Physical Diagnosis Physical Exam

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Physical Diagnosis Physical Exam
Hair

• Amanda Odom
• Physical Diagnosis, Fall 2002

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Hair
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Hair Inspection and Palpation

• Quantity
• Distribution
• Inspect entire body not just head
• Loss of hair on legs may indicate poor
  circulation
• Asymmetric hair loss may indicate a pathologic
  condition
• Male pattern pubic hair is upright triangle
• Female pattern pubic hair is inverted triangle

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Hair Inspection and Palpation

• Texture
• Vellus hair
• Fine hair that covers body
• Terminal hair
• Found on scalp, pubic and axillary areas
• Fine, curly, or straight
• Should be shiny, smooth, and resilient
• Palpate scalp for dryness and brittleness

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Male Pattern Baldness
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Alopecia Areata

• Sudden, rapid, patchy loss of hair from the
  scalp or face
• Hair shaft is poorly formed and breaks off at the
  skin surface
• Regrowth begins in 1-3 months
• Prognosis is good

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Alopecia Areata
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Alopecia Areata
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Scarring Alopecia

• Results from skin diseases (tinea) that cause
  destruction of the hair follicles

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Scarring Alopecia
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Scarring Alopecia
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Traction Alopecia

• Hair loss due to prolonged tension of the hair
  (braids, hair rollers, and hot combs)

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Traction Alopecia
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Traction Alopecia
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Traction Alopecia
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Hirsutism

• Male pattern hair growth on the face, body and
  pubic area in women

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Hirsutism
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Hirsutism
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Hirsutism
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Head Lice

• Head lice are small, wingless parasitic insects.
  They are typically 1/6 to 1/8 inch long, brownish
  in color with darker margins. The claws on the
  end of each of their six legs are well adapted to
  grasping a hair strand.  
• Head lice are primarily transmitted by direct
  head-to-head contact and sharing of personal
  grooming items. Lice cannot jump, hop or fly, but
  they can crawl rapidly.
• Female head lice glue their grayish-white to
  brown eggs (nits) securely to hair shafts. The
  eggs are resistant to pesticides, and they are
  difficult to remove without a special 'nit-comb.'
  The nits are generally near the scalp, but they
  may be found anywhere on the hair shaft.

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Head Lice
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Head Lice Nits
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Head Lice Nits
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Scabies Skin Mites

• The intraepidermal burrow is the pathognomonic
  clinical sign of scabies and contains the
  pregnant female mite, eggs, faeces and other
  discarded material from the mites.
• Scabies in the family setting usually means one
  or two other members of the family will also be
  affected. These patients usually have a low mite
  count (10-50) and appropriate treatment of the
  whole family is curative. In extended families,
  contact tracing is important to make sure that
  relatives and other people who had significant
  physical contact with the infested patient are
  also treated.

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Scabies

• Signs and symptoms
• Unexplained pruritus especially if other contacts
  are also itchy
• Atopic dermatitis of very recent onset
• Recurrent impetigo with itch
• Pustular lesions on the palms, webs of fingers,
  and soles particularly in the young
• Unusual pruritic rashes that are crusted and
  scaling or blistering

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Scabies
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Scabies
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Scabies
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Scabies