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78 Cards in this Set
- Front
- Back
List the 9 Functions of the Skin |
1. Protection
2. Prevents penetration 3. Perception 4. Temp Regulation 5. Identification 6. Communication 7. Wound Repair 8. Absorption/Excretion |
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What layer is the epidermis and what does it entail?
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The thin, outermost layer |
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What is the Dermis and what layer is it?
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Dense connective tissue layer forming the middle bulk of the skin. Also contains the nerves that innervate the skin.
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What is in the subcutaneous layer and where does it occur?
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Inner most layer
Chiefly composed of adipose (fatty connective) tissue |
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What determines the difference in skin color?
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We all have the same number of melanocytes but the concentration of melatonin, keratin and the blood vessels that lie under the skin.
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What is produced from Eccrine Sweat glands?
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Dilute saline solution. Matures by the age of 2 months. |
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What is produces from Apocrine glands?
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Sweat glands in the axila, hair, sticky solution. Active during puberty. Arises from sexual or emotional excitement. Musty Body odor. |
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What are Sebaceous glands?
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Produce Sebum
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What is most important to do when looking at the subjective history during the skin examination?
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If any questions asked are answered yes then you must do PQRSTU.
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Give some examples of Subjective Data for a skin exam
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-Previous History of Skin Disease.
-Changes in pigmentation -Change in mole (color or size) -Excessive dryness or moisture -Pruritus (itching) -Excessive Bruising -Rash and lesions -Medications -Hair loss -Change in nails -Self care behaviors (sunscreen) -Environment or occupational hazards |
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What are some considerations for objective data during a skin exam?
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-Need proper equipment. |
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What is pallor and when can it occur?
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Pallor is a washing out of the skin.
-can occur because of anemia, stress, fear, or if the exam room is too cool. -Raynaud's disorder-areas of pallor and others w/erythema (can be a rheumatological disorder) |
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What is erythema and when does it occur?
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Temporary reddening of the skin. |
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What are some considerations for objective data during a skin exam?
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-Need proper equipment.
-Color -Moisture -Temp -Texture -Mobility and Turgor -Any lesions |
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What is Cyanosis and when does it occur?
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When the skin turns a Blue color. |
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What are Mongolian Spots and which population(s) are more susceptible to them?
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Hyperpigmentation
-Bluish, black, usually on the buttocks and usually fades away after 1st year. -Occurs primarily in Black, Mexican and Asian populations -Only 9% occur in White |
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What Jaundice and when can it occur?
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Yellow undertone of the skin |
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What skin conditions are common in older adults?
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-Senile Purpura- bleeding under the skin (dark spots)
-Dry Skin (xerosis) -Senile lentigines- liver spots from sun exposure and are not cancerous. |
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Describe some moisture abnormalities in the skin
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Diaphoresis: profuse sweating. May be MI or excessive sweating
-Panic attacks may cause clamminess -Dehydration- look at oral mucous membranes |
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What skin disorder is a sign of pre-diabetes?
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Hyper pigmentation around the neck.
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What skin conditions are common in older adults?
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-Senile Purpura- bleeding under the skin (dark spots)
-Dry Skin (xerosis) -Senile lentigines- liver spots from sun exposure and are not cancerous. |
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Describe some moisture abnormalities in the skin
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Diaphoresis: profuse sweating. May be MI or excessive sweating
-Panic attacks may cause clamminess -Dehydration- look at oral mucous membranes |
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List some general observations when examining skin lesions
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-Distribution, configuration, Morphology |
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Describe a Macule and give examples
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Circumscribed, flat,Non-palpable, change in skin color.
-up to 1 cm exs. Freckles -fat nevi (little red spots) -measles (flat rash) -petechiae -scarlet fever |
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Describe a patch and give some examples
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-A macule larger than 1cm
-Senile lentigo (liver spots) -Mongolian spot -vitiligo -cafe au lait -spot -measles rash |
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What is a Papule and what are some examples?
