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Skin, hair, nails
Jarvis Health Assess, Ch 12, Skin, Hair, Nailes
| Term or question | Definition or answer |
|---|---|
| 3 Layers of skin | Epidermis, Dermis, Subcutaneous |
| Epidermis | Rugged protective barrier, consisting of the stratum germinativum and stratum corneum; regenerates about once every 4 weeks; avascular |
| Stratum germinativum | basal cell layer of epidermis, forms new cells; major ingredient: keratin; melanocytes are located here |
| Stratum corneum | Outer horny layer of the epidermis consisting of dead keratinized cells |
| 3 sources that det skin color | 1. brown pigment, melanin2. yellow-orange pigment, carotene3. the red-purple underlying vascular bed; all skin tones are varying shades of brown, yellow, red |
| Dermis | The inner supporting layer of the skin consisting mostly of connective tissue, collagen; enables skin to resist tearing; nerves, sensory receptors, blood vessels and lymphatics are located here; appendages from the epidermis are embedded here. |
| Appendages of the epidermis | hair follicles, sebaceous glands, sweat glands, nails |
| Vellus hair | Fine, faint hair that covers most of the body excedt palms, soles, dorsa of the distal parts of the fingers, the umbilicus, the glans penis and inside the labia |
| Terminal hair | Darker, thicker, hair that covers the scalp, eyebrows, axilla*, pubic area*, face*, and chest* (*after puberty, face and chest males) |
| Sebum | A protective lipid substance produced by sebaceous glands and secreted through hair follicles; retards loss of moisture through the skin. |
| Two types of sweat glands | Eccrine and Apocrine |
| Eccrine glands | Coiled tubules that open directly on to the skin surface and produce a dilute saline solution (sweat); widely distributed throughout the body and mature at 2 yrs; evap of sweat reduces body temp. |
| Apocrine glands | Produce a thick, milky secretion and open into the hair folicles; located mainly in the axilla, anogential area, nipples, and naval; vegstigal in human; active during puberty, secretion with emotional or sexual stimulation |
| Nails | hard plates of keratin on the ends of the fingers and toes |
| Functions of the skin | 1. Protection 2. Prevent penetration 3. Perception 4. Temp regulation 5. Identification 6. communication 7. Wound repair 8. Absorption/excretion 9. Vit D. |
| Skin protects from | injuury, cold, dehydration, microorganisms, loss of water or electrolytes |
| Perception includes | touch, pain, temperature, pressure |
| Communication via skin includes | Review if it is symmetrical, emotions via CNII, vascular mechs such as blushing or blanching |
| ABCDE | Evaluate skin changeAsymetry, Border irregularity, Color variation, Diameter (> 6mm), Elevation or Enlargement; also check for newly pigment lesions, itching, burning or bleeding from a mole. |
| External variables that may influece skin color | 1. emotional state 2. temp 3. smoking 4. prolonged elevation of extremeties 5. prolonged inactivity |
| 4 categories of widespread color change | Pallor, Erythema, Cyanosis, Jaundice |
| Pallor | pale |
| Erythema | An intense redness of the skin from excess blood (hyperemia) in dilated superficial capillaries; expected with fever, local inflammation or emotion |
| Cyanosis | bluish mottled color that indicates decreased perfusion; a nonspecific sign; difficult to detect in dark skinned. |
| Jaunice | Yellow color indicates increase in bilirubin in blood; occurs with hepatitis, cirhosis, sickle-cell disease, transfusion reaction and hemolytic disease of the newborn. |
| Inspect temperture | bilaterally using the dorsa of the hands |
| Moisture look for | diaphoresis (sweating) or dehydration |
| Edema ratings | 1+ mild pitting, slight indentation, no leg swelling2+ moderate pitting, indentation subsides rapidly3+ deep pitting, indentation remains for a short tiem, leg looks swollen4+ very deep pitting, indentation lasts a long time, leg is v swollen |
| Lesions look for | Color, elevation, pattern or shape, size, location & distribution on body, exudate |
| Assess hair | inspect/palpate, color, texture, distriution, lesions then promote self-care |
