Prof Dr. Salma Khadim - PowerPoint Presentation

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Prof Dr. Salma Khadim Jehad Dr. Ali Faris M.Sc Hassanain Mohammed Kadhim

Physical Assessment Integumentary System Lecture -2-

EquipmentRulerLightingPenlightGlovesMagnifying glassWoods lamp

Integumentary System; Including ( Skin , Hair , Nail ) Used Only 2 Techniques 1- Inspection2- Palpation

Nails Assessment PE Technique :InspectionColorNormal : pinkAbnormal: Pale, BluishHygiene: Clean, Wally trimmedAbnormal: Dirty , Consideration : client work , educate for cleaning

Shape: Convex ,the angle between the nail bad and the nail is 160 degree Abnormal: 1-spoon shape2-early clubbing 180 degree ,3-late clubbing; More than 180 degree 4-Beau’s line

Later Clubbing

Spoon Shape

Beau’s Line

PE PalpationTexture Normal: smooth & thin Abnormal: Hard & thick Vascularity Assessed by Blanch test ( refill) normal color returned within 2 second

Skin Assessment PE Technique InspectionColor : Evenly white to light brown Abnormal: pale, cyanosis , yellowish & Erythema ( local or general)Marks and pigmentation : Moles ,naive & birth marks normal Abnormal : changing of Moles ABCD

Changing Moles Or Navie And Pigmentation ABCDE A--- Asymmetrical B--- Boarder C--- Color D--- Diameter E--- Elevated

Pigmentation : petechiae ;pin point red flat impalpable discoloration of skin Purpura : hemorrhage into skin caused by decrease platelet ,liver dysfunctionEcchymosis : discoloration of skin called black and blue mark due to trauma

Lesion:Macule : red ,less than 1cm flat as frecklePapule :Solid elevated less than 0.5 cm such as warts & neviPatch : red flat more than 1cm 1stage pressure ulcerNodules : Solid elevated deep than papule within 0.5-2 cm such as cyst

Vesicle : Accumulation of fluid in skin elevated , less than 0.5 cm full of serous such as blister Bullae : as vesicle but great than 0.5 cmPustule : such as vesicle less than 0.5 cm put full of pus such as acne Wheal : local edema irregular elevation may be red or pale as insect bite

Palpation TemperatureTexture : smooth evenly firmAbnormal : roughness ( occupation , weather & chemical products Moisture : dry some perspiration in palm , axially , folded skin area Abnormal : diaphoresis clammy

Mobility and Elasticity ( turgor)MobilityElasticity

Assessment of Pitting Edema According To 1-Deep 2- Location 3- Extension 0+ No edema1+ Mild pitting edema ,2mm depression disappear rapidly.2+ Moderate pitting edema, ,4 mm disappear in 10-15 sec 3+ Moderate severe pitting edema ,6mm depression disappear in more than 1 min 4+ Severe pitting edema , 8 mm depression that can disappear more than 2min

Deep Of Edema

Hair Assessment Inspection Color ;natural color , gray or chemical color Abnormal ; gray (young), copper colorDistribution ; Evenly Hair distribution Abnormal; general loss of hair Or Alopecia (patch)

Palpation Texture; Normal Silky , Shinny , Oily or Dry Abnormal; Brittle hair, excessive Oily or DryCleanliness ; normal CleanAbnormal ; Dirty Infection & LesionNormal; free of lesion ,free of Lice and dandruffAbnormal; With lesion or Lice , Nits