skin, hair, nails, heentt

assessment of the skin

reveals the patient’s health status related to oxygenation, circulation, nutrition

skin coloration

cyanosis, jaundice, tanned

skin variations

vitiligo, seborrheic keratosis

inspection

check skin integrity
inspect for lesions

palpation

texture, thickness, moisture

skin

vascularity, edema, lesions

asymmetry

uneven shape

border irregularity

look for edges that are blurred, notched, or ragged

color

look for pigmentation that is not uniform

diameter

look for areas greater than the size of a typical pencil eraser

evolving

changes in size shape symptoms

three types of skin cancer

melanoma, basal cell carcinoma, squamous cell carcinoma

basal cell carcinoma

type of skin cancer that most often develops on areas of skin exposed to sun

squamous cell carcinome

type of skin cancer caused by overproduction of squamous cells in your epidermis

melanoma

most serious type of skin cancer, develops in cells that produces melanin

kaposi sarcoma

a disease in which cancer cells are found in the skin or mucous membranes that line the GI tract from mouth to anus.

caused by human herpesvirus 8 (HHV-8)

macule

flat lesion less than 1 cm without elevation or depression

patch

flat lesion greater than 1 cm without elevation or depression

plaque

flat, elevated lesion, greater than 1 cm

papule

elevated solid lesion less than 1cm

nodule

elevated solid lesion greater than 1cm

tumor

abnormal mass of tissue may be cancerous or premalignant

bulla

elevated fluid filled lesion

wheal

skin lesion caused by an allergic reaction

cysts

abnormal, fluid-filled sacs that can develop in tissues in any part of the body

erosion

intraepithelial loss of epidermis

lichenification

skin that is thick and leathery

scales

visible peeling or flaking of outer skin layers

crust

dried exudate on the skin surface

ulcer

crater-like, open sore on the skin

fissure

breaks in the skin look likes cuts or cracks

scars

can result from injury to the skin through disease and trauma

tinea corporis

measles (rubeola)

german measles

chickenpox (varicella)

herpes simplex

herpes zoster (shingles)

psoriasis

contact dermatitis

eczema

impetigo

hirsutism

furuncle

folliculitis

alopecia areata

tinea capitis (scalp ringworm)

seborrheic dermatitis (cradle cap)

clubbing

bulbous, club-like deformation of the distal portion of fingers and toes

raynaud disease

when blood vessels in your fingers and toes temporarily overreact to low temperature or stress

acute digital ischemia

may cause blue nails

lymphoedema

yellow nail syndrome

chronic paronychia

most often on the hands in person repeatedly exposed to moist environment prolonged and repeated contact with irritants

housekeepers, dishwashers, bartenders, swimmers

ingrown nail

nail as a foreign body - inflammatory response - erythema, edema, focal at the nail fold and nail plate junction

gastrointestinal disease

malabsorption leading to malnutrition, discoloration, lunula may be absent

renal disease

half-and-half nails, about 30% of dialysis patients have no lunula

nystagmus

extraocular movements

snellen chart and e chart

perrla

pupils, equal, round, reactive to light, and accommodation

cover test

measurement of eye posture
performed at distance (6cm) and near (40cm)

tuning fork

if a hearing loss is present, test the hearing using a __

weber’s test

hold fork at base and tap it lightly against heel of palm

rinne test

place stem of vibrating tuning fork against patient’s mastoid process

romberg’s test

pt stand w feet together
vision can compensate for loss of position sense

nose

assess by inspection and palpation

sinuses

assess by palpation
assess for tenderness

lips

color
texture
hydration

mouth and pharynx

buccal mucosa
gums
teeth

palate

hard
soft

pharynx

examine to rule out infection, inflammation
inspect the uvula, soft, palate

head and neck

inspect the head noting the position size shape

neck

anterior posterior triangle

lymph nodes

inspection, palpation