HBS109 Third Degree Burns - Anatomy and Physiology of the Integumentary System Assignment Sample

• Subject Code : HBS109
• University : Deakin University My Assignment Services is not sponsored or endorsed by this college or university.
• Subject Name : Nursing

Human Structure and Function

Introduction to Integumentary System

Skin, glands, nails, hair and nerves constitute the Integumentary System. The system includes four types of glands and those are sebaceous gland, sudoriferous glands, mammary glands and ceruminous glands. This system helps in protecting the body form the outside world through acting as a barrier between both. It also helps in retaining the body fluids, eliminating the waste products, regulating the temperature or the body along with protecting against diseases. This part of the work will try to focus on the anatomy and functions of the skin along with evaluating histology of the skin and the effects of the 3rd degree burns (Baxter, R. M., Dai, T., Kimball, J., Wang, E., Hamblin, M. R., Wiesmann, W. P., ... & Baker, S. M. (2013). Electrolyte imbalance and fluid retention of the body is highly related with the skin impacts that would also be a part of this work along with understanding the concept of how the skins helps in regulating the temperature of the body. The case study of fireman Jiemba Mbotunamba would be taken into consideration for having a better understanding who has encountered severe 3rd degree buns that has affected 20% of his body parts including his face, hands and neck. Although he is medically stable yet facing some serious complications with his core body temperature and frequent changes in the cardiac function.

Anatomy and Function of the Skin

Largest organ of the human body is the skin and its appendages like the hairs, nails and certain glands. About 15% of the weight of the adult is comprise of the skin and it weigh about six pounds. The thinnest part among the body skin is that of the eyelids which is about <0.1mm while soles of the feet and the palms of the hands are the thickest parts of the body skin which is about 1.5mm. Thickness, colour and texture of the skins vary in different parts of the body. Basically, there are two types of skins, one is thin and hairy while the other one is thick and hairless (Schaefer, T. J., & Tannan, S. C. (2019). The fist type of skin is found all over the body while the second skin type is found in areas of the body that encounter heavy friction like the soles of the feet and the palms of the hands. Technical name of skin is the cutaneous membrane and its primary role is to protect the body and the organs from various physical damages like abrasion, biological damage like that of microbial infection and chemical damage lie that for detergents, etc. Figure 1 shows various layers of the skin.

Figure 1. Cross section through all layers of the skin

Skin consists of three layers and those are,

• The Epidermis – It is the outermost layer of the skin which is visible through eyes. This layer does not have any blood supply of its own and thus, even upon shaving no bleeding occurs. Recycling of this layer takes about 25-45 days. This layer of the skin is having following parts and those are,

1. Stratum Basale – It is the base layer of the skin which is very close to the blood supply. It is the most important layer of the skin as it contains cells that undergoes the process of mitosis and can generate new cells. It also contains a protein named keratin that helps in making skin tough and supports external protection.
2. Stratum Spinosum – Below the Basale is the Spinosum that contains spiny-shaped cells that helps in providing flexibility and strength to the skin.
3. Stratum Granulosum – Below the Spinosum is the Granulosum and this layer contain lot of granules (Schaefer, T. J., & Tannan, S. C. (2019).
4. Stratum Lucidum – Below the Granulosum is the Lucidum which the deep layer of the epidermis and are transparent in their looks.
5. Stratum Corneum – Below the Lucidum is the Corneum which is filled with the cornified cells and this could be easily seen through naked eyes.

• The Dermis - It is the following layer of skin below the epidermis that is formed by the reticular and papillary layer that helps in providing cushion and protection to the body from strain and stress (Baxter, R. M., Dai, T., Kimball, J., Wang, E., Hamblin, M. R., Wiesmann, W. P., ... & Baker, S. M. (2013). It is the tough part of the skin and is composed of two layers,

1. Reticular Layer – It helps in providing strength to the skin along with elasticity
2. Papillary Layer – It helps in generating nutrition along with regulating temperature of the body

• The Subcutis/ Hypodermis – It is the deepest layer of skin that contains collagens and fats. This layer helps in insulating the body. Fats gets stored here and during the time of need, they serve as the source of energy.

Effects of 3rd Degree Burns

Buns damages skin layers and if the burn injury gets deeper, it might also damage the fat, tissues, muscles and even bone. Burns can be causes by many reasons and accordingly the treatment types of these burns are designed. Damage of the skin occurs based on the depth of the injury and there are three main types or levels of skin injury. Figure 2. represents types and degrees of burn.

