A man put a frozen turkey into a pot of boiling water and it exploded on him without wearing a shirt

Background Info

Structure of skin

Hypodermis (subcutaneous tissue): deep to skin, not part of the skin but shares the same functions, mostly adipose tissue

Dermis (underlies epidermis)

Epidermis (superficial region)

Maintaining Homeostasis: Functions of Skin

Body Temperature Regulations: under normal resting body temperature sweat glands produce 500 mL of sweat

Protection

Burns

Four types

Melanocytes: produce melanin, gives pigment to the skin

Dendritic (Langerhans) Cells: patrol epidermis, key activators of immune system

Keratinocytes: produce keratin , protective properties

Tactile (Merkel) Cells: sensory receptors that sense touch

Indirect/Direct Causes

Problems

Layers of Epidermis

Stratum Spinosum: "prickly layer," several layers thick, layers of kertinocytes

Stratum Granulosum: four to six flattened out cells, keratinization begins, cells above this layer die

Stratum Basale: "basal layer," deepest of all the epidermal layers, and firmly attached to dermis

Stratum Lucidum: "clear layer," found only in thick skin, two to three layers of clear, flat, dead keratinocytes

Stratum Corneum: "horny layer," 20-30 rows of flat, anucleated, keratinized dead cells

Thin Skin: covers most of the body, lacks stratum lucidum,

Thick Skin: palms fo hands, feet, and surfaces of fingers and toes

Papillary Layer : superficial layer of loose areolar connective tissue, contains dermal papillae

Reticular Layer : 80% of dermal thickness, dense irregular connective tissue,

Cutaneous Sensations: part of the nervous system, exteroreceptors respond to stimuli outside the body such as temperature and touch

Blood Reservoir: skin can hold up to 5% of the body's total blood volume , skin vessels can constrict to shunt blood to other organs

Metabolic Pathways

Rule of Nines: used to estimate fluid loss, body is broken into 11 sections all of which are 9% plus 1% perineum

First Degree: epidermal damage only

Second Degree: epidermal and upper, blisters can appear

Third Degree: entire thickness of skin, skin turns gray-white, cherry-red, or black, skin graft usually needed

Critical if: more than 25% of body has second degree burns, more than 10% of body has third degree burns, or face, hands, and feet have third degree burns

Treatment: debridement (removal) of skin, antibiotics, temporary coverings, or skin grafts

Physical Barrier: block most water and water soluble substances

Biological Barriers: epidermis contains phagocytic cells

Chemical Barrier: skin secretes sweat, sebum, and antimicrobial, melanin provides protection from UV radiation

Excretion: skin can secrete limited amounts of nitrogenous wastes such as ammonia

Metabolic Functions: skin synthesize vitamin D, akin makes collagenase which prevents wrinkles

forehead and face are sensitive but enough to be a second degree burn

second degree burns on arms all the way to his fingers

burned arms and chest , chest is gray white color

Dehydration

Overall pain

Infection

since at least 60% of his body was burned

could cause infection making it harder for him to heal

since it is most of his body, he is more prone to infection due to exposure

burns could effect nerves

electrolyte imbalance

since the third degree burns were severe, especially in chest area, he will need to be given fluids constantly to balance his hydration

arms and hands are blistered causing discomfort

forehead is sensitive

chest and abdomen will be the most painful considering the third degree burn and especially the areas surrounding the burns

treatment swill differ according to the different areas burned