Skin, Hair, and Nail

Rung-Fen Feng, 2007.3

Functions of the Skin

• Protection• Sensory perception• Temperature & blood pressure

regulation• Vitamin synthesis• Excretion & secretion• Absorption• Respiration

Structure of the skin

.The skin – epidermis

dermis subcutaneous

.Appendage – hair vellus Vs terminal

nail sebaceous gland sweat gland eccrine apocrine

Examination

• Preparation & position

environment

client

equipment

. Skills inspection

palpation

Skin

Inspection – color general pigmentation

freckles

mole

birthmark

vascularity or bruising

Palpation – texture & consistency (thickness)

temperature

moisture

tugor & mobility

If any lesions are present, note their:

• Morphology size, shape, elevation or depression of the lesion• Distribution generalized or localized • Location• Configuration grouped, diffuse, linear..• Any exudate color, odor, volume….

Hair

• Inspection – color

distribution

volume

free of debris

• Palpation - texture

Nail

• Inspection – shape & contour

color

consistency smoothness, symmetry

cleanliness

• Palpation – adherence to the nail bed

capillary refill <1”-2”

Head & NeckRegional Lymphatics

Rung-Fen Feng 2007.3

The Head

• 8 cranial bones frontal, parietal, occipital, and

temporal

• 14 facial bones nasal bone & nasal septum, zygomatic,

maxilla, mandible, lacrimal,

sphenoid, external acoustic meatus,

mastoid process

Examination

• Head Inspection – skull size & shape

scalp color

hair color, volume, distribution

Palpation – skull tenderness

hair texture

• Face

Inspection – facial expression symmetry

appearance

color

Palpation - temporomandibular joint

tenderness

• The neck

structures & anatomy

Inspection – symmetry range of motion muscle function

thyroid

lymph nodes

Palpation – trachea

thyroid

lymph nodes

Characteristics in Lymph Nodes Examination

LocationSize

ShapeConsistencySymmetry

Fixation & MobilityTenderness

BorderSurface characteristic (erythema, heat)

• Ascultation – thyroid artery