1. CHAPTER 5
Integumentary System

2. Integumentary System Skin Also called integument or cutaneous membrane
Epidermis
Dermis
Subcutaneous layer

3. Integumentary System
Accessory structures
Hair
Nails
Glands

4. Layers and Structures of the Skin

5. Structure of the Nail

6. Question
True or False: The epidermal layer contains most of the skin's vital structures.

7. Question
The half-moon we see at the base of our fingernails is called the _______.
cuticle
lunula
nail bed
edge

8. Skin Lesions Abrasion Abscess
Scraping or rubbing away of skin or mucous membrane as a result of friction to the area
Example: carpet burn
Abscess
Localized collection of pus in any body part that results from invasion of pus-forming bacteria
Example: pustule = small abscess

9. Skin Lesions Blister Bulla
Small, thin-walled lesion containing clear fluid
Also known as a vesicle
Bulla
Large blister

10. Skin Lesions Carbuncle Comedo
Circumscribed inflammation of skin and deeper tissues; contains pus
Comedo
Typical lesion of acne vulgaris
Example: whitehead = closed comedo
Example: blackhead = open comedo

11. Skin Lesions
Cyst
Closed sac or pouch in or within the skin; contains fluid, semifluid, or solid material
Example: hydrocele = fluid-filled cyst
Example: sebaceous cyst = solid-filled cyst

12. Skin Lesions Fissure Fistula
Crack-like sore or groove in the skin or mucous membrane
Example: anal fissure
Fistula
Abnormal passageway between two tubular organs, or from an organ to the body surface
Example: rectovaginal fistula

13. Skin Lesions Hives Laceration
Circumscribed, slightly elevated lesions on skin; paler in center than surrounding edges
Also called wheals
Example: mosquito bite
Laceration
Tear in skin; torn, jagged wound

14. Skin Lesions Macule Nodule
Small, flat discoloration of the skin; neither raised nor depressed
Example: bruises, freckles
Nodule
Small, circumscribed swelling protruding above the skin

15. Skin Lesions Papule Polyp
Small, solid, circumscribed elevation on the skin
Example: pimple, wart, elevated mole
Polyp
Small, stalk-like growth, protruding upward or outward from membrane surface
Example: nasal polyp

16. Skin Lesions Pustule Scales Small elevation of skin filled with pus
Example: small abscess on the skin
Scales
Thin flakes of hardened epithelium that are shed from the epidermis

17. Skin Lesions Ulcer Vesicle
Circumscribed, open sore or lesion of skin, accompanied by inflammation
Example: decubitus ulcer
Vesicle
Small, thin-walled lesion containing clear fluid
Example: blister

18. Skin Lesions Wheal Circumscribed, slightly elevated lesion of the skin
Paler in center than surrounding edges
Example: hives

19. Question
Notice that sometimes 2 different terms are used to describe the same thing. For instance, if a physician says a patient has hives, this patient also has:
comedos
papules
cysts
wheals

20. Question
A patient has a rash consisting of both macules and papules. What would be the combined adjective form?
maculepapular
papulemacular
papulomacular
maculopapular
c and d

21. Acne Vulgaris Pronounced Defined (ACK-nee vul-GAY-ris)
Common inflammatory disorder seen on face, chest, back, and neck
Appears as papules, pustules, and comedos

22. Albinism Pronounced Defined (AL-bin-izm)
Condition characterized by absence of pigment in the skin, hair, and eyes

23. Burns
Defined
Tissue injury produced by flame, heat, chemicals, radiation, electricity, or gases
Extent of damage determined by:
Mode and duration of exposure
Thermal intensity or temperature
Anatomic site of the burn

24. Burns First-degree (superficial) burns
Example: sunburn
Second-degree (partial-thickness) burns
Example: flash contact with hot objects
Third-degree (full-thickness) burns
Example: deep burns from a fire

25. Callus Pronounced Defined (CAL-us)
Common, usually painless thickening of the epidermis at sites of external pressure or friction, such as weight-bearing areas of the feet and on the palmar surface of the hands
Also known as a callosity

26. Question
True or False: The higher the degree rating, the deeper the burn.

27. Carcinoma, Basal Cell Pronounced Defined
(car-sih-NOH-mah BAY-sal sell)
Defined
A malignant epithelial cell tumor
Begins as a slightly elevated nodule with a depression or ulceration in the center

28. Carcinoma, Basal Cell Defined
As the depression enlarges, the tissue breaks down, crusts, and bleeds
Most common malignant tumor of epithelial tissue; occurs most often on skin exposed to the sun

29. Carcinoma, Basal Cell
Image courtesy of Robert A. Silverman, M.D., Pediatric Dermatology, Georgetown University

30. Carcinoma, Squamous Cell
Pronounced
(car-sih-NOH-mah SKWAY-mus sell )
Defined
Malignancy of the squamous, or scale-like, cells of the epithelial tissue
Much faster growing than basal cell carcinoma
Greater potential for metastasis if not treated

