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Bates Guide to Physical Examination - Hair/Skin/Nails Lecture, Chapter 6

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Bates Guide to Physical Examination - Hair/Skin/Nails Lecture, Chapter 6 1. What are some common or concerning symptoms related to hair, skin, and nails? Answer: Hair loss, rash, moles 2. When examining the skin, what characteristics should you note? Answer: Color, moisture, temperature, texture, mobility, and lesions 3. Where can you best assess the red color of oxyhemoglobin? Answer: Fingertips, lips, and mucous membranes (or palms and soles for dark skin) 4. Where should you look for central cyanosis? Answer: Lips, oral mucosa, and tongue 5. Where should you look for jaundice? Answer: Sclera of the eyes 6. What causes peripheral cyanosis? Answer: Decreased cutaneous blood flow and slowed blood flow, resulting in tissues extracting more oxygen from the blood than usual (a normal response to anxiety or a cold environment) 7. What are the characteristics of vellus hair? Answer: Short, fine, and inconspicuous 8. What are the characteristics of terminal hair? Answer: Coarser, thicker, more conspicuous, usually pigmented (found on scalp, eyebrows) 9. What are the two types of sweat glands? Answer: Eccrine (regulate body temperature) and apocrine (found in axillary and genital regions) 10. What are some causes of itching without a rash? Answer: Dry skin, pregnancy, uremia, jaundice, lymphoma or leukemia, drug reaction, lice infestation, diabetes or thyroid disease * When examining the skin, what characteristics should you note? + Answer: Color, moisture, temperature, texture, mobility, and lesions * What are some common or concerning symptoms related to hair, skin, and nails? + Answer: Hair loss, rash, moles * Where can you best assess the red color of oxyhemoglobin? + Answer: Fingertips, lips, and mucous membranes (or palms and soles for dark skin) Pallor ️Results from decreased redness in anemia and decreased blood flow (fainting or arterial occlusion) Causes of central cyanosis ️advanced lung disease, congenital heart disease, hemoglobinopathies Cyanosis of heart failure is ️usually peripheral, reflecting deoxygenation or impaired circulation COPD and pulmonary edema may give rise to central cyanosis Jaundice suggests ️liver disease or excessive hemolysis of red blood cells Erythema ️Red skin hue due to increased blood flow When testing mobility and turgor... mobility is... turgor is... ️Mobility - the ease with which the skin lifts up Turgor - the speed with which the lifted skin returns to place Café-Au-Lait Spot Slightly but uniformly pigmented macule or patch with a somewhat irregular border, benign ️Six or more suggests neurofibromatosis Tinea Versicolor Common superficial fungal infection of the skin, causing hypo- or hyperpigmented (" versicolor"), slightly scaly macules on the trunk, neck, and upper arms (short-sleeved shirt distribution). ️ Vitiligo Depigmented macules appear on the face, hands, feet, extensor surfaces, and other regions and may coalesce into extensive areas that lack melanin. The brown pigment is normal skin color; the pale areas are vitiligo. The condition may be hereditary. ️ Cyanosis ️Bluish color that is visible in fingers/toes Jaundice ️Diffusely yellow skin caused by liver disease and hemolysis of red blood cells Carotenemia ️Caused by high diets in carrots or other yellow vegetables or fruits Heliotrope ️violaceous patches over the eyelids in the collagen vascular disease dermatomyositis Pityriasis Rosea ️Reddish oval ringworm-like papules or plaques

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Bates Guide to Physical Examination - Hair/Skin/Nails Lecture, Chapter 6
1. What are some common or concerning symptoms related to hair, skin, and nails?



Answer: Hair loss, rash, moles



2. When examining the skin, what characteristics should you note?



Answer: Color, moisture, temperature, texture, mobility, and lesions



3. Where can you best assess the red color of oxyhemoglobin?



Answer: Fingertips, lips, and mucous membranes (or palms and soles for dark skin)



4. Where should you look for central cyanosis?



Answer: Lips, oral mucosa, and tongue



5. Where should you look for jaundice?



Answer: Sclera of the eyes



6. What causes peripheral cyanosis?



Answer: Decreased cutaneous blood flow and slowed blood flow, resulting in tissues extracting more
oxygen from the blood than usual (a normal response to anxiety or a cold environment)



7. What are the characteristics of vellus hair?



Answer: Short, fine, and inconspicuous

,8. What are the characteristics of terminal hair?



Answer: Coarser, thicker, more conspicuous, usually pigmented (found on scalp, eyebrows)



9. What are the two types of sweat glands?



Answer: Eccrine (regulate body temperature) and apocrine (found in axillary and genital regions)



10. What are some causes of itching without a rash?



Answer: Dry skin, pregnancy, uremia, jaundice, lymphoma or leukemia, drug reaction, lice infestation,
diabetes or thyroid disease



* When examining the skin, what characteristics should you note?

+ Answer: Color, moisture, temperature, texture, mobility, and lesions

* What are some common or concerning symptoms related to hair, skin, and nails?

+ Answer: Hair loss, rash, moles

* Where can you best assess the red color of oxyhemoglobin?

+ Answer: Fingertips, lips, and mucous membranes (or palms and soles for dark skin)

Pallor ✔️Results from decreased redness in anemia and decreased blood flow (fainting or arterial
occlusion)



Causes of central cyanosis ✔️advanced lung disease, congenital heart disease, hemoglobinopathies



Cyanosis of heart failure is ✔️usually peripheral, reflecting deoxygenation or impaired circulation



COPD and pulmonary edema may give rise to central cyanosis

, Jaundice suggests ✔️liver disease or excessive hemolysis of red blood cells



Erythema ✔️Red skin hue due to increased blood flow



When testing mobility and turgor... mobility is... turgor is... ✔️Mobility - the ease with which the skin
lifts up

Turgor - the speed with which the lifted skin returns to place



Café-Au-Lait Spot



Slightly but uniformly pigmented macule or patch with a somewhat irregular border, benign ✔️Six or
more suggests neurofibromatosis



Tinea Versicolor



Common superficial fungal infection of the skin, causing hypo- or hyperpigmented (" versicolor"), slightly
scaly macules on the trunk, neck, and upper arms (short-sleeved shirt distribution). ✔️



Vitiligo



Depigmented macules appear on the face, hands, feet, extensor surfaces, and other regions and may
coalesce into extensive areas that lack melanin. The brown pigment is normal skin color; the pale areas
are vitiligo. The condition may be hereditary. ✔️



Cyanosis ✔️Bluish color that is visible in fingers/toes



Jaundice ✔️Diffusely yellow skin caused by liver disease and hemolysis of red blood cells



Carotenemia ✔️Caused by high diets in carrots or other yellow vegetables or fruits
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