Skin, Hair, & Nails General Knowledge Q's

NUR 300 USM

5 components of the Integ system

skin

hair

nails

glands

mucus membranes

name some functions of the integ system

sensation/perception

thermoregulation

fluid balance

vit D synthesis

excretion

immunity

Layers components

epidermis: avascular outer layer

dermis: connective tissue, sensory nerve fibers, capillaries, collagen, elastin

subQ: adipose tissue

Difference between vellus and terminal

Vellus: fine hairs found throughout the body

Terminal: darker, coarser hair found in eyebrows & scalp hair

Sebaceous glands

Produce protective oil — sebum

Eccrine glands

Secrete odorless fluid

Maintain body temp & produce sweat

Located in all skin (mainly palms, soles of feet, axilla, forehead)

Apocrine glands

Produce body odor

in response to bacterial decomp and emotional stress

Located in axillary and genitals

List skin disorders w/ fam tendencies

Acne

Cancer

Eczema

Psoriasis

Seborrhea dermatitis

What does the American Cancer Society recommend for skin checks?

Yearly skin exam for patients 20+ y/o

Individuals should know their pattern for moles, blemishes, freckles, and other marks on skin

(UV) radiation from indoor tanning beds increases a person’s risk of developing melanoma by ____%!!!

75%

Albinism

Total or partial absence of Tyrosine (produces melanin)

Inherited disorder

Carotenemia

Yellowing of skin due to increased dietary intake of carotene

Foods: carrots, sweet potatoes, pumpkin, corn, yams, spinach, beans

Sclera does NOT become yellow

Central Cyanosis

Bluish discoloration to the skin due to decreased circulating O2

Erythema

Red, pink skin color

May indicate inflammation, fever, increased blood flow

Hyperpigmentation

Darker skin color

hypopigmentation

Lighter skin color

Jaundice

Yellowing of the skin → Increase bilirubin

Byproduct of hemoglobin breakdown = Bilirubin

Bilirubin is broken down in the liver

Symptoms: fatigue/lethargy, vomiting

Pallor

Pale skin

Anemia, decrease in RBC circulation, decrease in blood flow, absence of oxygenated blood

Peripheral cyanosis

Blue/gray/slate/dark purple discoloration of skin or mucus mems

Caused by deoxygenated/reduced hemoglobin in the blood

May occur w/ decreased Cardiac Output

Vitiligo

Smooth, white patches of skin all over the body

Autoimmune disorder (melanocytes attacked by immune system)

No major issues, except self-image issues

What affects skin texture?

Autoimmune diseases

Acne vulgaris

Eczema

Hormonal conditions

Rosacea (image)

Keloids

Overgrowth of collagen

Can be itchy and grow over other parts of the body

Can sometimes grow back even after being removed

ABCDEs of Melanoma

Asymmetry

Border

Color

Diameter (>6 mm)

Evolving

What can rashes be related to? (just name a few there are so goddamn many)

Diet,

stress,

medications,

allergies,

hormone imbalance,

autoimmune disease,

kidney disease,

toxic reactions,

digestive problems,

body imbalances,

chemicals, and

sun exposure.

Hair changes can be related to? and give example for easy ones

Diet (eating disorders can cause hair to be brittle)

Vitamin deficiency (A, B6, C)

Endocrine (Grave’s thins the hair)

Infestation (lice)

Stress (falling out)

Nail changes related to….

Nutrition

Stress

Systemic disease

Vitamin deficiency

Infection

Nail biting or picking

Nail care

What are the 3 angles for clubbing to remember?

160 —→ Normal

180 —→ Early clubbing

>180 —→ Late clubbing

Name the Primary Lesions (6)

Macule

Papule

Vesicle

Pustule

Nodule

Wheal

Description & size:
Macule

Small, flat (freckle)

<1 cm

Description & size:
Papule

Solid, elevated, rough texture (mole)

< 1 cm

Description & size:
Vesicle

Raised, filled w/ serous blood or clear fluid (HSV)

< 1 cm

Description:
Pustule

Vesicle filled w/ pus

Description & size:
Nodule

Solid, elevated (fatty lipoma)
1 cm

Description:
Wheal

red & itchy and raised (hives)

Macule that is >1 cm turns into a…

Patch (1 cm+)

Papule that is >1 cm turns into a…

Plaque

Vesicle that is >1 cm turns into a…

Cyst

Nodule that is >2 cm turns into a…

TUMOR

List the secondary lesions (8)

Crusts

Scale

Excoriation

Erosion

Ulcer

Fissure

Scar

Keloid

Crusts

Dried blood, pus, serum

Scale

Build up of dead skin cells that flake off

(Psoriasis)

Excoriation

Scratching (hollow)

Erosion

Depressed, moist, shiny

Ulcer

Erosions of different layers of skin

(Exudative)

Fissure

Linear break in skin

Scar

Fibrous tissue over healed wounds

Keloid

Excessive collagen production beyond wound boundaries

Generalized rash

Spread over most of the body

Localized rash

Contained to one specific area

Regional rash

Located in 1 body region

(i.e. is it only on the trunk and not the face? Only on the leg and not the groin?)

Disseminated

Widely scattered

Discreet

Individual/separate

Symmetric

No pattern

Asymmetric

Pattern lacking, randomness

Grouped

Clustered

Confluent (coalescing)

Smaller into larger

Cleavage plane

Arranged along lines of skin tension

Dermatomes

Lesions follow the nerve root

Zosteriform

Dermatomal

(Along the nerve root)

Besides bedbound patients, which patient population is at high risk for ulcers?

Diabetics due to peripheral neuropathy — excess sugar in the blood clogs up the vessels in extremities, and also patients cannot feel down there to know if their foot is okay or not

Stage 1 pressure injury

Non-blanchable erythema of intact skin

Stage 2 pressure injury

Partial-thickness skin loss with exposed dermis

• Wound bed = pink/red, moist, can appear as a blister

• Adipose fat is NOT visible

• NOT considered a moisture associated skin damage

Stage 3 pressure Injury

Full-thickness skin loss with exposed SubQ tissue (adipose)

• Granulation tissue and epibole are present

• Depth varies by location

• Fascia, muscle, tendon ligament, cartilage, bone NOT exposed

Stage 4 Pressure Injury

Full-thickness loss of skin and tissue

• Fascia, muscle, tendon ligament, cartilage, and/or bone exposed

How often does the Braden scale need to be done?

q12h

The _______ the score, the HIGHER the risk on Braden scale

LOWER

Name the components of the Braden Scale

Sensory perception

Moisture

Activity

Mobility

Nutrition

Friction/shear