PD Quiz 1- Hair, Skin and Nails

Macule

flat, colored spot on the skin less than 1 cm

Ex: freckles

Patch

a flat, discolored area on the skin larger than 1 cm

Ex: vitiligo

Papule

small, solid skin elevation less than 1 cm

Ex: Wart

Plaque

an elevated patch on the skin formed by a coalscense of papules

Ex: psoriasis

Nodule

solid, round or oval elevated lesion 1 cm or more

Ex: cyst

Vesicle

small circumscribed elevation of the epidermis containing clear fluid less than 1 cm

Ex: herpes simplex

Bulla

A circumscribed elevation of the epidermis containing clear fluid greater than 1 cm

Ex: 2nd degree burn

Wheal

a circumscribed, raised lesion consisting of dermal edema

Ex: hives

Pustule

small palpable collection of pus

Ex: acne, impetigo

Comedone

the plugged opening of a sebaceous gland at pore/follicle

Ex: Acne (white- closed black- open)

Furuncle

skin abscesses at the hair follicle and surrounding tissue

Carbuncle

multiple furuncles

Erosion

Loss of the superficial epidermis, surface is moist but does not bleed

Ex: rupture of a vesicle in chicken pox

Ulcer

deeper loss of skin, may bleed and scar

Ex: stasis ulcers

stage 1 ulcer

intact skin; red/irritation; unblanchable

stage 2 ulcer

broken skin; partial thickness; blister epidermis and dermis; can ooze

stage 3 ulcer

Full-thickness pressure ulcer extending into the subcutaneous tissue and resembling a crater. May see subcutaneous fat but not muscle, bone, or tendon.

stage 4 ulcer

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

Fissure

a linear crack in the skin

Ex: angular cheilitis

Crust

Hard and rough surface formed by dried sebum =, exudate, blood or toher body fluids

Ex: impetigo

Scale

a thin flake of exfoliated epidermis

Ex: dandruff

Lichenification

Thickening and roughening of the skin with increased visibility of the normal skin furrows

Ex: atopic dermatitis

Atrophy

thinning of the skin with the loss of normal skin furrows

Ex: seen in aging

Excoriation

an abrasion or scratch mark

Scar

replacement of destroyed tissue by fibrous tissue

Keloid

firm, hypertrophic mass of scar tissue that extends beyond area of injury

Telangiectasia

fine, irregular, blood vessels

Spider angioma

central red macule with radiating spider like arms

cherry angioma

small red papules

petechiae

reddish-purple macules

1-3mm

Purpura

reddish-purple macules

>3mm

Ecchymosis

purple or blue macules caused by trauma

Hematoma

A localized collection of blood

elevated ecchymosis

localized distribution

Restricted to one particular body area

generalized distribution

Covering much of the body in a regularly even pattern

symmetric distribution

lesions appear to be distributed in a similar arrangement on differing sides of the body

asymmetric distribution

Lesions are not distributed in a symmetrical pattern

discrete distribution

Separate, distinct lesions that are not joined to one another

coalescing distribution

lesions that have grown together

grouped distribution

lesions appear in clusters or groups

cleavage plane

arranged along lines of skin tension

circinate lesions

circular

arciform lesion

arc shaped

linear lesion

line

serpiginous lesion

wavy, snake like lesion

annular lesion

circular with central clearing

target lesion

concentric rings of color in lesions

Gyrate lesion

twisted, coiled spiral, snakelike

Zosteriform lesion

linear arrangement along a unilateral nerve route

geographic configuration

map like configuration

reticular configuration

lesions with a "net-like" arrangement

Verruca configuration

wart

Umbilicated configuration

skin nodule with central depression

Vegetative Configuration

the proliferation of papillomatous masses

Vitiligo

depigmented macule, may coalesce into extensive areas that lack melanin

Tinea versicolor

-Superficial fungal (yeast) infection of the skin

-Scaly macules

-Common in summer and tropical areas

what is the Nevi Evaluation?

an acronym used to guide questions/findings about a lesion

what is slow growing and locally invasive translucent papule or nodule with depressed center and rolled edges & what is it caused by?

basal cell carcinoma

sun exposure

grows quicker and more aggressively than a BCC

More ulcerated, also caused by the sun

squamous cell carcinoma

what is malignant melanoma?

most deadly skin cancer that develops in melanocytes

what is actinic keratosis? how is it described?

