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Skin assessment

314/315/ integementatary exam II

What is the ABCDE mnemonic r/o Malignancy? A = Asymmetry of lesion (not regularly round or oval),B= Border irregularity,C= Color variation,D=Diameter >6mm (pencil eraser)E= Elevation and enlargement
A== A = Asymmetry of lesion (not regularly round or oval)
B= B= Border irregularity
C= C= Color variation
D= E= D=Diameter >6mm (pencil eraser)E= Elevation and enlargement
Primary skin lesions MACULE = flat, nonpalpable, circimscribed, <1cm diamater, freckles =rubeolo & Rubella
circimscribed Bounded by a line; limited or confined.
freckles freckles =rubeolo & Rubella
Primary skin lesions Patch = flat nonpalpalpable, a macule >1cm. in diameter
Primary Lesions Plaque elevated, flat top, firm rough, a papule larger than o.5cm diameter, Psoriasis
Primary skin Lesions Papule elevated firm, <0.5 cm, circimscribed border, solid mass, warts
Primary skin lesions Bulla= >0.5 cm, elevated circumscribed, superficial, filled w/ serous fluid, contact dermatitis, posion ivy
Primary Skin Lesions Vesicle= elevated, circumscribed, superficial, filled with serous fluid, <0.5 cm in diameter, blister varicella
Primary Lesions Tumor >1-2 cm, elevated firm Palpable, deeper in dermis than Papule, irregular boarders
Primary Lesions Nodule elevated firm Palpable deeper in dermis than papule, 5-2 cm in diameter, lymphoma
lymphoma Any of various usually malignant tumors that arise in the lymph nodes or in other lymphoid tissue
Primary Lesions pustule elevated superficial,similar to a vesicle but filled with purulent fluid ie acne, impetigo=A contagious bacterial skin infection, usually of children, that is characterized by the eruption of superficial pustules and the formation of thick yellow crusts,
Primary Lesions cyst elevated , circumscribed, palpable, encapsulated, filled with liquid or semi solid material sabaeous cyst
superficial Of, affecting, or being on or near the surface: a superficial wound.
< is an acronym for: less than The "less than" symbol (<) is used to express a lower value. For example, if (x < 10) means "if X is less than 10."
> is an acronym for Greater than The "greater than" symbol (>) is used to express a larger value. For example, if (x > 10) means "if X is more than 10."
purulent fluid Containing, discharging, or causing the production of pus: a purulent infection. AKA pus A generally viscous, yellowish-white fluid formed in infected tissue, consisting of white blood cells, cellular debris, and necrotic tissue.
circumscribed Bounded by a line; limited or confined.
Primary Lesions wheal elevated mass, Irregular, serous fluid in the dermis, no fluid in a cavity, Urticaria, insect bites
Urticaria, = (AKA = hives)A skin condition characterized by intensely itching welts and caused by an allergic reaction to internal or external agents, an infection, or a nervous condition. Also called nettle rash, urticaria.
Primary skin Lesions Primary lesions are physical changes in the skin considered to be caused directly by the disease process. Types of primary lesions are rarely specific to a single disease entity.
Secondary skin Lesions Secondary lesions may evolve from primary lesions, or may be caused by external forces such as scratching, trauma, infection, or the healing process. The distinction between a primary and secondary lesion is not always clear.
Secondary Lesions erosion loss of superficial epidermis, dermis not involved, depressed moist area, scratch marks
2ndary lesions Ulcers = skin loss past epidermis, neccrotic tissue loss,bleeding and scarring, Pressure ulcar
neccrotic /ne·crot'ic Death of cells or tissues through injury or disease, especially in a localized area of the body.
2ndary lesions scar skin mark, replacement of connective tissue, new scars= red/purple old scars = white
Fissure linear, may involve dermis, chapped lips, athlete's foot
linear Of, relating to, or resembling a line; straight. Having only one dimension,In, of, describing, described by, or related to a straight line.
2ndary lesions Crust dried serum blood or purulent material, slightly elevated, varied size, scab, eczema
2ndary lesions scale flaky exfoliation, irregular, thick or thin, dry or oily, Psroiasis exfoliative dermatitis
2ndary lesions keloid hypertrophied scar tissue, elevated irregular, red, higher rate in African Americans, surigical incision
2ndary lesions atrophy transparent look of epidermis, loss of markings, vessels may be noted, aged skin arterial insufficiency
exfoliative dermatitis Widespread dermatitis characterized by scaling and shedding of the skin and usually accompanied by redness. Also called pityriasis rubra, Wilson's disease.
@ndary Lesions Lichenification thickening of skin, accentuated skin markings, repeated irritationThickening of the skin with hyperkeratosis caused by chronic inflammation resulting from prolonged scratching or irritation.
Vascular skin Lesions Petechia,Hematoma,cherry angioma, spider angioma
Petechia, A small purplish spot on a body surface, such as the skin or a mucous membrane, caused by a minute hemorrhage and often seen in typhus.
