Assessment of Skin, Head

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Assessment of Skin, Head Neck (Assessment Part
1)

• Presented by
• Chris Hicks

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Preparation

• Equipment
• Well-lit Room
• Comfortable Environment
• Handwashing
• Appropriate use of Gloves
• Privacy/Draping
• Organized Assessment
• Explanations

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Skin

• Inspection
• Color
• Bleeding
• Ecchymosis
• Vascularity
• Lesions

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• Palpation
• Moisture
• Temperature
• Texture
• Turgor
• Edema

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• Color
• NormalUniformed whitish pink or brown
• Abnormal
• Cyanosis
• Jaundice
• Carotemia
• Albinism
• Vitiligo

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• Bleeding, Ecchymosis, Vascularity
• NormalNo areas
• Abnormal
• Spontaneous Bleeding
• Petechiae
• Purpura
• Eccymosis
• Venous Star
• Necrosis

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• Lesions
• NormalNo lesions except freckles, birthmarks,
  nevi (flat moles)
• Abnormal
• Rashes
• Pressure Ulcers
• Burns

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• Moisture
• NormalDry with minimum of Perspiration
• Abnormal
• Exerosis
• Diaphoresis

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• Temperature
• Normal warm hands feet slightly cooler
• Abnormal
• Hypothermia
• Hyperthermia

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• Texture
• Normalsmooth, even, firm
• Abnormal
• Roughness
• Soft

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• Turgor
• Normalwhen skin is released, it should return to
  original contour rapidly
• Abnormal
• Dehydration

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• Edema
• NormalNo edema present
• Abnormal
• Pitting edema is rated on 4 point scale

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Assessment of Hair

• Color
• Distribution
• Lesions

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Assessment of Nails

• Color - Inspection
• NormalPink Brown
• Abnormal
• Cyanosis
• Leukonychia
• Melanochyia

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• Shape Configuration
• NormalSmooth, slightly rounded
• Abnormal
• Koilonychia
• Clubbing

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• Texture - Palpation
• Normalfirm
• Abnormal
• Spongy

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Gerontological Changes

• Wrinkles
• Lentigo
• Pruritus
• Keratosis
• Cancer of the skin
• Graying Hair, Hair Loss
• Nails-thick, yellow

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Assessment of the Head

• Shape - Inspection
• NormalNormocephalic Symetrical
• Abnormal
• Hydrocephalus
• Acromegaly
• Craniosynostosis

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• Palpation
• NormalSmooth, nontender, without masses or
  depressions
• Abnormal
• Masses
• Edema
• Softening

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• Scalp
• NormalShiny, intact, without lesions or masses
• Abnormal
• Lacerations
• Hematomas
• Lipomas

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• Symmetry of Face - Inspection
• NormalSymmetrical features bilaterally
• Abnormal
• Asymmetry

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• Shape of Face - Inspection
• NormalOval, round, slightly square
• Abnormal
• Downs Syndrome
• Hypertelorism
• Graves Disease
• Moon-faced
• Parkinsons Disease

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• Mandible - Palpation Auscultation
• NormalNo discomfort, without clicking
• Abnormal
• Discomfort
• Clicking snapping

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Assessment of the Neck

• Inspection of the Neck
• NormalNeck muscles symmetrical head in central
  position
• Abnormal
• Torticollis

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• Palpation of the Neck
• NormalMuscles symmetrical without masses
• Abnormal
• Tumor

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• Inspection of the Thyroid
• NormalTissue moves up down while swallowing
• Abnormal
• Enlargement

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• Palpation of Thyroid Gland
• NormalNo enlargement, masses, or tenderness
• Abnormal
• Enlargement
• Tenderness

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• Inspection of the Lymph Nodes
• NormalShould not be visible
• Abnormal
• Enlargement

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• Palpation of the Lymph Nodes
• NormalUnable to palpate
• Abnormal
• Enlargement

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Assessment of the Nose

• External - Inspection
• NormalSymmetrical shape
• Abnormal
• Asymmetrical
• Swelling

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• Internal - Inspection
• NormalEach nostril is patent Pink mucosa
• Abnormal
• Occlusion
• Discharge

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Assessment of Sinuses

• Inspection
• NormalNo swelling
• Abnormal
• Swelling

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• Palpation
• NormalNo discomfort
• Abnormal
• Temderness

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Assessment of Mouth Throat

• Inspection
• Lips
• Tongue
• Buccal Mucosa
• Gums
• Teeth
• Palate

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• Abnormal
• Lesions
• Discoloration
• Bleeding
• Absent Teeth

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• Inspection of Throat
• NormalRise symmetrically of palate uvula pink
  mucosa presence of tonsils
• Abnormal
• Red
• Swelling
• Patches of white
• Soreness with swallowing