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Lymph nodes are usually assessed when the part of the body in which they are located is examined. And the body's lymphatic drainage system is extensive. Since the major function of lymph nodes is to collect and filter the lymph of bacteria, and other foreign matter as it returns to the circulatory system, the doctor must have knowledge of the lymph's directional flow. Tender, enlarged warm lymph nodes are generally indicative of infection or inflammation proximal to their location. For example, occipital or post-auricular adenopathy is often seen in local scalp infection. Such as pediculosis, tick bite, or external otits. Cervical adenopathy usually accompanies acute infections in or around the mouth or throat. In children, however, small, nontender, movable nodes are frequently normal. Nodes are palpated with the distal portion of the fingers, by gently but firmly pressing in a circular motion along the regions where nodes are normally present. When assessing the nodes in the head and neck, the child's head is tilted upward slightly but without tensing the sternocleidomastoid or trapezius muscle. This position facilitates palpation of the submental, submaxillary, tonsilar, and cervical nodes. The axillary nodes are palpated with the arms relaxed at the side but slightly abducted. The inguinal nodes are best assessed with the child in the supine position. Localization, quantity, size, shape, mobility, consistency (elastic or dense), temperature, and tenderness are noted, as well as reports by the parents regarding any visible change of enlarged nodes. Skin disorder syndromes • Syndrome of changing the color of the skin and the mucous membrane (symptom of cyanosis, jaundice, paleness and hyperemia). • Syndrome of exudative diathesis (maceration, weeping, erosion, scaling, hyperemia, cradle cap). • Hemorrhagic skin syndrome (petechiae, hematoma, ecchymosis). • Dystrophy syndrome (thin skin, trophic rash, scaling, fissure).syndrome of injuring the skin (scratches, intertrigo, ulcer, excoriation or erosion, wound). • Pigmentation changes syndrome (local or total hyperpigmentation or depigmentation). • Moisture changes syndrome (dry skin, wet or moist skin). • Sensation changing the skin syndrome. • Elasticity changing the skin syndrome. • Itching syndrome (total or local). • Syndrome of general skin lesions. • Syndrome of local skin lesions.

Mucous membranes disorder syndromes • Fungous damage of the mucous membranes (candidosis, oral moniliasis). • Syndrome of inflammation of the mucous membranes (Ulcer, erosion, hyperemia, aphtae). The lymph nodes disorder syndromes • Hyperplastic syndrome of lymph nodes (local, general). • Lymphadenitis (local, general). The subcutaneous fat disorder syndromes • Syndrome of sclerema. • Syndrome of sclerederma. • Syndrome of decreased turgor • Syndrome of decrease trophy (local, general (anasarca)). • Syndrome of excessively developed fat (paratrophy, obesity). • Syndrome of edema (total, local). • Syndrome of thickening (infiltration) of subcutaneous fat. • Syndrome of myxedema. Appendages of the skin disorder syndromes Hair disorders syndromes • Alopecia syndrome (universal, circumscribed). • Hypertrichosis or hyrsutism excessive pilosis). • Hypotrichosis. • Dystrophic disorders of hair (thin hair, tailing of hair, fragility of hair, lusterless of hair). • Syndrome of untypical growth of hair. Nails disorders syndromes • Dystrophic disorders of nails • Micotic lesion • Trauma • Congenital disease • Syndrome of inflammation of nail • Nail dysplasia • Deformation of nails syndrome (congenital, acquired). These are possible syndromes you will diagnose when objectively examining the patient's skin. Complicated huh?

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