Dermatology, blister, contusions & acute wound management Flashcards
Name the two layers of skin?
Epidermis
Dermis
(beneath the dermis is the subcutaneous layer, also known as the subdermal, hypodermal or superficial fascia layer)
What is the latin name for the Basal layer of skin?
Stratum germinativum (basale)
What is the latin name for the Prickle cell layerof skin?
Stratum spinosum
What is the latin name for the Granular layer of the skin?
Stratum granulosum*
*thick skin may have Stratum lucidum
What is the latin name for the Horny cell layer of skin?
Stratum corneum
What is an abscess?
Pus surrounded (walled-off) by damaged & inflamed tissue.
Can occur anywhere on the body.
Eg; a boil (caused by Staphylococcus aureus)
What is a cicatrix?
A scar
What is skin/ tissue atrophy?
Wasting away of normally developed tissue due to cell degeneration.
What is a crust?
An accumulation of serum, blood & exudate
What is a cyst?
Abnormal sac or closed cavity lined with epithelial tissue cells & filled with liquid or semi-solid matter.
What is an erosion of the skin/tissue?
The eating away of surface tissue
(by chemical or physical processes, such as inflammation)
Loss of the epidermis above the basal layer.
Eg; Tinea Pedis
What is excoriation of the skin/ tissue?
The destruction or removal of the surface of the skin (or tissue covering an organ).
Often caused by scratching, scraping, or chemicals.
Eg: Eczema
What is a macule?
A flat circumscribed area of skin of altered skin colour
Eg: mole/ beauty spot
What is a nodule?
A small swelling or aggregation of cells forming a palpable lesion (0.5 cm - 2 cm in diameter)
Eg: RA
What is a papule?
A raised spot on the skin, a solid palpable lesion (up to 0.5 cm diameter)
Eg: pimple?
What is plaque?
A raised lesion whose surface area is much larger than its elevation (>2 cm)
What is a pustule?
Small blister on the skin containing pus
What is scale of the skin?
Flakes of dead epidermal cells
What is purpura?
A skin rash/condition where blood enters capilliaries.
What is sclerosis?
Hardening or “induration” of skin
What is Telangiectasis?
Localized group of distended blood capillary vessels
Eg: spider veins
What is an ulcer?
Break/erosion of skin
With loss of the epidermis & part or all of the dermis
What is a vesicle?
A small blister that contains serous fluid (maximum of 0.5 cm)
What is a wheal?
Rounded or flat-topped elevated lesions Eg; “hive”
Name types of basic injuries seen in podiatry
Blisters Cuts and grazes Nail injuries Cold injuries Contusions
What is the cause of a blister/blisters?
Repetitive friction and trauma
- Will extend & worsen without management
- Vary from superficial (epidermal) to full thickness (through dermis to underlying tissue/bone) Eg: blood blister etc
How are blisters managed?
Via prevention Tapes/dressings Padding Hot spots recognition Lubricant
What is the first aid treatment for closed blisters?
If n on-symptomatic = Leave
If can rest, REST
What is the first aid training for closed blisters in need to keep working/ training?
- Aseptic technique
- Puncture (several times) at the margin
- Keep roof intact
- Create donut pad
- Cover with sterile, absorbent and non-bulky dressing
What is the first aid treatment for open blisters?
Infection management
Aseptic technique
Wound dressing
Manage for signs of infection
What is the long term management for prevention of blisters?
- Biomechanical assessment /orthoses: for areas of high pressure
- Footwear: Seams, correct fit
- Sock choice: Breathable (e.g. cotton), wicking material, washed & tested, not thinning
True or false?
- 2 pairs of socks will stop blisters= ?
- Paint feet with methylated spirits for a week before heavy activity= True
- Toughening up activities= ?
- Only use broken-in shoes or old shoes= False?
What are grazes and minor cuts?
Epidermal injuries
Treatment for grazes and minor cuts?
Clean area, ensure no foreign body left Apply antiseptic (Povidine Iodine) Appropriate cover of wound for activity Tetanus shots! Advise follow up if no or slow resolution
Name types of nail injuries?
Full avulsion
Partial or incomplete avulsion
Subungal Haematoma (blood blister under nail) DDx subungal melanoma
How are nail avulsions treated?
Acute
Manage for infection (sterile dressing etc)
Normal dressing regime (Monitor)
Remove any lifting edges
Local Anaesthetic (if not infected)
Antibiotics
Educate client on what to expect (no nail for 3-6 months) 1-2 years until full nail growth
How is a subungal haematoma treated?
- By releasing the pressure
- Using a hot, sharp object to pierce/drill through the nail (called trepanation)
(Usually results in Onycholysis) - Manage for infection
Describe management/ treatment of cold cold injuries (walkers/ ski/ snowboarders)
•Gradual re-warming •Topical antisepsis •Regular monitoring •Vascular review if necessary •Pt education (Warn of recurrent low grade symptoms/ predisposing factors) cold temp/ tingling/ numbness etc
What is a contusion?
Bruise
What structures are damaged as a reult of a bruise/ contusion?
Damage to muscle damages myofibrils, fascia & blood vessels
What is the treatment/ management for a bruise/ contusion?
Note- there are 4 stages of management
Management depends on the severity of contusion (mild, moderate, severe)
Stage 1 – Control of Hemorrhage Stage 2 – Restoration of pain-free ROM Stage 3 – Functional rehabilitation Stage 4 – Graduated return to activity
What are the 2 different types of bruises/ contusions and which is more painful?
- Intermuscular & intramuscular
- Intramuscular = more painful & more restrictive of motion
- Severity is measured by the amount of passive knee flexion after 24 hours (thigh)
(ROM)
What are basic principles of wound/ dermatological issue management?
- Identify causative factor of injury to prevent it reoccurring
- Appropriate first aid
- Follow up advice/ pt education
- Documentation of treatment/ education
