Кожа – это защитный слой в организме человека. Она имеет большую площадь и вес. С ее помощью можно защитить себя от бактерий, урегулировать температуру. Кожный покров быстро сообщит мозгу об источнике боли. Он моментально реагирует на тепло или холод. Кожа имеет свойство менять цвет под воздействием различных химических веществ и солнечных лучей. Если в организме человека наблюдаются патологии, то она в первую очередь сообщит мозгу об этом. Синее пятно на коже свидетельствует о нарушении целостности капилляров. Нередко данное внешнее проявление свидетельствует о наличии патологий в работе внутренних органов. В медицинской практике были зарегистрированы также случаи, когда такая пигментация была беспричинной. Однако об этом может сказать только врач, с достаточной квалификацией в этой области.
Основные виды пятен на коже
Фиолетовые пятна на коже в научной практике получили название макул. Цвет может изменяться от розового, синего, винного до темно-фиолетового. В некоторых случаях дополнительно на нем наблюдается шелушение.
Все пятна на теле человека можно классифицировать по следующим признакам:
- присутствуют на коже с рождения человека;
- пигментные образования;
- приобретённые в процессе жизни;
- вызванные разрывом сосудов или капилляров.
Они отличаются друг от друга также цветом. Чаще всего причина кроется в нарушении естественной пигментации. Светлая окраска проявляется при злоупотреблении человеком времяпрепровождением на солнце. Часто с этой проблемой люди сталкиваются в период отдыха на море.
Врачи отмечают, что такой симптом характерен коже человека при наличии вредоносного воздействия грибка. Некоторые заболевания нарушают выработку меланина, поэтому наблюдаются изменения в цвете кожного покрова. С рождения такие пятна могут быть при диагностированном альбинизме. При этом дополнительно у человека волосы и радужная оболочка глаза имеет белый цвет.
Невусами или родинками называют пятна фиолетового или винного цвета, которые на теле человека либо присутствуют от рождения, либо проявляются в течение всей жизни. Не допускается их самостоятельное удаление, поскольку в таком случае увеличивается риск ее перерождения в злокачественное новообразование.
Под прямым воздействием солнечных лучей веснушки имеют свойство менять цвет на фиолетовый. В таком случае в зимнее-осеннее время они практически полностью исчезают с лица и тела. Их проявление на следующий год начнется в период увеличения активности солнца. Дерматологи отмечают, что с возрастом их будет появляться все меньше.
Во время беременности на теле женщины периодически появляются коричневые или кофейные пятна, которые в медицинской практике называют хлоазмами.
У пожилых людей пигментные пятна проявляются из-за нарушения работы печени. Они имеют слегка коричневатый цвет. Под воздействием прямых солнечных лучей их размер может быть увеличен в несколько раз. Пятна располагаются на лице, руках и теле. Дерматологи отмечают, что они не несут вреда здоровью человека, а являются простым внешним дефектом.
Высыпания черного цвета появляются у некоторых людей с возрастом. Они также могут располагаться на шее, в области паха и подмышечных впадин. Чаще всего такое проявления считают симптомом патологий в работе надпочечников или поджелудочной железы (сахарный диабет).
Причины появления пятен фиолетового цвета
Чаще всего такая пигментация на коже вызвана разрывом сосудов или капилляров. К примеру, обычный синяк проявляется после сильного ушиба. В некоторых случаях фиолетовые пятна наблюдаются из-за серьезных заболеваний. К ним относят капилляротоксикоз, пурпуру и другие заболевания.
Главное различие заключается в том, что синяк появляется после механического или силового воздействия. Пурпура проявляется без причины и не сходит с кожи в течение долгого периода времени. На пятне могут присутствовать мелкие капилляры. Чаще всего фиолетовые пятна в медицинской практике встречаются также на коленях, предплечьях и руках.
Пурпура или подкожная утечка крови диагностируется в случае, если винное пятно не сходит в течение долгого периода времени. Состояние считают одним из симптомов цинги или плохой свертываемости кожи. В пожилом возрасте патология проявляется из-за утончения стенок кровеносных сосудов. Нередко ситуация возникает на фоне употребления большого количества витамина Е и других лекарственных препаратов.
При наличии обширных фиолетовых пятен, которые не сходят в течение долгого периода времени, следует посетить кабинет дерматолога. Осмотр врача потребуется в случае периодического проявления синяков при отсутствии внешних воздействий. Фиолетовые пятна на коже могут свидетельствовать о наличии патологий в сосудах и капиллярах.
