Burn Injuries and Skin Anatomy

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Questions and Answers

Match the skin anatomy layer with its characteristic:

Epidermis = Highly vascular Dermis = Avascular Subcutaneous tissue = Consists of adipose tissue and fascia Stratum basale = Attached to dermis by basement membrane

Match the skin structure with its location:

Hair = Dermis Sweat glands = Epidermis Fat tissue = Dermis Nails = Epidermis

Match the skin anatomy layer with its function:

Dermis = Provides cushioning and insulation Epidermis = Responsible for fingerprints Subcutaneous tissue = Stores fat, which provides energy Stratum basale = Supports the skin

Match the skin structure with its type:

Fascia = Loose connective tissue Adipose tissue = Highly fibrous connective tissue Blood vessels = Avascular Oil glands = Highly vascular Signup and view all the answers

Match the skin anatomy layer with its thickness:

Epidermis = 2-4 mm thick Dermis = 0.06 to 0.6 mm thick Subcutaneous tissue = Consists of two layers Stratum basale = Thickest portions on palms and soles Signup and view all the answers

Match the skin anatomy layer with its composition:

Epidermis = Consists of adipose tissue and fascia Dermis = Consists of two layers: papillary and reticular Subcutaneous tissue = Consists of five stratums Stratum basale = Has three appendages: hair, glands, and nails Signup and view all the answers

Match the following zones of burn injury with their characteristic features:

Zone of coagulation = Characterized by erythema due to vasodilation and generally recovers within 7 to 10 days of injury Zone of stasis = Irreversible tissue loss due to coagulation of constituent proteins Zone of hyperemia = Characterized by coagulation, ischemia, and necrosis Signup and view all the answers

Match the following zones of burn injury with their potential outcomes:

Zone of coagulation = Complete tissue loss within 7 to 10 days of injury Zone of stasis = May recover with adequate perfusion and treatment Zone of hyperemia = Generally recovers within 7 to 10 days of injury Signup and view all the answers

Match the following processes with their descriptions:

Conversion = Process of widening and deepening of the original area of necrosis Coagulation = Characterized by erythema due to vasodilation and generally recovers within 7 to 10 days of injury Signup and view all the answers

Match the following zones of burn injury with the severity of tissue damage:

Zone of coagulation = Maximum tissue damage Zone of stasis = Moderate cellular injury Zone of hyperemia = Severe cellular injury Signup and view all the answers

Match the following zones of burn injury with the likelihood of tissue survival:

Zone of coagulation = Unlikely to survive Zone of stasis = Unlikely to survive if adequate perfusion is not restored within 1 to 2 days Zone of hyperemia = Likely to survive Signup and view all the answers

Match the following zones of burn injury with their location:

Zone of coagulation = Outer edges of tissue affected by the burn injury Zone of stasis = Central necrotic region Zone of hyperemia = Outer edges of tissue affected by the burn injury Signup and view all the answers

Match the following positions with the corresponding benefit in sidelying:

Flex shoulders to 90 degrees = Prevent pull on brachial plexus Use pillows = Support chest and abdomen Use towels = Support lower spine Use clavicle/shoulder strap = Prevent shoulder protraction Signup and view all the answers

Match the following exercises with their primary goal:

Range of Motion Exercises = Improve joint mobility Mobility Training = Increase patient adherence Aerobic Exercise = Enhance overall patient function Therapeutic Exercises = Reduce anxiety Signup and view all the answers

Match the following equipment with their primary use:

Foam wedges = Support sidelying position Airplane splints = Support elbow and forearm Hand cones = Improve wrist extension Bedside table = Support upper body during exercises Signup and view all the answers

Match the following conditions with their corresponding considerations:

Inhalation injury = Long-term restrictive lung injury Wounds = Healing before commencing swimming Anxiety = Medication timing during exercises Pain = Medication timing during exercises Signup and view all the answers

Match the following nutritional requirements with their importance in burn recovery:

High-calorie diet = Supports growth of healthy tissue Protein-rich diet = Counteracts hypermetabolic response Fat in the form of lipids = Maintains metabolic function Vitamins and trace minerals = Enhances immune response Signup and view all the answers

Match the following exercises with their primary benefits:

Walking = Improve cardiovascular function Cycling = Increase frequency of movement Jogging = Enhance overall patient function Swimming = Improve joint mobility Signup and view all the answers

Match the following physiological responses with their effects on burn patients:

Hypermetabolic response = Increases metabolic rate in proportion to burn size Anabolic response = Promotes wound repair and immune response Hyperglycemic response = Impedes wound healing Inflammatory response = Negatively impacts survival Signup and view all the answers

Match the following techniques with their primary purpose:

Immersion hydrotherapy = Reduce pain during exercises Active assisted exercises = Improve patient adherence Active exercises = Increase frequency of movement Purposeful activities = Enhance overall patient function Signup and view all the answers

Match the following nutrition-related consequences with their effects on burn patients:

Inadequate calorie intake = Impedes wound healing Protein deficiency = Weakens immune response Fat deficiency = Impacts metabolic function Vitamin and mineral deficiency = Increases risk of infection Signup and view all the answers

