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GENERAL ORTHO > Wounds + Burns > Flashcards

Wounds + Burns Flashcards

1
Q

Define “wound”

A

a disruption of the continuity of the skin

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2
Q

What is the largest protective organ?

A

The skin - forms a barrier between the body and external environment.

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3
Q

What are the three layers of the skin?

A
  1. epidermis
  2. dermis
  3. sub-dermal/sub-cutaneous
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4
Q

What layer of the skin is continuously sloughing off and removed?

A

epidermis

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5
Q

What 2 components is the dermis composed of? What does this allow for?

A

Elastin and collagen - gives the tissue flexibility and strength.

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6
Q

What are 6 things contained within the dermis?

A
  1. sebaceous (oil) glands
  2. sweat glands
  3. hair follicles
  4. nerve receptors
  5. blood
  6. lymphatic vessels
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7
Q

What 3 things are contained within the sub-dermal/sub-cutaneous layer?

A
  1. adipose tissues
  2. large bv’s
  3. deep hair follicles
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8
Q

Define “abrasion”

A

a superficial wound with ragged edges - usually resulting from a scrape or tear leading to a loss of skin

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9
Q

Should you let an abrasion air dry to reduce pain?

A

No - after cleaning, a dressing is applied to keep it moist for pain reduction (the wetter, the better)

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10
Q

Define “laceration”

A

increased tissue loss with ragged edges

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11
Q

What might be done after a laceration has been cleaned?

A

sutures or tape may be used to bring edges together

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12
Q

Define “incision”

A

clean, approximated edges resulting from a sharp edges object (sutures or tape used to secure together)

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13
Q

What is an animal bite a combination of?

A

crush, laceration and puncture wounds

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14
Q

Define “puncture”

A

clean edges with a small entry, can penetrate deeply - i.e. bullet wound or stepping on a nail.

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15
Q

Define “burns”

A

a specific type of wound caused by an external agent of varying severity

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16
Q

What are 7 classifications used to assessing the severity of a burn?

A
  1. depth of burn
  2. amount of tissue burned
  3. area of burn
  4. cause of burn
  5. age of person burned
  6. pre-existing illness
  7. associated injuries (i.e. smoke inhalation and #’s)
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17
Q

How many possible degrees are there when assessing depth of a burn?

A

4 degrees

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18
Q

Describe a 1st degree burn presentation:

A

redness and pain, and some mild localized edema (affects epidermis)

19
Q

What can cause a 1st degree burn?

A

Usually the result of prolonged exposure to low intensity heat or quick exposure to high intensity heat

20
Q

How does healing of a 1st degree burn present?

A

Within a week the epidermis sloughs off so healing is rapid and without scar tissue - skin discolouration may occur

21
Q

What is the distinguishing feature of a 2nd degree burn?

A

presence of blistering

extends to the dermis aka PARTIAL (superficial or deep) thickness burn

22
Q

What does the increased depth of a burn, increase the presentation of?

A

edema, risk of infection and often DECREASED pain

23
Q

What is the difference between a 3rd and a 4th degree burn?

A

3rd degree will affect all 3 layers of tissue, whereas 4th degree will affect all 3 skin layers, along with FASCIA, MUSCLE and possibly CLOSELY LYING BONE

4th degree burns are generally painless!

24
Q

Why is a 4th degree burn painLESS

A

Due to the depth of tissue damage there will be substantial damage to dermis structure INCLUDING NERVES!

25
Q

What degree burn would skin grafts be needed for?

A

4th degree

26
Q

What are 2 causes of thermal burns?

A
  1. heat: open flame, hot liquid

2. extreme cold

27
Q

What are 4 categories of causes of burns?

A
  1. thermal
  2. chemical
  3. radiation
  4. electrical
28
Q

What category of cause of burn is a sun burn?

A

radiation

29
Q

What category of cause of burn appears to heal more slowly than the rest?

A

chemical

30
Q

How does the entry site of an electrical burn present?

A

black at its centre surrounded by a ring of white necrotic tissue and an outer ring that is HYPEREMIC (xs blood)

31
Q

What category of cause of burn leads to the greatest number of amputations?

A

electrical

32
Q

What central nervous system damage may present with electrical burns?

A
  • memory loss
  • HA’s
  • personality changes
  • deafness
  • visual disturbances
  • convulsions
  • weakness/paralysis
    (may be temporary or permanent).
33
Q

What % of the body would need to have 2nd degree burns in order to lead to hospitalization?

A

15-25% of greater of the total surface area (% determined by “Rule of Nine”)
** children are 10 to 20% of total surface area.

34
Q

What % of the body would need to have 3rd degree burns in order to lead to hospitalization?

A

10% or greater.

35
Q

What specific areas of a 3rd degree burn would result in hospitalization?

A

face, eyes, ears, perineum, hands or feet

36
Q

What % do the trunk, arm and leg account for regarding the “rule of nine,” respectively?

A
  1. trunk = 36%
  2. arm = 9%/arm
  3. 18%/leg
37
Q

What can thoracic burns affect?

A

Thoracic burns can affect breathing.

38
Q

What is the most common cause of death when it comes to burns?

A

sepsis

39
Q

Systemic circulation will be affected when burns cover what percentage of the body?

A

25-30%

40
Q

When treating structures near a healing burn, what direction should direct pressure be used in?

A

toward the injury site to avoid pulling/tugging at the wound site

41
Q

In the healing process of burns, aAROM and pROM are introduced how long after a period of immobilization?

A

~10 days

42
Q

Why do burns affect thermoregulation even long after healing?

A

damage to sweat glands = body can’t get rid of excess heat through evaporation fo sweat

43
Q

What are the CI’s in treating someone with burns?

A
  1. no oil around wound site
  2. avoid direction contact with lesion
  3. modify hydro for altered temperature sensitivity
  4. no rROM in acute phase

GENERAL ORTHO (9 decks)

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