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-A palpable, elevated, circumscribe, solid mass
-caused by superficial thickening in the epidermis -up to 0.5cm -Ex. Elevated nevus (mole), lichen planus, wart, molluscum |
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What is a Plaque lesion? |
-A flat, elevated surface
-Larger than 0.5cm -Often formed by coalescence of papules -Ex. Psoriasis, lichen planus, xanthoma, xanthelasma |
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What is a nodule? Give an example |
-A solid, elevated, firm or solft mass less than 1-2 cm
-May be firmer and extend deeper into dermis than papule -Ex. Fibroma intradermal nevi |
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What is a tumor and what are its characteristics?
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-A solid elevated firm or soft mass larger than 1-2 cms
-Extending deeper into dermis -Benign or malignant -Lipoma, hemangioma |
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What type of lesion is known as a WHEAL? |
-A superficial, raised, erythemotaous, TRANSIENT lesion with irregular borders due to localized edema
-Fluid is held diffusely in the tissues -Ex. Mosquito bite, allergic reaction -can be a drug reaction |
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What is the lesion know as URTICARIA? What is an example |
-Wheals that have coalesced to form and extensive rash.
-can be from scratching -caused by intrinsic pruritic (itching) ex. Hives |
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What is a vesicle? Give some examples |
A circumscribed, superfical, elevated CAVITY
-contains free fluid -Clear fluid flows if wall ruptured -Up to 1 com in size -Ex. Herpes simplex, chicken pox, contact dermatitis. |
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What is a Bullae? Give some examples |
-A larger vesicle
-Usually single chambered -Superficial in epidermis -Thin walled so ruptures easily -Larger than 1cm -ex. Friction blister, pemphigus, burns, contact dermatitis |
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What is a Cyst? |
-An encapsulated fluid or pus-filled cavity in dermis or subcutaneous layer
-Tensely elevating the skin -Larger than 1cm Ex, Sebaceous cyst |
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What are pustules?
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-A circumscribed, superficial, elevated cavity
-Contains turbid fluid (pus) -Up to 1 cm Ex. Impetigo, acne |
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What is a crust? |
-Thickened, dried residue of burst vesicles, pustutles or blood
-can be red-brown, honey-colored, or yellow depending of the fluid's origin -exs. excema, impetgo, crust phase of herpes simplex |
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What is scaling of tinea pedis? |
-Tinea: is the fungus that causes this type of scaling
-Athletes's foot -compact desiccated flakes of skin -Dry or greasy -Silvery or white -from shedding of dead excess keratin cells -visible exfoliation of the dermis |
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What are fissures? |
-A linear crack with adrupt edges
-Extends into the dermis -Can be dry or moist -ex. cheilosis, athlete's foot, anal fissure, renal failure |
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What is erosion? Give some examples |
-A superficial circumscribed loss of epidermis
-Leaves a scopped-out but shallow depression -Moist but no bleeding -Heals without a scar because does not extend into the dermis -Ex, stage 2 pressure sore |
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What is an Ulcer? Give some examples
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-A circumscribed depression extending into the dermis
-Irregular shape -May bleed -Leaves a scar when it heals -Ex stasis ulcer, pressure sore, chancre |
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What is excoriation? What are some examples? |
-A scratch mark
-Superficial -Can be self-inflicted abrasion secondary to intense itching -Ex. Scratch from foreign body, insects bites, scabies, dermatitis, varicella |
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What is a scar? |
-After open reduction of fracture
-Replacement of destroyed normal skin tissue by fibrous connective tissue -A permanent change |
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What is skin atrophy? |
-Depressed skin level resulting from loss of tissue
-a thinning of the epidermis with loss of normal skin furrows, resulting in shiny, translucent skin -ex. Striae, senile skin, arterial insufficency |
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What is Lichenification? What are some examples? |
-Thickening and roughening of the skin usually as a result of intense scratching
-Results from a tightly packed set of papules -Causes increases visibility of the superficial skin markings -Ex long standing eczema, atopic dermatitis |
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What is a keloid scar?
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-Hypertrophic scar
-The resulting skin level is elevated by excess scar tissue, which is invasive beyond the site of the original injury |
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What is meant by annular configurations? |
the lesion occurs in circular pattern
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What are confluent lesions? |
Lesions that run together
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What is a discrete lesion? |
A lesions that is individual
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What are grouped lesions?
