Physical Diagnosis: Skin, Hair, and Nails
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Questions and Answers

What is the primary function of eccrine glands?

  • To regulate blood pressure
  • To produce hormones in response to emotional stress
  • To aid in the production of hormones related to hair growth
  • To help control body temperature (correct)

    • Where are apocrine glands typically found?

  • In the axilla and groin regions (correct)
  • On the scalp and face
  • Behind the ears and under the breasts
  • On the palms of the hands and soles of the feet

    • What is a common symptom that may indicate a skin-related issue?

  • Rash or pruritus (correct)
  • Fatigue
  • Nausea
  • Headache

    • When conducting a skin examination, what is the recommended lighting condition?

    <p>Natural light or artificial light that resembles natural light</p> Signup and view all the answers

    What is an important consideration when examining the skin?

    <p>Inspecting and palpating the skin from head to toe</p> Signup and view all the answers

    What is a recommended technique for examining the skin?

    <p>Using a dermascope</p> Signup and view all the answers

    Why is it important to ensure the patient is comfortable during the skin examination?

    <p>To reduce anxiety and promote relaxation</p> Signup and view all the answers

    What is an important area to inspect during the skin examination?

    <p>The web spaces (interdigital areas)</p> Signup and view all the answers

    What is a characteristic of a macule?

    <p>It is a circumscribed flat area of change in color of the skin</p> Signup and view all the answers

    What is a papule?

    <p>A small, raised lesion</p> Signup and view all the answers

    Why are bedbound patients particularly susceptible to skin damage and ulceration?

    <p>Because of sustained compression on arteriolar and capillary blood flow to the skin</p> Signup and view all the answers

    What is the ideal way to inspect the skin that overlies the sacrum, buttocks, greater trochanters, knees, and heels?

    <p>By rolling the patient onto one side</p> Signup and view all the answers

    What is the purpose of recording the physical examination?

    <p>To describe the physical findings in a concise manner</p> Signup and view all the answers

    What is a characteristic of a vesicle?

    <p>It is a fluid-filled lesion with a diameter of 1 cm</p> Signup and view all the answers

    What is the primary function of the skin in terms of body fluid regulation?

    <p>Excretion of water, salts, and urea</p> Signup and view all the answers

    What percentage of body weight does the skin account for?

    <p>16% of body weight</p> Signup and view all the answers

    Which of the following is NOT a function of the skin?

    <p>Filtering blood</p> Signup and view all the answers

    What is the main difference between vellous hair and terminal hair?

    <p>Vellous hair is shorter, with less pigmentation, while terminal hair is coarser and pigmented</p> Signup and view all the answers

    What is the primary function of sebaceous glands?

    <p>Producing fatty substances onto the skin surface</p> Signup and view all the answers

    Which of the following is NOT a layer of the skin?

    <p>Muscle Layer</p> Signup and view all the answers

    What is the function of nails in the human body?

    <p>Protecting the distal ends of fingers and toes</p> Signup and view all the answers

    What is the area of the skin in square meters?

    <p>1.2 – 2.3 m2</p> Signup and view all the answers

    What is the primary reason for asking permission to expose the area to be examined?

    <p>To maintain the patient's dignity and privacy</p> Signup and view all the answers

    What is the purpose of inspecting the skin for lesions?

    <p>To diagnose underlying skin conditions</p> Signup and view all the answers

    What is the correct way to palpate for temperature?

    <p>Using the dorsal surface of the hand</p> Signup and view all the answers

    What is the significance of inspecting the hair and scalp?

    <p>To identify potential hair diseases or disorders</p> Signup and view all the answers

    Why is it essential to wash your hands during an examination?

    <p>To prevent the spread of infection</p> Signup and view all the answers

    What is the purpose of inspecting the anterior and posterior aspect of the body surface?

    <p>To identify any abnormalities or lesions</p> Signup and view all the answers

    What is the correct technique for palpating lesions?

    <p>Using the finger pads</p> Signup and view all the answers

    Why is it important to inspect the axillae and inguinal areas?

    <p>To identify any signs of rash or infection</p> Signup and view all the answers

    What is the primary purpose of assessing skin turgor?

