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The Protective Covering (Melanocytes (Located deep in the epidermis and…
The Protective Covering
System Overview
Integumentary System is comprised of skin and its accessory component including hair, nails, and associated glands
The system is the most exposed system
integumentary system performs protection from pathogens, balances fluid levels, stores fatty tissue for energy supply, produces vitamin D, provides sensory input, helps to regulate body temperature.
The Skin
Largest organ, weighing approximately 20 pounds and covering area about 20.83 square feet on an adult
cross section of skin revels three layers: epidermis, dermis, and subcutaneous Fascia
Epidermis
Layer of skin we see on the outside made up of five or six even smaller layers of tissue.
There are no blood vessels or nerve endings in this layer (we call it avascular)
Cells on surface are constantly shedding being replaced with new cells that grow and a rise from deeper region called Stratum basale every 2-4 weeks
Cells are born in the basal layer (it germinativum)
Outermost layer is layer is layer of dead cells, called stratum corneum; which are flat, scaly, keratinized epithelial cells.
Melanocytes
Located deep in the epidermis and are responsible for skin color
melanocutes produce or make melanin This is the substance that actually affects the color of skin)
Melanin in patches one the skin forming freckles
All people have same number of melanocytes
There are different colors or variation of skin color because of the amount of melanin that is produced and now it is distributed
Carotene: is another form of skin pigment that gives yellowish nue to skin
Albinism is when there is very little pigment in their skin, hair, or eyes
Skin and Disease
Color of skin can indicated disease
Yellow skin (jaundice) may indicate live disease
Bronze Color may indicate adrenal gland disease; malfunctioning adrenal glands can cause skin to produce excessive melanin
Bruised Color (Ecchymosis) could indicate skin, blood, or circulatory problems
Dermis
Layer below or inferior, to epidermis sticker dermis layer
Contains the following; capillaries, collagenous/elastic fibers, involuntary muscles, nerve endings, lymph vessels, hair follicles, sudoriferous glands (sweat), and Sebaceous gland (oil)
Small "fingers" of tissue project from surface and anchor layer to epidermal layer
finger and toe prints arise from this layer
Nerve fibers allow you to sense what is happening in your environment; vasodilation of capillaries in this layer cause blushing
Collagen and elastic fibers allow for elasticity of skin preventing tearing with movement; allow skin to return to normal shape during periods of rest, older people lose some elasticity, leading to wrinkles.
Sudoriferous Glands
Two main types of sudoriferous glands, or sweat glands are apocrine gland and eccrine gland
Apocrine gland (sweat) secrete at hair follicles in grain and anal region as well as armpits; become active around puberty and are believed to act as sexual atractants
Eccrine Glands are found in greater numbers on palms feet forehead and upper lip; are important in regulation of temperature
Herpes
lifelong viral infection that produces dusters of small fluid-filled sacs (vesicles/blisters)
Signs and symptoms: usually come and go; there are periods of remission and exacerbation
Stress and other disease can temporarily decrease immunity, and lead to symptoms flare.
Herpes Varicella
Also known as Chickenpox
can be spread by airborne particles or direct contact-highly contagious
Vesicles can be found on face, trunk and extermities
Vesicles associated with intense itching
Vaccine given to children if children do get it after the vaccine-light case
Herpes Zoster
Also known as Shingles
Develops when dormant chicken pox virus re-activites
Causes extremely painful blisters/rashes that follow course of a sensory nerve
Symptoms develop when stress disease trauma or aging prevent immune system from keeping virus in check
last up to 10 days or more
Herpes Types
Herpes Simplex Type 1
Causes "cold sores" or "fever blisters" around mouth or nose
Commonly develops after common cold or fever
Herpes Simplex Type 2
Causes genital herpes
spread by direct contact
Most contagious when in active stage however, can be spread during remission
Acylovir (zovirax)
is used to treat outbreaks
Papilloma Virus (HPV)
Causes warts (verruca): hypertrophy of keratin cells in skin; types of warts
Common warts; usually found on childrens hands and fingers, spread by scratching and direct contact, and often disappear on their own
Plantar warts are found on slue of feet, tend to grow inward, have relatively smooth appearance on surface, and can cause pain when walking
Treatment: removal by surgery or freezing
Genital Warts
Sexually transmitted, and highly contagious
Some types of HPV have been associated with cervical cancer
Recenitiy developed vaccine may help prevent cervical cancer associated with certain types ofHPV
Fungal Infections
Tinea; general term for fungal skin infections, usually located in warm, moist regions of body, can be a chronic condition
Types of Tinea; Tinea pedis (athlete's foot); Fungal infection of foot
Spread by direct contact with contaminated surfaces (like locker room floors); most commonly develops in warm, moist area between toes
Tinea cruris (jock itch); fungal infection of grain and scrotal areas, mainly affects men, and aggravated by increased perspiration and tight fitting shorts/pants/under garments
Tinea corporis (ringworm); fungal infections of smooth skin on arms, legs, and body
Appearance: red, ring-shaped structure with pale center; there is no actual worm involved
Tinea Unguium; fungal infection under finger or toenails and if untreated, results overgrown and thick nails with white/brittle appearance
Bacterial Infection
Cellulitis; infection of skin and subcutaneous tissue, caused by staphylococcus, source of infection often wound of some kind, and can lead to life-threatening situations like endocarditis or even septicemia
Lyme Disease
Bacterial infection spread by deer tick bites
Signs and symptoms: "Bull's eye" rash: red circle with lightter center; often very first presenting sign of infection; appears few days to several weeks following tick bite.
