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The Skin Anatomy, Physiology and Microbiology

https://www.facebook.com/ArmandoHasudungan Support me: http://www.patreon.com/armando Instagram: http://instagram.com/armandohasudungan Twitter: https://twit...  
YouTube
over 4 years ago
Foo20151013 2023 zpmqsc?1444774026
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Assessing Types of Burns and their Severity

This is an excerpt from "Wound Care Made Incredibly Easy! 1st UK Edition" by Julie Vuolo For more information, or to purchase your copy, visit: http://tiny.cc/woundcare. Save 15% (and get free P&P) on this, and a whole host of other LWW titles at http://lww.co.uk when you use the code MEDUCATION when you check out! Introduction A burn is an acute wound caused by exposure to thermal extremes, electricity, caustic chemicals or radiation. The degree of tissue damage caused by a burn depends on the strength of the source and the duration of contact or exposure. Around 250,000 people per year sustain burn injuries in the UK (NBCRC 2001). Because of the specialist care burns require, they are considered here separately from other traumatic wounds. Types of burns Burns can be classified by cause or type. Knowing the type of burn will help you to plan the right care for your patient. Thermal burns The most common type of burn, thermal burns can result from virtually any misuse or mishandling of fire, combustible products, hot fluids and fat or coming into contact with a hot object. Playing with matches, pouring petrol onto a BBQ, spilling hot coffee, touching hot hair straighteners and setting off fireworks are some common examples of ways in which burns occur. Thermal burns can also result from kitchen accidents, house or office fires, car accidents or physical abuse. Although it’s less common, exposure to extreme cold can also cause thermal burns. Electrical burns Electrical burns result from contact with flowing electrical current. Household current, high-voltage transmission lines and lightning are sources of electrical burns. Internal injury is often considerably greater than is apparent externally. Chemical burns Chemical burns most commonly result from contact (skin contact or inhalation) with a caustic agent, such as an acid, an alkali or a vesicant. Radiation burns The most common radiation burn is sunburn, which follows excessive exposure to the sun. Almost all other burns due to radiation exposure occur as a result of radiation treatment or in specific industries that use or process radioactive materials. Assessment Conduct your initial assessment as soon as possible after the burn occurs. First, assess the patient’s ABCs. Then determine the patient’s level of consciousness and mobility. Next, assess the burn, including its size, depth and complexity. Determining size Determine burn size as part of your initial assessment. Typically, burn size is expressed as a percentage of total body surface area (TBSA). The Rule of Nines and the Lund–Browder Classification provide standardised and quick estimates of the percentage of TBSA affected. Memory Jogger To remember the proper sequence for the initial assessment of a burns patient, remember your ABCs and add D and E. Airway – Assess the patient’s airway, remove any obstruction and treat any obstructive condition. Breathing – Observe the motion of the patient’s chest. Auscultate the depth, rate and characteristics of the patient’s breathing. Circulation – Palpate the patient’s pulse at the carotid artery and then at the distal pulse points in the wrist, posterior tibial area and foot. Loss of distal pulse may indicate shock or constriction of an extremity. Disability – Assess the patient’s level of consciousness and ability to function before attempting to move or transfer them. Expose – Remove burned clothing from burned areas of the patient’s body and thoroughly examine the skin beneath.  
Lippincott Williams & Wilkins
over 6 years ago
Preview 300x206
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A Tularemia lesion on the dorsal skin of the right hand, caused by the bacterium Francisella tularensis.

Tularemia is caused by the bacterium, Francisella tularensis. Symptoms vary depending on how the person was exposed to the disease, and as is shown here, can include skin ulcers.  
Public Health Information Library
about 9 years ago
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236

The Embryology Of The Skin

a power point presentation about the embryological development of the skin  
Kamal Eldirawi
over 6 years ago
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Shotgun Histology Thin Skin

Shotgun Histology Thin Skin  
Nicole Chalmers
over 5 years ago
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Henoch Schonlein Purpura (HSP)

This is a vasculitis that most commonly occurs in children. It tends to only affect the small vessels, and typically presents with: Palpable purpura – red/purple discolorations in the skin, often on the extensor surfaces of the feet, legs, arms, or sometimes on the buttocks. The rash may initially resemble urtricaria, but later becomes palpable. GI disturbance – may include colicky abdominal pain, abdominal tenderness, melena – occurs in 50% of patients  
almostadoctor.com - free medical student revision notes
over 5 years ago
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Psoriasis

Pathology Keratinocyte hyperproliferation: differentiation, or ‘skin cell going from basal layer to horny layer’, reduced from 4 weeks to 4 days [approximately!] Histopathological features: Parakeratosis: retained nuclei Acanthosis: thick epidermis Absent granular layer Lengthened rete ridges Thin dermal papillae  
almostadoctor.com - free medical student revision notes
over 5 years ago
Www.bmj
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A woman with a sore spot on her leg

