Integumentary System

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Integumentary System

  1. 1. Integumentary System“W h e n a l l t h e f ie l d s a r o u n d l a y b o u n d a n d h o a r , B e n e a t h a t h ic k in t e g u me n t o f s n o w.” Henry David Thoreau (1877-1862), US Author
  2. 2. Integumentary System Florida State College of Jacksonville Professor: Michael L.Whitchurch, MHS, OT/L
  3. 3. Integumentary SystemFunctionThe skin provides a protective two-way barrier between our internal environment and the outside world. It also plays an important role in temperature regulation, houses sensory receptors to detect the environment around us and secretes important fluids
  4. 4. Integumentary Systemorgans Skin Hair Nail Sebaceous glands Sweat glands
  5. 5. Integumentary Systemanatomy and physiology o Cutaneous membrane o Hair o Integument o Integumentary system o Nails o Pathogens o Sebaceous gland o Sensory receptors o Skin o Sweat glands
  6. 6. Multimedia DirectorySlide 38Skin Anatomy ExerciseSlide 77Decubitus Ulcers VideoSlide 78 Eczema VideoSlide 83Skin Cancer Video
  7. 7. Integumentary Combining Formso albin/o white o diaphor/o profuseo bi/o life sweatingo cry/o cold o electr/o electricityo cutane/o skin o erythr/o redo cyan/o blue o hidr/o sweato derm/o skin o ichthy/o scaly, dryo dermat/o skin o kerat/o hard, horny
  8. 8. Integumentary Combining Formso leuk/o white o py/o puso lip/o fat o rhytid/o wrinkleo melan/o black o scler/o hardo myc/o fungus o seb/o oilo necr/o death o trich/o hairo onych/o nail o ungu/o nailo pil/o hairo phot/o light o vesic/o bladder o xer/o dry
  9. 9. Integumentary System Suffixeso –derma skino –opsy viewo –tome instrument to use to cut
  10. 10. Integumentary System Prefixeso allo – other, different from usualo xeno– strange, foreign
  11. 11. Anatomy and Physiologyorganso Skino Accessory organs n Sweat glands n Sebaceous glands n Hair n Nails
  12. 12. Anatomy and Physiologyskino Largest organ in bodyo Weighs more than 20 pounds (in adult)o Skin also called: n Integument n Cutaneous membrane
  13. 13. Functionsskino Protectiono House nerve receptorso Secrete fluidso Regulate temperature
  14. 14. Protectionskino Primary functiono Forms 2-way barrier n Keeps out pathogens and harmful substances n Prevents critical body fluids from escapingo Protects underlying tissues
  15. 15. Sensory Receptorsskino Located within middle layer of skino Detect: n Temperature n Pain n Touch n Pressureo Nerve endings convey messages to brain and spinal cord
  16. 16. Fluids Producedskino Sweat glands: n Assist body in maintaining internal temperature n Create cooling effect when sweat evaporateso Sebaceous glands: n Oil glands n Produce sebum n Lubricates the skin surface
  17. 17. Temperature Regulationskin o To conserve heato To cool skin: n Constrict superficial n Sweat evaporation blood vessels to keep n Dilate superficial blood warm blood away from vessels to release heat surface n Continuous fat layer acts as insulation
  18. 18. The Skinanatomyo Three layers n Epidermis – thin, outer membrane layer n Dermis – middle, fibrous connective tissue layer n Subcutaneous layer – innermost layer of fatty tissue
  19. 19. Copyright ©2009 by Pearson Education, Inc.Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
  20. 20. Epidermisskino Composed of ….. stratified squamous epithelium n Flat scale-like cells n Arranged in overlapping layers called stratao Has no blood supply or connective tissue n Depends on deeper layers of skin for nourishmento Basal layer the deepest layer of the Epidermis
  21. 21. Basal Layer of Epidermisskino Cells continuously grow o Melanocytes and push old cells toward surface  Special cells of basal layero During this process  Cells shrink, die, and fill  Produce black pigment with hard protein called melanin keratin  Gives skin coloro Keratinized cells allow  Protects against skin to act as barrier to ultraviolet rays of sun infection
  22. 22. Figure 3.2 – Photomicrograph of the epidermis layer of the skin.
