Midterms Flashcards by Rommel Milliam

caused by conduction or convection.

Thermal Burn

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Caused by passage of electrical current through thee body.

Electrical Burn

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Occurs when certain chemical compounds come in contact with the body.

Chemical Burn

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Occurs most commonly with exposure to external beam radiation therapy.

Radiation Burn

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Causes cell damage only to the epidermis

Best example is sunburn

The skin appears red or erythematous

The surface is dry

Blisters will be absent but slight edema may be apparent.

The epidermal layers will peel off in 3-4 days.

Epidermal healing is spontaneous

Epidermal Burn

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Damage occurs through the epidermis and into papillary layer of the dermis.

(+) presence of intact blisters

The surface is moist (if blisters are removed)

The wound will be bright red and will blanch

Edema can be moderate

Extremely painful

Complete healing occurs 7-10 days

Minimal scarring

Superficial Partial Thickness Burn

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Involves destruction of the epidermis and papillary dermis with damage down into the
reticular dermal layer.

Most of the nerve endings, hair follicles, and sweat ducts will be injured

Appears mixed red or waxy white in color

Capillary refill will be sluggish

The surface is usually wet from broken blisters

Diminished sensation to light touch or sharp/dull discrimination

Will heal in 3-5 weeks if it does not become infected.

(+) hypertrophic and keloid scars

Deep Partial Thickness Burn

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All of the epidermal and dermal layers are destroyed completely

Subcutaneous layer may be damaged to some extent.

Characterized by hard, parchment-like eschar covering the area.

The color of eschar may vary from black to deep red to white.

No blanching of the tissue is observed.

Wound will be insensate.

Skin grafting will be necessary.

Full Thickness Burn

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

Muscles and bones are subjected to necrosis when burned.

Occurs with prolonged contact with a heat source and routinely occurs as a result of contact
with electricity.

Subdermal Burn

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wound where the initial contact was made; appear
charred and depressed; smaller than exit wound; skin appears yellow and
ischemic.

Entrance Wound

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the ground site; often appears as though there was an
explosion out of the tissue in the site; dry in appearance.

Exit Wound

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This zone has cells that are irreversibly damaged and skin death occurs.

This area is equivalent to a full-thickness burn and will require a skin graft to heal.

Zone of Coagulation

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Contains injured cells that may die within 24 to 48 hours without diligent treatment.

It is in the zone of stasis that infection, drying, and/or inadequate perfusion of the wound
will result in conversion of potentially salvageable tissue to completely necrotic tissue and
enlargement of zone of coagulation.

Zone of Stasis

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This Zone is a site of minimal cell damage, and the tissue should recover within several days with
no lasting effects.

Zone of Hyperemia

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Most commonly used topical antibacterial agent; effective against Pseudomonas infections

SIlver sulfadiazine

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Topical antibacterial agent; effective against gram-negative or gram-positive organisms; diffuses easily through eschar

Mafenide Acetate (Sulfamylon)

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Topical solution with antimicrobial function against gram-positive and gram-negative organisms. Maintains moist enivronment. Antiseptic germicide and astringent; will penetrate only 1-2mm of eschar; useful for surface bacteria; stains black.

Mafeinide acetate solution Silver nitrate (Sulfamylon 5% Solution)

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Bland ointment; effective against gram-positive organisms.

Bacitracin/Polysporin

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Enzymatic debriding agent selectively debrides necrotic tissue; no antibacterial action.

Collagenase,Accuzyme

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is surgical removal of eschar; includes removal of peripheral layers
of eschar until vascular, viable tissue is exposed as the site for skin
graft placement.

it promotes more rapid healing, reduces infection and scarring, and
is more economical in terms of staff and hospital time.

Primary Excision

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patient’s own skin, taken
from an unburned area and
transplanted to cover a
burned area.

Provides permanent
coverage to the area

Autograft

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skin taken from
an individual of the same
species, usually cadaver
skin.

temporary grafts used to
cover
large burns when there is
insufficient autograft
available

Allograft

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skin from another species,
usually a pig.

