© 2009 the mcgraw-hill companies, inc. all rights reserved 24-1 the integumentary system...

© 2009 The McGraw-Hill Companies, Inc. All rights reserved

24-1

The Integumentary SystemThe Integumentary SystemPowerPoint® presentation to accompany:

Medical AssistingThird Edition

Booth, Whicker, Wyman, Pugh, Thompson

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Learning Outcomes

24.1 List the functions of skin.

24.2 Explain the role of skin in regulating body temperature.

24.3 Describe the layers of skin and the characteristics of each layer.

24.4 Explain the factors that affect skin color.

24.5 Identify and describe common skin lesions.

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Learning Outcomes (cont.)

24.6 List the accessory organs of skin and describe their structures and functions.

24.7 Explain the process of skin healing, including scar production.

24.8 Describe the effects of aging on skin.

24.9 List the different types of burns and describe their appearances and treatments.

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Learning Outcomes (cont.)

24.10 Describe the causes, signs and symptoms, and treatments of various types of skin cancer.

24.11 Describe the causes, signs and symptoms, and treatments of common skin disorders.

24.12 Explain the ABCD rule and its use in evaluating melanoma.

24.13 Using the acronym CAUTION, list the seven warning signs of cancer.

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Introduction Integumentary

system consists of skin and its accessory organs

Accessory organs: Hair follicles Nails Skin glands

Skin is the body’s outer covering and its largest organ.

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Functions of the Integumentary System Protection

First line of defense against Bacteria Viruses

Protects underlying structures from Ultraviolet (UV) radiation Dehydration

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Functions of the Integumentary System (cont.)

Body temperature regulation If too hot

Dermal blood vessels dilate Vessels carry more blood to

surface so heat can escape

If too cold Dermal blood vessels constrict Prevents heat from escaping

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Vitamin D production Needed for calcium absorption

Sensation Sensory receptors

Excretion Small amounts of waste products

are lost through perspiration

Functions of the Integumentary System (cont.)

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Apply Your Knowledge

What are the functions of the integumentary system?

ANSWER: The functions of the integumentary system are protection, regulation of body temperature, vitamin D production, sensation, and excretion.

Super!

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Skin Structure: Epidermis Most superficial layer Two parts

Stratum corneum Outermost layer Mostly dead cells form an impermeable layer

Stratum basale (stratum germinativum) Deepest layer Cells constantly dividing and pushing older cells

outwardTo Figure of Skin

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Skin Structure: Epidermis (cont.) Keratinocyte – most common

Makes and accumulates keratin Durable protein that makes the epidermis waterproof

and resistant to pathogens

Melanocyte Makes the pigment melanin

Traps UV radiation and prevents damage to underlying layers of the skin

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Skin Structure: Dermis Deeper of the two skin layers Contains all major tissue types, plus

Sudoriferous (sweat) glands Sebaceous (oil) glands Hair follicles and arrector pili muscles Collagen, elastic, and nerve fibers Blood vessels

Binds the epidermis to the subcutaneous tissue To Figure of Skin

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Skin Structure: Subcutaneous Layer Hypodermis Composed of

Adipose (fat) and loose connective tissue Blood vessels and nerves

Functions Storage in adipose tissue Cushions and insulates underlying

structures To Figure of Skin

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Where are melanocytes and keratinocytes, and what is their function?

ANSWER: Both are located in the epidermis of the skin. Keratinocytes make and accumulate keratin, which is a durable protein that makes the epidermis waterproof and resistant to pathogens.Melanocytes make the pigment melanin, which traps UV radiation and prevents damage to underlying layers of the skin.

Excellent!

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Skin Color Determined by amount

of melanin in the epidermis of skin

The more melanin, the darker the skin color Range is from yellowish

to brownish

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Skin Color (cont.)

Oxygenated blood Amount of oxygen dissolved in the hemoglobin

of the red blood cells Hemoglobin – a pigment in the RBCs

If blood is well-oxygenated, skin will be pink

If oxygen level in blood is low, skin will be pale or have a bluish color (cyanosis)

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What affects skin color?

ANSWER: The amount of melanin produced by the melanocytes and the oxygenation of the blood.

Nice Job!

