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CHAPTER 10
INTEGUMENTARY SYSTEM
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Chapter 10 Learning Objectives

Define at least 10 terms relating to the
integumentary system.

Describe the function of the integumentary
system.

Identify at least five integumentary system
structures and the function of each.
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Chapter 10 Learning Objectives

Identify at least three methods used to assess
the function of the integumentary system.

Describe at least five disorders of the
integumentary system.

Describe three methods that can be used to
maintain healthy skin.
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Chapter 10 Learning Objectives

Identify three types of skin cancer and at least
five methods for prevention.
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Structure and Function
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The integumentary system is composed of
the skin and accessory structures.
Functions of the integumentary system


Protects the other body systems from injury and
infection
Helps the body maintain homeostasis by
regulating temperature, retaining body fluids, and
eliminating wastes
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Structures of the Skin
FIGURE 10-1 Structures of the skin.
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Skin
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The largest organ of the body
Varies in thickness from 1/50 inch (0.5 mm) in
the eyelids to 1/4 inch (6.3 mm) in the soles
of the feet
Changes in the skin often indicate the
presence of other body system disorders,
including anemia, respiratory disorders, liver
disorders, cancer, and shock.
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Layers of Skin

Epidermis (cuticle)
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Outermost layer of the skin
 Composed of a surface layer of dead cells with an
underlying layer of living cells
 Keratinocytes make up 90%
 Contains sebaceous glands, sudoriferous glands,
and hair follicles
 Melanocytes (produce melanin) are located in the
epidermis.
• Melanin: pigment that gives skin its color
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Layers of Skin

Dermis (corium)
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Called the true skin
Contains the blood vessels and nerves
• Each inch of skin contains 15 feet of blood vessels

Subcutaneous layer

Innermost layer
 Contains adipose tissue, which cushions and
insulates the body’s organs
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Hair and Hair Follicles
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Skin has hair in all areas except the soles of
the feet and palms of the hands.
Hair blocks foreign particles from entering the
body through structures such as the nose and
eyes.
The visible portion is called the shaft.
The hair follicle is the root with its covering.
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Glands

Three types of glands in the skin
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Sebaceous glands (oil)
• Located everywhere except palms of hands and
soles of feet
• Sebum (oil) causes the skin to be soft and
waterproof

Sudoriferous glands (sweat)
• Help regulate the body temperature and excrete
body wastes
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Glands
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Ceruminous glands
• Located in the auditory canal of the ear
• Secrete wax that helps protect the ear from
infection and prevents entry of foreign bodies
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Nails
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Nails protect fingers and toes from injury.
They are formed from dead, keratinized
epidermal cells.
Root is covered by skin at the area of
attachment to finger or toe.
Lunula is the crescent-shaped white area
near the root.
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Assessment Techniques
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Dermatology is the study of skin.
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Dermatitis is inflammation of the skin.
Skin lesions can be seen with visual inspection.
• Size, shape, texture, and color often reveal cause.
• Biopsy is used to identify the causative organism.

Fingerprints and toe prints are unique to each
person.
• Papillae (ridges) form regular patterns in the
fingers, palms of the hands, and soles of the feet
where the skin is thick.
• Pattern of ridges may be linked to disorders such as
Down syndrome.
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Disorders of the
Integumentary System
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Acne vulgaris
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Caused by increased secretion of oil related to
increased hormones during puberty
 Primarily affects the face, chest, and back
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Albinism
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Alopecia
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Inherited disorder in which melanin is not produced
Baldness
Athlete’s foot
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Contagious fungal infection of the foot
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Disorders of the
Integumentary System
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Cellulitis
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Bacterial infection of the dermis and subcutaneous
layer of the skin
• May be caused by many different bacteria
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Chloasma
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Cleft lip or cleft palate
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Patchy discoloration of the face
Upper lip has a cleft where the nasal palate does
not close properly.
Contact dermatitis

Allergic reaction that may occur after initial contact
or as an acquired response
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Disorders of the
Integumentary System
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Dandruff
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Decubitus ulcers
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Sores or areas of inflammation that occur over
bony prominences of the body
Eczema
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White flakes of dead skin cells from the scalp
Group of disorders caused by allergic or irritant
reactions
Fungal skin infections

