Skin Anatomy and Functions Quiz

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Questions and Answers

What is a common cause of central cyanosis?

  • Anxiety
  • Severe burns
  • Chronic heart and lung diseases (correct)
  • Exposure to cold

What does jaundice indicate when serum bilirubin concentration is greater than 2.5-3 mg/dL?

  • Increased liver function
  • Normal physiological function
  • Liver dysfunction or hemolysis (correct)
  • Dehydration

In which areas does jaundice first manifest?

  • Skin and nail beds
  • Cheeks and forehead
  • Sclerae, hard palate, and mucous membranes (correct)
  • Fingers and toes

Which condition could cause peripheral cyanosis?

<p>Exposure to cold or anxiety (A)</p> Signup and view all the answers

How can one distinguish between jaundice and normal yellowish fatty deposits?

<p>By observing the sclerae for yellow near the limbus (C)</p> Signup and view all the answers

What skin color change is typically associated with polycythemia?

<p>Ruddy blue (D)</p> Signup and view all the answers

What skin condition results from poor venous return in the lower extremities?

<p>Stasis dermatitis (C)</p> Signup and view all the answers

Which symptom is typically observed in carbon monoxide poisoning?

<p>Bright cherry red in face and upper torso (C)</p> Signup and view all the answers

Which condition is associated with hemosiderin staining in the skin?

<p>Stasis dermatitis (A)</p> Signup and view all the answers

What symptom indicates venous disease?

<p>Warmth at feet with palpable pulses (A)</p> Signup and view all the answers

What does cyanosis indicate in terms of hemoglobin levels?

<p>Increased amount of unoxygenated hemoglobin (B)</p> Signup and view all the answers

In melanin-rich skin, what makes the detection of venous insufficiency challenging?

<p>Hemosiderin staining is difficult to detect (B)</p> Signup and view all the answers

Which observation is NOT typical of stasis dermatitis?

<p>Bright cherry red nail beds (B)</p> Signup and view all the answers

What does undermining in a wound indicate?

<p>Extension of the wound under the surface skin (A)</p> Signup and view all the answers

Which of the following is NOT assessed in the surrounding skin of a wound?

<p>Temperature (C)</p> Signup and view all the answers

What type of skin evaluation is performed to rule out malignancy?

<p>Skin biopsy (A)</p> Signup and view all the answers

What does a strong positive reaction in patch testing indicate?

<p>Blisters, pain, and ulceration (B)</p> Signup and view all the answers

What is the primary purpose of clinical photographs in skin evaluation?

<p>To document the nature and extent of the condition (A)</p> Signup and view all the answers

How are skin scrapings for fungal lesions conducted?

<p>With a scalpel blade moistened with oil (A)</p> Signup and view all the answers

What does assessment for induration around a wound involve?

<p>Checking for abnormal firmness of tissue (C)</p> Signup and view all the answers

In patch testing, what signifies a moderately positive reaction?

<p>Fine blisters and severe itching (B)</p> Signup and view all the answers

What is the outermost layer of the skin called?

<p>Epidermis (D)</p> Signup and view all the answers

Which type of sweat gland is found in all areas of the skin?

<p>Eccrine glands (D)</p> Signup and view all the answers

What change in the skin occurs due to aging, making it more vulnerable to injuries?

<p>Thinning at the junction of the dermis and epidermis (B)</p> Signup and view all the answers

Which of the following is classified as a benign change in the skin of older adults?

<p>Seborrheic keratoses (C)</p> Signup and view all the answers

What is the primary function of Langerhans cells in the skin?

<p>Immune response (B)</p> Signup and view all the answers

Which of the following skin changes is NOT typically associated with aging?

<p>Increased hair density (B)</p> Signup and view all the answers

What skin condition is characterized by dry, fish scale-like appearance?

<p>Ichthyosis (D)</p> Signup and view all the answers

What happens to the collagen production in skin as a person ages?

<p>Production decreases (A)</p> Signup and view all the answers

Which area of the body is associated with apocrine sweat glands?

<p>Axillae (D)</p> Signup and view all the answers

What is solar lentigo commonly referred to as?

<p>Age spots (B)</p> Signup and view all the answers

What structural change contributes to the development of wrinkles in aging skin?

<p>Loss of subcutaneous fat (A)</p> Signup and view all the answers

Which of the following best describes the condition known as neurodermatitis?

<p>Itchy spots caused by prolonged scratching (D)</p> Signup and view all the answers

What is the main role of the hypodermis in the skin?

