Survey of Anatomy and Physiology Chap 8

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Survey of Anatomy and Physiology Chap 8

  1. 1. The Integumentary System: The Protective Covering Chapter 8
  2. 2.  IntegumentaryIntegumentary Integumentary system shelters body from the environment Integumentary system shelters body from the environment
  3. 3.  IntegumentaryIntegumentary Skin forms protective barrier, shielding body from elements and pathogens, as well as performing several other vital functions Skin forms protective barrier, shielding body from elements and pathogens, as well as performing several other vital functions
  4. 4.  Skin’s AccessoriesSkin’s Accessories Skin is essential to well-being, helps to regulate body temperature, and contains many accessory components such as nail, hair, and glands Skin is essential to well-being, helps to regulate body temperature, and contains many accessory components such as nail, hair, and glands
  5. 5.  Skin-Vital FunctionsSkin-Vital Functions Skin keeps the body from drying out and is a natural sunscreen Skin keeps the body from drying out and is a natural sunscreen
  6. 6.  The PA/Instructor Asks What skin rash is caused by a viral illness and is a reaction to the body’s immune system trying to stop the virus? A. B. C. D. A. B. C. D. Tinea cruris Cellulitis Dermatitis Measles
  7. 7.  Figure 8-1 The three layers of the skin. Largest organ, weighing approximately 20 pounds and covering area about 20.83 square feet on an adult
  8. 8.  First Layer-EpidermisFirst Layer-Epidermis Layer of skin we see on outside; made up of several smaller layers of stratified squamous epithelium Do you remember what shape and arrangement this is? Layer of skin we see on outside; made up of several smaller layers of stratified squamous epithelium Do you remember what shape and arrangement this is?
  9. 9.  First Layer-EpidermisFirst Layer-Epidermis Avascular and contains NO NERVE CELLS Avascular and contains NO NERVE CELLS Cells on surface are constantly shedding, being replaced with new cells that grow and arise from the stratum basale EVERY 2 to 4 weeks Cells on surface are constantly shedding, being replaced with new cells that grow and arise from the stratum basale EVERY 2 to 4 weeks
  10. 10.  First Layer-EpidermisFirst Layer-Epidermis Outermost layer is layer of dead cells, called stratum corneum, which are flat, scaly, keratinized epithelial cells
  11. 11.  First Layer-EpidermisFirst Layer-Epidermis The body sloughs off 500 million cells every day, or about one and a half pounds of dead skin a year, allowing for rapid repair in case of injuries The body sloughs off 500 million cells every day, or about one and a half pounds of dead skin a year, allowing for rapid repair in case of injuries
  12. 12.  Melanocytes in EpidermisMelanocytes in Epidermis Specialized cells (melanocytes) located deep in epidermis; responsible for skin color Melanocytes produce melanin; actual substance that affects skin color in different people Specialized cells (melanocytes) located deep in epidermis; responsible for skin color Melanocytes produce melanin; actual substance that affects skin color in different people
  13. 13.  Melanocytes in EpidermisMelanocytes in Epidermis Variations of skin color result of amount of melanin produced and how it is distributed Carotene: gives yellowish hue to skin Albinism: little pigment in skin, hair, eyes Variations of skin color result of amount of melanin produced and how it is distributed Carotene: gives yellowish hue to skin Albinism: little pigment in skin, hair, eyes
  14. 14.  The PA/Instructor Asks A person who is an albino (very little pigment in their skin) is at risk for two conditions: Skin cancer and A. B. C. D. A. B. C. D. Photosensitivity Loss of Hair Dermatitis Acne
  15. 15.  Second Layer-DermisSecond Layer-Dermis Layer below, or inferior to, epidermis is thicker dermis layer (corium) Layer below, or inferior to, epidermis is thicker dermis layer (corium)
  16. 16.  Second Layer-DermisSecond Layer-Dermis
  17. 17.  Second Layer-DermisSecond Layer-Dermis
  18. 18.  Second Layer-DermisSecond Layer-Dermis Small dermal papillae project from surface and anchor this layer to epidermal layer- *page 174 diagram Small dermal papillae project from surface and anchor this layer to epidermal layer- *page 174 diagram
  19. 19.  Second Layer-DermisSecond Layer-Dermis Fingerprints and toe prints arise from this layer Nerve fibers allow you to sense what is happening in your environment Fingerprints and toe prints arise from this layer Nerve fibers allow you to sense what is happening in your environment
  20. 20.  Second Layer-DermisSecond Layer-Dermis
  21. 21.  The PA/Instructor Asks What other factor, besides aging, leads to change in the skin’s firmness and decreases its ability to recoil to its normal state when stretched? A. B. C. D. A. B. C. D. Bathing Too much oil Sun Exposure Acne
