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PT 854 Integument > Burns-Test 2 > Flashcards

Burns-Test 2 Flashcards

1
Q

How many burn injuries require medical treatment in the US each year?

A

450,000-500,000

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2
Q

Who is at the highest risk for burns?

A

Industrial workers

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3
Q

What is the pathophysiology of a burn?

A

Body absorbs the energy from a heat source
Which then results in tissue coagulation
Coagulation of tissue is depicted in zones

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4
Q

What are the different zones correlated with burns?

A

Zone of coagulation (highest pressure in the middle)
Zone of stasis
Zone of hyperemia

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5
Q

What occurs in the zone of coagulation?

A
  • Located in the center of the burn

- Tissue is irreversibly damaged (may require skin grafts to heal)

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6
Q

Which zone does the greatest amount of damage occur?

A

Zone of coagulation

*could be equivalent to a full thickness burn

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7
Q

What is the tissue called that is nonviable in the zone of coagulation?

A

Eschar

dead cells on top

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8
Q

T/F Zone of coagulation does not have a high risk of infection?

A

FALSE

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9
Q

T/F specialized burn center care is likely required?

A

TRUE

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10
Q

What is eschar?

A

Devitalized tissue consisting of plasma and necrotic cells

Constrictive (shrinks in on itself)

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11
Q

What does eschar feel like?

A

Dry, leathery, and rigid

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12
Q

What color is eschar?

A

Vary from black to deep red to white

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13
Q

What does white eschar indicate?

A

total ischemia of that area (basically just dead cells sitting on top)
*this will depend on the severity of the burn

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14
Q

Does the healing process change with eschar?

A

Yes, it may be slowed, or may prevent, progression through the normal phases of healing

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15
Q

Where is the zone of stasis found?

A

surrounds the zone of coagulation

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16
Q

T/F is the tissue viable in zone of stasis?

A

True

Marginally viable tissue

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17
Q

What are three other ways that tissue can be further damaged in the zone of stasis?

A

Edema
Infection
Hypoperfusion

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18
Q

Without treatment injured cells in the zone of stasis may die within _______ hours from injury

A

24-48

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19
Q

T/F Pressure from dressings, splints, or compression badges can compromise/kill involved tissue?

A

TRUE

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20
Q

Where is the zone of hyperemia located?

A

outermost area of the burn (least amount of damage)

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21
Q

T/F it takes a long time for the zone of hyperemia to heal?

A

False
*generally heals rapidly unless additional tissue injury occurs or patient has other co-morbidities that will delay normal wound healing

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22
Q

1st degree=?

A

superficial (epidermal) burn

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23
Q

2nd degree=?

A

both partial-thickness burns

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24
Q

3rd degree=?

A

full-thickness and subnormal burns

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25
Q

Depth of burns(5)

A 
Superficial (epidermal)
superficial partial-thickness
Deep partial-thickness
Full-thickness
Subdermal
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26
Q

What layer is affected with a superficial burn?

A

cell damage only to the epidermis

**best example–simple sunburn

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27
Q

How does the skin appear with superficial burns?

A

Red (erythematous)

28
Q

T/F Superficial burn results in epidermal damage and dermal irritation?

A

TRUE

no injury to the dermis

29
Q

T/F Blisters are present in superficial burns?

A

FALSE

30
Q

How long does it take for the damaged epithelial to peel off?

A

3-4 days

31
Q

What happens in superficial partial-thickness burns?

A

Damage occur into the papillary dermis

*epidermis is destroyed completely

32
Q

T/F There is an intact blister in a superficial partial thickness burn?

A

True

33
Q

T/F superficial partial thickness burns are blanchable?

A

TRUE

34
Q

_______ may be present in superficial partial thickness burns

A

Edema

35
Q

Why are superficial partial thickness burns painful?

A

nerve ending irritation

sensitive to temp changes, light touch, and exposed air

36
Q

How long does it take for complete healing to occur in superficial partial thickness burns?

