Burns and Skin Layers

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Questions and Answers

What condition results from the abnormal production of glucose during burns?

Insulinoma

Hyperglycemia (correct)

Hypoglycemia

Diabetes Mellitus

Why is oxygen important for maintaining consciousness in patients?

It prevents glucose production.

The brain requires 20% of the body's oxygen. (correct)

It promotes insulin resistance.

It increases metabolic acidosis.

What is typically involved in the assessment of a burn patient’s condition?

Monitoring respiratory rate

Documenting injury exposure (correct)

Eye examination

Calculating blood glucose levels

What should be considered for monitoring in burn patients?

Arterial and Central Venous Pressure lines Signup and view all the answers

What is a consequence of decreased glucose uptake in burn patients?

Hyperglycemia Signup and view all the answers

What is the primary cause of burns?

Radiation Signup and view all the answers

Which layer of skin is involved in thermoregulation?

Dermis Signup and view all the answers

What characterizes a 2nd degree superficial dermal burn?

Blisters and redness Signup and view all the answers

What is the zone of coagulation in burn injuries?

Area of maximum damage with clotting Signup and view all the answers

What does the zone of stasis indicate after a burn?

Decreased tissue perfusion with potential for salvage Signup and view all the answers

Which degree of burn is characterized by complete destruction of the epidermis and dermis?

3rd degree Signup and view all the answers

What happens to nerves in a 3rd degree burn?

They are destroyed Signup and view all the answers

How does the epidermis respond to injury from burns?

New cells migrate from deeper layers Signup and view all the answers

What procedure should be considered when a patient presents with stridor, wheeze, and low oxygen saturation levels?

Consider RSI with ET tube Signup and view all the answers

How does a 3rd degree burn around the chest affect breathing?

It restricts chest expansion Signup and view all the answers

What is the primary trigger for a patient to breathe when they are experiencing dyspnoea due to poor gas exchange?

Build-up of carbon dioxide Signup and view all the answers

In the context of burns, what is the role of cytokines and inflammatory mediators on circulation?

They lead to increased vascular permeability Signup and view all the answers

What is a significant consequence of losing the dermis layer in burn patients?

Inability to regulate body temperature Signup and view all the answers

What is the recommended room temperature for a patient with a significant burn injury?

Above 29°C Signup and view all the answers

What does the lethal triad of hypothermia, coagulation, and metabolic acidosis signify for burn patients?

A high risk of mortality Signup and view all the answers

What should be included in the management of a burn patient besides fluid replacement?

Nutritional support Signup and view all the answers

What is the main aim of burns resuscitation?

To increase tissue perfusion Signup and view all the answers

What effect do burns have on organ perfusion?

Reduced blood flow to organs Signup and view all the answers

What can convert the zone of stasis into an area of complete tissue loss?

Prolonged hypotension Signup and view all the answers

What condition can occur in severe burns affecting the lungs?

Adult respiratory distress syndrome Signup and view all the answers

In the zone of hyperaemia, what is the characteristic of blood flow?

Blood flow is increased Signup and view all the answers

What systemic effect is observed when the burn reaches 30% of total body surface area?

Increased systemic hypotension Signup and view all the answers

How much can the basal metabolic rate increase in burn patients?

Up to three times Signup and view all the answers

What happens to capillary permeability during a systemic response to burns?

It increases Signup and view all the answers

What is a consequence of high insulin resistance in burn patients?

Decreased glucose clearance Signup and view all the answers

What is one of the first steps in assessing burns?

Assess burn depth and surface area affected Signup and view all the answers

What occurs as a result of peripheral vasoconstriction during burn injury?

Blood is redirected to main organs Signup and view all the answers

What is a potential consequence of increased vascular permeability in burn injuries?

Fluid loss into surrounding tissues Signup and view all the answers

What hormonal changes occur due to burns?

Increase in cortisol and adrenaline Signup and view all the answers

What does the release of cytokines mainly affect in a burn injury?

Overall inflammatory response Signup and view all the answers

What physiological process is increased to generate glucose in burn patients?

Gluconeogenesis Signup and view all the answers

What should be considered if burns affect the airway areas?

Airway management Signup and view all the answers

Study Notes

Burns

A burn is an injury to skin or other tissue caused by heat, radiation, electricity, friction, or chemicals.
Understanding skin layers is crucial for managing burns (homeostasis).

Skin Layers

Epidermis: Five layers, deeper layers constantly divide and migrate to the surface.
Dermis: Crucial for thermoregulation (sweat, piloerection), nerve function, blood vessels and glands responsible for skin regeneration.
Dermal Vascular Plexus: Important for sweating, piloerection, skin regulation, blood flow and skin regeneration.

Burn Classifications

1st Degree: Superficial epidermal, rash, sunburn (no dermis damage).
2nd Degree:
- Superficial dermal: blisters, red, peeling skin, blanch when pressed, capillary refill present.
- Deep dermal: dry, mottled, red skin, may blister; no blanch on capillary refill.
3rd Degree: Full thickness (epidermis and dermis damaged, nerves destroyed, black leathery appearance).

Local Response (Pathophysiology)

Zone of Coagulation: Maximum damage, tissue damaged at the point of injury due to clotting of proteins.
Zone of Stasis: Surrounding zone; decreased tissue perfusion, potentially salvageable.
Zone of Hyperaemia: Outmost zone; increased tissue perfusion, inflammation.

Systemic Response (Pathophysiology)

The release of cytokines impacts the entire body.
Systemic effect when burns are 30% or higher total body surface area.
Cardiovascular changes, capillary permeability increases, vessels leak, (reduced blood flow to extremities).
Release of hormones (adrenaline, noradrenaline, cortisol).

Metabolic Changes

Basal metabolic rate increases up to three times normal.
Gluconeogenesis: increased glucose production.
Insulin resistance: reduced glucose uptake.
Hyperglycemia: high blood sugar.

Treatment Steps

Assess the burn's extent and severity.
Classify burns (superficial, deep).
Establish airway, breathing, and circulation.

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Description

This quiz focuses on understanding burns, their classifications, and the layers of skin involved in their management. Key concepts include the structure of the epidermis and dermis, as well as the various degrees of burn injuries. Test your knowledge on how burns affect skin and the body's response to injury.