<p>Storage of fat and insulation (B)</p> Signup and view all the answers

Which anatomical layer of the skin contains the majority of sensory receptors?

<p>Dermis (B)</p> Signup and view all the answers

What does a pressure ulcer indicate?

<p>Presence of necrotic tissue (C)</p> Signup and view all the answers

Which of the following describes a fissure?

<p>Linear crack that may extend to the dermis (A)</p> Signup and view all the answers

Scales on the skin may indicate which of the following?

<p>Desquamated, dead epithelium (B)</p> Signup and view all the answers

A crust on the skin is primarily made up of which materials?

<p>Serum, blood, or pus (A)</p> Signup and view all the answers

What characterizes a mature scar?

<p>White or glistening appearance (D)</p> Signup and view all the answers

Keloids are a result of which process during skin healing?

<p>Excessive collagen formation (D)</p> Signup and view all the answers

Atrophy in the skin is usually associated with what changes?

<p>Loss of collagen and elastin (A)</p> Signup and view all the answers

Lichenification often results from which of the following?

<p>Repeated rubbing and irritation (A)</p> Signup and view all the answers

What should be inspected in a wound bed?

<p>Necrotic tissue and granulation (C)</p> Signup and view all the answers

How does a scar differ from a keloid?

<p>Keloids are raised and may be larger than the original wound (B)</p> Signup and view all the answers

Which condition is typically characterized by dry, cracked skin?

<p>Fissure (D)</p> Signup and view all the answers

What is the appearance of young scars compared to mature scars?

<p>Young scars are red or purple; mature scars are white or glistening (C)</p> Signup and view all the answers

What is one possible cause of scales forming on the skin?

<p>Desquamation of dead epithelium (B)</p> Signup and view all the answers

Which option describes the characteristics of a crust?

<p>Dried serum, blood, or pus on skin (A)</p> Signup and view all the answers

What is a characteristic feature of carotenemia?

<p>Yellow-orange tinge in palms and soles (B)</p> Signup and view all the answers

Which type of primary lesion is characterized by being less than 1 cm and having a circumscribed border?

<p>Papule (B)</p> Signup and view all the answers

Which lesion is described as a pus-filled vesicle or bulla?

<p>Pustule (A)</p> Signup and view all the answers

What type of lesion has an irregular border and is larger than 1 cm?

<p>Patch (A)</p> Signup and view all the answers

Which primary lesion is often noted as elevated and solid, with a circumscribed border?

<p>Plaque (C)</p> Signup and view all the answers

What is the main factor distinguishing a vesicle from a bulla?

<p>Size of the lesion (B)</p> Signup and view all the answers

Which type of lesion is described as a loss of superficial epidermis that does not extend to the dermis?

<p>Erosion (C)</p> Signup and view all the answers

In which condition is yellowing mostly masked by pallor and may include signs of ecchymoses?

<p>Uremia (B)</p> Signup and view all the answers

What does a wheal signify in dermatology?

<p>Elevated mass with transient borders (C)</p> Signup and view all the answers

Which lesion is identified as encapsulated and may be fluid-filled or semisolid?

<p>Cyst (D)</p> Signup and view all the answers

What change in skin color characterizes a macule?

<p>Flat and nonpalpable skin color change (D)</p> Signup and view all the answers

Which of the following primary lesions is typically small and often described as being less than 0.5 cm?

<p>Macule (D)</p> Signup and view all the answers

Which of the following describes a plaque lesion?

<p>Elevated and may be coalesced papules, greater than 0.5 cm (A)</p> Signup and view all the answers

Which condition is associated with yellow-orange tinge in the nasolabial folds?

<p>Carotenemia (B)</p> Signup and view all the answers

Flashcards

Skin layers

The skin is made of three layers: epidermis (outermost), dermis (inner), and hypodermis (innermost).

Epidermis

The outermost layer of skin, providing a protective barrier.

Dermis

The inner layer of skin, containing blood vessels, nerves, and hair follicles.

Hypodermis

The innermost layer of skin, containing fat and connective tissue, providing insulation and cushioning.

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Merkel cells

Sensory receptors in the epidermis, associated with touch sensation.

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Langerhans cells

Immune cells in the epidermis, part of the skin's immune response.

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Eccrine sweat glands

Sweat glands found throughout the skin, producing sweat for thermoregulation.

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Apocrine sweat glands

Larger sweat glands primarily in the armpits and genital areas, active in puberty and involved in scent.