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Skin Lesions Any variation in the

skin As simple as a freckle

As serious as a tumor

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Skin Lesions (cont.)

Lesion Name DescriptionBulla A large blister or cluster of blisters

Cicatrix A scar, usually inside a wound or tissue

Crust Dried blood or pus on the skin

Ecchymosis A black-and-blue mark or bruise

Erosion A shallow area of skin worn away by friction or pressure

Excoriation A scratch; may be covered with dried blood

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Lesion Name DescriptionFissure A crack in the skin’s surface

Keloid An overgrowth of scar tissue

Macule A flat skin discoloration, such as a freckle or a flat mole

Nodule A large pimple or small node

Papule An elevated mass similar to but smaller than a nodule

Petechiae Pinpoint skin hemorrhages that result from bleeding disorders

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Lesion Name DescriptionPlaque A small, flat, scaly area of skin

Purpura Purple-red bruises usually due to clotting abnormalities

Scale Thin plaques of epithelial tissue on skin’s surface

Pustule An elevated (infected) lesion containing pus

Tumor A swelling of abnormal tissue growth

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Lesion Name DescriptionUlcer A wound that results from tissue loss

Vesicle A blister

Wheal Another term for hive

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Match the following:

___ Keloid A. A blister

___ Vesicle B. A crack in the skin’s surface

___ Crust C. An overgrowth of scar tissue

___ Fissure D. A small, flat scaly area of skin

___ Ulcer E. Dried blood or pus on the skin

___ Plaque F. A wound that results from tissue loss

A

E

B

F

D

C

ANSWER:

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Accessory Organs (cont.)

Hair follicles Tube-like depressions

in the dermis of skin Generate hairs Alopecia (baldness)

occurs when follicles die

Arrector pili muscles attached to follicles cause goose bumps

Sebaceous glands Produce sebum to keep

hair soft Prevent bacteria from

growing on skin

Nails Protect the ends of

fingers and toes Hard keratin

Diagram

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Accessory Organs (cont.)

Sudoriferous (sweat) glands Located in the dermis of skin Types

Eccrine Produce watery type of sweat Activated by heat

Apocrine Produce thicker type of sweat with more proteins Concentrated in armpit and groin areas Activated by nervousness or stress Diagram

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Accessory Organs

Hair follicle

Sebaceous gland

Sudoriferous gland

Return

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Skin Healing Injury inflammation

Redness due to dilation of nearby blood vessels

Swelling because vessels leak fluid into spaces between cells

Pain because excess fluid activates pain receptors

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Skin Healing (cont.)

Inflammation promotes healing Extra blood to area Extra nutrients for skin repair Defensive cells

Injury occursBlood clot

formsScab replaces

blood clot Clotted blood and other dried tissueCollagen fibers

replace scab Bind the edges of wound; major component of scars

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How does inflammation promote healing of the skin?

ANSWER: Inflammation promotes healing by bringing extra blood, nutrients for skin repair, and defensive cells to the area of injury.

Correct

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Skin and Aging Skin loses firmness due to

Loss of elastic and collagen fibers in dermis

Loss and shifting of underlying adipose tissues

Skin color changes Dermis becomes thinner and more transparent Paler due to decrease in circulation

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Skin and Aging (cont.)

Melanocytes decrease Those remaining gather “age” spots Hair grays and becomes thinner

Decreased tolerance to temperature changes Sudoriferous glands decrease in number

Decreased perspiration, hard to adjust to high temperatures

Loss in adipose tissue and decreased circulation Increased sensitivity to cold

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What happens to the skin in the elderly?

ANSWER: As a person ages, the skin loses firmness, skin color changes, melanocytes decrease, and tolerance to temperature changes decreases due to a loss of adipose tissue and sweat glands.

Very Good!

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Burns Second leading cause of accidental death in

the U.S.

Rule of nines is used to determine severity (degree) of burn

Burn severity: First-degree Second-degree Third-degree

Rule of Nines

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Back

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Burns: Treatment Do not remove anything

sticking to the burn

Do not apply butter, lotions, or ointments

Cool with large amounts of water

Cover with sterile sheet or plastic bag

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Apply Your KnowledgeUsing Figure 24-5, determine burn severity for a patient who has burnt his anterior face and both arms.

