INTEGUMENTARY SYSTEM
The skin and its accessory structures (hair, nails, and glands) form the integumentary system of the body. Integument means covering so skin is the outer covering of the body. Contains glands to secrete fluids, nerves to carry impulses and blood vessels to aid in the regulation of body temperature.
FUNCTIONS OF SKIN Protects the body against excessive loss of water, salts, heat and against invasion of pathogens and their toxins. Contains two glands, sweat gland to produce sweat and sebaceous gland to produce sebum. Sebum lubricates the surface of the skin and the sweat cools the body as it evaporates from the skin surface. Nerve fibers under the skin are receptors for sensations such as pain, temperature, pressure and touch. Helps in thermoregulation. ANATOMY OF THE SKIN
Three layers of the skin are, a. Epidermis a thin, cellular membrane layer, containing keratin b. Dermis dense, fibrous, connective tissue layer, containing collagen c. Subcutaneous layer or hypodermis thick, fat-containing tissue
EPIDERMIS
Outermost totally cellular layer of the skin. Composed of squamous epithelium. Epidermis lacks blood vessels, lymphatic vessels and connective tissue and dependant on the deep dermis layer and its rich network of capillaries for nourishment. The deepest layer called the basal layer constantly multiplies and it is the source of all the other cells in the epidermis. Within 3 to 4 weeks after beginning as a basal cell in the deepest part of the epidermis, the cell flatten, shrink and die becoming filled with a hard protein material called keratin. The keratinized cell are sloughed off from the surface of the skin. Thus the epidermis is constantly renewing itself. The basal layer of the epidermis contains special cells called melanocytes which forms and produces a brown-black pigment called melanin which gives color to the skin.
DERMIS Lies directly below the epidermis.
Composed of blood and lymph vessels, nerve fibers, as wells as the accessory organs of the skin, which are the hair follicles, sweat glands and sebaceous glands. Contains interwoven elastic and collagen fibers. Collagen (colla = glue) is a fibrous protein, tough and resistant but also flexible. Collagen fibers support and protect the blood and nerve networks that pass through the dermis.
SUBCUTANEOUS LAYER The subcutaneous layer specializes in the formation of fat. The epidermis and dermis are cutaneous layers. Adipocytes (fat cells) manufacture and store large quantities of fat in this layer. This layer is important in protection of the deeper tissues of the body, as a heat insulator and for energy storage.
ACCESSORY STRUCTURES OF THE SKIN The accessory structures of the skin are,
1. Hair 2. Nails STRUCTURE OF HAIR
A hair fiber is composed of a tightly fused meshwork of cells filled with the hard protein called keratin.
Deep-lying cells in the hair root produce keratinized cells that move upward through hair follicles. Melanocytes are located at the root of the hair follicle and they donate the melanin pigment to the cells of the hair fiber.
STRUCTURE OF A NAIL
Nails are hard keratin plates covering the dorsal surface of the last bone of each toe and finger. Cell division occurs in the region of the nail matrix, which is at the base of the nail plate. Lunula is the semilunar whitish region at the base of the nail. Cuticle, a narrow band of epidermis is at the base and sides of the nail plate. Paronychium, is the soft tissue surrounding the nail border Nail growth and appearance commonly alter during systemic disease.
SWEAT AND SEBACEOUS GLAND
SEBACEOUS GLANDS Sebaceous glands are located in the dermal layer of the skin over the entire body except palms, soles and lips. They secrete an oily substance called sebum. Sebum contains lipids lubricates the skin and minimizes water loss. They are closely attached with hair follicles. They are influenced by sex hormones, so they hypertrophy during puberty and atrophy in old age.
SWEAT GLANDS Sweat glands are tiny coiled glands found on almost all body surfaces, most numerous in the palm of the hand and sole of the foot. The tiny opening on the surface is a pore. Sweat is colorless and odorless. The odor produced when sweat accumulates on the skin is caused by the action of bacteria on the sweat. Perspiration is controlled by the sympathetic nervous system.
