1. PowerPoint ® Lecture Slide Presentation by Patty Bostwick-Taylor, Florence-Darlington Technical College Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings 4 Skin and Body Membranes

2. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Body Membranes  Function of body membranes  Cover body surfaces  Line body cavities  Form protective sheets around organs

3. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Classification of Body Membranes  Epithelial membranes  Cutaneous membranes  Mucous membranes  Serous membranes  Connective tissue membranes  Synovial membranes

4. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Epithelial - Cutaneous Membrane  Cutaneous membrane = skin  Dry membrane  Outermost protective boundary  Superficial epidermis is composed of keratinized stratified squamous epithelium  Underlying dermis is mostly dense connective tissue

5. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Cutaneous Membranes Figure 4.1a

6. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Epithelial - Mucous Membranes  Surface epithelium type depends on site  Stratified squamous epithelium (mouth, esophagus)  Simple columnar epithelium (rest of digestive tract)  Underlying loose connective tissue (lamina propria)  Lines all body cavities that open to the exterior body surface  Often adapted for absorption or secretion

7. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Mucous Membranes Figure 4.1b

8. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Epithelial - Serous Membranes  Surface is a layer of simple squamous epithelium  Underlying layer is a thin layer of areolar connective tissue  Lines open body cavities that are closed to the exterior of the body, protects organs and secretes lubricating fluids.  Serous membranes occur in pairs separated by serous fluid  Visceral (inner) layer covers the outside of the organ  Parietal (outer) layer lines a portion of the wall of ventral body cavity

9. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Serous Membranes Figure 4.1d

10. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Serous Membranes  Specific serous membranes  Peritoneum  Abdominal cavity  Pleura  Around the lungs  Pericardium  Around the heart

11. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Serous Membranes Figure 4.1c

12. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Body Membrane - Connective Tissue Membrane  Synovial membrane  Connective tissue only  Lines fibrous capsules surrounding joints  Secretes a lubricating fluid

13. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Connective Tissue Membrane Figure 4.2

14. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Integumentary System  Skin (cutaneous membrane)  Skin derivatives  Sweat glands  Oil glands  Hair  Nails

15. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Skin Structure  Epidermis—outer layer  Stratified squamous epithelium  Often keratinized (hardened by keratin)  Dermis  Dense connective tissue  Hypodermis  Subcutaneous – deep to dermis

16. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Skin Structure Figure 4.3

17. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Skin Structure  Subcutaneous tissue (hypodermis) is deep to dermis  Not part of the skin  Anchors skin to underlying organs  Composed mostly of adipose tissue

18. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Layers of the Epidermis  Stratum basale (stratum germinativum)  Deepest layer of epidermis  Lies next to dermis  Cells undergoing mitosis  Daughter cells are pushed upward to become the more superficial layers  Stratum spinosum  Stratum granulosum

19. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Layers of the Epidermis  Stratum lucidum  Formed from dead cells of the deeper strata  Occurs only in thick, hairless skin of the palms of hands and soles of feet  Stratum corneum  Outermost layer of epidermis  Shingle-like dead cells are filled with keratin (protective protein prevents water loss from skin)

20. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Layers of the Epidermis  Summary of layers from deepest to most superficial  Stratum basale  Stratum spinosum  Stratum granulosum  Stratum lucidum (thick, hairless skin only)  Stratum corneum

21. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Melanin  Pigment (melanin) produced by melanocytes  Melanocytes are mostly in the stratum basale  Color is yellow to brown to black  Amount of melanin produced depends upon genetics and exposure to sunlight

22. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Dermis  Two layers  Papillary layer (upper dermal region)  Projections called dermal papillae  Some contain capillary loops  Other house pain receptors and touch receptors  Reticular layer (deepest skin layer)  Blood vessels  Sweat and oil glands  Deep pressure receptors

23. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Dermis  Overall dermis structure  Collagen and elastic fibers located throughout the dermis  Collagen fibers give skin its toughness  Elastic fibers give skin elasticity  Blood vessels play a role in body temperature regulation

24. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Skin Structure Figure 4.4

25. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Normal Skin Color Determinants  Melanin  Yellow, brown, or black pigments  Carotene  Orange-yellow pigment from some vegetables  Hemoglobin  Red coloring from blood cells in dermal capillaries  Oxygen content determines the extent of red coloring

26. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Skin Appendages  Cutaneous glands are all exocrine glands  Sebaceous glands  Sweat glands  Hair  Hair follicles  Nails

27. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Appendages of the Skin  Sebaceous glands  Produce oil  Lubricant for skin  Prevents brittle hair  Kills bacteria  Most have ducts that empty into hair follicles; others open directly onto skin surface  Glands are activated at puberty

28. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Appendages of the Skin Figure 4.6a

29. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Appendages of the Skin  Sweat glands  Produce sweat  Widely distributed in skin  Two types  Eccrine  Open via duct to pore on skin surface  Apocrine  Ducts empty into hair follicles

30. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Appendages of the Skin Figure 4.6b

31. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Sweat and Its Function  Composition  Mostly water  Salts and vitamin C  Some metabolic waste  Fatty acids and proteins (apocrine only)  Function  Helps dissipate excess heat  Excretes waste products  Acidic nature inhibits bacteria growth  Odor is from associated bacteria

32. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Appendages of the Skin  Hair  Produced by hair follicle  Consists of hard keratinized epithelial cells  Melanocytes provide pigment for hair color

33. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Appendages of the Skin Figure 4.7c

34. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Appendages of the Skin  Hair anatomy  Central medulla  Cortex surrounds medulla  Cuticle on outside of cortex  Most heavily keratinized Figure 4.7b

35. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Appendages of the Skin  Associated hair structures  Hair follicle  Dermal and epidermal sheath surround hair root  Arrector pili muscle  Smooth muscle  Pulls hairs upright when cold or frightened  Sebaceous gland  Sweat gland

36. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Appendages of the Skin Figure 4.7a

37. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Appendages of the Skin Figure 4.8

38. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Appendages of the Skin  Nails  Scale-like modifications of the epidermis  Heavily keratinized  Stratum basale extends beneath the nail bed  Responsible for growth  Lack of pigment makes them colorless

39. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Appendages of the Skin  Nail structures  Free edge  Body is the visible attached portion  Root of nail embedded in skin  Cuticle is the proximal nail fold that projects onto the nail body

40. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Appendages of the Skin Figure 4.9

41. Six Categories of Skin Disorders Infectious: caused by a pathogen that infects the skin or enters through an opening. Allergic/Environmental Trauma/Burns Cancer Congenital Genetic

42. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Skin Homeostatic Imbalances  Infections  Athlete’s foot (tinea pedis)  Caused by fungal infection  Boils and carbuncles  Caused by bacterial infection  Cold sores  Caused by virus

43. Athletes Foot Tinea pedis: Athlete’s foot resulting from a fungal infection. Red, itchy, peeling skin. Treatment involves an antifungal cream or pill that will destroy the pathogen. Other similar cutaneous fungal infections include: –Ringworm –Sun spots

44. Cutaneous Fungal Infections

45. Boils and carbuncles Inflammation of hair follicles and sebaceous glands. Typically caused by bacterial infection; Staphylococcus aureus. Easily treated with an antibiotic that will destroy the bacteria if used properly.

46. Staph Infections and MRSA –M = Methicillin, a potent antibiotic –R = Resistant –S = Staphylococcus –A = Aureus MRSA = staph infection that is no longer cured with traditional antibiotics. 1950’s: hospital-acquired or NOSOCOMIAL infection. –1.2 million infections/19,000 deaths in 2011. Now becoming community-acquired. –19000 cMRSA deaths in 2011.

47. What does MRSA look like?

48. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Skin Homeostatic Imbalances  Infections and Allergies  Contact dermatitis  Exposures cause allergic reaction  Impetigo  Caused by bacterial infection  Psoriasis  Cause is unknown  Triggered by trauma, infection, stress

49. Impetigo Bacterial infection Pink, water-filled raised lesions. Usually found around the mouth and nose. HIGHLY contagious. Common in young children. Easily treated with antibiotics.

50. Cold sores Caused by herpes simplex (viral) infection. Small, fluid-filled blisters that itch and sting. Virus follows a cycle – Outbreaks result from environmental or emotional stresses. OTC medications can shorten infection time or reduce the size of the lesion. No cure.

51. Categories of Disorders Infectious Allergic/Environmental: exposure to agents that lead to irritation/inflammation. Trauma/Burns Cancer Congenital Genetic

52. Contact dermatitis Itching, redness, swelling of skin. Progresses to blisters. Caused by exposure to chemicals. Provokes an allergic response. Treated with steroids to reduce inflammation. Poison Ivy Chemical burn

53. Psoriasis Chronic condition; characterized by red lesions covered with dry, silvery scales. Cause is unknown, but may be hereditary. Attacks often brought on by emotional upset, hormonal changes, and trauma.

