Human Anatomy & Physiology with Pathophysiology MTCC 113 PDF

Disclaimer: The information provided herein are for instructional purposes only. Any use of this material beyond the intended purpose is at the discretion of the user. Make sure that you have the updated document...

Disclaimer: The information provided herein are for instructional purposes only. Any use of this material beyond the intended purpose is at the discretion of the user. Make sure that you have the updated document (Lecture) MTCC 113 HUMAN ANATOMY & PHYSIOLOGY with Pathophysiology Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Disclaimer: The information provided herein are for instructional purposes only. Any use of this material beyond the intended purpose is at the discretion of the user. Learning Objectives The students shall be able to: 1. describe the epidermal layers and the cells that compose them; 2. compare the composition of the dermal layers; and 3. contrast the structure, distribution, and function of hair, skin, glands, and nails. Copyright © 2022 Pearson Education, Ltd. All Rights Reserved.  Disclaimer: The information provided herein are for instructional purposes only. Any use of this material beyond the intended purpose is at the discretion of the user. Make sure that you have the updated document MTCC 113 Vocabulary HUMAN ANATOMY & PHYSIOLOGY with Pathophysiology Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Vocabulary of the Day Term Meaning(s) Example(s) kerat(o)- keratin keratinous hidr(o)- sweat hyperhidrosis trich(o)- hair trichomycosis onych(o)- nail onychia derm(o)- skin dermabrasion Copyright © 2022 Pearson Education, Ltd. All Rights Reserved.  Disclaimer: The information provided herein are for instructional purposes only. Any use of this material beyond the intended purpose is at the discretion of the user. Make sure that you have the updated document Topic 5 MTCC 113 HUMAN ANATOMY & PHYSIOLOGY Integumentary System with Pathophysiology Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Integumentary System Dermatology: medical specialty that deals with the structure, function, and disorders of integumentary system. Integumentary system consists of the: – Skin (cutaneous membrane) – Skin appendages Sweat glands Skin is the largest organ of the Oil glands body in weight. Hair In adults, it covers an area of Nails about 2 square meters and weighs 4.5–5 kg (about 7% of total body weight). Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Functions of the Integumentary System (1 of 2) Insulates and cushion deeper body organs Protects the entire body from: – Mechanical damage (bumps and cuts) – Chemical damage (acids and bases) – Thermal damage (heat or cold) – Ultraviolet (UV) radiation (sunlight) – Microbes (bacteria) – Water loss Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Functions of the Integumentary System (2 of 2) Regulates heat loss as controlled by the nervous system Acts as a mini-excretory system; sweat aids in the loss of – Urea – Salts – Water Synthesizes vitamin D Secretions create a protective acid mantle Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Table 4.1 Functions of the Integumentary System (1 of 2) Functions How accomplished Protects deeper tissues from Physical barrier contains keratin, which toughens cells; fat cells to cushion blows; and Mechanical damage (bumps) both pressure and pain receptors, which alert the nervous system to possible damage. Chemical damage (acids and bases) Has relatively impermeable keratinized cells; contains pain receptors, which alert the nervous system to possible damage. Microbe damage Has an unbroken surface and “acid mantle” (skin secretions are acidic and thus inhibit microbes, such as bacteria). Phagocytes ingest foreign substances and pathogens, preventing them from penetrating into deeper body tissues. Ultraviolet (UV) radiation (damaging Melanin produced by melanocytes offers effects of sunlight or tanning beds) protection from UV damage. Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Table 4.1 Functions of the Integumentary System (2 of 2) Functions How accomplished Aids in body heat loss or heat retention Heat loss: By activating sweat glands and by (controlled by the nervous system) allowing blood to flush into skin capillary beds so that heat can radiate from the skin surface. Heat retention: By not allowing blood to flush into skin capillary beds. Aids in excretion of urea and uric acid Contained in perspiration produced by sweat glands. Synthesizes vitamin D Modified cholesterol molecules in skin converted to vitamin D in the presence of sunlight. Thermal (heat or cold) damage Contains heat/cold/pain receptors. Desiccation (drying out) Contains a water-resistant glycolipid and keratin. Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Structure of the Skin (1 of 11) Two kinds of tissue compose the skin – Epidermis – Dermis Subcutaneous Tissue (Hypodermis) – Anchors the skin to underlying organs – Not technically part of the integumentary system – Composed mostly of adipose tissue – Serves as a shock absorber and insulates deeper tissues Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Figure 4.3 Skin Structure (1 of 2) Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Structure of the Skin (2 of 11) Epidermis—outer layer – Composed of stratified squamous epithelium – Most cells are keratinocytes which produce a fibrous protein called keratin Keratinization makes the epidermis tough Desmosomes connect keratinocytes together – Avascular – Composed of five layers (strata) Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Structure of the Skin (3 of 11) Summary of strata (layers) of the epidermis from deepest to most superficial – Stratum basale – Stratum spinosum – Stratum granulosum – Stratum lucidum (thick, hairless skin only) – Stratum corneum Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Structure of the Skin (4 of 11) Stratum basale (Stratum germinativum) – Deepest layer of epidermis – Lies next to dermis – Wavy borderline with the dermis anchors the two together – Cells undergoing mitosis (mitotic cells) – Daughter cells are pushed upward to become the more superficial layers Stratum spinosum – Cells become increasingly flatter and more keratinized Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Structure of the Skin (5 of 11) Stratum granulosum Stratum lucidum – Formed from dead cells of the deeper strata – Occurs only in thick, hairless skin of the palms of hands and soles of feet Stratum corneum – Outermost layer of epidermis; horny layer – Shingle-like dead cells are filled with keratin (protective protein prevents water loss from skin) Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Figure 4.4 The Main Structural Features of the Epidermis Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Structure of the Skin (6 of 11) Melanin – Melanin is a pigment produced by melanocytes – Melanocytes are mostly in the stratum basale – Yellow (pheomelanin) to brown to black (eumelanin) Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Structure of the Skin (7 of 11) Intraepidermal Dendritic Cells (Langerhans Cells) – Alert and activate immune cells to a threat (bacterial or viral invasion) Merkel Cells (Tactile Epithelial Cells) – Associated with sensory nerve endings – Serve as touch receptors called Merkel discs Pacinian Corpuscle (Lamellated Corpuscle) – Associated with the detection of pressure Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Structure of the Skin (8 of 11) Dermis – Connective tissue – Underlies the epidermis – Two regions Papillary Reticular Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Structure of the Skin (9 of 11) Two regions of the dermis – Papillary layer (upper dermal region) contain projections called dermal papillae Areolar connective tissue Indent the epidermis above Many projections contain capillary loops, and others house pain and touch receptors On palm and sole surfaces, papillae increase friction and gripping ability Fingerprints are identifying films of sweat Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Structure of the Skin (10 of 11) Two regions of the dermis – Reticular layer (deepest skin layer) Dense irregular connective tissue Blood vessels Sweat and oil glands Deep pressure receptors (lamellar corpuscles) Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Figure 4.5 Light Micrograph of the Two Layers of the Dermis !"## !$100 times Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Structure of the Skin (11 of 11) Other dermal features – Cutaneous sensory receptors – Phagocytes – Collagen and elastic fibers – Blood vessels – Nerve supply Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Skin Color (1 of 2) Three pigments contribute to skin color 1. Melanin Yellow, reddish brown, or black pigments 2. Carotene Orange-yellow pigment (also found in some vegetables) 3. Hemoglobin Red coloring from blood cells in dermal capillaries Oxygen content determines the extent of red coloring Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Skin Color (2 of 2) Redness (erythema)—due to embarrassment, inflammation, hypertension, fever, or allergy Pallor (blanching)—due to emotional stress (such as fear), anemia, low blood pressure, impaired blood flow to an area Jaundice (yellow cast)—indicates a liver disorder Bruises (black and blue marks)—hematomas Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Appendages of the Skin (1 of 10) Cutaneous glands are all exocrine glands – Sebaceous glands – Sweat glands Hair and hair follicles Nails Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Figure 4.3 Skin Structure (2 of 2) Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Appendages of the Skin (2 of 10) Sebaceous (oil) glands – Located all over the skin except for palms and soles – Produce sebum (oil) Makes skin soft and moist Prevents hair from becoming brittle Kills bacteria – Most have ducts that empty into hair follicles; others open directly onto skin surface – Glands are activated at puberty with increased