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Chapter 5: In this chapter, we learned about the integument system. This…

- - - - keratinocytes: produce fibrous keratin- protein that gives skin its protective properties
      - melanocytes: produce pigment melanin- packaged onto melanosomes
      - dendritic: star-shaped macrophages that patrol deep epidermis
    - - Stratum basale(basal layer): firmly attached to dermis, consists of a single row of stem cells that actively divide- produce 2 daughter cells each time
      - Stratum Spinosum(prickly layer): cells contain weblike system of intermediate prekertin filaments attached to desmosomes
      - Stratum Granulosum(granular layer): cell appearance changes- cells flatten, kertinization begins, cells also accumulate lamellar granules- CELLS ABOVE THIS LAYER DIE
      - Stratum Lucidum(clear layer): found only in thick skin, consists of thin, tanslucent band of two to three rows of clear, flat, dead kertinocytes
      - Stratum Corneum(horny layer): 20-30 rows of flat, anucleated, kertinized dead cells, even though they are dead they still have functons. Protect deeper cells from the environment, prevent water loss, protect from abrasion and penetration, and acts as a barrier against biological, chemical, and physical assaults
  - - - two types
        
        papillary: superficial layer of loose areolar connective tissue, loose fibers allow phagocytes to patrol for microorganisms.
        
        DERMAL PAPILLAE: region of dermis that sends finger like projections up into the epidermis, in thick skin it will lie on top of dermal ridges(friction ridges)
        
        reticular: 80% of dermal thickness, consists of dense irregular connective
        
        CLEAVAGE LINES are caused by many collagen fibers running parallel to skin surface
        
        FLEXURE LINES are dermal folds at or near joints
  - - - warn of insects on skin
      - hair on head guards against physical trauma
      - protect from heat loss
      - shield skin from sunlight
    - - Hairs(pilli): flexible strand of dead, keratinized cells produced by hair follicles
      - shaft: area that extends above scalp, where keratinization is complete
        
        three parts to hair shaft
        
        medulla: central core of large cells and air spaces
        
        cortex: several layers of flattened cells surrounding medulla
        
        cuticle: outer layer consisting of overlapping layers of single cells
      - Root: area within scalp, where keratinization is still going on
    - - hair bulb: expanded area at deep end of follicle
      - hair follicle receptor: sensory nerve endings that wrap around bulb
      - Wall of follicle
        
        perpheral connective tissue sheath
        
        epithelial root sheath derived from epidermis
      - hair matrix: actively dividing area of bulb that produces hair cells(as it makes new cells, its pushes older ones upward)
      - arrector pill: small band of smooth muscle attached to follicle (goosebumps)
      - hair papilla: dermal tissue containing a knot of cappillaries that supplies nutrients to growing hair
  - - - greater than 25% of body has second-degree bruns
      - greater than 10% of body has third-degree burns
    - - debridement (removal) of burned skin
      - antibiotics
      - temporary covering
      - skin grafts
    - - the Rule of Nines: estimate fluid loss
        
        body is broken into 11 sections
        
        each 9% + 1% perineum
- - - - second degree burn- blisters
    - - first degree burn- red and tender
    - - third degree burn- pale grey-white color
- - - - keep wounds cleaned and clean regularly, simple hand hygiene of all doctors and nurse is CRUCIAL
    - - have patient on iv fluids to stay hydrated, as well as making sure patient drinks as much water as possible
    - - will help with blood supply and quick healing
  - - - very common, since skin is deeply damaged
        
        keep wound clean and change out bandages regularly
    - - lots of fluid loss due to severity of burn