Assessment: Hair, Skin, & Nails

45 terms by awmused 

Create a new folder

Advertisement Upgrade to remove ads

Quiz 1: Ch. 9-11, focus on HSN D'Amico & Barberito, Health & Physical Assessment 2/e

Inspection of Skin

PI-OO-II (P-I-N-G-O: Bingo dog song ending, dogs inspect skin)

1. Position (sitting, exam gown)
2. Instruct (will be looking carefully at skin)
3. Observe (cleanliness, perspiration, sheen, smell)
4. Observe (skin tone)
5. Inspect (pigmentation)
6. Inspect (superficial arteries & veins)

Palpation of Skin

I'D APPP IPP ("I'd tap it")
Tempt Me To Thank Ellie's Little Sister

1. Instruct
2. Determine (skin temp)
3. Assess (moisture)
4. Palpate (texture)
5. Palpate (thickness)
6. Palpate (elasticity)
7. Inspect & Palpate (lesions)
8. Palpate (sensitivity)

Inspection of Hair & Scalp

I Oc Oc At ODist IL

1. Instruct
2. Observe (cleanliness)
3. Observe (color)
4. Assess (texture)
5. Observe (distribution)
6. Inspect (lesions)

Assessment of Nails

In A Hyper Insect's Pink Underwear, A Caterpillar Insists Playing a Sax & Cello, Putting Thousands of Regulars to Bed; It's a Party, Cutie!

1. Instruct
2. Assess (hygiene)
3. Inspect (even, pink undertone)
4. Assess (color)
5. Inspect & Palpate (shape & contour) 160
6. Palpate (thickness, regularity, attachment to bed)
7. Inspect & Palpate (cuticles)

Spoon nail

Assessment of Nails
6. Inspect & Palpate (shape & contour)
-Concave.
-Nail angle < 160 degrees

Normal nail

Assessment of Nails
6. Inspect & Palpate (shape & contour)
-Slightly convex.
-Nail angle ~160 degrees

Clubbing

Assessment of Nails
6. Inspect & Palpate (shape & contour)
-Convex and wide.
-Nail > 160 degrees

Splinter Hemorrhage

Assessment of Nails
6. Inspect & Palpate (shape & contour)
-Reddish brown spots in nail.
-Cause: Trauma or endocarditis (infection in heart)

Onycholysis

Assessment of Nails
6. Inspect & Palpate (shape & contour)
-Nail plate loosens from distal nail and proceeds to proximal portion.

Skin Inspection: Cleanliness (abnormal findings)

Urea & ammonia salts found on skin --> kidney disorder

Skin Inspection: Skin Tone (abnormal findings)

1. Cynosis or pallor --> low plasma oxygen (at risk for altered tissue perfusion)
2. Pallor --> anemia

Skin Inspection: Pigmentation (abnormal findings)

Vitiligo: patchy, depigmented areas over face, neck, hands, feed, and body folds

Skin Palpation: Moisture (abnormal findings)

1. Diaphoresis: profuse sweating (e.g. from hyperthyroidism, or impending myocardial infarction)
2. Pruritis: itching r/t dr skin

Skin Palpation: Texture (abnormal findings)

1. Excessively smooth and velvety: Hyperthyroidism
- thin, shiny skin --> impaired circulation
2. Excessively dry: Hypothyroidism
- rough, scaly skin

Skin Palpation: Temperature (abnormal findings)

HIGHER T caused by:
1. Metabolic disorders, such as HYPERTHYROIDISM
2. After vigorous activity
3. External environment is warm

LOWER T caused by:
1. Metabolic disorders, such as HYPOTHYROIDISM
2. External environment is cool

Skin Palpation: Elasticity (abnormal findings)

1. "Tent": Skin turgor decreased (pinch @ clavicle)
Caused by: Dehydration or losing a lot of weight
2. Increased skin turgor: scleroderma "hard skin" (scarred underlying connective tissue)
3. Edema: decrease in skin mobility caused by accumulation of fluid in intercellular spaces

Edema

Increased accumulation of fluid in a dependent part that is caused by an accumulation of fluid in the intercellular spaces

Four-point scale for grading edema:
+1: 2 mm
+2: 4 mm
+3: 6 mm
+4: 8 mm

Skin Palpation: Lesions (abnormal findings)

1. Ecchymosis: bruising (periumbilical & flank)
2. Cullen's sign: in periumbilical area --> bleeding in abdomen
3. Grey Turner's sign: in flank area --> bleeding in peritoneum
4. Pancreatitis: in flank area --> bleeding in peritoneum

*Physical abuse should be assessed

Primary Lesions

Initial lesion of a disease on previously unaltered skin

Secondary Lesions

Skin condition or changes to the skin that occurs following a primary lesion (e.g. scratching, abrasion, infection)

Skin Palpation: Sensitivity (abnormal findings)

Track marks: potential substance abuse; injection of drugs into veins or other parts of the body

