Podiatry Theory

Flashcards by JamesR, updated more than 1 year ago
Created by JamesR over 6 years ago


Flashcards on Podiatry Theory, created by JamesR on 03/14/2014.

Resource summary

Question Answer
Definition of hyperkeratosis a natural response when the physiological tolerance of the skin has been exceeded
Name the callus cycle? Intermittent compression triggers inflammatory response which increases keratinocyte production Quick turnaround so cells immature Diminshed desquamation so build up of skin cells on stratum corneum
Summarise hyperkeratosis Normal protective response of the skin Thickening of the stratum corneum Increase in cell proliferation, decrease in shedding
What stress causes callus? Intermittent compression
Causes of pathological callus? Abnormal foot mechanism Joint malalignment Foot deformity Dermatological conditions
Define keratinisation Process by which layers of the epidermis are formed
When should you consider not to debride callus? Atrophic skin Systemic disease Poor circulation Anatomical location
Name aetiologies for callus formation? Age Psoriarsis Intermittent compression High heels Narrow toe box
Name 5 layers of skin in the epidermis on the foot? Stratum corneum stratum lucidum Stratum granulosum Stratum Spinosum Stratum basale
What are the main cells of the epidermis? Keratinocytes Langerhans Merkel cells
Which layer of epidermis is only present on plantar aspect of the foot Stratum lucidum
Which layer of the epidemis produces the lipid layer which acts as a protective layer Stratum granulosum
What are the functions of the skin? Protection Sensation Thermoregulation Hydroregulation Storage and synthesis Absorption Interacts with external environment Communication
What is the role of merkel cells Sensitive to fine touch and pressure
Where are Langerhans situated and what do they do? Situated in spinosum Destroy FB and send message to immune system re harmful substances
What do melanocytes do and where are they located? Protect from UV radiation. Located in stratum basale
What happens in stratum basale? Keratinocyte production
What does the granulosum do? Acts as a protective barrier expels lipid components
What are two layers of dermis called? Papillary Reticular
Name main cells of dermis? Fibroblasts Macrophages Lymphocytes Mast cells Langerhan cells
Which part of the dermis do the appendages lie? Reticular
Name 3 appendages Sweat glands Sebaceous glands hair
Define eccrine gland All over the body Produce odourless watery fluid, secrete onto skin surfaces Secrete in response to stress
Define apocrine Located in armpit and groin, function at puberty
Define hypodermis? Subcutaneous tissue ie acts as a shock absorber fatty padding
Where are pacinian corpuscles located and what do they do? Mechanoreceptor In deep layer of dermis
Where are meissner cells located and what do they do? Situated in papillary layer of dermis Sensitive to touch/pressure
What are ruffini corpuscles and where are they located? Located in dermis Sensitive to touch and pressure
What is a noireceptor sensitive to? Pain
Name 9 effects of aging on the skin? Moisture content less Skin drier Skin less flexible/elastic Shock absorption less Atrophy of fatty pad Prone to fissures Increase in weigh bearing forces Higher chance of hyperkeratosis Increase in extravasated callus
Name 4 mechanoreceptor cells Meissner Merkel Ruffini Panicinian
where are ruffini cells more abundant and what do they do? Soles Stretching/grip
Name physiological stresses of skin Burn Cold Bacterial infection Fungal infection Viral infection Systemic disorder Aging?
