Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. C HAPTER 4 Integumentary System

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 2 C HAPTER 4 Lesson 4.1

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 3 O BJECTIVES Identify organs and structures of the integumentary system. Define and spell the word parts related to the integumentary system Define, pronounce, and spell disease and disorder terms related to the integumentary system.

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4 I NTEGUMENTARY S YSTEM The integumentary system is composed of skin, nails, and glands.

1. Your skin is known as your birthday suit. 2. You skin sends indicators. 3. Every month you have a whole new layer of skin. 4. Your nails grow.5mm per week. 5. You will shed 40lbs of skin in a lifetime. 6. You have 7 layers of flat, stacked cells. 7. The average amount of head hair is 120, Your eyelids have the thinnest skin. 9. Hair grows 1cm per month. 10. An adult has 20 sq.ft of skin facts that people researching the integumentary system should know :

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 6 I NTEGUMENTARY S YSTEM F UNCTION The skin forms a protective covering that when unbroken prevents entry of bacteria and other invading organisms. The skin also protects the body from water loss and from damaging effects of ultraviolet light. Other functions include regulation of body temperature and synthesis of vitamin D.

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 7 S TRUCTURE OF THE S KIN

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 8 E PIDERMAL L AYER Epidermal Layer Outermost skin layer Consists of several sublayers Top sublayer is called the stratum corneum Nonvascular Keratin is found in the cells Stratum germinativum is the bottom sublayer where new cells are produced that push up toward the stratum corneum epidermis

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 9 D ERMAL L AYER Dermal Layer Also called the corium or true skin Contains two sublayers the papillary layer and the reticular layer Holds many capillaries, lymph cells, nerve endings, sebaceous and sweat glands and hair follicles Collagen fibers are found in the connective tissue and when collagen fibers stretch, they form striae dermis

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 10

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 11 S UBCUTANEOUS L AYER Subcutaneous Layer Also called the hypodermis Found between the dermal layer and the inner organs Consists of adipose or fatty tissue and some fibrous tissue Fatty tissue protects inner organs and maintains body temperature Blood vessels and nerves are present subcutaneous

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 12

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 13 M AJOR S TRUCTURES OF THE S KIN epidermis: outer layer of skin keratin: horny, or cornified, layer composed of protein melanin: color, or pigmentation, of skin dermis (also called “true skin”): the inner layer of skin

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 14 M AJOR S TRUCTURES OF THE S KIN ( CONT ’ D ) sudoriferous glands: tiny, coiled, tubular structures that emerge through pores on the skin’s surface sebaceous glands: secrete sebum (oil) into the hair follicles, where the hair shafts pass through the dermis

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 15 Hair Hair grows out of the epidermis to cover parts of the body. Hair is compressed, keratinized cells that arise from hair follicles (sacs that enclose the hair fibers) The shaft is what we see and the root lies below the surface of the skin. Hair color is determined by the presence of melanin. Baldness or alopecia may result from heredity, disease, injury, or chemotherapy. H A IR

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 16 N AILS Nails Nails are plates made of hard keratin that cover the dorsal surface of the fingers and toes. They originate in the epidermis At the base of most nails a lunula or whitish half-moon is an area where keratin and other cells have mixed with air. The cuticle is a narrow band of epidermis that surrounds the base or bottom of nails.

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 17 C OMBINING F ORMS FOR THE I NTEGUMENTARY S YSTEM cutane/o, derm/o, dermat/o hidr/o kerat/o onych/o, ungu/o seb/o trich/o

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 18 C OMBINING F ORMS C OMMONLY U SED WITH I NTEGUMENTARY S YSTEM T ERMS aut/o bi/o coni/o crypt/o heter/o myc/o necr/o  pachy/o  rhytid/o  staphyl/o  strept/o  xer/o

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 19 P REFIXES epi- intra- para- per- sub- trans-

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 20 S UFFIXES - a -coccus -ectomy -ia -itis -malacia  -opsy  -phagia  -plasty  -rrhea  -tome

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 21 C LICKER Q UESTION Which of the following means “eating or swallowing”? a) pachy/o b) -phagia c) -plasty

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 22 D ISEASE AND D ISORDER T ERMS B UILT FROM W ORD P ARTS dermatitis dermatoconiosis dermatofibroma hidradenitis leiodermia leukoderma onychocryptosis onychomalacia  onychomycosis  onychophagia  pachyderma  paronychia  seborrhea  trichomycosis  xeroderma

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Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 24 N OTE paronychia The “ a” from para has been dropped. The final vowel in a prefix may be dropped when the word to which it is added begins with av owel.

