The document discusses the integumentary system, which includes the skin, hair, scalp, and nails. It describes how to assess various characteristics of the skin including color, moisture, temperature, texture, turgor, vascularity, and edema. Changes in these characteristics can provide information about a patient's health status and underlying conditions, such as oxygenation, circulation, nutrition, local tissue damage, fluid balance, and hydration. A thorough skin assessment requires inspection, palpation, and adequate lighting.

2. The Integumentary system
refers to the
SKIN
HAIR
SCALP
NAILS

3. SKIN
 Use the senses of sight , smell and touch while
performing inspection and palpation of the skin.
 Assessment of the skin reveals the patient’s health
status related to Oxygenation , Circulation , Nutrition,
local tissue damage and hydration.
 Adequate lighting is needed for assessment the skin
properly.

4. COLOUR
 Bluish(Cyanosis)- Increased amount of
deoxygenated hemoglobin associated with hypoxia
e.g. Heart or Lung disease, cold environment(Nail
beds, lips ,mouth, skin)
 Pallor(decrease in color)-Reduced amount of
oxyhemoglobin e.g Anaemia(Face , conjunctiva ,
nail beds , palms)
 Loss of pigmentation-Vitiligo e.g Congenital or
autoimmune condition(Patchy areas on skin over
face, hands , arms)

5. Continued………
 Yellow orange(Jaundice)-Increased deposit of
bilirubin in tissues e.g Liver disease, Destruction
of RBC(Sclera , mucous membrane ,skin)
 Red(Erythema)-Increased visibility of
oxyhemoglobin caused by dilation or increased
blood flow(Face, pressure area)
 Tan brown-Increased amount of melanin e.g
Suntan , pregnancy(Face , arms)

6. Moisture
 The hydration of skin and mucous mambranes
help to reveal body fluid imbalances, changes in
the environment of the skin and regulation of
body temperature.
 Dry skin is caused by lack of humidity, exposure to
sun, smoking, stress, excessive perspiration and
dehydration.

7. Temperature
 Increased or decreased skin temperatrure indicates
an increase and decrease blood flow.
 An increased skin temperature often accompanies
localized erythema or redness of the skin,
inflammation , infection.
 A reduction indicates pallor and decresed blood
flow.

8. Texture
 Texture refers to the character of the surface
of the skin and how the deeper layers feel.
 By palpating it can be felt that the patient’s
skin is smooth or rough , thin or thick , tight
or supple and indurated or soft.
 Localized skin changes result from trauma,
surgical wound or lesions.

9. Turgor
 Turgor refers to the elasticity of the skin.
 Normally the skin loses its elasticity with age , but
fluid balance can also affect skin turgor.
 Edema or dehydration diminishes turgor.
 To assess the skin turgor grasp a fold of skin on the
back of the forearm with the fingertips and release.
 Normally the skin lifts easily and falls immediately
back to its resting position..
 When turgor is poor it stays pinched and shows
tenting.

10. Vascularity
 Vascularity occurs in localized area and lead
to the appearance of superficial blood
vessels.
 Petechiae are non blanching pinpoint size ,
red or purple spots on the skin caused by
small haemorrhages in the skin layer.

11. Edema
 Palpate edematous area to determine mobility ,
consistency and tenderness.
 Edematous skin appears stretched and shiny.
 Assess for pitting edema.
2 mm deep-1+
4 mm deep-2+
6mm deep-3+
8 mm deep-4+