androgens Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Figure 4.6a Cutaneous Glands Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Appendages of the Skin (3 of 10) Sweat (sudoriferous) glands – Produce sweat – Widely distributed in skin Two types of sudoriferous glands 1. Eccrine glands 2. Apocrine glands Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Appendages of the Skin (4 of 10) Eccrine glands – More numerous, located all over the body – Open via duct to sweat pores on the skin’s surface – Produce acidic sweat Water, salts, vitamin C, traces of metabolic waste – Function in body temperature regulation Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Figure 4.6b Cutaneous Glands Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Appendages of the Skin (5 of 10) Apocrine glands – Ducts empty into hair follicles in the armpit and genitals – Begin to function at puberty – Release sweat that also contains fatty acids and proteins (milky or yellowish color) – Play a minimal role in body temperature regulation Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Appendages of the Skin (6 of 10) Hair – Located body-wide except for palms, soles, nipples, lips – Produced by hair follicle – Root is enclosed in the follicle – Shaft projects from the surface of the scalp or skin – Consists of hard keratinized epithelial cells – Melanocytes provide pigment for hair color – Hair grows in the matrix of the hair bulb in stratum basale Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Figure 4.7a Structure of a Hair Root and Follicle Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Appendages of the Skin (7 of 10) Hair anatomy – Central medulla – Cortex surrounds medulla – Cuticle on outside of cortex Most heavily keratinized region of the hair – Melanin provides color Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Figure 4.7b Structure of a Hair Root and Follicle Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Figure 4.7c Structure of a Hair Root and Follicle Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Appendages of the Skin (8 of 10) Associated hair structures – Hair follicle Composed of an inner epithelial root sheath and an outer fibrous sheath Dermal region provides a blood supply to the hair bulb (deepest part of the follicle) Arrector pili muscle connects to the hair follicle to pull hairs upright when we are cold or frightened Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Figure 4.7d Structure of a Hair Root and Follicle Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Appendages of the Skin (9 of 10) Nails – Heavily keratinized, scalelike modifications of the epidermis – Stratum basale extends beneath the nail bed, which is responsible for growth – Lack of pigment makes nails colorless Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Appendages of the Skin (10 of 10) Parts of a nail – Free edge – Body is the visible attached portion – Nail folds are skin folds that overlap the edges of the nail; the cuticle is the proximal edge – Root of nail is embedded in skin – Growth of the nail occurs from nail matrix of nail bed Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Figure 4.8 Structure of a Nail Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Homeostatic Imbalances of Skin (1 of 13) Infections and allergies – Athlete’s foot Caused by fungal infection (Tinea pedis) Itchy, red peeling skin between the toes – Boils (furuncles) and carbuncles Caused by inflammation of hair follicles Carbuncles are clusters of boils caused by bacteria – Cold sores (fever blisters) Caused by human herpesvirus 1 Blisters itch and sting Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Homeostatic Imbalances of Skin (2 of 13) Infections and allergies – Contact dermatitis Caused by exposure to chemicals that provoke allergic responses Itching, redness, and swelling of the skin – Impetigo Caused by bacterial infection Pink, fluid-filled raised lesions around mouth/nose – Psoriasis Triggered by trauma, infection, hormonal changes, or stress Red, epidermal lesions covered with dry, silvery scales that itch, burn, crack, or sometimes bleed Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Figure 4.9 Cutaneous Lesions Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Homeostatic Imbalances of Skin (3 of 13) Burns – Tissue damage and cell death caused by heat, electricity, UV radiation, or chemicals – Associated dangers Protein denaturation and cell death Dehydration and electrolyte imbalance Circulatory shock – Result in loss of body fluids and infection from the invasion of bacteria Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Homeostatic Imbalances of Skin (4 of 13) Extent of a burn is estimated using the rule of nines – Body is divided into 11 areas for quick estimation – Each area represents about 9 percent of total body surface area The area surrounding the genitals (the perineum) represents 1 percent of body surface area Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Figure 4.10a