Anatomy and Physiology: The Integumentary System PDF

ANATOMY AND PHYSIOLOGY: THE INTEGUMENTARY SYSTEM  THE INTEGUMENTARY SYSTEM Consists of the skin and accessory structures such as the hair, glands, and nails The appearance of the skin can indicate physiologic imbalances in the body Functions...

ANATOMY AND PHYSIOLOGY: THE INTEGUMENTARY SYSTEM  THE INTEGUMENTARY SYSTEM Consists of the skin and accessory structures such as the hair, glands, and nails The appearance of the skin can indicate physiologic imbalances in the body Functions Protection Sensation Vitamin D production Temperature regulation Excretion  SENSATION An important function of the skin dermis is to detect the different sensations of heat, cold, pressure, contact and pain.  PROTECTION ❖Skin is an elastic covering. It protects you against exposure to dangerous things in the environment such as bacteria. ❖Also repels water, minimizes water loss from the body and protects underlying structures such as blood vessels, nerves and organs.  THERMOREGULATION ❖Is a process that allows the body to maintain its core internal temperature. ❖ How is skin involved in thermoregulation?  SECRETION ▪The skin plays a part in the secretory functions in the body. Sebum (oil) secreted by sebaceous glands has antifungal and antibacterial properties and helps maintain the texture of the skin.  THE SKIN LAYERS ▪The skin consists of two layers: the epidermis, and a deeper layer of dense irregular connective tissue, the dermis (also known as the corium). SKIN LAYERS EPIDERMIS Epidermis. This is the outer, relatively thin layer of the skin that is composed of closely packed cells with little intercellular material. It is composed of stratified squamous epithelium that in most areas can be divided into different sub-layers. SUB – LAYER OF EPIDERMIS  STRATUM CORNEUM It forms the outermost layer of the epidermis and consists of dead cells completely filled with protein called keratin. ▪These keratinized cells are constantly in the process of flaking off the surface of the skin in the form of dandruff. And exposed to the outside environment.  STRATUM LUCIDUM The Stratum Lucidum is a smooth, seemingly translucent layer of the epidermis located just above the stratum granulosum and below the stratum corneum. The keratinocytes that compose the stratum lucidum are dead and flattened. These cells are densely packed with eleiden, a clear protein rich in lipids, derived from keratohyalin. STRATUM GRANULOSUM The Stratum Granulosum is a Latin term, which literally means granular layer. This layer is found in between the stratum corneum (or stratum lucidum,when present) and the stratum spinosum. These keratinocytes are particularly referred to as granular cells. STRATUM GRANULOSUM They contain keratohyalin granules, which aid in the binding of the keratin filaments together. These cells also have lamellar bodies filled with lipids, which are released into the extracellular space through exocytosis. LIPIDS These diverse compounds that make up the lipid family are grouped because they are insoluble in water. They are also soluble in other organic solvents such as ether, acetone, and other lipids.  STRATUM SPINOSUM ❑ The keratinocytes in the Stratum Spinosum are referred to as prickle cells. This layer is found in between the stratum basale and the stratum granulosum. These keratinocytes are polyhedral in shape and with large pale-staining nuclei. They are actively synthesizing fibrillary proteins that are essential for the formation of desmosomes. STRATUM BASALE oThe Stratum Basale (also called the stratum germinativum) is the deepest epidermal layer and attaches the epidermis to the basal lamina. DERMAL PAPILLAE  DERMIS Composed of dense collagenous connective tissue containing fibroblasts, adipocytes, and macrophages Nerves, hair follicles, smooth muscles, glands, and lymphatic vessels extend into the dermis Collagen and elastic fibers are responsible for the structural strength of the dermis HYPODERMIS ❖The hypodermis is composed of loose connective tissue that separates the dermis from underlying structures such as bone and deep fascia. ❖It permits a layer of fat to be interposed between the skin and deeper structures. CLEAVAGE LINES CLEAVAGE LINES BLEPHAROPLASTY  INJECTIONS Intradermal injection – skin test Subcutaneous injection – insulin injection Intramuscular injection - vaccines INTRADERMAL INJECTION SUBCUTANEOUS INJECTION INTRAMUSCULAR INJECTION  SKIN COLOR Factors that determine skin color 1. Skin pigments 2. Blood circulating through the skin 3. Thickness of the stratum corneum  MELANIN Pigments primarily responsible for skin,hair, and eye color Protects against UV light