond original site. Most often seen in blacks

Front 9

Pallor

Back 9

Extremely, unnatural, excessively pale, whitish-pink color to lightly pigmented skin, mucous membranes and conjunctivae
brown skin appears yellow-brown and dull
black skin - ashen gray, dull
Causes: anemia, shock, local arterial insufficiency, albinism, vitiligo or anything that causes vasoconstriction

Front 10

Jaundice

Back 10

Yellow color to skin, palms, palate, and sclera due to excess bilirubin in the blood
Causes: liver inflammation, hemolytic disease, severe burns, infection, Carotenemia (only in skin)

Front 11

Cyanosis

Back 11

Dusky blue mottling of the skin or mucous membranes due to a severe reduction of hemoglobin in the blood
Causes: heart and lung disease causing arterial desaturation; cold and anxiety (nail beds)

Front 12

Nevus

Back 12

a circumscribed lesion due to excess melanocytes, AKA Mole. Tan-brown color, flat or raised. Acquired nevi are characterized by their symmetry, small size (<6mm), smooth borders, and single uniform pigmentation
Junction - only in young children, compound - only in young adults, intradermal - older adults
ABCDE: Asymmetry, Border, color, diameter (>6mm), Elevation or enlargement

Front 13

Lesion

Back 13

an abnormal change in structure of of the skin in part due to injury or disease. Primary - develops on previously unaltered skin, Secondary - develops due to scratching or infection. Ex: papule, macule, rash,

Front 14

Alopecia

Back 14

Significant hair loss

Front 15

Uticaria

Back 15

Hives, can be chronic or acute. Wheals that have come together and form extensive reactions, intensely pruritic. Chronic- keep a diary of meals and environment to identify precipitating factors

Front 16

Vitiligo

Back 16

Complete absence of melanin pigment in patchy areas of white or light skin on the hands, face, neck, feet, body folds and around orifices. Can occur in all races, darker-skin is more severely affected.

Front 17

Freckle

Back 17

Ephelides - normal, small flat macules of brown melanin pigment that occur on sun-exposed skin. Benign.

Front 18

Erythema

Back 18

intense redness of skin from excess blood in the dilated superficial capillaries.
Dark skin - purplish tinge, increased warmth with inflammation, taut skin, hardening of deep tissues, cherry red nail beds, lips and oral mucosa, edema
Causes: fever, local inflammation, emotional reactions, carbon monoxide poisoning, polycythemia, venous stasis, extravascular presence of red blood cells, alcohol intake

Front 19

Pruritus

Back 19

severe itching or burning sensation of the skin
causes: contact dermatitis, bug bites, dry skin

Front 20

Diaphoresis

Back 20

Profuse perspiration. Normally appears on face, hands axilla, and skinfolds in response to activity, warm environment, anxiety, increased metabolic rate (fever, increased activity)
Causes: thyrotoxicosis,"", CNS stimulation, anxiety, pain

Front 21

Dehydration

Back 21

Mucous membranes are dry, lips look parched and cracked. Extreme - dryness, skin fissures

Front 22

Skin Turgor

Back 22

Pinching a fold of skin on the chest under the clavicle. The skin should promptly return when released.
"Tent" causes: dehydration, extreme weightloss

Front 23

Fissure

Back 23

Linear crack in skin extending into the dermis or painful longitudinal tear in skin

Front 24

Clubbing

Back 24

A nail presenting a profile sign of >160 degrees. Occurs with congenital cyanotic heart disease and neoplastic and pulmonary diseases. Nail will become convex as the digit grows. Accompanied by a spongy nail base

Front 25

Linear Bands

Back 25

Areas of dark brown-black pigmentation bands under nails in dark skinned people. In all skin tones can be caused by trauma to the nail bed, melanoma, Beau's lines

Front 26

Mongolian Spot

Back 26

Blue-black to purple macular area at the sacrum or buttocks but sometimes on the abdomen, thighs, shoulders or arms. Due to deep dermal melanocytes. Will gradually fade in the first year. Common variation of hyperpigmentation in Black, Asian, American Indian, and Hispanic newborns.

