1. Skin = Integument= Cutaneous Membrane
Integumentary System
Skin = Integument= Cutaneous Membrane

2. 7 Functions:
1. Protective covering
2. Regulates body temperature

3. 3. Manufactures Vitamin D
4. Sensory Function
5. Temporary storage of fat, glucose, water and salts

4. 6. Screens out harmful ultraviolet radiation
7. Absorbs certain drugs

5. Structure of the Skin
2 Basic Layers
Epidermis
Dermis

6. Epidermis Outermost covering Epithelial cells
Avascular- no blood vessels

7. Stratum Corneum- surface layer, consists of dead cells rich in keratin (provides a water proof covering & skin barrier).
Contains 4 cell types:
Keratinocytes- produce keratin (protein), flat, scale like cells, Thickest on palms of hands and soles of feet
Merkel Cells- sensory receptors for touch
Melanocytes- produce melanin
Langerhan Cells- helps protect against microorganisms

8. Stratum Germinativum Innermost epidermal layer
Reproductive layer – cells form and push their way up, become keratinized, and replace the top layer
Contains MELANOCYTES – cells that contain pigment -MELANIN

9. Melanin Black, brown or has a yellow tint depending on racial origin
The more melanin the darker the skin
Caucasians do not have much melanin in their melanocytes
Freckles = patches of melanin

10. Tanning Sunlight stimulates melanocytes to make more melanin
Tanning produced by UV rays
Prolonged exposure may lead to skin cancer,
Called ___________?

11. Papillae Ridges in stratum germinativum that arise from dermis
Create permanent ridges in fingers, palms and soles of feet
These friction ridges help
with grip, allows us to hold things
Cause “fingerprints”
Everybody’s is unique to
them

12. Dermis – thicker inner layer that contains:
Connective tissue
Blood vessels
Nerve endings
Hair follicles
Oil and sweat glands
Fat cells

13. Nerve Receptors in Dermis
Sensory nerves – heat, cold, touch, pain, and pressure
Touch receptors close to the surface (epidermis)
Pressure receptors are deeper

14. Subcutaneous Layer (Hypodermal)
Lies under the dermis (not really a true part of the integumentary system)
Made up of loose connective tissue
Contains half of the body’s fat
Attaches the integumentary system to the surface muscles

15. Appendages of the Skin Hair Almost everywhere on the body
Length, thickness, type and color varies

16. Hair cont’d. Outer layer – CORTEX Inner layer – MEDULLA
Part under the skin – ROOT
Part outside the skin – SHAFT
FOLLICLE – pocket in the epidermis, hair inside
PAPILLA – tuft of tissue in the root, contains capillaries

17. Arector Pili Muscle
- smooth muscle attached to follicle, contracts when stimulated, such as by a chill. Produces “goosebumps”
How does this muscle cause goose bumps?

18. Nails Nail is formed in the nail bed or MATRIX
Epidermal cells fuse together and fill with keratin

19. Sweat Glands-”Sudoriferous”
Perspiration is 99% water
Distributed over entire skin surface
Large #’s under arms, palms of hands, soles of feet and forehead
Sweat itself has no odor, gets odor from mixing with bacteria on skin

20. Sweat Glands cont’d.
Duct extends to form a pore in the skin, perspiration excreted through the pores
May be activated by heat, pain, fever, and nervousness
Average loss per day 500 ml

21. Sebaceous Glands
Secretes oil (sebum) that protects and lubricates the skin

22. Skin and Microorganisms
Intact skin is best protection against pathogens, toxins and water loss
Skin generally too dry for microbial growth – microbial growth occurs in moist areas
Most skin bacteria is associated with hair follicles or sweat glands
Underarm perspiration odor caused by bacteria and perspiration

23. The best way to prevent the spread of disease is by hand washing.

24. Disorders of the skin ACNE VULGARIS
Common and chronic disorder of the sebaceous glands
Sebum plugs pores and area fills with leukocytes
Also- blackheads, cysts, pimples and scarring

25. Athlete’s Foot
Contagious fungal infections
Usually contracted in public bathrooms and showers
Rx – antifungal agents

26. Dermatitis Non-specific inflammation of the skin
Can be a rash – reaction to soap, plants, etc
Can be emotional – stress can cause skin blotches

27. Genital Herpes
Viral
Blister in genital area
Spread through sexual contact
Periods of remission and exacerbation
Rx – Acyclovir
Can be passed to a newborn during delivery

28. Skin Cancer
Associated with exposure to the sun (UV rays) AND TANNING BEDS!!! 8X RISK/10 VISITS
3 TYPES:
BASAL CELL CARCINOMA-most common, non malignant
SQUAMOUS CELL CARCINOMA-most common on scalp & lip, spreads to lymph, can be treated if caught early
MALIGNANT MELANOMA- AFFECTS MELANOCYTES, SPREADS RAPIDLY!
NO CURE.

29. Tanning Beds
If you are under age 30 and use tanning beds 10 times or more in a year, your risk of developing melanoma is increased nearly 8 times.
A single tanning bed session increases your risk of melanoma by 22%.

30. Malignant Melanoma Occurs in melanocytes
Metastasizes to other areas quickly
Appears as brown or black irregular patch that occurs suddenly
A change in an existing mole or wart may indicate melanoma
Tx/Rx – surgical removal of melanoma and surrounding area, (chemotherapy), Immunotherapy, Radiation

31. Images Courtesy of: The Skin Cancer Foundation, www.skincancer.org
A, B, C, D RULE
Detection of Skin Cancer
Color
Border
Diameter
Asymmetry
Images Courtesy of: The Skin Cancer Foundation,

32. Reprinted with permission from the American Academy of Dermatology.
Melanoma
About Melanoma
More likely to metastasize than other types of skin cancer
Increased ability to spread makes melanoma more dangerous
When melanoma spreads to other parts of the body, it becomes very difficult to treat  
(3) American Cancer Society. Learn About Skin Cancer – Melanoma
Reprinted with permission from the American Academy of Dermatology.
All rights reserved.

33. Appearance
Tumors generally brown or black due to increased melanin production
Frequently appear on the trunk and lower legs but can occur anywhere on the body including the soles of the feet and between fingers/toes.

34. Treatment Surgical removal of the primary tumor
Removal of surrounding tissue for staging purposes
Removal and examination of any additional suspicious growths
Chemotherapy and radiation may be used in advanced cases
Biological treatments (Immunotherapy),
including interleukin 2 (IL-2) and Ipimulumaub (Ipi or Yervoy)
If BRAF positive gene, other drugs to treat
Investigational treatments
Radiation
DOES NOT respond well to Chemo

35. Terms
Albinism – absence of melanin
Alopecia – baldness, loss of hair

36. Burns
Caused by radiation, sun, boiling water, chemicals, fire or electricity, etc. PG 81 IN TEXTBOOK
Rules of Nines – Measures percent of body burned. Body divided into 11 areas, each is 9% of body surface.
PG. 83 IN TEXTBOOK
Be prepared to calculate burn %’s on test

38. 1* First Degree Burns Superficial Skin red and dry
Involves only epidermis
Rx – cold water
Healing within one week

39. 2* Second Degree Burns Epidermis and dermis
Pain, swelling, redness and blistering
Skin may be exposed to infection
Rx- pain medication, dry sterile dressing
Healing within 2 weeks

40. 3* Third Degree Burns Epidermis, dermis, and subcutaneous layers
Loss of skin, blackened, charred skin. Or may be white and leathery in appearance.
May be life threatening due to high risk of infection, loss of fluids (altered Homeostatsis)