Protection- 5.1

Explain why it is wise to give a burn victim "broad-spectrum" antibiotics.

When a subject receives a burn they are more prone to infection as the body's first line of defense is now breached. This will make it easier for pathogens to get quickly into the bloodstream and wreak havoc. Doctors will often prescribe broad spectrum antibiotics because they want to prevent infections from developing early and not have any more pain and issues to deal with.

what is the largest organ in the human body?

skin

2nd degree burns

(epidermis and part of the dermis) appears red, swollen and may have blisters scald injuries, flames, sunburn, chemicals, brief contact with hot objects and electricity can cause these treat with ointments, daily cleaning of the wound, change bandages twice a day, possible medications

1st degree burns

(epidermis) red, painful, dry, peeling occurs superficial no blisters ex: mild sunburn, flash burn (fast release of heat) long term tissue damage is rare treatments: cold compression, lotion/ointments and ibuprofen usually not bangaed

how many skin cells are shed per minute?

-35,000 -shed 9 pounds of cells per year

what can skin protect against and do for our bodies?

-bacteria -waterproofing -damaging sunlight -harmful chemicals -prevents infections (keeps out invaders) -manufactures vitamin D -packed with sensors -allows free movement

20-30

-cell turnover decreases -1% less collagen is being produced every year -collagen and elastin fibers become thicker , more clumped and losser -results in some wrinkles and sagging -exfoliation (getting rid of dead skin cells) decreases, dead skin cells clump together and stay for a longer time -number of melanocytes begins to decrease -lose a little 'baby fat" or the fat layer slightly decreases in size

50-60

-cell turnover takes 36-40 days -deepening of lines and wrinkles -skin becomes dry -the sebaceous gland decrease in size (produces less sebum easily bruised, damaged or broken)

what happens in remodeling/maturation?

-collagen is aligned along tension lines and cross links to provide strength to the wound -wounds mature -blood vessels heal and strengthen -other protein connection strengthen as well -skin regains some, but not all, of original strength -skin does not fully recover- scarring occurs

40-50

-collagen is no longer produced -collagen and elastin fiber break, thicken, stiffen, loose elasticity -results in aging line, wrinkles, and sagging

how do third degree burns affect the skin?

-completely destroyed dermis and epidermis, -can penetrate into hypodermis -loss of fat cells causing hypothermia -arterioles and venules can be damaged (more blood loss) -extreme pain, strong immune system response, all body systems direct energy to treating the injury

how does 1st degree burns affect the skin?

-damages cells in the epidermis -damages melanin -damages DNA so mutations can be present in other cells produced (like keratinocytes or melanocytes) -causes pain and swelling, trigger immune system and cell regrowth

what contributes to dust in homes?

-dead skin cells -other dust and particles

what is constantly happening on your skin?

-dead skin cells are being shedding -being replaced with new ones

how do second degree burns affect the skin?

-destroys cells in the epidermis (keratinocytes and melanocytes) -damages capillaries (leaks fluid) -damages nerve endings -damage hair follicles or hair shaft -can damage sweat gland and sebaceous gland (wound often appears wet and moist because capillaries and sebaceous gland leaks fluid) -causes pain, blisters, and swelling, triggers immune system, can cause dehydration and decreasing body temperature- triggers circulatory system and muscular system to heat up body, riggers urinary system to retain water

what are the 3 layers of skin?

-epidermis -dermis -subcutaneous (fat layer)

infancy to 20 (skin aging)

-fast skin cell turn over (28 days) -natural oil that nourishes and moisturizes -cells are round and healthy looking -excess oil on the skin due to hormonal changes during puberty

what happens in proliferative stage?

