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PTR1005 - Lecture 2

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22 views

PTR1005 - Lecture 2

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nc8vtvk9yd
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© © All Rights Reserved
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HEAT, LIGHT & HYDROTHERAPY

SKIN & SENSORY ASSESSMENT


Pelin Pişirici, PT, M.Sc, PhD
SKIN
It is the largest organ of the
body.

Its weight corresponds to 7%


of the total body weight.
(5.25 kg for a 75 kg person)
FUNCTIONS

Protection : Against heat (hot-cold), water loss, UV, chemicals, major /


minor traumas
Sense: Hot, cold, touch, pain
Termoregülation: Sweating, vasodilation, vasoconstriction
Immunological defense: Via Langerhans cells
Vitamin-D synthesis
FUNCTIONS

Wound healing: Reepithelization, dermal repair


Detoxification: Sweating
Expression of the mental state, aesthetics
Reflecting on general health
THE COLOR OF THE SKIN
VARIES.
Race
Gender
Body part :
- Nipple
- Genital organs
The skin is darker in
- Anus color.
- Fossa axillaris
- Linea alba
- Inner face of the thigh
Skin (Cutis) consists of three
layers:
Epidermis (cutis vera): The epidermis on the palms and soles is the
thickest, approximately 1.5 mm. It is the thinnest in the eyelids,
about 0.05 mm.
◦ - Melanin pigment (skin color)
Skin (Cutis) consists of three
layers:
Dermis (Corium): Average thickness is 1-3 mm. In the back area, the
dermis takes its thickest shape.
- Actual skin
- Its thickness varies.
- Its basic structure is COLLAJEN,
a fibrous protein.
◦ - Skin nerves and veins are located here.
Skin (Cutis) consists of three
layers:
Tela subcutanea (Subcutis): The fat layer under the skin is most
common in the abdomen and hips.
◦ - It consists of sections formed by fat cells.
◦ - Protection, energy-hormone store.
◦ This section has 2 parts:
◦ -Lamina superficialis
◦ -Lamina adiposus
TELA SUBCUTANEA (SUBCUTIS) :

a)Lamina superficialis
Petrus Camper
1722-1789

b)Lamina profundus
Antonio Scarpa
(1752-1832)
Lamina superficialis:
- Contains plenty of fatty tissue.
- It may not be found in the thin/fit people.
Lamina Profundus:
It contains a very thin membrane layer and elastic tissue.
It does not contain fat tissue.
In the areas where the bones are right under the skin, the two are tightly
adhered to each other and thus the movement of the skin is restricted.
Between its two layers, There is
◦ Superficial arteries / veins / nerves
◦ Lymph nodes
◦ Mammary gland
◦ Mimic muscles
◦ Platysma
HYDROTHERAPY-
HEAT-LIGHT
APPLICATIONS ARE
USED IN EVERY
STAGE OF
REHABILITATION
(ACUTE / CHRONIC).
PURPOSE OF USE OF THESE MODALITIES:

ACCELERATING HEALING
PHYSIOLOGICAL RESULTS OF HEAT USE
VASODILATATION
REDUCING BLOOD VISCOSITY
INCREASE CAPILLAR PERMEABILITY
ACCELERATION OF TISSUE METABOLISM
REDUCING MUSCLE TENSION
OBJECTIVES OF HEAT USE
PAIN RELIEF
VASODILATATION
REDUCING MUSCLE SPASM AND TONE
REDUCING JOINT ADHESION
INCREASE OF CELL METABOLISM
SURFACE SENSE
TOUCH
PAIN
HEAT
Superficial Sensory
Examination-1
A-TOUCHING SENSE
-Explain the test.
-Patient closes his/her eyes.
-A small piece of cotton is touched all over the face and body.
-He is asked to say "yes" every time he feels cotton. Where he does
not say 'yes', he is considered to have hypoesthesia.
Superficial Sensory
Examination-1
A-TOUCHING SENSE
-If the patient is cooperative, it is questioned whether he has the
same hearing on both sides of the body.
-If the neurological findings are on only one side of the patient,
compare the symmetrical points of the patient and the healthy side.
If both parts are effected, take face sense as reference.
Superficial Sensory
Examination-2
B-PAIN
- It should be contacted with sharp objects such as pins without
creating pressure.
-Applying on symmetrical parts of the body, can both sides feel the
same? Yes/No?
Pain
◦ Süperficial Sense
◦ Pointed-blunt test
◦ Pin
Superficial Sensory
Examination-3
C-HEAT
Have 2 separate tubes filled with hot and cold water.
Hot tube should be 40°-45 °, cold tube: should be around 5°-10°.
The more hot or cold tubes will stimulate the sensation of pain rather
than the sensation of heat.
Superficial Sensory
Examination-3
◦ - With the eyes closed, the patient is taught the temperature difference
of the tubes.
◦ It is desirable to say which of the tubes touching different parts of the
body is hot and which is cold.
◦ - If a precision assessment is to be made, the difference between cold /
hot stimuli is reduced.
◦ - A normal person can distinguish between 2-5 degrees of
temperature difference.
◦ When a superficial sensory defect is detected, this area is marked
on a body chart.
Assessment chart
0: no sense
1: hipoestesia
2: normal sense

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