Hematoma A localized swelling filled with blood resulting from a break in a blood vessel.
/ spider angioma/ cherry angioma Spider angiomas, also known as "nevus araneus," are found slightly below the skin's surface. They often contain a central red spot, and reddish extensions that radiate outward like a spider's web estrogen , pregnancy/Cherry angioma is the most common kind
ecchymosis The passage of blood from ruptured blood vessels into subcutaneous tissue, marked by a purple discoloration of the skin.
Epidermis -protective barrier epidermis replaced every ??? 4 weeks 1 pound shed a year
stratum germinativum-basal cell layer-forms ??? including ??? new cells include the protein keratin and pigment producers-melanocytes
cells migrate from the basal layer to the ??? stratum corneum-dead cells shedding
Dermis = Inner supportive layer connective tissue- collagen, nerves, sensory preceptors, blood vessels, lymphatics, hair follicles, sebacious, sweat glands,= prevents tearing of skin elderly loss = skin tears
subcutaneous layer adopose tissue, stores fat 4 energy, insulatation temp control
Epidermal appendages Hair Hair Vestigial-no longer needed for protection from cold or trauma Threads of keratin
2 types of hair and where found ? Vellus hair-fine, over body Terminal hair-scalp, eyebrows, axillae, pubis,face chest in males
Sebaceous glands Lipid substance-sebum-hair follicles Lubrication Abundant-face,, forehead,scalp, chin
Name the 2 types of sweat glands Ecrine-dilute saline-sweat (mature in 2 month olds) Apocrine glands-thick milky secretions-open to hair follicles
where r Apocrine glands- found etc Axillae, nipples,navel, anogenital area Active during puberty Bacterial flora react with apocrine sweat to produce musky body odor Function decreases with age
anogenital area Relating to the anus and the genitals.
name 10 functions of the skin Protection from dehydration and minor trauma Temperature control, absorption,excretionSensory input about the environment First line of defense vs penetration Expression of emotion Sweating Production of Vitamin D Wound repair Identification Communication
Name *8 subjective findings related to the skin 1Previous history of skin disease 2Change in pigmentation 3Change in moles 4Excessive dryness or moisture 5Pruritus-most common skin symptom (can + diabitis)6Excessive bruising 7Rash or lesion 8MEDICATIONS and ALLERGIES (photosensivity hives)
Name 4 subjective findings related to the skin 1Hair loss 2Change in nails 3Environmental or occupational hazards exposure to irrantants4Self-care behavior
what are some questions u might ask while taking a health history ???Why? 1Has skin changed with age 2Trouble clipping nails 3Multiple bruises Delayed wound healing (diabiates circulation)Itching Pain Skin care
Problem based history Rash Pain/Discomfort to the skin Itching and hives Change in skin color or moles Hair Nails
Risk factors concerning the skin include??? Systemic disease (lupus)Previous trauma or injury Infection Immobility Frequent sun exposure Exposure to chemicals Exposure to allergens Medications with photosensitivity
Equiptment needed to assess the skin? Magnifying lens Centimeter ruler Light source Gloves
Inspection of color cyanosis will present __ in light skin and in dark skin cyanosis light = grayish blue tone dark = ashen gray
cyanosis A bluish discoloration of the skin and mucous membranes resulting from inadequate oxygenation of the blood.
Inspection of color Ecchymosis will present in light skin and in dark skin light skin= Dark red, purple/ dark skin = deeper blue or black
Ecchymosis Brusing (AKA) The passage of blood from ruptured blood vessels into subcutaneous tissue, marked by a purple discoloration of the skin.
Inspection of color Jaundice will present in light skin and in dark skin light skin= yellowish dark skin =yellow green inside of eyelid or mouth
Jaundice Yellowish discoloration of the whites of the eyes, skin, and mucous membranes caused by deposition of bile salts in these tissues. It occurs as a symptom of various diseases, such as hepatitis, that affect the processing of bile.
Inspection of color Pallor will present in light skin and in dark skin in light skin = white in dark skin= lighter than nl
Pallor Extreme or unnatural paleness.
in light skin and Petechiae in dark skin light = SM pinpoints Dark = difficult 2 see
Petechiae A small purplish spot on a body surface, such as the skin or a mucous membrane, caused by a minute hemorrhage and often seen in typhus.
Inspection of color Rash will present in light skin and in dark skin light seen & palpate dark = palpate
Rash (blank)
Inspection of color scar will present in light skin and in dark skin light= narrow line dark = keloid
Inspection of color erythema will present in light skin and in dark skin light =red& warm dark = hard to see feel warm
erythema Redness of the skin caused by dilatation and congestion of the capillaries, often a sign of inflammation or infection.
7 Lesion Characteristics 1Location & distribution 2Color-vitiligo-pg 231 3Pattern 4Edges 5Flat, raised, sunken 6Size 7 Characteristics
what are 4 different shapes of skin lesions? 1Singular/discrete 2Groups/clustered-3Polycyclic-annular lesion group-4Confluent-runs together-5Linear 6Zosteriform 7Generalized
Name 7 different patterns of skin lesions 1Singular/discrete2Groups/clustered-3Polycyclic-annular lesion group-psoriasis
1Singular/discrete example of -molluscum
molluscum Any of various skin diseases in which soft spherical tumors form on the face or other part of the body.
