NR 509 Advanced Physical Assessment Chapter 10 lecture notes week 2

NR 509 Advanced Physical Assessment Chapter 10 lecture notes week 2 NR 509 Advanced Physical Assessment Chapter 10: Skin, Hair, and Nails I. Anatomy and Physiology A. Skin 1. Epidermis: thin, avascular keratinized epithelium 2. Dermis: dense layer of interconnecting collagen and elastic fibers 3. Normal skin color depends on amount and type of melanin 4. Pallor indicates anemia 5. Cyanosis, a blue color, can indicate decreased oxygen in the blood or decreased blood flow in response to a cold environment 6. Jaundice, or yellowing of the skin, results from increased bilirubin. B. Hair: villus and terminal C. Nails: nail protect ends of the fingers and toes D. Pilsebaceous Glands and Sweat Glands II. Health History: General Approach A. Lesions: single area of altered skin 1. Ask about family history B. Rashes and Itching 1. Rash: widespread eruption of lesions 2. Causes of generalized itching without apparent rash include dry skin, pregnancy, uremia, Janice, lymphomas, leukemia, drug reaction, and polycythemia and thyroid disease C. Hair loss and Nail Changes 1. Be familiar with common nail changes such as oncyhomycosis, habit tic deformity, melanoychia, etc 2. The most common causes of diffuse hair thing are pattern baldness. 3. Hair shedding at he roots is common in telogen effluvium and alopecia aerate. Hair break along the shaft suggest damage from hair care or tines captitis. III. Describing Skin Lesions A. Note: number, size, color, shape, texture, primary lesions, location, and configuration B. ABCDE-EFG 1. Asymmetry 2. Border irregularity 3. Color variation 4. Diameter >6mm 5. Evolving or changing rapidly in size symptoms or morphology 6. Elevation 7. Firmness 8. Growing over several weeks C. Primary Lesion: flat, raised or fluid filled 1. Macule: circumscribed flat area of changed color 1 cm 3. Papule: small solid elevation of 1 cm 1