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General Skin Assessment

Terms

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ASSESSMENT ?
Vascularity: = perfusion
• Look for blanching
• Color
• Pulses
• Modeling-means really bad circulation. Usually means the time is near--look at the knees. Marbled purple appearance.
• Temperature -warmth
• Turgor/Mobility- hydration
• Edema- 1+ -4+
• pitting- and non-pitting
• Dependent- sacrum/lower leg, added pressure on bottom
• ANASARCA- full bodied, generalized edema. Liver failure, CHF and right-sided heart failure. Lasix
• Color--pink, pale, blue tones= inflammation/ grey for cyanosis
• Sclera- grey/brown is normal in blacks
ASSESSMENT
Modeling-
means really bad circulation. Usually means the time is near--look at the knees. Marbled purple appearance.
• ANASARCA-
full bodied, generalized edema. Liver failure, CHF and right-sided heart failure.

Fix it. Lasix
•Dependent edema-
sacrum/lower leg, added pressure on bottom
alopecia
(baldness) hair loss
annular
circular shape to skin lesion
Bulla
elevated cavity containing free fluid larger than 1 cm diameter
Confluent
skin lesions that run together
Crust
thick dried out exudate left on skin when vesicles/pustules burst or dry up
Cyanosis
dusky blue color to skin or mucus membranes due to increased amount of unoxygenated hemoglobin
erosion
scooped out, shallow depression in skin
Erythema
intense redness of the skin due toexcess blood in dilated superficial capillaries, as in fever or inflammation
Excoriation
self-inflicted abrasion on skin due to scratching
Fissure
linear crack in skin extending into dermis
Furuncle
(boil) suppurative inflammatory skin lesion due to infected hair follicle
Hemangioma
skin lesion due to benin proliferation of blood vessels in the dermis
Iris
target shape of skin lesion
Jaundice
yellow color to skin,palate, and sclera due to excess bilirubin in the blood Liver issues
Keloid
hypertrophic scar, elevated beyond site of original injury
lichenification
tightly packed set of papules that thickens skin, from prolonged intense scratching
lipoma
benign fatty tumor
maceration
softening of t issue by soaking
Macule
flat skin lesion with only a color change
Nevus
(mole) circumscribed skin lesion due to excess melanocytes
Nodule
elevated skin lesion, ? 1 cm diameter
Plaque
skin lesion in which papules coalesce or come together
Pruritis
itching
Purpura
red-purple skin lesion due to blood in tissues from breaks in blood vessels
Pustule
elevated cavit containing thick turbid fluid
Scale
compact desiccated flakes of skin from shedding of dead skin cells
Telangiectasia
skin lesion due to permanently enlarged and dialat blood vessels that are visible
Ulcer
sloughing of necrotic inflammatory tissue causes a deep depression in skin, extending into dermis
Vesicle
elevated cavity containing free fluid up to 1 cm diameter
Wheal
raised red skin lesion due to interstitial fluid
Zosteriform
linear shape of skin lesion along a nerve route think shingles
List the 3 layers associated with the skin
1. Epidermis- elasticin
2. Dermis connective tissue
3. Subcutaneus adipose tissue
Describe 1 + Edema
mild slight indentation
Describe 2+ edema
Pits and stays, moderate- subsides rapidly
Describe 3+ Edema
Pits, stays a short time
Describe 4+ edema
Pits stays, lasts longer > 4-5 sec.s
Distinguish the terms primary vs secondary in reference to the skin lesions
primary-- initial, from normal skin

secondary -- came about from another lesion
The white lenear markings that normally are visible through the nail and on the pink nail bed are termed
leukonychia striada
Petichiae
no blanch cappilaries
Ecchymosis
large patch of capillary bleeding
Hematoma
bruise you can feel.
Select the best description of the secretion of the eccrine glands
a. thick, milky
b. dilute saline solution
c. protective lipid substance
d. keratin
b. dilute saline solution (sweat)
Nevus is the medical term for
a. a freckle.
b. a birthmark
c. an infected hair follicle
d. a mole
d. a mole
To assess for jaundice, the practitioner will assess the:
a. sclera and ucous membranes
b. nail beds
c. lips
d. all visible skin surfaces
a. sclera and mucous membranes
Checking for skin temperature is best accomplished by using
a. palmar surface of the hands
b. ventral surface of the hands
c. finger tips
d. dorsal surface of the hands
d. dorsal surface of the hands Back of hand
skin turgor is assessed by picking up a large fold of skin on the anterior chest under the clavicle. This part of the exam is done to determine the presence of
a. edema
b. dehydration
c. vitiligo
d. scleroderma
b. dehydration
a lesion has been noted on a client during an examination. Select the description that is most complete
a. raised, irregular lesion the size of a quarter located on the dorsum of the left hand
b. open lesion with no drainage or odor approximate
d. dark brown, raised lesion with irregular border, ondorsum of right foot, 3 cm in size wit hno drainage.
Nail beds should be examined for clubbinf. The normal angle between the nail base and the nail is
a. 100'
b. 140'
c. 160'
d. 180'
c. 160' degrees
During a routine visit, your client, aged 78, asks about small, flat, brown macules on the hands. Your best response after examining the areas is
a. these are the result of sun exposure and do not require treatment.
b.theses are related to exp
a. Theese are the result of sun exposure and do not require treatment.
Tiny, punctate red macules and papules on the cheeks, trunk, chest back and buttocks
a
Lower half of body turns red, uppper half blanches
g
transient mottling in trunk and extremities
g
bluish color around the lips, hands and fingernails and feet and toenails
c
large round or oval patch of light brown pigmentation, usually present at birth
f, cafe' au lait
yellowing of skin, sclera, and mucous membranes due to increased numbers of red blood cells hemolyzed following birth
b. eythema toxicum??
yellow-orange color in light-skinned persons fsrom large amounts of foods containing carotene
e. carotenemia

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