SKIN, HAIR, NAILS, HEAD, NECK, EYES, AND EARS

- Epidermis, Dermis, Hypodermis

3 layers of skin

1. Protection

2. Thermoregulation

3. Sensation

4. Metabolism

5. Excretion

Functions of the Skin

- even tone appropriate to the individual's ethnicity; no unusual discoloration.

what is the normal findings of the skin color?

warm to touch

what is the normal findings of the skin temperature

smooth and soft

what is the normal findings of the skin texture?

slightly moist

what is the normal findings of the skin moisture?

skin returns to its place quickly when pinched.

what is the normal findings of the skin turgor?

intact, no breaks, ipulcers, or laceration

what is the normal findings of the skin integrity?

Pallor

an abnormal pale appearance that can occur due to an illness

Cyanosis

bluish discoloration of the lips, nails, hands or skin due to lack of oxygen in the blood

EXAMPLE: Lung disease, Heart Failure

Jaundice

a yellow pigmentation of the skin due to a presence of underlying disease

EXAMPLE: Liver disease, Massive hemolysis (RBCdestruction; RBC-120 days)

Erythema

a skin redness associated with a variety of rashes and other conclusions

EXAMPLE: Cellulitis

Vitiligo

seen as patches of hypopigmented skin

Edema

medical term for swelling caused by fluid build up in the body's tissues,often in the legs, ankle, or feet.

EXAMPLE: Heart Failure, Kidney disease, Liverdisease

Macule

Papule

Patches

Vesicles

Pustules

Scales

Fissure

Scar

Types of skin lesions

Macule

circular flat discoloration; less than 1 cm

Patch

circumscribed flat discoloration; above 1 cm

Pustules

vesicle containing pus due to inflammatory cells

Vesicle

circular collection of free fluid;less than/equal 1 cm

Papule

superficial solid elevated ; less than or equal 0.5 cm; color varies

Scale

epidermal thickening consist of flakes of plates of compacted skin

Fissure

Crack or split

Scar

thickening permanent fibrotic changes that occur on the skin following damage of the epidermis

1. Protection

2. Sensation

3. Thermoregulation

Functions of Hair

even distributed of color throughout the scalp

what is the normal findings of the hair color?

normal distribution according to age, sex, and ethnicity

what is the normal findings of the hair distribution

smooth, fine or coarse, resilient, evenly textured

what is the normal findings of the hair texture

normal hair density with no patches of thining or baldness.

what is the normal findings of the hair quantity

dry, intact, no scales

what is the normal findings of the hair scalp

Alopecia

a condition where hair is lost from part of the head or body.

examples: chemotherapy, stress, autoimmune disease

Hirsutism

excessive hair growth

example: Cushing Syndrome, PCOS

Pupils, Equal, Round, Reactive to Light and Accommodation

what is PERRLA?

1. Protection

Enhancement of fine motor skills

Sensory function

Health Indicator

Functions of Nails

pink nail beds

what is the normal findings of the nail color?

convex nail surface

what is the normal findings of the nail shape?

smooth, firm and regular surface

what is the normal findings of the nail texture?

even thickness not brittle

what is the normal findings of the nail thickness ?

intact, smooth, not swollen

what is the normal findings of the nail cuticle?

Cyanotic nails

blue/purple fingernails

Example: Heart failure, Chronic Lung disease

Clubbing

enlargement and curving of the fingertips and nails, often seen as bulging

example Chronic Hypoxia

spoon-shaped nails

a nail condition characterized by concave or indented shape, resembling a spoon

example is Iron Deficiency Anemia

Beau's line

deep-grooved lines that run from side to side of the fingernails

- Stress, Illness

Delayed Capillary Refill

measured as a refill time; 2-3 seconds

- Blanch Test

- Shock , Vasoconstriction, Blockedarteries

Protection

Support

Framework for the face

Skull functions

normocephalic, symmetrical, no bulging

what is the normal findings of the head/skull shape and size

-intact, clean, no lesions, scaliness

what is the normal findings of the head/skull scalp

Firm, no tenderness and masses

what is the normal findings of the head/skull when palpating

symmetric facial movement

what is the normal findings of the head/skull face

Frontal Bossing

prominent or protruding forehead

example: Rickets

Microcephaly

head circumference below the average

Macrocephaly

above average head circumference

Vision

Function of the eye

symmetrical, no lesions, evenly distributed hair

what is the normal findings of the eyebrows?

must close completely and open symmetrically, no redness or ptosis, curves outward

what is the normal findings of the eyelids

clear and moist

what is the normal findings of the conjunctiva

white

what is the normal findings of the sclera

transparent and moist

what is the normal findings of the cornea

clear, no visible clouding

what is the normal findings of the lens

consistent color

what is the normal findings of the iris

PERRLA 2-3mm

what is the normal findings of the pupils

20/20

what is the normal findings for the visual activity

smooth with6 cardinal directions of gaze, nonystagmus, and strabismus

what is the normal findings of the extraocular movement

Ptosis

when the upper eyelid droops over the eye

example: Myasthenia Gravis, Congenital

cataract

clouding of the lens of the eye

age related

anisocoria

a condition in which the pupils are unequal in size

CN III Nerve palsy

Miosis

constricted pupils; less than or equal 2

neurological damage

Mydriasis

dilated pupils; greater than 6mm

brain injury

Nystagmus

involuntary rhythmic eye movement

strabismus

inalignment of eyes

Medial Rectus

Superior Rectus

Superior Oblique

Lateral Rectus

Inferior Rectus

Inferior Oblique

6 cardinals fields of gaze

Hearing and balance

functions of ears

symmetrical, intact skin,no tenderness, no discharge

what is the normal findings of the external ears

clear with small amount of cerumen (yellow to light brown)

what is the normal findings of the ear canal

pearly gray and intact (use otoscope)

what is the normal findings of the tympanic membrane

able to repeat whispered words

what is the normal findings for the whisper test

sound is heard equally on both ears

what is the normal findings for the weber test

air conduction >bone conduction test

what is the normal findings for the rinne

Supports the Head

Allows movement

Protection

Contains glands and lymph nodes

Functions of the neck

Neck is symmetrical

Trachea midline

Skin is intact

Visible carotid pulsation (but not bounding)

Thyroid gland is not enlarged

Lymph nodes are not palpable

Full range motion in all directions

No stiffness or pain

Equal Strength

What are the normal findings of the neck?

Asymmetrical

Swelling

Shifted trachea

JVD

Presence of skin lesioms

enlarged thyroid gland

palpable tender lymph nodes

limited movement

pain with movement

Give the abnormal findings of neck

Preauricular

Posterior Auricular

Occipital

Superficial Cervical

Tonsillar

Submental

Submandibular

Deep Cervical Chain

Posterior Cervical

Supraclavicular

Enumerate the lymph nodes