Flashcards
Podiatry Theory
Cards in this deck (121)
- 1Definition of hyperkeratosisa natural response when the physiological tolerance of the skin has been exceeded
- 2Name 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 - 3Summarise hyperkeratosisNormal protective response of the skin
Thickening of the stratum corneum
Increase in cell proliferation, decrease in shedding - 4What stress causes callus?Intermittent compression
- 5Causes of pathological callus?Abnormal foot mechanism
Joint malalignment
Foot deformity
Dermatological conditions - 6Define keratinisationProcess by which layers of the epidermis are formed
- 7When should you consider not to debride callus?Atrophic skin
Systemic disease
Poor circulation
Anatomical location - 8Name aetiologies for callus formation?Age
Psoriarsis
Intermittent compression
High heels
Narrow toe box - 9Name 5 layers of skin in the epidermis on the foot?Stratum corneum
stratum lucidum
Stratum granulosum
Stratum Spinosum
Stratum basale - 10What are the main cells of the epidermis?Keratinocytes
Langerhans
Merkel cells - 11Which layer of epidermis is only present on plantar aspect of the footStratum lucidum
- 12Which layer of the epidemis produces the lipid layer which acts as a protective layerStratum granulosum
- 13What are the functions of the skin?Protection
Sensation
Thermoregulation
Hydroregulation
Storage and synthesis
Absorption
Interacts with external environment
Communication - 14What is the role of merkel cellsSensitive to fine touch and pressure
- 15Where are Langerhans situated and what do they do?Situated in spinosum
Destroy FB and send message to immune system re harmful substances - 16What do melanocytes do and where are they located?Protect from UV radiation. Located in stratum basale
- 17What happens in stratum basale?Keratinocyte production
- 18What does the granulosum do?Acts as a protective barrier expels lipid components
- 19What are two layers of dermis called?Papillary
Reticular - 20Name main cells of dermis?Fibroblasts
Macrophages
Lymphocytes
Mast cells
Langerhan cells - 21Which part of the dermis do the appendages lie?Reticular
- 22Name 3 appendagesSweat glands
Sebaceous glands
hair - 23Define eccrine glandAll over the body
Produce odourless watery fluid, secrete onto skin surfaces
Secrete in response to stress - 24Define apocrineLocated in armpit and groin, function at puberty
- 25Define hypodermis?Subcutaneous tissue ie acts as a shock absorber fatty padding
- 26Where are pacinian corpuscles located and what do they do?Mechanoreceptor
In deep layer of dermis - 27Where are meissner cells located and what do they do?Situated in papillary layer of dermis
Sensitive to touch/pressure - 28What are ruffini corpuscles and where are they located?Located in dermis
Sensitive to touch and pressure - 29What is a noireceptor sensitive to?Pain
- 30Name 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 - 31Name 4 mechanoreceptor cellsMeissner
Merkel
Ruffini
Panicinian - 32where are ruffini cells more abundant and what do they do?Soles
Stretching/grip - 33Name physiological stresses of skinBurn
Cold
Bacterial infection
Fungal infection
Viral infection
Systemic disorder
Aging? - 34Name mechanical stresses on the skincompression
torsional
tensile
shearing - 35Define tensile stress and what does it cause?same plane but in opposite directions
fissures - 36Define shearingTissues stretched in opposite directions in different planes and one part slides across another
- 37What is a cause of superficial shearBlister
- 38Name 2 causes of deep shear?Bursae
Glassy callus - 39Define torsional?Amalgamation of all stress (twisting)
- 40What can intermittent compression result in?Callus
- 41What can constant compression result in?Necrosis