Melanoma Assessment

ABCDE
A=Assymetry
B=Border Irregularity
C=Color Variegation
D=Diameter greater than 6 mm
E=Evolving changes (size, shape, symptoms, surfaces, shades of color)

Hair Inspection: Cleanliness (abnormal findings)

1. Lesions may occur on scalp (cancerous). Use ABDCE method.
2. Excessive dandruff (dead, scaly flakes of epidermal cells)--> psoriasis or soborrheic dermatitis

vs. head lice (pediculosis capitis) - nits

Hair Inspection: Color (abnormal findings)

Graying in patches: nutritional deficiency (commonly protein or copper)

Hair Inspection: Texture (abnormal findings)

Dull, dry, brittle, coarse: hypothyroidism, nutritional deficiencies

Hair Inspection: Distribution (abnormal findings)

1. Excessive hair loss (women): imbalance in adrenal hormones
2. Widespread hair loss: illness, infection, metabolic disorders, nutritional deficiencies, chemotherapy
3. Alopecia areta: patchy hair loss-->infection

Hair Inspection: Lesions (abnormal findings)

1. Gray, scaly patches: Fungal infection (E.g. ringworm) --> Use Wood's lamp (UV) to fluoresce infection
2. Pediculosis capitis: head lice - nits, scratching. Check scalp for excoriation from scratching

Nail Assessment: Hygiene (abnormal findings)

Self-care deficit or r/t employment

Nail Assessment: Even, pink undertones (abnormal findings)

1. Colorless: peripheral arteriosclerosis or anemia
2. Yellow: jaundice
3. Dark red: Polycythemia (pathologic increase in production of RBC)

Nail Assessment: Capillary refill (abnormal findings)

Blue nailbeds, sluggish color return: CV or Resp. disorders

Nail Assessment: Shape & Contour (abnormal findings)

1. Clubbing: hypoxia or impaired peripheral tissue perfusion over time (cirrhosis, smoking, colitis, thyroid disease) >160
2. Spoon nail: Iron deficiency, concave <160

Nail Assessment: Thickness, regularity, attachment to bed (abnormal findings)

1. Onycholysis: sparation of nail plate from bed (trauma, infection, skin lesions)
2. Thick nails: circulatory disorders

Nail Assessment: Cuticles (abnormal findings)

Paronychia: infection of cuticle caused by untreated hangnails

Macule (lesion)

flat, nonpalpable change, < 1 cm, circumscribed border

Patch (lesion)

flat, nonpalpable change, > 1 cm, may have irregular border
EX: Mongolian spots, port-wine stains, vitiligo, chloasma

Papule (lesion)

Elevated, solid palpable masses with circumscribed border.
< 0.5 cm
EX: moles, warts

Plaque (lesion)

-Elevated, solid palpable masses with circumscribed border.
-Groups of papules that form lesions > 0.5 cm
EX: psoriasis

Nodule (lesion)

-Elevated, solid, hard or soft palpable masses extending deeper into the dermis that a papule.
-Circumscribed borders, 0.5 - 2 cm
EX: small lipoma, squamous cell carcinoma

Tumor (lesion)

-Elevated, solid, hard or soft palpable masses extending deeper into the dermis that a papule.
-May have irregular borders, > 2 cm
EX: large lipoma, carcinoma

Vesicle (lesion)

-Elevated, fluid-filled, round or oval shaped, palpable masses with thin, translucent walls and cicrumscribed borders.
Vesicles < 0.5 cm
EX: herpes simplex/zoster, early chicken pox, small burn blisters, poison ivy

Bulla (lesion)

-Elevated, fluid-filled, round or oval shaped, palpable masses with thin, translucent walls and cicrumscribed borders.
Bullae > 0.5 cm
EX: contact dermatitis, friction blisters, large burn blisters

Wheal (lesion)

Elevated, often reddish area with irregular border caused by diffuse fluid in tissues
EX: insect bites and hives (extensive)

Pustule (lesion)

Elevated, pus-filled vesicle or bulla with circumscribed border. Size varies.
EX: acne, impetigo, carbuncles (large boils)

Cyst (lesion)

Elevated, encapsulated, fluid-filled or semisolid mass orig. in subcutaneous tissue or dermis.
Usually 1 cm or larger
EX: sebaceous cysts, epidermoid cysts

Seborrheic dermatitis

"Cradle cap" common in infants. It appears as eczema of yellow-white greasy scales on scalp and forehead.

Please allow access to your computer’s microphone to use Voice Recording.

Having trouble? Click here for help.

We can’t access your microphone!

Click the icon above to update your browser permissions above and try again

Example:

Reload the page to try again!

Reload

Press Cmd-0 to reset your zoom

Press Ctrl-0 to reset your zoom

It looks like your browser might be zoomed in or out. Your browser needs to be zoomed to a normal size to record audio.

Please upgrade Flash or install Chrome
to use Voice Recording.

For more help, see our troubleshooting page.

Your microphone is muted

For help fixing this issue, see this FAQ.

Star this term

You can study starred terms together

NEW! Voice Recording

Create Set