The Integumentary System - danrogayan.weebly.com · The Integumentary System By Mr. Danilo Villar Rogayan Jr. Instructor I, Department of Natural Sciences College of Education, Arts

The Integumentary System

By Mr. Danilo Villar Rogayan Jr.

Instructor I, Department of Natural Sciences

College of Education, Arts and Sciences

RMTU San Marcelino, Zambales

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.

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.

Learning Outcomes (cont.)

24.10Describe 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.

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

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

24-5

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.

24-6

Functions of the Integumentary System

• Protection• First line of defense against

• Bacteria

• Viruses

• Protects underlying structures from

• Ultraviolet (UV) radiation

• Dehydration

24-7

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

24-8

• 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.)

24-9

Structure of Skin

• Epidermis

• Dermis

• Hypodermisor subcutaneous layer

Bac

k

24-10

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 outward

24-11

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

24-12

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

24-13

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

24-14

Checkpoint!

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.

24-15

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

24-16

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)

24-17

Checkpoint!

What affects skin color?

ANSWER: The amount of melanin

produced by the melanocytes and the

oxygenation of the blood.

24-18

Skin Lesions

• Any variation in the skin• As simple as a freckle

• As serious as a tumor

24-19

Skin Lesions (cont.)

Lesion Name Description

Bulla 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

24-20

Skin Lesions (cont.)

Lesion Name Description

Fissure 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

24-21

Skin Lesions (cont.)

Lesion Name Description

Plaque 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

24-22

Skin Lesions (cont.)

Lesion Name Description

Ulcer A wound that results from tissue loss

Vesicle A blister

Wheal Another term for hive

24-23

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

24-24

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

24-25

Accessory Organs

Hair follicle

Sebaceous

gland

Sudoriferous gland

Return

24-26

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

24-27

Skin Healing (cont.)

• Inflammation promotes healing • Extra blood to area

• Extra nutrients for skin repair

• Defensive cells Injury occurs

Blood clot

formsScab replaces

blood clot Clotted blood and

other dried tissueCollagen fibers

replace scab Bind the edges of wound;

major component of scars

24-28

Checkpoint!

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.

24-29

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

24-30

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

24-31

Chekpoint!

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.

24-32

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

24-33

Back

24-34

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

24-35

Apply Your Knowledge

Using 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!

24-36

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

24-37

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

24-38

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

24-39

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

24-40

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

24-41

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

24-42

Cancer Warning Signs

C – Change in bowel or bladder habits

A – A sore that will not heal

U – Unusual bleeding or discharge

T –Thickening or lump

I –Indigestion or difficulty swallowing

O – Obvious change in wart or mole

N – Nagging cough or hoarseness

24-43

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

Alopecia

Cellulitis

Dermatitis

Eczema

Folliculitis

24-49

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

Herpes simplex

Herpes Zoster

Pediculosis

Impetigo

Psoriasis

24-55

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

Ringworm

• Corporis • Capitis

RIngworm

• Corporis • Pedis

Scabies

Rosacea

24-60

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

24-61

We may have different religions, different

languages, different colored skin, but we all belong to

one human race.

~ Kofi Annan

Reference:

• Booth, Whicker, Wyman, Pugh, Thompson. 2009. Medical Assisting. Third Edition: McGraw Hill Companies.

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