- 42What is the cause of corns?Intermittent compression
- 43Define corn?Deep concentrated mass of immature cornified cells
- 44The nucleus of a hard corn is termed?Parakeratotic
- 45Heloma durum normally occur where?Apices of the toes
Plantar metatarsal heads - 46Definition of heloma millaireMillions of stone wedges
- 47Where do heloma millaire commonly occur?calcaneal
Margins of weight bearing areas - 48Define Heloma Molle and where they commonly occur?Soft corn
Interdigitally - 49Define Heloma Vasculare and where they commonly occur?Corn with a vascular element
Digital apices
dorsal ipj
plantar 1st mpj - 50What is a Durlacher corn?HD lateral to 5th nail due to rotation of 5th toe
- 51Name examples of preventative advice for H Molle?Astringents
Change hosiery regularly
Footwear advice - 52Name some treatment options for treating corns?enucleation
footwear appraisal
silicones
padding and strapping
redistributing insoles
caustics
biomechanic referral - 53Name 3 aetiologies for heloma durum?Narrow toe box
High heels
intermittent compressive stress - 54What is a vesicle?Less than 5 mm
contains fluid - 55What is a bullae?More than 5 mm
fluid fluid - 56What can cause blisters/bullae?Trauma
Infection
Idiopathic
Genetic
Immunological factors - 57Name 3 causes of trauma?Mechanical - shear
thermal - hot/burn
cold/cryotherapy
Chemical burn - 58Superficial raised blister occurs in which section of the skin?Stratum corneum
- 59If a bullae occurs in the spinosum, is visible raised and painful, what layer of skin is this known as?Intra-epidermal layer.
- 60What 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 - 61Do we treat a blister if it is not painful, epidermis is intact and there is no inflammation?No
- 62What do we do if a blister is painful?Need to dress and re-distribute pressure.
- 63Name ways of recording blisters?VAS scale
Photographs
Lesion charts
Good written notes - 64What 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. - 65What is an adventitious bursae?Arise as result of excessive shear in superficial fibrous tissue, in surfaces where the skin moves freely over bony surfaces.
- 66What is a deep shear?Tissues are stretched in opposite directions in different planes. One side slides across another causing trauma.
- 67Define bursitis.Increased shear at site of bursae causing inflammation, swelling, heat and redness.
- 68Name 4 common bursitis foot locationsPosterior aspect of heel
Plantar aspect of calcaneus
Under HD on dorsum of Ipj
Medial aspect of 1st metatarsal in HAV - 69How would you reduce shear?Footwear advice.
Pressure redistribution.
Orthotic assessment. - 70How would you treat acute bursitis?Reduce inflammation - cold compress.
RICE - 71How would you treat chronic bursitis?Apply heat (Rubefacient) to reduce blood flow to area in order to reduce fluid.
- 72How would you treat infective bursitis?Establish drainage.
? antibiotics/swab to be sent for culture.
Wound care. - 73What is tenosynovitis?Inflammation of a tendon sheath.
- 74List as many types of dressings as you can and give an exampleLow/non adherent - Melolin
Tulle
Foam
Hydrocolloid
Hydrofibre
Alignate
Antimicrobial
Hydrogel - 75Name what wounds low adherent dressings are used for and what they doUsed on low exuding wounds
Prevent damage to granulating/epithelialisation wound bed. - 76Name what wounds foams are used for and what they doMild to moderate exudate wounds
Absorbant and contour to surface of wound if shallow undulations - 77What are film used for and what do they doNon exuding wound
Non absorbent but vapour permeable
Flexible dressing, primary and secondary dressing - 78What type of wounds are hydrocolloids used for and what do they doDry, sloughy, necrotic wounds.
