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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
Depth of burns(5)
``` Superficial (epidermal) superficial partial-thickness Deep partial-thickness Full-thickness Subdermal ```
26
What layer is affected with a superficial burn?
cell damage only to the epidermis | **best example--simple sunburn
27
How does the skin appear with superficial burns?
Red (erythematous)
28
T/F Superficial burn results in epidermal damage and dermal irritation?
TRUE | no injury to the dermis
29
T/F Blisters are present in superficial burns?
FALSE
30
How long does it take for the damaged epithelial to peel off?
3-4 days
31
What happens in superficial partial-thickness burns?
Damage occur into the papillary dermis | *epidermis is destroyed completely
32
T/F There is an intact blister in a superficial partial thickness burn?
True
33
T/F superficial partial thickness burns are blanchable?
TRUE
34
_______ may be present in superficial partial thickness burns
Edema
35
Why are superficial partial thickness burns painful?
nerve ending irritation | sensitive to temp changes, light touch, and exposed air
36
How long does it take for complete healing to occur in superficial partial thickness burns?
7-10 days | *minimal scarring, skin color may change
37
What tissue is affected in deep partial thickness burns occur?
Damage extends through papillary dermis into the reticular dermis
38
What is damaged in a deep partial thickness burn?
most nerve endings, hair follicles, and sweat ducts will be injured
39
what color do deep partial thickness burns appear as?
mixed red and way white color | deeper the burn, the more white color, tissue ischemia
40
What kind of fluid leaks from the are of partial thickness burns?
Plasma
41
T/F the pt will have diminished sensation to light touch and sharp/dull discrimination? In a deep partial thickness burn
True- retain the ability to feel deep pressure
42
What tissue is affected in a full-thickness burn?
Epidermal/dermal tissues completely destroyed | *subcutaneous fat may also be damaged
43
Typically _________ due to vessel damage
non-blanchable
44
What color are full thickness burns?
deep red color of tissues results from hemoglobin fixation from destroyed RBC
45
What is destroyed in full-thickness burns?
Hair follicles | Nerve endings
46
T/F Eschar doesn't have elastic in full-thickness burns
True
47
What happens when the pressure occludes blood flow to the more distal areas?
Escharotomy may be necessary
48
What is escharotomy?
Procedure involving a midline, lateral incision of the eschar the length of the involved area to relieve pressure on underlying structures
49
If an escharotomy is successful what do you normally see?
Immediate improvement in distal blood flow - pulse - skin perfusion - Temp of distal tissues
50
What happens in a subdermal burn?
complete destruction of all tissue from the epidermis down and through the subcutaneous tissue
51
T/F Muscle and bones are subject to necrosis in subnormal burns?
True
52
What kind of burns to electrical burns generally produce?
Subdermal burns | *current moves through your body, the chemical or fire is not actually on your skin
53
What is the Rule of Nines?
Helps determine and quantify the severity of involved area | Divides the body surface into areas of 9%, or multiple of 9%
54
What is the extent of burns-hand method?
``` Patients hand (including fingers) is ~1% of their total body surface (TBSA) -Useful for smaller scattered burns ```
55
What are 4 different types of burns?
Thermal Electrical Chemical Ultraviolet/ionizing radiation
56
How do thermal burns happen?
Conduction or convection contacting the skin | hot object, liquid, chemical, flame or steam
57
What does the severity of a thermal burn depend on?
Location, temp of course, and duration of contact
58
How does an electrical burn happen?
Caused by exposure to low or high voltage current
59
What is damaged with electrical burns?
damage to subcutaneous tissue damage at contact points
60
T/F electrical burns have a high incidence of amputation
TRUE
61
What does electrical damage depend on?
Duration of contact with the source Voltage of the source Type and pathway of current Amperage and resistance through the body
62
How does a chemical burn occur?
Results of reduction, oxidation, corrosion or desecration of body tissue with or without an associated thermal injury
63
Chemical burns significantly alter _______ and _______
systemic tissue pH and metabolism
64
Severity of chemical burns depends on?
Type of concentration of the chemical Duration of contact Mechanism of action
65
What kind of pulmonary and metabolic complications can chemical burns cause?
Airway obstruction due to bronchospasm Liver necrosis Renal dysfunction Pulmonary edema
66
How does a UV/radiation burn occur?
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
Severity of UV/radiation burns depend on?
Dose Dose rate Tissue sensitivity of exposed cells

PT 854 Integument (11 decks)

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