SKIN, HAIR, NAILS, HEAD, NECK, EYES, AND EARS

• ASSESSMENT TOOL FOR SKIN, HAIR, AND NAILS

  • INSPECTION
  • PALPATION
• SKIN

  • body’s largest organ
• FUNCTIONS OF SKIN

  • HEAT REGULATION
  • PROTECTION
  • SECRETION
  • EXCRETION
  • VITAMIN D PRODUCTION
  • SENSATION
  • ABSORPTION
• HEAT REGULATION

  • HEAT IS RETAINED BY YOUR BODY : BLOOD CIRCULATION AVOIDS SURFACE OF SKIN TO RETAIN HEAT
  • HEAT THROUGH CONVECTION AND RADIATION: BLOOD CIRCULATES TO SURFACE OF SKIN TO DISPEL HEAT
• PROTECTION

  • PROTECTION AGAINST COLD AND HEAT
  • PROTECTION AGAINST MECHANICAL IMPACT
  • PROTECTION AGAINST PHYSICAL & CHEMICAL DAMAGE
  • DESTRUCTION OF INOCULATED MICROORGANISMS
  • PREVENTS MICROORGANISMS FROM PENETRATING
  • RESORPTION OF SPECIFIC SUBSTANCES
  • PREVENTS EXCESSIVE DEHYDRATION
• SECRETION

  • SKIN CONTAINS MELANIN: provides a chemical pigment defense against ultraviolet light that can damage skin cells
• EXCRETION

  • the skin is a site through which we can excrete urea and other wastes via the sweat
• SENSATIONS

  • to detect the different sensations of heat, cold, pressure, contact and pain
• ABSORPTION

  • DERMAL ABSORPTION HAPPENS WHEN A CHEMICAL GOES THROUGH THE SKIN AND TRAVELS INTO THE BODY
  • ABSORPTION IS WHEN IT GETS ALL THE WAY TO THE BOTTOM LAYER OF THE SKIN AND SUCKED IN THE BLOODSTREAM
  • PENETRATION IS WHEN IT GETS ALL THE WAY TO THE BOTTOM LAYER OF THE SKIN AND STOPS
• VITAMIN D PRODUCTION

  1. SKIN IS EXPOSED TO UV LIGHT
  2. UV LIGHT REACTS WITH AN ENZYME CALLED 7-DEHYDROCHOLESTEROL
  3. THIS REACTION CREATES PRE-VITAMIN D
  4. PRE-VITAMIN D REARRANGES ITS FORM TO VITAMIN D
• LAYERS OF THE SKIN

  • EPIDERMIS
  • DERMIS
  • SUBCUTANEOUS TISSUE
• EPIDERMIS

  • OUTERMOST LAYER OF THE SKIN
  • CONTAINS FOUR MAJOR LAYERS
  • STRATUM CORNEUM
  • STRATUM LUCIDUM
  • STRATUM GRANULOSUM
  • STRATUM GERMINATIVUM
  • THE EPIDERMIS CONSISTS OF DEAD, KERATINIZED CELSS THAT RENDER THE SKIN WATERPROOF
  • THE EPIDERMAL LAYER IS ALMOST COMPLETELY REPLACED EVERY 3-4 WEEKS
• KERATIN

  • IS A SCLEROPROTEIN THAT IS INSOLUBLE IN WATER.
  • FOUND IN EPIDERMIS, HAIR AND NAILS, DENTAL ENAMEL, AND HORNY TISSUES
• THE INNERMOST LAYER OF THE EPIDERMIS, STRATUM GERMINATIVUM, IS THE ONLY LAYER THAT UNDERGOES CELL DIVISION AND CONTAINS THE PIGMENT MELANIN AND KERATIN-FORMING CELLS
• THE MAJOR SKIN DETERMINANT IS MELANIN

  • OTHER DETERMINANTS INCLUDE COLLAGEN, CHROMOPHORES (CAROTENE AND LYCOPENE), AND CAPILLARY BLOOD FLOW
• DERMIS

  • WELL-VASCULARIZED, CONNECTIVE TISSUE CONTAINING COLLAGEN, ELASTIC FIBERS, NERVE ENDINGS, LYMPH VESSELS, HAIR FOLLICLES, SWEAT GLANDS, AND SEBACEOUS GLANDS
  • DERMAL PAPILLAE CONNECT THE DERMIS TO THE EPIDERMIS
• SEBACEOUS GLANDS ARE ATTACHED TO THE HAIR FOLLICLES

