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Integumentary System Structure Skin is the largest organ of the body. In adults, the skin covers an area of approximately 2 square meters and accounts for nearly 20% of one's body weight. Its thickness varies from 0.3-4.0 mm depending on the location on the body. Functions Skin is extremely important to normal physiologic function secondary to the roles that it plays in maintaining homeostasis. The chief functions of the skin are as follow: Regulation of body temperature Protection Sensation/perception Excretion Immunity Blood reservoir Synthesis of vitamin D INTEGUMENTARY SYSTEM (largest organ - 15-20% total body mass) FUNCTIONS : 1. Barrier (to physical, chemical and biological agents) 2. Homeostatic -prevents water loss and regulates body temperature 3. Sensory -touch, pain and pleasure sensitivity 4. Secretory -converts precursor molecules to vitamin D; lubricants for hair; pheromones 5. Excretory - sweat Two Principal layers: Epidermis Outer layer Cells are highly differentiated Dermis Supportive tissue Beneath these two layers is a 3rd layer of subcutaneous adipose tissue Epidermis Thin but tough Avascular Body’s first line of defense Color derived from 3 sources Stratified into several layers Stratum germinativum or basal layer Stratum corneum Skin Cells Langerhans cells Melanocytes Keratinocytes Merkel Dermis Irregular fibrous connective tissue Fibroblasts produce collagen and elastin Papillary layer Abundant capillaries Accessory skin structures Hair follicles Nail follicles Sensory receptors glands Hair Follicle made of epidermal tissue Growth similar to epidermis Nail Follicles Nails are hard plates of keratin Nails produced like hair Nail bed is living dermis and epidermis Name the Structures Glands Sebaceous Ceruminous Apocrine Eccrine Blood vessels Capillaries Arterioles Sensory Touch Pressure Temperature Pain Subcutaneous Tissue AKA: superficial fascia Second line of defense Consists of: Areolar connective tissue Adipose tissue The Aging Process Slow atrophy of skin structures Loss of elasticity Layers become thin Gland decrease in number and function Vascularity decreases, becomes more fragile Number and function of melanocytes decreases Normal variations Liver spots (Lentigines) Freckles Mole (nevus) Birthmark Cherry (senile) angioma Keratoses Acrochordons (skin tags) Vitiligo Common Skin Lesions Macule Papule Vesicle Pustule Patch Plaque Nodule Wheal Tumor Bulla Crust Scale Fissure Erosion Ulcer Excoriation Nevus Cyst Skin assessment Color Erythema Cyanosis Jaundice Pallor Hair distribution Mobility and turgor Lesions Temperature and moisture Capillary refill History Diagnostic procedures Wood’s Light examination Patch testing Biopsy Potassium hydroxide (KOH) Tzank smear Scabies scraping Patch Testing Biopsy Shave biopsy Punch biopsy Surgical excision Dressings Protect wounds Retain moisture to promote healing Several types Wet Dry Absorbent Occlusive Phototherapy Light in combination with drugs Treatment for: psoriasis, vitiligo, chronic eczema Contraindications: Hx of herpes simplex infection, skin cancer, cataracts, lupus erythematosus. Phototoxicity: redness, vesicles, pain Maintain Healthy Skin Vitamin A Stop smoking Sun Screen pachy/onych/ia thick/nail/condition of kerato/myc/osis hard/fungus/condition or increase dermato/logist skin/one who specializes in treatment of histo/troph/ic tissue/nourishment or development/pertaining to hyper/onych/ia above or excessive/nail/condition of leuko/trich/ia white/hair/condition of kerat/osis hard/condition or increase pachy/dermat/osis thick/skin/condition or increase epi/dermis upon/skin lip/oma fat/tumor sub/cutane/ous below or under/skin/pertaining to an/hidr/osis without/sweat/condition or increase histo/dia/lysis tissue/across or through/breaking down or dissolution dys/plas/ia painful, difficult or faulty/formation/condition of xantho/derma yellow/skin dys/plas/tic painful, difficult or faulty/formation/pertaining to pachy/dermato/cele thick/skin/pouching or hernia erythro/dermat/itis red/skin/inflammation histo/tox/ic tissue/poison/pertaining to melano/cyt/e black/cell/noun marker xer/osis dry/condition or increase purpur/ic purple/pertaining to squam/ous scale/pertaining to sebo/rrhea sebum(oil)/discharge steato/lysis fat/breaking down or dissolution Study Guide Know the skin diagram Structure and function Normal skin markings Tests and treatments: what are they for, patient teaching and preparation Burns Skin lesions Disorders