A 41 year old civil servant, with a background of poorly controlled Crohn’s disease, presented to her general practitioner with a skin lesion on her left shin that had been there for eight weeks (fig 1⇓).  
bmj.com
over 5 years ago
Foo20151013 2023 gvoh9v?1444774222
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Socks, Kiwis and Surgical Removal

I’m a klutz. Always have been. Probably always will be. I blame my clumsiness on the fact that I didn’t crawl. Apparently I was sitting around one day and toddling on two feet the next. Whatever the cause, it’s a well-tested fact that I’m not good on icy footpaths. Various parts of my anatomy have gotten up close and personal with frozen ground on many an occasion. Not usually an issue for a born-and-bred Australian, except when said Australian goes to visit her Canadian family during the northern winter. During one such visit, I found myself unceremoniously plopped onto slick ice while my two-year-old niece frolicked around me with sure-footed abandon. I thought, “There has to be an easier way.” As freezing water seeped through my jeans, providing a useful cold pack for my screaming coccyx, my memory was jogged. I recalled that a lateral-thinking group of New Zealand researchers had won the Ignoble Prize for Physics for demonstrating that wearing socks on the outsides of shoes reduces the incidence of falls on icy footpaths. To the amusement of my niece, I tried out the theory for myself on the walk home. I don’t know if I had a more secure foothold or not, but I did manage to get blisters from wearing sneakers without socks. I love socks. They cover my large, ungainly clod-hoppers and keep my toes toasty warm almost all year round. You know the song ‘You can leave your hat on.’? Well for me, it is more a case of ‘You can leave your socks on, especially in winter. There’s nothing unromantic about that… is there? I’m not, however, as attached to my socks as a patient I once treated. As an intern doing a psychiatry rotation, one of my tasks was to do physical examinations on all admissions. Being a dot-the-i’s kinda girl, when an old homeless man declined to remove his socks so that I could examine his feet, I didn’t let it slide. “I haven’t taken off my socks for thirty years,” he pronounced. “It can’t be that long. Your socks aren’t thirty years old. In fact, they look quite new,” I countered. “When the old ones wear out, I just slip a new pair over the top.” I didn’t believe him. From his odour, I would have believed that he hadn’t showered in thirty years, but the sock story didn’t add up. He eventually agreed to let me take them off. The top two sock layers weren’t a problem but then I ran into trouble. Black remains of what used to be socks clung firmly to his feet, and my gentle attempts at their removal resulted in screams of agony. I tried soaking his feet. Still no luck. His skin had grown up into the fibres, and it was impossible to extract the old sock remnants without ripping off skin. In retrospect I probably should have left the old man alone, but instead got the psych registrar to have a peek, who then involved the emergency registrar, who called the surgeon and soon enough the patient and his socks were off to theatre. The ‘surgical removal of socks’ was not a commonly performed procedure, and it provided much staff amusement. It wasn’t so funny for Mr. Sock Man, who required several skin grafts! From my perspective here in Canada, while I thoroughly commend the Kiwis for their ground-breaking sock research, I think I’ll stick to the more traditional socks-in-shoes approach, change my socks regularly and work a bit on my coordination skills. References: PHYSICS PRIZE: Lianne Parkin, Sheila Williams, and Patricia Priest of the University of Otago, New Zealand, for demonstrating that, on icy footpaths in wintertime, people slip and fall less often if they wear socks on the outside of their shoes. "Preventing Winter Falls: A Randomised Controlled Trial of a Novel Intervention," Lianne Parkin, Sheila Williams, and Patricia Priest, New Zealand Medical Journal. vol. 122, no, 1298, July 3, 2009, pp. 31-8. (This blog post has been adapted from a column first published in Australian Doctor http://www.australiandoctor.com.au/articles/58/0c06f058.asp) Dr Genevieve Yates is an Australian GP, medical educator, medico-legal presenter and writer. You can read more of her work at http://genevieveyates.com/  
Dr Genevieve Yates
over 5 years ago
Foo20151013 2023 s45v8o?1444774247
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Money-back guarantees

