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major functions of skin
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Vellus versus terminal hair
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NR 302 exam 2
| Question | Answer |
|---|---|
| major functions of skin | Protection Prevents penetration Perception-touch, pain, temp, pressure Temp regulation Self image Communication-emotions Wound repair-surface Absorption/secreation Production of vit d from cholesterol |
| Vellus versus terminal hair | Vellus-fine hair on most of body Terminal-dark, thick scalp and eyebrows After puberty- axilla, pubic, chest, face |
| Pediatric skin changes | -free of terminal hair only have lanugo(soft fine downy hair), no temp regulation, vernix(thick cheesy covering)-helps with temp reg-milka- pimples from mom estrogen -stork bites-head beating on opening in delivery-mongolian spots-bottom go away 1-2 yrs |
| pregnant skin changes | -Skin pigment increases--chloasma-raccoon face -linea nigra-medial line down belly -striae gravidarum-stretch marks |
| geriatric skin changes | tenting -sebum decreases-dryness -Sweat decreases-over heat easy -Melanin decreases- grey hair -sensitivity to light from subcu loss -senile legtigines-liver spots -cherry angiomas-small red moles -seborrhes keratosis- looks like warts skin tags-n |
| subjective data for past skin diseases | Allergies, hives, psoriasis-over production of skin cells triggered by stress, emotions, poor health,Eczema, birth marks, tattoos, piercings |
| generalized pigmentation | Pallor-pale Jaundice-yellow Cyanosis-blue Erythema-red, Change in nails Sun exposure Skin self-exam ruddy/blue-(low O2, from bone marrow) |
| Moles need to know | size, shape, color change, sores not healing |
| Seborrhea is | a lot of moisture |
| xerosis | dryness |
| Pruritus | itching—mild-prickling, tingling or intolerable |
| OBJECTIVE SKIN DATA inspect/ palpate | color, eye, dark mucous membranes-liver problems, temp-warm, thickness uniform, edema, mobility, turgor, vascularity, |
| edema skin scale | 1+mild pitting 2mm 2+ moderate pitting 4mm 3+ deep pitting 6mm 4+ very deep pitting 8mm Non-pitting-measuring tape |
| vascularity of skin | cherry angiomas-trunk after 30 yrs age bruising- contusion, hemotoma tattoos- educate for hep c |
| abnormal skin ABCDE criteria | A-asymmetry B-border irregularity C-color change D-diameter greater then 6mm E-evolving changes(size, shape, itching, tender, surface bleeding, shades of color |
| Primary lesions of macule | non palpable, smaller the 1cm, circular border Ex.) ephilides(freckles), senile lentigines(liver spots) |
| Primary lesions of patch | larger than 1 cm, irregular border Ex,) Mongolian spots, vitiligo, port-wine stain |
| Primary lesions of papule | raised, solid palpable masses, smaller than 0.5 cm, circular border Ex.) mole, warts |
| Primary lesions of plague | larger than 0.5 cm, groups of papules that form lessions Ex.) psoriasis, actinic keratosis |
| Primary lesions of Vesicle | smaller the 0.5 cm, fluid filled, round oval Ex.)rash |
| Primary lesions of Bulla | larger than 0.5 cm, full of water no pus, round, oval blister |
| Primary lesions of pustules | small, inflamed, pus-filled, blister-like lesions |
| Primary lesions of purpura | mucous membranes due to haemorrhage from small blood vessels |
| Primary lesions of cyst | fluid filld, semi-soild |
| Primary lesions of impetigo | crusty common skin infection caused by streptococcus (strep) or staphylococcus (staph) |
| Vascular lesions Venous lake | benign vascular lesions that result from dilated venules |
| Vascular lesions Spider angioma | collection of blood vessels near the surface of the skin |
| Vascular lesions Petechiae | small, purpuric lesions up to 2 mm across |
| Vascular lesions Ecchymosis | a large type of hematoma (>1 cm) |
| Malignant lesions basal cell carcinoma | looks like mole |
| Malignant lesions squamous cell carcinoma | dark irregular |
| Malignant lesions melanoma | dark |
| Malignant lesions Kaposi’s sarcoma | j shaped |
| (hair)Seborrhea | dandruff, cradle cap |
| (hair)tinea capitis | scalp ringworm |
| (hair)alopecia areta | a condition in which hair is lost from some or all areas of the body, usually from the scalp |
| (hair)folliculitis | infection in the hair follicles |
| (hair)Furuncles | or boils are caused by an accumulation of pus and dead tissue around the root of the hair |
| (nails)normal profile | 160 degrees |
| (nails)clubbing | 180 degrees |
| (nails)Schamroth technique | nails and fingers back to back diamond shape |
