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Unit 12 Introduction to Medical Terminology, Ehrlich Protection – Barrier to sun & invasion of pathogens, holds moisture in & prevents body tissues from drying out Sensory Perception – Nerves in the skin help body respond to pain, pressure, temperature & touch sensations Body Temperature – Blood vessels in skin help body retain or lose heat. Sudoriferous glands help cool body through evaporation of perspiration Storage - Tissues for temporary storage of fat, glucose(sugar), water, vitamins,& salts Absorption – Substances can be absorbed through skin, ex. Medications (creams, patches) called transdermal medications Excretion – Eliminate salt, a minute amount of waste, and excess water and heat through perspiration Production – Helps in the production of vitamin d by using ultraviolet rays from sun to form an initial molecule of vitamin D that matures in the liver Sebaceous Glands – secrete sebum (oil) that lubricates the skin and discourages the growth of bacteria on skin Sudoriferous Glands – (Sweat), help regulate body temperature and water content by secreting sweat. Small amount of metabolic waste also secreted. Hair – Helps control loss of body heat Nails – Protect the dorsal surface of the last bone of each toe & finger Covers the external surfaces of the body. Average adult has two square yards of skin, making it the largest bodily organ Cutaneous means relating to skin Skin is a complex system of specialized tissues & is made up of three basic layers: ◦ Epidermis ◦ Dermis ◦ Subcutaneous layer Epidermis - outermost layer of skin, made up of several specialized epithelial tissues ◦ Epithelial Tissues – form protective covering for all internal & external surfaces of body ◦ Squamous Epithelial Tissues – Forms upper layer of epidermis, consists of flat, scaly cells that are continuously shed ◦ Does not contain blood vessels or connective tissue, is dependent on lower layers for nourishment Epidermis ◦ Basal Layer – Lowest layer of epidermis. Here cells are produced and then pushed upward. When these cells reach the surface, they die & become filled with keratin. ◦ Keratin – fibrous, water-repellent protein. Soft keratin is primary component of the epidermis. Hard keratin found in hair & nails Epidermis ◦ Melanocytes – Special cells found in the basal layer. Produce & contain a dark brown to black pigment called melanin. Type & amount of melanin pigment determines color of skin. ◦ Melanin – has important function of protecting the skin against some of the harmful ultraviolet rays of the sun. Known as the corium & the true skin, thick layer of living tissue directly below the epidermis. Contains connective tissue, blood & lymph vessels, and nerve fibers. Contains the associated structures of the skin, which are the hair follicles plus the sebaceous & sudoriferous glands Sensory nerve endings in dermis are the sensory receptors stimuli such as touch, temperature, pain and pressure Collagen – Means glue, is a tough flexible, fibrous protein material found in the skin and in the bones, Cartilage, tendons & ligament Mast Cells – Found in the connective tissues of the dermis, respond to injury, infection, or allergy by producing and releasing substances, including heparin & histamine Heparin – is released in response to an injury, is an anticoagulant. An anticoagulant prevents blood clotting Histamine – Which is released in response to allergens, causes the signs of an allergic response, including itching and increased mucus secretion Subcutaneous Layer – Located just below the skin, connects the skin to the surface muscles Layer is made up of loose connective tissue and adipose tissue. Adipose means fat Cellulite – Term sometimes used to describe deposits of dimpled fat, is really just simply ordinary fat. Lipocytes – (fat cells) are predominant in the subcutaneous layer where they manufacture and store large quantities of fat Sebaceous Glands – Located in the dermis layer of the skin and are closely associated with hair follicles ◦ Secretes sebum which is released through ducts opening into the hair follicles. From here, the sebum moves onto the surface & lubricates the skin ◦ Sebum is slightly acidic, discourages the growth of bacteria on the skin ◦ Milk-producing mammary glands, which are modified sebaceous glands, are sometimes classified with the integumentary system. They are also part of the reproductive system Sudoriferous Glands – (Sweat Glands) are tiny, coiled glands found on almost all body surfaces. Most numerous in palms or hands, soles of feet, forehead, & armpits ◦ Pores – are openings on the surface of the skin for the ducts of the sweat glands ◦ Perspiration – (Sweat) is secreted by sweat glands and is made up of 99% water plus some salt & metabolic waste products ◦ Perspiring – (Sweating) one way the body excretes excess. Body odor associated with sweat comes from interaction of perspiration with bacteria on the skin’s surface ◦ Hidrosis – Production & excretion of sweat Hair - rod-like structures composed of tightly fused dead protein cells filled with hard keratin. Darkness & color of the hair is determined by the amount & type of melanin produced by the melanocytes that surround the core of the hair shaft ◦ Hair Follicles – sacs that hold the root of the hair fibers. Shape of the follicle determines whether the hair is straight or curly ◦ Dead Hair Tissue – appears to grow because cells at the base of the follicle divide rapidly & push old cells upward. As they are pushed upward they harden and undergo pigmentation Hair ◦ Arrector pili – tiny muscles fibers attached to the hair follicles that cause the hair to stand erect. ◦ In response to cold or fright, these muscles contract, causing raised areas of skin known as goose bumps. This action reduces heat loss through the skin. Unguis – Commonly know as a fingernail or toenail, is the keratin plate protecting the dorsal surface of the last bone of each finger and toe. Each nail consists of these parts: ◦ Nail Body – translucent, closely molded to the surface of the underlying tissues. Made up of hard, keratinized plates of epidermal cells ◦ Nail Bed – joins the nail body