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Class 5 Flashcards

1
Q

What is skin?

A

• link to internal & external environments
• own pathologies
• judge general health

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2
Q

What art the functions of human skin?

A
  1. Protection
  2. Immunity
  3. Thermoregulation
  4. Storage/reservoir
  5. Flexible/resilient
  6. Sensation
  7. Role in vitamin D synthesis
  8. Healing/repair
  9. Excretion
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3
Q

What are the skin layers?

A
  1. Epidermis
  2. Dermis
  3. Subcutaneous
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4
Q

Melanocytes produce melanin, which has what 2 purposes?

A
  1. Giving the skin colour (pigmentation)
  2. Protecting basal cells from UV damage
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5
Q

What are some of the general guidelines for manual practitioners?

A

➤ Research
➤ Avoid treating an undiagnosed lesion
➤ Hygiene care to area of inflamed, irritated or disrupted
skin
➤ Ask about type of treatment(s)
➤ Good reason to treat vulnerable skin?
➤ Patch test
➤ Modify heat hydro

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6
Q

What are examples of contraindications when it comes to skin?

A

➤ Infection or risk of spreading
➤ Acute inflammation or flare up present
➤ Vesicles/blisters
➤ Risk of promoting bleeding
➤ Broken or eroded skin
➤ Stretching friable tissue

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7
Q

When it comes to skin what are some of the key questions you should ask yourself?

A

➤ What is it? Has it been diagnosed?
➤ Is it a solitary lesion or circumscribed tissue area or is it
widespread?
➤ Is it contagious? can it be spread by contact?
➤ Is it inflamed?
➤ Is the skin surface broken/disrupted?
➤ Is there blistering, bleeding, oozing, crust or scabbing?
➤ Is there a secondary infection risk?
➤ Are there any applicable restrictions from the doctor?
➤ Any prescribed or medically approved cream or lotion?

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8
Q

What are some common manifestations of skin disorders?

A

➤ Lesions
➤ Rashes
➤ Blisters
➤ Calluses
➤ Corns
➤ Pruritis
➤ Xerosis

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9
Q

What are examples of lesions?

A

➤ Macule
➤ Patch
➤ Papule
➤ Nodule
➤ Pustule
➤ Vesicle
➤ Plaque
➤ Crust
➤ Lichenification
➤ Keloid
➤ Fissure
➤ Ulcer
➤ Erosion

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10
Q

What is a Macule?

A

SMALL, FLAT circumscribed lesion of DIFFERENT COLOUR than normal skin

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11
Q

What is a Patch?

A

Vitiligo, port wine stain. DIFFERENCE IS >1CM

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12
Q

What is a Papule?

A

Small, firm, ELVATED lesion

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13
Q

What is a Nodule?

A

ELEVATED LESION LARGER than papule

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14
Q

What is a Pustule?

A

ELEVATED, ERYTHEMATOUS lesion, usually contains PURULENT exudate

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15
Q

What is a Vesicle?

A

Elevated, THIN WALLED lesion containing CLEAR FLUID

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16
Q

What is a Plaque?

A

Large, SLIGHTLY ELEVATED lesion with flat surface, often TOPPED by SCALE

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17
Q

What is a Crust?

A

Dry, rough surface or DRIED EXUDATES or BLOOD

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18
Q

What is a Lichenification?

A

Thick, dry, rough skin surface (LEATHER LIKE)

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19
Q

What is a Keloid?

A

Raised, irregular mass of collagen from EXCESSIVE SCAR FORMATION

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20
Q

What is a Fissure?

A

SMALL, DEEP CRACK or tear in skin

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21
Q

What is an Ulcer?

A

CAVITY with loss of tissue from EPIDERMIS & DERMIS, OFTEN WEEPING or BLEEDING

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22
Q

What is an Erosion?

A

SHALLOW, MOIST CAVITY in EPIDERMIS

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23
Q

What are rashes?

A

➤ general term meaning skin outbreak that changes it’s appearance & texture
➤ temporary eruptions of skin
➤ associated with childhood diseases, heat, irritation (ex. diaper rash), drug induced reactions

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24
Q

What are the 4 types of rashes?

A

• blanched/ white
• erythematous/ red
• hemorrhagic/ purpuric/ containing blood
• pigmented/ coloured

