1
INTEGUMENTARY SYSTEM
CHAPTER 5
2
Integumentary System
• Skin
– Integument or Cutaneous membrane
– Epidermis
– Dermis
– Subcutaneous Layer
• Accessory Str...
3
Layers and Structures of the Skin
4
Skin Lesions
• Abrasion
– Scraping or rubbing away of skin or
mucous membrane as a result of friction to
the area
– Exam...
5
Skin Lesions (continued)
• Bedsore
– Ulcer in skin over a bony prominence
– Also known as pressure ulcer
– Example: decu...
6
• Bulla
– Large blister
• Carbuncle
– Circumscribed inflammation of skin and
deeper tissues; contains pus
• Comedo
– Typ...
7
Skin Lesions (continued)
• Cyst
– Closed sac or pouch in or within the skin;
contains fluid, semifluid, or solid materia...
8
Skin Lesions (continued)
• Fissure
– Cracklike sore or groove in the skin or
mucous membrane
– Example: anal fissure
• F...
9
Skin Lesions (continued)
• Hives
– Circumscribed, slightly elevated lesions on
skin; paler in center than surrounding ed...
10
Skin Lesions (continued)
• Macule
– Small flat, discoloration of the skin; neither
raised nor depressed
– Example: brui...
11
Skin Lesions (continued)
• Papule
– Small, solid, circumscribed elevation on the
skin
– Example: pimple, wart, elevated...
12
• Pustule
– Small elevation of skin filled with pus
• Example: small abscess on the skin
• Scales
– Thin flakes of hard...
13
PATHOLOGICAL CONDITIONS
INTEGUMENTARY SYSTEM
14
Acne Vulgaris
• Pronounced
– (ACK-nee-vul-GAY-ris)
• Defined
– Common inflammatory disorder seen on face,
chest, back, ...
15
Albinism
• Pronounced
– (AL-bin-izm)
• Defined
– Condition characterized by absence of
pigment in the skin, hair, and e...
16
Burns
• Defined
– Tissue injury produced by flame, heat,
chemicals, radiation, electricity, or gases
– Extent of damage...
17
• First-degree or superficial burns
– Example: sunburn
• Second-degree or partial-thickness burns
– Example: flash cont...
18
Callus
• Pronounced
– (CAL-us)
• Defined
– Common, usually painless thickening of the
epidermis at sites of external pr...
19
Carcinoma, Basal Cell
• Pronounced
– (car-sih-NOH-mah BAY-sal sell)
• Defined
– Most common malignant tumor of epitheli...
20
• Pronounced
– (car-sih-NOH-mah SKWAY-mus sell )
• Defined
– Malignancy of the squamous, or scalelike,
cells of the epi...
21
Carcinoma, Squamous Cell (continued)
• Frequent Sites on Sun-Exposed Areas
– Top of nose
– Forehead
– Margin of externa...
22
Dermatitis
• Pronounced
– (der-mah-TYE-tis)
• Defined
– Inflammation of the skin, seen in several
different forms
– Acu...
23
Eczema
• Pronounced
– (EK-zeh-mah)
• Defined
– Acute or chronic inflammatory skin condition
characterized by erythema, ...
24
Exanthematous Viral Diseases
• Pronounced
– (eks-an-THEM-ah-tus viral diseases)
• Defined
– Skin eruption or rash accom...
25
Exanthematous Viral Diseases (continued)
• Examples:
– Rubella = German Measles = 3 day measles
– Roseola Infantum
– Ru...
26
Gangrene
• Pronounced
– (GANG-green)
• Defined
– Tissue death due to loss of adequate blood
supply, invasion of bacteri...
27
Herpes Zoster
• Pronounced
– (HER-peez ZOS-ter)
• Defined
– Acute viral infection, characterized by painful,
vesicular ...
28
Herpes Zoster (continued)
Image courtesy of Robert A. Silverman,
M.D., Pediatric Dermatology,
Georgetown University
29
Impetigo
• Pronounced
– (Im-peh-TYE-goh)
• Defined
– Contagious superficial skin infection
characterized by serous vesi...
30
Kaposi’s Sarcoma
• Pronounced
– (CAP-oh-seez sar-KOH-ma)
• Defined
– Rare malignant lesions beginning as soft
purple-br...
31
Keloid
• Pronounced
– (KEE-loyd)
• Defined
– Enlarged, irregularly shaped, elevated scar
that forms due to the presence...