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Воскресенье, 27 Января 2008 г. 13:58 + в цитатник
Признаки жизни и смерти. Клиническая и биологическая смерть
При тяжелой травме, поражении электрическим током, утоплении, удушении, отравлении, а также ряде заболеваний может развиться потеря сознания, т.е. состояние, когда пострадавший лежит без движения, не отвечает на вопросы, не реагирует на окружающих. Это результат нарушения деятельности центральной нервной системы, главным образом головного мозга.
Оказывающий помощь должен четко и быстро отличать потерю сознания от смерти.
Наступление смерти проявляется в необратимом нарушении основных жизненных функций организма с последующим прекращением жизнедеятельности отдельных тканей и органов. Смерть от старости встречается редко. Чаще причина смерти — заболевание или воздействие на организм разных факторов.
При массивных повреждениях (авиационная, железнодорожная травмы, черепно-мозговые травмы с повреждением головного мозга) смерть наступает очень быстро. В других случаях наступлению смерти предшествует агония, которая может длиться от нескольких минут до часов и даже дней. В этот период ослабляется сердечная деятельность, дыхательная функция, кожные покровы умирающего становятся бледными, черты лица заостряются, появляется липкий холодный пот. Агональный период переходит в состояние клинической смерти.
Клиническая смерть характеризуется:
— прекращением дыхания;
— остановка сердца.
В этот период еще не развились необратимые изменения в организме. Различные органы умирают с различной скоростью. Чем выше уровень организации ткани, тем более она чувствительна к недостатку кислорода и тем более быстро эта ткань умирает. Самая высокоорганизованная ткань человеческого организма — кора больших полушарий головного мозга умирает максимально быстро, через 4-6 минут. Период, пока жива кора больших полушарий, называется клинической смертью. В этот период времени возможно восстановление функции нервных клеток и центральной нервной системы.
Биологическая смерть характеризуется наступлением необратимых процессов в тканях и органах.
При обнаружении признаков клинической смерти необходимо немедленно приступить к реанимационным мероприятиям.
Признаки клинической смерти
- Отсутствие признаков жизни.
- Агональное дыхание. Наступлению смерти в большинстве случаев предшествует агония. После наступления смерти в течение короткого времени (15-20 секунд) продолжается так называемое агональное дыхание, то есть дыхание частое, поверхностное, хриплое, возможно появление пены у рта.
- Судороги. Также являются проявлениями агонии и продолжаются короткое время (несколько секунд). Происходит спазм как скелетной, так и гладкой мускулатуры. По этой причине практически всегда смерть сопровождается непроизвольными мочеиспусканием, дефекацией и семяизвержением. В отличие от некоторых заболеваний, сопровождающихся судорогами, при наступлении смерти судороги несильные и неярко выраженные.
- Реакция зрачков на свет. Как было сказано выше, признаки жизни будут отсутствовать, однако реакция зрачков на свет в состоянии клинической смерти сохраняется. Данная реакция является высшим рефлексом, замыкающимся на кору больших полушарий головного мозга. Таким образом, пока жива кора больших полушарий головного мозга, будет сохраняться и реакция зрачков на свет. Надо отметить, что первые секунды после смерти в результате судорог зрачки будут максимально расширены.
Учитывая, что агональное дыхание и судороги будут иметь место только в первые секунды после смерти, главным признаком клинической смерти будет наличие реакции зрачков на свет.
Признаки биологической смерти
Признаки биологической смерти проявляются не сразу после окончания стадии клинической смерти, а некоторое время спустя. Причем каждый из признаков проявляется в разное время, а не все одновременно. Поэтому мы и разберем эти признаки в хронологическом порядке их возникновения.
“Кошачий глаз” (симптом Белоглазова). Появляется через 25-30 минут после смерти. Откуда такое название? У человека зрачок круглой формы, а у кошки — вытянутый. После смерти ткани человека теряют свою эластичность и упругость, и, если сдавить с двух сторон глаз мертвого человека, он деформируется, и вместе с глазным яблоком деформируется и зрачок, принимая вытянутую форму, как у кошки. У живого человека деформировать глазное яблоко если не невозможно, то очень трудно.
Высыхание роговицы глаза и слизистых оболочек. Появляется через 1,5-2 часа после смерти. После смерти перестают функционировать слезные железы, которые вырабатывают слезную жидкость, которая, в свою очередь, служит для увлажнения глазного яблока. У живого человека глаза влажные и блестят. Роговица глаза мертвого человека в результате высыхания теряет естественный человеческий блеск, становится мутной, иногда появляется серовато-желтоватый налет. Быстро высыхают слизистые оболочки, которые при жизни были более увлажнены. Например, губы становятся темно-бурого цвета, морщинистые, плотные.
