Human Skin Structure and Burns

Questions and Answers

What is the most common organ affected by burn injuries?

Heart

Kidneys

Lungs

Skin (correct)

Which of the following can lead to coagulation and necrosis of tissue?

Scalds

Cold exposure (correct)

Electrical injuries

Chemical burns

What is a potential complication affecting the gastrointestinal tract due to burn injury?

Ileus (correct)

Cirrhosis

Enteritis

Cholecystitis

What type of burn injury is most commonly associated with flammable liquids and matches?

Flame burns Signup and view all the answers

What is a likely consequence of edema resulting from endothelial damage in burn injuries?

Fluid loss and shock Signup and view all the answers

What is the primary zone of injury in a burn characterized by irreversible tissue loss?

Zone of coagulation Signup and view all the answers

Which function of the skin helps maintain hydration and balance electrolytes?

Preventing loss of water & electrolytes Signup and view all the answers

In which zone does tissue perfusion decrease but is potentially salvageable if managed properly?

Zone of stasis Signup and view all the answers

What is the average weight of the skin, the largest organ in the body?

4 kg Signup and view all the answers

What consequence does prolonged hypotension have on the zone of stasis in burn management?

Converts it into a zone of coagulation Signup and view all the answers

Which type of cell is NOT found in the epidermis?

Fibroblasts Signup and view all the answers

What is the outermost zone of a burn where tissue perfusion is increased?

Zone of hyperemia Signup and view all the answers

What is a common primary function of the skin in addition to its protective role?

Shock absorption Signup and view all the answers

What is the primary effect of carbon monoxide (CO) on hemoglobin?

Displaces oxygen due to higher affinity Signup and view all the answers

At what percentage of carbon monoxide saturation can symptoms such as headache and confusion occur?

15 - 20 % Signup and view all the answers

Which of the following is the most appropriate fluid for burn resuscitation?

Ringer's lactate Signup and view all the answers

What is the half-life of carbon monoxide in the bloodstream while breathing 100% oxygen?

40 minutes Signup and view all the answers

Which statement regarding the assessment of burn size is true?

A patient's whole hand is equal to 1% TBSA. Signup and view all the answers

What is the main concern when managing a patient with potentially high compliance during chest/escharotomy?

Increased blood loss Signup and view all the answers

What should be done immediately after discovering a patient is experiencing carbon monoxide intoxication?

Take the patient outside Signup and view all the answers

Which condition is most likely to occur with a carbon monoxide saturation greater than 60%?

Hallucination Signup and view all the answers

Which of the following is NOT a recommended topical antimicrobial for infection control in burns?

Betadine (10%) Signup and view all the answers

What is a key requirement for an early enteral feeding approach in burn patients?

Increased protein intake Signup and view all the answers

Which of the following criteria indicates a major burn injury?

<blockquote> 30% Body Surface Area (BSA) </blockquote> Signup and view all the answers

Which sign or symptom is NOT indicative of sepsis diagnosis?

Blood pressure <90/60 Signup and view all the answers

What is a consequence of electrical burns that requires careful monitoring?

Myoglobinuria and hemoglobinuria Signup and view all the answers

Which method is NOT typically used to assess burn depth?

Wet dressing application Signup and view all the answers

In the Lund and Browder chart, how is the entire trunk estimated regarding burn surface area?

36% Signup and view all the answers

Which of the following statements is true regarding superficial burns?

They typically cause capillary filling. Signup and view all the answers

What is the appropriate referral percentage for a child before referring to a Regional Burn Unit?

10% Signup and view all the answers

Which fluid resuscitation formula requires 4 ml/kg/% burn over 24 hours?

Parkland Signup and view all the answers

What characterizes full-thickness burns?

They feel leathery and have no sensation. Signup and view all the answers

What aspect of burn injury management has NOT contributed to decreased mortality rates?

Prevention of secondary injuries Signup and view all the answers

What percentage is assigned for the groin area in the Rule of Nines?

1% Signup and view all the answers

Study Notes

Structure and Function of the Skin

Largest organ, averaging 4 kg and covering approximately 2 m²
Composed of two main layers: Epidermis (four cell types: Basal, Prickle, Granular, Horny) and Dermis (two parts: papillary and reticular)
Protective barrier against microbes, chemicals, and water loss; also regulates temperature, provides sensation, and synthesizes Vitamin D

Zones of Thermal Injury

Zone of Coagulation: Closest to heat source; irreversible tissue loss due to protein coagulation.
Zone of Stasis: Reduced perfusion; potentially salvageable tissue, may progress to coagulation without proper management.
Zone of Hyperemia: Increased blood flow, typically recovers unless severe systemic issues arise.

Aetiology of Burns

Common causes include: scalds (children), flammable liquids (adolescents), flame burns (adults), electrical injuries, chemical burns, and rare causes such as cold or radiation.
Drug reactions and immunological responses (e.g., Toxic Epidermal Necrolysis) also contribute.

Pathophysiology of Burn Injury

Primarily affects the skin but can impact airways, lungs, and gastrointestinal tract.
Risk factors include inflammation, metabolic issues, and circulatory changes (e.g., capillary leak syndrome).
Potential for gastric complications, such as Curling ulcers from hypoperfusion.

Carbon Monoxide Intoxication

Symptoms range from headache (15-20% CO) to death (>60% CO).
High affinity of CO for hemoglobin reduces oxygen delivery and can cause anoxia.

Emergency Department Protocol

Breathing: Administer 100% oxygen; assess for chest trauma.
Circulation: Identify shock causes, initiate fluid resuscitation with Ringer's lactate; start two 14g cannulae.
Disability: Monitor GCS; investigate neurological status.
Exposure: Control environment, cover burns, and estimate size using the Rule of Nines.

Burn Assessment

Use the patient’s whole hand (1% TBSA) and the Rule of Nines for initial assessment.
Lund-Browder chart is preferred for children due to body proportion variations.
Determine burn depth through clinical examination; utilize pinprick tests or laser Doppler.

Fluid Resuscitation

Use formulas such as Parkland (4 ml/kg/% burn, with specific timing) for calculating fluid requirements and managing metabolic acidosis.

Nutrition and Recovery

Increased protein requirement; early enteral feeding helps prevent complications such as ileus and bacterial translocation.

Infection Control

Focus on hand hygiene, isolation precautions, topical antimicrobials (e.g., silver sulfadiazine), and wound cleaning techniques.

Major Thermal Injury Criteria

Classified as greater than 30% TBSA; special care for burns on hands, face, genitalia, or those exceeding 10% in adults and 5% in children.
Inhalation injuries and electrical burns require specialized management due to increased risks.

Simplified Referral Criteria

Patients exhibiting significant burns, suspected inhalation injuries, or existing health challenges (e.g., elderly or children) should be urgently referred for comprehensive care.

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Description

Explore the intricate structure and function of the skin, the largest organ of the body. This quiz covers the layers of the skin, the zones of thermal injury, and the aetiology of burns. Test your knowledge on how skin protects and heals.