Skin Circulation and Abnormal Findings Quiz

Skin Color Alterations

• Central cyanosis: apparent in the lips, oral mucosa, and tongue
• Peripheral cyanosis: appears in the hands, nails, and feet
• Pallor: decrease in color, observable in buccal mucosa, face, conjunctiva, and nail beds
• Loss of pigmentation: vitiligo, a congenital or autoimmune condition causing lack of pigment
• Jaundice: yellow discoloration, usually observed in the sclera, palpebral conjunctiva, lips, hard palate, under surface of the tongue, tympanic membrane, and skin
• Erythema: intense redness of the skin due to excess blood in dilated capillaries

Moisture

• Refers to the wetness and oiliness of the skin
• Indicates 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

Temperature

• Depends on the amount of blood circulating through the dermis
• Increased or decreased temperature indicates an increase or decrease in blood flow
• Normal findings: uniformly warm
• Abnormal findings: generalized warmth in fever and hyperthyroidism, coolness in hypothyroidism, local warmth in inflammation, cellulitis, and pressure ulcers

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 (hardening) due to repeated IM/SQ injections, roughness in hypothyroidism

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
• 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. dehydration), decreased mobility in edema, scleroderma

Vascularity

• The circulation of the skin affects the appearance of superficial blood vessels
• With aging, capillaries become fragile
• Abnormal findings: petechiae, tiny, pin-point sized, red-purple spots on the skin caused by small hemorrhages in the skin layers

Edema

• The collection of fluid in underlying tissues that separates the skin's surface from pigmented and vascular layers
• Dependent edema: appears in the feet, ankles, and sacrum
• Pitting edema: residual indentation left by the fingers with pressure when the fluid is displaced from the underlying tissues
• 4-point scale grading in pitting edema: +1 = mild pitting, +2 = moderate pitting, +3 = deep pitting, +4 = very deep pitting

Lesions

• The skin is normally free of lesions, except common freckles or age-related changes
• Inspect the skin for any lesions and describe the findings about any lesion in an orderly fashion: location, distribution, size, arrangement, color, configuration, secondary changes, and presence of drainage

Test your knowledge on skin circulation, abnormal findings such as petechiae, and the concept of edema. Learn about how the appearance of superficial blood vessels is affected by skin circulation, identify petechiae as tiny hemorrhages on the skin, and understand edema as the collection of fluid in underlying tissues.