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Chapter 4 Integumentary System Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Chapter 4 Lesson 4.1 Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-2 Objectives Identify organs and structures of the integumentary system. Define and spell the word parts related to the integumentary system Define, pronounce and spell disease and disorder terms related to the integumentary system. Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-3 Integumentary System Function The skin forms a protective covering that when unbroken prevents entry of bacteria and other invading organisms. The skin also protects the body from water loss and from damaging effects of ultraviolet light. Other functions include regulation of body temperature and synthesis of vitamin D. The integumentary system comprises the skin, nails, and sweat and oil glands. Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-4 Structure of the Skin Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-5 Major Structures of the Skin epidermis: outer layer of skin keratin: horny, or cornified, layer composed of protein melanin: color, or pigmentation, of skin dermis (also called “true skin”): the inner layer of skin Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-6 Major Structures of the Skin (cont’d.) sudoriferous glands: tiny, coiled, tubular structures that emerge through pores on skin’s surface sebaceous glands: secrete sebum (oil) into the hair follicles, where the hair shafts pass through the dermis Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-7 Accessory Structures of the Skin hair: compressed, keratinized cells that arise from hair follicles (sacs that enclose the hair fibers) nails: originate in the epidermis; found on the upper surface of the ends of the fingers and toes Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-8 Combining Forms for the Integumentary System cutane/o, derm/o, dermat/o hidr/o kerat/o onych/o, ungu/o seb/o trich/o Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-9 Cross Section of the Skin Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-10 Combining Forms Commonly Used with Integumentary System Terms aut/o bi/o coni/o crypt/o heter/o myc/o necr/o pachy/o rhytid/o staphyl/o strept/o xer/o Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-11 Prefixes epiintraparapersubtrans- Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-12 Suffixes -a -coccus -ectomy -ia -itis -malacia -opsy -phagia -plasty -rrhea -tome Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-13 Clicker Question Which of the following means “eating or swallowing”? pachy/o b) -phagia c) -plasty a) Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-14 Disease and Disorder Terms Built From Word Parts dermatitis dermatoconiosis dermatofibroma hidradenitis leiodermia oncychocryptosis onychomalacia onychomycosis onychophagia pachyderma paronychia seborrhea trichomycosis xeroderma Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-15 Note hidradenitis paronychia Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-16 The -a Ending The -a ending in the terms “pachyderma,” “xeroderma,” “erythroderma,” “leukoderma,” and “xanthoderma” is a noun suffix and has no meaning Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-17 Analyze and Define WR /CV/ WR / S onych/o/myc/osis CF / dermatoconiosis hydradenitis dermatitis abnormal condition of fungus in the nail Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-18 Disease and Disorder Terms Not Built From Word Parts abrasion abscess acne actinic keratosis albinism basal cell carcinoma (BCC) candidiasis carbuncle cellulitis contusion eczema fissure furuncle gangrene Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-19 Disease and Disorder Terms Not Built From Word Parts (cont’d.) herpes impetigo Kaposi sarcoma laceration lesion pediculosis psoriasis rosacea scabies scleroderma shingles squamous cell carcinoma (SqCCA) systemic lupus erythematosus (SLE) tinea urticaria Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-20 Common Skin Disorders Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-21 Common Skin Disorders (cont’d.) Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-22 Common Skin Disorders (cont’d.) Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-23 Cancers of the Skin Squamous cell carcinoma Melanoma Actinic keratosis Basal cell carcinoma Kaposi sarcoma Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-24 Clicker Question Shingles is also called tinea b) herpes zoster c) impetigo a) Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-25 Chapter 4 Lesson 4.2 Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Objectives Define, pronounce and spell surgical terms related to the integumentary system. Define, pronounce and spell complementary terms related to the integumentary system. Interpret the meaning of abbreviations related to the integumentary system. Interpret, read and comprehend medical language in simulated medical statements and documents. Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-27 Surgical Terms Built from Word Parts biopsy dermatoautoplasty dermatoheteroplasty dermatoplasty dermatome onychectomy rhytidectomy rhytidoplasty Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-28 Surgical Terms Not Built from Word Parts cauterization cryosurgery debridement dermabrasion excision incision incision and drainage (I&D) laser surgery Mohs surgery suturing Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-29 Complementary Terms Built from Word Parts dermatologist dermatology (derm) epidermal erythroderma hypodermic intradermal (ID) keratogenic leukoderma necrosis percutaneous staphylococcus (staph) (pl. staphylococci) streptococcus (strep) (pl. streptococci) subcutaneous (subcut) transdermal (TD) ungual xanthoderma Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-30 streptococci Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-31 staphylococcus Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-32 