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Health & Assessment
Skin Hair Nails Neck & the Lympathetic System
124
Health Care
Professional
06/13/2010

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Cards

Term
VESICLE
Definition
elevated, fluid-filled,round or oval-shaped, palpable mass with thin, translucent walls and circumscribed borders

smaller than 0.5 cm

Ex: herpes simplex/zoster, early chickenpox,poison ivy, and small burn blisters
Term
BULLA
Definition
elevated, fluid-filled,round or oval-shaped, palpable mass with thin, translucent walls and circumscribed borders

larger than 0.5 cm

Ex: herpes simplex/zoster, early chickenpox,poison ivy, and small burn
Term
WHEAL
Definition
an elevated, often reddish area with irregular border caused by diffuse fluid in tissues rather than free fluid in a cavity, as in vesicles

size varies

insect bites andhives (extensive wheals)
Term
PUSTULE
Definition
an elevated, pus-filled vesicle or bulla with circumscribed border; size varies;

acne, impetigo, and carbuncles/boils
Term
CYST
Definition
elevated, encapsulated, fluid-filled or semisolid mass originating in the subcutaneous tissue or dermis;

1 cm or larger

sebaceous cysts/epidermoid cysts
Term
URTICARIA
Definition
an allergic rxn marked by multiple discrete swellings on the skin (wheals) that are intensely itchy and last up to 24 hours; chest, back, extremities, face or scalp; aka hives
Term
SECONDARY LESIONS
Definition
crust, scale, fissure erosion, ulcer, excoriation, scar, atrophic scar, lichenification, keloid
Term
ATROPHY
Definition
translucent, dry, paperlike, sometimes wrinkled skin surface, resulting from thining or wasting of the skin due to loss of collagen/elastin

ex: striae, aged skin
Term
EROSION
Definition
wearing away of the superficial epidermis causing a moist, shallow depression; heal w/o scarring;

stratch marks, ruptured vesicles
Term
LICHENIFICATION
Definition
a rough, thickened, hardened area of epidermis resulting from chronic irritation such as scratching or rubbing;a protective mechanism

Chronic dermatitis
Term
SCALES
Definition
shedding flakes of greasy, keratinized skin tissue; may be white, gray, or silver; texture may vary from thick to thin;

dry skin, dandruff, psoriasis, and eczema
Term
CRUST
Definition
dry blood, serum, or pus left on the skin surface when vesicles or pustules burst; red,brown,orange,yellow; large crusts that adhere to the skin surface are called scabs;

eczema, impetigo, herpes, or scabss following abrasion
Term
ULCER
Definition
a deep,irregular shaped area of skin loss extending ito the dermis or subcutaneous tissue/ may bleed or leave a scar;

decubitus ulcers (pressure sores), stasis ulcers, chancres; also occus w/HIV and diabetics
Term
FISSURES
Definition
a linear crack with sharp edges, extending into the dermis;

cracks at the corners of the mouth or in the hands, athlete's foot
Term
SCAR
Definition
flat, irregular area of CT left after a lestion or would has healed; new scars may be red/purple; older scars may be silvery/white

healed surgical wound or injury; healed acne
Term
KELOID
Definition
an elevated, irregular, darkened area of excess scar tissue caused by exvessive collagen formation during healing; extends beyond the site of the original injury; more common in African-Americans;

ear-piercing/tatoos or surgery; genetic; hypertrophic
Term
CONFIGURATIONS/SHAPES OF LESIONS
Definition
Term
ANNULAR
Definition
lestions with a circular shape

tinea corporis, pityriasis rosea
Term
CONFLUENT
Definition
lesions that run together

urticaria
Term
DISCRETE
Definition
lesions that are separate and discrete

malluscum
Term
GROUPED
Definition
lesions that appear in clusters

purpural lesion
Term
GYRATE
Definition
lesions that are coiled or twisted
Term
TARGET
Definition
lesions with concentric circles of color
Term
LINEAR
Definition
lesions that appear as a line

