ASSESSMENT OF SKIN TO NAILS

• palpate skin for temperature, use dorsal part of hand. 
• Assess the distribution, thickness, texture, color and lubrication of hair.
• Inspect for infection or infestation of scalp.
• Palpate Temporal arteries for elasticity and tenderness.
• Palpate Temporomandibular joints (TMJ) when client opens and closes mouth.
• I. Olfactory


  (Cranial nerve) smell
• II. Optic


  (Cranial nerve) vision
• III. Oculomotor


  Cranial nerve- upward, downward, medial, up and in of eyes
• V. Trigeminal


  Crania nerve- touch forehead and cheek, clench teeth
• IV. Trochlear


  Cranial nerve- down and in of eyes
• VI. Abducens


  Cranial nerve- look side to side
• VII. Facial


  cranial nerve- taste for the anterior 2/3 of tongue, smile
• VIII. Acoustic


  Cranial nerve- hearing and equilibrium
• IX. Glossopharyngeal


  Cranial nerve- taste of posterior 1/3 of tongue, speech
• X. Vagus


  Cranial nerve- digestion, defecation, slowed heart rate
• XI. Spinal Accessory 


  Cranial nerve- shoulder shrug
• XII. Hypoglossal


  Cranial nerve- tongue movement
• Rosenbaum chart


  is the most widely used handheld card for measuring near visual acuity
• maxillary sinuses, frontal sinuses


  Transillumination test:
• EPIDERMIS


  -THIN LAYER COMPOSED OF EPITHELIAL TISSUE.
• DERMIS


  -THICK DEEPER LAYER THAT CONTAINS BLOOD VESSELS, LYMPHATIC VESSELS, NERVES, HAIR FOLLICLES AND SWEAT AND SEBACEOUS GLANDS.
• SUBCUTANEOUS


  -INNER MOST LAYER OF THE SKIN
• A= assymetry, B= border integrity, C= color variation, D= diameter more than 0.5 cm

  Assess for malignant lesions:
• CAFÉ-AU-LAIT SPOTS


  FLAT LIGHT BROWN UNIFORMALY HYPER PIGMENTED MACULES OR PATCHES ON THE SKIN SURFACE.
• CHERRY ANGIOMAS


  TINY BRIGHT RED ROUND PAPULES THAT MAY BECOME BROWN OVER TIME.
• PAPULAR RASH


  SMALL RAISED CIRCUMSCRIBED AND DISCOLORED (RED TO PURPLE) LESIONS .
• PORT WINE HEMANGIOMAS


  FLAT PURPLE MARKS USUALLY PRESENT AT BIRTH MAY APPEAR ON THE FACE AND UPPER BODY.
• PRURITUS


  UNPLEASANT ITCHING SENSATION
• PETECHIAE


  (PURPURIC LESIONS) BROWN, PINPINT LESIONS
• ECCHYMOSES


  (PURPURIC LESIONS) BLUISH OR PURPLISH DISCOLORATION OF LESION
• HEMATOMAS


  (PURPURIC LESION) MASSES OF ACCUMULATED BLOOD.
• TELANGIECTASES


  PERMANENTLY DILATED, SMALL BLOOD VESSELS TYPICALLY IN A WEBLIKE PATTERN.
• URTICARIA


  VASCULAR SKIN REACTION OF TRANSCIENT PRURITIC WHEALS.
• VESICULAR RASH

  SCATTERED OR LINEAR DISTRIBUTION OF BLISTERLIKE LESIONS FILLED WITH CLEAR, CLOUDY OR BLOODY FLUID.
• ALOPECIA


  HAIR LOSS
• HIRSUTISM


  EXCESSIVE HAIR IN WOMEN
• EAU’S LINES


  TRANSVERSE DEPRESSION IN THE NAILS EXTENDING TO THE BED.
• CLUBBING


  PROXIMAL END OF THE NAIL ELEVATES SO THE ANGLE IS GREATER THAN 180 DEGREES.
• KOILONYCHIA


  1.THIN SPOON SHAPED NAILS WITH LATERAL EDGES THAT TILT UPWARD.
• ONYCHOLYSIS


  NAIL PLATE LOOSENING WITH SEPARATING FROM THE NAIL BED.