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Bioscience II Brandon > Test #2 burns PPt- Josh > Flashcards

Test #2 burns PPt- Josh Flashcards

this PPt is fucking ridiculous!!!! fuck ton of slides and small as font!!! I am going to pull the important shit only hopefully

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
  1. Thermal
  2. Cold exposure
  3. Chemical
  4. electrical
  5. Inhalation
  6. 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
  1. Alteraion in PH
  2. Disruption of cellular membranes
  3. 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
  1. Depth
  2. Extent
  3. Location
  4. Pt’s age
  5. 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
  1. Stratum corneum
  2. Stratum lucidum
  3. Stratum granulosum
  4. Stratum spinosum
  5. 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

  1. adult
  2. Peds
  3. Full thickness
A
  1. <10%
  2. <5%
  3. <2%
71
Q

Burn injury grading system:

what is the criteria for Moderate burns in

  1. adults
  2. peds
  3. full thickness
A
  1. 10-20%
  2. 5-10%
  3. 2-5%
72
Q

Burn injury grading system:

what is the criteria for Major burns

  1. adult
  2. peds
  3. Fullthickness
A
  1. >20%
  2. >10%
  3. >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
  1. Tangential excision
  2. 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 Brandon (11 decks)

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