scratches
Term
POLYCYCLIC
Definition
lesions that are circular but united

psoriasis
Term
ZOSTERIFROM
Definition
lesions are arranged in a linear manner along a nerve route
Term
COLOR?
Definition
ERYTHEMIA, CYANOTIC, JAUNDICE
Term
ELEVATION?
Definition
depressed, level, slightly raised/palpate to determine
Term
SHAPE?
Definition
discrete, coalescing (joining together), target, demarcated
Term
SIZE?
Definition
millimeter, quarter, pea size, greater than 0.5 cm
Term
EXUDATE?
Definition
vesicular, crust, pus, blood
Term
LOCATION?
Definition
anterior chest and face
Term
INSPECT & PALPATE HAIR FOR....
Definition
color, texture; fine, thick, straight, kinky; distribution, lesions or pests;
Term
INSPECT & PALPATE NAILS....
Definition
shape & contour-perform the profile sign; consistency; capillary refill-depress nail edge to blanch and release; norm is 1-2 sec...more, abnormal
Term
NORMAL FINDINGS FOR SCALP/HAIR
Definition
scalp smooth w/no flaking, scaling, redness, open lesions, lice, ticks, etc...
hair-shiny, soft; evenly distributed
Term
NORMAL FINDINGS FOR NAILS
Definition
smooth, round edges; curvature-slighty flat&curved; smooth surface; nml. angle of nail base; uniform thickness; firm nail base;

clubbing?
Term
VASCULAR LESIONS
Definition
caused by veins
Term
PORT WINE STAIN
Definition
flat, irregularly shaped lesion ranging in color from pale red to deep purple red; color deepens with exertion, emotional response, or extreme temps;present at birth and does not fade; large flat mass of bld vessels;

commonly appears on the face/head but may occur at other sites
Term
HEMANGIOMA
Definition
bright red strawberry mark, raised lesion about 2-10cm; do not blanch;present at birth or within a few month of birth; disappears by age 3; cluster of immature capillaries;

appears on any part of the body/may require surgery
Term
VENOUS LAKE
Definition
varicose veins; flat blue lesion with radiating, cascading, or linear beins extending from the center; ranges in soze frp, 3-25cm; a type of talangiectasis (vascular dilation/spider veins) caused by increased intravenous pressure in superficical veins;

anterior chest/lower legs near varicose veins
Term
PETECHIAE
Definition
flat red/purple rounded freckles; 1-3mm; do not blanch/difficult to detect in dark skin;

minute capillary hemorrhages resulting from fragile capillaries; septicemias, liver disease or vit c or k deficiency; anticoagulant therapy; holding breath; clotting disorder;low platlets

appears on dependent surfaces of the body; may be seen in the oral mucosa/conjunctivae in dark skin clients
Term
ECCHYMOSIS
Definition
flat, irregularly shaped lesion of varying size with no pulsation; does not blanch; in light skin starts as a bluish purple mark that changes to greenish/yellow; in brown skin it appears as a darkened area;

release of blood from superficial vesels due to trauma, hemophilia, liver disease, or deficiency of vitamin C or K

occurs anywhere on the body at the site of trauma or pressure
Term
HEMATOMA
Definition
raised, irregularly shaped lesion similare to ecchymosis (bruise) except it elevates the skin and look like a swelling;

