Download The Integumentary System

Chapter 5
The Integumentary System
A. Skin (Integument system) pp. 150-157
1. Consists of two distinct regions
a. Epidermis (_________________)
1. ________________ region
2. Epithelial ________________
b. Dermis (________________)
1. Underlines ________________
2. Mostly ________________ connective tissue
2. Hypodermis (________________ fascia)
a. Subcutaneous ________________ deep to the skin
b. Not part of the ________________ but shares some functions
c. Mostly ________________ tissue that absorbs shock and ________________
d. ________________ skin to underlying structures – mostly ________________
B. Epidermis
1. Keratinized ________________ squamous epithelium
2. ________________ types of cells
a. Keratinocytes
1. Produce fibrous ________________ keratin
2. ________________ cells of the epidermis
3. ________________ connected by desmosomes
b. Melanocytes
1. ________________ of cells in deepest epidermis
2. Produce ________________ melanin
a. Packaged into melanosomes
b. Protect apical ________________ of keratinocyte nucleus from
________________ damage
c. Dendritic (Langerhans) cells
1. Macrophages – key activators of the ________________ system
d. Tactile (Merkel) cells
1. ________________ touch receptors
3. Four or five distinct layers
a. Stratum basale
1. ________________ epidermal layer
2. Also called ________________ germinativum
3. ________________ attached to ________________
4. ________________ row of ________________ cells
a. Actively ________________
b. Produces ________________ daughter cells
i. One cell journeys form basal layer to surface
1. Takes ________________ days
2. ________________ as moves toward surface
ii. One cell remains in stratum basale as ________________
cell
5. Melanocytes compose ________________ of this layer
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b. Stratum spinosum
1. ________________ layer
2. Is ________________ cell layers think
3. Cells contain ________________ system of intermediate prekeratin
filaments ________________ to desmosomes
4. Contains keratinocytes, ________________ granules and the highest
concentration of dentritic cells
c. Stratum granulosum
1. Granular ________________
2. Thin – four to ________________ cell layers
3. Cell ________________ changes
a. Cells ________________
b. Nuclei and ________________ disintegrate
c. Keratinization begins
i. Cells ________________ keratohyaline granules
ii. Help form ________________ in upper layers
d. Cell accumulate lamellar granules
i. Their ________________ -resistant glycolipid slows water
loss
4. Cells above this layer ________________
a. Too far from ________________ capillaries
d. Stratum lucidum
1. ________________ layer
2. Is found only in ________________ skin and is composed of dead
keratinocytes
3. Thin, ________________ band superficial to the stratum granulosum
4. A few ________________ of flat, dead keratinocytes
e. Stratum corneum
1. ________________ layer
2. ________________ rows of dead, flat, anucleate keratinized membranous
sacs
3. Three-quarters of ________________ thickness
4. Through ________________, its cells have functions
a. Protect ________________ cells from environment and water loss
b. Protect from ________________ and penetration
c. Barrier against ________________, chemical and physical assaults
C. Cell Differentiation in the Epidermis
1. Cells change from stratum basale to stratum corneum
2. This is accomplished by ________________ form of apoptosis
a. Controls ________________ suicide
b. ________________ and organelles break down
c. Plasma ________________ thickens
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d. It allows cells to ________________ off as dandruff and dander
e. We shed about ________________ cells every minute.
D. Dermis
1. ________________, flexible connective tissue
2. Cells found in the dermis
a. Fibroblasts
b. Macrophages
c. Mast cells
d. White blood cells
3. Fibers found in the matrix binds the body ________________ – “Hide” which is used to
make ________________.