-fibroblast cells begin to enter the wound -occurs 2-3 days after injury -produce collagen in the wound that forms connective tissue to replace fibrin -the cells in the epidermis begin to divide and form the barrier again and the dermis contracts to bring the cells closer together

elastin

-flexible and elastic, -allows tissue to resume shape after stretching -found in upper layers of the dermis

functions of the skin

-form a barrier between the body and environment to keep out foreign substances -protects from UV radiation -protects from physical injury -regulates body temperature (muscular, nervous, circulatory) -helps to synthesize vitamin D (endocrine) -sense hot, cold, pain, and touch (nervous) -can prevent loss of bodily fluids (blood) (urinary) -permits growth of the body -excretes water (urinary, nervous)

besides years, how else can the skin age?

-free radicals cause damage to the skin and cause it to age by damaging DNA -free radical from sunlight, pollution, smoking -cause skin proteins to be more brittle and less elastic

what makes up the integumentary system?

-hair -skin -nails

what are the 4 stages of healing?

-hemostasis -inflammation -proliferative -remodeling

collagen

-in dermis, -give skin its strength, durability, support and texture -plays a role in the replacement of dead skin cells

keratin

-in epidermis - anchors cells together and to the dermis -filament proteins that keeps cells together -function: hold cells together to form a barrier and form outermost layer of skin

what provides the first line of defense?

-integumentary system -skin

functions of skin

-keep out invaders -protect body from injury -keep important substances in

what comes from the pores?

-liquid that oozes out -serves to protect and regulate

nerves

-nerve endings on dermis and epidermis that signal heat, pain, touch and temperature -nerves stimulate sweat glands and arrector pili muscles

melanin

-pigment that contributes to skin color -comes in different shades based on genes -epidermis

hair follicle

-produces hair shaft -enhances sensation -helps regulate body temp -helps with protection

sweat gland

-produces sweat(in response to heat/stress) -released onto the epidermis -sweat composed of water, salt and other chemicals -evaporating sweat helps cool the body

sebaceous gland

-secretes sebum onto hair follicles sebum = oil that keeps skin moist and soft, acts as a barrier against foreign substances

60+

-skin gets loose -massive breakdown of collagen and elastin fibers -fat layer grows thinner resulting in more translucent skin -blood vessels more prominent -skin can look more discolored

what happens in inflammation?

-skin turns red about 3 hours after -at this point, bleeding is under control and outside barrier is secured -cells are sent to fight any pathogens that entered the body -white blood cells/macrophages destroy damaged/dead tissues and bacteria, pathogens or other foreign substances through phagocytosis -also produces growth factors to help healing -vasodilation (dilation of the blood cells) occurs to allow white blood cells and other factors to reach the wound site

arrector pili muscle

-small muscles attached to hair follicle -causes goose bumps -smooth muscle -pulls hair shaft -inserts on hair follicle

dermal papillae

-small projections that create an uneven boundary from the dermis into the epidermis, ridges - create fingerprints -provide blood supply and nutrients to the epidermis

what happen when you sunburn?

-some uv radiation can sneak by melanin and damage DNA -causes cells to produce warning signals -if enough cells produce this, inflammatory response is triggered (increased blood flow, more nutrients and WBC) -peeling caused when the damaged keratinocytes reproduce and don't mature properly -cause them to clump and peel off

blood vessles

-supply blood to the dermis -arterioles and venules -provides nutrients to the skin -helps regulate body temperature (dilations/constriction of blood vessels)

what are examples of accessory organs found in the skin?

-sweat glands -hair follicles

what happens in hemostasis?

-the wound in the dermis fills with blood from broken blood vessels -vasocontriction (blood vessels constrict) occurs to minimize bleeding -blood clot forms(forms on the surface of the wound, epidermis, and blood dries) - platelets, red blood cells, clotting factor, fibrin fibrin (protein) forms cross links across the clot to prevent blood from flowing out and pathogens from getting in -results in a scab

30-40

-transfer of moisture from dermis to epidermis is slowed -fat cells start to shrink -make the skin look dull and thin -cell turnover is slowed and cells are flatter -dermal papillae begins to flatten providing less nutrients to the epidermis

if you spread out the skin, how much space would it cover? how mush does it weigh?

