Skin, hair, nails flashcards

What connective components are found in the dermis?

connective tissue, elastin, and collagen

What gives skin its characteristic elasticity?

The dermis

How does the dermis provide nourishment to the epidermis?

Through its large vascular supply

What sensory functions does the dermis provide?

Responds to touch, pain, and temperature through sensory nerve fibers

What structures are located within the dermis?

Sebaceous glands, sweat glands, hair follicles, nail follicles, nerves, and lymphatics

How does the dermis help regulate body temperature and blood pressure?

Blood vessels dilate or constrict in response to stimuli

What type of tissue makes up the subcutaneous layer?

Adipose (fat) tissue

What does the subcutaneous layer connect the dermis to?

Muscles and bones

List three main functions of subcutaneous fat.

Provides insulation, cushions underlying structures, and serves as an energy reserve

From where are hairs formed?

Epidermal cells located in the dermis

What supplies the dermis with blood?

The subcutaneous layer

What is the papilla in the hair follicle?

A capillary loop at the base that provides nourishment

What provides hair color?

Melanocytes within the hair shaft

What are nails made of?

Hard plates of keratin

What should healthy nails look like?

Smooth and round

Why is the tissue under the nail plate significant?

It is highly vascular

By examining nails, what body system can we assess?

The circulatory system

What do sebaceous glands produce and what is their function?

They produce sebum, which lubricates skin and hair

Where are sebaceous glands most concentrated?

On the face and scalp

What type of sweat glands are the major sweat glands of the body?

Eccrine glands

Where are eccrine sweat glands highly concentrated?

Palms, soles, and forehead

What is the primary role of eccrine sweat glands?

Temperature regulation

What glands are responsible for body odor?

Apocrine glands

When do apocrine glands begin secretion and what influences them?

At puberty; strongly influenced by hormones

What should be assessed when looking at skin color?

If color is consistent with ethnic background

What should be described during skin inspection?

Color, consistency of color, clean, and moisture/dryness

What else should be noted during skin inspection?

Presence or absence of wounds, lesions, and whether skin is intact

What should be noted when palpating skin?

Texture, temperature, surface characteristics, and turgor

Skin turgor less than

2 seconds

What does "A" stand for in lesion assessment (ABCDE)?

Asymmetry – is the lesion symmetrical or asymmetrical

What does "B" stand for in lesion assessment?

Border – is it regular or irregular?

What does "C" stand for in lesion assessment?

Color – describe the color of the lesion

What does "D" stand for in lesion assessment?

Diameter – measure in millimeters or centimeters

What does "E" stand for in lesion assessment?

Elevation, Exudate, and Evolution

Give an example of a lesion description using ABCDE.

Symmetrical, regular border, brown in color, 2mm in diameter, flat, no exudate, and unchanged over time

What should you describe when inspecting and palpating hair?

Color, texture, distribution, and quantity

What scalp findings should be checked during a hair exam?

Lesions and parasites (e.g., lice)

Example hair assessment description?

Hair is brown, smooth, evenly distributed, and thick with no visible lesions or parasite

What should you describe when assessing nails?

Shape, contour, color, and capillary refill bilaterally

What nail findings may suggest systemic disease?

Clubbing, ridges, cracks, or abnormal color (blue/pale)

What is a normal capillary refill time?

Less than 2 seconds

What does a capillary refill >2–3 seconds indicate?

Respiratory or cardiac disease, anemia, or circulatory insufficiency

Example nail assessment description?

Nails are curved, smooth, pink, and round with brisk capillary refill (<2 seconds)

What does poor skin turgor indicate?

Dehydration (or in older adults, loss of adipose tissue and elasticity)

What descriptors can be used for skin texture and thickness?

Soft, smooth, rough, uneven, papery, thin, leathery, or firm

What does pallor indicate?

Paleness, possibly due to anemia or decreased circulation

What does erythema indicate?

Redness, often from inflammation or infection

What does cyanosis indicate?

Bluish discoloration due to poor oxygenation

What does jaundice indicate?

