1. THE SKIN B&S CHAPTER 6

2. Purpose of the skin It’s the largest organ in the body
Used for protection against drying (dehydration) and pathogens
Regulates temperature
Sensory – nerve-endings
Absorption and excretion

3. The skin includes…
Skin is associated with structures known as appendages which include glands, hair and nails
An appendage is anything attached, like the nails, hair and glands

4. Other names for skin Covering Cutaneous
Skin sheds, when it sheds, it’s ridding the body of pathogens that are on it

5. Facts about skin Skin DOES NOT BREATHE
The pores of the epidermis only serve as an outlet for perspiration from the sweat glands and sebum (oil) from the sebaceous glands
THEY ARE NOT USED FOR EXCHANGE OF GASES

6. Skin consists of 2 layers:
1) Epidermis
2) Dermis

7. Epidermis Outer most portion, it’s the surface layer of the skin
Epidermis is made up of epithelial cells and contain NO blood vessels
These epidermal cells are constantly lost through wear and tear

8. Is the epidermis living or non-living?
Non-living, but because there are no living blood vessels in the epidermis, THE ONLY LIVING CELLS ARE LOCATED IN THE DEEPEST LAYER OF THE EPIDERMIS CALLED:
STRATUM GERMINATIVUM

9. Stratum germinativum
Deepest layer of the epidermis where nourishment is provided by capillaries
It’s known as the “growing layer”
Cells in the stratum germinativum are constantly dividing, producing daughter cells which get pushed upward to the surface

10. Stratum germinativum

11. What happens when these cells get pushed up to the surface?
The surface cells die from the gradual loss of nourishment and they undergo changes
What changes you ask?

12. These cells develop keratin which serves to thicken and protect skin
By the time the epithelial cells reach the surface, they change in character

13. They become flat and horny, forming the uppermost layer of the epidermis called the…
Stratum Corneum – Does NOT contain blood vessels. But does contain nerves, hair follicles, sebaceous and sudoriferous glands

14. MELANIN
These are the cells that are formed in the deepest layer of the epidermis
Melanin is a dark pigment that colors the skin

15. Melanin Pigment (melanin) produced by melanocytes
Color is yellow to brown to black
Amount of melanin produced depends upon genetic and exposure to sunlight
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Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

16. Freckles
Irregular patches of melanin

17. THE DERMIS, 2nd layer of skin
Also called the corium or the true skin
Is make up of elastic connective tissue
Is well-supplied with blood vessels and nerves
Stretches dramatically like in pregnancy

18. Appendages in the dermis
Most of the appendages of the skin incl. sweat glands (sudoriferous) , oil glands (sebaceuos) and hair, are located in the dermis, they may extend down into the SQ layer too

19. Thickness of dermis Varies in different areas
Sole of feet and palms of hands are covered in thick layers of skin
Eyelids are covered with thin delicate layers

20. Fingerprints
Are formed by papillae which are extensions that form a distinct pattern of ridges on the surface of thick skin. They extend upward allowing blood vessels to get closer to the surface cells
These papillae help to prevent from slipping when grasping an object
These are your fingerprints, they are
determined by heredity

21. Subcutaneous Layer The dermis rests on the sub-Q layer
This layer connects the skin to the surface muscles
It consists of loose conn. Tissue and lrg. Amts of adipose tissue, the fat serves as insulation
Continuous bundles of elastic fibers connect the sub-Q tissue with the dermis, there's no clear boundary between the two

22. Subcutaneous layer

23. There are major blood vessels that supply the skin in this layer
This layer is rich in nerve endings
Thickness varies, thicker in abd than in eye lid
Sebaceous glands and hair roots extend here

24. APPENDAGES
Sudoriferous glands – or sweat glands are coiled, tubelike structures located in the dermis and sub-Q tissue
These glands function to regulate body temp through evaporation of sweat from the body surface

25. A 2nd Sudoriferous gland…
Is located in the armpits and groin area
When there is stress or sexual stimulation, these glands release their secretions through the hair folicles
This secretion, broken down by bacteria, produces body odor…peee-u

26. Modified Sweat Gland
The ceruminous glands in the ear canal produce ear wax or cerumen

27. Another appendage…
Sebaceous Glands – are sac-like in structure, their oily secretions called sebum, lubricates the skin and hair to prevent drying. The ducts of these glands, open to hair follicles

28. Vernix caseosa
Produced by the sebaceous glands, it’s a covering that resembles cream cheese to protect newborns at birth

29. Blackheads
Are a combo of keratin and dried sebum or oil that collect at the opening of the sebaceous gland
If these glands become infected, pimples result

30. Sebaceous Cysts
When sebaceous glands become blocked by accumulated sebum or oil, a sac of the secretion forms and grows in size, surgery may be needed to remove these

31. Hair Is made of keratin and is NOT living
Each hair develops within a sheath called a follicle and new hair is formed from cells at the bottom of the follicles

32. Goosebumps
Are what they are…attached to hair follicles, muscles contract, raising the hair on the body
This response is not import. To humans but in animals, it helps animals with furry coats to conserve heat

33. Nails Protective structure made of hard keratin
Nails are affected by general health. Changes including abnormal color, thickness, shape or texture occur in chronic diseases such as heart, peripheral vasc diseases, malnutrition and anemia.
Nailbeds should BE PINK, not blue

34. Skin can absorb and excrete
Substances such as medication can be absorbed through the skin through a dermal patch
Minimal amt of excretion through the skin occurs. H2O and electrolytes are perspired out of the skin