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Skin functions

Protection, sensation, temperature regulation, excretion, and vitamin D synthesis.

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Gerontologic skin changes

Age-related changes in skin including thinning, dryness, and increased vulnerability to injury.

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Cherry angiomas

Small, bright red spots common in older adults.

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Solar lentigo

Age spots or liver spots, caused by sun exposure.

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Wrinkles

Folds in the skin, due to loss of elastin and collagen.

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Xerosis

Dryness of the skin.

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Jaundice cause

Increased bilirubin in the blood, often due to liver issues or blood breakdown.

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Jaundice symptom

Yellowing of the sclera (whites of the eyes), mucous membranes, and skin.

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Central Cyanosis Cause

Heart or lung problems causing low blood oxygen.

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Peripheral Cyanosis Cause

Exposure to cold, or anxiety.

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Cyanosis

Bluish discoloration of skin, mucous membranes, and nail beds; symptom of low blood oxygen.

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Polycythemia Symptom

Increased red blood cells causing capillary stasis; skin appears ruddy-blue.

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Carbon Monoxide Poisoning

Skin is bright cherry-red, especially on face and torso, with cherry-red nail beds, lips, and oral mucosa.

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Stasis Dermatitis

Poor venous return causes hemosiderin buildup, skin cracking, and potential ulcers in lower extremities; skin discoloration (brown/rusty).

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Venous Disease Symptom

Edema, hyperpigmentation (brown/reddish), warmth at feet with palpable pulses (unless an artery issue).

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Warmth in Venous Disease

Warmth at feet indicated by palpation, while no coexisting arterial issue is present.

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Hemosiderin Staining

The reddish-brown discoloration of skin due to iron-containing pigment in tissue.

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Cherry Red Nail Beds

A sign, appearing as cherry-red color in nail beds.

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Wound edges

The borders of a wound, assessed for undermining (extension under the skin) or epibole (rolled edges).

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Wound size

The diameter and depth of a wound, measured in centimeters (cm).

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Surrounding skin

The area around a wound, assessed for factors like color, texture, firmness and scaling.

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Skin biopsy

A sample of skin tissue taken for microscopic examination to diagnose skin conditions like malignancy.

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Patch testing

A method to identify allergies by applying suspected allergens to the skin under patches.

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Skin scrapings

Scraping skin samples with a blade to examine under a microscope for fungal or parasite infections.

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Clinical photographs

Pictures taken to document skin conditions, their changes, and treatment progress.

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What is the purpose of skin biopsy?

Skin biopsies are performed to diagnose skin conditions, including cancer, infection, and inflammation. They help determine the exact cause of a skin problem.

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Pressure ulcer

An injury to the skin and underlying tissue, often caused by prolonged pressure on a body part.

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Fissure

A linear crack in the skin that may extend to the dermis.

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Scales

Flakes of dead skin cells.

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Crust

Dried residue of fluids, such as blood or pus, on the skin.

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Scar (cicatrix)

A mark left after a wound heals, made of connective tissue.

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Keloid

An overgrown scar that is elevated and irregular.

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Atrophy

Thinning and transparent skin due to loss of collagen and elastin.

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Lichenification

Thickening and roughening of skin due to irritation or repeated rubbing/scratching.

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Wound bed

The surface of a wound.

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Necrotic tissue

Dead tissue in a wound.

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Slough

Yellow, white, or gray dead tissue in a wound

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Granulation tissue

New reddish connective tissue forming in a healing wound.

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Epithelial tissue

Healthy skin cells that cover a healing wound.

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Exudate

Fluid present in a wound

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Color and Odor

Visual examination for the appearance of the surface of the wound bed.

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Jaundice location

Jaundice is most noticeable at the junction of the hard and soft palate, and on the palms.

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Carotenemia cause

High levels of carotene in the blood from eating foods rich in carotene.

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Carotenemia sign

Yellow-orange coloration in the forehead, palms, soles, and nasolabial folds without scleral or mucous membrane yellowing.

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Uremia cause

Kidney failure leading to urochrome build-up in blood.

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Uremia skin appearance

Skin might appear orange-green, gray, or pale, possibly with bruising (ecchymoses and purpura).

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Macule

A flat, non-palpable skin discoloration, smaller than 1cm.

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Patch

A larger, flat, non-palpable skin discoloration, greater than 1cm.

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Papule

A small, solid, palpable skin elevation, less than 0.5cm.

