Exam 2 Flashcards
Bacterial Infections
Staphylococcus
-Bacteria that appearsin clumps on skin and/or the upper respiratory tract.
Streptococcus
-Chain bacteria often associated with systemic disease and skin infections
Bacillus
-Spore forming, aerobic and occasionally mobile, and can cause systemic damage.
Methicillin-Resistant Staphylococcus Aureus (MRSA)
Strains of staphylococcus that are resistant to some antibiotics.
Often occurs in individuals that are already sick, hospitalized or have open wounds.
Easily contagious and transmitted via superficial abrasions and minor skin trauma.
Sx. Redness, swelling, tenderness. White fucking gross bubbles.
Management
Antibiotics provided intravenously
Treatment last several weeks
Always refer
BACTERIA
Impetigo Contagiosa
Caused by streptococci, S aureus or a combination of these bacteria.
Its is spread through close contact.
Sx. Mild itching and soreness followed by eruption of small vesicles and pustules that rupture and crust.
Generally develops in body folds that are subject to friction.
BACTERIA
Furuncles
Infection of a hair follicle that results in pustule formation.
Generally the result of a staph infection.
Pain and tenderness increase with pressure.
Most will mature and rupture.
Management
Care involves protection from additional irritation.
Refer
Keep them away from contact while boil is draining
BACTERIA
Carbuncles
Sx. Larger and deeper than furuncles and has several opening in the skin.
May produce a fever and elevation of WBC count.
Starts hard and red and over a few days emerges into a lesion that discharges yellowish pus.
Management
Surgical drainage combined with the administration of antibiotics.
Warm compress is applied to promote circulation.
Folliculitis
inflammation of a hair follicle
Caused by infectious or non-infectious agents
Management
Management is much like impetigo.
Moist heat is used to increase circulation
Antibiotics can also be used depending on the condition.
Hidradentis Suppurativa
Inflammation of the hair follicle resulting in secondary blockage of the apocrine gland.
Chronic inflammatory condition of sweat glands.
Cause is unknown.
Acne Vulgaris
Inflammatory disease of the hair follicle and the sebaceous glands.
Hormones can affect
Paronychia and Onychia
Caused by staph, strep and/or fungal organisms.
Sx. Rapid onset; painful with bright red swelling of proximal and lateral fold of the nail.
Accumulation of purulent material within the nail fold.
Management Soak in Epsom salts, warm water solution up to 3 times a day. Topical antibiotic Systemic Antibiotic Drainage, incision.
Paronychia
infection involving the lateral nail fold.
Onychia
Infection involving the nail bed,
Tetanus Bacillus Infection
BACTERIA
Acute infection of the CNS and muscles.
Caused by tetanus Bacillus
Sx. Stiffness of the jaw and muscles of the neck. Muscles of facial expression become contorted and painful.
Fever
Management
Hospitalization/ICU
Immunization
Fungal Infections
Group of organisms that include yeast and mold.
grows best in unsanitary conditions with warmth, moisture and stratum corneum.
Ringworm
FUNGAL
Raised border.
Tinea Capitis
Tinea of the scalp.
Sx. begins as a small papule that spreads peripherally.
Appears as small grayish scales resulting in scattered balding.
Easily spread through close physical contact.
Management
Topical creams and shampoos are ineffective in treating fungus in hair shaft.
Systemic antifungal agents are replacing older agents due to increased resistance
Some topical agents are used in conjunction
FUNGUS
Tinea Corporis
FUNGAL
Sx. extremities and trunk.
Itchy red-brown scaling plaque that expands peripherally.
Management
Topical antifungal cream
FUNGUS
Lamisil and Tinactin
Topical anti-fungal creams.
The athlete must finish the whole course of treatment.
Cover and protect
Refer if not resolving.
Tinea Unguium/Onychomycosis
FUNGAL
Fungal infection of the nail. The nail becomes thick, brittle and separated from its bed.
Management
Some topical anti-fungal agents have prove to be useful.
Systemic meds are the most effective.
Surgical removal of the nail may be necessary.
Tinea Cruris
FUNGAL
Tinea of the Groin
Symmetric re-brown scaling plaque with snake like border.
Sx. Mild to moderate itching
May progress to secondary bacterial infection
Management
Responds to non-percription medications
Tinea Pedis
FUNGAL
Sx. Extreme itching on soles of feet, between and on top of the toes.
Appears as dry, scaling patch of inflammatory, scaling red palpules forming larger plaques.
May develop secondary infection from itching and bacteria.
Management
Topical anti-fungal agents and good foot hygiene.
Candidiasis
FUNGAL
Infections within body folds
Beefy red patches with possible satellite pustules.
White macerated border may surround the red area, deep fissures may develop at skin creases.
Tinea Versicolor
FUNGAL
Caused by yeast
Appears commonly in area in which sebaceous glands actively secrete body oils.
Usually asymptomatic
Managements
Topical creams and Shampoos
Viral Infections
Ultamicroscopic organisms that require host cells to compete their life cycle.
Herpes Simplex Labialis, Gladiatorum and Zoster
VIRUS
Type 1 can be anywhere
Type 2 are only on the gentials
Highly Contagious and usually transmitted directly through a lesion in the skin or mucous membrane.