25
What is a blister?
➤ vesicle of fluid filled papule (aka BULLA) ➤ degeneration of epidermal cells & disruption of intercellular junctions that causes layers to separate & fluid to accumulate
26
How should you deal with blister?
• bandage or gauze • DO NOT BREAK
27
What is a callus?
➤ hyperkeratotic plaque of skin due to chronic pressure or friction ➤ increased cohesion & decreased shedding
28
How should we deal with callus?
• can be filed down
29
What are corns?
➤ small, defined perimeter, cone shaped, keratinous thickening ➤ common to toes & hands ➤ can reoccur if cause is not addressed
30
How should you deal with corns?
• paring (slicing to reduce size) • pressure or friction (MOI) removal • keratolytic agents (chemical debridement) • laser • injections • surgically removed
31
Differences between corns vs. callus?
• Calluses develop from forces distributed over broad area of skin whereas • Corns develop from more localized forces • Corns can occur within an area of callus, such as on plantar surface.
32
What is pruritis (Itch)?
➤ itch sensation originates in free nerve endings in skin (nociceptors) ➤ different ranges of severity ➤ can signal an internal disorder ➤ warmth, touch & vibration will irritate/make it worse ➤ scratching an itch is spinal reflex
33
How to deal with pruritis (Itch)?
• treatments are non specific
34
Pruritis = __________
Itch
35
Xerosis = __________
Dry Skin
36
What is Xerosis (dry skin)?
➤ dehydration of stratum corneum ➤ may be primary sign of sign disorder or systemic disease ➤ appears rough, scaly, wrinkled, lined ➤ predisposed to itching which could lead to cracking & fissuring ➤ commonly affects extremities, back, abdomen, waist
37
How to deal with Xerosis (dry skin)?
• moisturizing agents
38
What are key features of darker skin presentations and evaluation?
➤ darker skin provides better protection against skin cancer,premature wrinkling, aging of skin associated with sun exposure ➤ may be more difficult to evaluate pallor, cyanosis & erythema
39
What is Vitiligo?
➤ depigmented macule with definite, smooth border ➤ white, pale or greyish blue ➤ 3 ways this would occur: (etiology unknown) • decreased number of melanocytes • absence of melanocytes • melanocytes that don’t produce melanin ➤ affects skin, mucous membranes & retina - common to face, neck, axillae, extremities ➤ affected area can enlarge over time ➤ these areas are prone to sunburn ➤ can be asymptomatic or pruritic
40
How to deal with Vitiligo?
• no cure but range of treatments to manage
41
What is Albinism?
➤ genetic disorder ➤ complete or partial congenital absence of pigment ➤ affects skin, showing as pale to pink hues, hair as white to yellow & eyes light or pink ➤ most common type is recessively inherited oculocutaneous albinism ➤ sensitivity to light, refractive errors and nystagmus
42
What is Chloasma (Melasma)
➤ darkened macules on face ➤ brown hyperpigmentation macules or patches usually to face - cheeks, temple & forehead ➤ more common in women, especially if pregnant, anyone of Aboriginal, German, Russian and Jewish descent or dark skinned people ➤ exacerbated by sun exposure
43
How to deal with Chloasma (Melasma)?
• limit sun exposure, bleaching
44
What is Tinea/Mycosis/Ringworm?
➤ relatively common fungal infection - invades dead keratinized tissue ➤ name differs based on where on body it’s occurring ➤ fungus releases enzyme that allows it to digest keratin & results in skin scaling, nail degeneration, hair breakage or loss ➤ can become deeper in immunocompromised individuals & caused by inflammation due to toxins released by fungi ➤ Appears: itchy, scaly, red rash, sometimes bald patches
45
How to deal with Tinea/Mycosis/Ringworm?
• antifungal creams
46
What are bacterial infections?
➤ There are several types of bacteria that are present on skin as part of normal microflora. ➤ in certain environments or on certain occasions they can cause superficial or systemic reactions
47
Primary infections are _________________
usually superficial
48
Secondary infections usually _____________________________.
usually occur in preexisting lesion & may be deeper
49
Diagnosis of bacterial infection -> ____________
by culture
50
How to deal with bacterial infection?
• antibiotics
51
What are Furuncles (Boils)?
➤ infection of hair follicle which spreads to surrounding dermis ➤ face, back, neck are common sites ➤ progresses from firm, red + painful nodule to large, painful mass ➤ filled with purulent exudate ➤ spread by AUTOINNOCULATION
52
What are Carbuncles?
➤ collection of furuncles ➤ join together into bigger mass & may drain through different sinuses or develop into abscess.
53
What is Impetigo?
➤ superficial infection caused by Staph ➤ common in infants & young children ➤ easily contracted in warm + moist climates ➤ starts as small vesicle or pustule or as large bulla then ruptures & forms roughened area that discharges honey coloured liquid that crusts ➤ new vesicles appear within hours ➤ scratching can spread it
54
What is Impetigo?
➤ superficial infection caused by Staph ➤ common in infants & young children ➤ easily contracted in warm + moist climates ➤ starts as small vesicle or pustule or as large bulla then ruptures & forms roughened area that discharges honey coloured liquid that crusts ➤ new vesicles appear within hours ➤ scratching can spread it
55
How to deal with Impetigo?
• systemic antibiotics
56
What is Ecthyma?
➤ caused by Staph/Strep ➤ ulcerative form of Impetigo ➤ frequently seen in children, usually on buttocks & thighs ➤ when extensive cause present with fever, can spread to other organs
57
How to deal with Ecthyma?
• systemic antibiotics
58
What is Cellulitis?
➤ deep infection of dermis & subcutaneous tissue ➤ caused by Staph & Beta Hemolytic Strep ➤ portals of entry: pre-existing wound & tinea pedis ➤ legs, hands & ears most commonly affected ➤ presents: expanding red, tender, swollen plaque with indefinite border. frequently fever & acute inflammation s/s ➤ often involve lymph system- septicaemia, nephritis, death
59
How to deal with Cellulitis?
IV & oral antibiotics

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