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Plaque

A larger, raised skin elevation, greater than 0.5cm, often composed of fused papules.

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Nodule

A solid, palpable skin elevation, 0.5-2 cm, extending deep into the dermis.

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Tumor

A solid mass, larger than 1–2 cm, often with less sharp borders than nodules.

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Vesicle

A small, fluid-filled elevtion, less than 0.5cm, in the epidermis.

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Bulla

A large, fluid-filled elevation (greater than 0.5cm) in the epidermis.

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Wheal

Elevated skin lesion with transient borders, caused by fluid movement into the dermis.

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Pustule

Pus-filled vesicle or bulla.

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Study Notes

Skin Facts

  • Largest organ in the body, making up about 12% of body weight
  • Part of the integumentary system, which includes epidermis, dermis, hypodermis, glands, hair, and nails
  • These components work together

Skin Anatomy

  • Three layers: epidermis (outermost), dermis (middle), and hypodermis (innermost)
  • Epidermis: Continuously dividing cells, replaced every 3-4 weeks, primarily dead cells
  • Epidermis contains melanin-producing melanocytes (for skin and hair color) and Merkel and Langerhans cells (involved with touch and immune system respectively)
  • Dermis: Largest portion, providing strength and structure, composed of papillary and reticular layers. Thickest on palms and soles.
  • Hypodermis: Primarily adipose tissue, providing cushioning, promoting mobility, and insulation

Hair

  • Grows in follicles, in the dermis
  • Hair follicle growth cycles vary, inflammation can damage root, stop or alter growth
  • Hair follicle stem cells destroy = no regrowth

Nails

  • Transparent plates of keratin
  • Continuous growth, fingernails take 170days to renew themselves and toenails 12-18 months.

Glands

  • Sebaceous glands: associated with hair follicles
  • Sweat glands: classified as eccrine (found everywhere) and apocrine (found in specific body areas)

Skin Functions

  • Regulates body temperature
  • Maintains fluid and electrolyte balance
  • Provides sensation
  • Protects against infection and the environment
  • Produces vitamin D

Gerontologic Considerations

  • Increased vulnerability to injury & certain diseases
  • Changes such as, cherry angiomas, dyschromias, melasma, lentigines, seborrheic keratoses, telangiectasias, xerosis, ichthyosis.
  • Diminished hair, especially on scalp and pubic areas
  • Neurodermatitis and spider angiomas
  • Thinning at the dermis-epidermis junction, reducing anchoring sites
  • Loss of subcutaneous tissue components like elastin, collagen, and fat
  • Cellular replacement slows, reducing dermal thickness, and changes in blood supply
  • Reduced sweat and sebaceous glands
  • Reduced hormone levels = decreased hair growth

Assessment

  • Look at skin's condition, observe color, temperature, moisture, skin texture, lesions, vascularity & hair & nails
  • Observe skin turgor (tension) and elasticity, assess for possible edema
  • Some skin conditions cause depression, frustration, self-consciousness, etc.

Color Changes Light & Dark Skin

  • Light Skin: Erythema (redness) from hyperemia, possibly caused by inflammation, heat, alcohol, or fever. Polycythemia (increased red blood cells) results in ruddy blue coloration in face, oral mucosa, hands, and feet. Carbon monoxide poisoning causes a bright red face. Stasis dermatitis (venous stasis) can cause brown or rusty discolorations from hemosiderin buildup. Edema & hyperpigmentation with reddish/brown discoloration, warmth to feet (palpable pulse)
  • Dark Skin: Purplish tinge (difficult to see due to melanin covering), harder to detect early stage erythema. Well-concealed by pigment. Signs and symptoms for vascular insufficiency (stasis) similar to light skin discoloration but harder to visually see if there is excessive melanin production.

Diagnostic Evaluation

  • Skin Biopsy: Excision of a lesion for diagnosis (nodules, plaques, blisters, ulcers)
  • Patch Testing: Identifying skin allergies by applying suspected allergens to normal skin under patches. Reaction severity indicates allergy severity.
  • Clinical Photographs: Documenting skin condition and progress of treatment & changes in moles
  • Skin Scrapings: To look for fungal infections (spores/hyphae) and specific parasitic infections like scabies

Wounds

  • Inspect and describe wound bed (necrotic or granulation tissues, exudate, color, odor).
  • Assess wound edges (undermining, epibole), wound size (diameter), and surrounding skin (erythema, induration, scaling).

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