Health Occupations

Integumentary System

SKIN

Largest organ in the body 17 –26 square feet Varies in thickness

– Eyelid – 0.5 mm– Soles of feet – 6.6 mm

Three layers of Skin

Epidermis Dermis Subcutaneous

Epidermis

Outer layer, also called cuticle Surface is layer of dead cells with living cells

underneath 5 layers of cells

– Stratus corneum – sheds – Stratus germinativum – rebuilds– No blood vessels or nerve cells but has nerve endings

for• Light touch• Pain

90% of cells are water repellent

Hair follicles Melanocytes – make melanin, the

pigment that gives skin its color– Inherited characteristic– Freckles – concentrated melanin

Surface – covered with sweat, oil, & epithelial cells that– Lubricate– Hydrate– Provide antibacterial protection– Block toxins

Dermis “True” skin Contains blood vessels & nerves

– Nerve endings • Pressure• Heat & cold

Each square inch of skin has 15 ft. of blood vessels

Is 15-40 times as thick as epidermis Contain fingerprints – ridges or striations in this

layer that are unique to each person Contains sebaceous glands – oil glands

Subcutaneous or hypodermis

Innermost layer Adipose – fatty tissue that cushions &

insulates organs Connects skin to muscle Made of up elastic & fibrous tissue as

well Contains sudoriferous glands

Hair

Pili – found everywhere except soles of feet & palms of hand

Hair in nose & mouth block foreign particles from entering

Hair root originates in dermis Shaft - visible portion of hair Follicle – hair root with its covering

– Has 1-2 sebaceous glands attached to it

Arrector pili – small muscle attached to hair shaft– Causes goose bumps or hair to stand on

end due to cold or fear Color & texture of hair is inherited Color dependant on melanin

Glands

Sebaceous glands Sudoriferous glands Ceruminous glands

Sebaceous glands

Oil glands Found everywhere except palms & soles 2,000-2,000,000 glands in each square inch

of skin Causes skin to be soft & waterproof Usually open onto hair follicles Sebum – oil

– Antibacterial & antifungal, prevents infections– When gland is plugged, get pimple

Sudoriferous glands Sweat glands Originate in subcutaneous layer & opens at pores in

epidermis Apocrine

– Attached to hair follicles– Found in axilla, breasts, pubic area

Eccrine– Empty directly onto skin

Regulate body temp & excretes wastes Skin loses 500 ml of water each day, increases with

exercise

Ceruminous glands

In auditory canal of eat Secretes wax

– Protects ear from infection– Prevents foreign body entry

Nails

Protect fingers & toes from injury Formed from dead, keratinized

epidermal cells Root – where nail grows, covered by

skin where it attaches Lunula – crescent shaped white area

near root Nails regrow unless root is damaged

Function of integumentary system Protection

– Barrier to UV rays & pathogens– Keeps moisture in

Sensory perception– Helps body respond to pain, pressure, temperature, &

touch Body temperature regulation

– Helps skin retain or lose heat– Blood vessels dilate – heat escapes– Blood vessels constrict – heat is retained– Sudoriferous glands cool through perspiration

Storage– Tissues for temporary storage of fat, glucose, water,

vitamins, & salt– Adipose – source of energy

Absorption – Substances absorbed through skin– Transdermal meds

• Nitroglycerine – heart• Scopolamine – motion sickness• Hormones – birth control• Nicotine – smoking cessation

Excretion– Eliminates salt, wastes, excess water through sweat

Production– Vitamin D – uses UV rays to form Vitamin D that

matures in the liver

Arector piliSebaceous glandHair follicle

Root

Artery

Vein

Adipose tissueSudoriferous glandSubcutaneous tissueNerve

DermisEpidermis

Assessment

Dermatology – study of skin Dermatitis – inflammation of skin,

usually non-life threatening Skin lesions – visually inspected

– Look for size, shape, texture, color– Biopsy or culture for diagnosis

Color

Erythema – Reddish color

• Burns• Congestion in blood vessels

Jaundice– Yellowish color

• Liver or gall bladder disease or RBC destruction

Cyanosis – Bluish color

• Insufficient oxygen – heart, lung, or circulatory disease

Eruptions

Macules– Flat spots on skin

• Freckles

Papules

Firm raised areas– Pimples– End stage of chicken pox

Vesicles

Blisters or fluid filled sacs– Early chicken pox or small pox

Pustules

Pus filled sacs– Acne– Fire ant bites

Crusts

Areas of dried pus & blood– scabs

Wheals

Itchy, elevated areas with irregular shape– Hives or bites

Ulcer

Deep loss of skin surface, extends into dermis

May see scarring & bleeding

Diseases & Abnormal Conditions

Acne Vulgaris– Increased secretion of sebaceous glands– Bacteria grows & blocks hair follicle– Causes papules, pustules, & blackheads– Treat with