Трупные пятна. Возникают вследствие посмертного перераспределения крови в трупе под действием силы тяжести. После остановки сердца прекращается движение крови по сосудам, и кровь, в силу своей тяжести, начинает постепенно перетекать в более низко расположенные части трупа, переполняя и расширяя капилляры и небольшие венозные сосуды; последние просвечиваются через кожу в виде синюшно-багрового цвета пятен, которые получили название трупных. Окраска трупных пятен не равномерная, а пятнистая, имеет так называемый “мраморный” рисунок. Появляются они примерно через 1,5-3 часа (иногда через 20-30 минут) после смерти. Располагаются трупные пятна в нижележащих отделах тела. При положении трупа на спине, трупные пятна расположены на задней и заднее — боковых поверхностях тела, на животе — на передней поверхности тела, лице, при вертикальном положении трупа (повешение) — на нижних конечностях и нижней части живота. При некоторых отравлениях трупные пятна имеют необычную окраску: розовато-красноватую (окись углерода), вишневую (синильная кислота и ее соли), серовато-коричневую (бертолетова соль, нитриты). В некоторых случаях цвет трупных пятен может меняться при изменении состояния окружающей среды. Например, при извлечении трупа утопленника на берег имеющиеся на его теле трупные пятна синюшно-багрового цвета, вследствие проникновения кислорода воздуха через разрыхленную кожу могут изменить цвет на розово-красный. Если смерть наступила в результате большой кровопотери, то трупные пятна будут иметь гораздо более бледный оттенок или вообще отсутствовать. При нахождении трупа в условиях низких температур трупные пятна будут образовываться позднее, до 5-6 часов. Образование трупных пятен проходит в две стадии. Как известно, трупная кровь в течение первых суток после смерти не свертывается. Таким образом, в первые сутки после смерти, когда кровь еще не свернулась, расположение трупных пятен непостоянно и может изменяться при изменении положения трупа в результате перетекания несвернутой крови. В дальнейшем, после свертывания крови, трупные пятна изменять своего положения не будут. Определить наличие или отсутствие свертывания крови очень просто — нужно надавить на пятно пальцем. В случае, если кровь не свернулась, при надавливании трупное пятно в месте надавливания побелеет. Зная свойства трупных пятен, возможно на месте происшествия определить приблизительную давность смерти, а также выяснить, переворачивали труп после смерти или нет.
Трупное окоченение. После наступления смерти в трупе происходят биохимические процессы, приводящие вначале к расслаблению мышц, а затем к сокращению и затвердению — трупному окоченению. Развивается трупное окоченение в течение 2-4 часов после смерти. Механизм образования трупного окоченения до конца еще не ясен. Одни исследователи считают, что в основе лежат биохимические изменения в мышцах, другие — в нервной системе. В таком состоянии мышцы трупа создают препятствие для пассивных движений в суставах, поэтому для разгибания конечностей, находящихся в состоянии выраженного трупного окоченения, необходимо применять физическую силу. Полное развитие трупного окоченения во всех группах мышц достигается в среднем к концу суток. Развивается трупное окоченение не во всех группах мышц одновременно, а постепенно, от центра к периферии (сперва окоченению подвергаются мышцы лица, затем шеи, грудной клетки, спины, живота, конечностей). Спустя 1,5-3 суток окоченение исчезает (разрешается), что выражается в расслаблении мышц. Трупное окоченение разрешается в последовательности, обратной развитию. Развитие трупного окоченения ускоряется в условиях высокой температуры, при низкой отмечается его задержка. Если смерть наступает в результате травмы мозжечка, трупное окоченение развивается очень быстро (0,5-2 секунды) и фиксирует позу трупа в момент смерти. Трупное окоченение разрешается раньше установленного срока в случае насильственного растяжения мышцы.
Трупное охлаждение. Температура трупа вследствие прекращения обменных процессов и выработки энергии в организме постепенно понижается до температуры окружающей среды. Наступление смерти можно считать достоверным при понижении температуры тела ниже 25 градусов (по данным ряда авторов — ниже 20). Определять температуру трупа лучше на участках, закрытых от воздействия окружающей среды (подмышечная впадина, полость рта), так как температура кожи полностью зависит от температуры окружающего воздуха, наличия одежды и т.п. Скорость остывания тела может изменяться в зависимости от температуры окружающего воздуха, но в среднем составляет 1 градус/час.
