1. Integumentary System

2. Three main layers of tissue make up the skin
Epidermis
Dermis
Hypodermis

3. Epidermis The Outermost layer of skin Avascular
Complete regeneration approximately 35 days

4. Dermis Also called corium or “true skin”.
Contains blood vessels, nerves, involuntary muscle, sweat and oil glands and hair follicles.

5. Hypodermis (Subcutaneous Fascia)
Innermost layer of skin
Made of elastic and fibrous connective tissue and adipose tissue
Connects skin to underlying muscles

6. Two main types of glands
Sudoriferous Glands
Sebaceous Glands

7. Sudoriferous Glands (Sweat Glands)
Coiled tubes.
Extend through dermis and open on surface of skin at pores.
Sweat eliminated by these glands.

8. Sebaceous Glands Oil glands. Usually open to hair follicles.
Produces sebum which is an oil that keeps skin and hair from becoming dry and brittle.

9. Hair & Nails
Hair
Each hair consists of root which grows in hollow tube (follicle) and a hair shaft.
Helps protect body.

10. Hair & Nails
Nails
Consist of dead epithelial cells packed closely together to form thick, dense surface.
Formed in nailbed.

11. Function of Integumentary System
Protection
Serves as barrier to sun’s ultraviolet rays and invasion of pathogens (germs).
Hold moisture in .
Prevents deeper tissues from drying out.

12. Sensory Perception
Nerves in skin help body to respond to pain, pressure, temperature, and touch sensations.

13. Body Temperature Regulation
Blood vessels dilate- excess heat from blood escapes through skin.
Blood vessels constrict – heat is retained in body.

14. Excretion of oil, water, sodium and carbon dioxide.
Waste Disposal
Excretion of oil, water, sodium and carbon dioxide.

15. Vitamin D production.

16. Pigmentation Melanin Only pigment made in skin.
Yellow to reddish-brown to black
Absorbs ultraviolet light to tan skin.
Gives color to hair, skin, and the iris

17. Karotene
Yellowish-red pigment
Can help determine skin color.

18. Abnormal Skin Colors Jaundice Yellow discoloration of skin.
Can indicate bile in blood due to liver or gallbladder disease

19. Erythema
Reddish color of skin.
Due to burns or congestion of blood vessels

20. Cyanosis
Bluish discoloration of skin.
Caused by insufficient oxygen.
Associated with heart, lung, and circulatory diseases or disorders.

21. Skin Diseases and Disorders
Acne – overactive secretion of sebaceous glands.
Pimples and blackheads.
Teens to early twenties.
Rx: Thorough washing, steroid creams, UV light, avoidance of certain foods, chemical face peel.

22. Eczema
Vesicles or reddened skin which burst and weep a crust ( dried pus and blood)
Most common inflammatory disorder of the skin
Rx: Tranquilizers, antihistamines, wet dressings, starch baths.

23. Psoriasis
Psoriasis – Red thick areas covered with white or silver scales
Chronic, noncontagious, inherited skin disease
Rx: No Cure
Cortisone Ointments
Ultraviolet Light
Removal of Scales

24. Contact Dermatitis Redness, itching, blisters, edema
Caused by poison ivy, poison oak, cleansing agents, cosmetics, etc.
Rx: Wash with soap and water then apply alcohol and antipruritic (relieves itching) lotions.

25. Impetigo Erythema, vesicles with sticky yellow crusts Very contagious.
Infection with staph or strep
Rx: Remove crusts and apply antibiotic ointment

26. Warts Caused by virus. Painless except for plantar warts.
Rx: Nitric or sulfuric acid deep into root of wart or freezing with liquid nitrogen.

27. Scleroderma
systemic autoimmune disease of skin, muscles, bones, heart, lungs. Skin becomes hard and tight.
Progressive disease. Mainly affects women in child bearing years. Considered an auto immune disease
Rx: Ointment, heat, massage, steroids.

28. Skin Cancer
Definition: neoplasms or abnormal growth of cells that originate in the epidermis.
More than 800,000 new cases each year in the USA
One in five people in the US will develop skin cancer in his/her lifetime. This number jumps to one in three in the Sunbelt states.
Three Major Types of Skin Cancer
Basal Cell, Squamous Cell, Malignant Melanoma

29. Skin Cancer Basal Cell Carcinoma Most common type of skin cancer
Malignancy begins in cells at the base of the epidermis and most often appears on the nose and face
Incidence increases after age 40
Basal cell tumors rarely metastasize but may cause wide-spread destruction of normal tissue if left untreated

30. Skin Cancer Squamous Cell Carcinoma Slow-growing
Arises from the epidermis
Most frequently occurs in middle-aged and elderly individuals
Typically found on sun-exposed areas of skin
May metastasize but is not likely to spread to other body areas.

