Burns and Skin Layers Overview

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Questions and Answers

What is primarily affected in a patient experiencing hyperglycemia after burn trauma?

Increased glucose production

Increased insulin sensitivity

Decreased glucose uptake (correct)

Decreased hormone release

Which step is crucial for airway management in burn patients with facial or neck injuries?

Place the patient in a supine position

Do not intubate unless absolutely necessary

Consider rapid sequence intubation (RSI) (correct)

Administer non-invasive ventilation immediately

What sign indicates a deeper degree of burn during a capillary refill test?

No blanching observed (correct)

Delayed sensation in the area

Blanching present

Rapid capillary refill

What is a potential respiratory complication associated with third-degree burns?

Stridor and wheezing Signup and view all the answers

What effect does the release of cytokines have on circulation in burn patients?

Increased vascular permeability Signup and view all the answers

What is a common metabolic state experienced by burn patients after the wounds have healed?

Hypermetabolic and catabolic state Signup and view all the answers

What is a consequence of inadequate breathing due to burn-induced damage to the chest area?

Respiratory acidosis Signup and view all the answers

Which of the following hormones plays a role in glucose production after trauma from burns?

Cortisol Signup and view all the answers

What happens to the tissue in the zone of stasis if severe sepsis occurs?

The tissue may not recover. Signup and view all the answers

What is a primary cardiovascular change that occurs as a systemic response to burns?

Increased capillary permeability. Signup and view all the answers

What does systemic hypotension in burn patients primarily result from?

Fluid loss from the burn wound. Signup and view all the answers

What effect do inflammatory mediators have on the respiratory system during burns?

Bronchoconstriction leading to breathing difficulties. Signup and view all the answers

How does the basal metabolic rate change in burn patients?

It increases up to three times its normal rate. Signup and view all the answers

What is the impact of high insulin resistance in burn patients?

Poor response to insulin, resulting in elevated glucose levels. Signup and view all the answers

What is gluconeogenesis in the context of burn patients?

Utilization of non-carbohydrate sources to generate glucose. Signup and view all the answers

What happens to oxygen carrying capacity in severe burns?

Decreases due to the inflammatory response. Signup and view all the answers

What is the role of the dermis in relation to thermoregulation?

It contains blood vessels and glands that help regulate body temperature. Signup and view all the answers

Which type of burn is characterized by blisters, redness, and pain?

2nd Degree Superficial Dermal Burn Signup and view all the answers

What happens in the zone of coagulation after a burn injury?

Tissue is irreversibly damaged due to clotting. Signup and view all the answers

What defines a 3rd degree burn?

It is a full-thickness burn with nerve destruction. Signup and view all the answers

What is the primary goal of burns resuscitation?

To increase tissue perfusion in the zone of stasis. Signup and view all the answers

Which layer of skin is involved in the continuous regeneration of epidermal cells?

Dermis Signup and view all the answers

Which of the following describes the zone of hyperaemia?

It features high blood flow to the inflammation site. Signup and view all the answers

What distinguishes a 2nd degree deep dermal burn?

It involves damage to the dermis but not underlying tissues. Signup and view all the answers

What physiological response occurs to conserve fluid for main organs during burn injuries?

Peripheral vasoconstriction Signup and view all the answers

What is the appropriate action to maintain room temperature for a patient with severe burns?

Keep the room above 29°C Signup and view all the answers

Which of the following is a component of the lethal triad that can lead to poor outcomes in burn victims?

Hypothermia Signup and view all the answers

Why is monitoring glucose levels important in burn patients?

To manage hyperglycemia resulting from metabolic changes Signup and view all the answers

What percentage of overall oxygen does the brain require for consciousness?

20% Signup and view all the answers

What effect does fluid loss have on stroke volume and heart rate in burn patients?

Decreases stroke volume, which leads to an increased heart rate Signup and view all the answers

What happens to a patient who experiences a third-degree burn in terms of thermoregulation?

They will become hypothermic due to loss of dermis. Signup and view all the answers

What type of lines may be considered for monitoring in burn patients?

Arterial lines and CVP lines Signup and view all the answers

Study Notes

Burns Overview

A burn is an injury to skin or tissue caused by heat, radiation, electricity, friction, or chemicals.
Burns are classified by the depth of tissue damage:
- First-degree burns affect only the epidermis (superficial).
- Second-degree burns affect the epidermis and dermis (partial thickness).
- Third-degree burns affect all layers of skin, including subcutaneous tissue (full thickness).
Understanding skin layers (epidermis and dermis) and their functions is crucial for burn care.

Skin Layers and Function

Epidermis: Composed of five layers. Deeper layers continuously divide and migrate to the top layer, which is shed.
- Function: Acts as a barrier to microorganisms and regulates body temperature (sweat, piloerection).
Dermis: Main function is thermoregulation.
- Function: Involved in thermoregulation through sweat and piloerection to conserve heat. Also contains blood vessels, nerves, and glands. Plays a significant role in regenerating the epidermis in superficial burns.

Burns: Local Response

Zone of coagulation: Tissue damage at the injury site due to clot formation.
Zone of stasis: Surrounding the coagulation zone; characterized by decreased tissue perfusion, and potentially salvageable.
Zone of hyperemia: Outermost zone with increased tissue perfusion, reflecting inflammation and potentially recovery.

Burns: Systemic Response

Cardiovascular changes: Increased capillary permeability (fluid leakage), peripheral and splanchnic vasoconstriction, decreased myocardial contractility, systemic hypotension, and end-organ hypoperfusion.
Respiratory changes: Inflammation leading to bronchoconstriction, potential for acute respiratory distress syndrome, and decreased oxygen-carrying capacity.
Metabolic changes: Increased basal metabolic rate, need for increased glucose production (gluconeogenesis), and insulin resistance.

Burn Treatment

Assessment: Look at the burn location and surface area to assess the degree and extent of the burn.
Airway evaluation: Assess airway status (face/neck/chest burns) if needed.
Breathing: Assess breathing, particularly with severe burns (black, leathery appearance), and check for dyspnoea.
Circulation: Assess circulation, as vascular permeability and fluid maldistribution are concerns. Systemic response triggers peripheral vasoconstriction to conserve fluid.
Temperature: Hypothermia is a concern, especially with extensive third-degree burns.
Treatment goals: Immediate treatment focuses on stabilizing the airway, breathing, and circulation. Correcting hypothermia and preventing or treating significant hyperglycemia associated with burn injury is important.

Burn Complications

Hyperglycemia: Abnormal glucose production, and resistance to insulin.
- Consequences: Can lead to metabolic acidosis.
- Treatment: Requires careful monitoring and management.

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Description

This quiz covers the basics of burns, including their classification by depth and the functions of the skin layers involved in burn care. Understanding the epidermis and dermis is essential for effective treatment and recovery from burn injuries.