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semester 2 year 2 week 9-16 > burns and HCAI > Flashcards

burns and HCAI Flashcards

1
Q

Most common cause in burn

A

cutaneous thermal burns

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2
Q

acidic chemical burn

A

coagulative necrosis

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3
Q

alkaline chemical burn

A

liquefactive necrosis

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4
Q

types of inhalation injury

A

smoke: pharynx
sting: epiglottis
chemical: further airway

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5
Q

radiation burn

A

photo-energy and DNA damage

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6
Q

non-accidental burn

A

abuse

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7
Q

factors determining burn tissue response

A
  1. degree of temp elevation
  2. rate of temperature change
  3. duration of contact
  4. thickness of skin
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8
Q

degree of burn

A
  1. superficial epidermal
  2. superficial dermal
  3. deep dermal
  4. full thickness
  5. 4th degree burn
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9
Q

would you see nay lister in full thickness burn?

A

No

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10
Q

which burn will destroy blood vessel and not blanch?

A

deep dermal and full thickness

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11
Q

which burn will have anaesthesia or hypo- anaesthesia?

A

deep dermal and full thickness

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12
Q

Jackson burn wound model 3 zones?

A
  1. zone of coagulation
  2. zone of stasis
  3. zone of hyperaemia
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13
Q

what level of burn will only have regeneration not repair?

A

only superficial epidermal

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14
Q

stages of wound healing?

A
  1. haemostats
  2. finalisation
    3, repair( reepithelilizatoin, angiogenesis, firbogenesis)
  3. remodelling( vessel regression dan collagen deposition)
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15
Q

superficial epidermal

A

no blister, pain, dry, red, blanchable, no necrosis,no scarring +/- inflammation, vasodilation, oedema

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16
Q

superficial dermal

A

blisters, pain, red, sweeping blanch able, exudate and necrosis

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17
Q

deep dermal

A

blister, no blanching, minimal pain

18
Q

full thickness

A

loss of cells structure, eschar on granulation tissue, anaesthesia

19
Q

4th degree

A

fasciae, muscle and bone affected

20
Q

complication of wound healing

A 
wound dehiscence and ulceration ( deficient scar)
excessive repair( keloids, exuberant granulation, proud flesh)
infection and sepsis, contracture
21
Q

when will wound contraction happen

A

within 6 wk

22
Q

what hormones increased after burn

A

cortisol, glucagon, glucose

23
Q

what decreased in burn

A

immune response, myocardial contractility, Na, electrolytes albumin, muscle mass

24
Q

common causes of burn in adults and kids

A

kids: Scald>contact>flame
adults: scald>flame>contact

25
Q

common place of burn

A

home for both adults and kids( then work place and outdoor)

26
Q

CVS responses to burn

A

capillary permeability increased –> loss of intravascular proteins and fluid into intersitium

27
Q

resp responses to burn

A

bronchoconstriction

severe burns can cause rep distress syndrome

28
Q

what happens after burn

A

systemic responsive to burn: release of cytokines or inflammatory mediators at site of injury

29
Q

metabolic response to burn

A

BMR increased by 3X
increased glucose turnover –>hyperglycemia
increase catabolic hormone; adrenaline, cortisol, glucagon
- increased rate of gluconeogensis, glyocgenolysis and muscle proteolysis
- temp set point raised
increased protein turnover and synthesis
metabolic acidosis: loss of water causing PH imbalance

30
Q

immunologic response to burn

A

down regulation of immune response

31
Q

SIRS if burn>20% TBSA causing

A 
bronchconstriction
increased cap permeability
reduced immune response
increased BMR
peripheral and splanchnic vasoconstrction( hypoperfusion)
32
Q

inhalational injury

A 
increase mortality
- above larynx( inhale hot gases or steam)
- onset 4-24hr
below larynx
- chemical burn 
- immediate to 5d
systemic intoxication 
- systemic absorptio nof CO, HCN
33
Q

how to treat hypermetabolic response

A

propranolol

oxandrolone

34
Q

where does epidermal keratinocytes regeneration from

A 
skin appendages ( hair sheath cell, bulge stem cells, basaloid cells of sebaceous glands)
- speed of regeneration of depend on depth of injury
35
Q

risk factors for hypertrophic scar

A 
>2-3wk healing time
depth of burn
time to heal
genetics/ skin types
- mixed depth burns
so need grafting
36
Q

how to treat burn

A

epidermal: moisture
superficial dermal: dressing
deep dermal and full thickness: surgery and grafting

37
Q

features of superficial dermal burn

A
  1. necrosis confined to upper 1/3 of dermis
  2. zone of necrosis lifted off viable wound by edema
  3. small zone of injury
38
Q

features of mid dermal burn

A
  1. necrosis to mid dermis
  2. large zones of injury
  3. eschar separated from viable tissue by edema layer
39
Q

features of deep dermal burn

A
  1. necrosis involving majority of skin layers
  2. zone of necrosis adherent to zone of injury
  3. smaller edema layer
40
Q

full thickness burn features

A

no remaining viable dermis

41
Q

how to assess burn severity

A
  1. wallace rule of nines
  2. Lund and Browder chart
  3. palm= 1% TBSA

semester 2 year 2 week 9-16 (11 decks)

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