NR414: Exam2 (skin & musculoskeletal system)

Macules

• Primary skin lesion

• Flat lesion

• Diff pigment from skin

• <1cm diameter

• Ex: petechiae, freckles

Lesion

General term for rash

Patches

Macules >1cm

Primary Skin Lesion

Papules

• Primary skin lesion

• Elevated

• Solid

• Demarcated

• <1 cm diameter

• Ex: warts & some moles

Demarcated

Clear, distinct boundary between healthy & abnormal tissue

Vesicles

• Primary skin lesion

• Elevated

• <1cm

• Filed w/ serous fluid

• Ex: chicken pox, shingles

Bullae

• Primary skin lesion

• Vesicle

• >1cm

• Ex: blister

Pustules

• Primary skin lesion

• Elevated

• <1cm

• Filled w/ pus

• Ex:acne, impetigo

Plaques

• Primary skin lesion

• Papule coalesce to >1cm

• Elevated, firm, coarse, scaly

• Ex: psoriasis, seborrheic dermatitis (dandruff)

Nodule

• Primary skin lesion

• solid

• Hard

• >1cm

Wheals

• Primary skin lesion

• red

• Itchy

• Slightly raised

• Ex: mosquito bite

Urticaria

• Primary skin lesion

• hives

• Coalesced wheals

Primary Skin Lesion

• originate on previously healthy skin

• Initial, unaltered physical changes in skin directly caused by disease process

Secondary Skin Lesion

• evolution to primary skin lesion

• Development from external factors (scratching, trauma, healing process)

Excoriation

• Secondary Skin Lesion

• Self-inflicted excoriation usually from scratching

• skin picking

Lichenification

• Secondary Skin Lesion

• thickened “moss like” skin from prolonged scratching

Scale

• Secondary Skin Lesion

• Compact, flacks of skin

• Dry or greasy-silvery, or white

• Eczema

Keloid

• Secondary Skin Lesion

• Excess scar tissue

Coalesce

To come or grow together to form 1 single mass, whole, or system

Xerosis

Dry skin

Pruritus

Itching

Hirutism

Male-pattern hair growth

• often cause by high levels of cortisol

Alopecia

Hair loss

Pannus

Fold created from protruding abdomen

Jaundice results from…

Liver & gallbladder issues

CO2 Poisoning Characteristic

Redness around lips

Bulls eye rash

Indicative of tick bite

Angioma

Benign tumor made up of small blood or lymphatic vessels

Benign

Non-cancerous

Ecchymosis

Large bruise (>1cm) caused by blood leaking from ruptured blood vessels into subcutaneous tissue

Anasarca

Generalized edema across whole body

Turgor

• Def: skin elasticity

• Effected by edema & dehydration

• Best testing parts: under clavicle & forearm

Tenting

• poor turgor (holds shape when pinched)

• Late-stage sign of dehydration (except in older adults)

Taut skin

• Decreased mobility of skin

• Near impossible to pinch

• Often found in edema

Primary Contact Dermatitis

Irritation in skin caused by contact w/ something

Trichotillomania

Hair-pulling syndrome

Fissure

• Secondary skin lesion

• Crack/tear in surface, tissue, or organ

Hypoxia

Insufficient oxygenation to body/body part and disable proper function

Clubbing

• Divot between finger & nail is >180 degrees

Transverse Nail Ridges

• concerning

• Indicative of deficiency

Longitudinal Ridges

Not concerning

Melanoma Detection

• (A)ssymmetry

• (B)order

• (C)olor

• (D)iameter

• (E)volution

Are there changes? How quickly are they occurring?