31. Carcinoma, Squamous Cell
Frequent sites on sun-exposed areas
Top of nose
Forehead
Margin of external ear
Back of hands
Lower lip

32. Question
True or False: Basal cell carcinoma does not originate in the epithelial layer.

33. Dermatitis Pronounced Defined (der-mah-TYE-tis)
Inflammation of skin, seen in several different forms
Acute or chronic
Contact or seborrheic

34. Eczema Pronounced Defined (EK-zeh-mah)
Acute or chronic inflammatory skin condition characterized by erythema, papules, vesicles, pustules, scales, crusts, scabs, and itching

35. Exanthematous Viral Diseases
Pronounced
(eks-an-THEM-ah-tus VYE-ral dih-ZEEZ-ez)
Defined
Skin eruption or rash accompanied by inflammation, having specific diagnostic features of an infectious viral disease

36. Exanthematous Viral Diseases
Examples
Rubella = German measles = 3-day measles
Roseola infantum
Rubeola = red measles = 7- to 10-day measles
Erythema infectiosum = fifth disease

37. Gangrene Pronounced Defined (GANG-green)
Tissue death due to loss of adequate blood supply, invasion of bacteria; subsequent decay with foul odor

38. Herpes Zoster Pronounced Defined (HER-peez ZOS-ter)
Acute viral infection, characterized by painful, vesicular eruptions on the skin that follow along nerve pathways of underlying spinal or cranial nerves
Highest incidence in adults over 50

39. Herpes Zoster Image courtesy of Robert A. Silverman,
M.D., Pediatric Dermatology,
Georgetown University

40. Impetigo Pronounced Defined (im-peh-TYE-goh)
Contagious superficial skin infection characterized by serous vesicles and pustules filled with millions of staphylococcus or streptococcus bacteria
Usually forming on the face

41. Question
This viral infection is derived from a childhood disease, and then it most commonly flares up after age 50 along nerve pathways:
eczema
rubeola
Herpes zoster
impetigo

42. Kaposi’s Sarcoma Pronounced Defined (KAP-oh-seez sar-KOH-ma)
Rare malignant lesions beginning as soft purple-brown nodules or plaques on the feet
Gradually spreads throughout skin
Increased incidence in men with AIDS

43. Keloid Pronounced Defined (KEE-loyd)
Enlarged, irregularly shaped, elevated scar that forms due to the presence of large amounts of collagen during formation of a scar

44. Keratosis Pronounced Defined (kair-ah-TOH-sis)
Skin condition in which there is a thickening and overgrowth of the cornified epithelium

45. Seborrheic Keratosis Pronounced Defined
(seb-oh-REE-ik kair-ah-TOH-sis)
Defined
Brown or waxy yellow, wart-like lesions that are loosely attached to the skin
Also known as senile warts

46. Actinic Keratosis Pronounced Defined (ak-TIN-ic kair-ah-TOH-sis)
Premalignant, gray or red-to-brown, hardened lesion caused by excessive exposure to sunlight
Also known as solar keratosis

47. Leukoplakia Pronounced Defined (loo-koh-PLAY-kee-ah)
White, hard, thickened patches firmly attached to the mucous membrane
In mouth, vulva, or penis

48. Question
True or False: Keratosis literally means condition of a horny-like growth in the upper layer of skin, like a wart or callus.

49. Malignant Melanoma Pronounced Defined (mah-LIG-nant mel-ah-NOH-mah)
Malignant skin tumor originating from melanocytes in preexisting nevi, freckles, or skin with pigment
Darkly pigmented tumor with irregular surfaces and borders; variable colors

50. ABCDs of Malignant Melanomas
Asymmetry
Borders
Color
Diameter

51. Nevus Pronounced Defined (NEV-us)
Visual accumulation of melanocytes, creating a flat or raised rounded macule or papule with definite borders
Commonly known as a mole

52. Question
Based on the definition of melanoma, what is the actual meaning of melan-?
dark pigment
light pigment
blue pigment
white pigment

53. Onychocryptosis Pronounced Defined (on-ih-koh-krip-TOH-sis)
Ingrown nail
Most commonly involves the large toe

54. Onychomycosis Pronounced Defined (on-ih-koh-my-KOH-sis)
Fungal infection of the nails

55. Pediculosis Pronounced Defined (pee-dik-you-LOH-sis)
Highly contagious parasitic infestation caused by blood-sucking lice

