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Examination of ulcer
This document discusses the examination of ulcers. It defines an ulcer as a break in the epithelium's continuity caused by molecular death or trauma. When examining an ulcer, the doctor inspects its size, shape, edges, floor, discharge, and surrounding skin. They also palpate the ulcer's edges, base, depth, and surrounding tissues. The history taken includes how the ulcer developed, duration of symptoms, associated conditions, and character of any discharge. A full examination also evaluates lymph nodes, vascular status, and neurological function. The inspection and palpation aim to determine the ulcer's type and guide appropriate treatment.
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Examination of ulcer
- 1. Examination of Ulcer Dr.Shardool Vikram Gupta Assistant Professor M.Ch.(Minimal Access Surgery), AIIMS, New Delhi M.S. Gen Surgery (UCMS) Member of international college of laparoscopic surgeons(MCLS) Fellowship in Advanced laparoscopic surgery- Bariatric Surgery (FALS)
- 2. Dr. Shardool VikramGupta
- 3. Ulcer: Definition Dr. ShardoolVikram Gupta
- 4. Ulcer: Definition • Breakin the continuity of the covering epithelium — skin or mucous membrane • Molecular death of the surface epithelium • Traumatic removal Dr. Shardool Vikram Gupta
- 5. Parts of Ulcer Dr.Shardool Vikram Gupta
- 6. • 'Margin’ -junction between normal epithelium and the ulcer • Boundary of the ulcer • Edge’ -area between the margin and the floor of the ulcer • Floor - exposed surface within the ulcer • Base -on which the ulcer rests (better felt than seen) Dr. Shardool Vikram Gupta
- 7. History • Mode ofonset • How has the ulcer developed— following a trauma or spontaneously ? • Marjolin's • Duration • Pain • Inflammation/Traumatic • Trophic Ulcer Dr. Shardool Vikram Gupta
- 8. • Discharge • Associateddisease • Nervous diseases • T2DM • PAD • Varicose Vein Dr. Shardool Vikram Gupta
- 9. Examination • Inspection • Palpation •Examination of LN • Examination for Vascular insufficiency • Neurological Examination Dr. Shardool Vikram Gupta
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- 11. Examination • Size andShape • Number • Position • Margin Dr. Shardool Vikram Gupta
- 12. • Rodent ulcers-usually confined to the upper part of the face above a line joining the angle of the mouth to the lobule of the ear • Tubercular Ulcer – LN • Trophic ulcers are commoner on the heel of the foot or on the ball of the foot • Chancre Dr. Shardool Vikram Gupta
- 13. • Gaiter’s Area– Venous Ulcer Dr. Shardool Vikram Gupta
- 14. • Edge 1) Underminededge • Tuberculosis • Destroys the subcutaneous tissue faster than it destroys the skin Dr. Shardool Vikram Gupta
- 15. 2) Punched outedge • Trophic ulcer • Edge drops down at right angle to the skin surface as if it has been cut out with a punch Dr. Shardool Vikram Gupta
- 16. 3) Sloping edge •Healing Ulcer Dr. Shardool Vikram Gupta
- 17. 4) Raised andpearly-white beaded edge • Rodent ulcer (BCC) Dr. Shardool Vikram Gupta
- 18. 5) Rolled out(Everted) edge • Squamous cell carcinoma • Growing portion at the edge of the ulcer heaps up and spills over the normal skin Dr. Shardool Vikram Gupta
- 19. • Discharge • Characterof the discharge • Amount and smell • Sero-sanguinous discharge - tuberculous ulcer • Ulcer infected with B-pyocyanea /Pseudomonas - greenish • Surrounding area • Whole Limb • Varicose • PAD Dr. Shardool Vikram Gupta
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- 21. • Tenderness • Edgeand margin • Marked induration (hardness) of the edge is characteristic feature of a carcinoma • Base • Marked induration (hardness) of the base – Syphilitic Chancre Dr. Shardool Vikram Gupta
- 22. • Depth • Bleeding •Relations with the deeper structures • Surrounding skin Dr. Shardool Vikram Gupta
- 23. Dr. Shardool VikramGupta
- 24. • Examination ofLN • Examination for Vascular insufficiency • Neurological Examination Dr. Shardool Vikram Gupta
- 25. Clinical Surgery :Android Play Store Dr. Shardool Vikram Gupta
- 26. Dr. Shardool VikramGupta
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