leakage of bld into the skin/subcutaneous tissue as a result of trauma or surgical incision
Term
MONGOLIAN SPOTS
Definition
gray, blue, or purple spots in the sacral/buttocks areas of newborns; 90% African decent/80% Asian/Native American decent; fade during the first yr
Term
MACULES
Definition
freckles, measles and petechiae;
Term
PALLOR
Definition
loss of color;face, mouth, conjuctivea, and nails; occurs in fair and dark skin (check the mucous membranes for dark skinned clients)
Term
JAUNDICE
Definition
yellow due to increased billirubin in the blood;
Term
CYANOSIS
Definition
mottled blue color due to inadequate tissue perfusion with oxygenated blood; ck nails, lips, oral mucosa, tongue;
Term
ERYTHEMA
Definition
redness due to increasesd bisibility of nml oxyhemoglobin; face and upper chest
Term
TINEA
Definition
fungal infection; body, scalp or the feet; doesn't tan; aka roundworms(not really worms)
Term
COMMON HAIR/SCALP ABNORMALITIES
Definition
Term
DANDRUFF
Definition
flaking, scaliness, redness or open lesions
Term
HYPOTHYROIDISM
Definition
metabolic disorders/nutrition deficiencies may cause hair to be dull, coarse,and brittle
Term
ALOPECIA AREATA
Definition
patchy hair loss; may be due to infection
Term
PEDICULOSIS CAPITIS
Definition
head lice/nits
Term
HIRSUTISM
Definition
excessive hair growth in unusual places, especially in women; could be a side effect of hormone therapy or medication
Term
COMMON NAIL ABNORMALITIES
Definition
clubbing-lack of oxygen; grooves, ridges, pitting-chemo patients; brittle thickening, swelling;
Term
ONYCHOLYSIS
Definition
separation of the nail plate from the nail bed, occurs with trauma, infection or skin lesions
Term
SPOON NAILS
Definition
a concave curve/iron dificiency
Term
SCHAMROTH TECHNIQUE
Definition
used to assess clubbing; ends of fingers become enlarged, soft, and spongy; the angle b/t the skin and the bail base is >160 degrees
Term
HEAD/NECK
INCLUDING REGIONAL LYMPHATICS
Definition
structure/function;subjective data/health history Q&A; objective data/physical exam; abnormal findings; such as... throid, lymph glands, neck vessels
Term
HEAD: STRUCTURE AND FUNCTION
Definition
REVIEW FROM COLLEGE
Term
NECK: STRUCTURE AND FUNCTION
Definition
neck muscles, thyroid gland*, trachea, bones, and neck vessels*
Term
THYROID GLAND
Definition
largest gland, butterfly shaped; located at the anterior portion of the neck; lies over the trachea and the sternocleidomastoid muscles covering the lateral aspects of the lobes
Term
PERAURICULAR NODE
Definition
in front of the ear
Term
NODES ARE PALPABLE WHEN INFECTED/ENLARGED
Definition
MUST KNOW ALL LYMPHATIC NODES; USE CIRCULAR MOTION TO PALPATE
Term
POSTERIOR AURICULAR NODE
Definition
behind the ear,over the outer surface of the mastoid bone
Term
OCCIPITAL NODE
Definition
base of the skull
Term
SUBMENTAL NODE
Definition
behind the tip of the mandible at the midline (chin)
Term
SUBMANDIBULAR
Definition
mandible
Term
JUGULODIAGASTRIC
Definition
digastric/having 2 bellies; said of certain muscles
Term
SUPERFICIAL CERVICAL
Definition
anterior to and over the sternocleidomastoid muscle
Term
DEEP CERVICAL
Definition
posterior to and under the sternocleidomastoid muscle (neck)
Term
POSTERIOR CERVICAL
Definition
neck
Term
SUPRACLAVICULAR
Definition
above the clavicle
Term
DRAINAGE PATTERN????
Definition
down with gravity
Term
ASK YOUR PATIENT.....
Definition
headache, head injury, dizziness, neck pain, limitation of motion, lumps or swelling, history of head/neck surgery?
Term
DEVELOPMENTAL CONSIDERATIONS
Definition
fontanels, thryoid enlargement, older adults-nose & ears continue to grow
Term
FONTANELS
Definition
"soft spot" on a baby's head;anterior spot is diamond shaped; closes completely @ 18-24 months;should be nice and level; if sunken...could be dehydrated; elevated...swelling in the brain
Term
THYROID ENLARGEMENT
Definition
common in pregnancy
Term
GOITER
Definition
enlarged thyroid; due to iodine deficiency
Term
OBJECTIVE DATA: HEAD, FACE & NECK
Definition
Inspect the skull: size/shape of head; temporal area: artery
Inspect the face: facial structures/symmetry
Inspect the neck: symmetry, nodules, ROM: chin to chest, L to R, ear to shoulder
Term
OBJECTIVE DATA: HEAD, FACE & NECK
Definition
Palpate the head, lymphy nodes, trachea, thyroid gland, ROM; Tip head to side evaluating to relax the muscle; use small circular direction; Chart as descrete, nonpalpable, small, round, denies pain
Term
PALPATING THE THYROID GLAND
Definition
1)stand behind the person/can do from the front
2) have person bend head slightly forward and to the right
3)palpate rt side by displacing slightly with left hand and having person to swallow;
4)thyroid tissues moves upward/fixed may indicate a tumer/cancer
5)normally cannot palpate
Term
BRUIT
Definition
indicative of stenosis (narrowing) of the vessel
Term
HYPOTHYROIDISM
Definition