4. Dermis is well supplied with
a. ________________ vessels
b. Nerves
c. Lymphatic ________________
5. Contains epidermal ________________ follicles; oil and sweat glands
6. Two layers
a. Papillary
1. Areolar ________________ tissue with collagen and elastic fibers and
blood vessels
2. Loose tissue
a. ________________ can patrol for microorganisms
3. Dermal papillae layer
a. Superficial ________________ projections
b. Most contain ________________ loops
c. Some contain Meissner’s corpuscles (________________
receptors)
d. Some contain ________________ nerve endings (pain receptors)
e. In thick skin lies ________________ dermal ridges that causes
epidermal ridges
i. Collectively these ridges are called friction ridges
1. ________________ gripping ability
2. Contribute to ________________ of touch
3. Pattern is called ________________
b. Reticular layer
1. Makes up about ________________ of dermal thickness.
2. Made up of ________________ fibrous connective tissue
3. ________________ fibers provide stretch-recoil properities
4. Collagen fibers
a. Provide ________________ and resiliency
b. ________________ water
c. Forms Cleavage lines because most collagen fibers run parallel to
the skin’s surface
i. Externally ________________
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ii. Important to ________________
iii. Incisions made ________________ to cleavage lines will
gap ________________ and heal more ________________
7. Skin Markings
a. Flexure lines
1. Dermal folds at or near ________________
2. Dermis is ________________ secured to deeper structures
3. Skin cannot slide easily for ________________ movement causing deep
creases
4. Visible on hands, _____________, fingers, ________________, and toes
b. Striae
1. Silvery-white ________________
2. “________________ marks”
3. ________________ stretching causes dermal tears
c. Blister
1. From acute, ________________ -term trauma
2. Fluid-filled ________________ that separates epidermal and dermal layers
E. Skin Color
1. Three pigments contribute to skin color
a. ________________ (Only pigment made in the skin)
1. Reddish-yellow to brownish-________________
2. Color differences is due to the ________________ and form of melanin
3. Produced in melanocytes
a. Same ________________ of melanocytes in all people
4. ________________ to keratinocytes to form “pigment shields for
________________
5. ________________ and pigmented moles are accumulation of melanin in a
specific area
6. Sun ________________ stimulates melanin production
7. ________________ (tinea versicolor) are fungal infection; not related to
melanin
b. Carotene
1. Yellow to ________________ pigment
2. Most obvious in the ________________ of the hands and the soles of the
feet
3. ________________ in stratum corneum and hypodermis
4. Can be ________________ to vitamin A for vision and epidermal health
5. ________________ – tinge of some Asians is the combination of carotene
and melanin variations
6. ________________ can give a pinkish hue of fair skin individuals
2. Skin Color in diagnosis
a. Cyanosis – Blue skin color – ________________ oxygenation of hemoglobin
b. Erythema (________________) – can be caused by a ________________,
hypertension, inflammation or allergies
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c. Pallor (________________) – sign of anemia, low blood pressure, fear or anger
d. Jaundice (________________ cast) – liver disorder
e. Bronzing – inadequate ________________ hormones in Addison’s disease
f. Bruises – ________________ blood beneath the skin
F. Appendages of the Skin
1. Derivations of the epidermis
a. ________________ and hair follicles
b. Nails
c. ________________ glands
d. Sebaceous (________________) glands
2. Hair
a. Dead keratinized cells of hard ________________ – durable than soft keratin of the
skin.
b. Not in ________________, soles, ________________, nipples, and portions of
external genitalia
c. Functions include
1. ________________ that insects are on the skin
2. ________________ of physical trauma
3. ________________ loss
4. ________________ exposure
d. Hair pigments
1. ________________ (yellow, rust, brown, black)
2. Gray/________________ hair: decreased melanin production, increased air
bubbles in the ________________.
e. Hair Follicles
1. Extend from ________________ surface to dermis
2. Two layered wall – part ________________, part epidermis
3. Hair bulb
a. ________________ deep end
b. Hair follicle ________________ (root hair plexus)
c. ________________ nerve endings – touch receptors
d. Hair matrix – ________________ dividing area
4. Arrector pili
a. ________________ muscle attached to hair follicle
b. Responsible for ________________ bumps
5. Hair papilla
a. ________________ tissue – blood supply
f. Types and Growth of Hair
1. Vellus hair – ________________, fine body hair of children and adult
females
2. Terminal hair
a. ________________, long hair of eyebrows, scalp
b. At puberty
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3.
