Advanced Derm Procedures

Question 1

nerve injury

Answer 1

by sensory abnormality distal to the wound; suspicion is increased for lacerations near the course of significant nerves.

Examination should test light touch and motor function. Two-point discrimination is useful for hand and finger injuries.

Question 2

tendon injury

Answer 2

Complete tendon laceration usually causes a resting deformity (e.g, foot drop from Achilles tendon laceration, loss of normal resting finger flexion with digital flexor laceration) because forces from antagonist muscles are unopposed.

Resting deformity does not occur with partial tendon laceration, which may manifest with only pain or relative weakness on strength testing or be discovered only on exploration of the wound.

Question 3

vascular injury

Answer 3

signs of ischemia, such as pallor, decreased pulses, or perhaps delayed capillary refill distal to the laceration

Vascular injury is occasionally suspected in the absence of ischemia when a laceration traverses the territory of a major artery and is deep or complex or results from penetrating trauma.

rapidly expanding or pulsatile mass or a bruit.