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BIOSCIENCE II FROM JOSH N > deck_1548001 > Flashcards

deck_1548001 Flashcards

1
Q

Burns: Burns are acute wounds caused by a single, non-reoccuring insult to the skin or other organic tissue that is primarily caused by acute exposure to ____, _____, ____, ____, or _____

A

heat cold chemicals electricity radiation

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2
Q

what are the funtions of the skin

A

protection form infection injury Prevention of loss of body fluids Regulation of bdy temp Sensory with enviroment

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3
Q

Burns: what are the 6 types of burns

A

Thermal Cold exposure Chemical electrical Inhalation Radiation

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4
Q

Burns: Thermal are associated with what?

A

Steam flames hot liquids hot solid objects

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5
Q

Burns: Thermal Depth of thermal burn is related to what?

A

Temperature duration thickness of skin involved

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6
Q

Burns: Cold also called what

A

frost bite

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7
Q

Burns: Cold occurs when intracellular fluids freeze and the resulting ____ ____ puncture celss or when extracellular fluids freeze and create a hypotonic enviroment

A

ice crystals

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8
Q

Burns: Cold result in tissue hypoxia through the interruption of ____ ____, ____, and ______ _____

A

blood flow hemoconcentration intravascular thrombosis

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9
Q

Burns: Chemical tissue disruption results form a wide range of chemical reations such as what 3 main causes

A
  • Alteraion in PH
  • Disruption of cellular membranes
  • Direct toxic effects on metabolic processes
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10
Q

Burns: Electrical electrical current passes through the body and is transformed into _____ energy as it passes through the poorly conductive tissues of the body

A

thermal

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11
Q

Burns: Electrical electropration occurs!!! what the fuck is that?

A

damage to cell membranes that disrupt membrane potential and function

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12
Q

Burns: Electrical Severity of burn depends on the pathway of _______, the ____ of tissues to electrical current flow, and the ____ and ____ of the electrical flow

A

electrical current resistance strength and duration

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13
Q

Burns: Inhalation toxic chemicals produced in fires can injure the lower airways and cause a ______ burn

A

chemical

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14
Q

Burns: Inhalation how smoke usually only burns the what

A

pharynx

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15
Q

Burns: Inhalation stream can cause injury where?

A

below the glottis

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16
Q

Burns: Inhalation carbon monoxide produced from combustion can inpair cellular what?

A 
	respiration
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17
Q

Burns: Radiation ____ frequency and ______ energy can disrupt and destroy tissues

A

Radio ionizing

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18
Q

Burns: Radiation what is the most common type of radiation burn?

A 
	sunburn
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19
Q

Burns: Radiation depending on the photon, radiation burns can cause very deep ____ burns

A

internal

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20
Q

Burns: Radiation radiation burns are associated w/ what b/c of their ability to interact w/ and damage DNA

A

Cancer

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21
Q

Burns: Radiation _______is dependent on dose, _____ of exposure, and ____ of particle

A

Severity time type

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22
Q

Burns: Assessment what are the 5 things you want to assess with burns?

A

Depth Extent Location Pt’s age Pt’s comorbidities

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23
Q

Skin: Anatomy what are the layers of the skin (top down )

A

Epidermis Dermis Sub Q fat Muscle

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24
Q

Skin: Anatomy what are the 5 layers of the epidermis( top down)

A

Stratum corneum Stratum lucidum Stratum granulosum Stratum spinosum Stratum Basale ( cute latin girls suck balls)

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25
Q

Skin: Anatomy what is contained in the dermis

A

Hair follicle Sweat glands

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26
Q

Skin: Anatomy what is contained in the Sub Q

A

Sub q artery Sub Q Vein

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27
Q

Burns: Degrees Define 1st degree

A

superficial burn limited to epidermis (AKA sunburn Basic)

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28
Q

Burns: Degrees what is a superficial 2nd degree burn

A

Involves epidermis and superficial layers of dermis (usually a blister)

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29
Q

Burns: Degrees what is a DEEP 2nd degree burn

A

Involves epidermis and most of dermis

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30
Q

Burns: Degrees what is a third degree burn?

