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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
the classification by depth(new) did what?
extends into subcutaneous soft tissue involves vessels, nerves, muscles, bones, and joints
26
what is the healing time for superficial /first degree burns
3-6 days
27
what is the healing time for superficial partial thickness /second degree burns
7-21 days
28
what is the healing time for deep partial thickness /third degree burns
>21 days; surgical treatment
29
what is the healing time for full thickness /fourth degree burns
rare unless surgically treated
30
what is the healing time for deeper injury /fourth degree burns
never; unless surgically treated
31
what is the appearance of deep partial thick depth burns?
blisters; blanching with pressure may be sluggish
32
what is the assessment of burns
can progress and convert into deeper wounds over several days thin skin sustains deeper burn injuries that may be initially apparent
33
what are some areas that may sustain deeper burn injuries
volar surfaces of the forearms medial thighs perineum ears
34
how are burns assessed?
at percentage of total body surface area affected
35
are superficial burns are not accounted for in percentage?
no
36
oral burns
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
what are examples of oral burns from hot liquids or solids
tea, cheese, potatoes, noodles, spicy foods, coffee
38
what is treatment for minor burns on lips
vasline topical antibiotic ointment
39
what should be avoided for burns to the oral mucosa
pH changes in the mouth
40
what development should we look for in burns to the oral mucosa?
microstomia
41
what are the basic steps of burn management
removal of clothing, debris cooling cleansing dressing pain management tetanus prophylaxis close follow up
42
what is the difference between acute vs chronic wounds: time
acute = short chronic = not healed @ 6 weeks
43
what is the difference between acute vs chronic wounds: neutrophil, elastase, MMP levels
acute = low chronic = high (bacterial infection)
44
classification of wounds
open vs closed
45
what are the characteristics of open vs closed
penetrating vs non penetrating mechanism
46
what is the appearance of an open wound
deep layers and tissues are exposed
47
what is the appearance of a closed wound
superficial layer of the body remains intact
48
what are the types of wounds based on
mode of entry
49
abrasion
grazing injury scrapping off the superficial layer
50
incision
caused by a sharp-edged structure margin is straight
51
laceration
caused by blunt object margin is irregular
52
stab/puncture/penetration
caused by sharp, pointed object-directed perpendicular to skin margin of the wound has split ends (fish tail)
53
amputation
caused by force opposite direction
54
how many stages of open wounds are there
4
55
stage 1 open wound
burn superficial skin is intact
56
stage 2 open wound
open wound superficial laceration/puncture epidermis with dermis
57
stage 3 open wound
open wound/deep full thickness all layers involved (inc. subcutaneous layer)
58
stage 4 open wound
open wound; deep lacerations burn; full thickness all layers down to muscle, bone, and tendon
59
Phases of normal wound healing
coagulation inflammatory proliferative/granulation tissue formation remodeling
60
remodeling phase
fibroblast proliferation matrix formation apoptosis of fibrobastic cells formation for acellular scar tissue
61
what is needed for fibroblast proliferation
VEGF
62
What is produces in matrix formation during the remodeling phase
collagen III, fibrin, fibronectin, hyaluronic acid
63
when does the proliferative phase occur
2-3 days after injury
64
what induces and maintains cellular proliferation
inflammatory cells (leukocytes, neutrophils, macrophages)
65
what is produced in the proliferative phase needed for the remodeling phase
VEGF, FGF-2, PDGF
66
what does PDGF trigger
formation of granulation tissue intial epethialization angiogenic induction - endo progenitor cells
67
when does the inflammatory phase occur
hours after injury PGDF, TGF A1, TGF A2 attract leukocytes, neutrophils, and macrophages
68

Integument (6 decks)

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