Question 1

A patient presents with a burn that is red, painful, dry, and shows no blistering. Which layer(s) of the skin are most likely affected, and what is the primary risk if the burn covers a large area?

Accepted Answer

Epidermis only; risk of dehydration if widespread

Question 2

Which of the following best explains why the stratum corneum is resistant to abrasion and water loss?

Accepted Answer

It consists of dead, heavily keratinized cells that form a tough, hydrophobic barrier

Question 3

A patient with a third-degree burn on the anterior trunk and both anterior lower limbs is at high risk for which of the following complications, and why?

Accepted Answer

Severe dehydration and electrolyte imbalance due to loss of the epidermal barrier

Question 4

Which of the following best describes the main structural and functional difference between the papillary and reticular layers of the dermis?

Accepted Answer

The papillary layer is superficial and nourishes the epidermis; the reticular layer is deeper and provides strength and elasticity

Question 5

Akeem suffers a full-thickness burn on the dorsum of his right hand. Why might the center of his burn be painless, while the edges are extremely painful?

Accepted Answer

The center has destroyed sensory nerve endings, while the edges have intact, irritated nerves

Question 6

Which of the following best explains why the epidermis is avascular and how its cells receive nutrients?

Accepted Answer

Nutrients diffuse from dermal blood vessels into the deepest epidermal cells

Question 7

A patient with burns on the anterior trunk (18%), anterior right lower limb (9%), anterior left lower limb (9%), and genitalia (1%) has what total body surface area (TBSA) burned, according to the rule of nines? Provide the calculation.

Accepted Answer

$$18\% + 9\% + 9\% + 1\% = 37\%$$

Question 8

Why is an autograft generally preferred over an allograft for permanent coverage of a full-thickness burn?

Accepted Answer

It uses the patient's own tissue, minimizing rejection and providing permanent coverage

Question 9

Which of the following best explains why second-degree burns commonly form blisters, while third-degree burns do not?

Accepted Answer

Second-degree burns damage but do not destroy the dermis, allowing fluid to separate skin layers; third-degree burns destroy these layers

Question 10

A patient with a severe circumferential full-thickness burn on the lower leg develops decreased pulses and cold toes. What is the most appropriate immediate intervention, and why?

Accepted Answer

Perform an escharotomy to relieve pressure and restore circulation

Question 11

Which of the following is NOT a function of the hypodermis?

Accepted Answer

Providing tensile strength and elasticity to the skin

Question 12

A patient with a large second-degree burn is at increased risk for which of the following, and why?

Accepted Answer

Infection, because the protective barrier is compromised and moist tissue is exposed

Question 13

Which of the following best describes the main difference between thick and thin skin?

Accepted Answer

Thick skin contains a stratum lucidum and has a thicker stratum corneum; thin skin lacks stratum lucidum

Question 14

Why do epidermal cells die as they move from the stratum basale toward the stratum corneum?

Accepted Answer

They move farther from the dermal blood supply and lose organelles as they fill with keratin

Question 15

Akeem is advised to remove his ring and elevate his burned hand. What is the physiological rationale for these actions?

Accepted Answer

To prevent vascular compromise from swelling and to reduce edema by improving venous return

Question 16

Which of the following best explains why severe burns can lead to shock?

Accepted Answer

Loss of the epidermal barrier allows fluid and electrolytes to escape, reducing blood volume

Question 17

Which of the following cell types is primarily responsible for producing the waterproofing protein in the epidermis?

Accepted Answer

Keratinocytes

Question 18

A patient with a small full-thickness burn on the dorsum of the hand is being considered for a skin graft. Which type of graft is most appropriate and why?

Accepted Answer

Autograft, because there is enough healthy skin and it provides permanent, low-rejection coverage

Question 19

Which of the following best describes the main function of the dermal papillae in the papillary layer of the dermis?

Accepted Answer

They increase surface area for nutrient exchange and contribute to fingerprints

Integumentary System and Burn Pathology: Study Guide

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