Examination of ulcer -history taking

Examination of ulcer -history taking

• 1.
  EXAMINATION OF ULCER -HISTORY -BY ABHIRAMYASHASWI ROLL NO:-02
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  WHAT IS ANULCER? • An ulcer is a discontinuity of an epithelial surface • Characterized by progressive destruction of the surface epithelium and a granulating base
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  CLASSIFICATION OF ULCERS •Ulcers are classified into:-non specific ,specific ,malignant • A) non-specific:-peptic ulcers ,pressure sores ,gravitational ulcers(venous insufficiency) ,traumatic ulcers ,aphthous ulcers • B)specific (infective type):-herpes simplex ,tuberculous ,syphilis • c)malignant:-gastric carcinoma
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  MODE OF ONSET •How has the ulcer developed following a trauma or spontaneously? • TRAUMATIC ULCERS:-Generally heal by themselves if the traumatic agent is removed • Ulcer enlarges if the traumatic agent persists ,e.g.-dental ulcer of tongue • Healing of an ulcer is delayed if it lies over a joint
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  • SPONTANEOUS ULCER:-followsa swelling ,which may be matted tuberculous lymph nodes or gumma or rapidly growing malignant tumor • Ulcers may be present in the leg with varicose veins or vascular insufficiency
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  DURATION • How longis the ulcer present there? • Acute ulcer is present for a short duration • Chronic ulcer will remain for a long duration • Incubation period-time interval between exposure and onset of ulcer
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  PAIN • Is theulcer painful? • Only the ulcers associated with inflammation will be painful • Syphilitic and tropic ulcers resulting from nerve diseases are painless • Tuberculous ulcers are slightly painful • Ulcers from malignant diseases such as epithelioma or basal cell carcinoma are absolutely painless to start with and never become painful unless they infiltrate structures supplied by pain nerve endings
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  DISCHARGE • Does theulcer discharge or not? • If it discharges enquiry must be made about its nature- serum ,pus, or blood
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  ASSOCIATED DISEASES • Ifpresent-nervous diseases such as tabes dorsalis ,syringomylia may result in an ulcer • Syphilis at the primary stage gives rise to chancre and in tertiary stage gives rise to gummatous ulcer
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