Ironically, it seems the health products with the least evidence are coming with the greatest assurances. A few years ago, a package holiday company advertised guaranteed sunny holidays in Queensland (Australia). The deal went something like this: if it rained on a certain percentage of your holiday days, you received a trip refund. An attractive drawcard indeed, but what the company failed to grasp was that the “Sunshine State” is very often anything but sunny. This is especially so where I live, on the somewhat ironically named Sunshine Coast. We had 200 rainy days last year and well over 2 metres of rain, and that was before big floods in January. Unsurprisingly, the guaranteed sunny holiday offer was short-lived. There are some things that really shouldn’t come with guarantees. The weather is one, health is another. Or so I thought… “Those capsules you started me on last month for my nerve pain didn’t work. I tried them for a couple of weeks, but they didn’t do nothin'.” “Perhaps you’d do better on a higher dose.” “Nah, they made me feel kinda dizzy. I’d prefer to get my money back on these ones an’ try somethin’ different.” “I can try you on something else, but there are no refunds available on the ones you’ve already used, I’m afraid.” “But they cost me over 80 dollars!” “Yes, I explained at the time that they are not subsidised by the government.” “But they didn’t work! If I bought a toaster that didn’t work, I’d take it back and get me money back, no problem.” “Medications are not appliances. They don’t work every time, but that doesn’t mean they’re faulty.” “But what about natural products? I order herbs for me prostate and me heart every month and they come with a 100% satisfaction guarantee. You doctors say those things don’t really work so how come the sellers are willing to put their money where their mouths are?” He decided to try a “natural” treatment next, confident of its likely effectiveness thanks to the satisfaction guarantee offered. Last week I had a 38-year-old female requesting a medical certificate stating that her back pain was no better. The reason? She planned to take it to her physiotherapist and request a refund because the treatment hadn’t helped. Like the afflicted patient above, she didn’t accept that health-related products and services weren’t “cure guaranteed”. “My thigh sculptor machine promised visible results in 60 days or my money back. Why aren’t physios held accountable too?” Upon a quick Google search, I found that many “natural health” companies offer money-back guarantees, as do companies peddling skin products and gimmicky home exercise equipment. I even found a site offering guaranteed homeopathic immunisation. Hmmm… In an information-rich, high-tech world, we are becoming less and less tolerant of uncertainty. Society wants perfect, predictable results — now! For all its advances, modern medicine cannot provide this and we don’t pretend otherwise. Ironically, it seems the health products with the least evidence are coming with the greatest assurances. A clever marketing ploy that patients seem to be buying into — literally and figuratively. I think we all need to be reminded of Benjamin Franklin’s famous words: “In this world, nothing can be said to be certain except death and taxes.” We can’t really put guarantees on whether it will rain down on our holidays or on our health, and should retain a healthy scepticism towards those who attempt to do so. This blog post has been adapted from a column first published in Australian Doctor http://www.australiandoctor.com.au/articles/11/0c070a11.asp Dr Genevieve Yates is an Australian GP, medical educator, medico-legal presenter and writer. You can read more of her work at http://genevieveyates.com/  
Dr Genevieve Yates
over 5 years ago
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Differences in Mechanosensory Discrimination Across the Body Surface - Neuroscience - NCBI Bookshelf

The accuracy with which tactile stimuli can be sensed varies from one region of the body to another, a phenomenon that illustrates some further principles of somatic sensation. Figure 9.4 shows the results of an experiment in which variation in tactile ability across the body surface was measured by two-point discrimination. This technique measures the minimal interstimulus distance required to perceive two simultaneously applied stimuli as distinct (the indentations of the points of a pair of calipers, for example). When applied to the skin, such stimuli of the fingertips are discretely perceived if they are only 2 mm apart. In contrast, the same stimuli applied to the forearm are not perceived as distinct until they are at least 40 mm apart! This marked regional difference in tactile ability is explained by the fact that the encapsulated mechanoreceptors that respond to the stimuli are three to four times more numerous in the fingertips than in other areas of the hand, and many times more dense than in the forearm. Equally important in this regional difference are the sizes of the neuronal receptive fields. The receptive field of a somatic sensory neuron is the region of the skin within which a tactile stimulus evokes a sensory response in the cell or its axon (Boxes A and B). Analysis of the human hand shows that the receptive fields of mechanosensory neurons are 1–2 mm in diameter on the fingertips but 5–10 mm on the palms. The receptive fields on the arm are larger still. The importance of receptive field size is easy to envision. If, for instance, the receptive fields of all cutaneous receptor neurons covered the entire digital pad, it would be impossible to discriminate two spatially separate stimuli applied to the fingertip (since all the receptive fields would be returning the same spatial information). Figure 9.4Variation in the sensitivity of tactile discrimination as a function of location on the body surface, measured here by two-point discrimination. (After Weinstein, 1969.)  
ncbi.nlm.nih.gov
about 4 years ago
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Improving outcomes for people with skin tumours including melanoma | Guidance and guidelines | NICE

The NICE guidance on skin cancer services outlines how healthcare services for people with skin tumours should be organised. The key recommendations include:  
nice.org.uk
almost 4 years ago
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Hot tub folliculitis: MedlinePlus Medical Encyclopedia