Фоты со вскрытия.
Фото гематологического больного, так как взят костный мозг из бедренной кости, об этом говорит шов на левой ноге. Прошу прощения за качество фотографии — почти все органы уже вскрыты. Под №1 — головной мозг. №2 — почка с хроническим пиелонефритом, об этом говорит увеличенное количество жира. №3 — сердце, хорошо видна аорта, количество жира так же увеличено. №4 — желудок, хорошо видно кровоснабжение органа. №5 — легкое. №6 — большой сальник — укрывает органы брюшной полости от ударов из вне. №7 — небольшой кусочек печени, бледно-розового цвета. №8 — петли толстой кишки.
То же самое вскрытие, но слегка другой ракурс.
Труп женщины, с множественными трупными пятнами на спине.
Холодильная камера, рассчитана на 5 человек, за каждой дверцей. Там трупы хранятся до момента захоронения, а невостребованные трупы 3 месяца, затем они идут на Гос.захоронение.
Секционная комната обычно полностью выложена кафелем, секционные столы обычно железные или кафельные со сливом в канализацию, неотъемлемый атрибут — кварцевая лампа.
Труп женщины, вскрыт и одет, перед выдачей родственникам.
На каждом вскрытии из многих органов берут кусочки, затем после работы гистолога, они превращаются в такие вот препараты для микроскопа.
Возникновение фиолетовых пятен на коже сигнализирует человеку о том, что в его организме происходят различные патологические нарушения. Эпидермис является самостоятельным органом, покрывающим тело. Кожный покров необходим организму прежде всего для того, чтобы выполнять защитную функцию от разного рода воздействия бактерий и инфекций, а также чтобы регулировать температурный режим тела. Кроме этого, кожный покров человека реагирует на воздействие внешних факторов и на состояние внутренних органов.
Разновидности новообразований на кожных покровах
При возникновении разного рода неполадок в функционировании какого-либо внутреннего органа — кожа одна из первых начинает реагировать на такие нарушения, и в некоторых случаях такая реакция наблюдается в виде возникновения на ее поверхности пятен различной цветовой гаммы. Фиолетовые илисиние пятна могут образовываться на эпидермисе в результате нарушения целостности и структуры поверхностных капилляров, однако в некоторых случаях подобные новообразования свидетельствуют о развитии какого-либо серьезного патологического процесса в организме человека. Если синие пятна на телепоявляются беспричинно и имеют множественный характер, то это является первым сигналом необходимости обратиться к специалисту.
Макулы, или кожные пятна, могут возникать практически на любых участках эпидермиса и иметь разнообразную окраску, начиная от телесного оттенка и заканчивая темным фиолетовым или коричневым цветом. Все макулы подразделяются на:
Основной причиной возникновения таких кожных новообразований является нарушение выработки меланина на определенном участке эпидермиса. Таким образом, макулы светлого или телесного оттенка нередко являются одним из признаков чрезмерного нахождения тела человека под воздействием солнечных лучей. В основном такое явление возникает у людей, часто отдыхающих на морских курортах. Однако кроме этого причинами возникновения на кожном покрове пятен светлого оттенка могут являться всевозможные кожные патологии грибкового характера, при развитии и прогрессировании которых нарушаются процессы нормальной выработки меланина — кожного фермента, функция которого заключается в регулировании окраски эпидермиса.
Кожные пятна винного или темного оттенка могут быть врожденными, и в таком случае они называются родимыми пятнами, или родинками (невусами). Такие невусы могут формироваться еще у детей достаточно маленького возраста, но зачастую данные новообразования проявляются у людей с годами. Травмировать, или, еще хуже, самостоятельно удалять родимые пятна нельзя в связи с тем, что это может спровоцировать трансформацию невуса в злокачественное кожное новообразование.
Пятна коричневого или светло-кофейного оттенка могут появляться в результате чрезмерного пребывания человека на солнце. Такие макулы называются веснушками. Они возникают в основном в теплое время годана лице или других участках тела и постепенно исчезают с наступлением холодов. Кроме этого, такого рода кожные новообразования могут появляться у беременных, и в таком случае они имеют название "хлоазмы".
Макулы коричневого цвета возникают также и у людей пожилого возраста. Такие новообразования еще называют печеночными пятнами, или лентиго. Подобные макулы имеют более большой размер, чем веснушки, и под воздействием солнечного излучения не темнеют. Лентиго могут располагаться как на руках , так и на других участках тела, в том числе на лице . Возникновение такого рода макулы не свидетельствует о наличии в организме человека каких-либо патологических процессов и не причиняет вреда его здоровью, а является естественным физиологическим процессом, который представляет собой косметический дефект. А вот образование черных пятен на кожных покровах человека может являться следствием протекания различных болезней надпочечников или такого эндокринного заболевания, как сахарный диабет.
