Sophia Delgado
Fingernails and toenails are made of a tough, rigid protein called alpha-keratin. They are protective plates found at the tip of the digits of all primates, corresponding to the claws in other animals. One condition that can affect nails is onycholysis, which is when a nail separates from its nail bed. Another condition is nail clubbing, which is a deformity of the finger or toenails associated with a number of diseases, anomalies, and defects, some congenital, mostly of the heart and lungs.
| Characteristics | Values |
|---|---|
| General term | Nail |
| Technical term | Nail plate or corpus unguis |
| Part of the nail that is visible | Nail plate or nail body |
| Part of the nail that is beneath the nail plate | Nail bed |
| Part of the nail that is beneath the nail plate and contains nerves, lymph, and blood vessels | Nail matrix or matrix unguis, keratogenous membrane, or onychostroma |
| Part of the nail that is beneath the nail plate and made of epidermis | Hyponychium, also known as the "quick" |
| Condition where the nail separates from the nail bed | Onycholysis |
| Condition where the nail deforms | Nail clubbing, also known as digital clubbing or "Hippocratic fingers" |
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What You'll Learn
Fingernails are made of a tough protein called alpha-keratin
Fingernails are protective plates found at the tip of the fingers and toes of primates, corresponding to the claws in other animals. They are made of a tough, rigid protein called alpha-keratin, which is also found in the claws, hooves, and horns of vertebrates. Alpha-keratin is a type of fibrous protein that plays a structural role in mammals and birds, providing strength and support to the body.
The structure of alpha-keratin resembles the thread of a screw, with a helical shape. It is one of two main types of keratin, the other being beta-keratin, which is found in the feathers, claws, beaks, and scales of birds and reptiles. Beta-keratin has a different structure, consisting of sheets of polypeptide chains that extend in the same direction without overlapping, giving it a tough and rigid form.
In the context of fingernails, alpha-keratin provides structure and strength, contributing to the protective function of the nails. A healthy fingernail protects the distal phalanx, the fingertip, and the surrounding soft tissues from injuries. It also enhances precise delicate movements of the fingers through counter-pressure exerted on the pulp of the finger. Additionally, the nail acts as a counter-force when the finger touches an object, improving the sensitivity of the fingertip.
The nail consists of several parts, including the nail plate, the nail matrix, and the nail bed. The nail matrix, also known as the matrix unguis, keratogenous membrane, or onychostroma, is the active tissue that generates cells. These cells harden as they move outward from the nail root to the nail plate, contributing to the overall structure and strength of the fingernail.
Fingernails, just like toenails, can provide insights into an individual's health. Healthcare providers often examine the fingernail beds as an indicator of distal tissue perfusion, especially in individuals who may be dehydrated or in shock. Additionally, the growth and appearance of fingernails can reflect physiological imbalances and be used as a diagnostic tool. For example, deep transverse grooves known as "Beau's lines" may indicate aging or certain diseases.
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The lunula is the crescent-shaped base of the nail
The lunula, derived from the Latin word "small moon", is the crescent-shaped white base of the nail. It is the only visible part of the nail matrix, which is the tissue that lies beneath the nail plate and contains nerves, lymph, and blood vessels. The nail matrix produces cells that harden as they move outward from the nail root to the nail plate, forming the nail that we see. The lunula is most visible on the thumb and may not be visible on the little finger.
The lunula is usually a whitish colour and takes up a small portion of the bottom of the nail, just above the cuticle. It is normal for some people to not have visible lunulas. The size of the lunula can vary across each nail, with some nails having larger lunulas than others. While the lunula is part of the overall structure of the nail, it is not the only component. The nail matrix, cuticle, lateral nail fold, nail plate, nail bed, and proximal nail fold all contribute to the formation of healthy nails.
The appearance of the lunula can provide insights into an individual's health. For example, a red lunula may indicate heart failure, while pale blue lunulas could suggest undiagnosed or uncontrolled diabetes. Ingesting excessive fluoride can turn lunulas brown or black, and blue-grey lunulas may signal silver poisoning. However, it is important to note that discoloured or missing lunulas are usually not a cause for concern. If other unusual symptoms accompany nail changes, it is recommended to consult a doctor for a proper diagnosis.
The health of the nail matrix is crucial for maintaining healthy nails. Injuries and certain health conditions can damage the nail matrix, but proper treatment can aid in its recovery. The nail matrix consists of two parts: the germinal matrix and the sterile matrix. The germinal matrix, also known as the nail's germinal matrix, is located under the nail's base and is responsible for generating new cells that form the fingernails or toenails. The sterile matrix lies underneath the nail.
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The hyponychium is the epithelium located beneath the nail plate
The hyponychium, informally known as "the quick", is the thickened portion of the epithelium located beneath the nail plate. The nail plate, or nail body, is the hard, visible part of the nail, made of translucent keratin protein. The hyponychium is found at the distal end of each digit, at the junction between the free edge of the nail plate and the skin of the fingertip.
