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CHAPTER 5
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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