SPECONLEC_S1_L2 - 1st (37-72) Flashcards
Usually as a result of an industrial accident
Chemical Burns
Chemical Burns may occur with _____
househol chemical products
chemical burns are usually as a result of an ____
industrial accident
In chemical burns, ___ is greater than (>) __ products
alkali; acidic
alkali products cause a severe injury called ____
liquefactive necrosis
liquefactive necrosis results in (2) in adipose tissue and proteins
denaturing of proteins & saponification of adipose tissue
Inhalation injuries are classified as __, __, or __
carbon monoxide poisoning, heat, or smoke inhalation injuries
Inhalation injuries account for more than ____ of the burn related deaths per year
half
are classified as carbon monoxide poisoning, heat, or smoke inhalation injuries
inhalation injuries
one of the leading causes of death
inhalation injuries
carbon monoxide is bad because it is associated with ___ that impedes blood’s ability to carry oxygen to body tissues and vital organs to produce ATP
hemoglobin
Signs of inhalation injuries (HARCH FSH)
Facial burn
Singed nasal burn
Harsh cough
Hoarseness
Abnormal breath sounds
Respiratory distress
Carbonaceous sputum
Hypoxemia
burns to the airway can cause ___ that blocks the ___ into the lungs
swelling; flow of air
In pathophysiology, what is under the local response?
- zone of coagulation
- zone of stasis
- zone of hyperemia
Occurs at the point of maximum damage
zone of coagulation
outermost zone
zone of hyperemia
decreased tissue perfusion
zone of tissue
Zone of coagulation has IRREVERSIBLE ___ ___
tissue loss
Goal of zone of stasis
increase perfusion
In zone of hyperemia, tissue will recover unless there is __ __
severe sepsis
Pathophysiological Changes During Hypermetabolic/Hyperdynamic Phase of Burn (>48 hrs) in the brain
- Altered mental status
- Cerebral Edema
- Inc. Pain Response
Pathophysiological Changes During Hypermetabolic/Hyperdynamic Phase of Burn (>48 hrs) in the heart & circulation
- Tachycardia
- Inc. cardiac index
- Subclinical myocardial dysfunction
- Echocardiogram (Altered contractility)
- Inc SvO2
- Dec SVR
Pathophysiological Changes During Hypermetabolic/Hyperdynamic Phase of Burn (>48 hrs) in the kidney
- Inc golmerular filtration rate
- Dec tubular function
Pathophysiological Changes During Hypermetabolic/Hyperdynamic Phase of Burn (>48 hrs) in the lungs + inhalation injury
- Pulmonary Edema
- Bronchospasm, bronchorrhea
- Acute respiratory distress syndrome
Pathophysiological Changes During Hypermetabolic/Hyperdynamic Phase of Burn (>48 hrs) in the Liver
- Altered metabolic function
- Altered drug tolerance
- Fatty liver
- Inc live blood flow
- Inc gluconeogenesis
- Dec coagulation factors
- Albuminemia
Pathophysiological Changes During Hypermetabolic/Hyperdynamic Phase of Burn (>48 hrs) in the bone marrow
- Dec Hematopoiesis
- Anemia
- Immunoparesis
- Osteoporosis
Pathophysiological Changes During Hypermetabolic/Hyperdynamic Phase of Burn (>48 hrs) in the systemic inflammatory response
- High energy expenditure (Inc O2 consumption and Inc CO2 production)
- Muscle catabolism
- Insulin resistance- hyperglycemia
- Persistence of generalized edema with >25% body burn
T or F: Hypermatabolic or Hyperdynamic Phase of Burn can also lead to altered pharmacological responses
T
Old Burn Classification
- First Degree
- Second Degree
- Third Degree
- Fourth Degree
Identify Burn Degree: Red and sometimes painful
1st
Identify Burn Degree: Epidermis and dermis
3rd
Identify Burn Degree: Extend into skin and underlying tissues
4th
Identify Burn Degree: Epidermis and parts of the dermis
2nd
Identify Burn Degree: Epidermis
1st
Identify Burn Degree: Very painful
2nd
Identify Burn Degree: Whitish, charred or translucent
3rd
Identify Burn Degree: Deep and potentially life-threatening
4th
Identify Burn Degree: No pin prick sensation on burned area
3rd
Identify Burn Degree: Skin may be red and blistered and swollen
2nd
Identify Burn Degree: Superficial Injury
1st
New Burn Classification
Epidermal
Superficial Partial Thickness Burn
Deep Partial Thickness Burn
Full thickness Burn
Subdermal Burn
New Burn: Cell damage only to the epidermis
Epidermal
Appearance of skin in epidermal burns
red or erythematous
Texture or quality of skin surface in epidermal
dry
T or F: Blisters are common in epidermal burns
F, ABSENT BLISTERS!