Burns Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Homeostatic Imbalances of Skin (5 of 13) First-degree burn (superficial burn) – Only epidermis is damaged – Skin is red and swollen Second-degree burn (superficial partial-thickness burn) – Epidermis and superficial part of dermis are damaged – Skin is red, painful, and blistered – Regrowth of the epithelium can occur Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Homeostatic Imbalances of Skin (6 of 13) Third-degree burn (full-thickness burn) – Destroys epidermis and dermis; burned area is painless – Requires skin grafts, as regeneration is not possible – Burned area is blanched (gray-white) or black Fourth-degree burn (full-thickness burn) – Extends into deeper tissues (bone, muscle, tendons) – Appears dry and leathery – Requires surgery and grafting – May require amputation Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Figure 4.10b Burns Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Figure 4.10c Burns Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Homeostatic Imbalances of Skin (7 of 13) Criteria for deeming burns critical (if any one is met): – Over 30 percent of body has second-degree burns – Over 10 percent of the body has third- or fourth-degree burns – Third- or fourth-degree burns of the face, hands, feet, or genitals – Burns affect the airways – Circumferential (around the body or limb) burns have occurred Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Homeostatic Imbalances of Skin (8 of 13) Skin cancer – Most common form of cancer in humans – Most important risk factor is overexposure to ultraviolet (UV) radiation in sunlight and tanning beds Cancer can be classified two ways 1. Benign means the neoplasm (tumor) has not spread 2. Malignant means the neoplasm has invaded other body areas Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Concept Link Recall that mitosis gone wild is the basis for cancer (Chapter 3, pp. 104–105). These cells lack normal control of cell division and divide quickly, resulting in errors during DNA replication, mitosis, or both. Cells experiencing rapid, uncontrolled growth become cancerous and can metastasize (spread) to other parts of the body. Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Homeostatic Imbalances of Skin (9 of 13) Most common types of skin cancer – Basal cell carcinoma – Squamous cell carcinoma – Malignant melanoma Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Homeostatic Imbalances of Skin (10 of 13) Basal cell carcinoma – Least malignant and most common type of skin cancer – Arises from cells in stratum basale that are altered so that they can no longer make keratin – Lesions appear as shiny, dome-shaped nodules that develop a central ulcer Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Figure 4.11a Photographs of Skin Cancers Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Homeostatic Imbalances of Skin (11 of 13) Squamous cell carcinoma – Believed to be induced by UV exposure – Arises from cells of stratum spinosum – Lesions appear as scaly, reddened papules that gradually form shallow ulcers – Early removal allows a good chance of cure – Metastasizes to lymph nodes if not removed Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Figure 4.11b Photographs of Skin Cancers Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Homeostatic Imbalances of Skin (12 of 13) Malignant melanoma – Most deadly of skin cancers, but accounts for only 5 percent of skin cancers – Cancer of melanocytes – Metastasizes rapidly to lymph and blood vessels – Detection uses ABCDE rule for recognizing melanoma Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Homeostatic Imbalances of Skin (13 of 13) Malignant melanoma – A = Asymmetry Two sides of pigmented mole do not match – B = Border irregularity Borders of mole are not smooth – C = Color Different colors in pigmented area – D = Diameter Spot is larger than 6 m m in diameter illi eters – E = Evolution One or more of the ABCD characteristics is evolving Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Figure 4.11c Photographs of Skin Cancers Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Developmental Aspects of Skin and Body Membranes (1 of 2) Lanugo, a downy hair, covers the body by the fifth or sixth month of fetal development but disappears by birth Vernix caseosa, an oily covering, is apparent at birth Milia, small white spots, are common at birth and disappear by the third week Acne may appear during adolescence Pimples, scales, and dermatitis are more common with aging skin Copyright © 2022 Pearson Education, Ltd. All Rights Reserved. Developmental Aspects of Skin and Body Membranes (2 of 2) In youth, skin is thick, resilient, and well hydrated With aging, skin loses elasticity and thins Skin cancer is a major threat to skin exposed to excessive sunlight Balding (alopecia) and/or graying occurs with aging; both are genetically determined; other factors that may contribute include drugs and emotional stress Copyright © 2022 Pearson Education, Ltd. All Rights Reserved.