  22. 22.  Part of the Dermis-Part of the Dermis- Sweat GlandsSweat Glands Two main types of sudoriferous or sweat glands: Apocrine sweat glands secrete at hair follicles in groin, anal region, and armpits; become active around puberty and are believed to act as sexual attractants Two main types of sudoriferous or sweat glands: Apocrine sweat glands secrete at hair follicles in groin, anal region, and armpits; become active around puberty and are believed to act as sexual attractants
  23. 23.  Part of the Dermis-Part of the Dermis- Sweat GlandsSweat Glands Eccrine glands are found in greater numbers on palms, feet, forehead, and upper lip; important in regulation of body temperature Eccrine glands are found in greater numbers on palms, feet, forehead, and upper lip; important in regulation of body temperature
  24. 24.  Part of Dermis-Part of Dermis- Sweat GlandsSweat Glands
  25. 25.  Part of the Dermis-Part of the Dermis- Sweat & Oil GlandsSweat & Oil Glands
  26. 26.  Part of the Dermis-Part of the Dermis- Sebaceous GlandsSebaceous Glands
  27. 27.  Figure 8-2 Sweat and sebaceous glands. Sebaceous glands usually found in hair covered areas and deposit sebum on hair shaft where it is brought to the surface
  28. 28.  Figure 8-2 Sweat and sebaceous glands. Sebaceous glands also found on non hair covered areas such as eyelids, penis, labia minora and nipples in ducts that end at the sweat gland
  29. 29.  Meibomiam Glands Specialized form of sebaceous gland that secrete sebum into tears that coat the eye, slowing evaporation
  30. 30.  Subcutaneous FasciaSubcutaneous Fascia
  31. 31.  How Skin HealsHow Skin Heals Watch video “Wound Healing- Integumentary System” http://www.youtube.com/watch?v=IYL6vg89uds
  32. 32.  HOW SKIN HEALS If skin punctured and wound damages blood vessels, 1) wound fills with blood Blood contains substances that cause clotting If skin punctured and wound damages blood vessels, 1) wound fills with blood Blood contains substances that cause clotting
  33. 33.  HOW SKIN HEALS 2) Top part of clot exposed to air hardens to form a scab (nature's bandage) forming barrier and preventing pathogens from entering 2) Top part of clot exposed to air hardens to form a scab (nature's bandage) forming barrier and preventing pathogens from entering
  34. 34.  HOW SKIN HEALS Next, 3) inflammatory response occurs, with migration of white blood cells (WBCs) to damaged area to destroy any pathogens that may have entered Next, 3) inflammatory response occurs, with migration of white blood cells (WBCs) to damaged area to destroy any pathogens that may have entered
  35. 35.  Inflammatory Phase
  36. 36.  HOW SKIN HEALS At same time, 4) cells (fibroblasts) come in and begin pulling edges of wound together 5)Basal layer of epidermis begins to hyperproduce new cells for repair of wound At same time, 4) cells (fibroblasts) come in and begin pulling edges of wound together 5)Basal layer of epidermis begins to hyperproduce new cells for repair of wound
  37. 37.  How Skin HealsHow Skin Heals
  38. 38.  How Skin HealsHow Skin Heals Ideally wound starts to heal from inside out; aids in preventing pathogens from becoming trapped between healed surface and deeper layers of skin, where they could develop into a major pocket of infection Ideally wound starts to heal from inside out; aids in preventing pathogens from becoming trapped between healed surface and deeper layers of skin, where they could develop into a major pocket of infection
  39. 39.  Figure 8-7 Wound repair.
  40. 40.  The PA/Instructor Asks What factor, in addition to decrease in blood flow, contributes to problems with wound healing in diabetic patients? A. B. C. D. A. B. C. D. Decreased clotting Increased bleeding Decreased WBC activity Poor scab formation
  41. 41.  Figure 8-8 Keloids Keloid is a “scar gone wild” due to an overproduction of connective tissue Keloid is a “scar gone wild” due to an overproduction of connective tissue Formation more prominent in African Americans Formation more prominent in African Americans Treatment is steroid injection or cryotherapyTreatment is steroid injection or cryotherapy
  42. 42.  Accessory to Skin-NailsAccessory to Skin-Nails Specialized epithelial cells originating from nail root form nails Specialized epithelial cells originating from nail root form nails
  43. 43.  Accessory to Skin-NailsAccessory to Skin-Nails As cells grow out and over nail bed, they become keratinized forming substance similar to horns on a bull As cells grow out and over nail bed, they become keratinized forming substance similar to horns on a bull
  44. 44.  Accessory to Skin-NailsAccessory to Skin-Nails Cuticle is fold of tissue that covers nail root Cuticle is fold of tissue that covers nail root Portion that we see is called nail body Portion that we see is called nail body Nails normally grow 1 mm every week Nails normally grow 1 mm every week
  45. 45.  The PA/Instructor Asks How long do you pinch the fingernail of a patient before you release and check for return of the normal “pink” color? How long does it normally take to return (i.e. the capillary refill time)? What is the name of the condition that consists of reduced blood flow in patients with diabetes abbreviated PVD? What else can decrease blood flow? Page 185 Clinical Application
  46. 46.  Figure 8-11 Clinician performing capillary refill assessment.