State or level of edema in epidermal burns
Minimal!
Epidermal burns have a delay in the development of __
pain
Epidermal burns peels off and desquamates in how many days?
3-4 days
T or F: Epidermal burns have spontaneous healing but there will be a scar tissue
F, they have spontaneous healing BUT NO SCAR TISSUE
Superficial Partial Thickness Burn has its ___ into the ___ layer of dermis
epidermis; papillary
T or F: Superficial Partial Thickness Burn has (+) intact blisters
T
T or F: There is presence of blanching in superficial partial thickness burn
T
State or level of erythema in Superficial Partial Thickness Burn
Moderate
Level of pain in superficial partial thickness burn
extremely painful
Superficial Partial Thickness Burn undergo ___d/t effects of __
desquamation; topical agents
Days for healing od superficial partial thickness burn
7-10 days
Superficial Partial Thickness Burn will have residual skin ___ owing to destruction of ___
color change; melanocytes
Level of scarring in superficial partial thickness burn
minimal!
Layers and other structures affected in deep partial thickness burns
epidermis and papillary dermis with damage to reticular dermal layer
Most of the __, __, __ will be injured in deep partial thickness burns
nerve endings, hair follicles and sweat ducts
What is the color of deep partial thickness burns
mixed or waxy white
T or F: there is edema in deep partial thickness burns
T
State of edema in deep partial thickness burns
marked edema
deep partial thickness burns has large amount of ___ loss (__ to __ times)
evaporative water (15-20x)
deep partial thickness burns has diminished sensation to __ or ___ but retains __
light touch; sharp/dull discrimination; deep pressure
How does healing occur in deep partial thickness burns?
heals in 3-5 weeks IF NOT INFECTED
Kind of scar formation in deep partial thickness burns
hypertrophic scar formation
Epidermal and dermal layers completely destroyed
full thickness burns
What finding is seen in full thickness burn?
eschar
What is eschar?
Hard, parchment like, black/brown covering the area
In full thickness burns, __ are completely destroyed
hair follicles
In full thickness burns, all __ are destroyed
nerve endings
Full thickness burns cause damage to the ___
peripheral vascular system
Complete destruction of all tissue from the epidermis to the subcutaneous tissue
subdermal burn
In subdermal burn, muscle and bone are subject to __ when burned
necrosis
subdermal burn occurs with prolonged contact with a __ and routinely occurs in a result of contact with __
heat source; electricity
New Classification of First Degree
Epidermal
New Classification of Second Degree
Sueprfical Partial Thickness; Deep Partial Thickness
New Classification of Third Degree
Full thickness
New Classification of Fourth Degree
Subdermal
Level of Epidermal
Epidermis
Level of superificial partial thickness
dermis
Level of third degree
all of dermis and epidermis
Level of Fourth Degree
extends to the bone, muscle and tendon
Edema in superficial partial thickness burns?
moderate, blanches with pressure
Edema in deep partial thickness burns?
marked
Edema in first degree burns
Minimal, Blanches with pressure
Color of superficial partial thickness
Bright pink, or red, mottled red
Color of first degree burn
Pink or Red
Color of deep partial thickness
mixed red, waxy white
Color of Fourth degree or subdemal burn
charred
Color of full thickness burn
White (ischemic)
Charred, black/brown
Blisters in 1st degree
No blisters
Blisters in deep partial thickness
broken blisters
blisters in superficial partial thickness
intact blisters
Pain in deep partial thickness
/ Pressure
X light touch and pinprick
Third degree pain
anesthetic
First degree pain
delayed, tender
superficial partial thickness pain
very painful
Pain in subdermal burn
anesthetic
Scar level in epidermal burns
X none
Scar level in third degree
scarring
Scar level in deep partial thickness
excessive scarring
scar level in superficial partial thickness
minimal scarring
scar level in 4th degree
scarring
Healing in deep partial thickness
slow
Healing in full thickness
skin grafting required
Healing in 4th degree
skin grafting required
Healing in epidermal burns
spontaneous
Healing in superficial partial thickness
spontaneous