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53 Cards in this Set
- Front
- Back
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What is a second degree burn?
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both epidermis and superficial dermis are affected
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Appearance/characteristics of full thickness burn?
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white or charred
dry anaesthetic (nerve destruction) |
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Appearance/characteristics of partial thickness burn?
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pink or mottled with blisters; painful
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type of necrosis in a burn tissue sample?
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coagulative, w/inflammatory cells in adjacent tissue
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burns of at least 20% of the body cause what?
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shift of bodily fluids to interstitial compartment causing hypovolemic shock
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Why does fluid want to go to the interstial compartment when you have over 20% of your body burned? (2)
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increase in interstitial osmotic pressure (because of fragmented dead cells)
increases in vascular permeability |
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What effect do water soluble gases (ammonia, chlorine, sulfur oxides) inhaled in a fire have on the airway
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lead to inflammation of the upper airway, causing obstruction
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What effect do lipid soluble gases (nitrous oxide, burning plastics) inhaled in a fire have on the airway
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reach the deeper airways, causing pneumonitis
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Leading cause of death in burn patients?
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organ system failure due to sepsis
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most common bug that infects burn patients? Other two to worry about too?
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most common: psuedomonas aeruginosa
others: staph, candida |
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Why is a burn site ideal for infection? (3)
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serum and cellular debris provide nutrients
no inflammatory response because burn compromised blood flow cellular and humoral defenses against infection are compromised |
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two purposes of aggressive, early debridement of burn wounds?
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provide a clean, vascularized surface for wound repair
allow phagocytes ready access to invading/opportunistic bugs |
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why do burn patients starve to death?
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burns over 40% of the body cause hypermetabolism (double normal). Tissues end up being broken down for protein to use.
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treatment for hypermetabolic state of burn patients?
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elevate room temp to avoid body heat loss
nutritional supplementation |
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Three kinds of hyperthermia?
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heat cramps
heat exhaustion heat stroke |
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what are heat cramps?
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loss of electrolytes through sweating, happens in voluntary muscles during exercise
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What is heat exhaustion?
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the CV system fails to compensate for hypovolemia due to water loss from sweat. You collapse and then spontaneously recover
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what is heat stroke
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thermoregulatory mechanisms fail and core body temp rises
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mechanism of heat stroke
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marked peripheral vasodilation, so the blood pools up there and doesn't circulate effectively
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what can hasten the lowering of body temperature in hypothermia?
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cold, wet clothing
superficial vasodilation from alcohol |
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what is trench foot?
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slowly developing change that happens w/hypothermia: vasoconstriction and increased vasopermeability lead to edema, followed by atrophy and fibrosis
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So trench foot is a slow drop in temp, what happens with a fast drop in temp?
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sudden vasoconstriction and increased blood viscosity cause ischemic injury and damage to peripheral nerves.
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Fast drop in temps produce ischemia in tissues, what does this do?
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hypoxic changes and infarction of the affected tissues (gangrenous toes for example).
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why is wet skin more vulnerable to electrocution than dry skin
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lower resistance, means less of the energy is dissipated right away and it can travel through you
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flashover - def?
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when lightning hits someone and is conducted around them, blasting off the clothing but causing little damage
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Mech of high altitude illness?
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low oxygen causes confusion, and increased capillary permeability leading to pulmonary and generalized edema
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air blast injury - what happens?
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violent increase in pressure (blast wave) collapses the thorax or abdomen, can rupture internal organs
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difference between air blast and immersion blast injury?
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immersion happens in water and the force comes from all sides, not just one
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mech of decompression (Caisson) disease?
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deep sea divers have lots of atmospheric pressure, causing lots of oxygen and nitrogen to dissolve in the blood. When they come up and the pressure is released, the gas makes bubbles that come together and form an embolus in the vessel
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What is caisson disease of the bones?
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foci of aseptic necrosis in the bones, due to embolic occlusion of blood supply
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what does food preserved by smoking have in it?
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N-nitrosamines, a carcinogen
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Three components of an adequate diet?
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energy (carbs, fats, protein)
amino/fatty acids (used for making proteins and lipids) vitamins and minerals |
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what is primary malnutrition?
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one of the three essential components of the diet is missing
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what is secondary/conditional malnutrition?
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supply of nutrients is ok, but something is wrong in the body, and they aren't able to work right (malabsorption, impaired use/storage, etc.)
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what happens to infants fed only milk?
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iron deficiency
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what is PEM?
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protein-energy malnutrition - range of clinical syndromes caused by inadequate dietary intake of protein and calories
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important nutritional deficiency in alcoholics?
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thiamine deficiency
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What are the somatic and visceral protein compartments?
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somatic - skeletal muscle
visceral - in organs, mainly the liver |
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marasmus - def?
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calorie deficiency
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Kwashiorkor - def?
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protein deficiency
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how can you tell if the visceral protein compartment has enough protein?
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serum protein levels
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clinical definition of malnourishment?
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body weight falls to less than 80% of normal
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why does a child w/Marasmus lose muscle?
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the somatic protein department is being catabolized to make up for the deficiency in calories
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expected serum albumin levels in a marasmus patient? why?
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normal, because the serum protein reflects the visceral protein compartment status, and that is barely affected in marasmus (visceral protein is more precious to life than somatic)
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immune effects of marasmus?
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T cell deficiency
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why do you get generalized (aka dependent) edema w/Kwashiorkor?
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because protein is lost from the visceral compartment causing hypoalbuminuria, makes fluid leave the vasculature and cause edema
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how does kwashiorkor affect muscle mass and fat stores?
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doesn't really
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skin lesions characteristic of Kwashiorkor?
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alternating hyper/hypopigmentation ("flaky paint")
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difference in liver condition of Kwashiorkor vs marasmus?
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in kwashiorkor you see enlarged, fatty liver due to reduced synth of carrier proteins
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name for malnutrition seen in pts w/secondary PEM. what are the symptoms?
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cachexia
depletion of sub q fat muscle wasting sacral or ankle edema |
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difference in signs of cachexia and anorexia nervosa?
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cachexia you lose both fat and muscle
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effect of marasmus on the small intestine?
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mucosal atrophy and loss of villi and microvilli - this means they can't just be put on a normal diet right away (won't work)
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effect of marasmus/kwashiorkor on bone marrow? type of anemia seen?
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hypoplastic, because of fewer red cell precursors.
hypochromic microcytic anemia |