4.
5.
6.
i. Appear in axillary and pubic regions of both
________________
ii. ________________ and neck of males
3. ________________ and hormones affect hair growth
4. Follicles cycle between active and ________________ phases
5. Average ________________ mm growth per week
6. Lose ________________ % scalp hairs daily
g. Hair Thinning and Baldness
1. Alopecia
a. Hair ________________ in both sexes after age 40. Hair is not
replaced as quickly as it is lost.
2. True baldness
a. ________________ determined and sex influenced condition
b. Male ________________ baldness caused by follicular response to
DHT (dihydrotestosterone)
c. Treatments
i. Minoxidi (________________) and finasteride (propecia)
Nails
a. ________________ modifications of the epidermis
b. ________________ cover for distal, dorsal surface of fingers and toes
c. Contain ________________ keratin
d. Nail matrix ________________ for nail ________________
Sweat Glands
a. Also called sudoriferous ________________
b. All ________________ surfaces except nipples and parts of external genitalia
1. About ________________ million per person
c. Two main types
1. Eccrine (________________) sweat glands
2. Apocrine ________________ glands
d. Contain myoepithelial ________________
1. Contract upon ________________ system stimulation to force
________________ into ducts
Eccrine Sweat Glands
a. Most ________________
b. Abundant on ________________, soles and forehead
c. Ducts connect to ________________
d. ________________ in thermoregulation – ________________ by sympathetic
nervous system and prevents the body from ________________
e. Their secretion is sweat
1. ________________ % water, salts, vitamin c, ________________,
dermicidin (microbe killing peptide), metabolic ________________
Apocrine Sweat Glands
a. Confined to ________________ and anogenital areas
b. Sweat and ________________ substances and proteins
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1. Viscous; milky or ________________
2. ________________ until bacterial interaction – ________________ odor
c. ________________ than eccrine sweat glands
d. Ducts ________________ into hair follicles
e. Begin functioning at ________________
1. Function unknown but may act as sexual scent ________________
f. Modified apocrine glands
1. Ceruminous glands – lining of external ________________ canal; secrete
cerumen (earwax)
2. Mammary glands – ________________ milk
7. Sebaceous (________________) Glands
a. ________________ distributed – not in ________________ or soles
(________________ skin)
b. Most develop from hair follicles and secrete into ________________ follicles
c. Relatively inactive until puberty
1. Stimulated by ________________, especially androgens
d. Secrete sebum
1. Oily holocrine ________________
2. ________________
3. Softens ________________ and skin
G. Functions of the Integumentary system
1. Protection
a. Three types of barriers
1. ________________ barriers
a. Skin secretions
i. ________________ pH slows bacterial multiplication
ii. Sebum and ________________ kill bacteria
b. Melanin
i. ________________ against UV radiation damage
2. ________________ barriers
a. Flat, ________________ cells of stratum corneum surrounded by
lipids
b. Keratin and glycolipids ________________ most water and water
soluble ________________
c. Limited penetration of skin
i. Lipid-soluble ________________
ii. _________________ solvents
iii. ________________ oleoresins (ex. Poison ivy)
iv. ________________ of heavy metals
v. Some ________________
vi. Drug ________________
3. Biological barriers
a. Dendritic cells of ________________ – present foreign antigens to
white ________________ cells
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b. ________________ of dermis – present foreign
________________ to white blood cells
c. DNA
i. Its ________________ absorb UV radiation
ii. ________________ is converted to heat
2. Body temperature regulation
a. If body ________________ only about 500 ml/day of routine insensible
perspiration is released daily (if environmental ________________ is below 310320.
