Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 1 CHAPTER 10 INTEGUMENTARY SYSTEM

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.2 Structure and Function  composed of:  Skin  hair  Nails  Specialized glands  Nerves  Functions  Protects from injury and infection  Perceives environment with sensory receptors  Regulates homeostasis:  Temperature  retaining body fluids  eliminating wastes

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.3 Structures of the Skin FIGURE 10-1 Structures of the skin.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.4 Skin  The largest organ of the body  Varies in thickness  1/50 inch (0.5 mm) in the eyelids (thinnest)  1/4 inch (6.3 mm) in the soles of the feet (thickest)  Abnormalities in the skin can be caused by:  anemia  respiratory disorders  liver disorders  cancer  shock.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.5

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.6 Layers of Skin  Epidermis (cuticle)  Outermost layer  Composed of dead cells with an underlying layer of living cells  Keratinocytes (water repellent cells) make up 90%  Contains:  sebaceous glands (oil)  sudoriferous glands (sweat)  hair follicles  Melanocytes (produce melanin)  Melanin: pigment that gives skin its color

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.7 Layers of Skin  Dermis (corium)  AKA: true skin  Contains  blood vessels  nerves  Each inch of skin contains 15 feet of blood vessels  Sensitive to pain, pressure, touch & temperature changes  Subcutaneous layer  Innermost layer  Contains:  adipose tissue, which cushions and insulates the body’s organs

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.8 Hair and Hair Follicles  in all areas except the soles of the feet and palms of the hands.  blocks foreign particles from entering the body through structures such as the nose and eyes.  The visible portion is called the shaft.  The hair follicle is the root with its covering.  Arrector pili muscle creates goosebumps  Color and texture are genetic trait

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.9 Glands  Three types of glands in the skin  Sebaceous glands (oil)  Located everywhere except palms of hands and soles of feet  Sebum (oil) causes the skin to be soft and waterproof  Sudoriferous glands (sweat)  Help regulate body temperature & excrete body wastes  Ceruminous glands  Located in the auditory canal of the ear  Secrete wax that helps protect the ear from infection and prevents entry of foreign bodies

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.10 Nails  Nails protect fingers and toes from injury.  formed from dead, keratinized epidermal cells.  Root is covered by skin at the area of attachment to finger or toe.  Lunula is the crescent-shaped white area near the root.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.11 

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.12 Assessment Techniques  Dermatology is the study of skin.  Dermatitis is inflammation of the skin.  Skin lesions can be seen with visual inspection.  Size, shape, texture, and color often reveal cause.  Biopsy is used to identify the causative organism.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.13 Assessment continued  Fingerprints and toe prints are unique to each person.  Papillae (ridges) form regular patterns in the fingers, palms of the hands, and soles of the feet where the skin is thick.  Pattern of ridges may be linked to disorders such as Down syndrome.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.14 Disorders of the Integumentary System  Acne vulgaris  Caused by increased secretion of oil related to increased hormones during puberty  Primarily affects the face, chest, and back  Albinism  Inherited disorder in which melanin is not produced  Alopecia  Baldness  Athlete’s foot  Contagious fungal infection of the foot

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.15

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.16 Disorders of the Integumentary System  Cellulitis  Bacterial infection of the dermis and subcutaneous layer of the skin  May be caused by many different bacteria  Chloasma  Patchy discoloration of the face  Cleft lip or cleft palate  Upper lip has a cleft where the nasal palate does not close properly.  Contact dermatitis  Allergic reaction that may occur after initial contact or as an acquired response

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.17

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.18 Disorders of the Integumentary System  Dandruff  White flakes of dead skin cells from the scalp  Decubitus ulcers  Sores or areas of inflammation that occur over bony prominences of the body  Eczema  Group of disorders caused by allergic or irritant reactions  Fungal skin infections  Skin infections that live on dead outer surface or epidermis

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.19

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.20 Disorders of the Integumentary System  Lupus  Benign dermatitis or chronic systemic disorder  Psoriasis  Chronic skin disorder in which too many epidermal cells are produced  Rashes  May result from viral infection, especially in children

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.21 Disorders of the Integumentary System  Skin cancer  Three forms are basal, squamous, and melanoma.  Skin lesions  Differ in texture, color, location, and rate of growth  Streptococcus  Nonmotile bacteria that affect many parts of the body

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.22 Warning Signs of Melanoma

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.23 Viral Infections Causing a Rash

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.24 Skin Lesions

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.25 Disorders of the Integumentary System  Vitiligo  Condition that causes loss of pigment in the skin  Wart  Papule caused by a viral infection

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.26 Sun and Skin Cancer  Ultraviolet (UV) radiation in sunlight may change DNA structure in skin cells.  UV exposure is the main cause of skin cancer.  Damage to the skin from the sun is cumulative.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.27 Types of Skin Cancer  Basal cell carcinoma  Most common type of skin cancer  Starts in the lowest layer of the epidermis  Waxy, pearly growths or red, scaly patches  Commonly found on the face, arms, and hands  May alternate bleeding and healing  Increase in the number of basal cell carcinomas found in women younger than 40 years  Tanning beds may be a major cause of increase.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.28 Types of Skin Cancer  Squamous carcinoma  Second most common type of skin cancer  Starts in the middle layer of the epidermis  Spreads more quickly than basal cell carcinoma  Red, scaly patches  Appears on areas of the skin most often exposed to the sun

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.29 Treatment of Basal Cell and Squamous Cell Carcinomas  Surgery  Mohs microscopic surgery  Removes affected tissue by layers  Best cosmetic results  Radiation therapy  Chemotherapy  Photodynamic therapy (PDT)  Inactive drug is injected into blood vessels surrounding cancer cells.  Laser light is shined on skin, activating the drug and killing the cancer cells.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.30 Types of Skin Cancer  Melanoma  Most serious form of skin cancer  Originates in the pigment-producing or melanin cells of the skin  Most often caused by exposure to the sun  Appears as a brown or black molelike growth on the back, legs, or torso  One half of cases develop from existing pigmented moles.  If treated early, cure rate is almost 100%.  If not treated early, melanoma may be fatal.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.31 