  23. 23. Dermis skino Also called coriumo Located between epidermis and subcutaneous layero Name means “true skin”o Is living tissue with very good blood supply
  24. 24. Dermisskino Composed of: n Connective tissue and collagen fibers n Strong fibrous proteins give dermis flexible strengtho Houses: n Hair follicles n Lymph vessels n Sweat glands n Sensory receptors n Sebaceous glands n Nerve fibers n Blood vessels n Muscle fibers
  25. 25. Subcutaneous Layerskino Also called hypodermiso Third and deepest layero Composed of fat cells called lipocyteso Protects the deeper tissues of bodyo Acts as insulation for heat and cold
  26. 26. Accessory Organso Located within dermiso Include: n Hair n Nails n Sweat glands n Sebaceous glands
  27. 27. Hairo Hair follicleo Hair rooto Hair shafto Arrector pili muscle
  28. 28. Hairo Grows longer from the root n Deep cells of hair root force older cells to move upward n This forms hair shaft n Grows towards surface within hair follicleo Melanin gives hair its coloro Arrector pili n Slip of smooth muscle n Causes hairs to “stand up”
  29. 29. Figure 3.3 – Structure of a hair and its associated sebaceous gland.
  30. 30. Accessory Organso Located within dermiso Include: n Hair n Nails n Sweat glands n Sebaceous glands
  31. 31. Nailso Nail body n Flat plate of keratino Nail bed n Connects nail body to underlying tissueo Lunula n Half-moon white area at base of nail
  32. 32. Nailso Grow longer from nail rooto Cuticle n Soft tissue that covers nail rooto Free edge n Exposed edge
  33. 33. Figure 3.4 – External and internal structures of nails.
  34. 34. Sebaceous Glandso Open into hair follicleso Secrete the oil = sebum n Lubricates hair and skin n Prevents drying and cracking
  35. 35. Figure 3.3 – Structure of a hair and its associated sebaceous gland.
  36. 36. Sweat Glandso Also called sudoriferous glandso Coiled gland in dermiso Sweat travels to surface in sweat ducto Sweat pore – surface opening
  37. 37. Figure 3.1 – Skin structure, including the three layers of the skin and the accessory organs: sweat gland, sebaceous glands, and hair.
  38. 38. Sweat Glandso 2 million throughout bodyo Sweat or perspiration n Cools body as evaporates n Contains small amount of waste product n Normal colorless and odorlesso Apocrine glands n Found in pubic and underarm areas n Thicker sweat that can produce an odor
  39. 39. Skin Anatomy Exercise Click here to view an interactive exercise on skin anatomy. Back to Directory
  40. 40. Word Building withcutane/o & derm/osub– –ous subcutaneous pertaining to under skinepi– –al epidermal pertaining to upon skinhypo– –ic hypodermic pertaining to under skinintra– –al intradermal pertaining to within skin
  41. 41. Word Building withdermat/o–itis dermatitis inflammation of skin–logist dermatologist skin specialist–osis dermatosis abnormal skin condition–pathy dermatopathy skin disease–plasty dermatoplasty surgical repair of skin
  42. 42. Word Building with hidr/o and lip/oan– –osis anhidrosis abnormal condition of no sweathyper– –osis hyperhidrosis abnormal condition of excessive sweat–ectomy lipectomy surgical removal of fat–oma lipoma fat tumor/growth
  43. 43. Word Building withmelan/o & necr/o–oma melanoma black tumor–cyte melanocyte black cell–osis necrosis abnormal condition of death
  44. 44. Word Building withonych/o and py/o–ectomy onychectomy surgical removal of nail–malacia onychomalacia nail softeningmyc/o –osis onychomycosis abnormal condition of nail fungus–phagia onychophagia nail eating (nail biting)–genic pyogenic pus producing
  45. 45. Word Building withrhytid/o and seb/o–ectomy rhytidectomy surgical removal of wrinkles–plasty rhytidoplasty surgical repair of wrinkles–rrhea seborrhea oil discharge
  46. 46. Word Building withtrich/o and ungu/omyc/o -osis trichomycosis abnormal condition of hair fungus–al ungual pertaining to nail
  47. 47. Word Building with–dermaerythr/o erythroderma red skinichthy/o ichthyoderma Scaly, dry skinleuk/o leukoderma white skinpy/o pyoderma pus skinscler/o scleroderma hard skinxer/o xeroderma dry skin
  48. 48. Integumentary Vocabulary abrasion friction scraping away skin surface cicatrix normal scar comedo hardened sebum in hair follicle; blackhead contusion injury caused by a blow; causes swelling, pain, and bruising cyanosis bluish tint to skin caused by deoxygenated blood depigmentation loss of normal skin color
  49. 49. Figure 3.5 – A cyanotic infant. Note the bluish tinge to the skin around the lips, chin, and nose. (St. Bartholomews Hospital, London/Photo Researchers, Inc.)
