Cyanosis is the most common symptom of heart disease or great vessels, it gives bluish discoloration to the skin, mucous membrane, tip of the nose, around the lips, and the nail beds. When the blood is not well oxygenated the blood pigment is a darker red, which gives the skin a bluish appearance. The bluish discoloration due to the presence of deoxygenated hemoglobin in blood vessels near the skin surface, oxygen deficiency turns the hemoglobin a reddish violet color. This condition prevents the blood to receive enough amount of oxygen in the lung. It causes a heart failure and respiratory problem such as drowning, choking, lung diseases (emphysema, or respiratory arrest), it slows down circulation. Cyanosis caused by abnormalities/defects of the lungs, the heart, or the blood.
The sebaceous glands secrete less lubrication and the outer layer of the skin becomes more fragile and dry. The elastic fibers shrink, becoming more rigid and leading to a loss of elasticity in the skin. Loss of subcutaneous fat results in lines, wrinkles, and sagging. The dermal vascular network decreases in its ability to respond to heat and cold. This influence an older person to hypothermia and hyperthermia. The melanocytes decrease, making the skin more sensitive to the ultraviolet rays of the sun. There may also be the appearance on the skin of small; cherry red bumps (cherry angiomas) which are benign skin tumors.
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Skin maintains a temperature, temperature sensors in the skin and internal organs monitor core temperature and transmit signals to the control center located in the hypothalamus, a region of the brain. When the core temperature rises above its set point, the hypothalamus:
1) sends fewer nerve impulses to blood vessels in the skin, causing them to dilate, which increases blood flow to the skin and promotes heat loss.
2) activates the sweat glands, and when sweat evaporates off the skin surface it carries a large amount off the skin surface it carries a large amount of body heat with it.
In the hot day the heat brought to the skin's surface can be lost through the process of radiation (transfer of heat from a warm body to a cooler environment), convection (air currents that pick up and transfer heat away from a warm surface), conduction (transfer of heat from a warm object to a cooler object it is in contact with), or evaporation (transfer of heat into body fluids which are then evaporated from the body surface). Heat loss through these means will cool the body.
When humans information about body temperature is sent to the temperature-regulating center in the hypothalamus. When body temperature rises above normal, the hypothalamus sends messages by way of nerves to the sweat glands, increasing sweat secretion. These processes provide fluid for evaporation, the conversion of a liquid, such as sweat, to water vapor. When molecules enter the vapor phase, they take their heat energy with them. Temperature of the blood is monitored and detected by thermostat in the brain. If temperature in the body went above normal, the thermostat sends nerve impulses directly to the sweat glands for lowering body temperature. Sweat glands will increase their production of sweat in order to lower body temperature by evaporative cooling. During the hot day body temperature increased above the set point, the brain (control center) signals to skin via nerves. The skin helps maintain the steady state. Heat is transferred from the body to the surroundings, resulting in evaporative cooling. At the same time the hypothalamus sends messages to smooth muscle in the walls of capillaries in the skin, causing them to dilate. The capillaries in the skin vasodilate (open up) allowing more blood to come to the surface in order to release heat from inside the body. More blood circulates through the skin, bringing heat to the body surface. The skin acts as a heat radiator, allowing heat to radiate from the body surface into the environment. Heat released from body by blood vessels dilating and sweating. Blood temperature decreases, the signals via blood to the brain (control center). These homeostatic mechanisms help return body temperature to normal.
Now, there is a genetic affect in some males to a condition known as alopecia (baldness), which is a permanent hair loss. The normal hair is replaced by a very short hair which is transparent and for practical purposes invisible. Males experience more hair loss than women, it could happen at young age. Treatment involved medications and hair transplants. In some cases there is pattern baldness, the hair lost from particular regions of the scalp.
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Skin is a tissue membrane which consists of layers of epithelial and connective tissues. The outer layers of the skin's epithelial tissue is the epidermis and the inner layer of connective tissue is the dermis. A basement membrane that is anchored to the dermis separates these two layers. The epidermis and dermis rest on a supportive layer of connective tissue and fat cells called the hypodermis. This supportive layer is flexible and allows the skin to move and bend while the fat cells cushion against injury and excessive heat loss.
The epidermis: outer layer of cells with no blood vessels present, stratified, squamous epithelium. The epidermis consists of karatinocytes cells, merkel cells, melanocytes cells, langerhans cells. The surface layer consists of dead cells rich in keratin. This protein (keratin) provides a waterproof covering, preventing excessive water loss, resisting evaporation, serves as a barrier against ultraviolet light, bacteria, some chemicals and abrasions.
Dermis:inner layer of the skin, composed of masses of dense, irregular, fibrous connective tissue. It contains collagen tissue bands, elastic fibers, nerve endings, hair follicles, muscles, blood vessels, sudoriferous glands (sweat glands), sebaceous glands (oil glands), and fat cells. Blood vessels regulates body temperature to maintain homeostasis. The sensory nerves end in nerve receptors are sensitive to heat, cold, pain, touch, and pressure.
Hypodermal (subcutaneous): lies under the dermis, consists of loose connective tissue- adipose tissue and areolar connective tissue. It contains about one-half of the body's stored fat, this fat provides a thermal insulation layer and mechanical cushioning for underlying organs.
