1543

description of the eccrine glands

dilute saline solution

nevus is a medical term for

a mole

to asses for early jaundice you will assess

sclera and hard palate

checking for skin temperature is best accomplished by using:

dorsal surface of the hands

skin turgor is assessed by picking up a large fold of skin on the anterior chest under the clavicle. this is done to determine the presence of:

dehydration

you note a lesion during an examination, what is the the most complete description consist of?

dark brown, raised lesion, with irregular border, on dorsum of right foot, 3 cm in size with no drainage

you examine nail beds for clubbing. the normal angle between the nail base and the nails is:

160 degrees

the capillary beds should refill after being depressed in:

1-2 seconds

during a routine visit an old lady ask about small, round, flat, brown macules on the hands. Your best response after examining the areas is:

"these are the result of sun exposure and do not require treatment"

an area of thin, shiny skin with decreased visibility of normal skin marking is called

atrophy

flattening of the angle between the nail and its base is:

described as clubbing

the configuration for individual lesions arranged in circles or arcs, as occurs with ringworm, is called:

annular

ABCDE rule

Asymmetry, Border irregularity, Color variation, Diameter \> 6mm, Elevation or enlargement

a risk factor for melanoma is

skin that freckles or burns before tanning

lyme disease is more prevalent:

from May through September

herpes zoster (shingles):

lesions on only one side of body; does not cross midline

clubbing cna be assessed by:

noting a change in the angle of the nail base

Milia occur because

sebum occludes skin follicles

pallor

absence of red-pink tones from the oxygenated hemoglobin in blood

erythema

intense redness of the skin due to excess blood in the dilated superficial capillaries

cyanosis

bluish mottled color that signifies decreased perfusion

jaundice

increase in bilirubin in the blood causing a yellow color in the skin

tiny punctuate red macules and papules on the cheeks, trunk, chest, back, and buttocks

erythema toxicum

lower half of the body turns red, upper half blanches

harlequin

transient mottling on trunk and extremeties

cutis marmorata

bluish color around the lips, hands, fingernails, feet, and toenails

acrocyanosis

large round or oval patch of light brown usually present at birth

cafe au lait

yellowing of skin, sclera, and mucous membranes due to increased nembers of red blood cells hemolyzed following birth

physiologic jaundice

yellow-orange color in light-skinned persons from large amounts of foods containing carotene

carotenemia

epidermis

outer layer of the skin, stratifies,has an inner basal cell layer that forms new skin cells, major ingredient is the fibrous protein keratin; melanocytes are interspersed along this layer produce melanin; also has horny layer where the basal cells migrate up and flatten

dermis

inner supportive layer consisting mostly of connective tissue or collagen; the nerves, sensory receptors, blood vessels and lymphatics lie in this layer

sub-Q layer

adipose tissue which stores fat, provides insulation for temp and aids in protection by its soft cushioning effect.

2 types of hair

vellus and terminal hair

arrector pili

muscle around the hair follicle which contracts and elevates the hair making goose bumps

sebaceous glands

glands that produce sebum; everywhere except on palms and feet

eccrine gland

open directly into skin surface and produce a dilute saline solution called sweat

apocrine gland

glands that produce a milky secretion and open into the hair follicles; bacterial flora residing on the skin surface react with apocrine sweat to produce a characteristic body odor

nails

hard plate of keratin

pruritus

itchiness

vitiligo

the complete absence of melanin pigment in patchy areas of white or light skin on the face, neck, hands, feet, body fold, and around orfices

when checking temperature

use the backs of your hands to palpate the person and check bilaterally

hyperthyroidism skin

feels smoother and softer, like velvet

hypothyroidism skin

feels rough, dry, and flaky

edema

fluid accumulating in the intercellular spaces

1+

mild pitting, slight indentation, no perceptible swelling of the leg

2+

moderate pitting, indentation subsides rapidly

3+

deep pitting, indentation remains for a short time, leg looks swollen

4+

very deep pitting, indentation lasts a long time, leg is very swollen

mobility

the skin's ease of rising; decreased with edema

turgor

is its ability to return to place promptly when released; severe dehydration or extreme weihgt loss causes poor _

cherry angiomas

small, smooth, slightly raised bright red dots that commonly appear on the trunk in all adults older than 30 yrs.