Malasma (Aka chloasma)

Hyperpigmentation of face

• Presentation can happen during pregnancy

Línea Nigra

Dark line formation vertically down abdomen

• occurs during pregnancy

Stria Gravidarum

Stretch marks

Senile Lentigines

Aging spots

Senile Angioma

• “Cherry” angiomas

• Benign

• Bright red skin growth

Keratosis

• raised thickened growths on skin

Seborrheic Keratosis

Benign “”barnacles of aging”

• waxy, pasted-on look

Actinic Keratosis

• precancerous

• Rough, scaly, crusty patches on sun-exposed skin

Exudate

Whatever comes out of a lesion

Annular/circular Lesion

• Circular

• Ex: ringworm

Confluent Lesion

• Lesions run together

• Individual lesions that pop up in same general area

• ex: hives

Circumscribed

Clearly defined border

Discrete Lesion

• Separated lesions

• Ex: acne, skin tags

Grouped Lesions

• clusters

• Ex: contact dermatitis

Gyrate Lesions

• Twisted/ snakelike

Target/ Iris Lesion

• rings

• Ex: erythema multiforme, bullseye rash

Linear Lesion

• linear

Polycyclic Lesion

• annular lesions that grow together

• Ex: psoriasis

Zosteriform

• linear along a nerve route

• Ex: herpes zoster (shingles)

Purpura

Red or purple discoloration on skin or mucous membranes

-algia

Suffix for pain

• ex: myalgia (muscle pain)

Paresthesia

Numbness or tingling in extremities due to fluid buildup putting pressure on nerves

Mommy’s thumb (quervain’s tenosynovitis)

Inflammation of tendon @ base of thumb due to repetitive movement

• extremely common in new parents performing repetitive movement of holding and lifting babies

Parkinson’s disease

Disease that affects dopamine levels

• dopamine required for neuromuscular communication

• Results in tremors, shuffling, and short steps

Poikilothermia

Body’s ability to thermoregulate

Cachexia

• severe unintentional weight loss

• Life-threatening

• Muscle wasting and loss of appetite

Breathing retractions

When skin sinks around ribs, collarbone, and sternum during inhalation

Eschar

• Layer of thick, necrotic tissue that forms over tissue

• Scab tissue

Hematoma

Bruise you can feel

• Raised

• Firm

• Swollen

Allergic Reaction

• common skin lesion

• Inflammation/ swelling

• Rash

• Anaphylaxis

• Pruritis

Basal Cell Carcinoma

• slow growing

• Most common type of skin cancer

• Red Ulcer, pearly borders

Squamous Cell Carcinoma

• Erythematous scaly past

• Fast growing

Malignant Cell Carcinoma

• lethal

• Often dark lesion with irregular borders

Malignant

Cancerous

Dislocation

Loss of contact between two bones in a joint

Subluxation

Misalignment of 2 bones in a joint

• Partial dislocation

Contracture

Shortening of a muscle leading to limited ROM

Myalgia

Muscle pain

Orthralgia

Bone pain

Arthralgia

Joint pain

Cephalocaudal

Head to toe (heel technically)

Fasciculations

Involuntary, rapid muscle twitches/ spasms

Knee bulge sign

Fluid in knee

Ballottement Knee Sign

Excess fluid in knee

• Results in “floating” patella

Genu varum

Bowlegged

()

Genu Valgum

Knocked Knee

)(

Carpal tunnel

Condition where median nerve in wrist is compressed

Results in

• tingling

• Numbness

• Burning pain

• Phalange weakness (minus pinky)

CMS Check

(C)irculation. (M)otion. (S)ensation

6 P’s

6 P’s

• paralysis

• Pain

• Pallor

• paresthesia

• Pulseness

• Poikilothemia

Osteoporosis

Loss of bone density

• declined estrogen

• Ca2+ and Vit D deficit

• Lack of impact exercise

Rheumatoid Arthritis

Chronic autoimmune disease

• bilateral pain, edema, stiffness

• Morning stiffness

• Ulnar deviation, swan-neck deformity, boutonnière deformity

Ulnar deviation

Associated with Rheumatoid Arthritis

Swan-neck Deformity

Associated with rheumatoid arthritis

Boutonnière Deformity

Associated with rheumatoid arthritis

Osteoarthritis

Degenerative change in articular cartilage

• may be unilateral/ bilateral

• Affects weight bearing joints/ repetitive movement

• Stiffness, swelling, hard/ bony protuberance, limited ROM

• Heberdens/ Bouchard Nodes

Heberden’s Nodes

Bony prominence at distal interpharyngeal joint

Associated with osteoarthritis

Bouchard’s Node

Bony prominence at proximal interpharyngeal joint

Associated with osteoarthritis