Xenograft

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Motion to be stressed to fix Flexion in Anterior neck

Hyperextension

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Motions to be stressed to fix Adduction and internal rotation in the Shoulder-axilla

Abduction,flexion, and external rotation

Motions to be stressed to fix Flexion and Pronation in the elbow

Extension and supination

Motions to be stressed to fix claw hand

Wrist Extension

Motions to be stressed with FLexion and adduction of HIp and Groin

All motions

Motion to stress to fix knee flexion

extension

Motion to stress to fix ankle plantarflexion

All motion

Temperature drop causes Fatigue, weariness and failure of proper thinking

Lower than 95 degrees F/ 35 degrees C

Temperature drop causes Awareness ambiguity and arrythmia

Lower than 86 degrees F/ 30 degrees C

Body temperature lowers till the patient Eventually dies

Lower than 78.8 degrees F/ 26 degrees C

- refers to damage taken place above freezing point and high humidity. - It takes place when there is whole body hypothermia, which means central temperature being below 95 °F (35 °C) when measured in the rectum.

Nonfreezing Damage

Damage caused by prolonged neglect of physical body under freezing point or low humidity.

Freezing Damage

a medical condition caused by prolonged exposure of the feet to damp, unsanitary, and cold conditions.

Trench Foot

refers to foot skin damage taken place when one’s feet stays in 71.6 °F (22 °C) water or mud for 2–10 days.

Immersion Foot

a medical condition that occurs when a predisposed individual is exposed to cold and humidity, causing tissue damage.

Chilblain

A freezing injury which do not form ice crystal or tissue loss. Skin is pale Hypesthesia Symptoms go away No tissue is lost There could be burning feeling, sting or edema.

Superficial Frostbite

Severe pain with blisters Necrosis on the whole skin layer Later on, becomes dark and mummified --> amputation

Deep Frostbite

Damage on the outer skin No symptoms of blisters May feel pain from burning paresthesia or poking feeling.

First-Degree Frostbite

Damage to all layers of the skin (+) blisters form Decreased sensitivity and sharp pain.

Second-Degree Frostbite

Whole subcutaneous layers (+) purple or congested blisters are formed Black dried crust is formed after affected skin dies Numb skin and sharp pain

Third-Degree Frostbite

Whole hypodermic layers, muscle, and bones are frostbitten show few or no edema severe insensibility mummification necrosis Need to amputate Patients feel sore joints

Fourth-Degree Frostbite

the phenomenon of skin reacting abnormally and showing side effects to the sun in normal circumstances.

Photosensitivity

is a disease that occurs when your body's immune system attacks your own tissues and organs (autoimmune disease). Inflammation caused by lupus can affect many different body systems — including your joints, skin, kidneys, blood cells, brain, heart and lungs.

Lupus Erythematosus

Type of LE: most commonly causes inflamed, thick raised plaques with scale on your face, head and neck.

Discoid LE

Type of LE: often creates red, ring-shaped or raised lesions on your neck, back or chest.

Subacute cutaneous LE

Type of LE: is a systemic autoimmune disease with multisystem involvement and is associated with significant morbidity and mortality.

Systemic LE

is a rash caused by sun exposure in people who have developed sensitivity to sunlight. The rash usually appears as tiny, inflamed bumps or slightly raised patches of skin. Clinical symptoms or various forms of rashes start to appear from 30 minutes to 72 hours after exposure but most commonly from 18 to 48 hours. Lesions normally last from 24 to 48 hours but can last more than 1 week. Lesions typically appear at skin parts that are easily exposed to sun such as the cheek, chest, arm and dorsum of hand. Usually found in women and people of young age.

Polymorphous Light Eruption

Classification of Lupus Erythematosus

Photo Aggravative

Classification of Polymorphous Light Eruption

Idiopathic

is a rare allergic reaction to sun exposure. During or after skin exposure, pruritus or urticaria with erythema appears at the exposed body part but extreme exposure may cause shock.