b. If body temperature rises, ________________ of dermal vessels and increased
sweat gland activity (sensible ________________) cool the body
c. Cold external environment
1. ________________ blood vessels constrict
2. Skin ________________ drops to slow passive heat loss
3. Cutaneous sensation
a. Cutaneous sensory receptor
1. Part of the ________________ system
2. Detect ________________, touch and pain
3. See figure 5.1
4. Metabolic functions
a. Synthesis of vitamin ________________
b. Chemical ________________ of carcinogens and activate some hormones
5. Blood reservoir
a. Up to ________________ % of body’s blood volume
6. Excretion
a. ________________ wastes and ________________ are in sweat
H. Skin cancer
1. Most skin ________________ are benign (not cancerous) and do not metastasize (spread)
a. Risk factors
1. ________________ to UV radiation
2. Frequent ________________ of skin
b. Some ________________ lotions contain enzymes that can repair damaged
________________
c. Three major types of skin cancer
1. Basal Cell Carcinoma
a. Least ________________ – most common
b. Stratum basale ________________ proliferate and slowly invade
the dermis and hypodermis
c. Cured by ________________ excisions in ___________% of cases
2. Squamous cell carcinoma
a. Second most ________________ type
b. Involves ________________ of stratum spinosum
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c. Usually ________________ reddened papule or scalp, ears, lower
lip and hands
d. Does ________________
e. Good ________________ if treated by radiation therapy or
removed surgically
3. Melanoma
a. ________________ of melanocytes
b. Most ________________
c. Highly ________________ and ________________ to
chemotherapy
d. ________________ by wide surgical excision accompanied by
immunotherapy
e. Key to ________________ is early detection – ABCD rule
i. A – ________________; the two sides of the pigmented
area do not match
ii. B – ________________ irregularity; exhibits indentations
iii. C – ________________; contains several (black, brown tan
and sometimes red or blue)
iv. D - ________________; larger than 6mm (size of pencil
eraser)
I.
Burns
1. Tissue damage caused by ________________, electricity, radiation and certain
________________
a. ________________ proteins (changes the shape of the protein, so it will not work
properly)
b. ________________ cells
2. Immediate threat;
a. ________________ and electrolyte imbalance
1. Leads to renal shutdown and ________________ shock
b. To evaluate burns
1. Rule of ________________
2. Used to ________________ volume of fluid loss
3. Burns are classified by severity
a. Partial – ________________ burns
1. ________________ degree
a. ________________ damage only
b. localized ________________, edema (________________), and
pain
2. ________________ degree
a. Epidermal and upper ________________ damage
b. ________________ appear
b. ________________ -thickness burns
1. ________________ degree
a. ________________ thickness of skin involved
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J.
b. Skin ________________ -white, cherry red or blackened
c. Not ________________ (nerve endings ________________ or
swollen – at first
d. Skin ________________ usually necessary
c. Severity and Treatment of Burns
1. Critical if
a. >________________ % of body has second – degree burns
b. >________________ % of body has third - degree burns
c. Face, ________________ or feet bear third-degree burns
2. Treatment includes
a. Debridement (________________) of burned skin
b. ________________
c. Temporary ________________
d. ________________ grafts
Developmental Aspects
1. Fetal
a. ________________ – epidermis; Mesoderm – dermis and hypodermis
b. Lanugo coat: delicate hairs in 5th and 6th ________________
c. Vernix caseosa: ________________ gland secretion; protects skin of fetus
2. Infancy to adulthood
a. ________________ thickens; accumulates more ________________ fat
b. ________________ and sebaceous gland activity ________________
c. Effects of Cumulative ________________ assaults show after age 30
d. ________________ and dermatitis become more common
3. Aging skin
a. Epidermal ________________ slows, skin becomes ________________, dry and
itchy (decreased sebaceous ________________ activity)
b. Subcutaneous fat and ________________ decrease, leading to cold intolerance
and wrinkles
c. Increased risk of ________________ due to decreased numbers of melanocytes
and dendritic cells
d. Hair ________________
e. To delay
1. Use UV ________________
2. Good ________________
3. Lots of fluids
4. Good ________________
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