-
Integument conditions to avoid for massage
1. Compromised Skin (cut, open wound)
2. Oozing, Weeping wounds
-
Common manifestations of skin disease
- * itching
- * Edema -fluid swelling, cool to touch
- * Inflammation-blood swelling, red & warm
- * Lesions
- * Scars & Striae
- * Color
- * Decreased skin turgor -less elasticity
- * Nails, hair (extension of integument)
-
4 Congenital Disorders
- Born with congenital disorders
- 1 Nevus
- 2 Hemangiona
- 3 Blue Nevus
- 4 Dysplastic Nevus
-
Nevus (congenital Disorder)
- Most common
- High concentration melanocytes
- arranged abnormally
- happens in stratum basale
-
Hemangioma
- Benign tumor of a blood vessel
- 1 port wine stain=flat, red
- 2 Strawberry=elevated red bump
-
Dysplastic Nevus
- Precursor to malignant melenoma
- abnormal growth
- = to exposed and unexposed sun
-
4 Pigmentation disorders
V
L
E
A
- Vitiligo *Loss of melanocytes (color)
- Lentigo *Melanocyte hyperplasia (liver spot)
- Ephelides *freckle, fade & reappear with season
- Albinism *failure of melanocyte production
- Lack enzyme Tyrosinase
-
4 External Injury
M mothers
E eat
R radioactive
T trout
- Mechanical Injury
- Electrical Injury
- Radiation Injury
- Thermal Injury
-
Mechanical Injury
- Excess friction or pressure
- Corn *inward stratum corneum thickening
- Push deep into skin
- Callus *upward strum corneum thickening
- Push up out skin
-
Electrical Injury
- lightening
- finger in light socket
- always enter and exit point
- Death if through heard or brain
-
Radiation Injury
- Uv rays
- x-rays
- Not reversible
- causes free radicals
- Cumulative effects
-
Thermal Injury
- 1st degree - epidermis, sunburn, heals rapidly
- no scarrin
- 2nd degree - epidermis+dermis, blisters,
- healing through adnexa
- 3rd degree - epidermis+dermis+hypodermis(adnexa) severe scarring, heals slowly
-
Risk of 3rd degree burns
How can massage help
- * loss of fluids
- * risk of shock
- * increased risk of infection
- Massage can help contractures heal
-
5 Inflammatory and Vesicular Skin Disorders
E
SD
Ps
U
AV
- Excema or Dermatitis
- Seborrheic Dermatitis
- Psoriasis
- Urticaria
- Acne Vulgaris
-
Exzema or Dermatitis
- itchy, red rash, not contagious
- lichenification=thickening of skin, skin markings, chronic scratchin
-
Seborrheic Dermatitis
- dandruff, red scaly, itchy hair follicles
- chronic
-
Psoriasis
- inflammatory rash
- "beefy-red" plaques with silver scaling
- chronic
- extensor surfaces and scalp
-
Urticaria
- Hives
- appear and reappear in 24-28 hours
-
Acne Vulgaris
- non contagious
- sebaceous gland
- hormonally induced
-
6 infectious diseases/bacterial
- impetigo-contraindicated
- folliculitis-local contraindication
- cellulitis-contraindicated
- necrotizing fascilitis-contraindicated
- leprosy--contraindicated
- syphilis-contraindicated
-
Impetigo
- staph & strep
- spreads by scratching
- contagious w/direct contact
- heals rapidly
- no scarring
-
Folliculitis
- inflammation of follicle
- staph
- boil/pimple
-
Cellulitis
- Strep
- acute inflammation subcutaneous tissue often from wound infection
- Rapidly spread
- red, hot, swollen
-
Necrotizing fasciitis
- Uncommon spread deep subcutaneous tissue
- limbs, abdominal wall
- rapid spread
- amputation or death
-
Leprosy
- incubation 9 months to 20 years
- common tropical county disease caused by Mycobacterium leprae
-
Syphilis
- sexually transmitted
- initial stage-no pain, lesions
- second stage- pain, rash on body
- contagious 10 days to 3 months
- usually effects 20-29 year olds
-
7 viral infections
- small pox
- chicken pox
- herpes zoster (shingles)
- herpes simplex
- measles
- molluscum contagiousum
- wart (verruca vulgaris)
-
Smallpox
- vaccination has eradicated
- caused by variola virus
-
Chickenpox
- enters respiratory tract
- hides in spinal nerves
- incubation 13-17 days
-
Herpes Zoster (Shingles)
- same virus as chickenpox
- severe pain
- virus down sensory nerves
-
Herpes Simplex
- Type 1-cancers, cold sores
- Type 2-Genital lesions (sexually transmitted)
- highly contagious
- hides spinal nerves
-
Measles
- transmitted respiratory tract
- small dots w/white or blue centers
- acute highly contagious
-
Molluscum Contagiousum
- transmitted direct contact
- large dome-shaped "pearly" papules
- folds of arm or groin
- sexual transmission or swimming pool
-
Wart (Verruca Vulgaris)
- skin growth caused by human papilloma virus
- invades keratynocytes
-
2 Fungal Infections
- Dermatophytes-local contraindication
- Candidiasis- local contraindication
-
Dermatophytes
- fungi infect keratin of stratum corneum
- infect hair and nails
- circular, elevated, red scaly skin lesions
- Tinea Capitis-head
- Tinea Corporis-body surface
- Tinea Cruris-ingueal areas (jock itch)
- Tinea Pedis- athletes foot
- Tinea Unguium -toenails
-
Candidiasis
- yeast infection
- superficial skin and mucus membranes
- mouth=thrush
- blood stream=sepsis
-
Insect Bites= SCABIES, lice
- contagious
- mites burrow into stratum corneum
- itchy
- contraindicated
-
What is the single most important carcinogenic agent in most cutaneous cancer?
UV light (ultraviolet light)
-
Seborrheic Keratosis
- benign
- keratin filled cysts
- elderly, trunk extremities face
-
Keratoacanthoma
- Benign
- lesion collapses in on itself
- cup shaped, irregular keratin
-
Actinic Keratosis
- premalignant
- exposure to sun
- Brown spots can become carcinogenic
-
Basal Cell Carcinoma
- malignant neoplasms
- light skin people over 40
- punched out ulcer w/pearly rolled edges
-
Squamous Cell Carcinoma
- malignant
- elderly, fair skinned individuals
- locale aggressive
- rarely metastasizes
- shallow ulcer w/raised everted, firm border
-
5 Neoplasms of skin
- Seborrheic Keratosis - benign
- Keratoacanthoma - benign
- Actinic Keratosis - premalignant
- Basal Cell Carcinoma - malignant
- Squamous Cell Carcinoma - malignant
-
Malignant Melanoma
1. radial growth phase
2. vertical growth phase
- causes most deaths/increase in incidence
- 1. Radial growth phase-superficial, remove lesion to stop spread to blood
2. Vertical growth phase-deep into skin, cancer enters bloodstream
-
Possible Essay
List and describe the ABCD's of melanoma recognition
- A - Asymmetry 1/2 different from other
- B - Border Irregular
- C - Color Mixed colors, can change color
- D - Diameter Greater diameter pencil eraser
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