  47. 47.  Figure 8-10 Structures of the fingernail. Pink color of nail comes from vascularization of tissue under nails White half-moon shaped area (lunula) is result of thicker layer of cells at base Pink color of nail comes from vascularization of tissue under nails White half-moon shaped area (lunula) is result of thicker layer of cells at base
  48. 48.  Skin Accesory-HairSkin Accesory-Hair
  49. 49.  Skin Accessory-HairSkin Accessory-Hair Helps to regulate body temperature and functions as sensor to help detect things on skin, such as bugs or cobwebs Helps to regulate body temperature and functions as sensor to help detect things on skin, such as bugs or cobwebs
  50. 50.  Skin Accessory-HairSkin Accessory-Hair Eyelashes protect your eyes from foreign objects, and hair in the nose filters out particulate matter Eyelashes protect your eyes from foreign objects, and hair in the nose filters out particulate matter
  51. 51.  Skin Accessory-HairSkin Accessory-Hair
  52. 52.  Skin Accessory-HairSkin Accessory-Hair
  53. 53.  Skin Accessory-HairSkin Accessory-Hair
  54. 54.  Figure 8-12Figure 8-12 Diagram of a hair follicle.Diagram of a hair follicle. Factoid:Flat hair shafts produce curly hair, while round hair shafts produce straight hair Factoid:Flat hair shafts produce curly hair, while round hair shafts produce straight hair
  55. 55.  The PA/Instructor Asks What determines the color of your hair? What is alopecia? Page 185 Clinical Application
  56. 56.  Skin and TemperatureSkin and Temperature RegulationRegulation Vasodilation: body's attempt to get as much “hot” blood exposed to cooler environment Vasoconstriction: forces blood away from skin and back toward core of body where heat is Vasodilation: body's attempt to get as much “hot” blood exposed to cooler environment Vasoconstriction: forces blood away from skin and back toward core of body where heat is Change in size of blood vessels Change in size of blood vessels
  57. 57.  Skin and TemperatureSkin and Temperature RegulationRegulation Vasodilation: body's attempt to get as much “hot” blood exposed to cooler environment Vasoconstriction: forces blood away from skin and back toward core of body where heat is Vasodilation: body's attempt to get as much “hot” blood exposed to cooler environment Vasoconstriction: forces blood away from skin and back toward core of body where heat is A child’s lips are blue when they are cold getting out of a pool due to vasoconstriction A child’s lips are blue when they are cold getting out of a pool due to vasoconstriction
  58. 58.  Skin and TemperatureSkin and Temperature RegulationRegulation Sweat glands excrete water, nitrogenous wastes and sodium chloride (salt) to skin’s surface
  59. 59.  Skin and TemperatureSkin and Temperature RegulationRegulation As long as you stay hydrated and are able to produce sweat; thirst indicates body has reached level of dehydration
  60. 60.  Skin and TemperatureSkin and Temperature RegulationRegulation Muscles in skin called arrector pili attached to hairs; when those muscles contract, make your hairs stand erect (gooseflesh or goose bumps) when you are chilled Muscles in skin called arrector pili attached to hairs; when those muscles contract, make your hairs stand erect (gooseflesh or goose bumps) when you are chilled
  61. 61.  Figure 8-14Figure 8-14 Integumentary regulation ofIntegumentary regulation of body temperature.body temperature. Regulating temperature through vasoconstriction and vasodilitation Regulating temperature through vasoconstriction and vasodilitation *Page 189
  62. 62.  Figure 8-15Figure 8-15 Various types of skin lesions.Various types of skin lesions.
  63. 63.  Figure 8-15Figure 8-15 Various types of skin lesions.Various types of skin lesions.
  64. 64.  Figure 8-15Figure 8-15 Various types of skin lesions.Various types of skin lesions.
  65. 65.  Figure 8-15Figure 8-15 Various types of skin lesions.Various types of skin lesions.
