1. Integumentary System  What is the largest sensory organ of the body???? A. Eye B. Ear C. Tongue D. Nose E. Skin

2. Integumentary System Name for the skin and its structures Called a membrane because it covers the body Called an organ because it contains several kinds of tissues Called a system because it has organs and other parts that work together for a particular function

3. Functions Protection Sensory perception Regulation of body temperature Storage Absorption Excretion Production

4. Components of the Skin

5. Layers of the Skin Epidermis—outermost layer Dermis—“true skin” Subcutaneous fascia or hypodermis— the innermost layer

6. The Layers of Skin

7. Sudoriferous glands (sweat glands) Sebaceous glands (oil glands) Hair Nails Glands & Other Parts of the Skin

8. Hair Functions  Varies by location  Scalp: insulates head; grows @ 1 mm/day  Nostril: filters  Eyebrow/lash: protects; keeps dust and perspiration out of eyes  Body: none  Arrector pili: pilomotor muscle; stimulated by cold and emotions. Attached to base of dermal papilla and side of follicle. Contraction = goose bumps.  Alopecia = hair loss

9. NAILS  Protects the distal ends of phalanges  Provides ability to grip, pick up tiny objects  HCW observe for cyanosis to assess blood O2 if pulse ox not available

10. Skin Color—Pigmentation Skin color is inherited and is determined by pigments in the epidermis a. Melanin b. Carotene

11. Skin Color—Albino Absence of skin pigments Skin has pinkish tint Hair is pale yellow or white Eyes are red in color and sensitive to light

12. Skin Color—Abnormal Erythema Jaundice Cyanosis

13. Skin Lesions Any measurable variation in tissue structure Not always a sign of disease Can be flat, depressed or elevated

14. Elevated Lesions Papule: firm, raised; wart Plaque: large,raised region; psoriasis Vesicle: fluid filled; blister Pustule: filled w/ pus; acne Crust: scab Wheal/hive: firm, raised, reddened w/ whiter center; insect bite

15. Depressed Lesions Excoriation: scratch exposing the dermis Laceration: tearing of the skin Abrasion: scraping Pressure Ulcer: Decubutis ulcer bedsore Fissure: deep crack

16. Skin Eruptions  Macules (macular rash)  Papules (papular rash)  Vesicles  Pustules  Wheals  Crusts  Ulcer

17. Chicken Pox

18. Skin infections  Impetigo: staph, strept. Erythema then vesicles. Contagious. Tx: antibiotics  Tinea: Mycoses (fungal). Erythema, scaling and crusting. Ex: Ringworm (tinea capitis), athletes foot (tinea pedis). Tx: antifungal  Warts: verruca, caused by papilloma virus. Contagious. Tx: removal  Boils: furnacle. Staph inf of hair follicle. Lg pustule. Tx: topical antibiotic  Scabies: itch mite. Contagious. Tx: scabicide and antihistamine

19. Impetigo

20. Ringworm

21. Inflammatory Conditions Scleroderma: autoimmune. Affects blood vessels & connective tissue that causes hardening. Localized or Systemic Psoriasis: chronic inflammation. Scaly patches. Tx: topical steroids Eczema: most common. Papules, vesicles and crusts. Symptom of underlying condition. Tx: cause & topical steroids Hives: urticaria (transient wheals) due to allergy or irritant. Pruritits (itching). Tx: varies, treat the cause

22. BURNS Caused by fire, ultraviolet rays, electricity, chemicals. Cause will influence tx Severity: extent (total body surface area involved-%) + depth (layers involved) Extent of injury: Rule of 9’s to determine; 11 body areas 9% each Depth of inj: 1 st, 2 nd, 3 rd degree http://www.nlm.nih.gov/medlineplus/tutorials/burns/htm/_no_50_no_0.htm -

23. Rule of 9’s  Estimation of body surface area involved Ant head: 4.5% / Post head:4.5%  Ant arm: 4.5% / Post arm 4.5%  Ant leg: 9% / Post leg 9%  Ant trunk: 18% / Post trunk 18%  Modified in infants due to larger head size

24. Rule of 9’s

25. I ST DEGREE  Surface layers of epidermis  Some reddening and discomfort  No blistering  Sunburn  Partial thickness

26. 2 nd Degree  Deep epidermal and upper dermis  Severe pain and blistering  May damage hair, sweat and oil glands  Swelling (edema) and fluid loss occurs  Scarring results  Partial thickness

27. 2nd Degree

28. 3 rd Degree  Complete destruction of epidermis and dermis; may extend to SQ layer: full thickness burn (4 TH degree if underlying bone/muscle tissue destroyed)  Little pain d/t destruction of nerve endings  Severe fluid loss  If it covers a large extent, the pt is critically ill; ultimately may die due to sepsis

29. 3 rd Degree

30. Diseases and Abnormal Conditions Dermatitis what is this?? Eczema Impetigo Psoriasis Ringworm Verrucae/warts/plantar warts

31. Diseases and Abnormal Conditions Acne vulgaris Athlete’s foot Burns Skin cancer Basal cell carcinoma Squamous cell carcinoma Melanoma