-twenty square feet -10 pounds

how many layers does skin have?

3

psychologist

A burn can cause more than physical pain, but inner turmoil as well. A psychologist must help these patients cope with this major injury as they may even have PTSD, depression and dissatisfaction with their appearance. Psychologist must be patient and understanding with their patients as they are going through a very tough time in their life.

Why does Amy finally feel pain once she has been rescued?

Amy feels pain once she has been rescued because she is relaxed now and not in danger. The resulting signals her brain that she is safe from danger and not in "survival mode" any longer. The nervous system does not release endorphins any longer. When she was stranded, she had little to no resources to fight off nature. Pain would only inhibit her from surviving. The body suppresses this pain to help keep her alive.

Why did Amy's body want to keep her from feeling pain after her injury?

Amy's body kept her from feeling pain after injury to help her survive. This allows her to flee the dangerous situation and find enough available resources. If she felt pain, she would hurt so much she wouldn't be able to move or she would be able to only move slightly. Inhibiting the pain ultimately saves her life.

anesthesiologist

Burn treatment provides many challenges for an anesthesiologist as factors such as airway management, ventilation, heat-loss, fluid loss and cardiovascular instability. Most often if the burn is bad enough it will require an immediate operation and the anesthesiologist will have the knowledge to apply the correct amount of anesthesia even with the turmoil occurring in the body.

Describe the impact CIPA might have on other human body systems.

CIPA primarily affects the nervous system but also affects many other body systems and functions. First, it affects the body's ability to maintain body temperature. The sweat glands do not function properly so they do not produce sweat. This causes the core temperature to rise which affects the optimum temperature of other chemical reactions that occur. Next, this rare disease causes the inability to feel the need to urinate. This puts pressure on the urinary system, especially the bladder. The bladder can only hold up to about 2000 ml max of fluids before either you pass out and urinate or your bladder burst. This condition inhibits pain signals so often times scratching too hard or bumping into something and not realizing it will cause bleeding. When these are ignored, they can cause severe scarring which damages the integumentary system. Lastly, CIPA affects the skeletal system. Falling or bending bones in an unnatural way and still putting pressure on them can cause bone fractures and joint deformities. Still putting pressure on these bones can cause worse injuries to the bones and cause permanent damage.

Knowing what you do about the structural components of the skin, why do you think collagen is used in cosmetic procedures to fill and hide wrinkles?

Collagen is a key component of the skin as it acts like a framework for the rest of the structure and forms fibers. When people are younger they have moist and elastic skin, however as they grow older the collagen support framework deteriorates so the skin loses its elastic ability and creates the dreaded wrinkles. This is why collagen is used so often in the beauty world to help get rid of these unwanted wrinkles as the new collagen will help to rebuild the lost framework.

CIPA

Congenital Insensitivity to Pain with Anhidrosis -genetic disorder -can't feel pain

physical therapist

Designs activities and workouts to return a patient back to full capability or as close as possible after a burn alters their ability to perform certain functions. They must be patient and good with people in order to do their job well as they will deal with differing people all the time.

reconstructive surgeon

Duty is to recognize that they will more than likely not be able to get rid of all burn scars, but need to focus on restoring as much ability as possible to the skin. If scars are located on the face this can interfere with the function of the eyelids, lips and nostrils. Reconstructive surgery will help to avoid permanent damage and make one's appearance more normal. Often times this will take several months so the patient and surgeon must have a good relationship.

What are endorphins and how do these chemicals alter the communication of pain in the body?

Endorphins are chemicals released from the pituitary gland in response to pain. (natural pain relievers) They bind to opioid receptors in the brain triggering it to release chemical to block pain signals. These chemicals can coast synapses of nerves to block pain signals from traveling. The thick barrier prevents neurotransmitters from reaching binding sites so the signal is not able to travel down the neurons. This results in the body not feeling pain in order to aid with survival.