-Pre-cancerous lesions

-superficial flattened erythematous papules covered by dry scales

what is seborrheic keratosis?

common benign neoplasm, brown raised lesions in sun exposed areas

1/4 of the nail plate that is covered by the proximal nail fold

nail root

E in photo

what is the cuticle of the nail?

a thick layer of epithelium

what is the Lunula of the nail?

the half moon shaped, white area at the base of the nail

what is the hard, translucent part of the nail?

nail plate

what is the function of the nail bed?

Portion of the living skin that supports the nail plate as it grows toward the free edge.

What is the free edge of the nail?

the portion of the nail that grows out away from the body

what is the hyponychium of the nail? what is the paronychial edge of the nail?

-the region beneath the free edge of the nail (tip of nail)

-the lateral folds of the nail

what is the normal capillary refill of a nail?

<2 seconds

the distal phalanx of each finger is rounded and bulbous

nail clubbing

what is painless separation of the nail from the nail bed?

onycholysis

thickened yellow hypertrophic nail growth due to fungal infection

onychomycosis

paronychia

Inflammation and infection of the proximal and lateral nail folds, becoming erythematous, swollen, and tender

what occurs when the nail turns mostly white with a brown/red band? what can it indicate?

-terry's nails

-liver disease, heart failure, diabetes

what is leukonychia? who may have it?

-White spots on the nail

-people with anemia

Transverse depressions in the nails associated with acute or severe illness

beau's lines

what conditions cause pitted nails?

-Psoriasis

-psoriatic arthritis

what is hirstuism?

-excessive hair growth

-in females with PCOS this may occur in areas where males usually grow hair: chin, face, etc.

what is alopecia areata?

spot baldness

what is Telogen effluvium?

uniform hair thinning, constant shedding of hair

what is Trichotillomania?

hair pulling disorder, associated with psych conditions

what are the functions of the integumentary system?

secretion

heat regulation

absorption

protection

excretion

sensation

true or false? the epidermis contains many blood vessels

false- the epidermis contains no blood vessels

what structures exist in the dermis?

blood vessels

nerves

muscles

sweat glands

hair follicles

sebaceous glands

which layer is made up of fat, insulates the body, and serves as a place for energy storage?

subcutaneous tissue layer

what are sebaceous glands & where are they found?

oil secreting glands

located everywhere except palms & soles

what is the function of apocrine glands & where are they found?

-located deep in subcutaneous layer & secrete into the hair follicles

-located in the genitals & armpits

#2 in photo

what is the function of eccrine glands & where are they found?

-secrete to the surface (epidermis)

-located in the dermis

______ is the pigmentation in the skin

melanin

_________ is the golden/yellow layer in the skin

carotene

what are the two types of hemoglobin?

oxyhemoglobin

deoxyhemoglobin

which type of hemoglobin is bright red in color & predominant in the arteries & capillaries?

oxyhemoglobin

which type of hemoglobin is dark/somewhat bluish in color & is indicative of cyanosis or COPD?

deoxyhemoglobin

what acronym is used to form the HPI during an exam?

OPQRST

what are some important things to ask a patient when they come in for a skin check?

-any severe sunburns

-have you traveled recently

-family hx of skin cancer

-tattoos

-previous skin history

-allergies

when performing an exam, we start at the _________ and work towards the __________

head

toes

what parts of the hands & feet must be checked?

webbing

palms/soles

nails

what scale is used to determine skin pigmentation/skin type?

Fitzpatrick Scale

what does the Fitzpatrick scale tell us?

how the skin type will react to UV light & pt risk for cancer