| (nails)capillary refill | blanching for dehydration, blood flow |
| facial land marks of eyes | -palpebral tissue- area where the lower and upper lids meet -nasolabial fold-dimples symmetrical -pinna- eye lids -lateral canthus-opening of eye lids |
| lymph node locations | 1-preauricular-hair line by ear 2-postauricular-high behind the ear 3-occiptal- mid low behind ear 4-retropharngeal jaw lower lobe 5- Middle jaw line 6-submental-chin of jaw 7-superficial cervical chain-under ear middle neck 8-deep cervical chain-- |
| pediatric bones head | -Posterior triangle frontal closed at 1-2 months -Anterior diamond fontanel closed at 9-12 months |
| pregnant Head, Neck, and Lymph | -facial and extremities edema -thyroid enlarges slightly -headache 1st trimester from increased hormones Late sign of preeclampsia |
| Geriatric Head, Neck, and Lymph | -low elasticity, sub cu fat, moisture, thyroid functions -loss hair, teeth -ROM limits -cervical vertebra ridged |
| subjective headache migraine | -vascular, mainly women -alcohol, stress, menstruation, eating choco/cheese -family history -nausea, vomiting, visual -2x month 1-3 days |
| subjective headache cluster | vascular, mainly men -eye, temporal, forehead, check -Unilateral-same side -1-2x day, ½ to 2 hrs -remission -alcohol, ingestion, daytime nap -red eyes, tearing, rhinorrhea, naso congestion, eyelid drooping |
| subjective headache tension | -normal everyday -frontal band-like tightness |
| subjective head injury | Light head, blackout (nero/cardiac), seizure verigo, dizzines |
| subjective vertigo | perception that person spins |
| objective vertigo | person feels like rom is spinning |
| objective head-inspection, palpation, auscultation head | -size-normocephalic -round, symmetrical to body -Temporal artery-light pressure -2+ equal bilaterally -temporomandibular joint-crepitation(move of fluid -full ROM, not tenderness, Tics, tremors, fasciculation’s (eye twitching) |
| objective head-inspection, palpation, auscultation neck ROM | flexion 45’, extension 55’, lateral bending 40’, rotation 70’ |
| objective head-inspection, palpation, auscultation lymph nodes | – round circular pressure with fingerpads If palpable-location, size. Movable, tenderness |
| objective head-inspection, palpation, auscultation arteries | Carotid arteries-bruits- bell ends low pitch while holding breath Jugular veins –internal, external -central venous pressure with ruler lie flat JVD normal- 3 cm above sternal angle at 45’ meaning of abnormal reading |
| abnormal head Hydrocephalus- | big head |
| abnormal head Acromegaly | growth hormone, pituitary, gigantism |
| abnormal head Bell’s palsy | CN 7 facial, temporary unilateral facial paralysis from virus |
| abnormal head Cushing’s syndrome | excessive secretion from pituitary |
| abnormal head Down syndrome | flat nose, protruding tongue, short neck |
| abnormal head Parkinson’s disease | mask like expression |
| abnormal head CVA | no blood flow, hemorrhagic-burst |
| abnormal head Hypothyroidism | women- non-pitting edema, coarse facial features, dry skin, hair, eyebrows |
| abnormal head Hyperthyroidism | -graves -goiter -bulging eyes -nervousness, fatigue, muscle cramps, heat intolerance, bounding pulse, short breath, tachycardia,silky hair/skin, blinking, staring |
| eyes pediatric | Iris is brown to dark, greyish blue by 3 months real color appears 4th week tears Vision in both eyes by 6 weeks Adult size by age 8 Peripheral vision by age 3 |
| eyes pregnant | Dry eyes, visual problems by shifting fluids Change in shape in last trimester |
| eyes geriatric | By age 45 lens losses elasticity, decrease tear, dryness, decrease pupillary size/response Presbyopia-cant accommodate for near vision depth perception fails Cataracts-cloudy clumping proteins arcus senilis-lipids around limbus Macular degeneration-ce |
| eyes subjective | Photophobia-inability to tolerate light floaters- strings or dots that’s normal unless obstruct vision with myopia lacrimation- tearing epiphora- excessive tearing strabismus- walleves were both eyes go outward differently |
| 3 types of strabismus of eye subjective | diploia-2 images of single object esotropia- inward eyes exotropia- outward eyes |
| eyes Objective-inspect, palpation, opthalmoscope. Snellen-visual acuity is | E chart for distance 20 ft, cover 1 eye, when miss letter use as fraction for 20/20 vision |
| eyes Objective-inspect, palpation, opthalmoscope. Jaegar or Rosenbaum | charts and what readings mean, how to assess visual acuity- Near vision of 12 to 14 inches, without hesitancy, without moving card closer or further---PRESBYOPIA |
