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