32
Keratosis
• Pronounced
– (kair-ah-TOH-sis)
• Defined
– Skin condition in which there is a thickening
and overgrowth of ...
33
Seborrheic Keratosis
• Pronounced
– (seb-oh-REE-ik kair-ah-TOH-sis)
• Defined
– Brown or waxy yellow wart-like lesions ...
34
Actinic Keratosis
• Pronounced
– (ak-TIN-ic kair-ah-TOH-sis)
• Defined
– Premalignant, gray or red-to-brown, hardened
l...
35
Leukoplakia
• Pronounced
– (loo-koh-PLAY-kee-ah)
• Defined
– White, hard, thickened patches firmly
attached to the muco...
36
Malignant Melanoma
• Pronounced
– (mah-LIG-nant mel-ah-NOH-mah)
• Defined
– Malignant skin tumor originating from
melan...
37
ABCDS Of Malignant Melanomas
• Asymmetry
• Borders
• Color
• Diameter
38
Nevus
• Pronounced
– (NEV-us)
• Defined
– Visual accumulation of melanocytes, creating
a flat or raised rounded macule ...
39
Onychocryptosis
• Pronounced
– (on-ih-koh-krip-TOH-sis)
• Defined
– Ingrown nail – most commonly involves the
large toe
40
Onychomycosis
• Pronounced
– (on-ih-koh-my-KOH-sis)
• Defined
– Fungal infection of the nails
41
Pediculosis
• Pronounced
– (pee-dik-you-LOH-sis)
• Defined
– Highly contagious parasitic infestation caused
by blood-su...
42
Pediculosis (continued)
• Pediculosis capitis
– Head
• Pediculosis corporis
– Body
• Pediculosis palpebrarum
– Eyelashe...
43
Pemphigus
• Pronounced
– (PEM-fih-gus)
• Defined
– Rare, incurable disorder manifested by
blisters in the mouth and on ...
44
Pilonidal Cyst
• Pronounced
– (pye-loh-NYE-dal SIST)
• Defined
– Closed sac located in the sacrococcygeal
area of the b...
45
Psoriasis
• Pronounced
– (soh-RYE-ah-sis)
• Defined
– Common, noninfectious, chronic skin disorder
manifested by silver...
46
Scabies
• Pronounced
– (SKAY-beez)
• Defined
– Highly contagious parasitic infestation caused
by the “human itch mite”,...
47
Scleroderma
• Pronounced
– (sklair-ah-DER-mah)
• Defined
– A gradual thickening of the dermis and
swelling of the hands...
48
Systemic Lupus Erythematosus
• Pronounced
– (sis-TEM-ic LOO-pus air-ih-them-ah-TOH-sis)
• Defined
– A chronic, multi-sy...
49
Tinea
• Pronounced
– (TIN-ee-ah)
• Defined
– A chronic fungal infection of the skin;
characterized by scaling, itching,...
50
Tinea (continued)
• Tinea capitis
– Scalp
• Tinea corporis
– Body
• Tinea cruris
– Groin
• Tinea pedis
– Foot
51
Verruca
• Pronounced
– (ver-ROO-kah)
• Defined
– A benign, circumscribed, elevated skin lesion
that results from hypert...
52
• Verruca vulgaris
– Common wart on face, elbow, fingers, or
hands
• Plantar warts
– Singly or in clusters on the sole ...
53
DIAGNOSTIC TECHNIQUES AND
PROCEDURES
INTEGUMENTARY SYSTEM
54
Diagnostic Techniques and Procedures
• Allergy Testing
– Various procedures used to identify specific
allergens in an i...
55
Diagnostic Techniques and Procedures
(continued)
• Cryosurgery
– Noninvasive treatment that uses
subfreezing temperatur...
56
Diagnostic Techniques and Procedures
(continued)
• Debridement
– Removal of debris, foreign objects, and
damaged or nec...
57
• Dermatoplasty
– Skin transplantation to a body surface
damaged by injury or disease
• Electrodesiccation
– A techniqu...
58
Diagnostic Techniques and Procedures
(continued)
• Electrosurgery
– Removal or destruction of tissue with an
electrical...
59
Diagnostic Techniques and Procedures
(continued)
• Liposuction
– Aspiration of fat through a suction cannula
or curette...
60
Diagnostic Techniques and Procedures
(continued)
• Skin graft
– Process of placing tissue on a recipient
site, taken fr...