Routes of Administration 1. Intradermal 3. Transdermal 2. Subcutaneous, hypodermic Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-33 Complementary Terms Not Built from Word Parts adipose allergy alopecia bacteria cicatrix cyst cytomegalovirus (CMV) diaphoresis ecchymosis edema emollient erythema fungus induration Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-34 Complementary Terms Not Built from Word Parts (cont’d.) jaundice keloid leukoplakia macule nevus (pL nevi) nodule pallor papule petechia (pl. petechiae) pressure ulcer (decub) pruritus purpura pustule ulcer verruca vesicle virus wheal Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-35 Burn Keloid Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-36 Stage 2 Pressure Ulcer Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-37 Clicker Question The term which means profuse sweating is ecchymosis b) emollient c) diaphoresis a) Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-38 Abbreviations BCC bx CMV decub derm I&D ID SLE SqCCA staph strep subcut TD Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-39 Read Medical Terms In Use Emily visited the dermatology clinic because of pruritus secondary to dermatitis involving her scalp, arms, and legs. A diagnosis of psoriasis was made. Eczema, scabies, and tinea were considered in the differential diagnosis. An emollient cream was prescribed. In addition the patient showed the dermatologist the tender, discolored, thickened nall of her right great toe. Emily learned she had onychomycosis, for which she was given an additional prescription for an oral antifungal drug. Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 4-40 Chapter 5 Respiratory System Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Objectives Identify organs and structures of the respiratory system. Define and spell the word parts related to the respiratory system. Define, pronounce and spell disease and disorder terms related to the respiratory system. Define, pronounce and spell surgical terms related to the respiratory system. Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-42 Respiratory System Function Exchange of oxygen and carbon dioxide between the atmosphere and body cells. The process is called respiration. External respiration (breathing): Oxygen passes from lungs to blood (capillaries) and carbon dioxide passes from capillaries back into lungs to be expelled. Internal respiration: The body cells take on oxygen from the blood and give back carbon dioxide, which is transported back to the lungs. Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-43 Organs of the Respiratory System Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-44 Organs of the Respiratory System nose: lined with mucous membrane and fine hairs; acts as a filter to moisten and warm the entering air pharynx (throat): serves as a food and air passageway adenoid: lymphoid tissue located behind the nasal cavity tonsils: lymphoid tissue located behind the mouth Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-45 Organs of the Respiratory System (cont’d.) larynx (voice box): location of the vocal cords epiglottis: flap of cartilage that automatically covers the opening of the larynx during swallowing and keeps food from entering the larynx trachea: passageway for air to the bronchi Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-46 Organs of the Respiratory System (cont’d.) bronchus: one of two branches from the trachea, which conducts air into the lungs, where it divides and subdivides (referred to as a bronchial tree). bronchioles: smallest subdivision of the bronchial tree alveoli: air sacs at the end of the bronchioles; oxygen and carbon dioxide are exchanged through alveolar walls and capillaries Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-47 Organs of the Respiratory System (cont’d.) lungs: 2 sponge-like organs in the thoracic cavity (right lung has 3 lobes; left lung has 2 lobes) pleura: serous membrane covering each lung and lining the thoracic cavity diaphragm: muscular partition that separates the thoracic cavity from the abdominal cavity; aids in breathing mediastinum: space between the lungs Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-48 Combining Forms for the Respiratory System adenoid/o alveol/o bronchi/o, bronch/o diaphragmat/o epiglott/o laryng/o lob/o nas/o, rhin/o pharyng/o pleur/o pneum/o, pneumat/o, pneumon/o pulmon/o Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-49 Combining Forms for the Respiratory System (cont’d.) sept/o sinus/o thorac/o tonsill/o trache/o Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-50 Combining Forms Commonly Used with Respiratory System Terms atel/o capn/o hem/o, hemat/o muc/o orth/o ox/o, ox/i py/o spir/o Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-51 Prefixes a-, anendoeupanpolytachy- Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-52 Suffixes -algia -ar, -ary -cele -centesis -eal -ectasis -emia -graphy -meter -metry -pexy Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-53 Suffixes (cont’d.) -rrhagia -scope -scopic -scopy -spasm -stenosis -stomy -thorax -tomy Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-54 Clicker Question Which of the following is the combining form that means chest? -thorax b) -pexy c) thorac/o d) pleur/o a) Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-55 Disease and Disorder Terms Built from Word Parts adenoiditis atelectasis bronchiectasis bronchitis bronchogenic carcinoma bronchopneumonia diaphragmatocele epiglottitis hemothorax laryngitis laryngotracheobronchitis (LTB) lobar pneumonia nasopharyngitis pansinusitis pharyngitis pleuritis Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-56 Disease and Disorder Terms Built from Word Parts (cont’d.) pneumatocele pneumoconiosis pneumonia pneumonitis pneumothorax pulmonary neoplasm pyothorax rhinitis rhinomycosis rhinorrhagia thoracalgia tonsillitis tracheitis tracheostenosis Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-57 