Medical Terminology I

Chapter 16

Integumentary System

Integumentary System

• Provides Protection– Prevents excess loss of water, salts and heat– Prevents organisms and toxins from entering

the body

• Largest organ in the body

Skins Tissues

• Contains important of glands and tissues– Sebaceous secrete sebum- oily substance that

lubricates the skin– Sweat glands- secrete sweat that aids in cooling

the body

Skins Tissues

• Contains important of glands and tissues– Nerve fiber- receptors for pain, pressure and

temperature– Thermoregulation-nerve impulses regulate the

dilation of blood vessels near the body’s surface

Skin Structures

• Skin is comprised of three layers– Epidermis-thin layer the outermost area which

is dead– Dermis- dense fiberous connective layer

• Sweat glands, sebaceous glands, blood vessels and nerve endings

– Subcutaneous tissue- fat layer

       This is a file from the Wikimedia Commons. The description on its description page there is shown below.

http://training.seer.cancer.gov/ss_module14_melanoma/unit02_sec01_anatomy.htmlThis work is in the public domain because it is a work of the United States Federal Government under the terms of Title 17, Chapter 1, Section 105 of the US Code. This applies worldwide.

Epidermis

• Squamous Epithelium- flat scale like cells

• Skin squamous epithelium are arranged in layers (stratified)

Epidermis

• Basal layer-deepest layer constantly growing– Contains melanocytes- pigment cells they

produce melanin…it is transferred to other cells giving skin it’s color

• Stratum corneum- most superficial layer– Cells that move to this layer become flattened,

lose their nuclei and become filled with Keratin(horny cells)

Dermis

• Dermis is divided into two layers

• It assumes the responsibility of thermoregulation and supports the vasular network to supply the avascular epidermis with nutrients

Dermis layers

• Contains lymph vessels as well as blood vessels

• Composed of Collagen elastic tissue

Subcutaneous Layer

• Lipocytes- fat cells– This layer

protects the under lying tissues

– Acts as an insulator

Hair

• Produced in the hair follicle cells found in the epidermal layer of the skin

• The hair follicle produce horny cells filled with keratin– They are densely packed and twisted

Hair

                                                                   

This is a plate from Gray's Anatomy. Unless stated otherwise, it is from the online edition of the 20th U.S. edition of Gray's Anatomy of the Human Body, originally published in 1918.

Nails

• Keratin plates that cover the dorsal surface of the last bone of each finger and toe

• Made up of horny cells• nail growth plate zones are parallel to the skin

surface, which enables the nail to grow horizontally to the skin.

• specialized growth structures provide a flat plate rather than a cylindrical tube, such as a hair

Activities

• Vocabulary Flashcards

Assessment 16.01 Preview

• Epidermis• Dermis• Subcutaneous• Adipose• Causalgia• Dermatitis• Dermabrasion• Dermatologist• Seborrhea• Diaphoresis• Sebaceous Cyst• Erythema• Onychomycosis• Anhidrosis• Lipoma• Liposuction• Polyp

• Cyst• Fissure• Ulcer• Alopecia• Urticaria• Acne• Eczema• Gangrene• Impetigo• Psoriasis• Keloid• Nervus/nevi• Basal Cell Carcinoma• Malignant Melanoma• Squamish Cell • CarcinomaDecubitus • Ulcer

Describe each of these terms:

Assessment 16.02 Preview

• Look up one of the forms of skin cancer. Develop a flyer to describe the warning signs and symptoms, along with tips to prevent a person from developing this disease. You should have at least one picture.

Assessment 16.03 Preview

• Continue your research on the type of skin cancer you developed your informational flyer on in assignment 16. 02. In this assignment, write about the detection, treatment and prognosis for this type of cancer.

Assessment 16.04 – Case StudyCutaneous Nodules and Ulcers • The patient is a 67 year old white male who underwent orthotopic

cardiac transplantation in 1986 for cardiomyopathy. He was maintained on immunosuppressive therapy with FK-506 and prednisone since that time. He subsequently developed chronic renal failure due to FK-506 toxicity and has been on hemodialysis for the last two years. Dialysis access was via a loop left forearm AV graft, which was performed in April 1999 following failure of the original straight graft.

• In October, 1999 he presented to the dermatology clinic with multiple cutaneous lesions of the left forearm. Examination revealed multiple violaceous and suppurative nodules and ulcers on the lateral aspect of the left forearm with upward extension in a linear or lymphangitic pattern (Fig 1). Just distal to the antecubital fossa, well healed, surgical incisional scars were also seen.

• Fungal, mycobacterial and bacterial cultures were performed and an incisional biopsy of a representative lesion was submitted.

Assessment 16.05 – Case StudyWegener’s Granulomatosis:Background and present illness:• Lionel Lazarus was admitted to the hospital on 12/22/86 by Dr. Bernard Taylor. He is 21 year

old male admitted due to bilateral apical infiltrates and skin lesions.Past History:• Three months before admission multiple cystic acne appeared on the patient’s face, neck, chest

and back. Some were ulcerated and drained purulent material. A diagnosis of acne fulminans was made and adequate medication was given. He improved and started work again. Ten days ago a productive cough developed. Anorexia, myalgia and arthralgia also appeared followed by pleurisy and dyspnea.

Summary:• Chest x-ray flims and specimens of blood, urine and sputum were done. A lung biopsy, which

was negative, and dx procedure were preformed. • Diagnosis: multisystem febrile illness in which cutaneous lesions and progressively

worsening pulmonary infliltrates were the most prominent features. No infectious agent was found.

• The clinical triad of necrotizing granulomas in the upper respiratory tract and lungs, vasculitis involving both arteries and veins, and glomerulitis led to a final diagnosis of Wegener’s granulomatosis. Findings typical in this disease include anemia, thromboscytosis, elevated sedimentation rate, and conjunctivitis.

Conclusion:• The patient responded favorably to the prescribed medications with improvement in skin

lesions and other systems. He was discharged after 2 ½ weeks. Three-month follow-up revealed pulmonary function to be only 58% but this was believed to be from the scarring of multifocal necrosis of the lung. He has a voracious appetite and has gained 16 lbs.