A

7-10 days

*minimal scarring, skin color may change

37
Q

What tissue is affected in deep partial thickness burns occur?

A

Damage extends through papillary dermis into the reticular dermis

38
Q

What is damaged in a deep partial thickness burn?

A

most nerve endings, hair follicles, and sweat ducts will be injured

39
Q

what color do deep partial thickness burns appear as?

A

mixed red and way white color

deeper the burn, the more white color, tissue ischemia

40
Q

What kind of fluid leaks from the are of partial thickness burns?

A

Plasma

41
Q

T/F the pt will have diminished sensation to light touch and sharp/dull discrimination? In a deep partial thickness burn

A

True- retain the ability to feel deep pressure

42
Q

What tissue is affected in a full-thickness burn?

A

Epidermal/dermal tissues completely destroyed

*subcutaneous fat may also be damaged

43
Q

Typically _________ due to vessel damage

A

non-blanchable

44
Q

What color are full thickness burns?

A

deep red color of tissues results from hemoglobin fixation from destroyed RBC

45
Q

What is destroyed in full-thickness burns?

A

Hair follicles

Nerve endings

46
Q

T/F Eschar doesn’t have elastic in full-thickness burns

A

True

47
Q

What happens when the pressure occludes blood flow to the more distal areas?

A

Escharotomy may be necessary

48
Q

What is escharotomy?

A

Procedure involving a midline, lateral incision of the eschar the length of the involved area to relieve pressure on underlying structures

49
Q

If an escharotomy is successful what do you normally see?

A

Immediate improvement in distal blood flow

  • pulse
  • skin perfusion
  • Temp of distal tissues
50
Q

What happens in a subdermal burn?

A

complete destruction of all tissue from the epidermis down and through the subcutaneous tissue

51
Q

T/F Muscle and bones are subject to necrosis in subnormal burns?

A

True

52
Q

What kind of burns to electrical burns generally produce?

A

Subdermal burns

*current moves through your body, the chemical or fire is not actually on your skin

53
Q

What is the Rule of Nines?

A

Helps determine and quantify the severity of involved area

Divides the body surface into areas of 9%, or multiple of 9%

54
Q

What is the extent of burns-hand method?

A 
Patients hand (including fingers) is ~1% of their total body surface (TBSA)
-Useful for smaller scattered burns
55
Q

What are 4 different types of burns?

A

Thermal
Electrical
Chemical
Ultraviolet/ionizing radiation

56
Q

How do thermal burns happen?

A

Conduction or convection contacting the skin

hot object, liquid, chemical, flame or steam

57
Q

What does the severity of a thermal burn depend on?

A

Location, temp of course, and duration of contact

58
Q

How does an electrical burn happen?

A

Caused by exposure to low or high voltage current

59
Q

What is damaged with electrical burns?

A

damage to subcutaneous tissue damage at contact points

60
Q

T/F electrical burns have a high incidence of amputation

A

TRUE

61
Q

What does electrical damage depend on?

A

Duration of contact with the source
Voltage of the source
Type and pathway of current
Amperage and resistance through the body

62
Q

How does a chemical burn occur?

A

Results of reduction, oxidation, corrosion or desecration of body tissue with or without an associated thermal injury

63
Q

Chemical burns significantly alter _______ and _______

A

systemic tissue pH and metabolism

64
Q

Severity of chemical burns depends on?

A

Type of concentration of the chemical
Duration of contact
Mechanism of action

65
Q

What kind of pulmonary and metabolic complications can chemical burns cause?

A

Airway obstruction due to bronchospasm
Liver necrosis
Renal dysfunction
Pulmonary edema

66
Q

How does a UV/radiation burn occur?

A

ionizing radiation burn with or without thermal injury occur when electromagnetic or particulate radiation energy is transferred to body tissue, resulting in the formation of chemical free radicals

67
Q

Severity of UV/radiation burns depend on?

A

Dose
Dose rate
Tissue sensitivity of exposed cells

PT 854 Integument (11 decks)

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