Integumentary System

Classifications of Body Membranes 2 Main Categories of Body Membranes: Epithelial membranes – epithelial tissue & underlying fibrous connective tissue Connective tissue membranes – exclusively various types of connective tissues (no epithelial cells)

3 Types of Epithelial Membranes Cutaneous Membrane – “the skin” Primary organ of Int. System Serous Membrane – on surfaces within closed cavities Parietal Layer – lines the walls of a body cavity, like wallpaper Visceral Layer – inward layer covering the surface of organs Mucous Membrane Line body surfaces opening directly to the exterior Lining of respiratory, digestive, urinary, and reproductive tracts Mucus – thick, slimy material; fxn: keep membranes moist/soft

Connective Tissue Membranes Do NOT contain epithelial components Synovial Membranes – line the joint capsules Synovial Fluid – thick, colorless fluid; fxn: lubricate jnts. Bursae – small sacs between moving body parts

SKIN - Functions Protection Sensory perception Regulation of body temperature Storage Absorption Excretion Production

Components of the Skin

Layers of the Skin 1. Epidermis—outermost layer 2. Dermis—“true skin” Subcutaneous fascia or hypodermis— the innermost layer

The Layers of Skin

Glands & Other Parts of the Skin Sudoriferous glands (sweat glands) Sebaceous glands (oil glands) Hair Nails

Hair Functions Varies by location Scalp: insulates head; grows @ 1 mm/day Nostril: filters Eyebrow/lash: protects; keeps dust and perspiration out of eyes Body: none Arrector pili: pilomotor muscle; stimulated by cold and emotions. Attached to base of dermal papilla and side of follicle. Contraction = goose bumps. Alopecia = hair loss

NAILS Protects the distal ends of phalanges Provides ability to grip, pick up tiny objects HCW observe for cyanosis to assess blood O2 if pulse ox not available

Skin Color—Pigmentation Skin color is inherited and is determined by pigments in the epidermis a. Melanin b. Carotene

Skin Color—Albino Absence of skin pigments Skin has pinkish tint Hair is pale yellow or white Eyes are red in color and sensitive to light

Skin Color—Abnormal Erythema Jaundice Cyanosis

Skin Lesions Any measurable variation in tissue structure Not always a sign of disease Can be flat, depressed or elevated

Depressed Lesions Excoriation: scratch exposing the dermis Laceration: tearing of the skin Atrophy: loss of tissue Pressure Ulcer: Decubutis ulcer bedsore Fissure: deep crack

Skin Eruptions Macules (macular rash) – freckles Papules (papular rash) - warts Vesicles – fluid filled, blisters Pustules – pus filled, acne Crusts - scabs Wheals – hives, insect bite Plaques – friction cause or psoriasis

Chicken Pox Blisters, scab over Infectious agent???

Skin infections Impetigo: staph, strept. Erythema then vesicles and crusts. Contagious. Tx: antibiotics Tinea: Mycoses (fungal). Erythema, scaling and crusting. Ex: Ringworm (tinea capitis), athletes foot (tinea pedis). Tx: antifungal Warts: verruca, caused by papilloma virus. Contagious. Tx: removal Boils: furnacle. Staph inf of hair follicle. Lg pustule. Tx: topical antibiotic Scabies: itch mite. Contagious. Tx: scabicide and antihistamine

Impetigo

Ringworm

Inflammatory Conditions Scleroderma: autoimmune. Affects blood vessels & connective tissue that causes hardening. Localized or Systemic Psoriasis: chronic inflammation. Scaly patches. Tx: topical steroids Eczema: most common. Papules, vesicles and crusts. Symptom of underlying condition. Tx: cause & topical steroids Hives: urticaria (transient wheals) due to allergy or irritant. Pruritits (itching). Tx: varies, treat the cause

BURNS Caused by fire, ultraviolet rays, electricity, chemicals. Cause will influence tx Severity is determined by 3 factors: Total Body Surface affected. (total body surface area involved-%) + depth (layers involved) Extent of injury: Rule of 9’s to determine; 11 body areas 9% each Depth of injury & tissues involved: 1st, 2nd, 3rd degree Type of homeostatic mechanisms affected Ex: BP control, fluid and electrolyte balance http://www.nlm.nih.gov/medlineplus/tutorials/burns/htm/_no_5 0_no_0.htm -

Rule of 9’s Estimation of body surface area involved Anterior head: 4.5% / Posterior head:4.5% Anterior arm: 4.5% / Posterior arm 4.5% Anterior leg: 9% / Posterior leg 9% Anterior trunk: 18% / Posterior trunk 18% Modified in infants due to larger head size

1st DEGREE BURN Surface layers of epidermis Some reddening and discomfort No blistering Sunburn Partial thickness

2nd Degree Deep epidermal and upper dermis Severe pain and blistering May damage hair, sweat and oil glands Swelling (edema) and fluid loss occurs Scarring results Partial thickness

2nd Degree

3rd Degree Complete destruction of epidermis and dermis; may extend to SQ layer: full thickness burn (4TH degree if underlying bone/muscle tissue destroyed) Little pain d/t destruction of nerve endings Severe fluid loss If it covers a large extent, the pt is critically ill; ultimately may die due to sepsis

3rd Degree

Diseases and Abnormal Conditions Peritonitis Dermatitis what is this?? Eczema Impetigo Psoriasis Ringworm Verrucae/warts/plantar warts

Diseases and Abnormal Conditions Acne vulgaris Athlete’s foot Burns Skin cancer Basal cell carcinoma Squamous cell carcinoma Melanoma