  50. 50. Integumentary Vocabulary diagnosis and treatment of skin conditions; dermatology (Derm, derm) physician is a dermatologist diaphoresis profuse sweating blood collecting under skin following blunt trauma; ecchymosis a bruise erythema red flushing of skin thick layer of dead tissue develops over a deep eschar burn area hirsutism excessive hair growth
  51. 51. Figure 3.6A – Male lying supine with large ecchymosis on lateral rib cage and shoulder. Copyright ©2009 by Pearson Education, Inc.Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
  52. 52. Integumentary Vocabularyhyperemia redness of skin due to increased blood flowhyperpigmentation abnormal amount of pigmentationkeloid thick hypertrophic scar condition of excessive growth and thickening of epidermiskeratosis layerlesion general term for injury or abnormality pigmented skin blemish, birthmark, or mole; usuallynevus benign
  53. 53. Figure 3.7 – Keloids, hypertrophic scarring on the back. (Martin Rotker/ Phototake NYC) Copyright ©2009 by Pearson Education, Inc.Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
  54. 54. Integumentary Vocabulary pallor abnormal paleness of skin petechiae spots from minute hemorrhages under skin photosensitivity skin reacts abnormally to light plastic surgery repair, reconstruction, or improvement of body structures pruritus severe itching purpura skin hemorrhage due to fragile blood vessels
  55. 55. Figure 3.6B – Petechiae, pinpoint skin hemorrhages. Copyright ©2009 by Pearson Education, Inc.Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
  56. 56. Figure 3.6C – Purpura, hemorrhaging into the skin due to fragile blood vessels. Copyright ©2009 by Pearson Education, Inc.Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
  57. 57. Integumentary Vocabulary infection producing pus; dead bacteria, white purulent blood cells, and tissue debris congenital collection of dilated blood vessels; strawberry hemangioma birthmark suppurative containing or producing pus Urticaria hives; eruption of wheals with severe itching Verruca warts; benign growth caused by virus
  58. 58. Figure 3.8 – Strawberry hemangioma, a birthmark caused by a collection of blood vessels in the skin. (H.C. Robinson/Science Photo Library/Photo Researchers, Inc.) Copyright ©2009 by Pearson Education, Inc.Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
  59. 59. Pathology – Surface Lesionscyst fluid-filled sac under skinfissure cracklike lesion on skinlaceration torn or jagged woundmacule flat, discolored spot on skinnodule firm, solid mass larger than 0.5 cm
  60. 60. B Figure 3.9 A) Cutaway view and B) photograph of a cyst. (Barts Medical Library/Phototake NYC) Copyright ©2009 by Pearson Education, Inc.Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
  61. 61. D Figure 3.9 C) Cutaway view and D) photograph of a fissure. (Phototake NYC) Copyright ©2009 by Pearson Education, Inc.Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
  62. 62. Figure 3.9 E) Cutaway view and F) photograph of a macule. (Phototake NYC) F Copyright ©2009 by Pearson Education, Inc.Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
  63. 63. H Figure 3.9 G) Cutaway view and H) photograph of a nodule. (Phototake NYC) Copyright ©2009 by Pearson Education, Inc.Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
  64. 64. Pathology – Surface Lesionspapule small, solid raised spot smaller than 0.5 cmpustule raised spot on skin containing pusulcer open sore in skinvesicle small, fluid-filled, raised spot; blisterwheal small, round, swollen area; typical of allergic skin reaction
  65. 65. JFigure 3.9 I) Cutaway view and J) photograph of a papule. (ISM/Phototake NYC)
