Burns and Test Strategies - PowerPoint Presentation

1. Burns and Test Strategies

2. Test Strategies

3. Warning!

4. CollagenWhat is CollagenProtein that are the primary structural component of connective tissueWhat are the two types of connective tissue? Loose connective tissue vs. dense connective tissueLoose connective tissue vs. dense connective tissue examples?LCT: skin, blood vessels, and muscleDCT: bone, capsule, ligament and tendon

5. Collagen types and tissue (look more into this)Type 1: All hyaline and basement membraneType 2: Hyaline cartilage and vitreous humorType 3: Blood vesselsType 4:Basement membraneType 5:All tissues??Type 6: All tissues??

6. What is the largest organ on the body?SkinSkin is composed of which two basic layers?EpidermisAvascular, outermost layerDermisContain blood vessels, nerves, hair follicles, and sweat glands.

7. Question?Which side of the hand is the skin much thinner?Dorsal skin

8. Superficial partial thickness burnWhat degree of burn is it?First and second degree burnsWhat skin layer is involved with it?Epidermis and possibility of the upper dermis layerSensation is intactCan we get spontaneous recovery and healing timeline?Recover in 2 weeks or earlier, no skin graft needed

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10. Deep partial thickness burnWhat degree of burn is it?Deep second degree burnHair follicles and sebaceous glands remain intactWhat skin layer is involved with this?Epidermis and deeper portion of the dermisCan we get spontaneous recovery and healing timeline?Spontaneous recovery 3-6 weeks, but skin grafting may occur to expedite wound closurePrecaution: a deep partial thickness burn may convert to a full thickness burn

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12. Full Thickness BurnWhat degree of burn is this?Third-degree burnWhat skin layer is involvedEpidermis and entire dermisIncludes hair follicles, nerve endingsWhat can you expect to treat during therapy sessions?Can we get spontaneous recovery and healing timeline?Spontaneous recovery is impossible, skin grafting is required.

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14. A full thickness burn with subdermal injuryWhat degree of burn is this?Fourth-degree burnWhat skin layer is involvedInvolves deep tissue damage to fat, muscle, or even possibly boneCan we get spontaneous recovery and healing timeline?Spontaneous recovery impossible and skin grafting is required

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16. Wallace Rule of NinesHead and Neck = 9%Each upper extremity= 9%Each Lower extremity= 18%Front of the trunk=18%Back of the trunk= 18%Genitals=1%

17. Question?Somebody burns their entire UE63%Somebody burns entire LE37%

18. Wound Healing Phase 1InflammatoryCharacterized by inflammationPresence of neutrophils and macrophages, which is responsible for clearing debris and preparing for wound repairThis phase begins when the wound occurs, then will last between 3 to 5 days.

19. Wound Healing Phase 2 Fibroplastic/proliferationCharacterized by the presence of fibroblastsLay down collage and myofibroblasts that in turn cause wound contractures.Collagen is deposited in a random and disorganized fashion

20. Wound Healing Phase 3Maturation/modeling phaseCollagen continues to cross-link and tensile strength increasesMaturation stage can last for yearsTypically 50% of strength is regained at 6 weeksStrength will most likely return to 80% when compared to normal skin

21. Question After the wound is closed in skin grafting, what becomes the main therapy focus?Scar contractions

22. Phases of Burn RecoveryPhase 1: EmergentOccurs 2-3 days after injuryPhase 2: AcuteDay 2-3 till wound is closedPhase 3: Skin graftingPhase 4: RehabilitationLast from wound closure to scar maturity

23. Classic Burn DeformityWrist flexionMP hyperextensionIP flexionThumb adductionFlattened palmar arch

24. QuestionThe position of comfort is the position of deformity is something we want?

25. QuestionWhat are the three best ways to decreased edemaCompression, elevation and movement

26. QuestionThe best method for evaluating hand edema in a patient who has an infected open wound of the palm is by:A.)drawing sequential hand outlinesB.)measuring hand circumference at the level of the MCP jointsC.)performing volumetric measurementsD.)recording the distance from the fingertip to the distal palmer crease

27. QuestionA patient who had a distal radius fracture reports excessive pain and a burning sensation in the hand during PROM. The OTR also notes that the patent has moderate hand edema, shiny skin, and sweaty palms. These symptoms are most likely indicative of:A.)complete regional pain syndrome (reflexive sympathetic dystrophy)B.)brachial plexus lesionC.)an undetached fractureD.)neuroma in the hand

28. QuestionCan a deep partial thickness burn convert to a full burn?Yes, why

29. QuestionHow do you want to position the hand for an orthotic after a burn?Wrist extensionMP flexionIP extensionThumb abduction

30. QuestionA patient who has deep partial-thickness burns on both thighs develops increased lower extremity edema when standing. To minimize edema, the OTR should recommend that the patient:a.) wear knee-high compression garmentsb.)apply compression wraps to entire lower extremitiesc.)perform activities while seated on a barstoold.)massage both legs prior to standing

31. QuestionA patient who has a full-thickness burn to the dorsum of the entire hand is referred to OT for ROM exercises. There is questionable tendon involvement. The best method of performing the exercises is to:A.)simultaneously flex the PIP and DIP joints while maintaining the MCP joints in extensionB.)passively move the fingers into simultaneous maximum flexionC.)flex one joint at a time while maintaining the remaining joints in extensionD.)encourage the patient to actively make a full fist

32. QuestionDuring the acute phase of treatment for partial thickness burns to the trunk and upper extremities, a patient would benefit most from:A.)maximizing self-care skillsB.)being fitted for pressure garmentsC.)preventing contracturesD.)strengthening exercises

33. QuestionName some ways to decrease edema

34. QuestionShould you wear an orthosis at night? And why

35. ResourceFundamental of Hand Therapy, Cynthia Cooper