Aid with autolytic debridement
Low to medium exuding wounds
Waterproof - 79HydrogelsSuitable for dry, sloughy, necrotic wounds
Promotes rapid debridement by facilitating rehydration and autolysis of dead tissue - 80What wounds are hydrofibre used for and what does it doForms into a gel on contact with exudate
Highly absorbant
Highly exudating wounds - 81What wounds are alginates used for and what do they doModerate to high exudating wounds
Highly absorbent
Encourages autolytic debridement
Good for cavities
Fibres swell and form a gel on contact with exudate - 82Name microbial dressings and what does a microbial doDifferent types, aim to reduce microbial load to wound to enable wound healing to continue
Inadine
Medihoney
Silver - 83What is tinea pedia?Dermophyte infection of the skin
- 84What are the 3 classic types of dermatophytes called?(Trichophyton rubrum (red)
Trichophyton mentagrophytes (between digits)
Epidermophyton flocossum infection of epidermis - 85Name 5 host aetiologies for tinea pedia?Immunosuppression
Poorly controlled diabetes mellitus
Obesity
Age
Profession - 86Try and name 7 environmental factors for tinea pedia?Moist conditions
occlusive footwear
poor foot hygiene
hyperhidrosis
shared footwear
shared towels
public showering - 87Name health promotion advice for someone with tinea pediachange 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 - 88What is simplex tinea pedia?It is dry, can be itchy, epidermis may fissure
- 89What 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 - 90What is moccasin tinea pedia known as?T Rubrum
- 91What is pompholyxEczema which affects the hands and feet, causing vesicles and irritation. Differential diagnosis for tinea pedia
- 92How do we diagnose tinea pedia?Send skin scrapings for microscopy and culture
- 93Name 3 different types of tinea pedia treatments and their ingredientsCanestan - cliotrimazole
Daktarin - micanozole
Lamisil - terbinafine
Can have spray, creams and powder - 94What is an ointment?More occlusive than cream
Do not contain water
Ideal for people who react to preservatives
Often stiff and greasy - 95What is a cream?Mixture of fat and water
Easier to spread over sore skin
Need to be used frequently
Contain preservatives - 96What 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 - 97What 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
- 98What is a benefit of using a powder?Soak up moisture
Reduce friction between apposing skin surfaces - 99What is hypopigmentation?Too little melonin
- 100What is hyper pigmentationtoo much melolin (freckles)
- 101Summarise 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 - 102Define dermaphyteA common label for a group of 3 types of fungus that commonly cause skin disease
- 103What is pitted keratolysis?Erosion of stratum corneum due to corneobactrium - looks nibbled
- 104What is ichthyosis?Genetic disorder - dry thick scaly skin (fish scales)
- 105What is the process of deep wound healing?Haemostasis
Inflammation
Granulation
Epithelialisation
Maturation - 106What is haemostasis?Vascular response to minimise blood loss through platelet adhesion/aggregration
- 107What is granulation?Formation of new connective tissue and blood vessels (angiogenesis)
Contraction of wound - 108What is epithelialisation?Regrowth of keratinocytes across wound surface when granulation tissue has fully filled the wound
- 109What is maturation?Collagen bundle formation
Contracture of wound
maturation of scar - 110What is inflammation?Tidy up - preparing for healing
process involves heat, redness, swelling, pain and sometimes loss of function - 111Define wound?Break in the integrity of epidermis
- 112What does an alginate do and name an example?Absorbs exudate
Aims to limit maceration
Sorbsan - 113What does a film do and name an example?Opsite
Protects.
Good for shallow abrasions.
Maintains moist wound environment - 114What does an hydrocolloid do and name example?Hydration and autolysis of slough/eschar and necrosis
Maintains a moist wound environment
Granuflex
Duoderm - 115What does hydrofibre do and name an example?Absorption of exudate
Protects wound borders due to vertical exudate absorption
Aquacel - 116What does hydrogel do and name an example?Hydration and autolysis of slough/eschar
Medihoney - 117Name 4 antimicrobial dressings?Inadine
Silver
Medihoney
Bactigras - 118What does bactigras contain and what wounds would you use for?Chlorhexidine paraffin
for gram positive and negative bacteria - 119What 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 - 120What is biatain?Its a foam dressing with hydrocolloid
- 121Name 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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- Flashcards on Podiatry Theory, created by JamesR on 14/03/2014.
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