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Questions and Answers
What is the main purpose of inspecting skin folds during a physical assessment?
Which skin color changes could indicate abnormal conditions?
How should skin temperature be assessed during a physical examination?
What does 'tenting' refer to when assessing skin turgor?
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What does the presence of foul odors on the skin typically indicate?
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Which of the following is NOT considered a normal finding during skin assessment?
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What does ecchymosis tell a healthcare provider about the skin?
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Which assessment change is commonly expected in older adults regarding skin elasticity?
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What condition is characterized by increased growth of coarse hair on the face and trunk in women?
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What is a normal angle of the nail base indicating healthy nail structure?
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What should be assessed when inspecting the scalp and hair?
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What change in hair is typically expected in older adults?
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Which of the following could indicate a long-term lack of oxygen regarding nail health?
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What describes normal nails in terms of color for light-skinned patients?
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What should be noted when assessing the oral cavity?
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What is a common sign of aged nails related to health?
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Which skin alteration is characterized by small hemorrhages resulting from fragile capillaries?
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What type of fluid-filled lesion contains pus and can vary in size?
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Which of the following describes changes in skin associated with aging, particularly on sun-exposed areas?
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How do the eccrine and sebaceous glands change with age?
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What type of skin lesion is characterized by being fluid-filled with serous fluid and commonly includes conditions like herpes simplex or chickenpox?
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Which term describes superficial abrasions often resulting from scratching itchy areas?
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What age-related skin change might lead to increased risk for skin tears and slow wound healing?
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Which skin lesion is categorized as an encapsulated semi-solid material found in or under the skin?
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Study Notes
Integumentary System Assessment
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Health History:
- Previous skin conditions
- Sun exposure history
- Tattoos, piercings, or brands
- Environmental exposures
- Family history of skin conditions
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Hair Assessment:
- Changes in hair growth or loss
- Hair product use and coloring
- Scalp lesions or flaking
- History of systemic illnesses
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Nail Assessment:
- Changes in nail shape, color, and texture
- Nail care practices
- Risk of nail or feet problems
Skin Physical Assessment
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General Guidelines:
- Inspect and palpate the skin
- Examine skin folds
- Assess the front, back, and under the clothing for thoroughness
- Adequate lighting is crucial
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Skin Color:
- Normal: Brown, black, pink, ivory.
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Abnormal:
- Pallor: Paleness
- Cyanosis: Bluish discoloration
- Jaundice: Yellow discoloration
- Erythema: Redness
- Assess darker skin tones by inspecting areas of lighter pigmentation like lips, nail beds, and palms for discoloration.
- Hypo/hyperpigmentation: Areas of lighter or darker pigmentation than surrounding skin.
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Palpation:
- Temperature: Use the back of your hand to palpate. Skin should be warm, not hot. Look for symmetry.
- Moisture: Note if the skin is moist or excessively dry. Normal skin is generally dry.
- Texture: Smooth or rough, soft, or thickened.
- Odor: Normal skin has no foul odor. Foul odors may indicate poor hygiene or infection.
Skin Turgor
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Assessment:
- Gently lift and release a fold of skin on an extremity.
- The skin should return to its flat position quickly.
- Tenting: A delay in skin returning to its flat position indicates poor skin turgor.
Skin Alterations and Lesions
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Bleeding or Trauma:
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Ecchymosis: Purplish discoloration due to bleeding under the skin (bruise).
- Color: Bluish or purplish discoloration fades to green or yellow over time. Ecchymosis does not blanch.
- Note: Size, location, and shape of the bruise.
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Ecchymosis: Purplish discoloration due to bleeding under the skin (bruise).
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Erythema: Redness
- Generalized: Redness over a large area.
- Localized: Redness in a specific area.
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Flat Skin Alterations:
- Freckles: Small spots of pigmentation.
- Petechiae: Small hemorrhages from fragile capillaries. Can be seen as small red or purple dots.
- Wheal: Palpable, irregular-bordered, edematous raised lesions like hives or insect bites.
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Fluid-Filled Lesions:
- Vesicle: Filled with serous fluid (e.g., herpes simplex, chickenpox).
- Pustule: Contains pus, varies in size (e.g., acne, skin infections).
- Cyst: Semi-solid material contained within or under the skin.
- Excoriation: Superficial abrasions commonly due to friction or scratching itchy areas.
- Scars: Flat, irregular area of connective tissue after healing.
- Keloids: Abnormally enlarged scars.
- Tattoos and piercings.
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Rash: Eruption of multiple lesions or bumps on skin.
- Note: Color, location, size, distribution or shape (discrete, linear, grouped, generalized).
Oral Cavity Assessment
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Health History:
- Natural teeth or prosthetics
- Dry mouth
- Lesions of lips or mucous membranes
- Difficulty chewing or swallowing
- Use of tobacco products or alcohol
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Lips:
- Outline and Movement: Symmetrical and able to move freely.
- Color: Uniform pink to brown depending on ethnicity.
- Note: Any color alterations, lesions, or drooling.
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Tongue, Mucosa, and Back of Throat:
- Patient should be able to extend the tongue and move it side to side.
- Mucous membranes should be pink, glistening, smooth, and moist.
- Use a tongue blade and penlight for inspection.
Expected Age-Related Changes in the Older Adult
Skin
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Color:
- Paleness in white skin: Due to decreased vascularity of the dermis and decline in melanocytes.
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Uneven Pigmentation:
- Brown spots (age spots): Clusters of melanocytes, more apparent on sun-exposed skin.
- Senile Purpura: Red, purple, or brown areas on the legs and arms due to fragile capillaries.
- Decrease in Sweat and Oil Gland Function: Decreased perspiration and sebum production result in dry and rough skin.
- Elasticity and Turgor: Decreased elasticity and turgor lead to loose folds, wrinkles, and tenting.
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Texture: Thinner, more transparent skin due to slowed cell proliferation and decreased subcutaneous tissue.
- Increased risk for skin tears, pressure ulcers, injury, and infection.
- Slower wound healing.
Hair
- Decreased density and rate of hair growth.
- Thinning on the head and body.
- Hair loss on the head and body.
- Decreased number of melanocytes in hair resulting in graying.
Nails
- Slowed nail growth.
- Decreased peripheral circulation.
- Brittle nails.
- Longitudinal ridges.
- Thickening.
- Yellowing.
Nail Assessment
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Color:
- Normal: Pink in light-skinned individuals.
- Dark-skinned individuals: Brown or black pigmentation is normal.
- Note: Paleness, duskiness, cyanosis, or yellowing.
- Shape: Normal is convex.
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Texture: Normal nails are smooth.
- Note excessive thickness or thinness, discoloration, or detachment of the nail.
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Nail Angle: Less than 180°.
- An angle of 180° or greater can indicate long-term lack of oxygen.
- Clubbing: Change in nail shape that may be associated with heart or pulmonary conditions.
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Description
Test your knowledge on the integumentary system through this comprehensive quiz. It covers health history, hair and nail assessments, and guidelines for physical skin examination. Perfect for students and professionals in health and medical fields.
