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CHAPTER 5

CHAPTER 5. Integumentary System. Integumentary System. Skin Also called integument or cutaneous membrane Epidermis Dermis Subcutaneous layer. Integumentary System. Accessory structures Hair Nails Glands. Layers and Structures of the Skin. Structure of the Nail. Question.

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CHAPTER 5

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  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 • 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 • Small, thin-walled lesion containing clear fluid • Also known as a vesicle • Bulla • Large blister

  10. Skin Lesions • Carbuncle • 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 • 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 • 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 • 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 • 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 • 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 • 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. PATHOLOGICAL CONDITIONS Integumentary System

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

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

  24. 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

  25. 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

  26. Callus • Pronounced • (CAL-us) • Defined • 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

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

  28. Carcinoma, Basal Cell • Pronounced • (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

  29. 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

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

  31. 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

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

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

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

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

  36. 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

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

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

  39. Herpes Zoster • Pronounced • (HER-peez ZOS-ter) • Defined • 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

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

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

  42. 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

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

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

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

  46. Seborrheic Keratosis • Pronounced • (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

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

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

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

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

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