Name mechanical stresses on the skin compression torsional tensile shearing
Define tensile stress and what does it cause? same plane but in opposite directions fissures
Define shearing Tissues stretched in opposite directions in different planes and one part slides across another
What is a cause of superficial shear Blister
Name 2 causes of deep shear? Bursae Glassy callus
Define torsional? Amalgamation of all stress (twisting)
What can intermittent compression result in? Callus
What can constant compression result in? Necrosis
What is the cause of corns? Intermittent compression
Define corn? Deep concentrated mass of immature cornified cells
The nucleus of a hard corn is termed? Parakeratotic
Heloma durum normally occur where? Apices of the toes Plantar metatarsal heads
Definition of heloma millaire Millions of stone wedges
Where do heloma millaire commonly occur? calcaneal Margins of weight bearing areas
Define Heloma Molle and where they commonly occur? Soft corn Interdigitally
Define Heloma Vasculare and where they commonly occur? Corn with a vascular element Digital apices dorsal ipj plantar 1st mpj
What is a Durlacher corn? HD lateral to 5th nail due to rotation of 5th toe
Name examples of preventative advice for H Molle? Astringents Change hosiery regularly Footwear advice
Name some treatment options for treating corns? enucleation footwear appraisal silicones padding and strapping redistributing insoles caustics biomechanic referral
Name 3 aetiologies for heloma durum? Narrow toe box High heels intermittent compressive stress
What is a vesicle? Less than 5 mm contains fluid
What is a bullae? More than 5 mm fluid fluid
What can cause blisters/bullae? Trauma Infection Idiopathic Genetic Immunological factors
Name 3 causes of trauma? Mechanical - shear thermal - hot/burn cold/cryotherapy Chemical burn
Superficial raised blister occurs in which section of the skin? Stratum corneum
If a bullae occurs in the spinosum, is visible raised and painful, what layer of skin is this known as? Intra-epidermal layer.
What happens if a bulla is classed as being in the dermo-epidermal junction. It is in the basale and dermis Its a firm blister. Can be blood fluid
Do we treat a blister if it is not painful, epidermis is intact and there is no inflammation? No
What do we do if a blister is painful? Need to dress and re-distribute pressure.
Name ways of recording blisters? VAS scale Photographs Lesion charts Good written notes
What do you do if you suspect a blister is infected? Need to treat as open lesion. establish drainage using the ANTT technique. Need 2 drain points in lesion (proximal and distal) Dress with appropriate dressing, redistributing pressure.
What is an adventitious bursae? Arise as result of excessive shear in superficial fibrous tissue, in surfaces where the skin moves freely over bony surfaces.
What is a deep shear? Tissues are stretched in opposite directions in different planes. One side slides across another causing trauma.
Define bursitis. Increased shear at site of bursae causing inflammation, swelling, heat and redness.
Name 4 common bursitis foot locations Posterior aspect of heel Plantar aspect of calcaneus Under HD on dorsum of Ipj Medial aspect of 1st metatarsal in HAV
How would you reduce shear? Footwear advice. Pressure redistribution. Orthotic assessment.
How would you treat acute bursitis? Reduce inflammation - cold compress. RICE
How would you treat chronic bursitis? Apply heat (Rubefacient) to reduce blood flow to area in order to reduce fluid.
How would you treat infective bursitis? Establish drainage. ? antibiotics/swab to be sent for culture. Wound care.
What is tenosynovitis? Inflammation of a tendon sheath.
List as many types of dressings as you can and give an example Low/non adherent - Melolin Tulle Foam Hydrocolloid Hydrofibre Alignate Antimicrobial Hydrogel
Name what wounds low adherent dressings are used for and what they do Used on low exuding wounds Prevent damage to granulating/epithelialisation wound bed.