Match the following stages of burn recovery with their nutritional requirements:

Initial stage = Parenteral nutrition Intermediate stage = Enteral nutrition via feeding tube Advanced stage = Oral nutrition with high-calorie diet Rehabilitation stage = Nutrition plan tailored to individual needs Signup and view all the answers

Match the following burn-related complications with their consequences:

Poor wound healing = Increases risk of infection Impaired immune response = Prolongs hospital stay Malnutrition = Increases mortality rate Dehydration = Impedes rehabilitation progress Signup and view all the answers

Match the following signs and symptoms with the type of burn injury:

Bleeding = 2nd degree superficial Loss of sensation = 3rd degree Redness and swelling = 1st degree burn White and leathery = 4th degree burn Signup and view all the answers

Match the following methods with the assessment of burn depth:

Pinprick test = Sensation Visual inspection = Colour and appearance Palpation = Bleeding X-ray = Not a valid method Signup and view all the answers

Match the following criteria with the indication for hospital admission:

Major burn = Need for close monitoring Electrical burn = Risk of cardiac complications Inhalation injury = Risk of respiratory complications Burn of vital areas = Need for specialized care Signup and view all the answers

Match the following signs and symptoms with the diagnosis of smoke inhalation:

Singed nasal hairs = Upper airway injury Carbonaceous sputum = Lower airway injury Stridor = Acute airway obstruction Difficulty swallowing = Esophageal injury Signup and view all the answers

Match the following characteristics with the time period of critical concern for patients with inhalation injuries:

Airway edema = 24 to 48 hours post-burn Loss of ciliary function = 12 to 24 hours post-burn Increased airway resistance = 48 to 72 hours post-burn Respiratory mucosa sloughing = 6 to 12 hours post-burn Signup and view all the answers

Match the following types of burns with their corresponding descriptions:

Superficial partial thickness burn = 2nd degree superficial Deep partial thickness burn = 2nd degree deep Full thickness burn = 3rd degree Extensive burn = 4th degree Signup and view all the answers

Study Notes

Burn Injuries in Egypt

Burn injuries represent a major problem in Egypt, but the exact number of burns is difficult to determine.

Skin Anatomy

The skin consists of three layers: epidermis, dermis, and subcutaneous tissue (hypodermis).
Epidermis:
- Outer layer of the skin
- Avascular (no blood vessels)
- Thickness: 0.06-0.6 mm
- Consists of 5 stratums
- Has three appendages: hair, glands, and nails
Dermis:
- Inner layer of skin
- Highly vascular (has blood vessels)
- Thickness: 2-4 mm
- Consists of two layers: papillary dermis (thin and superficial) and reticular dermis (deeper and makes up 80% of dermal thickness)
- Contains blood vessels, oil glands, sweat glands, hair follicles, fat tissue, nerves, and connective tissue
Subcutaneous tissue (Hypodermis):
- Supports the skin
- Consists of adipose tissue and fascia
- Adipose tissue: highly vascular, loose connective tissue that stores fat, providing energy, cushioning, and insulation
- Fascia: highly fibrous connective tissue that separates and surrounds structures, facilitating movement between adjacent structures

Burn Zones

Local effect of burn injury involves 3 zones:
- Zone of coagulation: point of maximum damage, characterized by coagulation, ischemia, and necrosis
- Zone of stasis: area of cellular injury and compromised tissue perfusion, with red blood cells and platelets aggregating to form microemboli
- Zone of hyperemia: outer edges of tissue affected by the burn, characterized by erythema due to vasodilation, with minimal cellular injury and generally recovering within 7-10 days

Depth of Burn

Assessed subjectively through characteristics of the burn, including:
- Sensation (pinprick test)
- Color and appearance
- Bleeding
Types of burns:
- 1st degree: superficial and minimal cellular injury
- 2nd degree:
  - Superficial: minimal cellular injury and blistering
  - Deep: partial thickness and may require surgical intervention
- 3rd degree: full thickness and usually requires surgical intervention
- 4th degree: involves deeper tissues and structures

Smoke Inhalation

Signs and symptoms:
- Burns to the head and neck
- Singed nasal hairs, darkened oral and nasal membranes, carbonaceous sputum
- Stridor, hoarseness, and difficulty swallowing
- History of being burned in an enclosed space
- Exposure to flame
Critical period: 24-48 hours post-burn, with increased airway resistance and respiratory mucosa sloughing

Triage

Decision-making about admission of patient to hospital or discharge
Patient should be admitted to hospital in cases of:
- Major burn
- Electrical or chemical burn
- Inhalation injury
- Burn of vital areas (face, hand, foot, and genitalia)

Rehabilitation

Importance of nutrition in burn recovery
Patients require a diet high in calories and protein to counteract hypermetabolic response and support growth of healthy tissue
Burn patient's metabolic rate increases in proportion to the size of the injury
Patients require fat in the form of lipids, vitamins, and trace minerals
Inadequate nutrition can negatively impact immune response, wound healing, metabolic function, and survival

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Description

This quiz covers the basics of burn injuries in Egypt and the anatomy of the skin, including the epidermis, dermis, and skin appendages.