Burns and skin conditions

Question 1

Keratin and sebum perform what function in skin?

Answer 1

Both prevent loss of fluid, keratin also prevents external fluid from entering.

Question 2

What part of the skin protects blood vessels and nerves?

Answer 2

The dermis (made of collagen)

Question 3

What does melanin protect us from?

Answer 3

UV rays.

Question 4

How does skin protect us from bacteria?

Answer 4

Sebum is acidic/antimicrobal, hair keeps microbes at a distance.

Question 5

How does skin help to control body temp?

Answer 5

By sweating to cool us off, by vasodilation to warm us, and hair for insulation.

Question 6

Vitamin D is synthesized in the skin via sunlight, why is this important?

Answer 6

For production of calcium and potassium which in turn promote normal bone formation.

Question 7

How does skin protect us from noxious stimulai?

Answer 7

It contains various sensory nerve endings.

Question 8

What are the functions of skin? (7)

Answer 8

Prevention of fluid loss/absorption
Protects nerves and BV
Protects from UV rays
Protects from bacteria
Regulates body temp
Produces vit D 
Senses noxious stimuli

Question 9

What are the layers of the skin superficial to deep?(3)

Answer 9

Epidermis
Dermis
Subcutaneous (fatty) tissue

Question 10

Layers of the epidermis?(5)

Answer 10

Stratum 
"         " corneum
"         " lucidum
"         " granulosum
"         " spinosum
"         " basale

Question 11

Layers of the dermis?

Answer 11

Papilary (sup)

Reticular (deep)

Question 12

What is the reticular layer of the dermis made of? What is its function?

Answer 12

Collagen fibers, provides str, extensibility, and elasticity (protection)

Question 13

What are the 4 classifications of burns?

Answer 13

1. Superficial (used to be 1st degree)
   - affect only the epidermis (sunburn)
2. Superficial partial thickness (2nd degree)
   - Destroy the epidermis and part of the papilary dermis. (Blisters)
3. Deep partial thickness (3rd degree)
   - Damage the dermis as far down as the reticular layer. (some hair folicles remain intact)*
4. Full thickness (4th degree)
   - Destroy both epidermis and dermis and often underlying layers of fat. (have eschar) no haifolicles or nerve endings.

Question 14

What is the difference between a keliod and a hypertrophic scar?

Answer 14

Keloid scars extend beyond the margins of the wound.

Question 15

Rule of 9s?

Answer 15

Head=9% (4.5 ant/post)
UE=9% (4.5 ant/post)
LE=18% ((9% each)
Ant/post trunk 18% each

Children
Head=18%
Legs=13% each

Question 16

Burn complications?

Answer 16

Infection
smoke inhalation
Chemicals, 
Pneumonia (usually secondary to smoke inhalation)
Hypothermia
Scarring (loss of Fx)

Question 17

PT interventions for burns?

Answer 17

Debridement (by PT)
Skin grafts (we need to understand 48-72 hrs dnd)

Question 18

What are the 3 sources of a skin graft?

Answer 18

autograft-self (can be harvesed or grown)
allograft-another human
xenograft-animal

Question 19

What are the types of autogtafts?

Answer 19

Split thickness-Does not remove skin below the dermis.
Full thickness-Goes all the way through the dermis
Sheet graft-fenestrated (cut like a mesh)

Question 20

Inosculation?

Answer 20

The process of capillaries penetrating a graft

Question 21

What are he sensory nerve endings in the skin?

Answer 21

Free nerve endings (dermis and epidermis)
ruffini corpuscles (close to hair follicles in the dermis).
ruffini endo organs (dermis)
Pacinian corpuscles(deep layers of dermis)
Kraus end bulb (superficial dermis)
Merkel’s endings (dermis)

Question 22

Where are free nerve endings? What do they sense?

Answer 22

Dermis and epidermis. Pain and itching, finger and toe disc.

Question 23

Where are ruffini corpuscles? What do they sense?

Answer 23

Close to hair folicles (dermis). Pressure.

Question 24

Where are ruffini end organs? What do they sense?

Answer 24

Dermis. Warmth.

Question 25

Where are pacinian corpuscles? What do they sense?

Answer 25

Deep dermis. Vibration.

Question 26

Where are Krause end bulbs? What do they sense?

Answer 26

Superficial dermis. Cold.

Question 27

Where are Merkel’s endings? What do they sense?

Answer 27

Dermis. Touch.