Flu-like symptoms, fever, and shills, malaise, and joint inflammation
Lyme Disease; if untreated, can lead to neurologicalcardiovascular problems, arthritis; Diagnosis: blood test can confirm presence of infection
How Skin Heals
If skin is punctured and wound damages blood vessels, wound fills with blood; blood contains substances that cause clotting; top part of clot exposed to air hardens to from scab, natures band-aid, forming barrier and preventing pathogens from entering
Next, the inflammatory process kicks in and white blood cells enter and destroy any pathogens, while fibroblasts come and begin pulling edges of wound together; basale layer hyper-produces cells for repair of wound
If wound is deep, scar, composed of collagen fibers, develops; scars don't contain any accessory organs or nerve endings; siticries, adnesive strips (butterflies), or special give reduce scarring
Note, wound ideally starts to heal from inside out; this aids in preventing pathogens from becoming trapped between healed surface and deeper layer of skin where they could develop in pocket of infection
Burns
Can be caused by heat chemicals electricity, or radiation
two factors affect assessments of damage: depth and amount of area damaged
Depth of burn relates to layer or layers of skin affected by burn
First Degree burn: damage only outer layer, or epidermis; symptoms include redness and pain, but no blister; pain subsides in 2-3 days, there is no scarring; complete healing takes about one week.
Second degree burn: involve entire depth of epidermis and portion of dermis; symptoms include redness, pain , and blistering; extent blistering dependent on depth of burn; blistering extends after initial burn; scarring in second degree burn is common; open blister should be covered with aclry, sterile bandage.
Third Degree Burn: affects all three layers of epidermis (skin); surface of burn has leathery feel and will range in color from black, brown, tan, red or white; patient feels no pain because pain receptors are destroyed
Fourth degree burns: are worst burns; penetrate bone and cause bone damage; destroy tendons and muscle; rule of nines to estimate extent of area damaged by burns
Nails
Specialized epithelial cells originating from nail root (germinal matrix) form nails
As cell grow out and over nail bed, they become keratinized forming substance similar to horns on a bull (process occurs as cells dry and shrink and are pushed to the surface and filled with keratin
Cuticle: is fold of tissue that covers nail root
portion that we see is called nail body
Sterile matrix is a layer of cells that helps the nail body to stick the nail bed
nails normally grow 1 mm every week; pink color of nail comes from vascularization of tissue under area, while white half-moon shaped area, or lunula is result of thicker layer of cells at base.
Hair
Body hair: is normal and serves important purposes
helps to regulate body temperature and functions as sensor to help detect things on skin such as bugs or cobwebs; eyelashes help to protect eyes from foreign objects while hair in nose helps filter out particulate matter
Visible hair composed of fibrous protein called keratin; hair you see is called shaft with root extending down into dermis to follicle
Follicle: is formed by epithelial cells with rich source of blood provided by dermal blood vessels
Hair color and Textum
Hair color: is dependent on amount and type of melanin you produce; the more melanin, the darker your hair; white hair occurs in absence of melanin
red hair: is result of hair that has melanin with iron in it
Flat hair shafts: produce curly hair, while round hair shafts produce straight hair
Alopecia: is term for any type of hair loss and can be acute or chronic
hair loss can also be a result of chemotherapy for cancer treatments, hormonal balance, scale infection, severe emotional or physical stress or side effects of other medications
Lice
Tiny insect parasites that live on scalp/skin
lice spread by direct contact with infested person or infested objects (hair brushes, etc)
Types of lice are head lice, body lice, and public lice
head lice: extremely common; checked for in schools
Body Lice: result of poor personal hygiene and can carry disease
Public Lice: spread through sexual contact; also known as "crabs"
Treatments for lice; bathing of shampooing with medicated shampoo; shampoo eliminates lice and their eggs (called "nit"); through cleaning of all bedding, towels, clothing, hats, combs, and hair brushes (after natively, these items can be discarded)
Scables
Tiny mite that barrows into skin to lay eggs
Transmitted via direct contact with infection individual
Mites typically lodge in folds of skin (wrist, underarms, grain, under breasts, etc)
Symptoms: intense itching, vesicals, and pustules
Without treatment, cycle develops: eggs are laid under skin, eggs hatch in 3-5 days and young mature in 2-3 weeks, mites mate and start process over again
Treatment: speciallt form ulated cream is appiled to skin
Temperature Regulation
Integumentary system plays major oles in regulation of body's temperature
part of regulation of temperature isaccomplished by changes in size of blood vessels
