Skin System

Question 2

skin tolerates up to ? degrees

Answer 2

111F

Question 3

Jacksons Theory of Thermal Burns 3 burn zones:

Answer 3

1st Zone of Coagulation 2nd Zone of Stasis 3rd Zone of Hyperemia

Question 4

(Jacksons Theory) Zone of Coagulation:

Answer 4

Area of burn nearest to the heat source (most damage & tissue necrosis)Most damaged area

Question 5

Zone of Hyperemia:

Answer 5

surrounding Area of erythema, damage with more RBC coming to area b/c/& cap/s more permeable (increased blood supply) trying to get phagocytes to inside for healing process
Sig burns have sig swelling from shift of fluid

Question 6

Zone of Stasis / “Ischemia”:

Answer 6

Less damaged area adjacent to the Zone of Coagulation (treatable & posible reversible damage)

Question 7

Thermal burn phases:

Answer 7

Emergent, Fluid-shift, Hypermetabolic, & Resolution phase

Question 8

(Thermal burn phases) Emergent phase:

Answer 8

Vtach, cells anaerobic Body’s initial reaction to burn; pain response (afferent nerves damage> Nor/Epi release > tachycardia ; unless on beta blockers

Question 9

(Thermal burn phases) Fluid-shift phase:

Answer 9

2nd phase; can last up to 24 hours; larger than 15 to 20%(BSA) of total body surface area
vasodilates & capillaries more permeable for phagocytosis

Question 10

(Thermal burn phases) Hypermetabolic phase:

Answer 10

3rd phase Days or weeks depending on burn severity; increase in body’s demands for nutrients; begins process of repairing damaged tissue (needs Glucose, amino acids, carbohydrates, O2 to support damage)

Question 11

(Thermal burn phases) Resolution phase:

Answer 11

4th phase Scar tissue laid down and remodeled; rehabilitate and return to normal function (weeks to months) new collagen & usually doesnt remodel to original state & makes escar (burn keloid) bc overgrowth

Question 12

Chemical burns:

Answer 12

biochemical makeup of cell membranes; destroy cells

Question 13

Denature:

Answer 13

take away natural state (from chem burns)

Question 14

1 (Burn depth) 3rd degree:
2 feeling & appearance:

Answer 14

1= full thickness burn down to SCT may involve M. bone & organs
2= leather, looks Charred, dark brown or white, hard to touch “painless”

Question 15

(Burn depth) Degrees:

Answer 15

= 1st/Superficial, 2nd/partial, 3rd/full/complete

Question 16

(Burn depth) 1st degree:

Answer 16

= Epidermis only, red skin, pain & tender, NO blister(can lose temp/reg)

Question 17

(Moderate criteria) Superficial:
Partial thickness burns:
Full thickness burns:

Answer 17

= BSA >50%
= BSA <30%
= BSA <10%

Question 18

(Burn depth) 2nd degree:

Answer 18

= Partial, EPi & Dermis burned: intense pain, fluid shift comes up thus blisters, RED to WHITE, moist & mottled w/ shifts

Question 19

(Critical Criteria) 3rd & 2nd Degree criteria:
Any 2nd or 3rd degree burns involving:
Burn types that’re critical & Rx:

Answer 19

= 3rd>10% & 2nd>30%
= Face, Hands, Genitalia, Circumferential, Feet, (Dipping), Airway
= Chem, high voltage, Burns w/ major trauma go trauma center 1st then burn center

Question 20

(Wallace Rule of 9s) used only for:
Adult %s:
infants (0-1):
Form:

Answer 20

= burns >10%
= 1 genitals, 9 head thoracic & ABDMN, distal anterior (applies to other areas) arm 4 ½
= head 18, arm 9, legs 13.5, 18 front thoracic & ABDMN
= # of child -1 > take away from head then give to each leg (Applicable up 10y/o) For every year beyond age 1, subtract 1 from head / that # & add it evenly between the 2 legs.

Question 21

Rule of palm:

Answer 21

use of PT hand = 1% of BSA (burns <10%)

Question 22

Eschar:

Answer 22

= Burn destroys dermal cells; Skin constricts over wound site, increasing pressure of edema beneath & restricting flow of blood (compartment syndrome) May be severe enough to occlude all blood flow into distal extremity

Question 23

Dry dressing for burns:
Wet dressing for burns:

Answer 23

= >10%
= <10%

Question 24

1 Children for the Rules of Nines, the head is awarded:
2 Children for the Rules of Nines, each leg is awarded:
3 Children for the Rules of Nines, each arm is awarded:
4 Children for the Rules of Nines, the anterior trunk is awarded:
5 Children for the Rules of Nines, the posterior trunk is awarded:

Answer 24

1= 18 % of body surface area.
2= 13.5% of body surface area.
3= 9% of body surface area.
4= 18% of body surface area.
5= 18% of body surface area.

Question 25

1 Adults for the Rules of Nines, the head is awarded:
2 Adults for the Rules of Nines, the genitalia is awarded:
3 Adults for the Rules of Nines, the posterior trunk is awarded:
4 Adult for the Rules of Nines, each arm is awarded:
5 Adults for the Rules of Nines, each leg is awarded:
6 Adults for the Rules of Nines, the anterior trunk is awarded:

Answer 25

1= 9 % of body surface area.
2= 1 % of body surface area.
3= 9 % of body surface area.
4= 18 % of body surface area.
5= 18 % of body surface area.
6= 18 % of body surface area.

Question 26

Fluid shift phase of the burn process major sign:
During a burn, loss of plasma protein will what:

Answer 26

= Massive edema due to the fluid shift
= reduce body’s ability to draw fluids from uninjured Ts back into vascular compartment

Question 27

The presence of blisters differentiates:
A sunburn, resulting in red, painful skin, is EX of:
A superficial, or first-degree burn, involves:

Answer 27

= between a superficial and partial-thickness burn
= a 1st degree burn.
= only the epidermis

Question 28

The stage of the burn process characterized by catecholamine and pain-mediated reaction is called the:

Answer 28

Emergent Phase

Question 29

1 Minor burn criteria:
2 3 Critical burn criteria:
3 Moderate burn criteria:

Answer 29

1= Partial thickness: BSA <10%, Superficial: BSA <50% (sunburns, etc)
3= Inhale injury, Full thickness: BSA >10%, Partial thickness: BSA >30%
2= Superficial: BSA >50%, Partial thickness: BSA <30%, Full thickness: BSA <10%, partial or full thickness burns involving hands, feet, joints, face, or genitalia