Assessment of Skin, Head & Neck

(Assessment Part 1)

Presented by
Chris Hicks
Preparation

 Equipment
 Well-lit Room
 Comfortable Environment
 Handwashing
 Appropriate use of Gloves
 Privacy/Draping
 Organized Assessment
 Explanations
Skin

 Inspection
– Color
– Bleeding
– Ecchymosis
– Vascularity
– Lesions
 Palpation
– Moisture
– Temperature
– Texture
– Turgor
– Edema
 Color
– Normal=Uniformed whitish pink or brown
– Abnormal
 Cyanosis
 Jaundice
 Carotemia
 Albinism
 Vitiligo
 Bleeding, Ecchymosis, Vascularity
– Normal=No areas
– Abnormal
 Spontaneous Bleeding
 Petechiae
 Purpura
 Eccymosis
 Venous Star
 Necrosis
 Lesions
– Normal=No lesions except freckles, birthmarks,
nevi (flat moles)
– Abnormal
 Rashes
 Pressure Ulcers
 Burns
 Moisture
– Normal=Dry with minimum of Perspiration
– Abnormal
 Exerosis
 Diaphoresis
 Temperature
– Normal= warm; hands & feet slightly cooler
– Abnormal
 Hypothermia
 Hyperthermia
 Texture
– Normal=smooth, even, firm
– Abnormal
 Roughness
 Soft
 Turgor
– Normal=when skin is released, it should return to
original contour rapidly
– Abnormal
 Dehydration
 Edema
– Normal=No edema present
– Abnormal
 Pitting edema is rated on 4 point scale
Assessment of Hair

 Color
 Distribution
 Lesions
Assessment of Nails

 Color - Inspection
– Normal=Pink; Brown
– Abnormal
 Cyanosis
 Leukonychia
 Melanochyia
 Shape & Configuration
– Normal=Smooth, slightly rounded
– Abnormal
 Koilonychia
 Clubbing
 Texture - Palpation
– Normal=firm
– Abnormal
 Spongy
Gerontological Changes

 Wrinkles
 Lentigo
 Pruritus
 Keratosis
 Cancer of the skin
 Graying Hair, Hair Loss
 Nails-thick, yellow
Assessment of the Head

 Shape - Inspection
– Normal=Normocephalic & Symetrical
– Abnormal
 Hydrocephalus
 Acromegaly
 Craniosynostosis
 Palpation
– Normal=Smooth, nontender, without masses or
depressions
– Abnormal
 Masses
 Edema
 Softening
 Scalp
– Normal=Shiny, intact, without lesions or masses
– Abnormal
 Lacerations
 Hematomas
 Lipomas
 Symmetry of Face - Inspection
– Normal=Symmetrical features bilaterally
– Abnormal
 Asymmetry
 Shape of Face - Inspection
– Normal=Oval, round, slightly square
– Abnormal
 Down’s Syndrome
 Hypertelorism
 Graves’ Disease
 Moon-faced
 Parkinson’s Disease
 Mandible - Palpation & Auscultation
– Normal=No discomfort, without clicking
– Abnormal
 Discomfort
 Clicking; snapping
Assessment of the Neck

 Inspection of the Neck

– Normal=Neck muscles symmetrical; head in
central position
– Abnormal
 Torticollis
 Palpation of the Neck
– Normal=Muscles symmetrical; without masses
– Abnormal
 Tumor
 Inspection of the Thyroid
– Normal=Tissue moves up & down while
swallowing
– Abnormal
 Enlargement
 Palpation of Thyroid Gland
– Normal=No enlargement, masses, or tenderness
– Abnormal
 Enlargement
 Tenderness
 Inspection of the Lymph Nodes
– Normal=Should not be visible
– Abnormal
 Enlargement
 Palpation of the Lymph Nodes
– Normal=Unable to palpate
– Abnormal
 Enlargement
Assessment of the Nose

 External - Inspection
– Normal=Symmetrical shape
– Abnormal
 Asymmetrical
 Swelling
 Internal - Inspection
– Normal=Each nostril is patent; Pink mucosa
– Abnormal
 Occlusion
 Discharge
Assessment of Sinuses

 Inspection
– Normal=No swelling
– Abnormal
 Swelling
 Palpation
– Normal=No discomfort
– Abnormal
 Temderness
Assessment of Mouth & Throat

 Inspection
– Lips
– Tongue
– Buccal Mucosa
– Gums
– Teeth
– Palate
 Abnormal
– Lesions
– Discoloration
– Bleeding
– Absent Teeth
 Inspection of Throat
– Normal=Rise symmetrically of palate & uvula;
pink mucosa; presence of tonsils
– Abnormal
 Red
 Swelling
 Patches of white
 Soreness with swallowing