| Assess nails | contour, consistency, color: inspect/palpate, look at shape and contour (angle <= 160 normal); consistency (smooth, regular, with uniform thickness, not brittle); color - translucent with pink nail bed below, capillary refill in 2 sec or less is normal |
| Cherry (senile) angiomas | small (1 - 5 mm) smooth, slightly raised, bright red dots commonly on trunk in all adults > 30. |
| ecchymosis | bruising; should be consistent with expected trauma |
| purpura | a flat macular hemorrhage |
| zosteriform | a linear skin lesion that runs along a nerve route |
| primary lesion | occurs on new skin or previously unaltered skin |
| secondary lesion | changes over time due to a factor such as scratching or infection |
| lanugao | fine downy hair on a newborn infant; |
| annular | circular lesion; begins in center and spreads to periphery |
| confluent | lesions run together |
| uticaria | hives |
| discrete | distinct, individual lesions |
| target or iris | lesions that resemble iris of the eye, concentric rings of color |
| polycyclic | annular lesions grow together |
| macule | a color change; flat circumscribed, less than 1 cm; freckles, flat nevi, hypopigmentation, petechiaea, measles, scarlet fever |
| papule | something you can feel (solid, evelvated, less than 1 cm) caused by superficial thickeingin the epidermis |
| patch | macules that are larger than 1 cm (ex: vitiligo, cafe' au lait spot) |
| plaque | papules coalesce to form a surface elevation wider than 1 cm; psoriasis |
| nodule | solid, evelated, hard or soft, larger 1 cm; may extend deeper into dermis than paupule; |
| wheal | superficial, raised, transietn, ertyematous; slightly irregular shpae due to edema (mosquito bite, allergic reaction) |
| tumor | larger an a few cm in diameter, firm or soft; deeper into dermis; may be genign or malignant; example: hemiangioma |
| uticaria | hives; wheals coalesce to form extensive reaction; intensely pruritic |
| vesicle | elevated cavity containgin free fluid up to 1 cm; blister; clear serum flows if wall is ruptured. (herpes, simplex, early varicella, herpes zoster, contact dermititis) |
| bulla | larger than 1 cm diameter, usually single chambered; superficial in epidermis; thin walled, ruptures easily; ex: friction blister, burns |
| cyst | encapsulated fuli-filled cavity in dermis or subcutaneous layer, tensely elevating skin; |
| pustule | turbid fluid (pus) in the cavity; circumscribed and elevated. examples impetigo, acne |
| hematoma | a bruise you can feel; elevates the skin and is seen as swelling; |
| mongolian spot | common variation of hyperpigmentation in black, asian, american indian, and hispanci newborns; blue-black to purple macular area at the sacrum or buttocks or other locations; 90% of blacks, 80% of asians, 9% whites |
| harlequin color change | baby is in side lying position, lower half of the body turns red and upper half blances; transient |
| erythema toxicum | common rash in newborns; no reatment required |
| acrocyanosis | blueish color around lips, hands and fingernails, feet and toenails |
| cutis marmorata | transient mottli in trunk and extremeties in response to cooler room teperature |
| physiological jaundice | half of all newborns |
| carotenemia | yellow-orance color in light skinned persons, but no yellowing in sclera or mucous membranes from too much beta carotene |
| milia | tiny, white papules on cheeks, forehead and acros the nose and chin caused by sebum |
| storkbite | salmon patch on forehead; usually fades in first year |
| nails of newborns | may be blue for the first few hours of life, then they turn pink |
| chloasma | irregular borwn patch of hyper pigmentation in the face of pregnant women or woment taking contraceptives |
| vascular spiders | occur in 2/3 of pregnancies and white women |
| senile lentigines | liver spots; small, flat, brown, macules; |
| keratoses | raised, thickened areas of pigmentation that look crusted, scaly, warty |
| seborrheic keratosis | dark, greasy, stuck-on ; do not become cancerous |
| acrochordons | skin tags; overgrowths of normal skin that form a stalk and are polyp like |
| sebaceous hyperplasia | raised, yellow papules with ac entral depression; more common in men; forehead, nose, cheek, pebbly look |
Created by:
kgreen165
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