Solar Urticaria

Classification of Solar Urticaria

Idiopathic

is a skin disorder in which the skin, particularly on sunlight exposed areas, becomes inflamed and develops eczema (dermatitis). Patients are abnormally sensitive to sunlight and may also react to artificial light sources. The majority also have allergies to chemical substances in direct contact with their skin. Easily provoked at outdoor working men of middle age or above and can exacerbated in summer or can last a year. Common allergies are to: Plants Flowers Wood Perfumes Certain creams, ointments and preservatives Rubber Sunscreens

Chronic Actinic Dermatitis

Classification of Chronic Actinic Dermatitis

Idiopathic

Is a rare cutaneous disorder inherited by recessive chromosome. It is known to be caused by nonexistent of DNA endonuclease, which is an enzyme necessary for regeneration of DNA damage by ultraviolet ray. Symptoms include erythema, scaling and hyperchromatic spots appearing from the face and can further develop to the neck, legs and corpus. If early, symptoms can appear from 6 months after birth and normally from 1 to 2 years. Those who suffered in their young age may get skin cancer such as basal cell carcinoma, squamous carcinoma and malignant melanoma. Patient may also suffer from visionary disorders such as corneal clouding and amblyopia.

Xeroderma Pigmentosum

Classification of Xeroderma Pigmentosum

Genetic

Type of Contact Dermatitis: occurs when a substance to which you're sensitive (allergen) triggers an immune reaction in your skin. It often affects only the area that came into contact with the allergen.

Allergic Contact Dermatitis

Type of Contact Dermatitis: is the most common type. This nonallergic skin reaction occurs when an irritant damages your skin's outer protective layer.

Irritant Contact Dermatitis

Type of Contact Dermatitis: the result of an interaction between a harmful substance present in the skin and ultraviolet radiation.

Photocontact Dermatitis

CLASSIFICATION OF PHOTOSENSITIVITY BY EXOGENOUS DRUGS: With abundant amount of drug and proper dosage of sunlight, can be evoked to anyone

PHOTOTOXIC REACTION

CLASSIFICATION OF PHOTOSENSITIVITY BY EXOGENOUS DRUGS: Can only be evoked to a person who is sensitive to photoallergic materials.

PHOTOALLERGIC REACTION

is a rare type of cutaneous porphyria. It's the most common childhood porphyria. Sun or artificial light exposure quickly results in painful skin burning, irritation and swelling. Small bumps and blisters also appear. Repeated exposures can cause thick, leathery skin and scarring.

Erythropoietic protoporphyria

Classification of Cutaneous Porphyria

Metabolic

is a rough, scaly patch on the skin that develops from years of sun exposure. It's often found on the face, lips, ears, forearms, scalp, neck or back of the hands.

Actinic Keratosis

Classification of Actinic Keratosis

Neoplastic

MEDICAL TREATMENT : reduce redness and swelling (inflammation)

Steroids

MEDICAL TREATMENT : reduce inflammation, minimizing its direct effect on pain-nerve stimulation and sensitivity, as well as decreasing the resulting inflammatory heat and swelling.

NSAIDS

MEDICAL TREATMENT : work by killing the parasite present in the affected red blood cells.

Antimalarial drug

MEDICAL TREATMENT: stop your immune system from damaging healthy cells and tissues.

Immunosuppresants

MEDICAL TREATMENT: medicines often used to relieve symptoms of allergies

Antihistamine drug

MEDICAL TREATMENT: method of removing blood plasma from the body by withdrawing blood, separating it into plasma and cells, and transfusing the cells back into the bloodstream. It is performed especially to remove antibodies in treating autoimmune conditions.

Plasmapheresis

composed of thick keratinized layers of dead squamous epithelial cells and accounts for up to 75 % of the epidermal thickness

Stratum Corneum

thin, translucent layer that presents only in thick skin such as the lips, the palm of the hand, and the sole of the feet.

Stratum Lucidum

is composed of three to four layers of flattened cells and contains irregular granules of keratohyalin.

Stratum Granulosum

(+) prickle cell layer called SPINE

Stratum Spinosum

composed of a single layer of columnar epithelial cells placed on the surface of the dermis, and its basal surface has a role to fix the epidermis to the dermis.

Stratum Basale

Superficial layer of the dermis

Papillary layer

Deep layer of the dermis

Reticular Layer

thin and flexible filament produced by hair follicle.

Hair

firm plates formed in the stratum corneum of the epidermis and consist of highly compressed and keratinized dead cells

Fingernails and Toenails

Secrete oil and sebum

Sebacous glands

Secretes sweat to the surface of the skin

Sweat gland

Sweat gland: - Located on entire surface - Drains unto sweat pores - Regulates body temp - Aids in removal of waste

Eccrine

Sweat gland: - Located in axillary area and genitals - Drains unto hair - Stimulated during emotional stress

Apocrine

in female breasts are modified sweat glands lying in the subcutaneous tissue

Mammary glands

 modified sweat glands that are found only in the external auditory canal  secrete cerumen, whose role is to lubricate the ear canal and to protect the eardrum from bacteria, insects, and water.