lesions

traumatic or pathologic changes in previously normal structures; when it develops on previously unaltered skin it is primary; when it changes over time or changes because of a factor such as scratching or infection it is secondary

capillary refill

depressing the nail edge to blanch and then release, noting the return of color; normally returns in 1-2 seconds; sluggish return suggests cardiovascular and respiratory dysfunction

senile lentigines

commonly called liver spots, small, flat, brown macules; areas are clusters of melanocytes that appear after extensive sun exposure; appear on the forearms and dorsa of hands

keratoses

lesoins of raised, thickened areas of pigmentation that look crusted, scaly, and warty; seborrheic _ looks dark, greasy, and stuck on;mostly on trunk exposed and unexposed areas; do not become cancerous; actinic are red-tan scaly plaques that increase over the years to become raised and roughened, may have silvery-white scale, directly related to sun-exposure, may develop into sqaumous cell carcinoma

xerosis

dry skin

acrochordons

skin tags, polyp-like, occur frequently on eye lids, cheeks, and neck, axillae and trunk

sebaceous hyperplasia

consist of raised yellow papules with a central depression

annular

shape of lesion begins in the center and spreads to periphery

confluent

lesions run together (hives)

discrete

distinct, individual lesions that remain separate

gyrate

twisted, coiled, snakelike lesion

linear

a scratch, streak, line, or stripe lesion

zosteriform

a linear arrangement along unilateral nerve route lesion

grouped

cluster of lesions

target

or iris, resembles iris of the eye, concentric rings of color in the lesions

polycyclic

annular lesions grow together

macule

a color change, flat and circumscribed, of less that 1 cm. ex. freckles, flat nevi, petechiae, measles, scarlet fever

papule

something you can feel caused by superficial thickening in the epidermis. ex. elevated nevus, lichenn planus, molluscum, warts

patch

macules that larger than 1 cm. ex. mongolian spot, vitilligo, cafe au lait spot, chlosma, measles rash

nodule

solid elevated, hard, or soft, larger that 1 cm. ex. xanthoma, fibroma, intradermal nevi

tumor

larger than a few cm in diameter, firm or soft, deeper into dermis; may be benign or malignant. ex. lipoma, hemangioma

plaque

papules coalesce to form surface elevation wider than 1 cm. a plateau liek, disk shaped lesion. ex psoriasis, lichen, planus

wheal

superficial, raised, transient, and erythematous; slightly irregular shape due to edema. ex. psoriasis, lichen, planus

urticaria (hives)

wheals coalesce to form extensive reaction, intensely pruritic

vesicle

elevated cavity contain free fluid. ex. chickpox, herpes,dermatitis

bulla

larger than 1 cm, unilocular, superficial in epidermis, thin walled. ex. friction blister, pemphigus, burns, contact dermatitis

cyst

encapsulated fluid filled cavity in dermis or subcutaneous layer, tensely elevating skin. ex. sebaceous cyst, wen

pustule

turbid fluid in cavity. ex. impetigo, acne

fissure

linear crack with abrupt edges, extends into dermis, dry or moist. ex. athletes foot

erosion

scooped out but shallow depression in the skin

excoriation

self-inflicted abrasion; superficial; sometimes crusted scratches from intense itching. ex. insect bites, scabies, dermatitis, varicella

lichenification

prolonged intense scratching eventually thickens the skin produces tightly packed sets of papules; looks like surface of mass

keloid

a hypertrophic scar

stage 1 ulcer

intact skin appears red but unbroken, localized redness in lightly pigmented skin will blanch

stage 2 ulcer

partial thickness skin erosion with loss of epidermis or also the dermis, looks like a blister

stage 3 ulcer

full thickness extending into the subacutaneous tissue and resembling a crater

stage 4

full thickness involves all skin layer and extends into supporting tissues and even exposes muscle, tendon and bone

hematoma

a bruise you can feel, multiple petechiae and purpura may occur on the face when prolonged vigorous crying or coughing rasies venous pressure

contusion

a mechanical injury results in hemorrhage into tissues

port-wine stain (nevus flammeus)

a large flat macular patch covering the scalp or face. frequently along the distribution of cranial nerve V

strawberry mark

a raised bright red area with well defined borders about 2 - 3 cm, does not blanch with pressure, consist of immature capillaries, is present at birth and usually disappears by age 5

cavernous hemangioma

a reddish blue, irregularly shaped, solid, and spongy mass of blood vessels; may be present at birth and may enlarge during first 10 to 15 months

telaniectasia

caused by vascular dilation; permanently enlarged and dilated blood vessels that are visible on the skin surface

venous lake

a bluish- purple dilation of venules and capillaries in a str-shaped, linear, or flaring pattern, located on the legs near vericose veins and also on face, lips, ears, and chest

petechiae

tiny punctate hemorrhages 1-3 mm, round and discrete, dark red, purple, or brown in color, caused by bleeding from superficial capillaries; will not blanch; thrombocytopenia, subactue bacterial endocarditis and other septicemias are characterized by petechiae in the mucous membranes as well as on the skin

ecclymosis

a purplish patch resulting from extravasation of blood into the skin, \>3 mm in diameter

purpura

extensive patch of petechiae and ecchymoses flat, red and purple, macular hemorrhage; occurs in old age as blood leaks from capillaries in reponse to minor trauma and diffuses through dermis

diaper dermatitis

red, moist, maculopapular patch with porrly defined borders in diaper area

intertrigo

scalding red moist patches, the candida fungus infects the superficial skin layers