Learning Objectives Define integumentary system terminology Describe the

Learning Objectives • Define integumentary system terminology • Describe the function of the integumentary system • Identify integumentary system structures and the function of each • Identify methods used to assess the integumentary system • Describe disorders of the integumentary system • Describe three methods that can be used to maintain healthy skin • Identify three types of skin CA and at least five methods for prevention

Structure The Integumentary system is composed of: * Skin – main organ * Accessory structures - Hair, Nails, Specialized glands, & Nerves

Function • Functions of the integumentary system: Main function: - Protects the other body systems from injury and infection Other functions: – Helps the body maintain homeostasis by regulating temperature, retaining body fluids, and eliminating wastes – Perceive environment with sensory receptors – Store energy & Vitamins / produce Vitamin D from sun

Structures of the Skin

Skin • The largest organ of the body • Varies in thickness from 1/50 inch (0. 5 mm) in the eyelids to 1/4 inch (6. 3 mm) in the soles of the feet • Changes in the skin often indicate the presence of other body system disorders including anemia, respiratory disorders, liver disorders, cancer, and shock

Layers of Skin • Epidermis (cuticle): – Outermost layer of the skin – Composed of a surface of dead cells with an underlying layer of living cells – Keratinocytes make up 90% -water repellant – Contains sebaceous and sudoriferous glands as well as hair follicles – Melanocytes (produces melanin) are located in the epidermis • Melanin: pigment that gives skin its color

Layers of Skin (cont) • The surface of the epidermis is covered with a film composed of: - Oil - Sweat - Epithelial cells • Together these work to: - Lubricate - Hydrate - Provide antibacterial protection - Block toxic agents from entering the body

Layers of Skin (Continued) • Dermis (corium) – Called the “true” skin – Contains the blood vessels and nerves • Each inch of skin contains 15 feet of blood vessels • Nerve endings in skin allow it to be sensitive to environmental stimuli • Subcutaneous – Innermost layer – Contains adipose, which cushions and insulates the body’s organs

Hair and Hair Follicles • Skin has hair in all areas except the soles of the feet and palms of the hands • Hair blocks foreign particles from entering the body through structures such as the nose and eyes • Originate in the dermis • The visible portion is called the shaft • The hair follicle is the root with its covering • Tiny muscle attached at hair shaft causes “goose bumps” in response to cold or fear • Hair color & texture are inherited

Glands • Three types of glands in the skin: – Sebaceous glands (oil) • Located everywhere except palms of hands and soles of feet • Sebum (oil) causes the skin to be soft and waterproof – Sudoriferous glands (sweat) • Help regulate the body temperature and excrete body wastes – Ceruminous glands • Located only in the auditory canal of the ear • Secrete wax that helps protect the ear from infection and prevents entry of foreign bodies

Assessment Techniques

Assessment of the Skin • Dermatology: Study of the Skin • Dermatitis: general term for inflammation of the skin • Skin disorders are generally uncomfortable & unattractive but not life threatening

Assessment of the Skin • Visual Inspection: - Skin lesions can usually be seen - Size, shape, texture & color of a lesion often help reveal it’s cause • Biopsy: - Removal or examination of living tissue - Biopsy or culture may be used to identify the causative organism

Biopsy

Biopsy

Disorders of the Integumentary System

Acne Vulgaris • Usually appears in adolescence & may continue into adulthood • Often caused by increased oil (sebum) related to increased hormones during puberty • Bacterial growth & blockage of hair follicles cause papules, pustules, & blackheads • Tends to run in families • Diet does NOT tend affect severity of acne • Treatment: - exposure to ultraviolet light, - oral or topical antibiotics, - Dermabrasion (removal of top layers of skin that has scarred)

Acne Vulgaris

Acne Vulgaris Papule Pustule

Albinism Inherited disorder Melanocytes do not produce melanin Pale skin, white hair, pink eyes Prone to severe sunburn / Skin CA Light may damage unprotected structures of eyes Vision problems are very common Treatment: - Albinism can not be cured - treatment of symptoms only (protecting skin/eyes from sun AND correcting vision) • •

Albinism

Alopecia • Baldness • Inherited tendency to lose hair • Production of androgenic hormones in puberty initiate loss • More common in men but may occur in women • Temporary hair loss may be caused by: Drugs High fever Radiation Anorexia • No FDA approved treatments Pregnancy Cosmetics

Athlete’s Foot • Epidermophytosis • Fungal Infection • Skin may itch, blister and crack (especially between toes) • Very contagious – transmitted on wet floors • Treatment: - Application of antifungal medication (Topical cream) - Keep area clean, ventilated, and dry

