1. Anatomy and Physiology The Integumentary System (Skin)

2. Skin Cutaneous Membrane With its derivatives they make up the Integumentary System –Sebacous glands –Sweat glands –Hair nails

3. Functions of the Integ. System Covers the body Waterproofs Protects from mechanical, chemical, and bacterial damage Helps maintain body temperature –Capillary network –Sweat glands

4. More Functions Protects from UV radiation –Melanin Produces Vitamin D Sensory Perception –Pressure –Pain –temperature

5. Epidermis 5 Layers of avascular tissue Most of the cells are keratinocytes Deepest layer is Stratum Basale Most nourished Site of mitosis Melanocytes (freckles and moles) Cells move superficially through the next two layers (flatten and keratiniized) Stratum Spinosum Stratum Granulosum

6. Epidermis Cont Dead cells form the outer two most layers Stratum Lucidum (palms and soles) Stratum Corneum 20-30 cells thick Shed on a continual basis (40lbs in lifetime) Replaced in 25-45 days

9. Dermis Dense Fibrous Connective Tissue Outer layer s the papillary layer –Named for the papillae (peg-like projections) –Many house capillaries that nourish the epi –May contain nerve endings and touch receptors (Meissner’s corpuscles –Forms the fingerprints

10. Reticular Layer Blood vessels –Help in maintaining temperature Sweat glands Oil glands Pressure sensors (pacinian corpuscles) Collagen for tensile strength and elastic fibers for elasticity

13. Homeostatic Imbalance Prolonged pressure on the skin can cut off blood supply Can result in cell death Decubitus Ulcers –Bedsores From not turning patients

14. Skin Color Melanin –Brown, black to yellow Carotene –Yellow-Orange Hemoglobin –Red from RBC’s picking up oxygen –Gives Caucasian's their pink color –Poor O 2 causes cyanosis (blue)

15. Skin color variation Redness or erythema –Blushing, fever, hypertension, inflammation, or allergy Palor (Pale) –Stress, anemia, hypotension, ischemia Jaundice (yellowing) – liver disorder –Bile pigments circulating Bruises (black and blue) –Blood into tissue (hematoma) –Vitamin C deficiency or hemophilia?

17. Skin Appendages Exocrine Glands –Release secretions to the skin via ducts Sebaceous glands (sebum) –Open to hair follicle or to the surface –Lubrication and anti-bacterial –Increase in teenage years in response to testosterone Sweat Glands (sudoriferous) –Eccerine produce sweat (pH 4-6) released via a duct/pore »Heat regulation –Apocrine produce a substance high in protein and fatty acid »Found axillary and groin »As bacteria break the substance down creates odor

18. Apocrine Glands Activated by stress and sexual arousal

19. Hair and Hair Follicles The body has 1,000,000’s of hairs Not much function –Eyelashes and nose hairs filter Deepest part below the surface is the root Hair above the surface is called the shaft –Most of it is dead keratinized cells None on hands, feet, nipples and lips Hormones determine growth of some areas –Scalp, axillary, and groin regions

20. Hair Structure Central core is the medulla Cortex is the middle layer Cuticle is outermost layer –Most keratinized –Wears away to cause split ends Pigment from melanocytes Shaft shape determines hair texture

21. Hair Follicles Site of hair production Hair formed by division of stratum basale in the matrix As cells mature the migrate outward, die and become keratinized Dermal sheath outside an epidermal sheath –Dermal supplies nutrients to the matrix Arrector pili stands hair up

23. Nails

24. Scale like modification of the epidermis –Body is exposed and root is hidden Nail bed is thickened stratum Basale –Proximal end is the nail matrix site of nail growth –Damage the matrix and nail regrowth is stunted

25. Homeostatic Imbalance Wide range of over 100 different ailments –Very visible when something is wrong Allergies Infections –Bacterial, viral or fungal Burns Cancer

26. Infections and Allergies Athletes foot (tinea pedius) –Fungal infection –Red peeling skin Boils and carbuncles –Inflamed hair follice and sebaceous gland –Bacterial infection Cold Sores –Viral infection (herpes simplex) in cutaneous nerve –Activated by emotion, fever, or sun

27. Infections and Allergies Contact dermatitis –Allergic reaction to chemical –Itching red skin Impetigo –Pink weepy lesions that develop a crust and rupture –Highly contagious staphlococcus infection Psoriasis –Overpopulation of skin cells –Red lesions with scaly skin that itches and burns –Perhaps auto immune

28. Pictures

29. Burns Damage to the skin caused by heat, electricity, UV, or chemical Very serious threat! –Effects many systems –Dehydration and electrolyte imbalance Kidney damage shock –Infection Leading cause of death in burn victims

30. Burn Estimation To determine the extent of fluid loss the rule of 9’s is used 11 areas of 9% and 1% for genitals

31. Burn classification 1 st Degree –Epidermis only –Heals in 2-3 days ex: sunburn 2 nd Degree –Involves the epidermis and dermis –Blistering occurs 3 rd Degree –Full thickness of the skin is destroyed –Painless due to loss of nerves –Skin grafting must be done Critical if any of the following 1.25% has 2 nd degree 2. 10% 3 rd degree 3.3 rd degree on hands, face or feet –Facial can hinder breathing –Joint issues in hands and feet

32. Burn Pictures First Degree Second Degree Third Degree

33. Skin Cancer Tumors are referred to as neoplasms –Benign do not spread –Malignant invade other body tissues Skin cancer is the most common type of cancer in humans –1/5 develop in lifetime Overexposure to UV is the greatest risk factor

34. Skin Cancers 1.Basal Cell Carcinoma Least malignant and most common Affects the stratum basale Cells invade dermis and sub-q creating a small raised nodule Cure rate 99%

35. 2.Squamous Cell Carcinoma Stratum Spinosum Scaly papule turns into shallow ulcer with raised border Scalp, ears, hands, and lips Sun induced? Good chance with early detection and treatment

36. 3.Malignant Melanoma Cancer of the melanocytes Only about 5% but increasing Often develop from a mole Rapid metastasis 50% survival rate with excision and immuno Use ABCD rule in examination

37. ABCD Rule A.Asymmetry B.Border Irregularity C.Color Spot contains different pigments Black, brown, tan, red, blue D.Diameter Greater than 6mm (E. Elevation)

39. Developmental Aspects of Skin Prenatal to newborn  Lanugo- hairs  Vernix Caseous- cheese from seb gland  Milia- baby pimples Adolescence  Skin and hair oily ----  acne Old age  Skin gets thinner and drier  Colder and bruising  Loss of elasticity leads to wrinkles (smoke, UV)

40. Developmental Aspects of Hair Hair looses luster Lose follicles over time –Thinning hair is called alopecia –May be male pattern baldness Hairs may become gray –Delayed action gene shuts down melanin production Stress, chemical, nutritional, radiation, and fungi are all possible causes