Explain the role inflammation plays in protecting the body.

Inflammation occurs when the skin is punctured or an injury present in the body. It is the swelling (redness) of the bodies tissues because of the white blood cells and other immune cells. The white blood cells attack the foreign substances and pathogen that have entered the body. This helps destroy harmful substances and heal the wound.

Examine why a person with third degree burns may feel limited or no pain.

Often times a third degree burn will cause little to no pain because the burn will go through the epidermis, dermis and maybe even the hypodermis. This deep penetration will damage or destroy the nerve endings and therefore pain signals will not be able to be sent to the brain and registered throughout the body.

Describe how other human body systems interact with the skin to protect the body.

One other body system that helps the skin protect the body from harm is the cardiovascular system. If the layer of the skin is cut and the barrier between the outside world and the body is broken, the blood vessels will be broken and blood will begin to pool around the wound. After this occurs the blood will eventually begin to clot and the cut will be closed temporarily until a scab forms. The immune system is also involved as white blood cells will come into effect to help get rid of any foreign invaders such as bacteria that will create an infection. A final system that interacts with the skin is the endocrine system, it will secrete oil from the exocrine gland to keep dust, dirt and bacteria out of the body.

How can pain be considered a protective mechanism?

Pain is a protective mechanism because it signals the brain and the body that there is an issue that needs attention and correcting. If pain wasnt felt we would more than likely not notice something was wrong unless is was extremely obvious. Pain can sometimes not be effective which is why the body and brain has the ability to shut off pain signals by sending in a flood of endorphins to counteract and override the signals. This normally occurs when we are in extreme situations or danger that needs full focus and effort to survive.

Why does the signal of pain move slower than other signals in the body? Why does the nervous system allow this lag time, and how does this delay relate to protection of the human?

Pain moves slower than any other signal in the body, allowing us to feel the delay between injury and pain. The nervous systems allows this to protect us. The lag time lets us flee a dangerous situation before the intense feeling sets in. If pain set in earlier, we would be trapped in the situation because the intense feeling would overcome us.

burn care nurse

Responsible for treatment of patients located in the burn care unit of the hospital. Their job is to manage the fluid levels and pain as well as critical care and stabilization of the patients. Those suffering from severe burns will be of all different backgrounds and ages so the nurses must be adapted to deal with people well.

What do you think is going on inside the body of these individuals that keeps them from feeling pain? Provide at least two possible mechanisms.

Studies have shown that in CIPA, there is not a problem with the messages being sent, the signals can travel just fine. But it is a hereditary condition that causes the nerves to not be formed or function properly. Some scientists say that there is an absence of nerve fibers (myelinated and unmyelinated) throughout the body. This inhibits the signal of pain from going all the way to the brain and being processed. Another mechanism that was present was the absence of sensory neurons in the dorsal root ganglia (collection of cell bodies of sensory neurons). This was proposed for a reason why pain signal were not reaching the brain and being interpreted.

Explain how the homeostasis in the body may be disturbed by 2nd degree burns.

The body will be thrown out of homeostasis if one contracts a second degree burn. This is because this severity of burn will cause inflammation and send white blood cells in attempt to treat the wound and possible bacteria on it. This disrupts the normality at which the body normally operates and therefore affects the homeostasis.

Briefly explain how pain is interpreted by the brain.

The brain receive signals from nerve endings and sensory nerves in the body that indicates a wound or injury. There are nociceptors present in the skin which are receptors for pain. These receptors sense a wound/injury so they send a signal to a sensory neuron that leads to the spinal cord to the brain. The signal travels slowly to create a lag to allow time to flee the threatening situation. The brain interprets these pain signals and signals motor neuron to run or stay put. Then, the pain is felt. This can cause them to stop doing a painful activity or get help. Endorphins are released and if the situation is dire and enough is released, then pain is masked in order to let the person fight for survival and heal.

How does the epithelial tissue found in the epidermis of the skin differ in structure from the connective tissue found in the dermis of the skin? How is this structure linked to the function of each layer?

