Nails
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Questions and Answers

What is the primary function of the nail plate?

  • To enhance the aesthetic appearance of the hands
  • To protect the fingertips (correct)
  • To serve as a place for nail polish application
  • To provide a flexible surface for typing

    • Which layers are found in the nail bed?

  • Epidermis and subcutis
  • Epidermis and dermis (correct)
  • Muscle and fat
  • Keratin and collagen

    • The nail bed contributes to the production of the nail plate.

    False

    What does the nail bed supply to the nail plate?

    <p>Nutrients</p> Signup and view all the answers

    What is the function of the hyponychium?

    <p>To act as a protective barrier between the nail plate and fingertip</p> Signup and view all the answers

    The lunula is responsible for the production of the nail plate.

    <p>False</p> Signup and view all the answers

    What is the primary site of nail growth?

    <p>Nail matrix</p> Signup and view all the answers

    The skin beneath the nail plate is referred to as the ______.

    <p>nail bed</p> Signup and view all the answers

    Match the following terms with their descriptions:

    <p>Nail Bed = Skin beneath the nail plate that supplies nutrients Cuticle = Protective barrier between the skin and nail plate Lunula = Crescent-shaped white area at the base of the nail Hyponychium = Thick skin under the nail tip that acts as a barrier</p> Signup and view all the answers

    What could yellow nails potentially indicate?

    <p>Chronic respiratory illness</p> Signup and view all the answers

    Which condition is associated with blue nails indicating potential cyanosis?

    <p>Asthma</p> Signup and view all the answers

    What do splinter hemorrhages potentially indicate?

    <p>Endocarditis</p> Signup and view all the answers

    Which of the following can cause longitudinal ridges in nails?

    <p>Lichen planus</p> Signup and view all the answers

    What might broad, flat nails indicate?

    <p>Secondary syphilis</p> Signup and view all the answers

    What condition is characterized by a nail base angle of over 180 degrees?

    <p>Clubbing</p> Signup and view all the answers

    What might cause transverse grooves in the nails?

    <p>Repeated trauma</p> Signup and view all the answers

    Which of the following is commonly linked to the appearance of pitting in nails?

    <p>Psoriasis</p> Signup and view all the answers

    What underlying disease might cause clubbing, characterized by an increase in nail base angle to over 180 degrees?

    <p>Cystic fibrosis</p> Signup and view all the answers

    Which condition could result in general nail depressions?

    <p>High fevers</p> Signup and view all the answers

    What does a presence of Beau's lines in nails typically indicate?

    <p>Sudden interruption in nail growth</p> Signup and view all the answers

    What is often the cause of splinter hemorrhages under the nails?

    <p>Minor trauma or injury</p> Signup and view all the answers

    Study Notes

    Word Origins

    • 'Onych' is derived from the Greek word for 'nail'
    • 'Onych' directly refers to the nails, specifically fingernails
    • 'Nychium' connects to 'onych': 'nychium' is the nail bed
    • The suffix 'ium' in 'nychium' signifies a 'place, state, or tissue'
    • Both 'nychium' and 'onych' stem from the Greek language

    Nail Bed Description

    • The nail bed is the skin underneath the nail plate that provides essential nutrients.

    Nail Bed Layers

    • Consists of two layers: the epidermis and the dermis.

    Nail Production

    • Does not contribute to nail production.
    • Supports the nail plate.
    • Helps attach the nail plate to the finger.

    Nail Bed

    • The nail bed is the skin beneath the nail plate that supplies nutrients.
    • Consists of two layers: epidermis and dermis.
    • Doesn't contribute to nail production, but does support the nail plate and helps attach it to the finger.
    • Has a rich blood supply from digital arteries, which causes profuse bleeding in injuries.
    • The nail bed's vascularity makes it a good indicator of systemic circulation issues.
    • Densely innervated by the median and ulnar nerves in the hands and the tibial and peroneal nerves in the feet.
    • Plays a key role in diagnosing systemic conditions, managing nail disorders, and performing nail surgeries.

    Nail Matrix

    • Site of nail growth where cells proliferate and harden to form the nail plate.
    • Located beneath the proximal nail fold at the base of the nail.

    Cuticle (Eponychium)

    • Protective barrier between the skin and the nail plate.
    • Prevents pathogens from entering the nail bed and matrix.

    Lunula

    • Crescent-shaped white area at the base of the nail.
    • White color is due to thickened cells of the nail matrix obscuring underlying blood vessels.

    Hyponychium

    • Thick skin under the nail tip.
    • Acts as a protective barrier between the nail plate and the fingertip.
    • Prevents pathogens and irritants from entering the nail bed, reducing infection risk.

    Nail Color

    • Yellow nails: Can indicate psoriasis, fungal infections, or chronic respiratory illness. In HIV patients, proximal subungual fungal infections are common.
    • Darkening nails: May be due to antimalarial drugs, candidal infection, hyperbilirubinemia, or chronic trauma.
    • Green-Black nails: Might signify a Pseudomonas infection or a subungual hematoma, often painful.
    • Blue nails: Temporary blue nails can occur due to cold. Persistent blue nails may indicate cyanosis (asthma, heart disease, severe anemia), melanoma, silver poisoning, or Wilson disease.
    • Splinter hemorrhages: Linear streaks under the nail that could be a sign of endocarditis, vasculitis, severe psoriasis, or minor trauma.
    • White spots: Often result from mild trauma but can indicate systemic issues if they appear as streaks or bands (liver disease, anemia).

