CHAPTER 10 INTEGUMENTARY SYSTEM Adipose Biopsy Ceruminous Dermatitis Dermis Epidermis Follicle Lunula Melanin Papilla Pilus Sebaceous Subcutaneous Sudoriferous Journal question: What are the primary functions of the integumentary system?

Chapter 10 Learning Objectives Define at least 10 terms relating to the integumentary system. Describe the function of the integumentary system. Identify at least five integumentary system structures and the function of each.

Chapter 10 Learning Objectives Identify at least three methods used to assess the function of the integumentary system. Describe at least five disorders of the integumentary system. Describe three methods that can be used to maintain healthy skin.

Chapter 10 Learning Objectives Identify three types of skin cancer and at least five methods for prevention.

Structure and Function The integumentary system is composed of the skin and accessory structures. Functions of the integumentary system Protects the other body systems from injury and infection Helps the body maintain homeostasis by regulating temperature, retaining body fluids, and eliminating wastes Have students identify the structures of the integumentary system. Refer the students to the next slide (slide 6) or to figure 10-1 in their textbook. Discuss how each function of the integumentary system is important to good health.

Structures of the Skin Have students identify the structures of the integumentary system. FIGURE 10-1 Structures of the skin.

Skin The largest organ of the body Varies in thickness from 1/50 inch (0.5 mm) in the eyelids to 1/4 inch (6.3 mm) in the soles of the feet Changes in the skin often indicate the presence of other body system disorders, including anemia, respiratory disorders, liver disorders, cancer, and shock. Have students look at their own skin and notice the different degrees of thickness of their skin (eyelids, arms, skin between fingers and toes, soles of feet, and palms of the hands etc.). Ask students to identify reasons for the different thicknesses.

Layers of Skin Epidermis (cuticle) Outermost layer of the skin Composed of a surface layer of dead cells with an underlying layer of living cells Keratinocytes make up 90% Contains sebaceous glands, sudoriferous glands, and hair follicles Melanocytes (produce melanin) are located in the epidermis. Melanin: pigment that gives skin its color

Layers of Skin Dermis (corium) Subcutaneous layer Called the true skin Contains the blood vessels and nerves Each inch of skin contains 15 feet of blood vessels Subcutaneous layer Innermost layer Contains adipose tissue, which cushions and insulates the body’s organs Ask the students why they think the dermis is called the true skin. Discuss how adipose tissue cushions and insulates the body’s organs.

Hair and Hair Follicles Skin has hair in all areas except the soles of the feet and palms of the hands. Hair 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. Ask the students why the soles of the feet and the palms of the hands are hairless.

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 the body temperature and excrete body wastes Query students why they think there are no sebaceous glands in the palms of hands and soles of feet.

Glands 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

Nails Nails protect fingers and toes from injury. They are 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.

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. 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. Discuss fingerprint uniqueness and fingerprinting. Ask the students if they have gone through the process of being fingerprinted. Some police jurisdictions provide free fingerprinting of children for identification purposes. Why is it a good idea for everyone to have his or her fingerprints on file?

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 Discuss each of the disorders of the integumentary system on this slide and the following three slides. If the students have completed their assignment of further researching a specific disorder, have students present their findings to the class at this time or follow-up later.

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 Ask the students if they have ever encountered contact dermatitis. What were the symptoms, causes, and treatment of contact dermatitis?

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 Discuss the different stages of decubitus ulcers and possible ways to prevent them.

Disorders of the Integumentary System Furuncle Bacterial infection of a hair follicle, also called a boil Hirsutism Abnormal amount of hair growth in unusual places Impetigo Very contagious bacterial skin infection that occurs most often in children Kaposi sarcoma Form of cancer that originates in blood vessels and spreads to skin Impetigo is a contagious childhood disease. Discuss why and how impetigo children are more susceptible to this disease.

Disorders of the Integumentary System Lupus Benign dermatitis or chronic systemic disorder Morgellons disease Causes sensation of insects crawling, stinging, and biting the skin Psoriasis Chronic skin disorder in which too many epidermal cells are produced Rashes May result from viral infection, especially in children Scleroderma Rare autoimmune disorder that affects blood vessels and connective tissues of the skin Discuss types of rashes students have had. What was the source?

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 Note: Skin cancer is addressed in more detail in Slides 26-31.

Warning Signs of Melanoma

Viral Infections Causing a Rash

Skin Lesions

Disorders of the Integumentary System Vitiligo Condition that causes loss of pigment in the skin Wart Papule caused by a viral infection

Issues and Innovations Skin and hair care Skin care products include soap, astringents, and cosmetics Ways to remove hair include wax, depilatory creams, and electrolysis Tattooing (permanent makeup) Risk of infections Allergic reaction Granulomas Keloid formation Complications during magnetic resonance imaging (MRI) Discuss tattooing with the students and the resulting complications.

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. Ask students to explain what is meant by “damage to the skin from the sun is cumulative.”

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. Discuss rationale for why tanning beds may be a cause of basal cell carcinoma.

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 Discuss areas of the skin most often exposed to the sun and how this exposure may be limited or prevented.

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. Ask the students why they think that Mohs microscopic surgery as a treatment for basal cell and squamous cell carcinomas would have the best cosmetic results.

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.

Treatment of Melanoma Gene therapy Marked gene is inserted into tumor and then can be recognized for attack by the body’s immune system. Extracorporeal photochemotherapy (photopheresis) Process separates and irradiates white blood cells. Cells are washed and reinserted. These cells act as a vaccine against the existing cancer. Discuss how white blood cells are washed and reinserted as part of the photopheresis treatment of melanoma.

Summary The function of the integumentary system is to protect the other body systems from infection and injury. Five integumentary structures Hair Epidermis Dermis Sebaceous gland Melanocytes

Summary Three methods for assessing the integumentary system Visual inspections Biopsy Culture

Summary Five disorders of the integumentary system Acne Albinism Alopecia Athlete’s foot Dandruff

Summary Three types of skin cancer Methods to prevent skin cancer Squamous cell Basal cell Melanoma Methods to prevent skin cancer Wearing sunblock Avoiding sun exposure Wearing protective clothing

Review Question The term cutaneous, with regard to the integumentary system, refers to: a. The skin b. Blue skin c. Inflammation of the skin d. A condition of the skin characterized by itching e. Plastic repair of the nose

Review Question The term cutaneous, with regard to the integumentary system, refers to: a. The skin b. Blue skin c. Inflammation of the skin d. A condition of the skin characterized by itching e. Plastic repair of the nose

Review Question Disorders of the integumentary system include all of the following except: a. Alopecia b. Chloasma c. Dandruff d. Tetanus e. Furuncle

Review Question Disorders of the integumentary system include all of the following except: a. Alopecia b. Chloasma c. Dandruff d. Tetanus e. Furuncle