Vasodilation: exposes heated blood to external cooling air
Vasoconstriction: keeps cooling of blood to minimum when it's cold outside
Sweat glands: excrete water onto skin's surface, allowing cooling through evaporation; requires adequate hydration to continue to produce sweat
Shivering causes muscle activity that produces heat to warm you when you're cold
hairs on skin stand erect when arrector pili muscles contract; known as goose bumps; these hairs create dead space insulating you from cooler surroundings, like a goose down jacket
Skin Lesions
pathologically altered piece of tissue
Types of lesions include; macule, wheal (urticaria), papule, nodule, vesicle, bulla, pustule, ulcer, crust, scale, and fissure
Acne
Etiology: metabolic condition allergies various drugs or endocrine disorders are possible causative agents
signs and symptoms: inflammation of hair follicles/sebaceous glands especially on face, neck, chest, upper back/shoulder; can form blackheads, cyst, nodules, pustules, and pimples
Diagnostic tests: visual examination
Treatment: mila and severe
mila: proper cleansing techniques and OTC treatments
Severe: proper cleansing techniques including prescribed medications antibiotics, steroids and/or all-transretnoi acid
Skin Lesions
Decubitus ulcer: (pressure ulcers; bed sores)
Etiology: tissue injury resultant of unrelieved pressure placed upon a specific area
Signs and symptoms: red, inflamed crater-like lesion usually located over bony prominnence
Diagnostic tests: visual inspection, culturing of site for infection
Treatment: preventative measures such as turning and padding important; treat infection of the sore
Boil (furuncle)
Etiology: staphylococcus bacteria
Signs and Symptoms: inflammation, localized encapsulated pus filled lesion, painful affected site; carbuncles are a large abscess composed of several furuncles
Diagnostic tests: visual examination, site culture
Treatment: proper antiseptic cleansing technique, antibiotics, application of warm moist heat, depending on seventy, may require draining
Eczema
Etiology: genetic predisposition to allergies (infants it may include reaction to milk/dairy products, other foods), stress
Signs ans symptoms: skin inflammation, redness, vesicles, scales, crushing, and pustules
Diagnostic tests: visual examination, hsitory
Treatment: no true cure, treat symptoms; eliminate offending food, reduce stress, topical contortionist creams, skin moisturizers, antinistamines
Folliculitis
Etiology: bacteria (usually staphylococcus)
Signs and Symptoms: small pustules that form around base of hair follicle
Diagnostic tests: visual examination, site culture
Treatment: proper daily cleansing with antiseptic cleanser oral antibiotics (Chronic or severe cases)
Hives (urticaria)
Etiology: allergic reaction to external agent such as bee stings, plants, temperature extremes, sunlight, or internal agents such as food additives, medication antibiotics, or specific disease conditions
Signs and symptoms: itchy wheals surrounding by red inflamed area; can cover most of body
Diagnostic tests: visual examination, patient history
treatment: antihistamines, allergen avoidance
Keloid
Etiology: tissue trauma or surgical incision
Signs and Symptoms: over production of collagen during tissue repair often creating larger structure than original scar/traumatized area
Diagnostic tests: visual inspection
treatment: surgical removal but there is a great potential for keloids to grow back
Malignant Melanoma
etiology: occurs in melanocytes, excessive exposure to the sun
Signs and symptoms: brown or black irregular patch that appears suddenly a color or size change in a prexisting wart or mole may also be an indication
Diagnostic tests: biopsy
Treatment: surgical removal and the surrounding area; chemotherapy
Psoriasis
Etiology: possible genetric basis with attacks triggered by emotional stress, illness, sunlight, or skin damage
Signs and symptoms: red skin with silver patches, rapid replacement of epidermis cells, dry cracking skin with crusting, can be painful; common to have periods remission then exacerbation; may be arthritic component
Diagnostic tests: Visual examination, patient history
treatment: supportive skin applications to deal with symptoms; medications: steroids, ultraviolet light
Pharmacology Corner
transdermal patches; placed on skin in morning and left in place for 24 hour (or more), and allows medications to be slowly absorbed over time
Examples of common transdermal patches; niotine (for smoking cessation), nitroglycerine (a heat medication), and birth control
Topical creams; for skin irritation; mild preparations stop itching; more powerful preparations containing corticosteroids work as local anit-inflammatory agents; because cream is not fully absorbed into bloodstream, systemic side effects are minimal
Antifungal: treat fungal infections like ring worm and athlete's foot
Topical Creams
Anti-viral: used to treat herpes and other viral skin conditions
Antibiotic: used to treat bacterial infections; can also be used to prevent wound from becoming infected
medicated shampoos: useful in treating lice and dandruff (excessive dry scalp with sloughing skin)