35. Vitamin D
Vit. D is needed for the development and maintenance of bone tissue
Vit D is manufactured in the skin under the effects of ultra violet rays from the sun

36. Skin Homeostatic Imbalances
Burns
Tissue damage and cell death caused by heat, electricity, UV radiation, or chemicals
Associated dangers
Dehydration
Electrolyte imbalance
Circulatory shock
Slide 4.25
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

37. Burns to the skin…
1st degree – involves the epidermis, it becomes red and painful, like sun burn
Treatment: bathing the wound in cold water

39. 2nd degree burn – penetrates into deeper layers and often causes a blister to form
Examples: severe sunburns or scalding with hot water
Silvadene cream

40. 2nd degree burn

41. 3rd degree – is full thickness burn, is the most serious
3rd degree – is full thickness burn, is the most serious. Usually involved underlying tissues such as muscle and connective tissue

42. 3rd degree burn

43. HOW TO CLASSIFY A BURN
“RULE OF NINE’S”

44. RULE OF NINE’S
rule of nines - a method of estimating the extent of body surface that has been burned in an adult, dividing the body into sections of 9 per cent or multiples of 9 per cent.
Rule of nines.

45. Color of skin
Melanin gives skin it’s color, skin should be pink

46. Pallor
Pallor – is pale colored skin often caused by reduced blood flow
Most easily noted in lips, nail beds, and mucous membranes

47. Flushing Redness of the skin related to fever
Most noticeable in the face or neck

48. Cyanosis Bluish discoloration in skin
Due to not enough oxygen circulating in the blood
This is a symptom of heart failure or of breathing problems such as asthma or respiratory obstruction

49. Jaundice Yellow discoloration of the skin
May be due to the presence of excessive quantities of bile pigment called bilirubin, in the blood

50. Lesion Is any wound or local damage to tissue
A surface lesion is called a rash
A raised lesion is called an eruption

51. Terms used to describe surface skin lesions:
Macules – spots that are neither raised nor depressed. They are typical of measles and descriptive of freckles
Papules – firm raised areas as in some stages of chicken pox. Pimples are papules
Nodule – a large firm papule

52. Vesicle – blisters or small sacs full of fluid like chicken pox
Pustules – vesicles filled with pus, can develop in chicken pox

53. Deeper lesions
Deeper lesions may develop from surface lesions or may be caused by trauma

54. Deep injuries to the skin
Excoriation – scratch of the skin surface
Laceration – rough, jagged wound made by the tearing of the skin
Ulcer – a sore associated with disintegration and death of tissues
Fissure – a crack in the skin, like in athletes foot

55. Excoriation
Laceration

56. Ulceration
Fissure

57. Dermatitis Inflammation of the skin
May be d/t irritants such as poison oak or ivy, detergents, strong acids or other chemicals

58. Treatment of dermatitis
Prompt removal of the irritant is most effective
Washing thoroughly with soap and water to wash away the plant oil

59. Atopic Dermatitis or eczema
Intense itching and skin inflammation
Redness (erythema)
Blisters (vesicles)
Pimple-like lesions (papules)
Scaling and crusting of skin

60. When does eczema start?
Occurs first in childhood and recurs throughout life
Skin may be sensitive to soaps or detergents
Person may be subject to allergic disorders like asthma, hayfever and food allergies

61. Impetigo
Acute, contagious disease of staphylococcal or streptococcal origin
Can cause death in newborn infants
It’s a blister-like lesion filled with pus that contain millions of virulent bacteria
One can infect and re-infect himself and others..need antibiotics

63. Alopecia
baldness

64. Other disorders of the skin…
Carbuncle – a pus producing lesion formed from an infected boil. These involve skin and sub-Q tissues and have numerous drainage channels that extend to the skin surface

65. Herpes Simplex Virus
Characterized by formation of watery vesicles (cold sores, fever blisters) on the skin and mucous membranes including the genital area

66. Shingles (herpes zoster virus)
Virus is seen in adults and is caused by same virus that causes chicken pox
Infection follows nerve pathways producing small lesions on the skin
Pain, increased sensitivity and itching are common symptoms that usually last longer than a year

67. What to treat herpes virus with?
Antivirals like acyclovir or Zovirax
P.O. takes away itching, sensitivity and lesions
IS NOT A CURE OF THE VIRUS, only helps with symptoms

68. Decubitis Bed sore d/t decreased circulation
Treatment: frequent position changes, adequate nutrition and
if sore is present, aggressive skin treatment

69. Affects of aging on skin
Loss of fat and collagen=wrinkles
Skin becomes transparent and can tear easily
Decreased pigment esp. in hair (grey hair) and in skin, except in some areas such as hands
Decreased sweat glands
Hardening of nails

74. Jaundice

75. Jaundice

76. Cyanosis

77. Macule

78. Terms used to describe surface skin lesions:
Macules – spots that are neither raised nor depressed. They are typical of measles and descriptive of freckles
Papules – firm raised areas as in some stages of chicken pox. Pimples are papules
Nodule – a large firm papule

79. Papule

80. Vesicle

81. Pustule

82. Excoriation

83. Laceration

84. Ulcer

85. Fissure on Heel

86. Cold Sores Herpes Simplex
Boils- Furuncle
Cold Sores Herpes Simplex

87. Basal Cell Carcinoma

88. Malignant Melanoma

89. ABCD Rule for moles or nevus
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
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Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

90. Impetigo
Psoriasis

91. Shingles- Herpes Zoster

92. Athlete’s Foot

93. THE END