ASSESSMENT INTEGUMENTARY SYSTEM

• Covers the internal structures of the body and provides a window fow viewing changes taking place inside the body.

  SKIN
• • Protecting tissues from the trauma and bacteria.
  • Preventing the loss of water and electrolytes from the body.
  • Sensing temperature, pain, touch, and pressure.
  • Regulate body temperature.
  • Synthesizing of vitamin D from the sun.

  FUNCTIONS OF INTEGUMENTARY ANATOMY
• The top layer of the skin

  EPIDERMIS
• The second layer of the skin.

  DERMIS
• The bottom layer of the skin

  SUBCUTANEOUS FAT
• CULTURAL FACTOR / CONSIDERATION:

  • men have very little facial hair.

  CHINESE
• CULTURAL FACTOR / CONSIDERATION:

  • have thick and kinky hair.

  AFRICAN AND AMERICANS
• CULTURAL FACTOR / CONSIDERATION:

  • produce less sweat/less body odor.

  ASIANS
• DEVELOPMENTAL CONSIDERATION:

  • less resistant and sensitive.

  INFANTS AND CHILDREN
• DEVELOPMENTAL CONSIDERATION:

  • hormonal change

  ADOLESCENTS ACNE
• DEVELOPMENTAL CONSIDERATION:

  • clients glows.
  • increases blood flow in the skin

  PREGNANT / PREGNANCY
• DEVELOPMENTAL CONSIDERATION:

  • loose fat, lose skin elasticity ( inelastic skin )

  MENOPAUSAL
• DEVELOPMENTAL CONSIDERATION:

  • dry and wrinkled skin ( due to lose of oil glands )

  OLDER ADULTS
• EQUIPMENT NEEDED FOR SKIN INSPECTION

  dequate lighting, comfortable room temperature, gloves, penlight, magnifying glass, transparent ruler
• GIVE ATLEAST 4 TYPICAL QUESTION TO ASK IN SKIN ASSESSMENT?

  • Do you have chronic illness?
  • Are you taking medications?
  • What type of work do you do ? are you exposed to chemicals at home or working place?
  • Have anyone in your family ever had skin related problems?. Is the change confined to one area, or has the condition to spread?
  • What do you do to keep your skin healthy?
• Skin Inspection and Palpation

  • Expose the body part to be inspected


  Inspect skin for the ff :

  • Note color, odor, and integrity
• Skin Inspection and Palpation.

  • uniform skin color w/ slightly darker exposed areas

  NORMAL
• Skin Inspection and Palpation.

  • color changes may be benign and may indicate underlying pathology.
  • Cyanosis
  • Pallor
  • Acanthosis Nigricans
  • Jaundice

  ABNORMAL
• Skin Inspection & Palpation: 1. Texture

  -The character of the skin’s surface and the

  feel of deeper portions.

  • SOFT AND SMOOTH

  NORMAL
• Skin Inspection & Palpation: 1. Texture

  -The character of the skin’s surface and the

  feel of deeper portions

  • ROUGH, THICK AND DRY

  ABNORMAL
• Skin Palpation : 2. Temperature

  -The temperature of the skin depends on

  the amount of blood circulating through

  the dermis.

  • WARM


  NORMAL
• Skin Palpation : 2. Temperature

  -The temperature of the skin depends on

  the amount of blood circulating through

  the dermis.

  • EXTREMELY COOL AND WARM

  ABNORMAL
• Skin Palpation: 3. Moisture

  -The hydration of skin and mucous

  membrane.

  • DRY AND SMOOTH

  NORMAL
• Skin Palpation: 3. Moisture

  -The hydration of skin and mucous

  membrane.

  • WET AND OILY

  ABNORMAL
• Skin Palpation: 4. turgor

  -Elasticity of the skin.

  • RETURNS IMMEDIATELY

  NORMAL
• Skin Palpation: 4. turgor

  -Elasticity of the skin.

  • IT TAKE MORE THAN 30 SECS. TO RETURN OR NO LONGER RETURN.

  ABNORMAL
• Skin Inspection and Palpation

  Palpate skin for the ff:

  > Edema: press firmly for 5 secs over tibia and ankle.

  • NO SWELLING, PITTING, OR EDEMA

  NORMAL
• Skin Inspection and Palpation

  Palpate skin for the ff:

  > Edema: press firmly for 5 secs over tibia and ankle.

  • SWOLLEN, SHALLOW TO DEEP PITTING, ASCITES

  ABNORMAL
• Skin Inspection and Palpation

  • STRIAE, MOLE, FRECKLES, BIRTHMARKS

  NORMAL
• Skin Inspection and Palpation.

  • PRIMARY LESIONS - MELANOMA
  • SECONDARY LESIONS - ECZEMA
  • VASCULAR LESIONS - ECCHYMOSIS

  ABNORMAL
• Skin Inspection and Palpation

  • raised but superficial :Papule < 1cm (mole, wart); plaque > 1 cm (psoriasis)

  PALPABLE - PRIMARY LESIONS
• Skin Inspection and Palpation

  Primary Lesions: PALPABLE W/FLUID FILLED

  • < 1CM - BLISTER ( HERPES SIMPLEX )


  VESICLE ( SEROUS )
• Skin Inspection and Palpation

  Primary Lesions: PALPABLE W/FLUID FILLED

  • > 1CM ( BLISTER, BURNS )

  BULLA ( SEROUS )
• Skin Inspection and Palpation

  Primary Lesions: PALPABLE W/FLUID FILLED

  • PUS - FILLED ( ACNE )

  PUSTULE
• • Occur when skin affected by a primary lesion undergoes change related to manipulation, treatment or disease progression.

  SECONDARY LESIONS
• Secondary Lesions:

  That add to:

  • Thickening and scaling w/ increased skin markings:

  LICHENIFICATION ( ECZEMA )
• Secondary Lesions:

  That add to:

  • Shedding, dead skin cells; Scales: can be dry or oily

  PSORIASIS
• Secondary Lesions:

  That add to:

  • Linear breaks in the skin w/ well-defined borders, may extend to dermis:

  FISSURES ( SYPHILIS CHEILITIS, ATHLETE'S FOOT )
• • Are the result of numerous or large vessels that form directly underneath the skin.
  • This usually results in a red appearancein the skin since the vessels can be visible through the skin.

  VASCULAR LESIONS
• VASCULAR LESIONS:

  • extravasation of blood into skin layer caused by trauma/injury.


  ECCHYMOSIS