Yellow discoloration due to liver dysfunction or bilirubin buildup

Cyanosis (light skin)

grayish blue tone, especially in nail beds, mucous membranes, palms

Cyanosis (dark skin)

ashen-gray color easily seen in the conjunctiva, oral mucous membranes, and nail beds

Ecchymosis (bruise)

dark red, purple, yellow or green color depending on age of bruise

Erythema

reddish tone with an increased temp due to inflammation

Jaundice

yellowish color of the skin, sclera of the eyes, fingernails, palms of hands, and oral mucosa

Pallor 

pale skin that may appear white 

How is skin temperature documented?

“Warm to touch” or “Cool to touch.”

What should be documented if skin findings are within normal limits (WDL)?

“Skin is warm, dry, and intact.”

What should you check for when assessing skin integrity?

Wounds, tears, or blisters

How to document skin assessment findings

“Skin is warm, dry, and intact”

What is pitting edema?

Indentation remains in the skin after palpation

+1 edema

2 mm depression, barely detectable; immediate rebound

+2 edema 

4mm deep pit. a few seconds to rebound

+3 edema

6mm deep pit. 10-12 seconds to rebound

+4 edema

8 mm very deep pit. >20 seconds to rebound

What does a generalized lesion distribution mean?

Lesions are scattered all over the body

What does a zosteriform lesion pattern indicate?

Lesions follow a nerve pathway (e.g., shingles).

What type of border do melanoma lesions typically have?

Irregular borders with indistinct margins

What changes in melanoma require concern?

Recent growth, color change or variation, and change in sensation (pain, itching, tenderness)

What surface changes may occur in melanoma?

Bleeds easily or becomes scaly

Why does melanoma require prompt referral?

It is the deadliest form of skin cancer and metastasizes quickly

What medical devices can cause pressure injuries?

NG tubes, neck collars, braces, casts, oxygen tubing, CPAP masks

What is a Stage 1 pressure injury?

Non-blanchable erythema of intact skin

What is a Stage 2 pressure injury?

Partial thickness loss of dermis

What is a Stage 3 pressure injury?

Full-thickness loss involving subcutaneous tissue

What is a Stage 4 pressure injury?

Full-thickness loss with exposed bone, tendon, or muscle

What is an unstageable pressure injury?

The base is covered by slough or eschar; staging can only be done after debridement

hat is a suspected deep tissue injury?

Discolored, intact skin suggesting underlying damage

What are the six categories of the Braden Scale?

Sensory perception, moisture, activity, mobility, nutrition, friction & shear

Braden scale 15-18

at risk

Braden scale 13-14

moderate risk

Braden scale 10-12

high risk

Braden scale <9

very high risk

Hirsutism

increase growth in facial, body, or pubic hair in women

What is paronychia?

Inflammation of the cuticle, usually caused by staphylococcal infection

What is koilonychia and what is it associated with?

Spoon-shaped nails; associated with anemia

What is onychomycosis?

Fungal infection of the nail plate

What is clubbing of the nails associated with?

Chronic respiratory disease (and sometimes cardiovascular disease)

What is congenital dermal melanocytosis (Mongolian spot)?

Dark, irregularly shaped flat area over sacrum/buttocks; common in African American, Hispanic, Native American, and Asian infants. Disappears by age 1–2

What is nevus simplex (stork bite)?

A common birthmark on back of neck or head that fades over time

What is seborrheic dermatitis (cradle cap)?

Scaly crust on the scalp in infants

What is irritant contact dermatitis in infants?

Diaper rash

What are milia in infants?

Small white papules at birth; benign; disappear by week 3

What is melasma (mask of pregnancy)?

Darkening of freckles/moles during pregnancy

What are striae?

Stretch marks that occur during pregnancy

What causes varicose veins in pregnancy?

Venous congestion from increased blood volume and pressure

What is the linea nigra?

A dark vertical line on the abdomen during pregnancy (“line of pregnancy”)

How does skin change in older adults?

thinner, less elastic, more wrinkled, uneven pigmentation, higher risk for tears

What are age spots (lentigines)?

Benign, flat, brown macules on sun-exposed areas (hands, arms)

What serious skin risk increases in older adults?

Skin cancers

What did the International Agency for Research on Cancer (IARC) classify tanning beds as?

Highest cancer-risk category (Group 1 carcinogen).