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Patient with major burns on his arm, chest and both arms (Background (how…

- - - - temperature regulation
        
        sweat glands
        
        secrete water to prevent overheating
        
        dermal blood vessels
        
        contract to prevent heat loss
      - provide protection
        
        protect against UV radiation
        
        melanin
        
        physical injury
        
        multiple layer of dead flat cells for protection
        
        protection against bacteria
        
        defensins
        
        cathelicidins
      - metabolic function
        
        vitamin D production
      - Cutaneous Sensation
        
        Lamellar
        
        alerts us to bumps or contacts involving deep pressure
        
        Hair follicle receptors
        
        reports on wind blowing through our hair
        
        Tactile
        
        aware of caress or feel of our clothing against our skin
        
        Free nerve endings
        
        sense painful stimuli
      - Blood Reservoir
        
        dermal blood vessels constrict to provide more blood for other organs
      - Excretion
        
        eliminates nitrogen-containing waste
    - - Temperature Regulation
        
        when body is hot
        
        sweat glands secrete water to cool the body
        
        tiny blood vessels in the skin enlarge,permitting
        internal heat to escape
        
        when body is cold
        
        arterioles constrict to minimize heat loss
      - Sensory Reception
        
        skin is a major sense organ
        
        serves as a means of
        communication with the outside environment
        
        Responds to pressure, touch, pain and temperature
      - Protection
        
        main barrier between your internal
        organs and the outside world
      - Absorption
        
        The skin is selectively soluble to fat-soluble substances
        
        substances enter the bloodstream through the capillary networks in the skin
        
        absorbs vitamin A, D, E, and K, as well as steroid hormones
      - Water balance
        
        Water holding capasity, helps
        maintain the body’s balance of fluid and electrolytes
  - - - hair
        
        made of columns of tightly packed dead keratinocytes
        
        helps to protect the body from UV radiation
        
        insulates the body by trapping warm air around the skin
        
        3 major parts: the follicle, root, and shaft
      - nails
        
        sheets of hard keratinized cells
        
        protective covering for the fingers and toes
      - skin
        
        outer covering of the body
        
        largest organ of the integumentary system
        
        provides a waterproof barrier and creates our skin tone
      - glands
        
        Sebaceous gland- oil glands
        
        secretes sebum
        
        lubricate hair and skin
        
        bactericidal
        
        Sudoriferous glands- sweat glands
        
        apocrine
        
        in axillary and anogenital areas
        
        secretes sweat, fatty substances and proteins
        
        milky or yellowish color
        
        types of modified glands
        
        mammary glands
        
        secretes milk
        
        ceruminous glands
        
        produces waxy secretion in ear canal
        
        eccrine
        
        in palms, soles of feet and forehead
        
        secretes water, salts, metabolic waste
        
        prevent body from over heating
        
        regulated by autonomic nervous system
    - - Epidermis
        
        the outer, thinner
        layer of skin
        
        4-5 distint layers
        
        stratum spinosum
        
        layers of keratinocytes
        
        pre-keratin
        
        stratum granulosum
        
        1-5 layers of flattened cells
        
        full of lamellar granules and keratohyaline granules
        
        stratum lucidum
        
        few rows of flat, dead keratinocytes
        
        stratum corneum
        
        20-30 layers of dead cells
        
        flat membranous sacs filled with keratin
        
        most superficial layer in epidermis
        
        glycolipid
        
        keeps layer waterproof
        
        stratum Basale
        
        deepest epidermal layer
        
        sigle row of active mitotic stem cells
        
        made up of both dead and living cells
        
        cells rise to
        the surface to replace the old ones
        
        composed of epithelial cells
        
        4 distint cell types
        
        melanocytes
        
        spider-shaped epithelial cells
        
        synthesize melanin
        
        forms pigment shield from (UV) radiation
        
        dendritic cells
        
        star shaped
        
        ingest foreign substances
        
        activates immune system
        
        keratinocytes
        
        produce keratin
        
        fibrous protein with protective properties
        
        makes cells water prove
        
        tactile cells
        
        spiky hemisphere shape
        
        disclike sensory nerve endings
        
        senses touch
      - Dermis
        
        the inner, thicker layer of skin
        
        made up of strong, flexible connective tissue
        
        types of cells
        
        macrophages
        
        white blood cells
        
        fibroblast
        
        elasticity, or spongy, flexible quality
        
        Nerve endings, hair follicles and glands
        
        vascular
        
        layers
        
        papillary dermis
        
        areolar connective tissue
        
        dermal papilae
        
        get rid of bacteria that penetrated the skin
        
        friction ridges
        
        reticular dermis
        
        dense irregular connective tissue
        
        dermal vascular plexus
        
        collagen fibers form cleavage lines
        
        flexure lines
      - Hypodermis (subcutaneous tissue)
        