Hot tub folliculitis is an infection of the skin around the lower part of the hair shaft (hair follicles). It occurs when you come into contact with certain bacteria that live in warm and wet areas.  
nlm.nih.gov
almost 4 years ago
Wound%20care
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Clinical Guidelines (Nursing) : Wound care

The skin is the largest organ of the body, making up 16% of body weight. It has several vital functions, which include; immune function, temperature regulation, sensation and vitamin production. Skin is a dynamic organ in a constant state of change; cells of the outer layers continuously shed and are replaced by inner cells moving to the surface. These guidelines have been developed by a range of clinicians who treat children with skin disorders, breakdowns and wounds; they reflect current research and evidence based expert opinion.  
rch.org.au
almost 4 years ago
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Complex Regional Pain Syndrome - Causes, Treatment & Therapies - Gold Canyon AZ

The Complex regional pain syndrome (CRPS) is an unceasing pain condition that often affects one of the limbs (that can be arms, legs, hands, or feet), generally after an injury or trauma to that particular limb. Complex regional pain syndrome is believed to be caused due to damage, or malfunctioning of the peripheral and central nervous systems. The central nervous system encompasses the brain and spinal cord; whereas the peripheral nervous system includes the nerve signaling from the brain and the spinal cord to the other parts of the body. The Complex Regional Pain Syndrome is exemplified by prolonged or a chronic pain and mild or dramatic changes in the color of the skin, temperature or even swelling in the affecting area.  
calmareaz.com
almost 4 years ago
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Melanoma Skin Cancer - The Mount Sinai Hospital

Learn more about the #risk factors, #signs, stages and advanced #treatments for melanoma skin cancer. Visit our #Skin #Cancer Center at http://www.mountsinai.org/skincancer #infographic #Health #Medical #Medicine #treatment #HealthyTips #Wellness |Skin Cancer, Cancer and Infographic.  
uk.pinterest.com
over 3 years ago
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What is the origin of autonomic fibers supplying the skin of the face?

This video is part of a playlist of short videos which are intended to combine multiple choice questions' answering experience with an improved understanding...  
youtube.com
over 3 years ago
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SABCS 2008 | Case08

ResearchToPractice.com/SABCS_2008 – Second Opinion: Proceedings and Interviews from a 2-Part CME Satellite Symposia Held at the 31st Annual San Antonio Breast Cancer Symposium. Case: 76-year-old woman who underwent a mastectomy for a 6-cm, ER/PR-positive, HER2-positive, T4b IDC with skin ulceration and extensive dermal involvement. Interviews conducted by Neil Love, MD. Produced by Research To Practice.  
Dr Neil Love
about 9 years ago
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MTPB3 2007 | Case 04 presented by Philip Glynn, MD

www.MeetTheProfessors.com – Case from the practice of Philip Glynn, MD; 76-year-old widow in otherwise good health presented with back pain and a large breast mass causing skin contracture and erosion presented to Drs Cobleigh, Holmes  
Dr Neil Love
about 9 years ago
29635
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Step 4 - Ten Steps to Successful Breastfeeding

Every facility providing maternity services and care for newborn infants should: Help mothers initiate breastfeeding within a half-hour of birth. Mothers in the maternity ward who have had normal vaginal deliveries should confirm that within a half-hour of birth they were given their babies to hold with skin contact, for at least 30 minutes, and offered help by a staff member to initiate breastfeeding...At least 50% of mothers who have had caesarean deliveries should confirm that within a half-hour of being able to respond, they were given their babies to hold with skin contact. It is now well established that mothers who are supported to initiate breastfeeding soon after the baby is born are more likely to have a successful breastfeeding experience. So the fourth step is to initiate breastfeeding within a half--hour of birth. More inf http://tensteps.org/step-4-successful-breastfeeding.shtml Initiation of Breastfeeding by Breast Craw http://breastcrawl.org --.-- Ten Steps to Successful Breastfeeding - Video Series Babies who are breastfed are generally healthier and achieve optimal growth and development compared to those who are fed formula milk. If the vast majority of babies were exclusively fed breastmilk in their first six months of life -- meaning only breastmilk and no other liquids or solids, not even water -- it is estimated that the lives of at least 1.2 million children would be saved every year. If children continue to be breastfed up to two years and beyond, the health and development of millions of children would be greatly improved. This video series aims to raise awareness, encourage early adoption, promote training of health care staff, and build capacity for, and to stimulate dialogue about, breastfeeding and its impact on the public, in a range of community and public contexts in low- and middle-income countries. Our goal is to have these ten steps in every facility providing maternal services and care for newborn infants. Videos, presentations, research, evidence, papers, training and counselling materials, tools, and many other related and supporting resources are available. Visit us on-line a http://tensteps.org .  
Nand Wadhwani
almost 9 years ago