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Physical and Chemical Injury to the Skin
Terms in this set (68)
What are the 3 layers to the skin?
Epidermis, dermis, subcutaneous tissue
So the skin covers the entire body surface and merges with mucous membranes where?
At portals of entry/exit
What are the 4 types of specialized dermal appendages?
Scent (apocrine) glands
Scent glands release _________
What are the 3 sensory organs involved with the skin?
1. Pacinian corpuscles
2. Meissner corpuscles
3. Merkel cells
The skin is a protective barrier against what 3 things?
3. Heat, fluid, and electrolyte loss
The skin has insulation via what?
Dermal and Subcutaneous fat
Skin is essential for temperature regulation by what 3 things?
Convection (production and evaporation of sweat)
Tight epithelial intercellular adhesion
Skin supports _________ nerve endings
Skin is a ________ protective barrier and _______ barrier
What type of cells migrate from skin to present antigen to lymph nodes?
What two things make skin inhospitable to microbial attack?
1. Sebaceous secretions
2. Commensal bacteria
Chronic exposure to solar radiation leads to the generation of what?
1. Formation of Reactive oxygen species (ROS) and the
2. Activation of transcription factors that enhance inflammation and the breakdown of collagen by MMPs and inhibit the synthesis of new collagen
Actinic (Solar) Damage coagulates what?
Elastin fibers in skin
Actinic (Solar) Damage causes skin to do what?
It becomes saggy and stretches and loses recoils and causes the skin to tear easily and repair more slowly
Actinic change is noted as what 7 things?
5. Yellowing of skin
7. Elastosis (lines and wrinkles)
What are 3 acute outcomes of UV radiation on the skin?
1. Sunburn inflammation (erythema)
2. Tanning (increased melanogensis)
3. Local/systemic immunosuppression
What are 3 chronic outcomes (due to multiple exposures over time)
What is Hyperthermia?
Prolonged exposure to elevated ambient temperatures
Hyperthermia can cause what 3 things?
A heat cramp is due to what?
Loss of electrolytes via sweating
What is a hallmark of heat cramps?
Cramping of voluntary muscles, usually associated with vigorous exercise
What is the most common hyperthermic syndrome?
Heat exhaustion is sudden onset with ______ and ______
Prostration and collapse
Heat exhaustion is due to failure of what?
The cardiovascular system to compensate for hypovolemia (decreased blood circulating in the body) caused by dehydration
If the individual can rehydrate, what happens?
Equilibrium is re established
A heat stroke is due to what 3 things?
1. High ambient temperatures
2. High humidity
What 3 types of individuals are at high risk for heat stroke?
1. Older adults
2. Individuals undergoing intense physical stress
3. People with cardiovascular disease
What are the 3 common symptoms of heat stroke?
1. Thermoregulatory mechanisms fail,
2. sweating ceases
3. core body temperature rises to above 40 celsius, leading to multi organ dysfunction that can be fatal
The heat stroke hyperthermia is accompanied by what when it comes to blood and blood vessels?
vasodilation, with peripheral pooling of blood and decreased circulating blood volume
What are 3 common systemic effects from heat stroke?
What can worsen the hyperthermia and lead to muscle necrosis (rhabdomyolysis)?
Sustained contractions of skeletal muscle
What is malignant hyperthermia?
Heat stroke like rise in core body temperature and muscle contractures following exposure to common anesthetics
Malignant Hyperthermia causes inherited mutations in what?
What does RYR1 regulate?
The release of calicium from the sarcoplasm
With mutation, the calcium does what?
Leaks from sarcoplasm into cytoplasm stimulating muscle contraction and heat production
Hypothermia is due to what?
Prolonged exposure to low ambient temperatures
Hypothermia is commonly caused by what 3 things?
1. High humidity
2. Wet clothing
3. Dilation of superficial blood vessels resulting from the ingestion of alcohol hasten the lowering of body temperature
At what temperature does loss of consciousness occur?
About 90 Farenhite
Direct effects from Hypothermia are caused by what?
Due to physical disruptions within cells by high salt concentrations caused by the crystallization of intra- and extracellular water
Indirect effects of Hypothermia are due to what?
Circulatory changes, which vary depending on the rate and duration of the temperature drop
Slow chilling causes what?
Vasoconstriction and increases vascular permeability, leading to edema and hypoxia
Sudden, persistent chilling causes what?
Vasoconstriction and increased viscosity of the blood in the local area and may cause ischemic injury and degenerative changes in peripheral nerves
When looking at sudden chilling, vascular injury and edema become evident only after what?
The temperature begins to return to normal
During the period of ischemia, _______ changes and _______ of the affected tissues may develop
Now looking at burns, burns cause what?
Cells and tissues to denature and undergo coagulative necrosis (accidental cell death)
Chemical burns are caused by what?
Caustic chemicals within strong acids or alkalis
Thermal burns are caused by what?
Direct contact with an external heat source
Electrical burns (massive amount of electricity travels through body tissues) may involve what?
Deep tissues, internal organs, muscles, nerves without obvious skin damag
The clinical significance of burn injuries depend on what 4 things?
1. Depth of the burns
2. Percentage of body surface involved
3. Internal injuries caused by the inhalation of hot and toxic fumes
4. Promptness and efficacy of therapy
Burn injuries are classified according to what?
Depth of skin damage
Superficial (1st degree) burns are confined where and take how long to heal?
Confined to the epidermis..... heal in about a week
Partial-thickness( 2nd degree) involved where and take how long to heal?
Involve the dermis..... and heal within 1-2 weeks and don't usually scar unless deep dermis is involved
Full thickness (3rd degree) burns involve what?
Entire dermis and subcutaneous fat..... often requires grafting
When looking at complications of burn injuries, what are the 3 greater threats to life?
3. Respiratory insufficiency
In burns >20% of the body surface, the systemic inflammatory response syndrome causes what?
A rapid shift of body fluids into the interstitial compartments, both at the burn site and systemically leading to shock
Generalized edema (swelling), including pulmonary edema can be severe due to what?
Widespread vascular leakiness
Within 24-48 hours post-burn, injury to the airways and lungs may develop due to what 2 things?
1. Direct effect of heat on the mouth, nose, and upper airways
2. Inhalation of heated air and noxious gases in the smoke
How do you treat first degree burns and shallow partial-thickness burns?
Topical antibiotics (silvadene) geven to prevent bacterial infection
Electrical injuries depend on what?
The strength (amperage), duration, and path of the electric current within the body
Electrical injuries, often fatal, arise from contact with what?
1. Low-voltage currents
2. High voltage currents carried by high-power lines or produced by lightning
What are the two types of injuries associated with Electrical injury?
2. Ventricular fibrillation or cardiac and respiratory center failure, due to disruption of normal electrical impulses
What is radiation?
Energy that travels in the form of waves or high-speed particles
Energy of non ionizing radiation can cause what?
Atoms in a molecule or cause them to vibrate, but insufficient to displace bound electrons from atoms
Energy of ionizing radiation is sufficient to cause what?
Ionizaiton - electron collision with other molecules with release of electrons in a reaction cascade
What are 4 sources of ionizing radiation?
1. X-rays and gamma rays
2. High energy neutrons
3. Alpha particles
4. Beta particles
Ionizing radiation is a double edged sword, because you need with treatment, but it produces what 4 adverse effects?
Besides the physical properties of the radiation, ionizing radiation has what 5 biologic effects?
1. Rate of delivery
2. Field size
3. Cell proliferation
4. Oxygen effects and hypoxia
5. Vascular damage
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