Group 1

Case 1: Integumentary System & Fascias

Anatomy of Integumentary System & Fascias
 Explain about skin colours signs in physical diagnosis (cyanotic, erythema,
yellowish )

Cyanosis:
• Cyanosis refers to a bluish discoloration
of the skin and mucous membranes. It
occurs when there is decreased oxygen
saturation in the blood.
• Cyanosis can be central or peripheral.
Central cyanosis affects the lips, tongue,
and mucous membranes, indicating
systemic hypoxemia, often due to lung or
heart problems.
• Peripheral cyanosis affects the extremities
and can be caused by poor circulation or
exposure to cold temperatures.
Erythema
• Erythema is the medical term for redness of
the skin. It occurs due to increased blood
flow to the skin's surface, usually in response
to inflammation, infection, or injury.
• Erythema can vary in intensity and
distribution depending on the underlying
cause.
• For example, localized erythema may
indicate a skin infection or allergic reaction,
while widespread erythema may suggest a
systemic condition like lupus or allergic
reaction.
 Yellowish ( jaundice)
• Yellowish (Jaundice): Yellowish discoloration
of the skin, sclera (whites of the eyes), and
mucous membranes is called jaundice.
• It occurs due to elevated levels of bilirubin in
the blood. Bilirubin is a yellow pigment
produced from the breakdown of red blood
cells.
• Jaundice can be caused by various liver
diseases (such as hepatitis or cirrhosis),
obstruction of the bile ducts, or excessive
breakdown of red blood cells (hemolysis).
Jaundice can range from mild to severe and
often indicates underlying liver or biliary tract
pathology.
Explain about scaring
• Scarring is a natural part of the body's healing process in response to
injury or trauma to the skin. When the skin is damaged, whether by cuts,
burns, surgery, acne, or other causes, the body initiates a complex repair
process involving the formation of new tissue to close the wound.
• This repair process often results in the formation of scar tissue.
Key point
1. Formation: After an injury, the body's immune system responds by sending specialized cells to the wound site to clean up debris
and initiate the repair process. Fibroblasts, a type of connective tissue cell, then produce collagen, a fibrous protein that forms the
structural framework of scar tissue. Over time, collagen fibers organize and remodel to strengthen the wound, leading to scar
formation.
2. Types of Scars: Scars can vary in appearance, texture, and severity depending on factors such as the type and extent of the injury,
genetics, and individual healing characteristics. Common types of scars include:
1. Hypertrophic Scars: Raised, red scars that remain within the boundaries of the original wound.
2. Keloid Scars: Thick, raised scars that extend beyond the boundaries of the original wound and may continue to grow over time.
3. Atrophic Scars: Depressed or sunken scars often seen in conditions like acne or chickenpox.
4. Contracture Scars: Tight, shiny scars that result from burns, causing skin tightening and potential restriction of movement.
3. Factors Influencing Scar Formation: Several factors can influence how scars form and their eventual appearance, including:
1. Depth and Size of the Wound: Deeper or larger wounds are more likely to result in prominent scars.
2. Location: Scars on certain parts of the body, such as the face or joints, may be more noticeable or problematic.
3. Skin Type: Individuals with darker skin tones may be more prone to developing keloid or hypertrophic scars.
4. Age: Younger individuals tend to heal with less noticeable scarring compared to older individuals.
5. Wound Care and Treatment: Proper wound care, including cleaning, protecting from infection, and minimizing tension on the wound, can
help optimize scar formation.
4. Treatment: While scars are permanent, various treatments can help improve their appearance or minimize associated symptoms,
such as itching or pain. Treatment options include topical treatments (such as silicone gel or sheeting), injections (such as
corticosteroids or collagen), laser therapy, surgical revision, and dermal fillers.
 Key point