  66. 66.  Figure 8-15Figure 8-15 Various types of skin lesions.Various types of skin lesions.
  67. 67.  Figure 8-15Figure 8-15 Various types of skin lesions.Various types of skin lesions.
  68. 68.  Figure 8-15Figure 8-15 Various types of skin lesions.Various types of skin lesions.
  69. 69.  Figure 8-15Figure 8-15 Various types of skin lesions.Various types of skin lesions.
  70. 70.  Figure 8-15Figure 8-15 Various types of skin lesions.Various types of skin lesions.
  71. 71.  Figure 8-15Figure 8-15 Various types of skin lesions.Various types of skin lesions.
  72. 72.  Figure 8-15Figure 8-15 Various types of skin lesions.Various types of skin lesions.
  73. 73.   S: A 27-year-old female presents to her doctor's office with complaints of red, itching, and oozing skin on arms and legs for the past two days. The patient states that she returned from a primitive camping and hiking vacation in Virginia two days ago. Case Study-SOAP NoteCase Study-SOAP Note
  74. 74.   O: Physical exam and history reveal a well- nourished, white female who is otherwise in good health, has NKA (no known allergies).  Vital Signs: T: 98 P: 87 R: 12 BP: 110/60  EENT; pupils are normal and reactive, ENT negative  Lungs: normal breath sounds  Skin: liquid-filled vesicles, and scabbing on inside of right arm and top of her sock lines to the bottom of her shorts, and new vesicles have formed around her eyes. Case Study-SOAP NoteCase Study-SOAP Note
  75. 75.   Based on the case study information, what do you think the diagnosis is?  What caused the vesicles to begin to form around her eyes? Case Study-SOAP NoteCase Study-SOAP Note
  76. 76.  DermatologyDermatology Tic Tac ToeTic Tac Toe • Also known as shingles • Dormant, adult version of chickenpox • Blisters/rashes found on trunk in midline fashion, following course of sensory nerve • Extremely painful lesions producing sharp, stabbing sensations; may last from 10 days to several weeks • Result of stress, disease, trauma, aging process
  77. 77.  Dermatology Tic Tac Toe • These are noncancerous skin growths on the soles of your feet caused by the human papillomavirus (HPV), which enters your body through tiny cuts, breaks or other vulnerable sites on the skin of your feet. • They often develop beneath pressure points in your feet, such as the heels or balls of your feet. This pressure also may cause one to grow inward beneath a hard, thick layer of skin (callus).
  78. 78.  Dermatology Tic Tac Toe • Inflammation of the skin and subcutaneous tissue with redness, heat, swelling and pain (4 characteristics of inflammation) • This often develops in patients with diabetes or compromised healing capacity. Usually caused by strep and staph bacteria. SERIOUS infection in patients with MRSA (methicillin resistant staph aureas)
  79. 79.  Dermatology Tic Tac Toe • Inflammation in a LOCALIZED encapsulated lesion. One lesion is called a boil but this collection of abscesses under the skin have another name. Lesions can grow and fill with pus, until they become painful and burst. • Can start as an infection of the hair follicle and are usually caused by Staph aureus bacteria. Individuals with weakened immune systems, adolescents and young adults are more susceptible to these than younger children or older adults.
  80. 80.  Dermatology Tic Tac Toe • A metabolic condition, allergies, drug or endocrine disorders are possible causative agents. • Inflammation of hair follicles/sebaceous glands especially on the face, neck, chest, upper back/shoulders. Can form blackheads, cysts, nodules, pustules and pimples.
  81. 81.  Dermatology Tic Tac Toe • Red ring shaped patches (mimicking a worm), with red inflamed skin, cracked and weeping areas with itch, discoloration. • Caused by a fungus; It can be spread on towels, clothing, or sports equipment. Personal hygiene is important in preventing the spread of ringworm. Dogs and cats can pass it to people through direct contact.
  82. 82.  Dermatology Tic Tac Toe • Occurs in melanocytes, from excessive sun exposure • May appear as a brown or black irregular patch that appears suddenly . A color or size change in a pre-existing mole or wart may also indicate a melanoma. These metastasize to other areas quickly
  83. 83.  Dermatology Tic Tac Toe • Unknown agent(s) causing benign overgrowth of epithelial cells. • This looks like a well defined warty-scaled lesion that can present in a variety of colors from yellow to brown and can be removed with scraping (curettage) or freezing
  84. 84.  EXAMEXAM Chapters 4,5 and 8Chapters 4,5 and 8 Exam will be on Oct 17 at 9:30 am •Multiple Choice •Fill in the Blanks •Short Essays (taken directly from the Short Essays at end of Chap 4 and 5) •Diagram of skin

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