Name what wounds foams are used for and what they do Mild to moderate exudate wounds Absorbant and contour to surface of wound if shallow undulations
What are film used for and what do they do Non exuding wound Non absorbent but vapour permeable Flexible dressing, primary and secondary dressing
What type of wounds are hydrocolloids used for and what do they do Dry, sloughy, necrotic wounds. Aid with autolytic debridement Low to medium exuding wounds Waterproof
Hydrogels Suitable for dry, sloughy, necrotic wounds Promotes rapid debridement by facilitating rehydration and autolysis of dead tissue
What wounds are hydrofibre used for and what does it do Forms into a gel on contact with exudate Highly absorbant Highly exudating wounds
What wounds are alginates used for and what do they do Moderate to high exudating wounds Highly absorbent Encourages autolytic debridement Good for cavities Fibres swell and form a gel on contact with exudate
Name microbial dressings and what does a microbial do Different types, aim to reduce microbial load to wound to enable wound healing to continue Inadine Medihoney Silver
What is tinea pedia? Dermophyte infection of the skin
What are the 3 classic types of dermatophytes called? (Trichophyton rubrum (red) Trichophyton mentagrophytes (between digits) Epidermophyton flocossum infection of epidermis
Name 5 host aetiologies for tinea pedia? Immunosuppression Poorly controlled diabetes mellitus Obesity Age Profession
Try and name 7 environmental factors for tinea pedia? Moist conditions occlusive footwear poor foot hygiene hyperhidrosis shared footwear shared towels public showering
Name health promotion advice for someone with tinea pedia change hosiery regularly Foot hygiene wash and dry feet regularly Don't not share towels Wash towels over 60 degrees Important to protect feet in communal showers
What is simplex tinea pedia? It is dry, can be itchy, epidermis may fissure
What does complex mean? Foot can be itchy, burning and malodour Peeling macerating skin, interdigital and sub digital fissures can lead to bacterial infection Secondary ba
What is moccasin tinea pedia known as? T Rubrum
What is pompholyx Eczema which affects the hands and feet, causing vesicles and irritation. Differential diagnosis for tinea pedia
How do we diagnose tinea pedia? Send skin scrapings for microscopy and culture
Name 3 different types of tinea pedia treatments and their ingredients Canestan - cliotrimazole Daktarin - micanozole Lamisil - terbinafine Can have spray, creams and powder
What is an ointment? More occlusive than cream Do not contain water Ideal for people who react to preservatives Often stiff and greasy
What is a cream? Mixture of fat and water Easier to spread over sore skin Need to be used frequently Contain preservatives
What is a lotion? Contain more water and less fat Spread easily and are cooling Quick absorbing Good for hairy skin Not effective for very dry skin
What happens in eczema? Change in skin moisture levels, reduction in barrier fuction, increases water loss allowing for penetration of allergens and irritants which trigger eczema
What is a benefit of using a powder? Soak up moisture Reduce friction between apposing skin surfaces
What is hypopigmentation? Too little melonin
What is hyper pigmentation too much melolin (freckles)
Summarise what you do when assessing wounds? Document size - ? increase Site Onset and duration Medical/family history Surface features type of lesion/? edges like Colour Picture (consent) Lesion base ? bleeding
Define dermaphyte A common label for a group of 3 types of fungus that commonly cause skin disease
What is pitted keratolysis? Erosion of stratum corneum due to corneobactrium - looks nibbled
What is ichthyosis? Genetic disorder - dry thick scaly skin (fish scales)
What is the process of deep wound healing? Haemostasis Inflammation Granulation Epithelialisation Maturation
What is haemostasis? Vascular response to minimise blood loss through platelet adhesion/aggregration
What is granulation? Formation of new connective tissue and blood vessels (angiogenesis) Contraction of wound
What is epithelialisation? Regrowth of keratinocytes across wound surface when granulation tissue has fully filled the wound
What is maturation? Collagen bundle formation Contracture of wound maturation of scar
What is inflammation? Tidy up - preparing for healing process involves heat, redness, swelling, pain and sometimes loss of function
Define wound? Break in the integrity of epidermis
What does an alginate do and name an example? Absorbs exudate Aims to limit maceration Sorbsan
What does a film do and name an example? Opsite Protects. Good for shallow abrasions. Maintains moist wound environment
What does an hydrocolloid do and name example? Hydration and autolysis of slough/eschar and necrosis Maintains a moist wound environment Granuflex Duoderm
What does hydrofibre do and name an example? Absorption of exudate Protects wound borders due to vertical exudate absorption Aquacel
What does hydrogel do and name an example? Hydration and autolysis of slough/eschar Medihoney
Name 4 antimicrobial dressings? Inadine Silver Medihoney Bactigras
What does bactigras contain and what wounds would you use for? Chlorhexidine paraffin for gram positive and negative bacteria
What type of dressing is inadine, and when should it not be used? Broad spectrum antimicrobial, tulle dressing. Not to be used on pregnant, lactating mums or thyroid problems
What is biatain? Its a foam dressing with hydrocolloid
Name a foam dressing and what type of wounds it would be used for? Allevyn Highly absorbant mild/moderate exudate contour to surface of shallow wounds
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