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Ones that are grouped in a particular place ie contact dermatitis
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What is a target configuration of a lesion?
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Described as an iris ex. lime disease.
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What is the gyrate shape of a lesion? |
The lesion looks twisted or snake like. ie scabies
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What is a linear configuration?
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striped lesions ie scratches
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What are polycyclic lesions?
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Annular lesions that grow together
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What are zosteriform lesions?
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linear along a nerve route. Ex. Herpes Zoster
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What the the vascular lesions? |
-Petechiae
-Purpura -Ecchymosis -Cherry Angioma -Spider Angioma -Telangiectasia -Nevus Flammeus-Port wine stain |
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Describe Petechiae |
-Color-red |
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Describe a Purpura
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-A large macule or papule of blood in the skin
-Such blood-filled lesions do not blanch |
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What is Ecchymosis? |
-Larger extravasations of blood into the skin.
-bruises |
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What are Cherry Angiomas?
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-aka Campbell de Morgan spots
-small bright red papules and of no consequence -Benign angiomas common on the trunks of the middle-aged and elderly |
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What are spider Angioma?
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-Satellite telangiectases that look like spiders with legs radiated from a central, often palpable feeding vessel
-if diagnosis in doubt, press the center with slide and lesion will disappear -If many on trunk check liver function. May be normal in faces of children or erupt in pregnancy |
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Telangiectasia?
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-Term refers to permanently dilated and visible vessels in the skin
-They can appear as linear, punctate stellate crimson-purple markings Can be caused by nifedipine |
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What is Nevus Flammeus? |
-Present at birth
-Caused by dilated dermal capillaries pale, pink to purple macules -Mostly on face and trunk |
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What are the Skin Cancer Warning signs? |
-Asymmetry in shape: one half unlike the other half
-Border is irregular: edges are irregularly scalloped -Color is mottled- haphazard display of color; shades of brown, black, gray, red and white -Diameter is unusually large: greater than the tip of a pencil eraser (6mm) -Elevations is almost always present: surface distortion is assessed by side-lighting. Melanoma in situ may be flat Enlargement: history of an increase in the size of lesion is perhaps one of the most important signs of malignant melanoma |
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What is the most common skin cancer? |
Basal Cell Carcinoma
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Describe Basal Cell Carcinoma
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-Locally invasive and destructive
-Slow growing rarely metastasized -Almost translucent, dome-shaped papule with overlying telangiectasias |
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What are actinic keratosis of the Scalp?
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Keratotic lesions with malignant potential
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Describe Squamous cell Carcinoma |
-Invasive malignancy
-Commonly found on the head, neck or hands -May arise from actinic keratosis or de novo |
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What is malignant melanoma? |
-The most serious of skin cancers
-whenever it is very black or raised |
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What are the 2 types of hair? |
Vellis hair: the thin hair that is all over the body
Terminal hair: hair on the scalp, eyebrows, axila, pubic or chest |
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Why does hair turn white? |
-Melanin in shaft gets replaced by colorless hair bubbles
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What is Alopecia Areata?
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-Non scarring hair loss, typically of rapid onset in a sharply defined, usually round or oval area
-The loss may be diffuse or patchy or band-like at the margins of the scalp -Most likely immunological phenomenon |
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Hirsutism?
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-More hair in areas that are not normal
-May be normal for heritage or certain diseases polycystic ovarian syndrome=more hair |
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What is nail clubbing?
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Flattening of the nail at the bed
-can be a sign of cancer of the lungs or lung disease |
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What is capillary refill? |
-Color should return to the nail between 1-3 seconds
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What is impetigo? |
It is a staph or strep infection
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What is paronychia? |
-Acute bacterial infection of the proximal and lateral nail fold
-Rapid onset of pain and swelling -Pus accumulates behind the cuticle -Chronic irritant exposure |
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Name the structures of the nail
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-Nail plate: actual nail
-Lanula: crest shaped half moon -Lateral nail fold -Nail matrix: where nail grows from -Posterior nail fold -Nail Bed |
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What is pitting? |
Pits in the nail
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