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Skin assessment
314/315/ integementatary exam II
| Question | Answer |
|---|---|
| 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 |
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garrowcousino
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