PATHOLOGY CUTANEOUS LESION Crust Cyst Erosion Fissure Macule Nodule Papule Polyp Pustule Ulcer Vesicle Wheal SIGNS AND SYMPTOMS Alopecia Ecchymosis, ecchymoses Petechia, petechiae Pruritus Urticaria DESCRIPTION Collection of dried serum and cellular debris Thick-walled, closed sac or pouch containing fluid or semisolid material Wearing away or loss of epidermis Groove or crack-like sore Flat lesion measuring less than 1 cm in diameter Solid, round or oval elevated lesion 1 cm in diameter Small less than 1 cm in diameter solid elevation of the skin Growth extending from the surface of the mucous membrane Papule containing pus Open sore on the skin or mucous membranes Small collection of clear fluid, blister Smooth, edematous papule or plaque that is redder or paler than surrounding skin Absence of hair from areas where it normally grows Bluish-purplish mark on the skin Small, pinpoint hemorrhage Itching Acute allergic reaction in which red, round wheals develop
ABNORMAL CONDITIONS Acne Burns Cellulitis Eczema Inflammatory skin disease with erythematous, papulovesicular lesions Gangrene Impetigo Psoriasis Scabies Scleroderma Systemic lupus erythematosus (SLE) Tinea Vitiligo SKIN NEOPLASMS BENIGN Callus Keloid Keratosis Leukoplakia Nevus, nevi Verruca CANCEROUS LESION Basal cell carcinoma Squamous cell carcinoma Malignant melanoma Kaposi sarcoma LABORATORY TESTS Bacterial analyses Fungal tests CLINICAL PROCEDURES Cryosurgery Curettage
Chronic papular and pustular eruption of the skin with increased production of sebum Injury to tissues caused by heat contact Diffuse, acute infection of the skin marked by local heat, redness, pain, and swelling Inflammatory skin disease with erythematous, papulovesicular lesions Rash (exanthem) of the skin due to a viral infection
Death of tissue associated with loss of blood supply Bacterial inflammatory skin disease charecterized by vesicles, pustules, and crusted-over lesions Chronic, recurrent dermatosis marked by itchy, scaly, red plaques covered by silvery gray scales Contagious, parasitic infection of the skin with intense pruritus Chronic progressive disease of the skin and internal organs with hardening and shrinking of connective tissue Chronic autoimmune inflammatory disease of collagen in skin, joints, and internal organs Infection of the skin caused by a fungus Loss of pigment in areas of the skin (milk white patches) Increased growth of cells in the keratin layer of the epidermis caused by pressure or friction Hypertrophied, thickened scar developing after trauma or surgical incision Thickened and rough lesion of the epidermis, associated with aging or skin damage White, thickened patches on mucous membrane tissue of the tongue or cheek Pigmented lesion of the skin Epidermal growth (wart) caused by a virus Malignant tumor of the basal cell layer of the epidermis Malignant tumor of the squamous epithelial cell in the epidermis Cancerous growth composed of melanocytes Malignant, vascular, neoplastic growth charecterized by cutaneous nodules Samples of skin are examined for presence of microorganisms Scrapping from skin lesions, hair specimens, or nail clippings are sent to a laboratory for culture and microscopic examination Use of sub freezing temperature via liquid nitrogen application to destroy tissue Use of a sharp dermal curette to scrape away skin lesion
Electrodessication Mohs micrographic surgery Skin biopsy Skin test
Tissue is destroyed by burning with a electric spark Thin layers of malignant tissue are removed and each is examined under a microscope to check for adequate extent of the resection Suspected malignant skin lesions are removed and examined microscopically by a pathologist Substances are injected intradermally or applied to the skin and results are observed
EXERCISES I MATCH THE TERMS WITH THE DESCRIPTION TERMS Squamous epithelium Sebaceous gland Albinism Electrocautery Subcutaneous tissue Collagen Dermis Melanocyte Erythema Dermabrasion DESCRIPTION Connective tissue layer of skin Surgical procedure to scrape away tissue Flat, scale like cells Connective tissue protein Pigment deficiency of the skin Contains a dark pigment Redness of skin Contains lipocytes Oil-producing organ Knife used to burn through tissue
II COMPLETE THE FOLLOWING A fat cell is a/an ----The half-moon shaped white area at the base of the nail is the ----A structural protein found in skin and connective tissue is ----A black pigment found in the epidermis is ----A deepest region of the epidermis is ---The outermost layer of the epidermis which consists of flattened keratinized cells is the ---An oily substance secreted by sebaceous gland is --The middle layer of the skin is the ----A hard, protein material found in epidermis, hair and nails is ---A band of epidermis at the base and sides of the nail plate is the ----
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