Причины возникновения пятен фиолетового цвета
В большинстве случаев синюшный или фиолетовый оттенок кожного новообразования имеет происхождение сосудистой природы. В связи с этим такого рода пятнышко на эпидермисе может возникнуть в результате механического повреждения одного из его участков, при котором также происходит повреждение структуры поверхностных капилляров. Механическое повреждение того или иного участка эпидермиса бывает вследствие травмы или ушиба. Однако в некоторых случаях появление фиолетовых макул может свидетельствовать о протекании в организме человека различных патологий, поражающих его сосудистую систему. К таким болезням относятся менингококцемия, тромбоцитопеническая пурпура и капилляротоксикоз. Чаще всего макулы фиолетового оттенка появляются на внутренних поверхностях рук , предплечьях или на голеностопе человека.
Если такого рода пятна не исчезают в течение достаточно длительного промежутка времени, то это не синяк, а подкожное повреждение капилляров, при развитии которого происходит утечка крови из поврежденного кровеносного капилляра. У людей пожилого возраста возникновению таких винных макул способствуют возрастные изменения кровеносной системы, которые характеризуются утончением стенок капилляров и сосудов. Такое явление называется старческой пурпурой.
Кроме этого, образование кожных пятен фиолетового оттенка возникает на фоне слишком большого употребления витамина E, различных медикаментозных нестероидных средств противовоспалительного характера, каких-либо препаратов, разжижающих кровь, и в результате чрезмерного употребления алкогольных напитков.
К другим более серьезным причинам возникновения кожных новообразований винного оттенка относятся:
- наличие каких-либо болезней, поражающих печень;
- ревматоидный артрит;
- лейкемия — рак крови;
- синдром мраморной кожи;
- пламенеющий невус;
- болезнь Фабри;
- саркома Капоши;
- синдром Кобба.
В случае наличия винных макул большого размера и не исчезающих на протяжении длительного промежутка времени следует незамедлительно обратиться к специалисту.
Саркома Капоши и пятна фиолетового оттенка
Саркома Капоши характеризуется возникновением небольших кожных новообразований темного фиолетового цвета, возникающих у человека вследствие наличия СПИДа или в результате перенесения трансплантации каких-либо внутренних органов. Такое явление образуется на фоне развития злокачественного опухолевого новообразования в желудочно-кишечном тракте. Наиболее часто новообразования поражают слизистую оболочку желудка, тонкой кишки либо толстого кишечника.
В группу риска образования такого заболевания, как саркома Капоши, входят:
- люди пожилого возраста и мужского пола;
- ВИЧ-инфицированные люди;
- люди, имеющие в организме герпетический вирус 8 типа.
Образующиеся пятна на кожных покровах человека при развитии болезни саркома Капоши внешне похожи на специфические высыпания фиолетового или синего оттенка и имеют вид округлых небольших узелков, размер которых может достигать в диаметре 50 мм. При этом такие макулы сопровождаются болезненными ощущениями, если на них произвести давление.
Лечение данного патологического процесса подразумевает использование местного и системного применения различных химиотерапевтических медикаментозных средств и лучевой терапии, воздействующей непосредственно на опухолевое новообразование.
Пламенеющий невус и кожные пятна
Пламенеющий невус представляет собой патологический процесс, который характеризуется нарушением структуры и целостности сосудов кровеносной системы человека, располагающихся достаточно близко к коже. Данное заболевание является разновидностью дисплазии. В народе пламенеющий невус имеет такое название, как винные пятна, из-за характерных подкожных новообразований фиолетового цвета. Данный патологический процесс развивается у ребенка еще в период внутриутробного развития.
Пламенеющий невус проявляется в виде макул неправильной формы и не исчезает на протяжении всей жизни. Иногда развитие такого заболевания может являться одним из симптомов наличия таких генетических патологий, как:
- синдром Рубинштейна-Тейби;
- синдром Кобба.
Лечение пламенеющего невуса производится только посредством его полного удаления при помощи лазерного излучения или криотерапии (замораживания патологического участка кожи).
Возникновение на кожных покровах пятен любого размера и цвета не должно оставаться без внимания, и поэтому, обнаружив у себя такое явление, необходимо обратиться к врачу, который при необходимости назначит соответствующий курс лечения.
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