38 Questions
What is the primary function of eccrine glands?
To help control body temperature
Where are apocrine glands typically found?
In the axilla and groin regions
What is a common symptom that may indicate a skin-related issue?
Rash or pruritus
When conducting a skin examination, what is the recommended lighting condition?
Natural light or artificial light that resembles natural light
What is an important consideration when examining the skin?
Inspecting and palpating the skin from head to toe
What is a recommended technique for examining the skin?
Using a dermascope
Why is it important to ensure the patient is comfortable during the skin examination?
To reduce anxiety and promote relaxation
What is an important area to inspect during the skin examination?
The web spaces (interdigital areas)
What is a characteristic of a macule?
It is a circumscribed flat area of change in color of the skin
What is a papule?
A small, raised lesion
Why are bedbound patients particularly susceptible to skin damage and ulceration?
Because of sustained compression on arteriolar and capillary blood flow to the skin
What is the ideal way to inspect the skin that overlies the sacrum, buttocks, greater trochanters, knees, and heels?
By rolling the patient onto one side
What is the purpose of recording the physical examination?
To describe the physical findings in a concise manner
What is a characteristic of a vesicle?
It is a fluid-filled lesion with a diameter of 1 cm
What is the primary function of the skin in terms of body fluid regulation?
Excretion of water, salts, and urea
What percentage of body weight does the skin account for?
16% of body weight
Which of the following is NOT a function of the skin?
Filtering blood
What is the main difference between vellous hair and terminal hair?
Vellous hair is shorter, with less pigmentation, while terminal hair is coarser and pigmented
What is the primary function of sebaceous glands?
Producing fatty substances onto the skin surface
Which of the following is NOT a layer of the skin?
Muscle Layer
What is the function of nails in the human body?
Protecting the distal ends of fingers and toes
What is the area of the skin in square meters?
1.2 – 2.3 m2
What is the primary reason for asking permission to expose the area to be examined?
To maintain the patient's dignity and privacy
What is the purpose of inspecting the skin for lesions?
To diagnose underlying skin conditions
What is the correct way to palpate for temperature?
Using the dorsal surface of the hand
What is the significance of inspecting the hair and scalp?
To identify potential hair diseases or disorders
Why is it essential to wash your hands during an examination?
To prevent the spread of infection
What is the purpose of inspecting the anterior and posterior aspect of the body surface?
To identify any abnormalities or lesions
What is the correct technique for palpating lesions?
Using the finger pads
Why is it important to inspect the axillae and inguinal areas?
To identify any signs of rash or infection
What is the primary purpose of assessing skin turgor?
To assess dehydration or edema
What is the characteristic of a primary lesion?
It characterizes the disease process
What is the best way to assess oxyhemoglobin?
By observing lip, finger, and mucous membrane color
What is the purpose of the ABCDE rule in assessing skin lesions?
To identify characteristics of skin lesions
What is the significance of palpating the skin of the face, neck, trunk, arms, and legs?
To detect tenderness and lesions
What is the purpose of using the dorsum of the hands to assess skin temperature?
To assess skin warmth or coolness
What is the significance of assessing the quantity, distribution, and texture of lesions?
To arrive at a dermatologic diagnosis
Why is it important to consider the patient's history and physical examination when assessing skin lesions?
To arrive at a dermatologic diagnosis
Study Notes
Anatomy and Physiology of Skin
- Skin functions: regulates body temperature, protects underlying tissues, aids in excretion, synthesizes vitamin D, and provides sensation
- Skin layers: epidermis, dermis, superficial fascia, and deep fascia
- Skin appendages: hair, nails, sebaceous glands, and sweat glands
- Hair types: vellous (fine, unpigmented) and terminal (coarser, pigmented)
- Nail function: protects distal ends of fingers and toes
- Sebaceous glands: produce fatty substances, found everywhere except palms and soles
- Sweat glands: eccrine glands (widely distributed, helps control body temperature) and apocrine glands (found in axilla and groin, stimulated by emotional stress)
Health History
- Common skin symptoms: hair loss, nail changes, rash, pruritus, moles, and growths
- Questions to ask patients:
- Have you noticed any changes in your skin, hair, or nails?
- Have you had any rashes, sores, or lumps?
- Have you had any new moles?
Techniques of Examination
- Inspect the skin in a systematic order, including:
- Anterior and posterior surfaces of the body
- Behind the ears, axillary, under the breasts, inguinal regions, genitalia, and intergluteal crease
- Palms and soles, web spaces (interdigital areas)
- Hair distribution and condition
- Nails
- Use a dermoscope in good light, preferably natural light
- Palpate the skin, noting characteristics such as:
- Color
- Moisture
- Temperature
- Texture
- Mobility and turgor
- Lesions
Tips for Skin Examination
- Conduct the examination in a private space with the patient's permission
- Ensure the patient is comfortable and ask if they would like a chaperone present
- Inspect and palpate the skin, using the palm of the hand and fingers
- Wash hands before and after the examination
Inspection
- Inspect skin for:
- Rashes
- Lesions
- Bruises
- Nevi
- Color changes
- Scars
- Inspect specific areas, including:
- Upper and lower back
- Shoulders, arms, and hands
- Chest and abdomen
- Anterior and posterior thighs and legs
- Feet and toes
- Axillae and inguinal areas
- Scalp, face, and neck
Palpation
- Palpate the skin, noting:
- Tenderness
- Lesions
- Temperature
- Texture
- Mobility and turgor
- Palpate the scalp, hair, and nails
Lesions
- Primary lesions: develop as a direct result of the disease process
- Secondary lesions: result from changes in primary lesions
- Characteristics of lesions: number, size, color, texture, shape, location, and configuration
- DANGER SIGNS: ABCDE (Asymmetry, Border irregularity, Color variation, Diameter, Elevation and Enlargement)
Evaluating the Bedbound Patient
- Bedbound patients are susceptible to skin damage and ulceration due to pressure sores
- Inspect the skin that overlies the sacrum, buttocks, greater trochanters, knees, and heels
Recording the Physical Examination
- Use sentences or phrases to describe findings, such as color, skin temperature, and nail condition
Learn about the anatomy and physiology of the skin, how to perform a correct skin examination, and identify normal and abnormal findings of skin, hair, and nails.
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