• Overall, scarring is a normal part of the body's healing process,

but it can sometimes lead to cosmetic or functional concerns.
Understanding the factors that influence scar formation and the
available treatment options can help individuals manage their
scars effectively.
Explain about stretch marks (L. striae
gravidarum)
• Stretch marks, medically known as striae distensae or striae
gravidarum when they occur during pregnancy, are a common skin
condition characterized by streaks or lines that appear on the skin's
surface.
• These marks typically have a different color and texture compared to
the surrounding skin. Here's an explanation of stretch marks, including
their causes, appearance, and treatment options:
Causes
1. Rapid Stretching of the Skin: Stretch marks occur when the skin is stretched
rapidly beyond its elastic capacity, causing the collagen and elastin fibers in
the dermis (the middle layer of skin) to rupture. This rapid stretching often
happens during periods of rapid growth, weight gain, or hormonal changes,
such as during puberty, pregnancy, or significant weight gain or loss.
2. Hormonal Factors: Hormonal changes, particularly increased levels of
cortisone (a hormone produced by the adrenal glands), can weaken the skin's
structural support, making it more susceptible to stretch marks.
3. Genetic Predisposition: Some individuals may be more genetically
predisposed to developing stretch marks, as family history can play a role in
their formation.
Appearance:
1. Initially, stretch marks often appear as
reddish or purplish streaks on the skin,
reflecting the inflammation and blood vessel
dilation associated with the initial stretching.
2. Over time, the color of stretch marks may
fade to a lighter shade, resembling the
surrounding skin, but they often remain
slightly depressed or raised compared to the
surrounding skin.
3. Stretch marks can occur on various parts of
the body, including the abdomen, breasts,
thighs, hips, buttocks, and upper arms,
depending on the underlying cause.
Treatment
• Topical Treatments: Various topical treatments, such as creams, lotions, or oils containing
ingredients like retinoids, hyaluronic acid, vitamin E, or cocoa butter, are commonly used to
moisturize the skin and improve its appearance. However, the efficacy of these treatments in
reducing the appearance of stretch marks varies, and results may be limited.
• Laser Therapy: Laser treatments, such as fractional laser therapy or pulsed dye laser therapy, can
help stimulate collagen production, improve skin texture, and reduce the appearance of stretch
marks. Multiple sessions may be required for optimal results.
• Microdermabrasion and Chemical Peels: These procedures involve removing the outer layer of
skin to promote new skin growth and improve the appearance of stretch marks. They may be used
in combination with other treatments for enhanced efficacy.
• Microneedling: Microneedling involves using a device with fine needles to create micro-injuries
in the skin, stimulating collagen production and facilitating the remodeling of stretch marks.
• Surgical Procedures: In severe cases, surgical procedures such as abdominoplasty (tummy tuck)
may be considered to remove excess skin and tighten the abdominal area, reducing the appearance
of stretch marks.
 Classification of burn
First-Degree Burns (Superficial
Burns):
• First-degree burns affect only the outer
layer of skin, known as the epidermis.
• Symptoms typically include redness,
pain, and mild swelling.
• These burns usually heal within a few
days to a week without scarring.
• Examples include minor sunburns or
brief contact with hot surfaces.
 Second-Degree Burns (Partial Thickness Burns):
1. Second-degree burns affect both the
outer layer of skin (epidermis) and part
of the underlying layer (dermis).
2. Symptoms may include redness, pain,
swelling, and blistering.
3. These burns can take several weeks to
heal and may result in scarring.
4. Superficial second-degree burns involve
damage to the upper layers of the dermis
and tend to heal without surgical
intervention.
5. Deep second-degree burns extend deeper
into the dermis and may require medical
treatment such as wound care, topical
medications, or possibly skin grafting.
Third-Degree Burn (Full Thickness Burn):
1. Third-degree burns involve
damage to the entire thickness
of the skin and underlying
tissues.
2. The skin appears white,
blackened, charred, or
leathery.
3. The affected area may be
numb due to complete
destruction of nerve endings.
4. Third-degree burns often
require medical intervention,
such as skin grafting, to heal.
 Fourth-Degree Burn (In some classifications):
1. Fourth-degree burns are the
most severe and extend
through the skin and
underlying tissues to involve
muscle, tendon, or bone.
2. These burns often result from
prolonged exposure to high
temperatures or from severe
chemical or electrical injuries.
3. The affected area may appear
charred, and underlying
tissues may be visible.
Fascial Space
 Fascial Spaces are the
potential spaces between the
various layers of muscles,
normally filled with loose
connective tissue
Case 1