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Assess10_Integument
skin, hair & nails
| Question | Answer |
|---|---|
| skin | largest organ, provides clues about general health, changes in the environment |
| relat to respiratory | central & peripheral cyanosis |
| relat to digestive | jaundice |
| relat to cardiovascular | lesions, ulcerations, necrosis |
| relat to neurological | sensation of touch, temp, pressure, vibration and pain |
| relat to urinary | pruritis due to toxin buildup |
| age related skin changes: infant | less subcutaneous tissue, skin appears pinkish |
| seborrheic dermatitis | from infant sebum secretion (cradle cap?) |
| age related skin changes: adolescent | apocrine glands become active, axillary sweating, body odor. Sebaceous glands start producing oil, acne predisposition |
| age related skin changes: older adult | keratotic lesions, age spots = increased melanocytes graying hair = decrease in melanocytes |
| How do you check for color variations in Asians? | Sclera, conjuntiva |
| subj history: changes in skin | new moles, lesions; rashes, itching, dryness, pain, bleeding; fever, sore throat, SOB; recent environmental exposures; hair and nail changes |
| subj history: skin cancer risk | fair skin, family history, exposure to sun, age |
| PA approach | Head to toe, anterior, posterior, lateral. Assess by regions when examining cardio, resp and other systems |
| PA techniques | Inspection and palpation |
| Primary lesion | Initial alteration in the skin |
| When assessing color changes in dark-skinned people, check this | oral mucosa membranes |
| Secondary lesion | lesions resulting from changes in the primary lesion |
| Vitiligo | patchy pallor |
| Inspection of skin (4) | color, odor, lesions, signs of abuse |
| Inspection of nails (4) | Color, length/cleanliness, ridges or pitting in nailbed, clubbing |
| clubbing | > 180 degrees, vs normal at 160 degrees |
| Inspection of hair (3) | color/quality/distribution, scalp conditions, infestations |
| what causes clubbing? | poor circulation/resp, causes excess CO2. COPD, lung cancer* |
| Palpation of skin (4) | Temperature, Moisture, Texture, Turgor |
| Palpate nail bed | Capillary refill <3 seconds, texture |
| palpate scalp | mobility, tenderness, masses, texture of hair |
| macule | primary lesion; flat, distinct color area <1cm FRECKLE |
| patch | primary lesion; large macule >1cm |
| papule | primary lesion; solid, elevation of skin, no visible fluid <1cm |
| plaque | primary lesion; broad, raised area on skin |
| nodule | primary lesion: slightly elevated lesions, larger than papule but <2cm |
| purulent | having pus |
| pustule | primary lesion; small elevation containing purulent material |
| vesicle | primary lesion; small fluid-filled blister |
| bulla | primary lesion; fluid-filled blister >5mm diamter |
| wheal | primary lesion; raised, pruritic |
| pruritic | causing itching |
| secondary lesions | scale, crust, erosion, ulcers, fissures |
| atrophy | scarring |
| Descriptions of lesions | surface relationship (raised, flat or depressed) |
| Descriptions of lesions | blanching or pulsation of vascular lesions |
| Descriptions of lesions | pattern, configuration and distribution |
| Descriptions of lesions | size, shape, color, texture, exudate, tenderness |
| pattern configuration | round/oval |
| pattern configuration | discrete |
| pattern configuration | grouped |
| pattern configuration | confluent |
| pattern configuration | linear |
| pattern configuration | annular/circular |
| pattern configuration | arciform |
| pattern configuration | iris |
| pattern configuration | reticular |
| pattern configuration | gyrate |
| pattern configuration | polycyclic |
| distribution | diffuse |
| distribution | scattered |
| distribution | localized |
| distribution | dermatome |
| distribution | hairy areas |
| distribution | extensor/flexor surfaces |
| distribution | sun exposed areas |
| distribution | interiginous (folds) |
| Purpuric Lesions | Vascular lesion; ecchymosis; non-blanchable, variable size; caused by trauma |
| Purpuric Lesion | vascular lesion; |
Created by:
kpieroni
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