Figure 2. Types and degrees of burn

Depth of the skin damage due to burn represents the what kind and level of symptoms it will show. Ideally intense burn is highly susceptible to microbial infection (Schaefer, T. J., & Tannan, S. C. (2019). It is highly important that the third-degree burn, and more should be kept under observation as the protective layer had been damaged and this makes the inner skin layer of the body exposed to infection. Based on the depth of the burn injury, the burns are categorized into,

• First-Degree burn – This type of burn is superficial and only the outer layer of the skin gets damaged. Here mostly the damage is limited to the epidermis. Here the site of the burn is red, dry, painful and there are no blisters. One of the examples of first-degree burn is the sunburn. Here there is a rare scope for long term tissue damage and often the skin colour gets changed. It gets
• Second-Degree burn – This type of burn includes injury in the lower part of the epidermis and the dermis. The site of the burn looks deep red with blisters. The injury would be painful, and the areas would be swollen. This is a partial thickness burn.
• Third-Degree burn – This type of burn destroys the dermis and the epidermis. It is a full thickness burn where the innermost layer gets affected along with the subcutaneous tissue (Baxter, R. M., Dai, T., Kimball, J., Wang, E., Hamblin, M. R., Wiesmann, W. P., ... & Baker, S. M. (2013). The injury site gets charred and blackened. Healing process would take 3 weeks or even more.

Homeostasis is maintaining the pH, temperature, heart rate, fluid level, blood pressure and blood sugar level of the body. It is a balancing act of the body where body try to accommodate or adjust the outer impact to maintain a balance. In this case study of the fireman Jiemba Mbotunamba who has encountered severe 3rd degree buns that has affected 20% of his body parts, his body homeostasis capability got affected. His buns have affected his body at the cellular level thereby disrupting the self-repair and self-regulating ability of the skin and the Integumentary System. Third degree bun patients are often get affected by dehydration and infection wherein the blood capillaries and the vessels get highly effected.

Damage to the Skin Impacts on Fluid Retention and Electrolyte Imbalance

In third degree burn, entire thickness of the skins gets affected thereby the barrier against the loss of water gets affected and does not exists anymore. This allows the fluid to get slip by causing severe dehydration which if not addressed immediately would lead to hypovolemic shock (Baxter, R. M., Dai, T., Kimball, J., Wang, E., Hamblin, M. R., Wiesmann, W. P., ... &

Baker, S. M. (2013). Buns damages skin layers and if the burn injury gets deeper, it might also damage the fat, tissues, muscles and even bone. Burns can be causes by many reasons and accordingly the treatment types of these burns are designed. It is highly important that the third-degree burn, and more should be kept under observation as the protective layer had been damaged and this makes the inner skin layer of the body exposed to infection.

References for Human Structure and Function

Akhoondinasab, M. R., Khodarahmi, A., Akhoondinasab, M., Saberi, M., & Iranpour, M. (2015). Assessing effect of three herbal medicines in second and third degree burns in rats and comparison with silver sulfadiazine ointment. Burns, 41(1), 125-131.

Baxter, R. M., Dai, T., Kimball, J., Wang, E., Hamblin, M. R., Wiesmann, W. P., ... & Baker, S. M. (2013). Chitosan dressing promotes healing in third degree burns in mice: gene expression analysis shows biphasic effects for rapid tissue regeneration and decreased fibrotic signaling. Journal of Biomedical Materials Research Part A, 101(2), 340-348.

Choi, J., Cho, J. T., Choi, J. Y., Seo, B. F., & Jung, S. N. (2019). Feasibility of Cultured Allogenic Keratinocyte Treatment for Third Degree Burns. J Korean Burn Soc, 22(2), 45.

Moravvej, H., Hormozi, A. K., Hosseini, S. N., Sorouri, R., Mozafari, N., Ghazisaidi, M. R., ... & Mirzadeh, H. (2016). Comparison of the application of allogeneic fibroblast and autologous mesh grafting with the conventional method in the treatment of third-degree burns. Journal of Burn Care & Research, 37(1), e90-e95.

Schaefer, T. J., & Tannan, S. C. (2019). Thermal Burns. In StatPearls [Internet]. StatPearls Publishing.

Venter, N. G., Marques, R. G., dos Santos, J. S., & Monte-Alto-Costa, A. (2016). Use of platelet-rich plasma in deep second-and third-degree burns. Burns, 42(4), 807-814.

Wu, Y. C., Wu, G. X., Huang, H. H., & Kuo, S. M. (2019). Liposome-encapsulated farnesol accelerated tissue repair in third-degree burns on a rat model. Burns, 45(5), 1139-1151.

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