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Chapter 5 - Integumentary System

  1. 1. 1 INTEGUMENTARY SYSTEM CHAPTER 5
  2. 2. 2 Integumentary System • Skin – Integument or Cutaneous membrane – Epidermis – Dermis – Subcutaneous Layer • Accessory Structures – Hair – Nails – Glands
  3. 3. 3 Layers and Structures of the Skin
  4. 4. 4 Skin Lesions • Abrasion – Scraping or rubbing away of skin or mucous membrane as a result of friction to the area – Example: carpet burn • Abscess – Localized collection of pus in any body part that results from invasion of pus-forming bacteria – Example: pustule = small abscess
  5. 5. 5 Skin Lesions (continued) • Bedsore – Ulcer in skin over a bony prominence – Also known as pressure ulcer – Example: decubitus ulcer • Blister – Small, thin-walled skin lesion containing clear fluid – Also known as a vesicle
  6. 6. 6 • Bulla – Large blister • Carbuncle – Circumscribed inflammation of skin and deeper tissues; contains pus • Comedo – Typical lesion of acne vulgaris – Example: whitehead = closed comedo – Example: blackhead = open comedo Skin Lesions (continued)
  7. 7. 7 Skin Lesions (continued) • Cyst – Closed sac or pouch in or within the skin; contains fluid, semifluid, or solid material – Example: hydrocele = fluid-filled cyst – Example: sebaceous cyst = solid-filled cyst
  8. 8. 8 Skin Lesions (continued) • Fissure – Cracklike sore or groove in the skin or mucous membrane – Example: anal fissure • Fistual – Abnormal passageway between two tubular organs; or from an organ to the body surface – Example: recto-vaginal fistula
  9. 9. 9 Skin Lesions (continued) • Hives – Circumscribed, slightly elevated lesions on skin; paler in center than surrounding edges – Also called wheals – Example: mosquito bite • Laceration – Tear in skin; torn, jagged wound
  10. 10. 10 Skin Lesions (continued) • Macule – Small flat, discoloration of the skin; neither raised nor depressed – Example: bruises, freckles • Nodule – Small, circumscribed swelling protruding above the skin
  11. 11. 11 Skin Lesions (continued) • Papule – Small, solid, circumscribed elevation on the skin – Example: pimple, wart, elevated mole • Polyp – Small, stalklike growth, protruding upward or outward from membrane surface – Example: nasal polyp
  12. 12. 12 • Pustule – Small elevation of skin filled with pus • Example: small abscess on the skin • Scales – Thin flakes of hardened epithelium that are shed from the epidermis • Ulcer – Circumscribed, open sore or lesion of skin, accompanied by inflammation • Example: decubitus ulcer Skin Lesions (continued)
  13. 13. 13 PATHOLOGICAL CONDITIONS INTEGUMENTARY SYSTEM
  14. 14. 14 Acne Vulgaris • Pronounced – (ACK-nee-vul-GAY-ris) • Defined – Common inflammatory disorder seen on face, chest, back, and neck – Appears as papules, pustules, and comedos
  15. 15. 15 Albinism • Pronounced – (AL-bin-izm) • Defined – Condition characterized by absence of pigment in the skin, hair, and eyes
  16. 16. 16 Burns • Defined – Tissue injury produced by flame, heat, chemicals, radiation, electricity, or gases – Extent of damage determined by • Mode and duration of exposure • Thermal intensity or temperature • Anatomic site of the burn
  17. 17. 17 • First-degree or superficial burns – Example: sunburn • Second-degree or partial-thickness burns – Example: flash contact with hot objects • Third-degree or full-thickness burns – Example: deep burns from a fire Burns
  18. 18. 18 Callus • Pronounced – (CAL-us) • Defined – Common, usually painless thickening of the epidermis at sites of external pressure or friction, such as weight-bearing areas of the feet and on the palmar surface of the hands • Also known as a callosity
  19. 19. 19 Carcinoma, Basal Cell • Pronounced – (car-sih-NOH-mah BAY-sal sell) • Defined – Most common malignant tumor of epithelial tissue, occurring most often on areas of skin that are exposed to the sun • Presents as a slightly elevated nodule with a depression or ulceration in the center that becomes more obvious as the tumor grows
  20. 20. 20 • Pronounced – (car-sih-NOH-mah SKWAY-mus sell ) • Defined – Malignancy of the squamous, or scalelike, cells of the epithelial tissue; much faster growing than basal cell carcinoma and has greater potential for metastasis if not treated Carcinoma, Squamous Cell
