Physical Assessment: Skin/hair/nails

Front 1

What condition is this?

Back 1

Vitiligo: compelte absence of melanin pigment. Harmless.

Front 2

Mnemonic for danger signs of pigmented skin lesions

Back 2

ABCDE
Assymetry
Border irregulatiry
color variation
diameter greater than 6 mm
elevation/enlargment

Front 3

What is this?

Back 3

Junctional Nevus (mole). Macular only (not palpable) and occurs in children and adolescents

Front 4

What is this?

Back 4

Compound Nevi (Junctional Nevi can evolve to this). Macular and papular.

Front 5

erythema

Back 5

intense redness of skin from excess blood in the dilated superficial capillaries.
D/t blushing, infection, local inflammation etc.

Front 6

alopecia

Back 6

baldness (hair loss)

Front 7

annular

Back 7

circular shape to skin lesion

Front 8

bulla

Back 8

elevated cavity containing free fluidl arger than 1 cm diameter

Front 9

confluent

Back 9

skin lesions that run together

Front 10

crust

Back 10

thick, dried-out exudate left on skin when vesicles/pustules burst or dry up

Front 11

What condition is this?

Back 11

cyanosis: dusky color d/t increased amount of unoxygenated hgb

Front 12

What is this?

Back 12

Cafe au lait spot, present at birth, normal finding

Front 13

what are these?

Back 13

cherry angioma

Front 14

What is this?

Back 14

erythema toxicum, common rash in first 3-4 days of life, normal, unknown cause

Front 15

Furuncle

Back 15

(boil) suppurative inflammatory skin lesion d/t infected hair follicle

Front 16

fissure

Back 16

linear crack in skin extending into dermis

Front 17

erosion

Back 17

scooped out shallow depression in skin

Front 18

excoriation

Back 18

self inflicted abrasion on skin d/t scratching

Front 19

Hemiangioma

Back 19

skin lesion d/t benign proliferation of blood vessels in the dermis

Front 20

keloid

Back 20

hypertrophic scar elevated beyond site of original injury

Front 21

lichenification

Back 21

tichtly packed set of papules that thickens skin, from prolonged intesnse scratching

Front 22

What is this?

Back 22

maceration: softening of tissue by soaking

Front 23

lipoma

Back 23

benign fatty tumor

Front 24

macule

Back 24

flat skin lesion with only a color change

Front 25

nodule

Back 25

elevated skin lesion > 1 cm diameter

Front 26

pallor

Back 26

excessively pale

Front 27

papule

Back 27

palpable skin lesion, < 1 cm diameter

Front 28

Purpura

Back 28

red-purple skin lesion d/t blood in tissues from breaks in blood vessels

Front 29

pustule

Back 29

elevated cavity containing thick, turbid fluid

Front 30

Telangiectasia

Back 30

skin lesion d/t permanently enlarged and dilated blood vessels that are visible

Front 31

what are these?

Back 31

vesicles: elevated cavities containing free fluid up to 1 cm diameter

Front 32

What is this?

Back 32

wheal: raised red skin lesion d/t interstitial fluid

Front 33

zosteriform

Back 33

linear shape of skin lesion along a nerve route

Front 34

3 layers of skin

Back 34

epidermis: keratin (strength, protein) & melanin (color)
dermis: inner supportive layer, mostly collagen (connective tissue)
subcutaneous layer: adipose

Front 35

define 2 types of human hair

Back 35

fine faint vellus hair (covers most of body)
terminal hair: darker thicker scalp, groin, axilla, face/chest in men

Front 36

eccrine gland

Back 36

coiled tubules that open directly onto skin surface and produce sweat

Front 37

apocrine gland

Back 37

produce thick milky secretion and open into hair follicles, secrete with emotional/sexual stimulation

Front 38

sebaceous gland

Back 38

produce protective lipid substance called sebum secreted through hair follicles

Front 39

functions of this skin (9)

Back 39

protection (microorganisms)
prevents penetration
perception
temperature regulation
identification
communication
wound repair
absorption and excretion
production of vit D

Front 40

causes of pallor

Back 40

acute high stress states d/t peripheral vasoconstriction, exposure to cold, cigarette smoking, edema

Front 41

describe pitting edema 4 point scale

Back 41

1= mild pitting, slight indentation no perceptible swelling of leg
2= moderate pitting, indentation subsides rapidly
3=deep pitting, indentation remains for a short time, leg looks swollen
4= very deep pitting, indentation lasts a long time, leg is very swollen

Front 42

anasarca

Back 42

generalized body edema, consider a central cause like heart failure/kidney failure

Front 43

peau d'orange/pig skin

Back 43

raised hair follicles from edema give this look

Front 44

What is this?

Back 44

peau d'orange skin or pig skin, from edema (raises hair follicles)

Front 45

hypothyroidism effect on skin

Back 45

skin feels dry rough and flaky

Front 46

hyperthyroidism effect on skin

Back 46

skin feels smoother, softer like velvet

Front 47

What is this?