2Groups/clustered-example of contact dermatitis
contact dermatitis An acute or chronic skin inflammation resulting from contact with an irritating substance or allergen.
3Polycyclic-annular lesion group-psoriasis psoriasis
psoriasis A noncontagious inflammatory skin disease characterized by recurring reddish patches covered with silvery scales.
Polycyclic-annular lesion group- Shape: Round, oval, polycyclic, annular. 4. Arrangement: Zosteriform, arciform,
4Confluent-runs together- urticaria
urticaria aka hives A skin condition characterized by intensely itching welts and caused by an allergic reaction to internal or external agents, an infection, or a nervous condition.
5Linear- example scratch, streak, stripe
6Zosteriform- example linear arrangement along nerve route Zoster
Zoster eruptions along a nerve path often accompanied by severe neuralgia
7Generalized-example over most of body
What is noted while palpating during a skin assessment? Turgor-elasticity Moisture Temperature Mobility- tenting Texture Thickness Edema
What should be noted about the hair during a skin hair and nail assessment? Head, axillary, pubic, facial, body Scalp and hair-inspect for surface characteristics, hair distribution, texture, quantity, and color Facial & body hair-inspect for hair distribution, quantity, and texture. Hirsutism-excess body hair-think endo in femal
Hirsutism -excess body hair-think endo in female
how are the assessed? Inspect & palpate
What is noted about the nails in a nail assessment? Shape-profile sign Contour-profile sign Consistency-smooth,regular Color Thickness-uniform Cleanliness Cap refill TOES—foot care?
What are some normal findings in an older adult that could be found ina hair, skin, nails assessment? Skin is dryer, less perspiration-xerosis Folded and wrinkled appearance, itchy skin loose flaky Decrease in melanin production Age associated baldness Slower nail growth
normal findinds concerning skin Texture in older adults Acrochordons,Senile lentigines-liver spots-keratosis Seborrheic,Actinic keratosis, keratosis
Acrochordons - skin tags-eyelids cheeks, neck axillae, trunk
Senile lentigines Senile lentigines-liver spots-extensive sun exposure-forearms, dorsa of hands
Keratoses- raised thick crusty scaly warty
Seborrheic keratosis -dark greasy-sun exposure
Actinic keratosis -red-tan,plaque- silvery white scale adhered to plaque-r/t sun exposure-PREMALIGNANT-may becone squamous cell cancer
Changes in the skin in older adults Thickness Thin-parchment-subcutaneous fat diminishes Mobility, turgor Less elasticity-tenting
changes in hair in older adults Growth decreases Post menopause-women bristly hairs chin upper lip Men- hair bristly hair ears,nose,eyebrows Male pattern baldness-inherited Hair turns gray-decrease of melanocytes
Changes in Nails in older adults ? growth rate decreases Surface brittle,peeling yellowed Toenails thick misshapen Fungal infection-thick crumbling, erythematous scaling of contiguous skin surfaces
other changes in the kin in older adults Mongolian spots Café au lait spot 6+ neurofibromatosis Erythema toxicum-newborn Acrocyanosis Physiological jaundice Carotenemia Milia Lanugo
Mongolian spots Any of a number of dark-bluish or mulberry-colored spots on the lower back, observed in newborn infants, that enlarge for a short time after birth and then gradually recede. Also called blue spot.
Café au lait spot 6+ neurofibromatosis look up
Acrocyanosis A circulatory disorder in which the hands, and less commonly the feet, are persistently cold, blue, and sweaty.
Physiological jaundice look up Mild jaundice of newborns caused mainly by functional immaturity of the liver. Also called physiologic icterus.
Carotenemia The presence of excess carotene in the blood, often resulting in yellowing of the skin.
Milia milk spots White plaques of hyalinized fibrous tissue situated in the epicardium and overlying the right ventricle of the heart where not covered by lung.
Lanugo A covering of fine, soft hair, as on a leaf, an insect, or a newborn child.
start @ stages of preassure ulcar (blank)
Stages of preassure ulcers Stage 1= skin unbroken appears red
Stages of preassure ulcers Stage 2 skin brokensuperficial skin loss involving epidermis or dermis lesion vesical or blister
Stages of preassure ulcers Stage 3 involves epidermis dermis and sub q tissue crater not into fascil
Stages of preassure ulcers Stage 4 involves open dermis & sub Q bone & other tissue
variations Limited mobility Risk for skin breakdown Stages of skin breakdown Bony prominences
Health Promotion Immunizations Sun exposure and protection Skin cancer Basal cell carcinoma Melanoma
Basal cell carcinoma blistered crusty lesions
squamous crater indentation
Skin self evaluation Pg238 know this
Created by: garrowcousino