Resides in sensory nerve neurilemmal sheath following initial outbreak.
Recurrent attacks stimulated by sunlight, emotional disturbances, illness, fatigue or infection.
Sx. Early indication = tingling or hypersensitivity in an infected area 24 hours prior to appearance of lesions.
local swelling followed by outbreak of vesicles.
Patients may feel ill w/ headache, sore-throat, swollen lymph glands and pain in area of lesions.
Vescilces generally rupture 1-3 days spilling serious material
Heal in generally 10-14 days
The athlete should be disqualified from contact during an outbreak.
Management
Can only reduce recurrance of outbreaks
Verruca Virus and Warts
Verruca plana (flat wart), verruca plantaris (plantar wart) and condyloma accuminatum (venereal wart)
Wart enters through lesion in skin.
Verruca Plana (Common Wart)
Sx. Small, round, elevated lesion with rough dry surfaces.
Painful if pressure is applied.
May be subject to secondary infection.
Management
Electrocautery, topical salicylic acid or liquid nitrogen.
Verruca Plantaris (Plantar Warts)
Spread through papilloma Virus
Sx. Sole of foot, or adjacent to areas o abnormal weight bearing
Areas of excessive epidermal thickening
discomfort, point tenderness
Hemorrhagic puncta
Management
In general, protect and prevent spreading
Shave callus and apply keratolytic agent
Can be removed by freezing or electrodessication.
Molluscum Contagiosum
Poxvirus infection
Contagious with direct body contact
Sx. small, flesh or red colored, smooth-domed papules
Management
Physican reffereal
Removed with a counterirritant, surgically or cryosurgery.
Allergic, Thermal and Chemical Skin Reactions
Allergens may be food, drugs, clothing, dust, pollens, plants, animals, heat, cold, dyes, or light.
Reddening and swelling of tissue, hives, burning, and/or itching.
ATC must:
Recognize gross signs of allergic responses.
be prepared to remove allergens
Treat topically or systemically
Contact Dermatitis
Plants, poison ivy, poison oak, sumac, ragweed, primrose
Topical medications
Chemical found in fragrences, soaps and detergents
Pre-wrap, tuf skin, tape or ice and heat.
Sx. Redness, swelling, formation of vesticles that ooze fluid and form crust, constant itching.
Can change to lichenified papules and plaques
Management
Avoid Allergen
Compresses or soaks, topical corticosteroids.
Miliaria (Prickly Heat)
Continued exposure to heat and moisture causing retention of perspiration.
Sx. Itching and bruning vesciles and pustules.
Occurs most often on arms, trunks, and bending areas of the body.
Management
Avoidance of overheating, frequent bathing with non-irritating soap, wearing loos fitting clothing and use of antipruritic lotions
Scabies
Caused by mites that tunnel and lay eggs which causes extreme nocturnal itching.
Sx. Dark lines between fingers and toes, body flexures, nipples and genitalia.
Lyme Disease
From Ticks
Headaches, fever, maliase, myalgia and rash
Pityriasis Rosea
Acute inflammatory skin rash of unknown origin
Occurs between the ages of 10-35
May be the result of a virus
Can be spread to others.
Sx. Single pinkish -red patch on the chest of back.
Red and scaley with a clearing in the center.
Within 2 days - weeks a sceondary eruption occurs on chest or upper extremities.
Management
Typically does not require treatment
Psoriasis
Exact cause is unknown –genetic factors may play a role in condition.
Infection, smoking, some drugs and hormonal factors may cause an outbreak.
Sx. Lesion begins as reddish papules that progress to plaques.
Lesions progress to yellowish, white scaly condition that tends to be located on the elbows, knees, trunk, genitalia, and umbillicus.
Management
Glucocorticoids and kerolytic agents can be used in conjuction with each other.
Long term oral medications may be necessary.
Counseling may e necessary for psychological aspects of the condition
Skin Cancer
Exposure to Sun
Malignant tumore thata rows in the skin, that accounts for 50% of all cancers.
Basal cell and squamous cell carcinoma.
Malignant melanoma - high mortality rate as it often spreads to other parts of the body.
Malignant Mole
Begins as a mole May show: Asymmetry Border (irregular or jagged) Color (variations throughout the mole) Diameter (larger than a pencil eraser)
Metabolic Heat Production
Normal metabolic function results in production of heat.
Conductive Heat Exchange
Physical contact with objects resulting in heat loss of gain.
Convective Heat Exchange
Body heat can be lost of gained depending on circulation of medium.
Radiant Heat Exchange
Sunshine will cause an increase in temperature.
Dehydration
Mild Dehydration occurs when 2% of the body weight is lost in fluid.
Sx. Thirst Dizziness Dry mouth Irritability Excessive fatigue Possible cramps
Move athlete to a cool environment and begin re-hydration.
Return to activity only after fluid weight loss has been regained and the absence of any heat illness symptoms
Fluid and Electrolyte Replacement
Body requires 2.5L of water daily when engaged in minimal activity.
