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Integument > 5. Burns and Wounds > Flashcards

5. Burns and Wounds Flashcards

1
Q

What are burns?

A

traumatic injuries to the skin or other tissues by thermal cause or other exposures

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2
Q

T/F: burns are an isolated, nonrecurring insult

A

true

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3
Q

What causes a burn?

A

heat
electrical discharge
friction
chemicals
radiation

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4
Q

A heat injury can be related to:

A

contact temperature
duration of contact
thickness of skin

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5
Q

A heat injury involves what area(s) of the skin

A

epidermis and part of the dermis

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6
Q

Most heat injuries are caused by?

A

flames
hot liquids
hot solid objects
steam

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7
Q

electrical discharge is

A

electric energy transferred into heat

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8
Q

How does electricity pass through the body

A

it passes through poorly conducting body tissues

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9
Q

what disrupts membrane potential and function (injury to the cell membrane) in electrical discharge injuries?

A

electroporation

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10
Q

What dictates the severity of an electrical discharge injury

A

pathway of current

resistance to the current flow through tissues

strength and duration of current flow

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11
Q

what leads to a friction injury

A

mechanical disruption of tissues

heat generated by friction

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12
Q
A
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13
Q

the severity of chemical injury is determined by

A

duration of exposure
nature of agent

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14
Q

what are acid burns?

A

coagulation necrosis of tissue

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15
Q

what are alkaline burns?

A

liquification necrosis

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16
Q

What can ionizing radiation trigger?

A

merkel cell carcinoma

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17
Q

Merkel cell carcinoma is another name for what?

A

sunburn

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18
Q

therapeutic radiation is dependent on what factors?

A

dose
time of exposure
type of particles

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19
Q

what type of burns can radiation cause?

A

deep internal burns

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20
Q

first degree burn

A

superficial; epidermal burn that only involves the epidermal layer of skin

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21
Q

second degree burn

A

partial thickness - involves the epidermis and portions of the dermis

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22
Q

how are second degree burns characterized?

A

superficial or deep

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23
Q

third degree burns

A

full thickness - extends through and destroy all layers of the dermis and often injure the underlying subcutaneous tissue.

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24
Q

fourth degree

A

deep burn injury - extends into underlying soft tissue and can involve muscle and or bone

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25
Q

the classification by depth(new) did what?

A

extends into subcutaneous soft tissue
involves vessels, nerves, muscles, bones, and joints

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26
Q

what is the healing time for superficial /first degree burns

A

3-6 days

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27
Q

what is the healing time for superficial partial thickness /second degree burns

A

7-21 days

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28
Q

what is the healing time for deep partial thickness /third degree burns

A

> 21 days; surgical treatment

29
Q

what is the healing time for full thickness /fourth degree burns

A

rare unless surgically treated

30
Q

what is the healing time for deeper injury /fourth degree burns

A

never; unless surgically treated

31
Q

what is the appearance of deep partial thick depth burns?

A

blisters; blanching with pressure may be sluggish

32
Q

what is the assessment of burns

A

can progress and convert into deeper wounds over several days

thin skin sustains deeper burn injuries that may be initially apparent

33
Q

what are some areas that may sustain deeper burn injuries

A

volar surfaces of the forearms
medial thighs
perineum
ears

34
Q

how are burns assessed?

A

at percentage of total body surface area affected

35
Q

are superficial burns are not accounted for in percentage?

A

no

36
Q

oral burns

A

hot liquids or foods
inhalation of hot vapors or liquids
holding flammable /corrosive objects in the mouth
minor burns on the lips
oral commissure
oral mucosa

37
Q

what are examples of oral burns from hot liquids or solids

A

tea, cheese, potatoes, noodles, spicy foods, coffee

38
Q

what is treatment for minor burns on lips

A

vasline
topical antibiotic ointment

39
Q

what should be avoided for burns to the oral mucosa

A

pH changes in the mouth

40
Q

what development should we look for in burns to the oral mucosa?

A

microstomia

41
Q

what are the basic steps of burn management

A

removal of clothing, debris
cooling
cleansing
dressing
pain management
tetanus prophylaxis
close follow up

42
Q

what is the difference between acute vs chronic wounds: time

A

acute = short
chronic = not healed @ 6 weeks

43
Q

what is the difference between acute vs chronic wounds: neutrophil, elastase, MMP levels

A

acute = low
chronic = high (bacterial infection)

44
Q

classification of wounds

A

open vs closed

45
Q

what are the characteristics of open vs closed

A

penetrating vs non penetrating
mechanism

46
Q

what is the appearance of an open wound

A

deep layers and tissues are exposed

47
Q

what is the appearance of a closed wound

A

superficial layer of the body remains intact

48
Q

what are the types of wounds based on

A

mode of entry

49
Q

abrasion

A

grazing injury
scrapping off the superficial layer

50
Q

incision

A

caused by a sharp-edged structure

margin is straight

51
Q

laceration

A

caused by blunt object
margin is irregular

52
Q

stab/puncture/penetration

A

caused by sharp, pointed object-directed perpendicular to skin

margin of the wound has split ends (fish tail)

53
Q

amputation

A

caused by force opposite direction

54
Q

how many stages of open wounds are there

A

4

55
Q

stage 1 open wound

A

burn
superficial
skin is intact

56
Q

stage 2 open wound

A

open wound
superficial laceration/puncture

epidermis with dermis

57
Q

stage 3 open wound

A

open wound/deep

full thickness

all layers involved (inc. subcutaneous layer)

58
Q

stage 4 open wound

A

open wound; deep lacerations
burn; full thickness

all layers down to muscle, bone, and tendon

59
Q

Phases of normal wound healing

A

coagulation
inflammatory
proliferative/granulation tissue formation
remodeling

60
Q

remodeling phase

A

fibroblast proliferation
matrix formation
apoptosis of fibrobastic cells
formation for acellular scar tissue

61
Q

what is needed for fibroblast proliferation

A

VEGF

62
Q

What is produces in matrix formation during the remodeling phase

A

collagen III, fibrin, fibronectin, hyaluronic acid

63
Q

when does the proliferative phase occur

A

2-3 days after injury

64
Q

what induces and maintains cellular proliferation

A

inflammatory cells (leukocytes, neutrophils, macrophages)

65
Q

what is produced in the proliferative phase needed for the remodeling phase

A

VEGF, FGF-2, PDGF

66
Q

what does PDGF trigger

A

formation of granulation tissue
intial epethialization
angiogenic induction - endo progenitor cells

67
Q

when does the inflammatory phase occur

A

hours after injury
PGDF, TGF A1, TGF A2 attract leukocytes, neutrophils, and macrophages

68
Q
A

Integument (6 decks)

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