Back 47

Mongolian spot. Normal finding in new borns, Hyperpigmentation, present in 85% of blacks, asians and american indieans 9% whites

Front 48

what is this?

Back 48

cutis marmorata: transient mottline in response to cooler room temps, normal in infants

Front 49

Milia

Back 49

tiny white papules on the cheeks/forehead/nose/chin infants d/t sebum that occludes follicle opening. Don't squeeze. resolve on own in a few weeks. Normal in infants.

Front 50

What is this?

Back 50

curtis marmorata: transient mottling in the trunk and extremities in response to cooler room temps.

Front 51

What is this?

Back 51

lentigines: or "liver spots" flat brown macules. non malignant, normal in elderly

Front 52

seborrheic keratosis

Back 52

dark greasy "stuck on" appearing lesions, non cancerous, normal in older adult

Front 53

actinic keratosis

Back 53

red-tan scaly lesions increase over the years to become raised and roughened, directly related to sun exposure can lead to squamos cell carcinoma

Front 54

What is this?

Back 54

acrochordon: "skin tag", overgrowth of normal skin, normal in adults

Front 55

sebaceous hyperplasia

Back 55

raised yellow papules with central depression,more common in older men on face, pebbly appearance

Front 56

urticaria

Back 56

hives, wheals coalesced to form extensive reaction, intensely pruritic

Front 57

difference between macule and papule?

Back 57

you can feel a papule, both are < 1 cm

Front 58

hematoma

Back 58

a bruise you can feel

Front 59

petichia

Back 59

purple spots caused by minor hemorrhage (broke capillaries), can be caused by intense bout of crying/coughing/vomiting

Front 60

purpura vs petichia

Back 60

purpura measure up to 1 cm
petichia less than 3 mm

Front 61

hematoma

Back 61

localized collection of blodo outside blood vessel (whereas bruise is thin layer of blood under skin)

Front 62

Chicken pox

Back 62

small, tight vesicles first appear on trunk, errupt in crops over several days, then become pustules then crusts. Very pruritic

Front 63

German measles (rubella)

Back 63

pink papular rash (similar to measles but paler) first on face then spreads. Differentiated from measles by Presence of neck lymphadenopathy and absence of Koplik spots.

Front 64

Measles (Rubeola)

Back 64

red-purple maculopapular rash, appears on 3rd/4th day. Koplik spots in mouth (bluish white, red-based elevated 1-3 mm)

Front 65

Stage I pressure ulcer

Back 65

skin intact but red, blanchable in light skin. Darker skin does not blanch

Front 66

blanchable

Back 66

An erythematous lesion that loses all redness when pressed is termed "blanchable."

Blanchable lesions are due to vascular dilatation. Non-blanchable, erythematous lesions are due to the presence of red blood cells outside of blood vessels (extravasation).

Front 67

Stage II pressure ulcer

Back 67

partial thickness skine rosion with loss of epidermis or also teh dermis. Looks like abrasion/open blister.

Front 68

Stage III pressure ulcer

Back 68

full thickness extending into Sub Q tissue

Front 69

Stage IV pressure ulcer

Back 69

full thickness ulcer involves all ayers and exposes muscle, tendon or bone too

Front 70

skin abscess vs. furuncle

Back 70

abcess is collection of pus in dermis whereas furuncle is collection of pus in hair follicle

Front 71

what condition is this?

Back 71

koilonychia= or spoon nails, sign of hypochromic anemia, nails are flat or even concave in shape

Front 72

What condition is this?

Back 72

paronychia
red swollen tender inflammation of teh nail folds, usually bacterial if acute, chronic often fungal in those who perform "wet" work

Front 73

what condition is this on nail?

Back 73

Beau's line
transverse furrow/groove d/t trauma that temporarily impairs nail formation (acute illness etc)

Front 74

What are these linear markings on nail?

Back 74

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

Front 75

What nail condition is this?

Back 75

Onycholysis
slow persistent fungal infection,more common in toenails. Fungus causes greenish color change, crumbling or breaking

Front 76

What nail condition is this?

Back 76

late clubbing
associated with platelet production
diseases that disrupt normal pulmonary circulation (chronic lung disease, heart defects etc) cause fragmented platelets to become trapped in the fingertip vasculature, releasing platelet derived growth factor and promoting growth of vessels, develops slowly

Front 77

What is the horny cell layer?

Back 77

dead keratin cells that are interwoven and closely packed Its the top outer layer of the epidermis

Front 78

where is the basal cell layer in skin and what is its purpose?

Back 78

the bottom of the epidermis, where new skin cells are formed

Front 79

hairs are threads of ____________

Back 79

keratin

Front 80

lanugo

Back 80

by 3 wks gestation, most of infants skin is covered with this, the find downy hair of the newborn

Front 81

seborrhea

Back 81

oily

Front 82

xerosis

Back 82

dry

Front 83

causes of pruritis

Back 83

dry skin
aging
drug reactions
allergy
obstructive jaundice
uremia
lice