to the underlying connective tissue, nourished the nail. The blood vessels here give he nail its characteristic pink color Unguis ◦ Free Edge – Portion of the nail not attached to the nail bed, extends beyond the tip of the finger or toe ◦ Lunula – Pale half moon-shaped region at every nail root that is generally most easily seen in thumb nail. This is the active area of the nail, where new keratin cells form. ◦ Cuticle – Narrow band of epidermis attached to the surface of the nail in front of the root protecting the new keratin cells as they form. ◦ Nail Root – Fastens the nail to the finger or toe by fitting into a groove in the skin Dermatologist – A physician, who specializes in diagnosing & treating disorders of the skin Cosmetic Surgeon – (plastic surgeon) a physician who specializes in the surgical restoration & reconstruction of body structures Acne Vulgaris – Commonly known as acne. Chronic inflammatory disease characterized by pustular eruptions of the skin caused by an overproduction of sebum. Often triggered by a hormones in puberty & adolescence Seborrhea – over activity of sebaceous glands, results in the production of an excessive amount of sebum Seborrheic Dermatitis – Inflammation that causes scaling & itching of the upper layers of skin or scalp. Lesion – Pathologic change of the tissues due to disease or injury. Skin lesions are described by their appearance, location, color, and size as measured in centimeters Crust – scab, a collection of dried serum and cellular debris Macule – freckle, discolored, flat spot usually <1 cm in diameter Nodule – solid, raised skin lesion > 0.5 cm in diameter & deeper than a papule Papule – small, raised red lesion < 0.5 in diameter & does not contain pus, ex. small pimples & insect bites Plaque – scaly, solid raised area of closely spaced papules, ex. psoriasis lesions Scales – flakes or dry patches made up of excess dead epidermal cells, ex. Psoriasis scales Verrucae – warts, small, hard skin lesions caused by the human papilloma virus Wheal – welt, small bump that itches, can appear as a symptom of an allergic reaction Abscess – closed pocket containing pus, caused by a bacterial infection Cyst – abnormal sac containing gas, fluid, or semisolid material, most common is sebaceous cyst Pustule – pimple, small circumscribed lesion containing pus Vesicle – small blister <0.5 cm, contains watery fluid Bulla – Large blister >0.5 cm, contains watery fluid Abrasion – injury, superficial layers of skin are scraped or rubbed away Pressure Sore, decubitus ulcer or bed sore. Ulcerated area caused by prolonged pressure that caused tissue death Fissure – groove or crack-like break in skin Laceration – torn or jagged wound, or an accidental cut wound Puncture wound – deep hole made by sharp object such as a nail. Increased risk of infection Ulcer – Open lesion of skin or mucous membrane resulting in tissue loss around the edges Dermatitis – inflammation of the skin Contact DermatitisLocalized allergic response caused by contact with an irritant, ex diaper rash, jewelry rash Eczema – form of persistent or recurring dermatitis characterized by redness, itching, & dryness Pruitus – itching that is associated with most forms of dermatitis Erythema – Redness of the skin due to capillary dilation Erythema multiformResults from generalized allergic reaction to illness, infection or medication. Characterized by rash (nodules, papules, vesicles or bullae) Erythema infectiosum – fifth disease, mildly contagious viral infection common in childhood. Red lace-like rash on face Exfoliative Dermatitis – Widespread scaling of the skin, often with pruritus, erythroderma & hair loss. May occur in severe cases of many common skin conditions, ex. Eczema, psoriasis, & allergic reactions Psoriasis – Chronic noncontagious, inherited. Has flare-ups with red plaque covered with silvery scales occur on elbows knees, scalp back or buttocks. Urticaria – (hives), itchy wheals caused by an allergic reaction Xeroderma – (xerosis) excessively dry skin Cellulitis – acute, rapidly spreading infection within tissues with malaise, swelling, warmth & red streaks Gangrene – tissue necrosis, caused by a loss of circulation to tissues. Tissue death is followed by bacterial invasion that causes putrefaction & if this infection enters bloodstream it can be fatal Impetigo – highly contagious bacterial skin infection that commonly occurs in children. Isolated pustules become crusted & ruptures Necrotizing Fasciitis – Severe infection caused by group A strep bacteria. (flesh eating) If bacteria enter the body serious infection can result. If untreated body tissue is destroyed & can be fatal Tinea – Fungal infection that can grow on skin, hair, or nails. (ringworm) Tinea Capitis – on the scalps of children Tinea Corporis – fungal infection on the body Tinea Cruis – (jock itch) found on genital area Tinea pedis – (athlete’s foot) fungus on foot & between toes Tinea Versicolor – fungal infection that causes painless, discolored areas on skin Basal Cell Carcinoma – malignant tumor of basal cell layer of epidermis. Slow growing & rarely spreads to other parts of the body. Squamous Cell Carcinoma – malignant tumor of the scaly squamous cells of the epithelium. Can quickly spread to other body systems Malignant Melanoma – skin cancer that occurs in the melanocytes. Most serious type of skin cancer Injury to the body tissues caused by heat, flame, electricity, sun, chemicals, or radiation. Degree of burn is determined by the layer of skin involved Biopsy – Removal of a small piece of living tissue for examination to confirm or establish a diagnosis Incisional Biopsy – a piece but not all, of the tumor or lesion is removed Excisional Biopsy – entire tumor or lesion & a margin of surrounding tissue are removed Needle Biopsy – a hollow needle is used to remove a core of tissue for examination Belpharoplasty – (lid lift), surgical reduction of the upper & lower eyelids Botox – formulation of botulinum toxin type A, temporarily blocks the nerve signals to injected muscle to reduce frown lines Dermatoplasty – (skin graft), replacement of damaged skin with healthy tissue taken from a donor site on patient’s body