Front 27

Macule

Back 27

Flat skin lesion with only a color change <1cm (ex - freckle, liver spot, keratoses, flat nevi, hypopigmentation, petechiae, measles, scarlet fever)

Front 28

Papule

Back 28

Solid, elevated, circumscribed (palpable) skin lesion <1cm in diameter. Ex: mole, sebaceous hyperplasia, wart, molluscum, lichen planus

Front 29

Pustule

Back 29

A circumscribed elevated cavity contain a thick turbid fluid (pus). Ex severe acne, impetigo

Front 30

Plaque

Back 30

Skin lesions which papules come together >1cm. A plateau like disk shaped lesion
Ex: actinic (senile or solar) keratosis, psoriasis, lichen planus

Front 31

Erosion

Back 31

Scooped out shallow depression in the skin, superficial, epidermis lost, moist but not bleeding, heals without scar. Ex: sore

Front 32

Lesion type: Annular

Back 32

circular lesions, begins in center and spreads to periphery
Ex: tinea corporis or ringworm, tinea vericolor, pityriasis rosea

Front 33

Lesion Type: Confluent

Back 33

lesions that run together
Ex: urticaria

Front 34

Lesion Type: Discrete

Back 34

distinct individual lesions that remain separate
Ex: skin tags, acne, acrochordon

Front 35

Lesion Type: Gyrate

Back 35

twisted, coiled, spiral, snakelike lesions

Front 36

Lesion Type: Grouped

Back 36

clusters of lesions
Ex: contact dermatitis

Front 37

Lesion Type: Linear

Back 37

a scratch, streak, line or stripe
Ex: cut

Front 38

Lesion Type: Target

Back 38

AKA iris, resembles iris of eye, concentric rings of color in the lesions
EX: erythema multiforme

Front 39

Lesion Type: Zosteriform

Back 39

linear arrangement along unilateral nerve route
Ex: herpes zoster

Front 40

Lesion Type: Polycyclic

Back 40

annular lesions grow together.
Ex: lichen planus, psoriasis

Front 41

Ecchymosis

Back 41

Bruise

Front 42

Vesicle

Back 42

Elevated cavity containing free fluid, up to 1cm, when ruptures clear serum flows out
Ex: blister, chickenpox, herpes zoster, contact dermatitis

Front 43

Nodule

Back 43

Solid, elevated, hard or soft >1cm. May extend deeper into dermis than papule
Ex: xanthoma, fibroma, intradermal nevi

Front 44

Wheal

Back 44

Superficial, raised, transient and erythematous; slightly irregular shape due to edema
Ex: mosquito bite, allergic reaction, dermographism

Front 45

Tumor

Back 45

Larger than a few centimeters in diameter. Firm or soft, deeper into dermis; may be benign or malignant
Ex: lipoma, hemangioma

Front 46

Cyst

Back 46

Encapsulated fluid filled cavity in dermis or subcutaneous layer, tensely elevating skin
Ex: sebaceous cyst, wen

Front 47

Crust

Back 47

Thickened, dried out exudated left when vesicles/pustules burst or dry up. Color can be red-brown, honey or yellow, depending on the fluids makeup
Ex: impetigo (dry honey colored), weeping, eczematous dermatitis, scab after abrasion

Front 48

Ulcer

Back 48

Deeper depression extending into dermis, irregular shape, may bleed, leaves scar when heals
Ex: stasis ulcer, pressure sore, chancre
Stage I - skin intact, localized redness, pigment will not blanch
Stage II - partial thickness skin erosion with loss of epidermis or also dermis. Superficial, shallow like an abrasion or blister with a red-pink wound bed
Stage III - Full thickness pressure ulcer extending into subcutaneous tissue, resembles crater, may see subQ fat
Stage IV - full thickness pressure ulcer of skin layers extending into supporting tissue, exposes bone, muscle, tendon, or stringy matter stuck to wound bed, necrosis

Front 49

Excoriation

Back 49

self inflicted abrasion, superficial, sometimes crusted, scracteches from intense itching
EX: insect bites, scabies, dermatitis, varicella

Front 50

Hematoma

Back 50

Elevated bruise you can feel and see (swelling). Caused by trauma or abuse

Front 51

Hemangioma

Back 51

Caused by a benign proliferation of blood vessels in the dermis Ex: port wine stain, cavernous hemangioma, strawberry mark,

Front 52

Impetigo

Back 52

Moist, thin roofed vesicles with thin, erythematous base. Rupture to form thick, honey colored crusts. Contagious bacterial infection of skin. Common in infants and children.

Front 53

Dermatitis

Back 53

Erythematous papules and vesicles with weeping, oozing and crusts. Can be on forehead, cheeks, forearms, and wrists, elbows, backs of knees.
Ex: Eczema