The epithelial tissue has the cells tightly packed together and no blood vessels in it. The dermis is made up of loosely packed connective tissue so the cells are not as closely located in relation to each other in comparison to the epidermis. Also this tissue will contain blood vessels within it.

Compare the role of pain in each of the video cases. Why did the body want to keep Amy from feeling pain, but want David to feel pain?

The role of pain in both cases is to protect the body. In Amy's case, the body prevented the pain signals so she could flee the dangerous situation. If pain was present, she would be struck in the same place, not able to obtain resources needed to survive. David's body wanted him to feel pain, again, to protect him. The pain is inflammation of the injury. Inflammation is a vital process to healing and protects the body.

How do the skin and the nervous system interact to allow you to feel pain?

The skin and nervous system both allow you to feel pain. The skin contains hundreds of nerve endings that lead to sensory nerves. (part of the nervous system) these sensory neurons carry the signal of the wound to the to spinal cord and then to the brain. The signal is carried slower however to allow time to flee the situation of applicable. The brain then processes the injury and then sends a signal of pain back. The signal travels down your spinal cord, through sensory neurons and into the nerves endings in the skin causing you to feel pain in that certain area of the body.

How do the skin proteins - keratin, melanin, elastin and collagen - each contribute to our physical identity? How about the dermal papillae?

The skin protein of keratin contributes to our physical identity by making up most of our hair and keeping it hydrated and healthy. Melanin determines and contributes to our skin color which is another major factor in our appearance, and collagen makes up the framework of our skin which keeps it elastic as well as wrinkle free. Elastin is another protein that is very important because it allows for the skin to keep its original shape after stretching or contracting. Finally dermal papillae creates the ridged lines that make up our distinct hand and foot prints which in a lot of ways helps people determine who we are. All in all these factors help to make up our physical appearance and our identity.

Explain how the skin helps in regulating body temperature. Mention at least two of the structures you labeled in your model. 2 structures that help maintain body temperature are the sweat glands and the hypodermis (fat layer).

The sweat glands receiving signals of the bodies increasing temperature. They are triggered to release sweat, made up of mostly water, with a few other chemicals in the body onto the surface of the epidermis. This liquid then evaporates carrying some of the body's heat away with it. The hypodermis does the opposite, it helps keep the body warm. It is composed of fat molecules that sit right above the muscle tissue. This provides insulation for the body by keeping body heat in.

Based on what you know about the structure and function of different types of tissue in the body, what specific type(s) of tissue do you think make up human skin? Explain your reasoning.

The type of tissue that makes up the skin is epithelial tissue. This tissue helps to protect the body from the outside world. It will keep bacteria, dirt and dust out and therefor the body more healthy. The major functions of the epithelial tissue is protection, secretion, absorption and filtration. The shape of these cells can be flat and cubic or elongated.

Drugs such as morphine and heroin mimic endorphins and bind to the same receptors in the brain. Describe the effect these drugs most likely have on the body. Explain your reasoning.

These drugs most likely bind to opioid receptors in the brain to prevent pain signals from traveling. Binding to these receptors causes a sense of euphoria and relief from pain. However, endorphins are the body's natural pain relievers so they are healthy. Becoming addicted to morphine or heroin is unhealthy and can cause severe damage to the rest of your body.

Through brain mapping, what have scientists learned about the processing of pain in the brain?

Through brain mapping, scientists have learned that pain is not processed in just one section of the brain. This is unlike other senses such as hearing and seeing which are processed in specific lobes and areas. Pain is processed all throughout the brain and in different parts.

Explain why a person is more likely to have acne during adolescence than during young adulthood. Make sure to mention the exocrine glands that are found in the skin.

When someone is in their adolescent years of their life they have an increase in hormone activity as their body is beginning to go through puberty. This hormone activity will also signal the endocrine system to release more oil onto the skin from the exocrine glands, allowing for dirt and bacteria to get trapped on the surface and acne to more easily form.

