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  1. What is the major function of skin?
  2. How does the skin protect the body?
    • boundaries=BF
    • against pathogens
    • radiation
    • harmful substances
    • VD
  3. How much of the TBW is skin?
  4. What are the 3 layers of the skin?
    • Epidermis
    • Dermis
    • Subcut tissue
  5. What are the appendages of skin?
    • hair
    • nails
    • sebaceous & sweat glands
  6. what is the most superficial layer of skin?
  7. Explain the epidermis:
    • thin
    • NO BV
    • Outer horny layer
    • Inner cellular layer
  8. What supplies nutrition to epidermis?
  9. Does the dermis have a blood supply?
  10. What type of tissue is the dermis?
    connective tissue
  11. What type of glands are located within dermis?
    sebaceous glands
  12. What does the dermis merge with below?
    adipose tissue or subcut tissue
  13. What are the 2 types of hair?
    • vellus
    • terminal
  14. This type of hair is short, fine, less pigmentation?
  15. This type of hair is coarser, pigmented (scalp/eyebrows)?
  16. What protects distal ends of toes & fingers?
  17. These glands are present all over except for palms/soles & produce a fatty substance onto skin surfaces via hair follicles?
    sebaceous glands
  18. What are the 2 different types of sweat glands?
    Eccrine & apocrine
  19. Which type of sweat glands help to control body temp?
    eccrine glands
  20. which type of sweat glands are found in axilla & groin that is stimulated by stress?
    apocrine glands
  21. What are some common or concerning symptoms of skin?
    • hair loss
    • rash
    • moles
  22. What is a good question to ask for the health hx for skin?
    have you noticed any changes in your skin or hair?
  23. What is a good question for moles?
    • have you noticed any moles that have changed size, shape, color, sensation?
    • Have you noticed any new moles?
  24. How should the clinician explain the importance of health promotion & counseling when educating patients?
    • early detect=moles
    • protective skin care measures
    • excessive sun exp
  25. Where is skin cancer most prevalent?
    • hands
    • neck
    • head
  26. This type of skin cancer is most prevelant that is shiny, grows slowly & rarely metastasizes?
    basal cell carcinoma
  27. This type of skin cancer comprises about 16% that is crusted, scaly, ulcerated & can metastasize?
    squamous cell carcinoma
  28. this type of skin cancer can spread rapidly comprising of only 4%?
  29. What are the HARRM risk factors for melanoma?
    • hx=previous melanoma
    • Age over 50
    • Regular dermatologist absent
    • Mole changing
    • Male gender
  30. What are the additional risk factors for melanoma?
    • greater than or equal 50 common moles
    • greater than or equal 1-4 atypical or unusual moles=dysplastic
    • red/light hair
    • actinic lentigines, macular brown/tan spots
    • heavy sun exp
    • light eye/skin color-freckles/burn easy
    • FHx melanoma
  31. What is the ABCDE method for screening moles for possible melanoma?
    • A=asymmetry
    • B=Irregular borders=ragged, notched, blurred
    • C=variation or change in color=blue or black
    • D=diameter greater than or equal 6mm or different from other moles=changing,itching,bleeding
    • E=elevation/enlarment
  32. What does the american cancer society recommend skin exams as part of routine cancer screening?
    • every 3yrs btwn 20-40
    • yearly=over 40
  33. How can you as a clinician do health teaching for patients about melanoma?
    • Risk factors
    • avoid=sun exp
    • exams
  34. how should you conduct your own-self skin exam?
    • front to back in mirror
    • bend elbows & look at forearms, upper arms, palms
    • back of legs, feet, space=toes & soles
    • back of neck & scalp=hand held mirror
    • back & butt=hand held mirror
  35. when do you want to avoid sun exposure?
    midday=UVB=intense most
  36. what type of sun screen is recommended at least?
    • SPF 15-screens out 93%
    • water resistant
    • reapply often
  37. Is there an spf scale for UV-A rays that cause aging?
  38. When does the examination of the skin, hair, nails begin with?
    gen sur
  39. should the patient wear a gown for the skin inspection?
  40. What type of light should be used to inspect skin surface?
    • natural light
    • artificial light=resembles natural
  41. Does artificial light often distort color?
  42. What should you look for when inspecting color of skin?
    • increase/degrease pigmentation
    • redness, pallor, cyanosis, yellowing
  43. where is red color of oxyhemoglobin best assessed?
    • fingertips, lips, muc mem
    • dark skin=palms & soles
  44. Where should you look for central cyanosis?
    • lips
    • oral mucosa
    • tongue
  45. where should you look for jaundice?
  46. What should you note when accessing moisture of skin?
    • dryness
    • sweating
    • oilliness
  47. How do you test temp of skin?
    back of fingertips & ID=warmth,cooliness skin
  48. What to note about texture of skin?
    rough or smooth
  49. How do you test for mobility & turgor?
    lift fold of skin at hand/wrist
  50. What to take note of with skin lesions?
    • anatomic location
    • type
    • color
    • arrangement
  51. What are the 8 types of primary skin lesions?
    • macule
    • papule
    • plaque
    • nodule
    • pustule
    • vesicle
    • wheal
    • bulla
  52. What are the 8 types of secondary skin lesions?
    • scale
    • erosion
    • ulcer
    • fissure
    • crust
    • excoriation
    • lichenfication
    • hyperpigmentation
  53. What are the dermatologic basics?
    • flex & ext areas
    • palms & soles
    • fingerwebs, groin, feet
    • scalp, ears, central face
  54. What dermatologic issue can happen in the flexural areas?
    atopic dermatitis & acanthosis nigracans
  55. What derm issue can happen in the ext surfaces?
  56. What derm issue in palms/soles?
    syphilis & hand/foot disease
  57. What can develop in groin, feet & fingerwebs?
  58. What can develop in scalp, ears, central face?
  59. What can a red color tell you?
    vascular: cherry angioma, spider angioma
  60. What can a blue color tell you?
    Blue nevus, mongolian sopt
  61. what can a yellow color tell you?