  66. 66. L Figure 3.9 K) Cutaway view and L) photograph of a pustule. (P.Marazzi/Science Photo Library/Photo Researchers, Inc.) Copyright ©2009 by Pearson Education, Inc.Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
  67. 67. N Figure 3.9 M) Cutaway view and N) photograph of an ulcer. (Dr. P.Marazzi/Photo Researchers, Inc.) Copyright ©2009 by Pearson Education, Inc.Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
  68. 68. Figure 3.9 O) Cutaway view and P) photograph of a vesicle. (ISM/Phototake NYC) P Copyright ©2009 by Pearson Education, Inc.Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
  69. 69. R Figure 3.9 Q) Cutaway view and R) photograph of a wheal. (Charles Stewart MD FACEP, FAAEM) Copyright ©2009 by Pearson Education, Inc.Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
  70. 70. Pathology of the Skin abscess collection of pus in skin inflammation of sebaceous glands and hair follicles with acne papules and pustules chronic form of adult acne with redness and tiny pimples, acne rosacea primarily on nose common form of teenage acne with comedo, papules, and acne vulgaris pustules genetic condition; unable to make melanin; white hair and albinism skin, and red eyes
  71. 71. Pathology of the Skin cancerous tumor in basal cell layer; common cancer; rarelybasal cell carcinoma metastasizes skin damage caused by fire, electricity, ultraviolet light, or causticburn chemicals; percentage of skin burned is estimated by Rule of Nines
  72. 72. Figure 3.10 – Basal cell carcinoma. A frequent type of skin cancer that rarely metastasizes. (ISM/Phototake NYC) Copyright ©2009 by Pearson Education, Inc.Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
  73. 73. Figure 3.12 – Rule of Nines. A method for determining percentage of body burned. Each differently colored section represents 9% of the body surface. Copyright ©2009 by Pearson Education, Inc.Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
  74. 74. First Degree BurnFirst degree burn skin reddened and painful; no blisters; damage to epidermis
  75. 75. Second Degree Burn skin reddened and painful with blisters; damage to epidermis andSecond degree burn dermis
  76. 76. Third Degree Burn skin charred; epidermis and dermis burned away; subcutaneousThird degree burn layer exposed
  77. 77. Pathology of the Skincellulitis diffuse acute infection of connective tissue of skindecubitus ulcer open sore caused by pressure over bony prominences; caused by(decub) loss of blood flow to skin late stages of gangrene; affected area becomes dried, blackened,dry gangrene and shriveledeczema superficial dermatitis; redness, vesicles, itching, and crusting
  78. 78. Decubitus Ulcer Video Click here to view a video on decubitus ulcers.
  79. 79. Eczema Video Click here to view a video on eczema.
  80. 80. Pathology of the Skingangrene tissue necrosis due to loss of blood flowichthyosis skin becomes dry, scaly, & keratinized highly infections bacterial infection with pustules that ruptureimpetigo and crust overKaposi’s sarcoma skin cancer seen in AIDS patients; brownish-purple lesions
  81. 81. Figure 3.13 – Impetigo, a highly contagious bacterial infection. Note the extensive crusting around the eye. (Barts Medical Library/Phototake NYC) Copyright ©2009 by Pearson Education, Inc.Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
  82. 82. Pathology of the Skin dangerous form of cancer; begins in malignant melanoma (MM) melanocytes; quickly metastasizes Pediculosis lice infestation Psoriasis chronic inflammatory condition with papules forming “silvery scale” patches rubella contagious viral infection; German measles scabies mite infestation
  83. 83. Figure 3.14 – Malignant melanoma. This tumor demonstrates the highly characteristic color of this tumor. (ISM/Phototake NYC)
  84. 84. Skin Cancer Video Click here to view a video on skin cancer.