Describe three situations where having CIPA puts young children at risk for other injuries.

With CIPA, children do not have the ability to feel temperatures. Children can easily burn themselves by touching the stove and keeping their hand on the burner for a long time. They can never sense the temperature differences causing a severe burn to the integumentary system. Next, children can rub and scratch their eyes too hard causing them to scratch the cornea. This results in damage to the eyes and loss or blurry vision. Lastly, children are subject to infections without any symptoms being present. Appendicitis usually produces extreme pain so it can be treated. However, with this disease, they are unable to feel pain so it cannot be treated. They often go until the appendix bursts and they get other symptoms. This is very dangerous because it has the ability to damage and affect other body systems.

You cut yourself slicing your morning bagel on the same morning your brother gets a wicked paper cut. Using your knowledge of the skin, explain why your injury will take much longer to heal.

Your injury will take much longer to heal because it penetrated deeper into the skin. Paper cuts often only slice through the surface of the dermis. They are extremely painful however because of the rough edges of the paper. Often times only small blood vessels are sliced so little to no bleeding occurs. The capillaries are easily repaired through blood clots and cell reproduction. SInce the wound is not as deep, less cells have to reproduce in order for the wound to close. On the other hand, the knife penetrated deep into the dermis and can hit the hypodermis, if severe. This mean that your wound is much deeper and will slice more capillaries causing more bleeding. A bigger blood clot is needed to form and more cells need to reproduce to close the epidermis. The dermis needs a longer time to repair all of the cells and structures that were damaged.

what does melanin do?

absorbs uv radiation to try and prevent damage to DNA

when is melanin present in the skin?

all the time

skin protects and also..

allows us to connect with the outside world

hemostasis

body's response to losing blood and that the physical barrier is broke

what is the dermis made up of?

connective tissues (collagen), smooth muscle (arrector pili) and nervous tissue (nerves)

3rd degree burns

destroyed epidermis and dermis may go into hypodermis full thickness burn causes: scalding liquid, flames, chemical or electrical source dry/leathery skin, black, white, or yellow skin swelling lack of pain (nerve endings destroyed) ointments/creams, iv fluids, nutritional supplements, pain meds, skin grafting, tetanus shot, cosmetic reconstruction skin graft- piece of unburned skin is put on the burned part donor site- place where the skin graft is placed dressing left on graft for 2-5 days

tiny sensors in the skin ...

detect: -touch -temperature -pain

what are the layers of skin effects in a cut?

epidermis and dermis (if severe hypodermis)

what is the epidermis made of?

epithelial cells (stratified squamous cells)

classifications of burns

first, second and third degree burns

function, location and structure of epidermis

location: outermost layer of the skin function: waterproofing, outermost barrier, prevents most pathogens from getting in structure: keratinocytes and epithelial cells

function and location of dermis

location: thick second layer of skin function: contains accessory organs, flexibility and strength

function and location of the subcutaneous layer

location: third layer made up of fat molecules, touches muscle function: regulate body temperature, insulate the body, protective padding and energy storage

skin plays a key role in...

maintaining homostasis

what produces melanin?

melanocytes

what happens first when skin is exposed to UV light?

melanocytes (found in basal layer of epidermis) produce more melanin and is transferred to keratinocytes

what happens when you tan?

more melanin is produced and transferred to the keratinocytes -results in a darker color of skin

what happen when exposed to the sun?

more sun = darker skin

what are the accessory organs?

nerves, hair follicles, hair shaft, sebaceous gland, sweat gland, and blood vessels

integumentary system

organ system that protects the body from various kinds of damage

remodeling/maturation

the new collagen deposited is converted into different types

what type of light causes tanning/sunburns?

ultraviolet

inflammation

when a part of the body becomes reddened, swollen or painful

proliferative

wound is rebuilt with new tissue

read over paragraph about the burn unit

yay