  21. 21. 21 Carcinoma, Squamous Cell (continued) • Frequent Sites on Sun-Exposed Areas – Top of nose – Forehead – Margin of external ear – Back of hands – Lower lip
  22. 22. 22 Dermatitis • Pronounced – (der-mah-TYE-tis) • Defined – Inflammation of the skin, seen in several different forms – Acute or chronic – Contact or seborrheic
  23. 23. 23 Eczema • Pronounced – (EK-zeh-mah) • Defined – Acute or chronic inflammatory skin condition characterized by erythema, papules, vesicles, pustules, scales, crusts, scabs, and itching
  24. 24. 24 Exanthematous Viral Diseases • Pronounced – (eks-an-THEM-ah-tus viral diseases) • Defined – Skin eruption or rash accompanied by inflammation, having specific diagnostic features of an infectious viral disease
  25. 25. 25 Exanthematous Viral Diseases (continued) • Examples: – Rubella = German Measles = 3 day measles – Roseola Infantum – Rubeola = Red Measles = 7-10 day measles – Erythema Infectiosum = Fifth disease
  26. 26. 26 Gangrene • Pronounced – (GANG-green) • Defined – Tissue death due to loss of adequate blood supply, invasion of bacteria, subsequent decay with foul odor
  27. 27. 27 Herpes Zoster • Pronounced – (HER-peez ZOS-ter) • Defined – Acute viral infection, characterized by painful, vesicular eruptions on the skin that follow along the nerve pathways of underlying spinal or cranial nerves – Highest incidence in adults over 50
  28. 28. 28 Herpes Zoster (continued) Image courtesy of Robert A. Silverman, M.D., Pediatric Dermatology, Georgetown University
  29. 29. 29 Impetigo • Pronounced – (Im-peh-TYE-goh) • Defined – Contagious superficial skin infection characterized by serous vesicles and pustules filled with millions of staphylococcus or streptococcus bacteria (usually forming on the face)
  30. 30. 30 Kaposi’s Sarcoma • Pronounced – (CAP-oh-seez sar-KOH-ma) • Defined – Rare malignant lesions beginning as soft purple-brown nodules or plaques on the feet – Gradually spreads throughout the skin – Increased incidence in men with AIDS
  31. 31. 31 Keloid • Pronounced – (KEE-loyd) • Defined – Enlarged, irregularly shaped, elevated scar that forms due to the presence of large amounts of collagen during the formation of a scar
  32. 32. 32 Keratosis • Pronounced – (kair-ah-TOH-sis) • Defined – Skin condition in which there is a thickening and overgrowth of the cornified epithelium
  33. 33. 33 Seborrheic Keratosis • Pronounced – (seb-oh-REE-ik kair-ah-TOH-sis) • Defined – Brown or waxy yellow wart-like lesions that are loosely attached to the skin – Also known as senile warts
  34. 34. 34 Actinic Keratosis • Pronounced – (ak-TIN-ic kair-ah-TOH-sis) • Defined – Premalignant, gray or red-to-brown, hardened lesion caused by excessive exposure to sunlight – Also known as solar keratosis
  35. 35. 35 Leukoplakia • Pronounced – (loo-koh-PLAY-kee-ah) • Defined – White, hard, thickened patches firmly attached to the mucous membrane – in the mouth, vulva, or penis
  36. 36. 36 Malignant Melanoma • Pronounced – (mah-LIG-nant mel-ah-NOH-mah) • Defined – Malignant skin tumor originating from melanocytes in preexisting nevi, freckles, or skin with pigment – Darkly pigmented tumor with irregular surfaces and borders; variable colors
  37. 37. 37 ABCDS Of Malignant Melanomas • Asymmetry • Borders • Color • Diameter
  38. 38. 38 Nevus • Pronounced – (NEV-us) • Defined – Visual accumulation of melanocytes, creating a flat or raised rounded macule or papule with definite borders – Commonly known as a mole
  39. 39. 39 Onychocryptosis • Pronounced – (on-ih-koh-krip-TOH-sis) • Defined – Ingrown nail – most commonly involves the large toe
  40. 40. 40 Onychomycosis • Pronounced – (on-ih-koh-my-KOH-sis) • Defined – Fungal infection of the nails
  41. 41. 41 Pediculosis • Pronounced – (pee-dik-you-LOH-sis) • Defined – Highly contagious parasitic infestation caused by blood-sucking lice
  42. 42. 42 Pediculosis (continued) • Pediculosis capitis – Head • Pediculosis corporis – Body • Pediculosis palpebrarum – Eyelashes and eyelids • Pediculosis pubis – Pubic hair