If thirst is ignored, dehydration results in:
nausea
vomiting
fainting and increased risk for heat illness
Heat Illness
More likely to occur when exercising outdoors, sweating heavily and engaging in strenuous exercise.
Prevent through hydration
Don’t ignore thirst
Fluids should be replaced before, during and after exercise.
Gradual Acclimation
Progressive exposure to heat and exercise over a 7-10 day period is reccommended.
greatly reduces risk of heat illnesses.
NCAA Mandated Guidelines/FB
Day 1: Only one practice a day. Equipment restrictions
Day 1 and 2: Helmets only
Days 3 and 4: Helmets and shoulder pads only.
Day 5: full pads
After day 5: Twice a day practices every other day.
Identifying Susceptible Individuals
Athletes with large muscle mass
Overweight athletes
Death from heat stroke increases 4:1 as body weight increases
Women re more physiologically more effecient at temperature regulation
Susceptible individuals include those with poor fitness, a history of heat illness of febrile condition, the young and elderly.
Heat Rash
Prickly heat
Benign condition associated with red raised rash.
Result of the skin being continuously wet from in-evaporated sweat.
Keep skin dry. towels, powder.
Generally localized to areas covered with clothing.
Heat Syncope
Standing in heat for long periods of time.
Fatigue
Overexposure to sun. Dizzy, Fainting
Caused by peripheral vasodilation or pooling of blood in extremities.
Treat by placing athlete in cool environment, consuming fluids, laying down, elevating legs.
Heat Cramps
Painful muscle spasms due to excessive water loss and electrolyte imbalance.
Lose sodium, calcium, potassium, magnesium through sweating.
A result of overexertion in a hot environment
Occurs primarily in calf and abdomen
Treat with light stretching, ice massage and hydration plus electrolyte consumption.
Exertional Heat Exhaustion
A result of inadequate fluid replacement. Unable to sustain adequate cardiac output Signs: Profuse sweating Pale skin Mildly elevated temperature Dizziness Nausea, vomiting or diarrhea Hyperventilation Muscle Cramping Loss of coordination
Heat Exhaustion
May develop heat cramps May become faint and/or dizzy Core temperature will be less than 104 Will affect athlete performance It affects people for a couple of days, they're outa it!
Treatment
Fluid ingestion (intavenous replacement)
Place in a cool environment
Remove excess clothing
Return to play must be fully hydrated and be cleared by a physician.
If not appropriately treated heat exhaustion could progress to heat stroke.
Exertional Heat Stroke
A serious life threatening condition. Specific cause is unknown.
breakdown of thermoregulatory system
Sudden collapse
LOC,CNS Dysfunction
Flushed hot skin, minimal sweating, shallow breathing, strong rapid pulse, core temperature is Greater than or equal to 104 F
Drastic measures must be taken to cool the athlete: Strip clothing Sponge with cool water Use of ice packs Transport to the hospital immediatly Cool first, transport second.
Malignant Hyperthermia
A rare genetic muscle disorder causing hypersensitivity to anesthesia and extreme exercise in hot environments.
They experience similar signs to heatstroke
Acute Extertional Rhabdomyolysis
Sudden catabolic destruction and degeneration of skeletal muscle.
Occurs during intense exercise in heat and humidity
Signs:
Gradual muscle weakness, swelling, pain, dark urine, renal dysfunction.
Can lead to sudden collapse, renal failure and death.
Associated with sickle cell trait
Refer to a physician immediatly
Extertional Hyponatremia
Fluid/electrolyte disorder resulting in abnormally low concentration of sodium in blood.
Caused by ingesting too much fluid before, during or after exercise.
Sx.
Progressively worsening headache, nausea and vomiting.
Swelling of hands and feet, lethargy, apathy or agitation
Low blood sodium
Could compromise CNS and create a life-threatening situation
Frostbite (Chillblains)
Results from prolonged exposure to cold causing redness swelling, tingling pain in toes and fingers as a result from poor circulation.
Superficial and Deep
Superficial Frostbite
Involves only skin and subcutaneous tissue.
Appears pale, hard, cold and waxy.
The area will feel numb, then sting and burn as it rewarms
May blister and be painful for several weeks.
Deep Frostbite
Indicates frozen skin requiring hospitalization.
Gradual re-warming is necessary
Tissue will become blotchy red,swollen, painful and may become gangrenous.
Frost Nip
Affects the ears, nose, cheeks, chin, fingers, and toes.
It commonly occurs when there is high wind, svere cold, or both.
The skin initially appears very firm, with col, painless areas that may peel or blister in 24 to 72 hours.
Can be treated by pressure. Do Not RUB!
Skin Cancer Types
Basal Cell Carcinoma
Squamous Cell Carcinoma
Malignant Melanoma
Taping and Wrapping Purpose
Minimize swelling, provide support to injured areas and prevent injury.
Correct application requires a solid background in anatomy.
Tape limits abnormal or excessive motion.
Supports muscles and tendons.
Provide proprioceptive feedback.
Secures pads, dressings and splints.
Countless variations by athletic trainers
Common Viruses that attack the Skin
Herpes Simplex
Herpes Zoster
Verruca
Molluscum Contagiosum