54. Checkpoint Questions What 3 types of pathogens can cause infections in the skin? How do we treat a herpes simplex infection? What does MRSA stand for? What is the treatment for typical bacterial infections?

55. Checkpoint Questions What 3 types of pathogens can cause infections in the skin? Fungus, Bacteria, Virus How do we treat a herpes simplex infection? OTC medicines only. No cure What does MRSA stand for? Methicillin Resistant Staphylococcus Aureus What is the treatment for typical bacterial infections? Antibiotics

56. Burns A burn is tissue damage and cell death caused by intense heat or cold, electricity, UV radiation, or chemicals. Two life-threatening problems 1. Loss of fluids resulting in dehydration and electrolyte imbalance. 2. Threat of infection due to loss of intact barrier.

57. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Rule of Nines  Way to determine the extent of burns  Body is divided into 11 areas for quick estimation  Each area represents about 9% of total body surface area  1% is the genital region

58. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Rule of Nines Figure 4.11a

59. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Severity of Burns  First-degree burns  Only epidermis is damaged  Skin is red and swollen  Second-degree burns  Epidermis and upper dermis are damaged  Skin is red with blisters  Third-degree burns  Destroys entire skin layer  Burn is gray-white or black

60. First-degree burn Only the epidermis is damaged. Area becomes red and swollen. Temporary discomfort. Generally not serious and heals in two to three days. Example: sunburn

61. Second-degree burn Injury to the epidermis and the upper region of the dermis. Skin is red, painful, and blistered. Regeneration will occur. Usually no permanent scarring.

62. Third-degree burn AKA Full Thickness Burn; destroys the entire thickness of the skin. Burned area appears blanched (gray-white) or blackened. Nerve endings are destroyed. Requires skin grafts.

63. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Critical Burns  Burns are considered critical if  Over 25% of body has second-degree burns  Over 10% of the body has third-degree burns  There are third-degree burns of the face, hands, or feet

64. Categories of Disorders Infectious Allergic/Environmental Trauma/Burns Cancer: abnormal mitosis leading to malignancy. Congenital Genetic

65. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Skin Cancer  Cancer—abnormal cell mass  Classified two ways  Benign  Does not spread (encapsulated)  Malignant  Spreads  Metastasized (moves) to other parts of the body

66. Skin cancer The most commonly diagnosed cancer Many factors can affect a person ’ s predisposition to getting skin cancer. Genetics Exposure to UV radiation Frequent skin irritation Physical trauma

67. Basal cell carcinoma Least malignant/ most common Involves cells of st. basale. No longer forms keratin; invades dermis and hypodermis. Shiny, dome shaped nodule that eventually develops a central ulcer with raised edge.

68. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Skin Cancer Types Figure 4.12a

69. Squamous cell carcinoma Arises from cells in st. spinosum Scaly red papule that forms a shallow ulcer with a firm raised border. Grows rapidly and spreads quickly to lymph nodes. Good chance for cure if caught early.

70. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Skin Cancer Types Figure 4.12b

71. Malignant melanoma Cancer of melanocytes. 5% of skin cancers. Occurs wherever there is pigment. Randomly located, but can occur from a pigmented mole. Spreads quickly to lymph nodes and blood vessels. ABCD Rule

72. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings Skin Cancer Types Figure 4.12c

73. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings ABCD Rule  A = Asymmetry  Two sides of pigmented mole do not match  B = Border irregularity  Borders of mole are not smooth  C = Color  Different colors in pigmented area  D = Diameter  Spot is larger then 6 mm in diameter

74. Categories of Disorders Infectious Allergic/Environmental Trauma/Burns Cancer Congenital: malformation of development occurring during gestation (pregnancy) Genetic

75. Hemangioma Benign swelling of the lining of blood vessels. Dense capillary network that does not dissolve as fetal development progresses. Many dissolve on own without intervention by age 10. Some can be severely disfiguring. CAUTION!

77. Categories of Disorders Infectious Allergic/Environmental Trauma/Burns Cancer Congenital Genetic: mutation of a specific gene sequence that leads to a malformation of a protein needed for normal structure or function.

78. Ichthyosis Malformation of proteins needed for normal skin development. Rough, scaly, “fish- like” skin. Most dangerous is Harlequin type.

79. Epidermolysis bullosa Malformation of collagen and other connective proteins that bind/hold the skin together. Results in blistering as the epidermis pulls away from the dermis.