    <p>To assess dehydration or edema</p> Signup and view all the answers

    What is the characteristic of a primary lesion?

    <p>It characterizes the disease process</p> Signup and view all the answers

    What is the best way to assess oxyhemoglobin?

    <p>By observing lip, finger, and mucous membrane color</p> Signup and view all the answers

    What is the purpose of the ABCDE rule in assessing skin lesions?

    <p>To identify characteristics of skin lesions</p> Signup and view all the answers

    What is the significance of palpating the skin of the face, neck, trunk, arms, and legs?

    <p>To detect tenderness and lesions</p> Signup and view all the answers

    What is the purpose of using the dorsum of the hands to assess skin temperature?

    <p>To assess skin warmth or coolness</p> Signup and view all the answers

    What is the significance of assessing the quantity, distribution, and texture of lesions?

    <p>To arrive at a dermatologic diagnosis</p> Signup and view all the answers

    Why is it important to consider the patient's history and physical examination when assessing skin lesions?

    <p>To arrive at a dermatologic diagnosis</p> Signup and view all the answers

    Study Notes

    Anatomy and Physiology of Skin

    • Skin functions: regulates body temperature, protects underlying tissues, aids in excretion, synthesizes vitamin D, and provides sensation
    • Skin layers: epidermis, dermis, superficial fascia, and deep fascia
    • Skin appendages: hair, nails, sebaceous glands, and sweat glands
    • Hair types: vellous (fine, unpigmented) and terminal (coarser, pigmented)
    • Nail function: protects distal ends of fingers and toes
    • Sebaceous glands: produce fatty substances, found everywhere except palms and soles
    • Sweat glands: eccrine glands (widely distributed, helps control body temperature) and apocrine glands (found in axilla and groin, stimulated by emotional stress)

    Health History

    • Common skin symptoms: hair loss, nail changes, rash, pruritus, moles, and growths
    • Questions to ask patients:
      • Have you noticed any changes in your skin, hair, or nails?
      • Have you had any rashes, sores, or lumps?
      • Have you had any new moles?

    Techniques of Examination

    • Inspect the skin in a systematic order, including:
      • Anterior and posterior surfaces of the body
      • Behind the ears, axillary, under the breasts, inguinal regions, genitalia, and intergluteal crease
      • Palms and soles, web spaces (interdigital areas)
      • Hair distribution and condition
      • Nails
    • Use a dermoscope in good light, preferably natural light
    • Palpate the skin, noting characteristics such as:
      • Color
      • Moisture
      • Temperature
      • Texture
      • Mobility and turgor
      • Lesions

    Tips for Skin Examination

    • Conduct the examination in a private space with the patient's permission
    • Ensure the patient is comfortable and ask if they would like a chaperone present
    • Inspect and palpate the skin, using the palm of the hand and fingers
    • Wash hands before and after the examination

    Inspection

    • Inspect skin for:
      • Rashes
      • Lesions
      • Bruises
      • Nevi
      • Color changes
      • Scars
    • Inspect specific areas, including:
      • Upper and lower back
      • Shoulders, arms, and hands
      • Chest and abdomen
      • Anterior and posterior thighs and legs
      • Feet and toes
      • Axillae and inguinal areas
      • Scalp, face, and neck

    Palpation

    • Palpate the skin, noting:
      • Tenderness
      • Lesions
      • Temperature
      • Texture
      • Mobility and turgor
    • Palpate the scalp, hair, and nails

    Lesions

    • Primary lesions: develop as a direct result of the disease process
    • Secondary lesions: result from changes in primary lesions
    • Characteristics of lesions: number, size, color, texture, shape, location, and configuration
    • DANGER SIGNS: ABCDE (Asymmetry, Border irregularity, Color variation, Diameter, Elevation and Enlargement)

    Evaluating the Bedbound Patient

    • Bedbound patients are susceptible to skin damage and ulceration due to pressure sores
    • Inspect the skin that overlies the sacrum, buttocks, greater trochanters, knees, and heels

    Recording the Physical Examination

    • Use sentences or phrases to describe findings, such as color, skin temperature, and nail condition

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    Description

    Learn about the anatomy and physiology of the skin, how to perform a correct skin examination, and identify normal and abnormal findings of skin, hair, and nails.

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