occurs when there is a decrease in production of thyroid hormones; results in lowered basal metabolism; mostly in females b/t ages 30-50; fatigue, weakness, weight gain, constipation, memorm impairment
Term
HYPERTHYROIDISM
Definition
excessive production of thyroid hormones; enlargement of the gland, exophthalmos (bulging eyes), fine hair, weight loss, diarrhea
Term
HYDROCEPHALUS
Definition
enlargement of the head cause by inadequate drainage of cerebrospinal fluid; resulting in abn. growth of the skull
Term
ACROMEGALY
Definition
enlargement of the bones, and facial features due to increased growth hormone; abn. pituatary gland
Term
FACIAL PARALYSIS
Definition
brain attack, stroke, or cerebrovascular accident (CVA)
Term
BELL'S PALSY
Definition
a temporary disorder affecting the CN VII and producing a unilateral facial paralysis; may be caused by a virus
Term
CUSHING'S SYNDROME
Definition
increased adrenal hormone production leading to a rounded "moon" face, ruddy cheeks, prominent jowls, and excess facial hair
Term
DOWN SYNDROME
Definition
trisomy 21;having 3 homologous chromosomes per cell instead of 2; defect causing varying degrees of mental retardation and characterists facial features...slanted eyes, flat nasal bridge, flat nose, protruding tongue, and a short broad neck
Term
FETAL ALCOHOL SYNDROME
Definition
a disorder characterized by epicanthal folds, narrow palpebral fissures, a deformed upper lip below the septum of the nose, and some degree of mental retardation
Term
ONYCHOGRYPHOSIS
Definition
overgrowth of the nail
Term
FLAT NAILS
Definition
protein deficiency
Term
RIDGES IN THE NAILS
Definition
Term
PITTING IN THE NAILS
Definition
Term
HYPERTRICHOSIS
Definition
above-average amt of body hair; genetic; incorrect--wolfman or wookieeism
Term
LICE/NITS
Definition
peruvian mummy--1,000 yr.old nits!
Term
HEALTH & ASSESSMENT
N3313
SKIN HAIR NAILS HEAD NECK
LYMPHATIC SYSTEM
Definition
Term
3 LAYER OF SKIN
Definition
1)epidermis - basal cell layer (makes new cells), horny cell layer, origin of skin color
2)dermis - CT and elastic tissue
3)subcutaneous
Term
EPIDERMAL APPENDAGES
Definition
hair
gland - sebaceous and sweat
nails
Term
SEBACEOUS GLANDS
Definition
secrete sebum through hair follicles/oil
Term
2 FORMS OF SWEAT GLANDS
Definition
eccrine - produces sweat all over the body
apocrine - produces sweat at the axillae and peineal area
Term
FUNCTIONS OF THE SKIN
Definition
physical barrier from injury, chemicals, thermal and UV sources
prevents penetration of microrganisms, loss of H2O and electrolytes
perception,temp regulation, production of vit. D, ID, communication - touch, wound repair, absorption.excretion
Term
Skin Development Considerations
Definition
Infants -immature integrity and function until puberty/lymphatic
Pregnancy - hormonal changes-preg. mask/ BC pills
Older adults - atrophy, think subq. disappears
Term
CHECK SKIN TUGOR
Definition
elasticity at clavicle/normal if it springs back/hydrated
Term
CULTURAL CONSIDERATIONS
Definition
Term
MELANIN
Definition
controls skin tone
protects skin against UV
Term
SWEAT GLANDS
Definition
asians/native americans - mild body odor
whites/blacks - strong body odor
Term
HAIR
Definition
genetic
blacks: fragile, dry, thick
asians: silky/straight
Term
SUBJECTIVE DATA
Definition
Previous history of diagnosis
change in pigmentation/moles
puritus/itching
excessive moisture-hot flashes
dryness-eczemia
bruising/leukemia/clotting
rash/lesion
meds/orange-yellow color
hair loss/stress
change in nails/nutrition
Term
OBJECTIVE DATA
Definition
palpate only; inspect for consistency w/genetic background/pigmentation-freckles, moles, birthmarks;
self-care behaviors...sunscreen, moisturizers, reg. checks for mole changes
Term
WARNING SIGNS/COLOR CHANGES OF SKIN
Definition
erythema - red
pallor - white
cyanosis - blue
Term
PALPATE SKIN FOR...
Definition
temp/dorsal aspect of hand/bilaterally
moisture/perspiration or dehydration
texture/smooth & firm
(unless maj. wt. loss)
thickness/uniformly thin
(except callus' on palms & soles)
Term
TYPES OF SKIN LESIONS
Definition
Primary, Secondary, and Tertitary Lesions
Term
Primary Lesion
Definition
lesion develops on skin that was normal
forms naturally
Term
SECONDARY LESION
Definition
changes overtime
scratching/infection
Term
ASSESSMENT OF LESIONS
Definition
must describe exactly what is seen
color, elevation, shape, size, location, exudate
Term
TUMOR
Definition
elevated, solid, hard or soft, palpable mass, deep into dermis, irregular border, larger than 2cm;

lipoma, carcinoma, hemangioma
Term
NODULES
Definition
elevated, solid, hard or soft, palpable mass, deeper than papule, circumscribed borders, 0.5-2cm:

small lipoma, squanous cell carcinoma
Term
PLAQUE
Definition
elevated, solid, palpable mass, circumscribed border, larger than 0.5cm,

psoriasis, actinic keratosis, lichen palms
Term
PAPULE
Definition
elevated, solid palpable mass w/a circumscribed border, smaller than 0.5cm

elevated moles, warts, and lichen planus
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