• UV light• Antibiotics• dermabrasion

Albinism

Melanocytes don’t produce melanin Pale skin White hair Light eyes Sensitivity to light Decreased visual acuity

Alopecia

Baldness Inherited tendency to lose hair Androgenic hormones at puberty can

begin hair loss May occur in females too

Athlete’s foot

Fungal infection Skin itches, blisters, cracks Contagious, transmitted by wet floors Treatment

– Antifungals– Clean & dry– Well ventilated

Cellulitis Bacterial infection of dermal & subcutaneous layers Symptoms

– Fever & chills– Vesicles– Warm, red skin– Decreased circulation– lymphedema

Treatment– Rest, elevation– Immobilization– Antibiotics

Chloasma

Patchy discoloration on face Due to high hormone levels

– Pregnancy– Oral contraceptives– Liver disease

Cleft lip and palate

1 in 700 babies born with this Space where nasal processes or palate do not

meet, see open area Causes

– 25% heredity– Environment– Prematurity

Treatment– Surgery– Dental therapy– Speech therapy

Contact dermatitis

Allergic reaction to anything– Poison ivy, jewelry, bleach, etc

Symptoms– Redness– Swelling– Itching– Blisters

Treatment– Washing– Anti inflammatory meds– Avoid exposure

Dandruff

Scalp itching Causes white flakes of dead skin cells Treatment

– Scalp massage– Shampoo– brushing

Decubitus ulcers Sores of inflammation over body prominences Due to

– Prolonged pressure & hypoxia to affected area “Bedsores” Prevention

– Frequent position changes– Good nutrition– Massage

Described in 4 stages, depending on severity Treatment – antibiotics, remove necrotic tissue,

frequent cleaning, maggots

Eczema

Caused by dermatitis Symptoms

– Swelling– Redness– Itching– Weeping/crusting lesion

Familial Treatment

– Remove irritant– Keep skin clean

Fungal infection

Only on epidermis Ranges from no symptoms to scaly, red,

swelling, & blisters Usually on moist areas

– Athlete’s foot– Jock itch– Ringworm

Treatment– antifungals

Furuncle

Boil Sometimes infected hair follicle Treatment

– Hot compresses– Antibiotics– lancing

Hirsutism or Hypertrichosis

Increased hair growth in abnormal places– Hair, back, chest

Hormone related or hereditary Treatment – temporary

– Shave– Wax– electrolysis

Impetigo

Contagious bacterial infection Vesicles to pustules to crusts Symptoms

– Itching– Burning– Can lead to kidney infection if untreated

Lesions usually clear without damage Can be fatal to infants

Kaposi’s Sarcoma

CA that originates in blood vessels and spreads to the skin

Round or oval spot Red, purple, or brown 2 types

– Aging– Diabetes, lymphoma, AIDS

• Spreads to liver, lungs, intestine• Tx with inteferon or chemotherapy

Lupus

Benign dermatitis or chronic systemic disorder

Symptoms– Scaly rash– Baldness– Vascular connective tissue affected

• Butterfly rash

Treatment– Protect from sun– Anti-inflammatory meds

Psoriasis

Too many epidermal cells Red thick areas covered with scales

– Gray– Silver

Triggered by stress Familial Treatment

– Topical cream– Scale removal– UV light

Rashes

Usually viral Treat symptoms Usually childhood disease

Scleroderma

Autoimmune disease Affects

– Blood vessels– Connective tissue– Epithelial tissues

Treatment– Anti-inflammatory meds– PT to avoid muscle contractures

Skin Cancer

Basal cell Squamous cell Malignant melanoma

Streptococcus

Bacteria that can affect the skin Group A may be flesheating

Vitiligo

Loss of pigment Leads to formation of white patches

Warts

Papule caused by HPV Comes & goes unexpectedly Types

– Plantar– Common– Flat

Treatment– Chemicals– Freezing– burning

UV light Skin protects us from this by producing melanin Makes a tan Process of damage

– UV light causes damage to dermal cells– Moisture is lost– Wrinkled & dry skin

Main cause of skin cancer Burns

– 1st degree – sunburn– 2nd degree – blister– 3rd degree - full

Basal cell carcinoma Starts in lower layer of epidermis Symptoms

– Waxy, pearly growths– Red scaly patches– Face, arms, hands– Bleed then heal, over & over

Treatment – Scraping– Burn– Cut out lesion

Most benign form of CA

Squamous Cell Carcinoma

Middle layer of epidermis Symptoms

– Spreads more quickly– Red, scaly patches that don’t heal– Eventually grows into surrounding tissue

Treatment– Same as basal cell

Malignant Melanoma

Originates in melanin cells SERIOUS Symptoms

– Brown, black color– Can start on back, legs, torso– ½ develop from moles

Treatment– Removal– If spread, survival rate decreases

• Needs chemo