A

full thicknness burn Involves epidermis all layers of dermis and sub q

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31
Q

Burns: Degrees what is a 4th degree burn

A

full thickness burn extends down to muscle and/ or bone

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32
Q

Burns: 1st degree depth

A

Epidermis

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33
Q 
	Burns: 1st degree	appearance
A 
	dry	red	blanches
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34
Q

Burns: 1st degree sensations

A

painful

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35
Q

Burns: 1st degree outcome

A

heals spontaneously

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36
Q

Burns: partial thickness 2nd degree superficial depth

A

epidermis and superficial dermis

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37
Q

Burns: partial thickness 2nd degree superficial appearance

A

blisters moist red weeping blanches

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38
Q

Burns: partial thickness 2nd degree superficial sensation

A

painful to air and temp

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39
Q

Burns: partial thickness 2nd degree superficial outcomes

A

heals spont

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40
Q

Burns: partial thickness 2nd degree Deep depth

A

Epidermis deep dermis

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41
Q

Burns: partial thickness 2nd degree Deep appearance

A

blisters wet/waxy patchy to cheesy white to red DOES NOT BLANCH

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42
Q

Burns: partial thickness 2nd degree Deep sensation

A

pain to pressure only

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43
Q

Burns: partial thickness 2nd degree Deep outcomes

A

requires excision and usually grafting

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44
Q

Burns: Full thickness 3rd depth

A

destruction of epidermis and dermis

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45
Q

Burns: Full thickness 3rd appearance

A

waxy white leathery gray/ charred/ black dry inelastic DOES NOT BLANCH

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46
Q

Burns: Full thickness 3rd Sensation

A

deep pressure only

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47
Q

Burns: Full thickness 3rd outcome

A

complete excision limited function

48
Q

Burns: Full thickness 4th Depth

A

muscle fascia bone

49
Q

Burns: Full thickness 4th appearance

A

waxy white leathery gray/ charred/ black dry inelastic DOES NOT BLANC

50
Q

Burns: Full thickness 4th sensation

A

deep pressure only

51
Q

Burns: Full thickness 4th outcome

A

complete excision limited function

52
Q

Burns: what burns are partial thickness?

A

2nd superficial 2nd deep

53
Q

Burns: what burns are full thickness

A

3rd 4th

54
Q

Burns: the extent of the burn s expressed in what?

A

TBSA (total body surface area)

55
Q

Burns: the ___ ___ ___ is commonly used to estamiate the burn injury in adults

A

rule of nines

56
Q

Burns: the ____-____ chart is reccomended for estimates in pediatric population

A

lund-Browder

57
Q

Burns: what method may be used to assess irregular and patchy burn injuries

A

The palm method

58
Q

Burns: name the rule of nines

A

head- 4.5 and 4.5 =9 chest and abd 18 Back 18 Right arm 4.5 and 4.5 =9 Left arm 4.5 and 4.5 = 9 right leg 9 and 9=18 left leg 9 and 9 =18 no no area = 1%

59
Q

rule of nine pic

A
60
Q

Lund-browder chart picture

A
61
Q

Burns: what is the palm of hand estimation

A

the palm of the PATIENTS hand represents 0.5% of TBSA the palm of thr PATIENTS hand including the fingers is 1% of TBSA

62
Q

Palm of hands estimation pic

A
63
Q

Location of injury and complications: facial and chest burns may indicate possible damage to what?

A

respiratory system

64
Q

Location of injury and complications: 3rd and 4th degree burns on neck, chest, and abd, could restrict what efforts

A

respiratory

65
Q

Location of injury and complications: circumferential burns can restrict what and compress neurovascular bundles

A

blood flow

66
Q

Location of injury and complications: burns on what can restrict range of motion

A

Joints

67
Q

Burn Injury and age of Pt: children and elderly tend to have ____ skin

A

thinner

68
Q

Burn Injury and age of Pt: higher motolity in what poopulation due to deeper and more severe burns

A

children and elderly

69
Q

Burn injury grading system: what are the 3 classes

A

minor Moderate Major

70
Q

Burn injury grading system: what is the criteria for MINOR burns in adult Peds Full thickness

A
71
Q

Burn injury grading system: what is the criteria for Moderate burns in adults peds full thickness

A

10-20% 5-10% 2-5%

72
Q

Burn injury grading system: what is the criteria for Major burns adult peds Fullthickness

A

> 20% >10% >5%

73
Q

Patho of burn injury: what is the patho of a burn?

A

Acute burn injury Inflammatory mediators released increased capillary permeability extravasation of fluids into burned tissue tissue edema

74
Q

Mediators of burns: what are local mediators released

A

Histamine Prostaglandins Bradykinin Nitric oxide Seratonin Substance P

75
Q

Mediators of burns: what are systemic mediators released

A

Cytokins Endotoxins Nitric oxide

76
Q

Mediators of burns: what is the systemic response of the body from all the mediators released from a burn injurt

A

immune supression hypermetabolism Protein catabolism Sepsis Multiple organ system failure

77
Q

what are the 2 main phases of a burn

A

burn shock Hypermetabolic phase

78
Q

Hypermetabolic phase of a burn: CO and HR can increase up to how much?