  85. 85. Figure 3.15 – Psoriasis. This photograph demonstrates the characteristic white skin patches of this condition. Copyright ©2009 by Pearson Education, Inc.Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
  86. 86. Pathology of the Skinsebaceous cyst sebum filled sac forms around sebaceous gland cancer of epidermis layer; may invade deeper tissuesquamous cell carcinoma (SCC) and metastasize chronic disease of connective tissue; injures skin,systemic lupus erythematosus joints, & kidneys; produces red, scaly butterfly rash(SLE) across facetinea fungal infection; itching & scaling lesions
  87. 87. Pathology of the Skintinea capitis fungal infection on scalp; ringwormtinea pedis fungal infection of foot; athlete’s footvaricella contagious viral infection; chickenpox disappearance of pigment from skin in patches; causes milk-whitevitiligo lesionswet gangrene area of gangrene with secondary bacterial infection and pus
  88. 88. Figure 3.16 – Varicella or chickenpox, a viral skin infection. In this photograph, the rash is beginning to form scabs. Copyright ©2009 by Pearson Education, Inc.Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
  89. 89. Pathology of the Hairalopecia absence or loss of hair; baldnesscarbuncle furuncle involving several hair follicles bacterial infection of hair follicle; redness, pain, andfuruncle swelling; a boil
  90. 90. Pathology of the NailsOnychia infected nail bedparonychia infection of skin fold around nail
  91. 91. Clinical Laboratory Testsculture & sensitivity grows bacteria removed from infected area to identify infecting(C&S) bacteria; then determines sensitivity to various antibiotics
  92. 92. Biopsy Proceduresbiopsy removal of piece of tissue to examine under a microscope; aids in(BX, bx) diagnosisexfoliative cytology scraping cells from tissue to examine under microscopefrozen section thin piece of tissue is cut from frozen specimen for rapid examination(FS) under microscope scrapings from lesion is cultured and then examined underfungal scrapings microscope
  93. 93. Skin Graftingskin graft (SG) transfer of skin from normal area to cover another siteallograft skin graft from one person to anotherautograft skin graft from a person’s own body skin graft from an animal of another species; usually a pig;heterograft xenograft skin graft from an animal of another species; usually a pig;xenograft heterograft
  94. 94. Figure 3.17 – A freshly applied autograft. Note that the donor skin has been perforated so that it can be stretched to cover a larger exposed area. (Courtesy of Dr. William Dominic, Community Regional Medical Center) Copyright ©2009 by Pearson Education, Inc.Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
  95. 95. Skin Grafting instrument for cutting skin or for producing thin transplantsdermatome of skindermatoplasty skin grafting
  96. 96. Surgical Procedures destruction of tissue by using chemicals, electricity, heat,cauterization or freezingcryosurgery use of extreme cold to freeze and destroy tissuecurettage removal of superficial skin lesion with a scraper (curette) removal of foreign material & dead or damaged tissuedebridement from wound
  97. 97. Debridement - Decubitis removal of foreign material &debridement dead or damaged tissue from wound
  98. 98. Surgical Procedureselectrocautery using an electric current to destroy tissueincision & drainage (I&D) making an incision to drain material such as pus
  99. 99. Surgical Proceduresincision & drainage making an incision to drain(I&D) material such as pus
  100. 100. Plastic Surgerychemabrasion abrasions using chemicals; chemical peel abrasion using wire brushes or sandpaper; removesdermabrasion scars, tattooslaser therapy removal of lesions using a laser beamliposuction removal of fat beneath skin by means of suction surgical removal of excess skin to eliminate wrinkles; facerhytidectomy lift
  101. 101. rhytidectomy
  102. 102. Integumentary Pharmacologyanesthetics deaden pain Xylocaine, Novocainantibiotics kill bacteria Neosporinantifungals kill fungi Monistat, Lotriminantiparasitics kill mites or lice Kwell, Nix
  103. 103. Integumentary Pharmacologyantipruritics reduce severe itching Benadryl, Caladryl isopropyl alcohol, hydrogenantiseptics kill bacteria peroxideanti-virals treat herpes simplex infection Valtrex, Zoviraxcorticosteroid cream powerful anti-inflammatory Cortaid; Kenalog
  104. 104. Integumentary AbbreviationsBCC basal cell carcinomaBX, bx biopsyC&S culture and sensitivitydecub decubitus ulcerDerm, derm dermatologyFS frozen section
  105. 105. Integumentary AbbreviationsHSV herpes simplex virusI&D incision and drainageID intradermalMM malignant melanomaSCC squamous cell carcinomaSG skin graft
  106. 106. Integumentary AbbreviationsSLE systemic lupus erythematosusSTSG split thickness skin graftsubcu, SC, sc, subq subcutaneousUV ultraviolet
  107. 107. Integumentary System“W h e n a l l t h e f ie l d s a r o u n d l a y b o u n d a n d h o a r , B e n e a t h a t h ic k in t e g u me n t o f s n o w.” Henry David Thoreau (1877-1862), US Author

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