Podcast
Questions and Answers
What does a larger angle and softening of the nail bed indicate?
What does a larger angle and softening of the nail bed indicate?
Which condition is characterized by a bluish or purplish cast to the nail bed?
Which condition is characterized by a bluish or purplish cast to the nail bed?
What might poor capillary refill indicate?
What might poor capillary refill indicate?
Which abnormal finding involves an increase in the angle between the nail and nail bed?
Which abnormal finding involves an increase in the angle between the nail and nail bed?
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What does a brown or black pigmentation in longitudinal streaks on the nails indicate in dark-skinned individuals?
What does a brown or black pigmentation in longitudinal streaks on the nails indicate in dark-skinned individuals?
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What is the normal capillary refill time in healthy individuals?
What is the normal capillary refill time in healthy individuals?
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What is the term for the condition where there is painless separation of the nail plate from the nail bed?
What is the term for the condition where there is painless separation of the nail plate from the nail bed?
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Which nail condition is associated with a distal band of reddish-brown color and is linked to aging, liver cirrhosis, and other medical conditions?
Which nail condition is associated with a distal band of reddish-brown color and is linked to aging, liver cirrhosis, and other medical conditions?
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What nail abnormality is identified by red or brown linear streaks in the nail bed and can be related to endocarditis or infections?
What nail abnormality is identified by red or brown linear streaks in the nail bed and can be related to endocarditis or infections?
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Which nail condition presents as a concave shape and is typically associated with iron-deficiency anemia or syphilis?
Which nail condition presents as a concave shape and is typically associated with iron-deficiency anemia or syphilis?
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What term describes white spots that gradually grow out of the nail plate after trauma?
What term describes white spots that gradually grow out of the nail plate after trauma?
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In what condition do you observe transverse depression in the nails associated with acute severe illness or nail injury?
In what condition do you observe transverse depression in the nails associated with acute severe illness or nail injury?
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Which abnormal nail finding is characterized by a convex curvature of the nail, increased nail fold, and drumstick appearance?
Which abnormal nail finding is characterized by a convex curvature of the nail, increased nail fold, and drumstick appearance?
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What is the primary cause of cyanosis in the nails?
What is the primary cause of cyanosis in the nails?
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Which nail finding is usually associated with anemia?
Which nail finding is usually associated with anemia?
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What is the most common cause of paronychia?
What is the most common cause of paronychia?
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What is the capillary refill assessment used to evaluate?
What is the capillary refill assessment used to evaluate?
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Which abnormal nail finding is characterized by the separation of the nail plate from the nail bed?
Which abnormal nail finding is characterized by the separation of the nail plate from the nail bed?
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Study Notes
Nail Examination
- Normally, nails are transparent, smooth, well-rounded, and convex with a nail bed angle of about 160 degrees.
- The surrounding cuticles are smooth, intact, and without inflammation.
- Abnormal findings:
- Clubbing: increase angle and softening of the nail bed due to chronic oxygenation problems.
- Cyanosis: bluish or purplish cast to the nail bed.
- Anemia: white cast or pallor.
- Paronychia: inflammation of proximal and lateral nail folds due to trauma and local infection.
- Onycholysis: painless separation of the nail plate from the nail bed.
Nail Abnormalities
- Terry's nails: nail plate color mostly whitish with a distal band of reddish brown due to aging, liver cirrhosis, CHF, NIDDM.
- Leukonychia: white spots that grow slowly out of the nail plate after trauma.
- Transverse white lines (Mee's lines): curves similar to lunula.
- Beau's lines: transverse depression in nails associated with acute severe illness, nail injury.
- Psoriasis: small pits in the nails, marked nail thickening, onycholysis, circumscribed yellowish tan discoloration (oil spot lesion).
- Koilonychia (Spoon nail): concave curves due to iron-deficiency anemia, syphilis, or use of strong detergents.
- Splinter hemorrhages: red or brown linear streak in nail bed due to minor trauma, sub acute bacterial endocarditis, trichinosis.
Hair and Scalp
- Hair distribution patterns are examined for symmetry and distribution according to age and sexual development.
- Scalp: the skin covering the head, containing sebaceous glands that produce sebum, a mixture of keratin, fat, and cellulose debris.
- Types of hair covering the body:
- Tan-brown: due to increased amount of melanin seen in sun tanning and pregnancy.
Skin Examination
- Moisture: refers to the wetness and oiliness of the skin, indicating body fluid imbalances, changes in the skin's environment, and regulation of body temperature.
- Normal findings: smooth and dry with minimal perspiration and oiliness.
- Abnormal findings: dullness, excessive dryness, crusting, flaking, scaling, overly moist and cool.
Skin Temperature
- Depends on the amount of blood circulating through the dermis.
- Normal findings: uniformly warm.
- Abnormal findings: generalized warmth in fever and hyperthyroidism, coolness in hypothyroidism, local warmth in inflammation, cellulitis, and pressure ulcer.
Skin Texture
- Refers to the character of the skin's surface and the feel of deeper portions.
- Normal findings: smooth, soft, even, and flexible in children and adults.
- Abnormal findings: scar or hardening (recent skin injury), tenderness or localized areas of induration or hardening due to repeated IM/SQ injections, roughness in hypothyroidism.
Skin Mobility and Turgor
- Turgor is the skin's elasticity, which can be diminished by edema or dehydration.
- Mobility is the ease in lifting up the skin when pinching and turgor is the speed with which the skin returns to its resting position.
- Normal findings: skin lifts easily and snaps back immediately to its resting position.
- Abnormal findings: skin stays or tented when turgor is poor (e.g., due to dehydration or edema).
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Description
Test your knowledge on various nail disorders such as paronychia, onycholysis, Terry’s nails, leukonychia, Mee’s lines, and more. Identify different nail conditions based on their descriptions.