  SEBACEOUS GLANDS SECRETE AN OILY SUBSTANCE, SEBUM, WHICH WATERPROOFS THE HAIR AND SKIN
• SWEAT GLANDS HAVE TWO TYPES: ECCRINE AND APOCRINE

  • ECCRINE SWEAT GLANDS ARE LOCATED OVER THE ENTIRE SKIN AND THEIR PRIMARY FUNCTION IS SECRETION OF SWEAT AND THERMOREGULATION, WHICH IS ACCOMPLISHED BY EVAPORATING SWEAT ON THE SURFACE OF THE SKIN
  • APOCRINE SWEAT GLANDS ARE ASSOCIATED WITH HAIR FOLLICLES IN THE AXILLAE, PERINEUM, AND AREOLAE OF BREASTS. THEY ARE SMALL AND NONFUNCTIONAL UNTIL PUBERTY. ONCE THEY ARE ACTIVATED, THEY SECRETE A MILKY SWEAT. IN WOMEN, APOCRINE SECRETIONS ARE LINKED WITH THE MENSTRUAL CYCLE
• SUBCUTANEOUS TISSUE IS A LOOSE CONNECTIVE TISSUE THAT CONTAINS THE FAT CELLS, BLOOD VESSELS, AND THE REMAINING PORTIONS OF SWEAT GLANDS AND HAIR FOLLICLES.

  FUNCTIONS

  • STORES FAT AS AN ENERGY RESERVE
  • SERVES AS A CUSHION THE PROTECT BONES AND INTERNAL ORGANS
  • PROVIDE INSULATION TO CONSERVE BODY HEAT
  • CONTAINS VASCULAR PATHWAYS TO SUPPLY NUTRIENTS AND REMOVAL OF WASTE FROM AND TO THE SKIN
  • CONNECTS THE SKIN TO UNDERLYING STRUCTURES
• QUESTIONS TO ASK FOR SKIN ASSESSMENT

  ◦ Have you noticed any changes with your skin color, sensation?

  ◦ Are you experiencing any pain, numbness, itchiness or tingling sensation?

  ◦ Are you taking any medication?

  ◦ Do you have trouble controlling your body odour?
• Color


  • Assess the skin color for any variations or abnormalities
  • Normal skin color varies depending on factors such as ethnicity
  • Any significant changes, such as yellowing or pallor, may indicate underlying health conditions
• Texture


  • Normal skin should be smooth and even
  • Rough, dry, or scaly patches could indicate conditions like eczema or psoriasis
• Moisture


  • Excessively dry or excessively oily skin can both be signs of certain skin conditions or underlying health issues
• Lesions or Rashes

  • Look for any lesions, rashes, or unusual spots on the skin
  • These could include moles, birthmarks, acne, hives, or any other abnormal growths or discolorations
• Temperature


  • Normally, the skin should be warm but not overly hot or cold to the touch
  • Extreme temperature changes may indicate circulatory or vascular issues
• Sensation


  • Ask the individual about any unusual sensations they may be experiencing, such as itching, tingling, or pain
  • These sensations can provide valuable information about the skin's health
• Macule


  A flat, nonpalpable circumscribed area (up to 1 cm) of color change that's brown, red, white, or tan
• Patch


  A flat, nonpalpable lesion with changes in skin color, 1 cm or larger
• Papule


  An elevated, palpable, firm, circumscribed lesion up to 1 cm
• Plaque


  An elevated, flat-topped, firm, rough, superficial lesion 1 cm or larger, often formed by coalescence of papules
• Examples of plaques

  • Psoriasis vulgaris
  • Actinic keratosis
• Nodule


  An elevated, firm, circumscribed, palpable area larger than 0.5 cm; it's typically deeper and firmer than a papule
• Cyst

  A nodule filled with an expressible liquid or semisolid material
• Examples of cysts


  • Sebaceous cyst
  • Epidermoid cyst
• Vesicle


  A palpable, elevated, circumscribed, superficial, fluid-filled blister up to 1 cm
• Bulla


  A vesicle 1 cm or larger, filled with serous fluid
• Pustule


  An elevated and superficial lesion, similar to a vesicle, but is filled with pus
• Examples of pustules


  • Acne
  • Impetigo
  • Furuncles
  • Carbuncles
• Wheal


  A relatively transient, elevated, irregularly shaped area of localized skin edema. Most wheals are red, pale pink, or white
• Examples of wheals


  • Urticaria (hives)
  • Insect bites