Produced by Melanocytes MELANOCYTE WHAT CONDITION? VITILIGO  VITILIGO Non-contagious, non-life-threatening May start at any age, but often appears before age 20 Of unknown cause, may be autoimmune in nature Melanocytes either die or become non-functional ALBINISM  ALBINISM Congenital disorder caused by lack of skin pigments Caused by mutation in the TRP-1 gene leading to deficiency of an enzyme (Tyrosinase) required in melanin production Two types Oculocutaneous Ocular Associated with a number of vision defects, such as photophobia, nystagmus, and amblyopia No treatment, managed through lifestyle adjustments  MELANIN Production is determined by 1. genetic factors 2. exposure to light 3. hormones CHLOASMA – MASK OF PREGNANCY CYANOSIS BIRTHMARKS  SUBCUTANEOUS TISSUE Supplies the skin with blood vessels and nerves Loose connective tissue, including adipose tissue that contains about half the body’s stored lipids Serve as padding and insulation ACCESSORY SKIN STRUCTURES ❖The skin is covered HAIRS by hairs. ❖The visible portion of the hair is called the shaft while the cells embedded in the skin form the root. ❖Each hair strand is composed of three parts: the cuticle, cortex and medulla.  TYPES OF HAIRS Terminal hair is the type of natural hair to which most people refer in their everyday lives. It is the type of hair that grows on your head, in your pubic regions and on almost all parts of your body. Vellus hair, frequently referred to as “peach fuzz,” is the short, fine, colorless hair found all over the body. During puberty, vellus hair can turn into intermediate or terminal hair. Lanugo is the special downy hair that completely covers the human baby inside the womb. HAIR HAIR ANDROGENIC ALOPECIA ALOPECIA AREATA HIRSUTISM  PEDICULOSIS (LICE INFESTATION) PEDICULOSIS TREATMENT  GLANDS Sebaceous glands – simple branched acinar glands which produce sebum by holocrine secretion Sweat glands Eccrine sweat glands - simple, coiled tubular glands which release sweat by merocrine secretion Apocrine sweat glands – simple, coiled tubular glands that produce a thick secretion released by merocrine secretion GLANDS Group of cells that remove materials from the blood The glands of the skin are chiefly of two kinds, sudoriferous and sebaceous. SEBACEOUS GLAND ❑ Sebaceous gland, small oil producing gland present in the skin of human. Sebaceous glands are usually attached to hair follicles and release a fatty substance, sebum, into the follicular duct and to the surface of the skin.  The glands are distributed over the entire body with the exception of the palms of the hands and the soles of the feet; they are most abundant on the scalp and face. SUDORIFEROUS Sudoriferous sweat glands, from Latin ‘sudor’ meaning ‘Sweat’, are small tubular structures of the skin that produce sweat.  Sweating leads to a loss of heat in the body owing to the fact that heat is required to evaporate water in the sweat.  TWO TYPES OF SWEAT GLANDS ❖Merocrine or Eccrine glands – not associated with hair follicles and found in most parts of the body; numerous in the palms and soles. Eccrine sweat is an important mechanism for temperature control. ❖Apocrine types – connected to hair follicles and reach deeply into the subcutaneous layer of the skin. They are found in certain regions of the body such as the armpits, anogenital area , navel and nipples. SECRETION OF GLANDS NAILS BEAU LINES MEES’ LINES MUEHRCKE’S LINES CLUBBING  PHYSIOLOGY OF THE INTEGUMENTARY SYSTEM Sensation Vitamin D production Temperature regulation Excretion JAUNDICE RINGWORM – NOT DUE TO WORMS HERPES SIMPLEX INFECTION HERPES SIMPLEX VIRUS FUNGAL INFECTION  VARICELLA (CHICKENPOX) SHINGLES  SHINGLES – DUE TO HERPES ZOSTER/VARICELLA ZOSTER VIRUS NEUROFIBROMATOSIS DECUBITUS ULCER DECUBITUS ULCER DECUBITUS ULCER  PREVENTION OF DECUBITUS ULCERS (BEDSORES) Check the patient’s body everyday from head to toe Early signs of pressure ulcers: 1. Skin redness 2. Warm areas 3. Spongy or hard skin 4. Breakdown of the top layers of skin Patient’s position must be changed every 1 to 2 hours to keep the pressure off any one spot Sheets and clothing should be dry and smooth, with no wrinkles DO NOT raise the head of the bed to more than a 30- degree angle. Sliding down may further harm the skin. BURNS RULE OF NINES FOR BURN ASSESSMENT  SKIN CANCER Three main types Basal Cell Carcinoma – most common, begins with cells in stratum basale and extends into the dermis to produce an open ulcer Squamous Cell Carcinoma – develops from cells immediately superficial to the stratum basale; nodular, keratinized tumor Malignant Melanoma – rare form of skin cancer that arises from melanocytes SKIN CANCER SKIN CANCER