| eyes Objective-inspect, palpation, opthalmoscope. Fields of vision by confrontation | Stand eye level 2 ft away, both cover eye and move fingers 50 degrees upward, 70 degrees downward, 60 degrees nasally, saying now when see fingers |
| eyes Objective-inspect, palpation, opthalmoscope. EOMs Function - Corneal light reflex (Hirschberg test) | Person stares straight ahead light shines 12 inches away, note for same reflextion spot on both eyes |
| eyes Objective-inspect, palpation, opthalmoscope. cover test | stare straight ahead remove cover from 1 eye and find “steady, fixed gaze”, no jumping |
| eyes Objective-inspect, palpation, opthalmoscope. 6 cardial positions or fields of gaze | Head steady follow object with parallel eyes |
| eyes Nystagmus | Fine, oscillating movement, beating or jumping of eyes |
| eyes Ptosis | Lid lag, drooping upper lid |
| eyes Palpebral fissures | Horizontal, upward-Asian’s |
| Horizontal, upward-Asian’s | protrusion of eyeballs |
| eyes Ectropion | lower lids roll out |
| eyes Entropion | lower lids roll in |
| eyes Sclera should be | china white/grey-blue |
| eyes PERRLA | Pupils Equal Round, React to Light, and Accommodate (direct same side, consensual with other pupil) |
| eyes Mydriasis | dilatation of the pupil |
| eyes Miosis | constriction of the pupil |
| eyes Horner’s syndrome | Drooping eyelid (ptosis), Sinking of the eyeball into the face, Small (constricted) pupil (the black part in the center of the eye) |
| EYES Argyll Robertson | - where the pupils can respond to changes in distance (accommodation) but not to light |
| eyes abnormal Chalazion | blocked duct in one of the Meibomian glands |
| eye abnormal Stye | is an infection of the eyelid, resulting from a blocked oil gland |
| ear Helix | top curl of ear |
| ear Tragus | edge of ear t face where piercings |
| ear Lobus- | lower lobe |
| ear Cone of light | triangle that points to nose |
| ear Malleus | arm like bone |
| ear Eustachian tube | connects middle ear to nasopharynx |
| ear pediatric | -Eustachian tube straight -pull pinna down for temp -salivation in infants at 3 months |
| ear pregnant | -fullness, earaches -Rhinitis-inflammation, epitaxies-nose bleed from more blood flow -heightened smell -edema of vocal cords -gingivitis |
| ear geriatric | presbycusis-nerve degeneration, hearing loss -cerumen-cilla stiff -xrostomia-dry mouth bleeding gums Tinnitus-ringing, buzzing Vertigo-objective-feel like spinning, subjective room is spinning Rhinitis, epistaxis, gingivitis, auditory canal and Eust |
| ear Subjective-inspection, palpation, percussion, transilumination | equal size, shape, bilateral -skin color same as face -no tenderness pinna, tragus, mastoid process -External-no swelling, redness, discharge of cerumen (color, texture) -Tympanic-color(pearly grey), membrane intact, scarring,Otorrhea, tinnitus, vert |
| ear objective tympanic membrane | bluish tinge by blood in middle ear -perforation and scarring |
| ear objective Darwins tubercle- | bump sm outside |
| ear abnormal Hemotympanum | blood in tympanic membrane |
| ear abnormal otitis externa | infection of outer ear |
| ear abnormal otitis media- | infection of inner ear |
| ear abnormal Tophi | small yellowish non-tender nodules, uric acid crystal, gout |
| Hearing acuity whispered test | 1 ear at time, 1-2 feet away 3 random words to test high frequency loss |
| Hearing acuity Rinne | tunning forks for conductive hearing loss, equal bilaterally Air conduction 30 sec Bone conduction 15 sec |
| Hearing acuity Weber | conductive or nerve damage, midline frontal forehead with no lateralization Conductive loss from impact cerumen, infection, bad eardrum Nerve loss- lateralization to better ear |
| Palpate frontal sinuses | eye corners by nose on eyebrow, percuss |
| Palpate Maxillary sinuses | above corners of mouth meet with nose holes |
| mouth buccal mucosa | pink, smooth, moist |
| throat tonsils and grading | 1+ visible 2+ halfway between pillars and uvula 3+ touching uvula 4+ touching each other |
| throat tongue | protrudes midline -halitosis- bad breath |
| deviated septum | both side close in, long |
| perforated septum | Perforated-small circular hole |
| throat Ankyloglossia | tongue anchored to bottom born with |
| throat atrophic glossitis | smooth glossy vit deficiency |
| throat aphthous ulcers | canker sores |
| throat Leukoplakia | white patches from smoking/drinking, precancerous |
Created by:
mbruckman03