  62. what can a white color tell you?
  63. what can a black color tell you?
    melanocytic nevus & melanoma
  64. what can a purple or violaeceous color tell you?
  65. what are some changes in melanin?
    • cafe-au-lait-spot
    • tinea versicolor
    • vitiligo
  66. What are some purpuric lesions?
    • petechia/purpura
    • ecchymosis
  67. What are some skin tumors?
    • actinic keratosis
    • seborrheic keratosis
    • BCC
    • Kaposi' sarcoma
  68. What is described by a superficial flattened papules, covered by a dry scale with multiple round or irregular pink tan grayish that appear on sun exposed areas and are benign but may give rise to SQ CC?
    actinic keratosis
  69. What is a common benign lesion that is yellowish to brown papules with slightly greasy or warty & typically multiple & symetrically distributed?
    seborrheic keratosis
  70. What is a Slow growing malignancy,Seldom metastasizes,Most common in fair skinned adults over 40,Usually on face,Usually starts as translucent nodule, which spreads leaving a depressed center and a firm elevated border Often accompanied by telangiectatic vessels?
  71. What is usually on sun exposed areas of skin,Fair haired adults over 60
    • May develop actinic keratosis,Grows more quickly than basal cell?
    • squamous cell carcinoma
  72. Appears in AIDS,Malignant tumor has many forms,Can appear almost anywhere on body,Lesions multiple,May involve internal structures?
    kaposi's sarcoma
  73. Why do bedbound patients get pressure sores?
    sustained compression obliterates arteriolar & capillary blood flow to skin
  74. What are the skin lesions patterns & shapes?
    • Linear
    • geographic
    • clustered
    • serpignous
    • annular,acriform
  75. example of linear skin lesion
    linear epidermal nevus
  76. example of geographic skin lesion
    mycosis fungoides
  77. example of clustered skin lesion pattern
    herpes simplex
  78. example of serpignous skin lesion pattern
    tinea corporis
  79. example of annular skin lesion pattern
  80. small flatspot up to 1.0cm
  81. flat spot 1.0cm or larger
  82. example of macule
  83. example of patch
    cafe au lait spot
  84. elevated superficial & 1.0cm or larger that is formed by papules
  85. a palpable elevation that is up to 1.0cm
    • papule
    • ex:psoriasis
  86. a marble like deeper & firmer than papule that is greater than .5cm
    • nodule
    • ex:dermatofibroma
  87. a nodule filled with a liquid or semisolid
  88. an irregular relatively transcient superficial localized with edema
  89. up to 1.0cm that is filled w/serous fluid
  90. greater than 1.0cm that is filled w/serous fluid
  91. filled with pus
  92. minute slightly raised tunnel epidermis that is in the fingerwebs & sides fingers that is 5-15mm, linear & curvy grayline
    burrow (scabies)
  93. thin flake of dead exfoliated in the epidermis
  94. dried residue of skin exudate that has serum, pus, blood (impetigo)
  95. visible palpable thickening of the epidermis with rough skin (neurodermatis)
  96. conn tissue that arises in injury/disease due to a hypertrophic scar from a steroid injection
  97. hypertrophic scaring that extends beyond borders from injury in the earlobe
  98. nonscarring loss superficial epiderms on moist skin surface with no bleeding
  99. linear or punctuate erosion caused by stratching from a cat stratch
  100. line or crack in skin caused by excessive dryness (athletes foo)
  101. deep loss epidermis & dermis that bleeds & scars
  102. 3 types of vascular lesion
    • spider angioma
    • spider vein
    • cherry angioma
  103. fiery red that is up to 2cm surrounded by erythema on face, neck or arms
    spider angioma
  104. bluish with varying size & shape that appears near the veins in the legs (varicose)
    spider vein
  105. bright or ruby red that is 1-3mm that turns brownish in time that is surrounded by a pale halo
    cherry angioma
  106. deep red or reddish purple that fades in time that is 1-3mm
  107. deep red or reddish purple that fades in time that is larger than a petechia
  108. purple or purplish blue which fades to green yellow or brown that is larger than 3mm with round & irregular & has a central hematoma
  109. common mole that is round/oval shape with sharp defined borders that is uniform in color with a diameter less than 6mm
    benign nevus
  110. round oval pathches of hair loss with no visible scaling/inflammation
    alopecia areata
  111. round scaling alopecia with hairs broken off usually caused by a fungal infection
    tinea capitis/ringworm
  112. superficial infection in the proximal & lateral nail folds that is seen as red, swollen & tender
  113. bulbous swelling in the fingers with losing the angle btwn nail & nail fold
    clubbing of fingers
  114. separation of the opaque nail plate from the pink nail bed
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