Skin infections that live on dead outer surface or
epidermis
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Disorders of the
Integumentary System
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Furuncle
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Hirsutism
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Abnormal amount of hair growth in unusual places
Impetigo
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Bacterial infection of a hair follicle, also called a
boil
Very contagious bacterial skin infection that
occurs most often in children
Kaposi sarcoma

Form of cancer that originates in blood vessels
and spreads to skin
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Disorders of the
Integumentary System
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Lupus
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Morgellons disease
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Chronic skin disorder in which too many epidermal
cells are produced
Rashes
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Causes sensation of insects crawling, stinging, and
biting the skin
Psoriasis
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Benign dermatitis or chronic systemic disorder
May result from viral infection, especially in children
Scleroderma
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Rare autoimmune disorder that affects blood vessels
and connective tissues of the skin
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Disorders of the
Integumentary System
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Skin cancer
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Skin lesions
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Three forms are basal, squamous, and melanoma.
Differ in texture, color, location, and rate of growth
Streptococcus

Nonmotile bacteria that affect many parts of the
body
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Warning Signs of Melanoma
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Viral Infections Causing a Rash
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Skin Lesions
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Disorders of the
Integumentary System
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Vitiligo
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Condition that causes loss of pigment in the skin
Wart
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Papule caused by a viral infection
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Issues and Innovations
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Skin and hair care
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Skin care products include soap, astringents, and
cosmetics
 Ways to remove hair include wax, depilatory
creams, and electrolysis
 Tattooing (permanent makeup)
•
•
•
•
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Risk of infections
Allergic reaction
Granulomas
Keloid formation
Complications during magnetic resonance imaging
(MRI)
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Sun and Skin Cancer
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Ultraviolet (UV) radiation in sunlight may
change DNA structure in skin cells.
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UV exposure is the main cause of skin cancer.
 Damage to the skin from the sun is cumulative.
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Types of Skin Cancer
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Basal cell carcinoma
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Most common type of skin cancer
Starts in the lowest layer of the epidermis
Waxy, pearly growths or red, scaly patches
Commonly found on the face, arms, and hands
May alternate bleeding and healing
Increase in the number of basal cell carcinomas
found in women younger than 40 years
• Tanning beds may be a major cause of increase.
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Types of Skin Cancer
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Squamous carcinoma
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Second most common type of skin cancer
Starts in the middle layer of the epidermis
Spreads more quickly than basal cell carcinoma
Red, scaly patches
Appears on areas of the skin most often exposed
to the sun
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Treatment of Basal Cell and
Squamous Cell Carcinomas
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Surgery
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Mohs microscopic surgery
• Removes affected tissue by layers
• Best cosmetic results
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Radiation therapy
Chemotherapy
Photodynamic therapy (PDT)
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Inactive drug is injected into blood vessels
surrounding cancer cells.
Laser light is shined on skin, activating the drug
and killing the cancer cells.
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Types of Skin Cancer
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Melanoma
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Most serious form of skin cancer
Originates in the pigment-producing or melanin
cells of the skin
Most often caused by exposure to the sun
Appears as a brown or black molelike growth on
the back, legs, or torso
• One half of cases develop from existing pigmented
moles.

If treated early, cure rate is almost 100%.
• If not treated early, melanoma may be fatal.
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Treatment of Melanoma
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Gene therapy
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Marked gene is inserted into tumor and then can
be recognized for attack by the body’s immune
system.
Extracorporeal photochemotherapy
(photopheresis)
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Process separates and irradiates white blood
cells.
• Cells are washed and reinserted.
• These cells act as a vaccine against the existing
cancer.
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Summary

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The function of the integumentary system is
to protect the other body systems from
infection and injury.
Five integumentary structures
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Hair
 Epidermis
 Dermis
 Sebaceous gland
 Melanocytes
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Summary
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Three methods for assessing the
integumentary system
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Visual inspections
Biopsy
Culture
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Summary
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Five disorders of the integumentary system
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Acne
Albinism
Alopecia
Athlete’s foot
Dandruff
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Summary
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Three types of skin cancer
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Squamous cell
Basal cell
Melanoma
Methods to prevent skin cancer
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Wearing sunblock
Avoiding sun exposure
Wearing protective clothing
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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