56. Pediculosis
Pediculosis capitis
Head
Pediculosis corporis
Body

57. Pediculosis Pediculosis palpebrarum Pediculosis pubis
Eyelashes and eyelids
Pediculosis pubis
Pubic hair

58. Pemphigus Pronounced Defined (PEM-fih-gus)
Rare, incurable disorder manifested by blisters in the mouth and on the skin
Spreads to involve large areas of the body

59. Pilonidal Cyst Pronounced Defined (pye-loh-NYE-dal SIST)
Closed sac located in the sacrococcygeal area of the back
Sometimes noted at birth as a dimple

60. Psoriasis Pronounced Defined (soh-RYE-ah-sis)
Common, noninfectious, chronic skin disorder manifested by silvery-white scales over round, raised, reddened plaques producing itching
Pruritus

61. Psoriasis
Image courtesy of Robert A. Silverman, M.D., Pediatric Dermatology, Georgetown University

62. Question
True or False: Pilus means hair and nidus means nest; therefore, a pilonidal cyst probably literally means a fluid “nest” containing hair.

63. Rosacea Pronounced Defined (roh-ZAY-she-ah)
Chronic inflammatory skin disease that mainly affects the skin of the middle third of the face
Characterized by persistent redness over areas of the face, nose, and cheeks

64. Scabies Pronounced Defined (SKAY-beez)
Highly contagious parasitic infestation caused by the “human itch mite”
Resulting in a rash, pruritus, and a feeling in the skin of “something crawling”

65. Scleroderma Pronounced Defined (sklair-oh-DER-mah)
Gradual thickening of the dermis and swelling of the hands and feet to a state in which the skin is anchored to the underlying tissue

66. Systemic Lupus Erythematosus
Pronounced
(sis-TEM-ic LOO-pus air-ih-them-ah-TOH-sus)
Defined
Chronic, multisystem inflammatory disease characterized by lesions of the nervous system and skin, renal problems, and vasculitis
Characteristic “butterfly rash” is often seen on nose and face

67. Tinea Pronounced Defined (TIN-ee-ah)
Chronic fungal infection of the skin
Characterized by scaling, itching, and sometimes painful lesions

68. Tinea
Tinea capitis
Scalp
Tinea corporis
Body

69. Tinea
Tinea cruris
Groin
Tinea pedis
Foot

70. Verruca Pronounced Defined (ver-ROO-kah)
Benign, circumscribed, elevated skin lesion that results from hypertrophy of the epidermis
Commonly known as a wart

71. Verruca Verruca vulgaris Plantar warts
Common wart on face, elbow, fingers, or hands
Plantar warts
Singly or in clusters on the sole of the foot

72. Verruca Venereal warts Seborrheic warts Transmitted by sexual contact
Seen in the elderly on the face, neck, chest, or upper back

73. Question
When people say they can feel their skin crawl, perhaps they have this condition where a tiny bug is the culprit?
verruca vulgaris
dermatitis
scabies
rosacea

74. Diagnostic Techniques, Treatments, and Procedures
Allergy testing
Various procedures used to identify specific allergens in an individual by exposing the person to a very small quantity of the allergen
ImmunoCAP Allergy Blood Test more advanced, convenient, and reliable
Cautery
Heat or caustic substances that burn and scar the skin

75. Diagnostic Techniques, Treatments, and Procedures
Cryosurgery
Noninvasive treatment that uses subfreezing temperature to freeze and destroy tissue
Curettage and electrodesiccation
Scraping away of abnormal tissue, followed by destroying the tumor base with a low-voltage electrode

76. Diagnostic Techniques, Treatments, and Procedures
Debridement
Removal of debris, foreign objects, and damaged or necrotic tissue from a wound in order to prevent infection and promote healing
Dermabrasion
Removal of the epidermis and a portion of the dermis with sandpaper or brushes in order to eliminate superficial scars of unwanted tattoos

77. Diagnostic Techniques, Treatments, and Procedures
Dermatoplasty
Skin transplantation to a body surface damaged by injury or disease
Electrodesiccation
Technique using an electrical spark to burn and destroy tissue
Also known as fulguration

78. Diagnostic Techniques, Treatments, and Procedures
Electrosurgery
Removal or destruction of tissue with an electrical current
Escharotomy
Incision made into the necrotic tissue resulting from a severe burn

79. Diagnostic Techniques, Treatments, and Procedures
Liposuction
Aspiration of fat through a suction cannula or curette to alter the body contours
Skin biopsy
Removal of a small piece of tissue from skin lesions for examination under a microscope to confirm or establish a diagnosis

80. Diagnostic Techniques, Treatments, and Procedures
Skin graft
Process of placing tissue on a recipient site, taken from a donor site, in order to provide the protective mechanisms of skin to an area unable to regenerate skin
Wood’s lamp
Ultraviolet light that is used to examine the scalp and skin for the purpose of observing fungal spores

81. Question
True or False: A person with third-degree burns would benefit from a dermatoplasty.