3. FUNCTIONS OF THE SKIN
protects the body from the external
environmental stimuli
Participates in maintenance of
homeostasis
Synthesizes Vitamin D
Oil Production
Cosmesis
5. Layers of the Epidermis
Stratum Corneum: composed of thick
keratinized layers of dead squamous
epithelial cells and accounts for up to 75 %
of the epidermal thickness
Stratum Lucidum: thin, translucent layer
that presents only in thick skin such as the
lips, the palm of the hand, and the sole of
the feet.
Stratum Granulosum: is composed of three
to four layers of flattened cells and
contains irregular granules of keratohyalin.
6. Stratum Spinosum: (+) prickle cell
layer called SPINE
Stratum Basale: composed of a single
layer of columnar epithelial cells placed
on the surface of the dermis, and its
basal surface has a role to fix the
epidermis to the dermis.
10. SKIN APPENDAGES
Hair
thin and flexible filament produced by
hair follicle.
consists of keratinized dead cells
contributes to maintaining body
temperature and perceiving touch
sensation
11. Fingernails and Toenails
firm plates formed in the stratum
corneum of the epidermis and consist
of highly compressed and keratinized
dead cells.
almost transparent and colorless, but
it appears slightly pink due to the
capillaries running underneath.
12.
13. SEBACEOUS GLANDS SWEAT GLANDS
AKA: oil glands
Secrete oil and sebum
Sebum: lubricates and
moisturizes hair and
skin
Secretes sweat to the
surface of the skin
a. Eccrine
- Located on entire
surface
- Drains unto sweat pores
- Regulates body temp
- Aids in removal of waste
b. Apocrine
- Located in axillary area
and genitals
- Drains unto hair
- Stimulated during
emotional stress
14. Mammary Glands
in female breasts are modified sweat glands
lying in the subcutaneous tissue
Ceruminous Glands
modified sweat glands that are found only in
the external auditory canal
secrete cerumen, whose role is to lubricate
the ear canal and to protect the eardrum
from bacteria, insects, and water.
15. SENSORY NERVE ENDINGS
1. Free Nerve Endings: for pain and itch
2. Meissner Corpuscle: for light touch; typical
speed sensors and sense low- frequency
vibrations.
3. Pacinian Corpuscle: for deep touch and
vibration
4. Ruffini Corpuscle: for heat sensation; respond
to continuous pressure and stretching of the
skin and detect the intensity and speed of the
stimulus.
16. 5. Krause End Bulb: for cold sensation
6. Merkel Disk: light touch and
continuous pressure
7. Muscle Spindle: pocket-shaped neural
structures that detect the length of
skeletal muscles and the speed of
muscle contraction.
8. Golgi Tendon: tension detectors by
providing information about tension
applied to tendons.
18. CUTANEOUS NERVES
Cutaneous Nerve of the Scalp
-terminal branches of trigeminal nerves
are distributed mainly on the front and
sides of the head, while cutaneous
cervical nerves are located in the neck.
Cutaneous Nerve of the Face
- Trigeminal nerves control facial
sensation and are distributed on the
scalp, teeth, and mucous membrane of
the mouse and nose
19. Cutaneous Nerves of the back:
posterior rami of the spinal nerves
Cutaneous Nerves of the Chest:
supraclavicular nerves
Cutaneous Nerve of the Upper Limb:
C4 to T2 nerve
Cutaneous Nerve of the Lower Limb :
mainly segments L1 to L5 and S1 to
S3 of the spinal cord.
20. SENSORY CONDUCTION PATHWAY
Posterior White Column: Medial
Lemniscal Pathway
conveys :
- discriminative touch information
- conscious proprioceptive information
- stereognosis information
22. CHARACTERISTICS OF THE SKIN
Skin Types
a. Normal: soft, elastic, and well
moisturized
Dry: has a rough surface; accompanied
by the formation of the erythema,
fissure, and scale.
Oily: greasy skin type with excessive
sebum secretion due to overactive oil
glands
Combination: both characteristics of
26. CAUSATION THEORY OF SKIN AGING
1. Programmatic Theory
- argues that aging process is genetically
decided, that is, an individual’s aging and
lifespan are results of a process that is set
and controlled by a genetic program.
2. Stochastic Theory
- claims that the continuous environmental
stimuli destroy genes and proteins, and as
cell damages accumulate, the cells
become dysfunctional or deformed, which
eventually leads to aging
27. CAUSES OF SKIN AGING
1. Changes in the integumentary structure and
function caused by intrinsic aging.
2. Environmental factors such as the
accumulation of ultraviolet radiation damage
(photoaging).
3. Cutaneous changes or diseases related to the
aging of other organs or age-related systemic
diseases (diabetes, vascular insufficiency, and
neurological syndromes).
4. Skin problems due to environmental changes:
with more spare time, people make physical
contact with more diverse range of materials.
28. 5. Living conditions such as living alone,
nutrition deficiency, poor hygiene, lack of
energy, and financial difficulty make it
difficult to receive medical cares.
6. Problems on physiological functions or
cognitive functions: those with these
problems tend to be stubborn and
reluctant to listen to other people’s advices
(amnesia and dementia).
7. Declined motor ability: proper disease
prevention and therapeutic activities (e.g.,
applying ointment to a wound) are difficult.