Click for Figure 24-5 Rule of Nines

ANSWER: Head = 9%

Both arms, hands, and shoulders = 18% + 18%

9% + 18% + 18% = 45%

It all adds up to a right answer!

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Skin Cancer Basal cell carcinoma – progresses slowly and

rarely spreads to other body parts

Squamous cell carcinoma – more likely to spread to surrounding tissues

Malignant melanoma – more aggressive and occurs anywhere Most arise from melanocytes

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Skin Cancer: Basal Cell Carcinoma Signs and symptoms

New growth or sore that will not heal Waxy, smooth, red, pale, flat, or lumpy May or may not bleed

Treatment: Curettage and electrodessication Cryosurgery Mohs’ surgery Laser therapy

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Skin Cancer: Squamous Cell Carcinoma Less common than basal cell carcinoma

Found on face, lips, ears, and backs of hands

Signs and symptoms and treatments are the same as for basal cell carcinoma

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Skin Cancer: Malignant Melanoma Signs and Symptoms

From melanocytes Appear on trunk, head,

neck of men Appear on arms and

legs of women Itches or bleeds

Treatment Surgery and biopsy Removal of lymph

nodes Chemotherapy and

radiation therapy Immunotherapy

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Skin Cancer: Stages of Melanoma

Stage 0 Only found in epidermis

Stage I Spread to epidermis and dermis (1 to 2 mm thick)

Stage II 2 to 4 mm thick plus ulceration

Stage III Spread to one or more lymph nodes

Stage IV Spread to other body organs or lymph nodes far from original melanoma

24-43


Skin Cancer: ABCD Rule

A Asymmetry: The mole should not become asymmetrical

B Border should not become irregular

C Color should not change or become mixture of colors

D Diameter should not grow larger than the diameter of a pencil eraser

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Cancer Warning SignsC – Change in bowel or bladder habitsA – A sore that will not healU – Unusual bleeding or discharge T – Thickening or lumpI – Indigestion or difficulty swallowingO – Obvious change in wart or moleN – Nagging cough or hoarseness

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True or False:

___ Basal cell carcinoma is the most aggressive form of skin cancer and can form anywhere.

___ Squamous cell carcinoma is more likely to spread to surrounding tissues.

___ Lesions of melanoma appear on trunk, head, neck of men and on arms and legs of women.

___ The borders of skin cancers are usually regular.___ Basal cell carcinoma progresses slowly and rarely spreads to

other body parts.

ANSWER:

F

T

T

FT

Melanomas are more aggressive .

Borders are irregular.

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Common Skin Disorders Alopecia

Results in hair loss

Cellulitis Inflammation of

connective tissue in skin

Dermatitis Inflammation of skin

or a rash

Eczema Chronic dermatitis

Folliculitis Inflammation of hair

follicles

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Common Skin Disorders (cont.)

Herpes simplex Type 1 – cold sores Type 2 – genital

Herpes zoster Shingles

Impetigo Oozing skin lesions that

eventually crust over

Pediculosis Head lice Body lice Pubic lice

Psoriasis Inherited autoimmune

disorder

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Common Skin Disorders (cont.)

Ringworm Tinea corporis Tinea capitis Tinea pedis

Rosacea Dilation of small facial

blood vessels

Scabies Contagious skin

condition caused by mites

Warts Harmless growths

caused by a virus

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Match the following:

___ Alopecia A. Dilation of small facial blood

vessels

___ Folliculitis B. Inherited autoimmune disorder

___ Impetigo C. Hair loss

___ Psoriasis D. Growths caused by a virus

___ Rosacea E. Inflammation of hair follicles

___ Warts F. Oozing skin lesions

ANSWER:

C

F

A

B

D

E

Right!

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In Summary: First line of defense for body Protects the body from

Invading organisms Chemicals UV light Water loss

Regulates body temperature Understanding this system can help you be more

effective in your role

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End of Chapter

We may have different religions, different languages, different colored skin, but we all belong to one human race.

~ Kofi Annan

© 2009 the mcgraw-hill companies, inc. all rights reserved 24-1 the integumentary system...

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