1. Memmler’s The Human Body in Health and Disease 11th edition
Chapter 6
The Skin in Health and Disease

2. The Integumentary System
Skin and associated structures form integumentary system

3. Structure of the Skin Skin consists of two layers Epidermis Strata
Blood vessels, nerve endings, and glands

4. Cross section of the skin.

5. Epidermis Surface portion of the skin
Stratum basale or stratum germinativum
Stratum corneum

6. Dermis Contains most of the accessory structures of the skin
Blood vessels
Nerves
Sweat glands
Oil glands
Hair
Dermal papillae

7. Checkpoint 6-1: The skin and all its associated structures comprise a body system. What is the name of this system?
Checkpoint 6-2: The skin itself is composed of two layers. Moving from the superficial to the deeper layer, what are the names of these two layers?

8. Subcutaneous Layer Connects the skin to the surface muscles
Loose connective tissue
Adipose (fat) tissue
Blood vessels
Nerves and nerve endings

9. Checkpoint 6-3: What is the composition of the subcutaneous layer?

10. Question: In what layer of the skin do you find the sebaceous glands? a. dermis b. stratum corneum c. subcutaneous

11. Answer: a. dermis

12. Accessory Structures of the Skin
Some structures of the integumentary system protect the skin and have some more generalized functions as well

13. Sebaceous (Oil) Glands
Produce a variety of secretions
Sebum
Vernix caseosa
Eye lubrication

14. Sudoriferous (Sweat) Glands
Located in the dermis and subcutaneous tissue
Eccrine type sweat glands
Apocrine sweat glands
Ceruminous glands
Ciliary glands
Mammary glands

15. Checkpoint 6-4: Some skin glands produce an oily secretion called sebum. What is the name of these glands?
Checkpoint 6-5: What is the scientific name for the sweat glands?

16. Hair Composed mainly of keratin and is not living Hair follicles
Melanocytes
Arrector pili

17. Portion of skin showing associated glands and hair.
ZOOMING IN
• How do the sebaceous glands and apocrine sweat glands secrete to the outside? • What kind of epithelium makes up the sweat glands?

18. Checkpoint 6-6: Each hair develops within a sheath
Checkpoint 6-6: Each hair develops within a sheath. What is this sheath called?

19. Nails
Made of keratin produced by cells that originate in the outer layer of the epidermis
Nail root
Nail plate
Nail bed
Lunula
Cuticle

20. Nail structure.

21. Functions of the Skin Four major functions
Protection against infection
Protection against dehydration (drying)
Regulation of body temperature
Collection of sensory information

22. Protection Against Infection
Intact skin forms a primary barrier against invasion
Interlocking pattern resists penetration
Shedding removes pathogens
Protects against bacterial toxins
Protects against some harmful environmental chemicals

23. Protection Against Dehydration
Skin prevents water loss by evaporation
Keratin in the epidermis
Sebum release from the sebaceous glands

24. Regulation of Body Temperature
Loss of excess heat and protection from cold are important functions of the skin
Constriction of blood vessels
Dilation of blood vessels
Evaporation of perspiration

25. Collection of Sensory Information
Skin has many nerve endings and other special receptors
Free nerve endings
Touch receptors (Meissner corpuscle)
Deep pressure receptors (Pacinian corpuscle)

26. Other Activities of the Skin
Absorption of substances such as medications
Excretion
Water
Electrolytes
Wastes
Manufacture of vitamin D

27. Checkpoint 6-7: What two mechanisms are used to regulate temperature through the skin?

28. Question: True or False?: Gas exchange is a function of the skin.

29. Answer: False: No, gas exchange is not a function of the skin; the skin does not “breathe.”

30. Observation of the Skin
Skin attributes can indicate a serious systemic disorder

31. Color Factors that influence skin color
Amount of pigment in the epidermis
Melanin
Carotene
Discoloration
Pallor: pale skin, reduced blood flow
Flushing: redness, as in fever
Cyanosis: bluish color of skin; lack of oxygen in blood
Yellow skin: jaundice, bilirubin in blood; carotenemia from excessive intake of carrots or other deeply colored vegetables

32. Checkpoint 6-8: What are some pigments that impart color to the skin?

33. Lesions Any wound or local damage to tissue Surface lesions Macule
Papule
Vesicle
Pustule
Deeper lesions
Excoriation
Laceration
Ulcer
Fissure

34. Checkpoint 6-9: What is a lesion?

35. Question: A crack in the skin is called a____. a. macule b. fissure c
Question: A crack in the skin is called a____. a. macule b. fissure c. ulcer

36. Answer: b. fissure

37. Burns Categorized by Depth of damage Superficial partial-thickness
Deep partial-thickness
Full-thickness
Amount of body surface area (BSA) involved
Rule of nines
Lund and Browder method

38. Question: What is the Rule of Nines used for. a
Question: What is the Rule of Nines used for? a. to measure the severity of acne b. to determine the depth of decubitus ulcers c. to calculate the percentage of body surface area affected by a burn

39. Answer: c. to calculate the percentage of body surface area affected by a burn

40. Tissue Repair Wound healing
Occurs only in areas with actively dividing cells
Epithelial tissues
Connective tissues
Minimally in muscle and nervous tissue
Is affected by
Nutrition
Blood supply
Infection
Age

41. Checkpoint 6-10: What two categories of tissues repair themselves most easily?

42. Effects of Aging on the Integumentary System
Changes in
Skin
Tissues
Pigment
Hair
Sweat glands
Circulation
Fingernails and toenails

43. Care of the Skin Proper nutrition Adequate circulation
Regular cleansing
Removes dirt and dead skin
Sustains slightly acid environment to inhibit bacteria
Protection from sunlight
Exposure to UV light causes genetic mutations in skin that can lead to cancer, and causes premature aging.

44. Skin Disorders
Range from superficial to deep-seated

45. Dermatitis Inflammation of the skin Dermatosis is any skin disease
Atopic dermatitis

46. Psoriasis Chronic, recurrent overgrowth of epidermis
Sharply outlined red (erythematous) areas
Flat areas (plaques) covered with silvery scales
A hereditary pattern sometimes present
Immune disorder may be involved

47. Checkpoint 6-11: What is the difference between dermatosis and dermatitis?

48. Cancer Skin cancer is most common form of cancer in the United States
Basal cell carcinoma
Squamous cell carcinoma
Melanoma

49. Checkpoint 6-12: What is the name for a cancer of the skin’s pigment-producing cells?

50. Acne and Other Skin Infections
Sebaceous glands disease
Impetigo
Staphylococcal or streptococcal origin
Viral infections
Herpes simplex virus
Herpes zoster virus (shingles)
Human papillomavirus (HPV) (wart or verruca)
Fungal infections
Tinea or ringworm

51. Checkpoint 6-13: What are some viruses that affect the skin?
Checkpoint 6-14: What causes tinea or ringworm infections?

52. Question: Acne is a disease of what component of the integumentary system? a. sebaceous glands b. hair follicles c. epidermis

53. Answer: a. sebaceous glands

54. Alopecia (Baldness) Factors that affect baldness
Heredity, aging, and male sex hormones (male pattern baldness)
Systemic disease
Drugs

55. Allergy and Other Immune Disorders
Often involve the skin
Allergy—reaction to a substance
Autoimmune disorders—reaction to one’s own tissues
Pemphigus
Lupus erythematosus
Scleroderma

56. Pressure Ulcers
Skin lesions that appear where the body rests on skin that covers bony projections.
Also known as decubitus ulcers or bedsores

57. Checkpoint 6-15: What are several autoimmune disorders that involve the skin?

58. End of Presentation