  43. 43. 43 Pemphigus • Pronounced – (PEM-fih-gus) • Defined – Rare, incurable disorder manifested by blisters in the mouth and on the skin; spreads to involve large areas of the body
  44. 44. 44 Pilonidal Cyst • Pronounced – (pye-loh-NYE-dal SIST) • Defined – Closed sac located in the sacrococcygeal area of the back; sometimes noted at birth as a dimple
  45. 45. 45 Psoriasis • Pronounced – (soh-RYE-ah-sis) • Defined – Common, noninfectious, chronic skin disorder manifested by silvery-white scales over round, raised, reddened plaques producing itching (pruritus)
  46. 46. 46 Scabies • Pronounced – (SKAY-beez) • Defined – Highly contagious parasitic infestation caused by the “human itch mite”, resulting in a rash, pruritus, and a feeling in the skin of “something crawling”
  47. 47. 47 Scleroderma • Pronounced – (sklair-ah-DER-mah) • Defined – A gradual thickening of the dermis and swelling of the hands and feet to a state in which the skin is anchored to the underlying tissue
  48. 48. 48 Systemic Lupus Erythematosus • Pronounced – (sis-TEM-ic LOO-pus air-ih-them-ah-TOH-sis) • Defined – A chronic, multi-system, inflammatory disease characterized by lesions of the nervous system and skin, renal problems, and vasculitis; characteristic “Butterfly rash” is often seen on the nose and face
  49. 49. 49 Tinea • Pronounced – (TIN-ee-ah) • Defined – A chronic fungal infection of the skin; characterized by scaling, itching, and sometimes painful lesions
  50. 50. 50 Tinea (continued) • Tinea capitis – Scalp • Tinea corporis – Body • Tinea cruris – Groin • Tinea pedis – Foot
  51. 51. 51 Verruca • Pronounced – (ver-ROO-kah) • Defined – A benign, circumscribed, elevated skin lesion that results from hypertrophy of the epidermis – Commonly known as a wart
  52. 52. 52 • Verruca vulgaris – Common wart on face, elbow, fingers, or hands • Plantar warts – Singly or in clusters on the sole of the foot • Venereal warts – Transmitted by sexual contact • Seborrheic warts – Seen in the elderly on the face, neck, chest, or upper back Verruca (continued)
  53. 53. 53 DIAGNOSTIC TECHNIQUES AND PROCEDURES INTEGUMENTARY SYSTEM
  54. 54. 54 Diagnostic Techniques and Procedures • Allergy Testing – Various procedures used to identify specific allergens in an individual by exposing the person to a very small quantity of the allergen • Cautery – Heat or caustic substances that burn and scar the skin
  55. 55. 55 Diagnostic Techniques and Procedures (continued) • Cryosurgery – Noninvasive treatment that uses subfreezing temperature to freeze and destroy tissue • Curettage and electrodesiccation – Scraping away of abnormal tissue, followed by destroying the tumor base with a low- voltage electrode
  56. 56. 56 Diagnostic Techniques and Procedures (continued) • Debridement – Removal of debris, foreign objects, and damaged or necrotic tissue from a wound in order to prevent infection and promote healing • Dermabrasion – Removal of the epidermis and a portion of the dermis with sandpaper or brushes in order to eliminate superficial scars of unwanted tattoos
  57. 57. 57 • Dermatoplasty – Skin transplantation to a body surface damaged by injury or disease • Electrodesiccation – A technique using an electrical spark to burn and destroy tissue – Also known as fulguration Diagnostic Techniques and Procedures (continued)
  58. 58. 58 Diagnostic Techniques and Procedures (continued) • Electrosurgery – Removal or destruction of tissue with an electrical current • Escharotomy – An incision made into the necrotic tissue resulting from a severe burn
  59. 59. 59 Diagnostic Techniques and Procedures (continued) • Liposuction – Aspiration of fat through a suction cannula or curette to alter the body contours • Skin biopsy – Removal of a small piece of tissue from skin lesions for the purpose of examining it under a microscope to confirm or establish a diagnosis
  60. 60. 60 Diagnostic Techniques and Procedures (continued) • Skin graft – Process of placing tissue on a recipient site, taken from a donor site, in order to provide the protective mechanisms of skin to an area unable to regenerate skin • Wood’s lamp – Ultraviolet light that is used to examine the scalp and skin for the purpose of observing fungal spores
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