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 25 T HE - A E NDING The -a ending in the terms “pachyderma,” “xeroderma,” “erythroderma,” “leukoderma,” and “xanthoderma” is a noun suffix and has no meaning

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 26 A NALYZE AND D EFINE WR/CV/WR/S onych/o/myc/osis abnormal condition CF/ of fungus in the nail dermatoconiosis hydradenitis dermatitis

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 27 D ISEASE AND D ISORDER T ERMS N OT B UILT FROM W ORD P ARTS ( CONT ’ D ) abrasion abscess acne actinic keratosis (see slide) albinism basal cell carcinoma (BCC) (slide) candidiasis Carbuncle (slide 2)  cellulitis (slide)  contusion  eczema  fissure  furuncle (slide)  gangrene (slide)  herpes  impetigo  infection

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 28

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 29 Diagnosis carbunclecarbuncle abscess follicular mucinosis Staphylococcal infectionabscessfollicular mucinosisStaphylococcal infection Age 34 years Comments This 34-year-old diabetic presented with a carbuncle on her upper back. A carbuncle is a group of boils that show deep infection of contiguous follicles with Staphylococcus aureus. Common sites include the back of the neck, shoulders, hips, and thighs. It is frequently associated with diabetes mellitus, exfoliative dermatitis, prolonged steroid therapy or other immunocompromised state. Description tender firm indurated erythematous subcutaneous fluctuant mass studded with draining pustules

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 30 Kaposi sarcoma laceration lesion MRSA infection pediculosis psoriasis rosacea scabies  scleroderma  squamous cell carcinoma (SqCCA)  systemic lupus erythematosus (SLE)  tinea  urticaria  vitiligo Disease and Disorder Terms Not Built from Word Parts (cont’d)

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 31 T YPES OF S KIN I NFECTIONS

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 32 T YPES OF S KIN I NFECTIONS ( CONT ’ D )

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 33 C LICKER Q UESTION Death of tissue is called a) impetigo b) gangrene c) pediculosis

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 34 C HAPTER 4 Lesson 4.2

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 35 O BJECTIVES Define, pronounce, and spell surgical terms related to the integumentary system. Define, pronounce, and spell complementary terms related to the integumentary system. Interpret the meaning of abbreviations related to the integumentary system. Interpret, read, and comprehend medical language in simulated medical statements and documents.

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 36 S URGICAL T ERMS B UILT FROM W ORD P ARTS biopsy dermatoautoplasty dermatoheteroplasty dermatoplasty dermatome onychectomy rhytidectomy rhytidoplasty

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 37 S URGICAL T ERMS N OT B UILT FROM W ORD P ARTS cauterization cryosurgery debridement dermabrasion excision incision incision and drainage (I&D) laser surgery Mohs surgery suturing

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 38 C OMPLEMENTARY T ERMS B UILT FROM W ORD P ARTS dermatologist dermatology (derm) epidermal erythroderma hypodermic intradermal (ID) keratogenic necrosis  percutaneous  staphylococcus (staph) (pl. staphylococci)  streptococcus (strep) (pl. streptococci)  subcutaneous (subcut)  transdermal (TD)  ungual  xanthoderma

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 39 STREPTOCOCCI

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 40 STAPHYLOCOCCUS

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 41 R OUTES OF A DMINISTRATION 1. Intradermal 2. Subcutaneous, hypodermic 3. Transdermal

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 42 C OMPLEMENTARY T ERMS N OT B UILT FROM W ORD P ARTS alopecia bacteria cicatrix cyst cytomegalovirus (CMV) diaphoresis  ecchymosis  ecchymoses  edema  erythema  fungus  induration

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 43 C OMPLEMENTARY T ERMS N OT B UILT FROM W ORD P ARTS ( CONT ’ D ) jaundice keloid leukoplakia macule nevus (pL nevi) nodule pallor papule petechia (pl. petechiae)  pressure ulcer (decub)  pruritus  purpura  pustule  ulcer  verruca  vesicle  virus  wheal

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 44 B URN K ELOID

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 45 S TAGE 2 P RESSURE U LCER

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 46 T YPES OF S KIN L ESIONS

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 47 T YPES OF S KIN L ESIONS ( CONT ’ D )

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 48 C LICKER Q UESTION The term which means profuse sweating is a) ecchymosis b) alopecia c) diaphoresis

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 49 A BBREVIATIONS BCC Bx CA-MRSA CMV decub derm HA-MRSA I & D ID  MRSA  SLE  SqCCA  staph  strep  subcut  TD

Copyright © 2012, 2009, 2005, 2002, 1998, 1994, 1989, 1985 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 50 R EAD M EDICAL T ERMS IN U SE Emily visited the dermatology clinic because of pruritus secondary to dermatitis involving her scalp, arms, and legs. A diagnosis of psoriasis was made. Eczema, scabies, and tinea were considered in the differential diagnosis. An emollient cream was prescribed. In addition, the patient showed the dermatologist the tender, discolored, thickened nail of her right great toe. Emily learned she had onychomycosis, for which she was given an additional prescription for an oral antifungal drug.