31. Skin Cancer Malignant Melanoma Most deadly of all skin cancers
Steady increase in incidence of 4% per year over last 20 years
Median age of diagnosis is 53 years
Sometimes develops from a pigmented Nevus (mole) to become a dark spreading lesion
Most likely to metastasize

32. Skin Cancer
Malignant Melanoma

33. Skin Cancer http://www.skincancer.org/
“ABCD” Rule of Self-Examination of Moles
Asymmetry: Lesion halves are not mirror images of each other giving a lopsided appearance
Border: Irregular or indistinct borders
Color: Unevenly colored, exhibiting a mixture of shades or colors
Diameter: By the time lesions exhibit characteristics A, B, and C, it is probably larger than 6mm or ¼ inch

34. BURNS
Burn is an injury that can be caused by fire, heat, chemical agents, radiation and/or electricity
Classification of burns: Severity of burn is determined by depth of lesion and percent of body surface burned.

35. Burns First-degree or superficial Least severe type of burn
Involves only top layer of skin, the epidermis
Usually heals in 5 to 6 days without permanent scarring
Skin is reddened or discolored
May have some mild swelling
Victim feels pain
Three common causes
Overexposure to sun or mild sunburn
Brief contact with hot objects or steam
Exposure of skin to weak acid or alkali

36. Burns Second-degree or partial-thickness
Usually causes injury to top layers of skin and involves both epidermis and dermis
Blister or vesicle forms
Skin is red or has mottled appearance
Swelling occurs along with severe pain
Surface of skin appears to be wet
Painful burn that may take 3 to 4 weeks to heal
Three common causes
Excessive exposure to sunlamp or artificial radiation or severe sunburn
Contact with hot or boiling liquids
Burns from fires

37. Burns Third-degree or full-thickness Most severe type of burn
Involves injury to all layers of skin in addition to underlying tissue
Area has a white or charred appearance
Can be extremely painful or relatively painless if nerve endings are destroyed
Can be life-threatening because of fluid loss, infection, and shock
Common causes
Exposure to fire or flames
Prolonged contact with hot objects
Contact with electricity
Immersion in hot or boiling liquids

38. Burns Methods to Determine Percent of Body Surface Burned
“Rule of Palms”: Based on the assumption that palm size of burn victim is about 1% of body surface. Estimating the number of “palms” burned will approximate the percentage of body surface involved.

39. Burns Methods to Determine Percent of Body Surface Burned
“Rule of Nines”:
9% of total skin area covers head and each upper extremity, including front and back surfaces
18%of total skin area covers each of the following:
front of trunk
back of trunk
each lower extremity including front and back surfaces

40. Burns Methods to Determine Percent of Body Surface Burned
Lund-Browder Charts:
Permits more accurate estimates of burned surface area in children
Makes allowances for large percent of surface are in certain body regions in children such as the head

41. Burns Medical help for burns
Usually not required for first-degree or superficial burns
Should be obtained if:
More than 15% of adult’s body is burned
More than 10% of child’s body is burned
Rule of nines is used to calculate the percentage of body surface burned
Burns affect face or respiratory tract
Victim is having difficulty breathing
Burns cover more than one body part
Victim has a partial-thickness burn and is under 5 or over 60 years of age
Burns result from chemicals, explosions, or electricity

42. Burns
All third-degree or full-thickness burns should receive medical care
First aid for superficial and mild partial-thickness burns with closed blisters
Cool area by flushing with large amounts of cool water
Do not use ice or ice water because it causes body to lose heat
Use dry, sterile gauze to blot area dry
Apply dry, sterile dressing (nonadhesive or nonstick is best) to prevent infection
Elevate affected part if possible to reduce swelling
Do not apply oils, grease, butter or other substances unless instructed to do so by physician
Do not break or open any blisters as this creates an open wound prone to infection

43. Burns
First aid for severe second-degree and full-thickness or third-degree burns
Call for medical help immediately
Cover burned area with thick, sterile dressings
Elevate Hands or feet if they are burned
Do not allow victim to walk if feet or legs are burned
Do not attempt to remove particles of clothing from burn
Watch for respiratory distress or signs of shock

44. Burns