Atelectasis Showing Collapsed Alveoli Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-58 Disease and Disorder Terms Not Built from Word Parts adult respiratory distress syndrome (ARDS) asthma chronic obstructive pulmonary disease (COPD) coccidioidomycosis cor pulmonale croup cystic fibrosis (CF) deviated septum emphysema epistaxis influenza (flu) Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-59 Disease and Disorder Terms Not Built from Word Parts (cont’d) Legionnaire disease obstructive sleep apnea (OSA) pertussis pleural effusion pulmonary edema pulmonary embolism (PE) tuberculosis (TB) upper respiratory infection (URI) Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-60 Clicker Question Which of the following correctly labels the diagram? a) pneumothorax b) pleurothorax Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-61 Surgical Terms Built from Word Parts adenoidectomy adenotome bronchoplasty laryngectomy laryngoplasty laryngostomy laryngotracheotomy lobectomy pleuropexy pneumobronchotomy pneumonectomy Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-62 Surgical Terms Built from Word Parts (cont’d) rhinoplasty septoplasty septotomy sinusotomy thoracocentesis thoracotomy tonsillectomy tracheoplasty tracheostomy tracheotomy Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-63 Clicker Question Which of the following correctly labels the diagram? a) thoracocentesis b) tracheoplasty Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-64 Objectives Define, pronounce and spell diagnostic terms related to the respiratory system Define, pronounce and spell complementary terms related to the respiratory system. Interpret the meaning of abbreviations related to the respiratory system. Interpret, read and comprehend medical language in simulated medical statements and documents. Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-65 Types of Diagnostic Imaging Procedures radiography: radiographic images of internal organs using ionizing radiation nuclear medicine: scans using radioactive material to determine the functional capacity of an organ ultrasound: sonograms, or echograms, using highfrequency sound waves to create an image of body organs computed tomography (CT scans): computerized images of body organs in slices, horizontally magnetic resonance imaging (MRI scans): gives information about the body’s biochemistry by placing the patient in a magnetic field Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-66 Other Types of Diagnostic Procedures endoscopy: endoscopes, which are lighted, flexible instruments, are used for visual examination of a hollow organ or body cavity laboratory: diagnostic procedures performed on specimens such as blood, tissue, sputum, and urine pulmonary function tests: diagnostic tests performed to determine lung function Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-67 Diagnostic Terms Built from Word Parts bronchoscope bronchoscopy capnometer endoscope endoscopic endoscopy laryngoscope laryngoscopy oximeter polysomnography (PSG) spirometer spirometry thoracoscope thoracoscopy Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-68 Pulse Oximetry Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-69 Spirometer Capnometer Spirometer Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-70 Diagnostic Terms Not Built from Word Parts Diagnostic imaging Laboratory acid-bacilli (AFB) smear Pulmonary function chest CT (computed tomography) scan chest radiograph ventilation-perfusion scanning arterial blood gases (ABGs) pulmonary function tests (PFTs) pulse oximetry Other PPD skin test Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-71 Clicker Question Which of the following is a diagnostic imaging term? pulse oximetry b) chest radiograph c) AFB smear d) PPD skin test a) Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-72 Complementary Terms Built from Word Parts acapnia anoxia aphonia apnea bronchoalveolar bronchospasm diaphragmatic dysphonia dyspnea endotracheal eupnea hypercapnia hyperpnea hypocapnia hypopnea hypoxemia hypoxia Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-73 Complementary Terms Built from Word Parts (cont’d.) intrapleural laryngeal laryngospasm mucoid mucous nasopharyngeal orthopnea phrenalgia phrenospasm pulmonary pulmonologist pulmonology rhinorrhea tachypnea thoracic Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-74 Compare and Contrast a/pne/a dys/pne/a eu/pne/a hyper/pne/a hypo/pne/a orth/o/pne/a tachy/pne/a Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-75 Complementary Terms Not Built from Word Parts airway asphyxia aspirate bronchoconstrictor bronchodilator cough hiccup hyperventilation hypoventilation mucopurulent mucus Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-76 Complementary Terms Not Built from Word Parts (cont’d.) nebulizer nosocomial infection paroxysm patent sputum ventilator Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-77 Clicker Question Acapnia, hypocapnia and hypercapnia are terms describing the amount of ______ in the blood. carbon dioxide b) oxygen a) Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-78 Abbreviations ABGs AFB ARDS CF CO2 COPD CT CXR Flu LLL LTB LUL O2 OSA Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-79 Abbreviations (cont’d.) PE PFTs PSG RLL RUL TB URI VPS Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-80 Read Medical Terms In Use A 24-year-old man visited the emergency department because of dyspnea, hyperpnea, paroxysms of cough (kawf), and the presence of thick, tenacious mucus. He had a history of asthma since the age of 12 years. A chest radiograph was negative for pneumonia. Arterial blood gases showed hypoxemia but no hypercapnia. Pulmonary function tests disclosed bronchoconstriction, which was corrected by a bronchodilator. A nebulizer was prescribed for treatment. The asthma attack was probably precipitated by an episode of bronchitis. Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5-81