Ceruminous glands

Sensory nerve endings: for pain and itch

Free Nerve Endings

Sensory nerve endings: for light touch; typical speed sensors and sense low- frequency vibrations.

Meissner Corpuscle

Sensory nerve endings: for light touch; typical speed sensors and sense low- frequency vibrations.

Pacinian Corpuscle

Sensory nerve endings: for heat sensation; respond to continuous pressure and stretching of the skin and detect the intensity and speed of the stimulus.

Ruffini Corpuscle

Sensory nerve endings: for cold sensation

Krause End Bulb

Sensory nerve endings: light touch and continuous pressure

Merkel disk

Sensory nerve endings: pocket-shaped neural structures that detect the length of skeletal muscles and the speed of muscle contraction.

Muscle spindle

Sensory nerve endings: tension detectors by providing information about tension applied to tendons.

Golgi Tendon

Cutaneous nerve of the scalp

terminal branches of trigeminal nerves

Cutaneous nerve of the face

trigeminal nerves

Cutaneous nerves of the back

posterior rami of the spinal nerves

Cutaneous nerves of the chest

supraclavicular nerves

Cutaneous nerves of the upper limb

C4 to T2 nerve

Cutaneous nerves of the lower limb

L1 to L5 and s1 to s3 of the spinal cord

- argues that aging process is genetically decided, that is, an individual’s aging and lifespan are results of a process that is set and controlled by a genetic program.

Progammatic Theory

- claims that the continuous environmental stimuli destroy genes and proteins, and as cell damages accumulate, the cells become dysfunctional or deformed, which eventually leads to aging

Stochastic Theory

display circular or oval shapes without elevation or depression; Their borders can be well defined or fade out into the surrounding.

macule

small, solid elevation of the skin with diameters less than 5 mm.

papule

their diameters are normally larger than 5 mm, and they can invade any layer of the skin.

nodule

fluid filled sac or lesion that has diameters more than 1 cm

bulla

small blisters less than 1 cm in diameter.

vesicle

pus-filled blisters.

pustule

refer to epidermal nodules containing fluid or semisolid materials.

cyst

are temporarily developed papules or plaques caused by urticaria or allergic reaction.

wheal

elevated skin with 2 cm in diameter

plaque

are aggregates of keratin debris in the stratum corneum

scales

caused by mechanical traumas or repetitive scratching to ease pruritus.

excoriation

occur by bursting of vesicles in varicella, variola, impetigo, or herpes simplex.

erosion

imply skin loss extending through the epidermis and part of the dermis, which leads to a breach in epithelial continuity

ulcer

linear cleavages of the skin which sometimes extend into the dermis

fissure

dried layers of serum, blood, or purulent exudate and are composed of bacteria and epidermal debris

crust

as a part of the healing processes, replace the damaged skin tissues.

scar

symptom with a decrease in cell size due to the loss of organelles and substances.

atrophy

a condition in which a part of the dermis thickens.

lichenification

an unpleasant sensation that causes an urge to scratch or rub.

pruritus

absence of sensitivity to sensory stimuli

anaesthesia

decreased sensitivity to sensory stimuli

hypoesthesia

increased sensitivity to sensory stimuli

hyperesthesia

- Uses UV light - helpful in the diagnosis of various skin conditions because infected skin shows a unique fluorescence reaction under the light of a Wood’s lamp

Wood's lamp examination

- method used for examining brown papule and nodule and differentiating the causes of erythema and purpura. - performed by pressuring a transparent, flat, firm object against the surface of the lesion.

diascopy

- used to diagnose the cause of skin reactions that occur after the substance touches the ski.

patch test

examines photosensitivity reactions of patients’ skin by measuring the decrease of minimal erythema dose (MED) after the illumination with ultraviolet light or visible light.

photo test

-used to diagnose tuberculosis and is performed by injecting a small dose of tuberculin

tuberculin test

performed by inspecting the specimen obtained by scratching superficial lesions.

scratch test