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

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

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

Components of the Skin

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

The Layers of Skin

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

Hair Functions  Varies by location  Scalp: insulates head; 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

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

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

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

Skin Color—Abnormal Erythema Jaundice Cyanosis

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

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

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

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

Chicken Pox

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

Impetigo

Ringworm

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

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 -

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

Rule of 9’s

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

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

2nd Degree

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

3 rd Degree

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

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