FINALS: Burns

Question 1

What are the components of the skin and its appendages?

Answer 1

Hair, nails, sebaceous glands, sweat glands. Skin thickness ranges from 0.5 to 6.0 mm.

Question 2

Name the five layers of the epidermis.

Answer 2

Corneum: Dead cells
Lucedum
Granulosum: Contains keratin
Spinosum: Provides flexibility and strength
Basale: Site of cell division

Question 2

Describe the hypodermis.

Answer 2

Not a true skin layer; composed of fat and connective tissues. It functions in shock absorption.

Question 2

What are the two layers of the dermis and their functions?

Answer 2

Papillary Dermis: Made of loose connective tissue, highly vascularized.
Reticular Dermis: Made of dense connective tissue, provides strength and elasticity.

Question 3

What are the 7 major functions of the skin?

Answer 3

Temperature regulation
Protection
Sensation
Excretion
Immunity
Blood reservoir
Vitamin D synthesis

Question 3

What causes electrical burns, and what factors affect severity?

Answer 3

Caused by exposure to low or high voltage.
Severity factors: Contact duration, voltage, current type/path, and tissue resistance.

Question 3

What are UV burns, and what causes them?

Answer 3

Overexposure to UV radiation, typically from the sun.

Question 3

What is the focus of emergency management in burn care?

Answer 3

Systemic stabilization and burn care to improve survival

Question 3

What are some clinical variations in skin structure?

Answer 3

Men have thicker skin than women.
Young and elderly individuals have thinner skin compared to adults.
Skin thickness varies depending on body location.

Question 3

What are the three burn wound zones?

Answer 3

Zone of Hyperemia: Outermost area; least damage; heals rapidly.
Zone of Stasis: Salvageable tissue; viable but at risk.
Zone of Coagulation: Non-viable tissue; eschar; greatest damage.

Question 3

Describe ionizing radiation burns.

Answer 3

Caused by exposure to electromagnetic or particulate radiation, creating free radicals in tissue.

Question 3

Describe the types of wounds from electrical burns.

Answer 3

Entrance wound: Necrotic, depressed
Exit wound: May be single or multiple
Arc wounds: Occur between joints

Question 4

What immediate physiological effects occur after a burn injury?

Answer 4

Release of vasoactive substances, increased vessel permeability, and cell damage.
Edema from fluid leakage, electrolyte imbalance (low K+, altered Na+ and Cl-), and increased BUN.
Hematologic changes: Increased Hct, RBCs, and WBCs; decreased platelets.
Increased blood viscosity, reduced blood volume, kidney impact, and risk of organ failure.

Question 4

What are the systemic effects of chemical burns?

Answer 4

Alters tissue pH and metabolism, can cause pulmonary and metabolic complications.

Question 4

What causes chemical burns, and what factors determine their severity?

Answer 4

Caused by reduction, oxidation, or corrosion of tissue.
Factors: Type/concentration of the chemical, contact duration, and mechanism of action.

Question 4

Cardiac arrest, arrhythmias, myocardial damage
Headache, seizures, nerve injury, spinal paralysis
Dislocations, fractures, visceral damage, cataracts, hearing issues

Answer 4

Result from conduction/convection (hot objects, liquids, flames). Types:

Scalds: Hot liquid or steam
Flame burns: Open flames
Flash burns: Intense heat exposure
Contact burns: Hot solid objects

Question 4

How do deep partial-thickness (second-degree) burns differ from moderate ones?

Answer 4

Appearance: Pink to pale ivory, dry blisters, slow capillary refill. Healing: 2-3 weeks, often grafted if >3 weeks. Pain: Decreases with depth.

Question 4

What are common complications from electrical burns?

Question 4

What is used to assess the extent of burns, and why is it important?

Answer 4

Total Body Surface Area (TBSA); it’s essential for calculating fluid therapy needs and predicting morbidity.

Question 4

What factors affect the severity of thermal burns?

Answer 4

Location, temperature source, and contact duration.

Question 4

What are signs of inhalation injury?

Answer 4

Altered mental status, burns on the face/neck/chest, singed nasal hair, laryngeal edema, hypoxia, and soot in mouth/sputum.

Question 4

What is the Rule of Nines used for?

Answer 4

Calculating the TBSA affected by burns.

Question 4

What are the characteristics of moderate partial-thickness (second-degree) burns?

Answer 4

Appearance: Pink to red, moist blisters, blanches with capillary refill. Healing: 1-2 weeks. Pain: Very painful.

Question 4

What factors determine the severity of a burn?

Answer 4

The extent and depth of the burn, which influence the severity and guide acute care management.

Question 4

Describe the appearance, healing time, and pain level of superficial (first-degree) burns.

Answer 4

Appearance: Pink to red, may have edema, intact skin. Healing: 3-5 days. Pain: Tender or painful.

Question 5

What are common goals of physical therapy for burn patients?

Answer 5

Improve ROM, manage pain, prevent scar contractures, enhance functional mobility, and promote overall functional outcomes.

Question 5

List key components of systemic stabilization.

Answer 5

Assess inhalation injury & CO poisoning, fluid resuscitation, pain management, and treatment of secondary injuries.

Question 5

: Describe full-thickness (third-/fourth-degree) burns.

Answer 5

Appearance: White, red, brown, or black, dry with possible blisters. Healing: >3 weeks, usually needs surgery. Pain: Insensate.

Question 5

What are some admission guidelines for burn injuries?

Answer 5

Partial-thickness burns >10% TBSA, burns on face/hands/feet/genitalia, 3rd-degree burns, electrical/chemical burns, inhalation injuries, and burns with preexisting conditions.

Question 5

How is body temperature maintained in burn patients?

Answer 5

Use dry dressings, warm environments, radiant heat panels, and warmed IV fluids to prevent hypothermia.

Question 5

What causes inhalation injury and increases its mortality risk?

Answer 5

Inhaling superheated gases, steam, or fumes, leading to asphyxia or direct cellular injury.

Question 6

What relevant history is needed for a burn patient evaluation?

Answer 6

Burn incident details, inhalation injuries, secondary injuries, and psychosocial considerations.

Question 6

What is a cultured epidermal autograft (CEA)?

Answer 6

Lab-cultured epidermal cells transplanted to the wound.

Question 7

Differentiate between STSG and FTSG.

Answer 7

STSG: Thin layer of skin (epidermis + part of dermis). FTSG: Full thickness of skin (epidermis + dermis).

Question 7

What are escharotomy and fasciotomy, and when are they needed?

Answer 7

Escharotomy: Incision through eschar for decompression. Fasciotomy: Incision through fascia to relieve compartment pressure. Needed for neurovascular/respiratory complications.

Question 8

What additional medications are used for pain control?

Answer 8

NSAIDs, mild analgesics, anesthetics, and anxiolytics.

Question 8

What are the initial steps in burn care?

Answer 8

Neutralize burn source, remove clothing/jewelry, rinse the burn, ensure medical stability, debride, clean, and dress with topical antimicrobial agents.

Question 9

What factors should be assessed during inspection and palpation?

Answer 9

Consciousness level, pain, location of burns/grafts, dressings, splints, and lines/tubes.