Shank Ulcer Flashcards
What are shank ulcers?
Shank ulcers are chronic open sores.
Where do shank ulcers typically occur?
They typically affect the lower one third of the lower leg.
What are the TCM etiologies and pathogenesis related to long-period standing and being overweight?
Long-period standing and being overweight
–> damages Qi and blood
–> leading to unsmooth flow in the channels and collaterals
–> causing local Qi and Blood stagnation
–> malnourishment of the muscle and skin.
What is the effect of damp-heat in TCM?
Damp-heat flows downward –> preventing the nourishment of the muscle and skin
What is the pathogenesis in the etiology of external factors causing a shank ulcer?
External injury, insect bites, and eczema –> toxins invasion
What is the second most common venous condition according to western medicine?
Arteriosclerosis. Arteriosclerosis refers to the thickening, hardening, and loss of elasticity of the arterial walls
What is the most common venous disease in Western Med?
Shank Ulcer
What are the initial clinical manifestations of a shank ulcer?
In most instances, itching precedes pain, with some cases experiencing alternating itching and pain. This is followed by erythema (redness of skin), edema, breakage of the skin, oozing, and then ulcer formation.
What happens to the lesions in a shank ulcer after initial symptoms?
The lesions may then expand rapidly, and the tissue inside the ulcer becomes inflamed with necrotic debris.
What is a common characteristic of the odor from shank ulcer lesions?
There is often a foul odor coming from the lesions.
What variations can be observed in the edges of shank ulcers?
The edges of the ulcers may be thick or thin.
What can be observed in the tissue surrounding a shank ulcer?
The tissue surrounding the ulcer may be either red or deep purple and may have burning pain.
What happens to the opening of a shank ulcer as it progresses?
The opening sinks and the edges become slightly smooth and round.
What colors may the tissue within an advanced shank ulcer appear?
The tissue may be grayish white, yellow, or deep purple.
What types of exudate may be present in an advanced shank ulcer?
The exudate may be grayish, black, or green.
What is a notable characteristic of the smell associated with advanced shank ulcers?
There is a very foul smell.
What change occurs in the surrounding tissue of an advanced shank ulcer?
The surrounding tissue becomes hyperpigmented, causing the skin to turn reddish brown.
What happens to the area around an advanced shank ulcer as the condition advances?
The area becomes hardened with fibrosis, leading to chronic and disabling ulcers.
What may severe cases of shank ulcers reveal?
Severe cases may present with deep ulcers revealing the bone.
How does the size of lesions in advanced shank ulcers vary?
The size of the lesions may vary from small to involving large portions of the leg.
The following are patterns of _________.
Damp-Heat in LJ
SP Xu w/ Dampness
Qi Stagnation + Blood Stasis
LR + KI Yin Xu
Shank Ulcer
The following are S/sx of a Shank Ulcer due to __________.
Lesion begins with pain, redness, and swelling, followed by breakage of the skin, oozing, severe itching, pus formation
As the lesion becomes chronic, the edges of the ulcer harden and become rounded
Severe cases may present with an aversion to cold, fever, dry mouth, yellow urine
T: Red, thick-yellow-greasy coating
P: Rapid + Slippery
Damp-Heat in LJ
The following are S/sx of a Shank Ulcer due to __________.
Grayish lesion with white tissue inside the
wound and weeping of copious and clear
exudate, poor appetite, tiredness of limbs,
dizziness, dry mouth
T: Pale w/ white coating
P: Slippery + Weak
SP Xu with Dampness
The following are S/sx of a Shank Ulcer due to __________.
Progression of disease, wwelling, dark purple skin and tissue, may
have varicosities, ulcer is moist and sharp
pain, lower limb is heavy and numb, difficulty with walking
T: Purple
P: Choppy
Qi Stagnation + Blood Stasis
The following are S/sx of a Shank Ulcer due to __________.
Surrounding skin is deep red, slight pain
or no pain, low-grade fever or afternoon fever, emaciation, dream-disturbed sleep
T: Red w/ scanty coating
P: Rapid + Thready
LR + KI Yin Xu
What are the points of treating Shank Ulcers due to Damp-Heat in LJ?
Clear Heat + Resolve Dampness:
ST-44 + GB-43 + BL-66 + LI-11
SP-9 + BL-40 + KI-10
SP-10
What are the points of treating Shank Ulcers due to SP Qi w/ Dampness?
Tonify SP + Resolve dampness
SP-3 + ST-36 + SP-5 + SP-9
What are the points of treating Shank Ulcers due to Qi Stagnation + Blood Stasis?
Move Qi + Remove stasis
4 Gates
ST-36 + GB-34 + BL-40
SP-10 + BL-17
Xi-cleft of the involved channels
What are the points of treating Shank Ulcers due to LR + KI Yin Xu?
Nourish LR & KD Yin
KI-3 + KI-6 + SP-6 + KI-10
LR-8 + BL-18 + BL-23 + REN-4
