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Integumentary System. CHAPTER 5. Integumentary System. Skin Integument or cutaneous membrane Epidermis Dermis Subcutaneous layer Accessory structures Hair Nails Glands. Layers and Structures of the Skin. Skin Lesions. Abrasion
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Integumentary System CHAPTER 5
Integumentary System • Skin • Integument or cutaneous membrane • Epidermis • Dermis • Subcutaneous layer • Accessory structures • Hair • Nails • Glands
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
Skin Lesions • Bedsore • Ulcer in skin over a bony prominence • Also known as pressure ulcer • Example: decubitus ulcer • Blister • Small, thin-walled lesion containing clear fluid • Also known as a vesicle
Skin Lesions • Bulla • Large blister • Carbuncle • Circumscribed inflammation of skin and deeper tissues; contains pus • Comedo • Typical lesion of acne vulgaris • Example: whitehead = closed comedo • Example: blackhead = open comedo
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
Skin Lesions • Fissure • Cracklike 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: recto-vaginal fistula
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
Skin Lesions • Macule • Small flat, discoloration of the skin; neither raised nor depressed • Example: bruises, freckles • Nodule • Small, circumscribed swelling protruding above the skin
Skin Lesions • Papule • Small, solid, circumscribed elevation on the skin • Example: pimple, wart, elevated mole • Polyp • Small, stalklike growth, protruding upward or outward from membrane surface • Example: nasal polyp
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 • Ulcer • Circumscribed, open sore or lesion of skin, accompanied by inflammation • Example: decubitus ulcer
Skin Lesions • Vesicle • Small, thin-walled, lesion containing clear fluid • Example: blister • Wheal • Circumscribed, slightly elevated lesion of the skin • Paler in center than surrounding edges • Example: hives
PATHOLOGICAL CONDITIONS Integumentary System
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
Albinism • Pronounced • (AL-bin-izm) • Defined • Condition characterized by absence of pigment in the skin, hair, and eyes
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
Burns • First-degree or superficial burns • Example: sunburn • Second-degree or partial-thickness burns • Example: flash contact with hot objects • Third-degree or full-thickness burns • Example: deep burns from a fire
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
Carcinoma, Basal Cell • Pronounced • (car-sih-NOH-mah BAY-sal sell) • Defined • Most common malignant tumor of epithelial tissue, occurring most often on areas of skin that are exposed to the sun • Presents as a slightly elevated nodule with a depression or ulceration in the center that becomes more obvious as the tumor grows
Carcinoma, Squamous Cell • Pronounced • (car-sih-NOH-mah SKWAY-mus sell ) • Defined • Malignancy of the squamous, or scalelike, cells of the epithelial tissue • Much faster growing than basal cell carcinoma • Greater potential for metastasis if not treated
Carcinoma, Squamous Cell • Frequent sites on sun-exposed areas • Top of nose • Forehead • Margin of external ear • Back of hands • Lower lip
Dermatitis • Pronounced • (der-mah-TYE-tis) • Defined • Inflammation of skin, seen in several different forms • Acute or chronic • Contact or seborrheic
Eczema • Pronounced • (EK-zeh-mah) • Defined • Acute or chronic inflammatory skin condition characterized by erythema, papules, vesicles, pustules, scales, crusts, scabs, and itching
Exanthematous Viral Diseases • Pronounced • (eks-an-THEM-ah-tus viral diseases) • Defined • Skin eruption or rash accompanied by inflammation, having specific diagnostic features of an infectious viral disease
Exanthematous Viral Diseases • Examples: • Rubella= German Measles= 3 day measles • Roseola Infantum • Rubeola= Red Measles= 7-10 day measles • Erythema Infectiosum= Fifth disease
Gangrene • Pronounced • (GANG-green) • Defined • Tissue death due to loss of adequate blood supply, invasion of bacteria, subsequent decay with foul odor
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
Herpes Zoster Image courtesy of Robert A. Silverman, M.D., Pediatric Dermatology, Georgetown University
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
Kaposi’s Sarcoma • Pronounced • (CAP-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
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
Keratosis • Pronounced • (kair-ah-TOH-sis) • Defined • Skin condition in which there is a thickening and overgrowth of the cornified epithelium
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
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
Leukoplakia • Pronounced • (loo-koh-PLAY-kee-ah) • Defined • White, hard, thickened patches firmly attached to the mucous membrane • In mouth, vulva, or penis
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
ABCDs of Malignant Melanomas • Asymmetry • Borders • Color • Diameter
Nevus • Pronounced • (NEV-us) • Defined • Visual accumulation of melanocytes, creating a flat or raised rounded macule or papule with definite borders • Commonly known as a mole
Onychocryptosis • Pronounced • (on-ih-koh-krip-TOH-sis) • Defined • Ingrown nail • Most commonly involves the large toe
Onychomycosis • Pronounced • (on-ih-koh-my-KOH-sis) • Defined • Fungal infection of the nails
Pediculosis • Pronounced • (pee-dik-you-LOH-sis) • Defined • Highly contagious parasitic infestation caused by blood-sucking lice
Pediculosis • Pediculosis capitis • Head • Pediculosis corporis • Body • Pediculosis palpebrarum • Eyelashes and eyelids • Pediculosis pubis • Pubic hair
Pemphigus • Pronounced • (PEM-fih-gus) • Defined • Rare, incurable disorder manifested by blisters in the mouth and on the skin • Spreads to involve large areas of the body
Pilonidal Cyst • Pronounced • (pye-loh-NYE-dal SIST) • Defined • Closed sac located in the sacrococcygeal area of the back • Sometimes noted at birth as a dimple
Psoriasis • Pronounced • (soh-RYE-ah-sis) • Defined • Common, noninfectious, chronic skin disorder manifested by silvery-white scales over round, raised, reddened plaques producing itching • Pruritus
Rosacea • Pronounced • (roh-ZAY-she-ah) • Defined • Chronic inflammatory skin disease that mainly affects the skin of the middle third of the face • Characterized by persistent redness over the areas of the face, nose, and cheeks
Scabies • Pronounced • (SKAY-beez) • Defined • Highly contagious parasitic infestation caused by the “human itch mite” • Resulting in a rash, pruritus, and a feeling in the skin of “something crawling”
Scleroderma • Pronounced • (sklair-ah-DER-mah) • Defined • 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
Systemic Lupus Erythematosus • Pronounced • (sis-TEM-ic LOO-pus air-ih-them-ah-TOH-sis) • Defined • Chronic, multi-system, 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