The hyponychium forms a seal that protects the nail bed, which is the skin beneath the nail plate. The nail bed is made up of two types of tissues: the dermis and the epidermis. It is highly innervated, meaning that it contains many nerve endings, and it supplies nourishment to the entire nail unit. The nail bed is also the site of the nail matrix, the active tissue that generates cells. As new cells are made, they push older cells forward, causing them to become compressed, flat, and translucent. This process starts at the nail root, or nail groove, which is the base of the nail underneath the skin.
The nail plate itself does not contain any nerves or blood vessels. However, it grows out from the nail bed and is strongly attached to it. The nail plate has a nail body and a free edge, and it extends deep into the dermis to form the nail root. The nail plate is made up of tightly packed, hard, keratinized epidermal cells, which give it strength and flexibility.
In summary, the hyponychium is the thickened epithelium located beneath the nail plate, forming a seal to protect the nail bed. The nail plate, or nail body, is the hard, visible part of the nail, made of translucent keratin protein, and it grows out from the nail bed, which is the site of nail cell generation.
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Fingernails can be used as tools, like for scratching
Fingernails can be used as tools for scratching or scraping, but they are not strong enough to be used as weapons. The nail plate, or the hard nail area from the nail root to the free edge, is made of a tough, rigid protein called alpha-keratin. This protein is also found in the claws, hooves, and horns of vertebrates. The nail plate is strongly attached to the nail bed, which is the skin beneath it. The nail bed contains nerves and blood vessels that supply nourishment to the entire nail unit. The nail plate itself does not contain any nerves or blood vessels.
The shape of the fingernail is determined by the form of the underlying bone. The width and thickness of the nail plate are influenced by the size, length, and thickness of the matrix unguis, the active tissue that generates cells. These cells harden as they move outward from the nail root to the nail plate, resulting in a strong yet flexible nail structure.
Fingernails have a protective function, safeguarding the distal phalanx, fingertip, and surrounding soft tissues from injuries. They also enhance precise delicate movements of the distal digits through counter-pressure exerted on the pulp of the finger. This allows for an extended precision grip, such as when pulling out a splinter.
In terms of grooming and maintenance, various tools can be used to shape and care for fingernails. Nail cutters, also known as nail clippers, are commonly used to trim and shape the nails. They come in different sizes and shapes to accommodate varying nail types and thicknesses. Cuticle pushers and nippers are other tools used to manage the skin around the nails, known as cuticles and hangnails, respectively. These tools help create a neat and uniform appearance, enhance the beauty of the hands, and improve nail health by promoting blood circulation and nourishment.
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Onycholysis is when a nail separates from its nail bed
Onycholysis is a common nail disorder that affects the separation of the nail from its nail bed. It is characterised by the lifting or peeling of the nail plate from the underlying nail bed, resulting in a visible gap between the two structures. This condition can occur in both fingernails and toenails and is known to affect individuals of all ages, sexes, and races, although it is most frequently observed in adult women.
The nail plate, or the visible hard nail area, is typically firmly attached to the nail bed, which is the skin beneath it. The nail bed contains nerves, blood vessels, and lymphatics that supply nourishment to the nail unit. In onycholysis, this attachment is disrupted, leading to the separation of the nail plate from its underlying support. The condition can manifest in different ways, with the nail detaching distally, laterally, or proximally.
The causes of onycholysis are varied and can be idiopathic (unknown cause) or secondary to trauma, skin diseases, nail infections, tumours, or systemic events. Common triggers include nail injuries, artificial nails, and fungal or yeast infections. Additionally, onycholysis can be associated with underlying medical conditions such as psoriasis, thyroid disease, or vitamin deficiencies. In some cases, medication side effects or interactions can also lead to onycholysis.
The affected nail may undergo discolouration, turning yellow, greenish, purple, white, or gray. While onycholysis is usually painless, acute or inflammatory cases may cause discomfort. The condition predisposes the nail to secondary infections, with Candida albicans and Pseudomonas aeruginosa being the most common causative agents. These infections can further contribute to nail discolouration.
The treatment of onycholysis focuses on addressing the underlying cause and promoting the regrowth of a healthy nail attached to the nail bed. This includes keeping the nails trimmed short, avoiding irritants such as nail enamel and detergents, and wearing gloves to protect the nails. In some cases, antimicrobial soaks or topical treatments may be recommended to prevent or treat secondary infections. For underlying medical conditions, appropriate medications or supplements may be prescribed.
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Frequently asked questions
Fingernails have several functions, including protecting the distal phalanx, the fingertip, and the surrounding soft tissues from injuries, enhancing precise delicate movements of the distal digits through counter-pressure exerted on the pulp of the finger, and acting as a tool for scratching or pulling out a splinter.
The scientific name for fingernails is "nail plates" or "corpus unguis". The word "nail" in common usage typically refers only to the nail plate, which is the visible hard nail area from the nail root to the free edge.
When the fingernail separates from the nail bed, it is called onycholysis. Onycholysis can be caused by injuries, fungal infections, certain medications, or nail psoriasis. It is characterised by the nail peeling away from the nail bed, an abnormal border between the pink and white areas of the nail, and discoloration of the nails and nail beds.
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