First-degree burns: Burns that are red and painful, swollen, such as from a sunburn, and damage only the epidermis. Healing usually occurs within one week.
Second-degree burns: Burns that are red, painful, swelling and blistering, these burns involve injury to the epidermis and the upper region of the dermis, temporary scarring will occur. The skin may be exposed to infection. Healing usually occurs from 2-4 weeks.
Third-degree burns: Burns usually are severely painful, but in some cases no pain, giving the skin a white, bright red, blanched, eschar or charred appearance; they destroy all layers of the skin (epidermis, dermis and often the subcutaneous), including blood vessels (fluid and blood plasma lost) and nerve endings. Skin damaged by third-degree burns does not regenerate. Damage to the skin affects the body's ability to retain fluids. Treatment will include to prevent infection, contracture, fluid replacement, and skin grafting.
Angela has a severe second-degree and third-degree burns. The third-degree burn destroys dermal nerve endings that cause numbness feeling and no pain. She may feel pain around the borders of her third-degree burn in a second-degree burn areas since around the borders a nerve endings are still function and capable to transmit impulses.
Swollenness in tissues has an effect on circulation, slowing down a circulation in her body and make a low blood flow into the area of the burn. Also, impair respiration in torso burns. She had a third-degree burns over 15% of her body, so her blood vessels been destroyed or damaged, fluid and blood plasma been lost. She lost water-tight and protecting covering. The damaged/survived blood vessels leak fluid into surrounding tissue causing an inflammatory response in the area of the burn. The movement of water from her bloodstream to the interstitial spaces making her hypovolemic (reduced blood volume). Angela's blood pressure is low due to reduced blood volume. Her body tries to increase blood pressure to a stable level by increasing a heart rate. In order to relieve a tissue pressure an escharotomy needs to be performed.
Angela had a third-degree burns over 15% of her body, so her blood vessels been destroyed or damaged, fluid and blood plasma been lost. She lost water-tight and protecting covering, therefore she needs intravenous fluids to replace the fluid that she lost from her blood stream. In order to avoid a hypovolemic shock (low blood pressure) she needs to receive a IV fluids. This fluid will give her sufficient blood flow to her organs, so her organs will function properly and survive.
A "broad-spectrum" antibiotic is medication to treat and/or prevent infections. Angela had a third-degree burns over 15% of her body make her prone to infection due to missing a protective covering against bacteria. Most of the skin surface is not a favorable place for microbial growth because it is very dry. Microbes live only on moist skin areas where they adhere to and grow on the surfaces of dead cells. Bacteria normally colonize healthy skin, this bacteria called normal flora. In unbroken, healthy skin this type of bacteria protects us from dangerous microorganisms, but in damaged skin can cause a severe blood-borne infections. Therefore in order to avoid a blood-borne infection, antibiotic such as broad-spectrum needs to be prescribed (topically over the skin and by intravenous).
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The third-degree burn heals very slow, it takes from weeks to months to heal. The skin-grafting speeds up the healing process. By speeding up healing process the patient will have a low risk in developing complications such as systemic infection, hypovolemic shock, or severe electrolyte imbalance that can be life-threatening causing dysrhythmias of the heart.
The treatment of a third-degree burn will include a debridement of the burned skin and topical antibiotics intake. In order to remove the burned tissue patient needs to place the burned body part in a hydrotherapy tank filled with jet-like propulsion of the water. Then, human amniotic membrane, cadaveric skin, or a pig skin is placed over the debrided area to lower the risk of infection and minimize fluid loss. And after the patient's condition is stabilized this temporary covering is removed. If size of the burn is big it is replaced by skin from another part of the patient's body or by a synthetic skin graft. In the process when fibroblasts migrating in new connective tissue the macrophages digesting and follow the grafts' collagen and cartilage. A ground cartilage and plastic meshwork covered with collagen in synthetic skin graft placement is placed onto the burn area. During the healing process a patient's own dermal blood vessels start growing into the synthetic graft, healthy epidermis is developed from non-burned parts of the body and later reproduced in the laboratory. The sheets of epidermal cells are placed over the top of injury, allowing them to reproduce as the tissue in the synthetic dermis is reorganized. Nutrients may help the epidermal cells to form a large sheet of tissue and cover the entire burned area with epidermis.
Decubitus ulcers occur when a person is constantly lying or sitting in the same position without shifting his/her weight (immobile). Any area of tissue that lies over a bone is likely to develop a decubitus ulcer in the area such as spine, hips, coccyx, elbows, sacrum, greater trochanters, medial and lateral malleoli, and heels. A decreased blood supply into the area caused by constant pressure against this area. Both pressure and low blood supply slows down the rate of epidermal cell division that lead a tissue to decay. Prevention is the best treatment for decubitus ulcers. Frequent turning, relief of pressure on bony prominences, sufficient amount of fluids and nutrition, skin massaging may reduce Angela's risk of developing decubitus ulcers.
The healing process requires a sufficient amount of calorie intake to provide the energy for fast recovery. Since Angela's body is undergoing an inflammatory it uses up a lot of calories for energy, therefore she loses so much weight.