A

150-300%

79
Q

Effects of burns: Cardiac what are early effects

A

hypovolemia myocardial depression

80
Q

Effects of burns: Cardiac late effects

A

systemic HTN tachycardia Increased CO

81
Q

Effects of burns: PULMONARY early effects

A

Upper airway obstruction Airway damage (laryngospasms) Chemical pneumonitis Pulmonary edema

82
Q

Effects of burns: PULMONARY late effects

A

restriction of chest wall Oxygen toxicity barotrauma Infections Laryngeal damage Tracheal strictures

83
Q

Effects of burns: Electrolytes/ renal early efefcts

A

Decreased renal blood flow (hypovolemia) Myoglobinuria Hyperkalemia Oliguria/anuria

84
Q

Effects of burns: Electrolytes/ renal late effects

A

Increased renal blood flow varible drug clearance Hypokalemia (diuresis)

85
Q

Effects of burns: Endocrine and GI effects GI response

A

Adynamic ileus Stress ulcers Impaired GI barrier to bacteria Endotoxemia

86
Q

Effects of burns: Endocrine and GI effects Endocrine response

A

Increased serum NE Hyperglycemia

87
Q

Effects of burns:Hemotology early effects

A

Activation of thrombotic and fibrinolytic factors hemoconcentration hemolysis

88
Q

Effects of burns:Hemotology late effects

A

Anemia Thrombocytopenia

89
Q

Effects of burns: Thermoregulation Fxns of the skin such as what are diminished or obliterated

A

Vasoactivity Sweating piloerection insulation

90
Q

Effects of burns: Thermoregulation hypermetabolic phase of burn injury results in what

A

* increased skin and core temp

91
Q

Effects of burns: Thermoregulation what does GA do to the hypermetabolic response

A

Depresses vasoconstriction and metabolism results in rapid decrease in body temp

92
Q

Effects of burns: Immunologic what happens

A

Loss of protective barrier immune system impaired Burn eschar- ideal medium for bacterial growth Macrophage activity in alveoli is impaired

93
Q

Fluid resuscitation: fluid resuscitation should be titrated to maintain a UOP if ___-__ ml/kg/hr in adults and ___-___ mL/kg/hr for peds

A

0.5-1 mL/kg/hr -adults 1.0-1.5 mL/kg/hr peds

94
Q

Fluid resuscitation: what is the parkland formula for the 1st 24hrs

A

LR 4 mL/kg x % TBSA

95
Q

Fluid resuscitation: what is teh parkland formula for 2nd 24 hrs

A
  • crystalloids
  • 20-60% esamated plasma volume
  • Colloids
  • to OUP of 30 mL/hr
96
Q

Fluid resuscitation: Capillary leak is a its greatest when

A

1st 24hrs post burn

97
Q

Fluid resuscitation: why is use of colloids contraversial in 1st 24 hrs

A

increased capillary permeability leads to proteins leak into the interstitial space leading to an oncotic effect in extracellular compartment and corsen edema and intravasular hypovolemia

98
Q

Inhalation Injury: patiens often exhibit no signs or symptoms for first ____ hours

A 
	24 hours
99
Q

Inhalation Injury: CO poisoning shifts oxyhemoglobing curve where?

A

left

100
Q

Inhalation Injury: CO poisoning does what to pulse ox readings

A

False high

101
Q

Inhalation Injury: what is the best tx for CO poisoning?

A

100% fio2

102
Q

Inhalation Injury: w/ CO poisoning the use of 100Fio2 decreases the half life of CO from 4-6 hours to what?

A

40-80 min

103
Q

Inhalation Injury: S/S of CO poisoning

A

H/a Nausea Breathlessness Collapse Dizziness LOC (just like a hangover)

104
Q

Debredment and Dressing procedures: sugical debredment is done by what 2 methods

A

Tangential excision Fascial Excision

105
Q

Debredment and Dressing procedures: what is Tangential excision

A

thin slices of eschar are shaved

106
Q

Debredment and Dressing procedures: what is Fascial Excision

A

involves removing the burn eschar and underlying fat to the level of the muscle

107
Q

Debredment and Dressing procedures: massive blood loss of how much

A

10 PRBCs

108
Q

Debredment and Dressing procedures: how to estimate blood loss

A

2-3% of blood loss for each 1% of TBSA

109
Q

Anesthestic management: b/c the facemask may be uncomfortable what is a great way to intubate

A

AFOI

110
Q

Anesthestic management: all fluids should be what?

A

warm

111
Q

Anesthestic management: room temp should be what?

A

28 C 83 F

112
Q

Anesthestic management: what is a great drug for burn pts b/c it wil increase SVR and drcrease heat loss, increase HR and BP

A

Keta-fucking-mine

113
Q

Anesthestic management: what inhalation agaent may be best

A

N2O b/c least depressant effect of CV

114
Q

Anesthestic management: do not use what NMBD

A

SCh

115
Q

Anesthestic management: many burn pt’s may need a __-___ increase in NDMBD

A

2-5%

116
Q 
	that is i guess
A

boo that sucked

BIOSCIENCE II FROM JOSH N (5 decks)

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