30. CUTANEOUS SIGNS
Primary Lesions
a. Macule
b. Papule
c. Nodule
d. Bulla
e. Vesicle
f. Pustule
g. Cyst
h. Wheal
i. Plaque
Secondary Lesions
a. Scale
b. Excoriation
c. Erosion
d. Ulcer
e. Fissure
f. Crust
g. Scar
h. Atrophy
i. Lichenification
31. PRIMARY LESIONS
a. Macule: display circular or oval shapes
without elevation or depression; Their
borders can be well defined or fade out
into the surrounding.
b. Papule: small, solid elevation of the skin
with diameters less than 5 mm.
c. Nodule: their diameters are normally
larger than 5 mm, and they can invade
any layer of the skin.
d. Bulla: fluid filled sac or lesion that has
diameters more than 1 cm
32. Vesicle: small blisters less than 1 cm
in diameter.
Pustule: pus-filled blisters.
Cyst: refer to epidermal nodules
containing fluid or semisolid
materials.
Wheal: are temporarily developed
papules or plaques caused by
urticaria or allergic reaction.
Plaque:elevated skin with 2 cm in
diameter
33. SECONDARY LESIONS
Scales: are aggregates of keratin debris in the
stratum corneum; in psoriasis, scales look white
or silver, and they may appear similar to fish
scales.
Excoriation: caused by mechanical traumas or
repetitive scratching to ease pruritus.
Erosion: occur by bursting of vesicles in
varicella, variola, impetigo, or herpes simplex.
Ulcer: imply skin loss extending through the
epidermis and part of the dermis, which leads to
a breach in epithelial continuity
Fissure: linear cleavages of the skin which
sometimes extend into the dermis
34. Crust: dried layers of serum, blood,
or purulent exudate and are
composed of bacteria and epidermal
debris.
Scar: as a part of the healing
processes, replace the damaged skin
tissues.
Atrophy: symptom with a decrease in
cell size due to the loss of organelles
and substances.
Lichenification: a condition in which a
part of the dermis thickens.
35.
36.
37.
38. CUTANEOUS SYMPTOMS
Pruritus (MC)
- an unpleasant sensation that causes an urge
to scratch or rub.
Pain
- Herpes zoster causes stitching pains along
the nerves and is a typical pain related to the
skin diseases.
- Dermalgia and arthralgia are found in
cellulitis squamous cell carcinoma, malignant
melanoma, lupus erythematosus, systemic
sclerosis, and polymyositis
39. Anaesthesia: absence of sensitivity
to sensory stimuli
Hypoesthesia: decreased sensitivity
to sensory stimuli
Hyperesthesia: increased sensitivity
to sensory stimuli
40. CUTANEOUS SIGNS AND SYMPTOMS IN SYSTEMIC
DISEASES
a. Pruritus
b. Eczema
c. Erythroderma
d. Urticaria
e. Nodule
f. Vascular Lesions
g. Flush
h. Vesicle and Bulla
i. Hypertrichosis and Hirsutism
46. SKIN TESTS WITH DIAGNOSIS SUPPORTING DEVICES
Dermoscopy
- convex lens with 3.5–5× magnification
- For detailed evaluation of fine wrinkles,
pigmentation and acne
47. WOOD’S LAMP EXAMINATION
- Uses UV light
- helpful in the diagnosis of various skin conditions
because infected skin shows a unique fluorescence
reaction under the light of a Wood’s lamp.
48. DIASCOPY
- method used for examining brown papule and nodule and
differentiating the causes of erythema and purpura.
- performed by pressuring a transparent, flat, firm object against the
surface of the lesion.
49. PATCH TEST
- used to diagnose the cause of skin reactions
that occur after the substance touches the ski.
SKIN
REACTION
TESTS
50. PHOTO TEST AND PHOTOPATCH TEST
•Photo test examines photosensitivity reactions of patients’
skin by measuring the decrease of minimal erythema dose
(MED) after the illumination with ultraviolet light or visible
light.
•Photopatch test is used together with patch test for skin
disease diagnosis.
51. TUBERCULIN TEST
-used to diagnose tuberculosis and is performed by injecting
a small dose of tuberculin.
-> 10 mm= positive
-5-9 mm = false positive
-< 4 mm = negative
52. IMMEDIATE SKIN TESTS
PRICK TEST SCRATCH TEST
performed by inspecting
the specimen obtained
by scratching superficial
lesions.
INTRADERMAL TEST
53. PHYSICAL THERAPY DIAGNOSIS AND EVALUATION
METHODS
Examination
- provides data gathered from medical
histories, systematic reviews, tests, and
measurements.
- It includes the process of collecting
data from physical therapy evaluation
forms, while physical therapy and
intervention are ongoing
54. Medical History
- initial information that physical therapists
obtain from the patient interview.
- includes general details gained from history
taking, family history, birth records, past
health status, occupational history, marital
history, pregnancy, menstruation,
previous(and current) illnesses, injuries,
surgeries, and medications.
55. Systematic Review
- includes the process of evaluating
emotional status, learning type,
communication, communicative
competence, and cognitive status by
making an observation on the
cardiovascular system, integumentary
system, musculoskeletal system, and
nervous system.
56. Test and Measurements
- are performed based on the information
gained from the history taking and
systematic review.
Assessment
- includes the disease’s progress, phases of
symptoms and signs, stability of the disease
and correlation between the involved system
and the damaged site
Diagnosis
- is information about the final result of
57. Prognosis
- refers to the process of figuring out the
possible results of a patient’s current
status based on the collected data
regarding the treatment of the patient or
other patients with similar symptoms.
Plan of Care
- a list of suggested intervention methods
and their frequency and duration.
58. Intervention
- means various approaches and
techniques of physical therapy
designed to improve the patients’
medical condition.
Reexamination
- is carried out to detect the changes
after the treatment.