Athlete’s Foot

Fungal Skin Infections • Live only on the dead, outer surface or epidermis • May cause no symptoms • Others may have following symptoms: - irritation - scaling - blisters - redness - swelling • Occur in areas of body that provide moisture • Examples: - Athlete’s Foot - Jock itch - Ringworm

Ringworm

Cellulitis • Bacterial infection of dermis and subcutaneous layer of skin • Occurs in people with low resistance to infection - elderly, children & chronically ill • Symptoms: - fever, chills, & vesicles on red, warm area of skin • Can lead to impaired circulation and permanent lymphedema in the extremities • Treatment: Rest Immobilization of infected area Antibiotics

Cellulitis

Chloasma • Patchy discoloration of skin (usually face) caused by high hormone levels that occur during pregnancy or prolonged use of oral contraceptives • May disappear at end of pregnancy or when birth control pill usage has stopped • May be sign of problem with liver (liver spots) • Treatment usually not necessary - cosmetics used to hide

Chloasma

Cleft Lip / Cleft Palate • Upper lip has a cleft (or space) where nasal processes or palate does not meet properly • Occurs in 1 of 700 babies born in US each year • Heredity is direct cause - may also be caused by environmental factors or premature birth • Treatment: - Surgical & dental correction - Speech therapy - Psychological counseling (sometimes)

Cleft Lip / Cleft Palate

Contact Dermatitis • Allergic reaction that may occur after an initial reaction or as an acquired response • Frequent causes: - poison ivy - nickel in jewelry, - Preservatives in cosmetics • Symptoms: - Redness, itching, swelling, blisters • Treatments: - wash affected area - avoid exposure to irritating substance - applying anti-inflammatory creams

Eczema • A form of dermatitis • Group of disorders caused by allergic or irritant reactions • Characterized by swelling, redness, itching & weeping, crusted skin lesions • Not contagious • Treatment: - remove irritant - keeping affected skin clean

Eczema

Dandruff • Characterized by itching of the scalp • Produce white flakes of dead skin cells • Can be controlled by massaging the scalp, brushing & shampooing the hair - Medicated shampoos often help

Dandruff

Decubitus Ulcer • Sores or areas of inflammation that occur over bony prominences of the body due to prolonged pressure and hypoxia to the affected tissues • “Bedsores” • Seen most often in elderly & immobilized people • Prevention: Frequent position change, good nutrition, and massage to the area • Described in four stages by severity • Treatment: Antibiotics, removal of necrotic tissue, frequent cleaning of open sores * Larvae (maggots) of blowflies used in some severe cases

Decubitus Ulcer

Decubitus Ulcer

Furuncle Commonly called a “boil” Bacterial infection of a hair follicle Carbuncle = several boils that join together Boils are infectious but can be controlled with careful cleanliness & handwashing • Treatment: includes hot compresses, antibiotics & sometimes drainage by lancing • •

Furuncle Carbuncle

Impetigo • Bacterial infection (most commonly staph, but also strep) • Occurs most often in children • Very contagious • Begins with small vesicles, which become pustules and form a crust • Symptoms may include itching & burning • Often fatal in infants • May lead to kidney infection • Treatment: antibiotics & isolation to prevent spread

Impetigo

Psoriasis • Chronic skin disorder • Too many epidermal cells are produced • Appears as red, thick areas, or plaques covered with scales, which may be gray/silver • Cause: Unknown • Trigger: Stress & other factors • Treatment: Topical medication, removal of scales, & application of ultraviolet light

Psoriasis

Viral Rash • Result from a viral infection • Common in children • Treatment: Symptomatic – prevent scratching to avoid scars

Viral Rash Chicken Pox

Skin Cancer • Most common form of Cancer • Most treatable form of CA (if diagnosed early) • 3 basic forms: Basal cell - most common Squamous cell - more likely to grow & spread Melanoma – developed from melanocytes • Treatment: Removing lesions by burning, freezing, or surgery

Kaposi’s Sarcoma • Form of skin CA that originates in blood vessels and spreads to the skin • Appears as a round or oval spot on the skin that may be red, purplish, or brown in color • Two forms: - one affects older people & rarely spreads to other parts of body - second form associated with diabetes, lymphoma, or AIDS. This one spreads to the lungs, liver, & intestines • Treatment may include chemotherapy or interferon - has NOT had much success

Kaposi’s Sarcoma

Vitiligo • Loss of pigment of the skin that results in irregular white patches • May appear at any time and has an increased incidence in some families • Occurs in all races but may be more noticeable in people with darker skin • Unknown cause • Usually untreated

Vitiligo

Wart • • • Papule (raised, solid area) Caused by viral infection Types: Plantar, Common, Flat May last a few weeks to years Removal: Chemicals Freezing with liquid nitrogen Burning

Common Warts

Flat Warts

Plantar Warts