    Nail Shape and Structural Abnormalities

    • Nail Plate Separation: When the nail lifts from the bed, a white, yellow, or green tinge can appear. This may be caused by an injury to the nail matrix, which generally resolves in about 6 months for fingernails and 12 months for toenails.
    • General Nail Depressions: Can signal systemic diseases such as syphilis, high fevers, peripheral vascular disease, or uncontrolled diabetes.
    • Pitting: Small depressions in the nail surface, commonly associated with psoriasis.
    • Broad, Flat Nails: May occur due to secondary syphilis.

    Ridges, Grooves, and Nail Deformities

    • Longitudinal Ridges and Grooves: Often a result of lichen planus, but can occur normally with ageing.
    • Transverse Grooves: Caused by repeated trauma or behaviors like thumb-picking (habit-tic deformity).
    • Transverse Rippling: May result from chronic inflammation due to paronychia or eczema.
    • Stress Lines: Stress can cause depressions at the base of the lunula (the white crescent area at the nail base).
    • Beau’s lines: Can result from a sudden interruption in nail growth caused by injury, medical condition, illness, severe stress, or certain medications (e.g., chemotherapy).

    Nail Curvature and Clubbing

    • Inward Folding of Nail Edges: Often painful and may be linked to the pressure exerted by shoes, especially in toenails.
    • Nail Base Angle: Ideally 160 degrees. An increase to or over 180 degrees, called clubbing, suggests underlying diseases.
    • Clubbing Detection: The Schamroth technique can be used to detect clubbing by placing thumb nails together; clubbing eliminates the diamond-shaped window at the nail base.
    • Associated Conditions: Clubbing is linked to respiratory and cardiovascular disorders, cirrhosis, colitis, and thyroid disease.

    Congenital and Pigmentation Variations

    • Anonychia: The congenital absence of a nail.
    • Pigmented Bands: Common in individuals with darker skin, but the sudden appearance of a band, extending to the proximal nail fold, could indicate melanoma.

    Nail Color Changes

    • Yellow Nails: Could indicate psoriasis, fungal infections, or chronic respiratory illness. In HIV patients, proximal subungual fungal infections are common.
    • Darkening Nails: Can be due to antimalarial drugs, candidal infection, hyperbilirubinemia, or chronic trauma (e.g., tight shoes).
    • Green-Black Nails: Might signify a Pseudomonas infection or a subungual hematoma, the latter often painful.
    • Blue Nails: Temporary blue nails could be due to cold. Persistent blue nails may indicate conditions causing cyanosis (like asthma, heart disease, severe anemia), melanoma, or even silver poisoning and Wilson disease.
    • Splinter Hemorrhages: Linear streaks under the nail that could be a sign of endocarditis, vasculitis, severe psoriasis, or minor trauma.
    • White Spots: Often result from mild trauma but can indicate systemic issues if they appear as streaks or bands (liver disease, anemia).

    Nail Shape and Structural Abnormalities

    • Nail Plate Separation: When the nail lifts from the bed, a white, yellow, or green tinge can appear. This may be caused by an injury to the nail matrix, which generally resolves in about 6 months for fingernails and 12 months for toenails.
    • General Nail Depressions: Can signal systemic diseases such as syphilis, high fevers, peripheral vascular disease, or uncontrolled diabetes.
    • Pitting: Small depressions in the nail surface, commonly associated with psoriasis.
    • Broad, Flat Nails: May occur due to secondary syphilis.

    Ridges, Grooves, and Nail Deformities

    • Longitudinal Ridges and Grooves: Often a result of lichen planus, also common in ageing.
    • Transverse Grooves: These can be caused by repeated trauma or behaviors like thumb-picking, known as habit-tic deformity.
    • Transverse Rippling: May result from chronic inflammation due to paronychia or eczema.
    • Stress Lines: Stress can cause depressions at the base of the lunula (the white crescent area at the nail base), also called Beau lines.
    • Beau’s Lines: Can result from a sudden interruption in nail growth due to injury, medical conditions, severe stress, or certain medications (e.g., chemotherapy).

    Nail Curvature and Clubbing

    • Inward Folding of Nail Edges: Often painful and may be linked to the pressure exerted by shoes, especially in toenails.
    • Nail Base Angle: Ideally 160 degrees. An increase to or over 180 degrees, called clubbing, suggests underlying diseases.
    • Clubbing Detection: The Schamroth technique can be used to detect clubbing by placing thumb nails together; clubbing eliminates the diamond-shaped window at the nail base.
    • Associated Conditions: Clubbing is linked to diseases like respiratory and cardiovascular disorders, cirrhosis, colitis, and thyroid disease.

    Congenital and Pigmentation Variations

    • Anonychia: The congenital absence of a nail.
    • Pigmented Bands: Common in individuals with darker skin, but the sudden appearance of a band, particularly extending to the proximal nail fold, could indicate melanoma.

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