        beneath the epidermis
        
        attaches the skin to bone and muscle
        
        mainly for fat storage
        
        insulator
        
        reduces heat loss
        
        shock absorber
        
        not part of skin but shares same functions
        
        made of adipose and some areolar connective tissue
    - - Connective
        
        fibrous connective tissue in the dermis
        
        loose connective tissue and adipose tissue in the hypodermis
        
        support
      - Nervous
        
        Receives stimuli and conducts nerve impulses
        
        structures
        
        lamellar corpuscle
        
        hair follicle receptor
        
        sensory nerve fibers
      - Epithelial-first line of protection
        
        located in the epidermis
        
        surface
        
        avascula- no blood flow
        
        protects against bacteria and viruses
        
        allows secretion
        
        has sensory receptors
        
        stratified squamous epithelium
  - - - affect the epidermis and the dermis
      - cause pain, redness, swelling, and blistering
      - partial thickness burns
    - - go through the dermis and affect deeper tissues
      - result in white or blackened, charred skin that may be numb.
      - full thickness burns
    - - considered mild compared to other burns
      - result in pain and reddening of the epidermis
      - partial thickness burns
  - - - front of head-4.5%
      - back of head- 4.5%
    - - front-18%
      - Back-18%
    - - anterior 4.5%
      - Posterior 4.5%
    - - anterior legs- 18%
      - posterior legs-!8%
  - - - face
      - feet
      - hands
- - - - ice turned into steam
        
        causing an explosion
      - The oil coming into contact with the burner
        
        caused a large fire
      - Man dropped a frozen turkey into a large tub of boiling water
        
        causing it to overflow
  - - - unsafe operations
        
        careless
        
        use of material in an unsafe manner
        
        taking shortcuts
      - no personal protective equipment
        
        goggles
        
        gloves
        
        face shield
        
        apron
      - poor education
        
        incomplete instructions
- - - - Third degree burn
        
        signs
        
        damage is so extensive that there may not be any pain because of nerve damage
        
        waxy and white color
        
        dark brown color
        
        blisters that do not develop
        
        risk for complications, such as infections, blood loss, and shock
        
        treatment
        
        removing dead skin and tissue from the burned area
        
        Intravenous (IV) fluids containing electrolytes and supplementary nutrition
        
        Antibiotic ointments or creams
        
        Pain medications
        
        Functional and cosmetic reconstruction
        
        Skin grafting
        
        extra food calories to replace lost proteins and tissue
        
        healing time
        
        There is no set timeline for complete healing for third-degree burns
        
        wounds heal with severe scarring
    - - First degree burn
        
        signs
        
        pain
        
        red, nonblistered skin
        
        dry, peeling skin occurs as the burn heals
        
        minor inflammation, or swelling
        
        healing time
        
        heal within 7 to 10 days without scarring
        
        treatment
        
        antibiotic ointment and loose gauze to protect the affected area
        
        applying lidocaine (an anesthetic) with aloe vera gel or cream to soothe the skin
        
        take acetaminophen or ibuprofen for pain relief
    - - second degree burn
        
        signs
        
        redness
        
        swelling
        
        blisters
        
        healing time
        
        heal within two to three weeks without scarring, but may cause pigment changes to the skin
        
        treatment
        
        Skin grafting on sever blisters
        
        applying antibiotic cream to blisters
        
        pain medication
  - - - over 10% of the body has 3rd degree burns
        
        chest and abdoment for a total of 18%
  - - - pain
    - - more painful than 1st degree
    - - not painful
        
        nerve ending were damaged
  - - - dehydration because they damage the entire thickness of the skin
    - - severe burns also carry the risk of hypothermia
      - excessive loss of body heat from an injury
    - - an infected burn can cause blood poisoning (sepsis)
      - toxic shock syndrome
      - signs of infection
        
        Greenish discharge or pus
        
        Change in color of the burnt area
        
        Fever.