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INTEGUMENTARY
CHAPTER 6
CUTANEOUS
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SKIN –
• EPIDERMIS
• KERATINIZED UPPER LAYERS
• STRATIFIED SQUAMOUS EPITHELIUM
• EXPOSED TO AIR
• DRY MEMBRANE
• DERMIS
• DENSE CONNECTIVE TISSUE
• DEEP & WET MEMBRANE
SKIN
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TOUGH YET PLIABLE
BARRIER FOR WATER –PREVENTS
DESSICATION
PROTECTIVE
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INSULATES & CUSHIONS
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• MECHANICAL DAMAGE
• CHEMICAL DAMAGE
• THERMAL DAMAGE
• ULTRAVIOLET RADIATON
• BACTERIA
CONTINUED
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REGULATES HEAT LOSS
MINI-EXCRETORY SYSTEM
• UREA, WATER AND SALTS IN SWEAT
SYNTHESIZES VITAMIN D
NERVE RECEPTORS PROVIDE INPUT ON
THE AREA AROUND US
• TOUCH, PRESSURE, PAIN AND TEMPERATURE
EPIDERMIS
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5 LAYERS
• STRATUM GERMINATIVUM (BASALE)
• LIES NEXT TO VASCULAR DERMIS
• STRATUM SPINOSUM
• STRATUM GRANULOSUM
• STRATUM LUCIDUM
• STRATUM CORNEUM
• ******AVASCULAR********
STRATUM GERMINATIVUM
(BASALE)
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LIES CLOSEST TO THE DERMIS WHERE THE
BLOOD SUPPLY IS RICH
MAKES MILLIONS OF NEW CELLS/ DAY
PUSHED UPWARD TOWARD SURFACE AS
MORE CELLS ARE MADE; AWAY FROM
SOURCE OF NUTRITION
CONTAIN KERATIN (MAKES SKIN TOUGH)
BECOME STRATUM SPINOSUM THEN
GRANULOSUM
STRATUM LUCIDUM
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3-5 ROWS OF CLEAR, FLAT, DEAD
CELLS
FURTHER FROM NUTRIENT SO
CAN’T LIVE AND GROW
ONLY SEEN WHERE SKIN IS
HAIRLESS AND THICK
• PALMS OF HANDS
• SOLES OF FEET
STRATUM CORNEUM
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25-30 ROWS OF FLAT DEAD CELLS
FILLED WITH KERATIN
PROVIDES A PROTECTIVE BARRIER
CONTINUOUSLY SHED
REPLACED BY LAYERS FROM
BELOW DAILY
MELANIN
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FOUND MOSTLY IN BASALE LAYER
AMOUNT OF MELANOCYTES SAME, COLOR IS
DETERMINED BY GENETICS/ SUN EXPOSURE
EXPOSURE TO SUN STIMULATES PRODUCTION
OF MELANIN
PHAGOCYTOSIS BY THE CELL CAUSES A DARK
UMBRELLA ON THE UPPER SIDE OF THE CELL TO
PROTECT ITS DNA FROM SUN DAMAGE
DERMIS
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INNER THICKER AMOUNT THAN SKIN
RICH IN BLOOD SUPPLY, NERVES
AND SWEAT PORES
CONNECTIVE TISSUE – COLLAGEN
AND ELASTIC FIBERS
2 MAJOR LAYERS
• PAPILLARY LAYER – UPPER REGION
• RETICULAR LAYER – LOWER REGION
PAPILLARY LAYER
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UPPER DERMAL REGION
DERMAL PAPILLAE – PUSH UP INTO
EPIDERMIS WITH CAPILLARY LOOPS
PROVIDING NUTRIENT TO STRATUM
BASALE
RIDGES HAVE DISTINCT PATTERNS
ON HANDS AND FEET= PRINTS
MEISSNER’S CORPUSCLES – TOUCH
FREE NERVE ENDINGS
RETICULAR LAYER
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DEEPEST LAYER
BLOOD VESSELS, SWEAT & OIL GLANDS
BLOOD PLAYS A ROLE IN BODY HEAT
PACINIAN CORPUSCLES – DEEP PRESSURE
PHAGOCYTES HERE ATTACK BACTERIA
THAT INVADES PAST THE EPIDERMIS
COLLAGEN IS TOUGH; ATTRACTS & BINDS
WATER
ELASTIN PROVIDES STRETCH
Skin Structure
Figure 4.4
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 4.13b
SUBCUTANEOUS LAYER
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HYPODERMIS
CONNECTS SKIN TO SURFACE OF
MUSCLES
CONTAINS FAT
BLOOD VESSELS AND NERVES RUN
THROUGH THIS LAYER
THINNEST LAYER? THICKEST?
ACCESSORY STRUCTURES
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SEBACEOUS GLANDS = OIL GLANDS
• ALL OVER THE BODY EXCEPT HANDS
•
•
•
AND FEET
ENTER HAIR FOLLICLE OR DIRECT TO
SKIN VIA A DUCT & PORE
SEBUM = OIL; ACTS AS A LUBRICANT FOR
SKIN; PREVENTS HAIR FROM BECOMING
BRITTLE; KILLS BACTERIA
3000/ SQ INCH OF SKIN
SWEAT GLANDS - SUDERIFEROUS
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2.5 MILL/PERSON
ECCRINE – MORE; ALL OVER BODY
• SWEAT – CONTAINS WATER, SALTS,
•
VITAMIN C, METABOLIC WASTE AND
LACTIC ACID; ACIDIC (4-6) TO PREVENT
BACTERIA GROWTH
IMPORTANT IN HEAT REGULATION
APPOCRINE SWEAT GLAND
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AXILLARY AND GENITAL AREAS
EMPTY INTO HAIR FOLLICLES
SAME AS SWEAT BUT ALSO HAS
PROTEIN & FATTY ACIDS
ODORLESS UNLESS BACTERIA GROW
USING THE SWEAT FOR NUTRIENT
NOT FOR THERMOREGULATION
INCREASE OUTPUT WITH PUBERTY
ADDITIONAL GLANDS
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CERUMINOUS - EAR
CILIARY - EYE
MAMMARY - BREAST
HAIR FOLLICLES
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SHAFT – FROM ROOT THROUGH
EXTERNAL PORTION SEEN BY EYES
GUARDS HEAD FROM BUMPS
SHIELD EYES FROM DEBRIS
KEEPS RESPIRATORY TRACT CLEAR
OF FOREIGN PARTICLES (CILIA)
SMALL ROLE IN KEEPING US WARM
ANATOMY OF HAIR
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FOLLICLE- SURROUNDS THE ROOT
ROOT –EXTENDS FROM BULB UP
THE FOLLICLE & BECOMES SHAFT
BULB – IN THE BASE OF EACH HAIR
FOLLICLE; PROVIDES NOURISHMENT
FOR GROWING HAIR AND NEW HAIR
PRODUCTION
MATRIX – GROWTH ZONE WITHIN
THE BULB
ARRECTOR PILI
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SMALL BANDS OF SMOOTH MUSCLE
CELLS CONNECT FOLLICLE TO THE
DERMAL TISSUE
MUSCLES CONTRACT WHEN WE ARE
COLD CAUSING “GOOSEBUMPS”
(HAIR STANDS UP AND SKIN
DIMPLES)
NAILS
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SCALE-LIKE ALTERATION OF EPIDERMIS
FREE EDGE, BODY, & ROOT
THICK SKIN FOLD IS CUTICLE
NAIL BED BENEATH NAIL IS STR. BASALE ;
PROXIMAL END IS NAIL MATRIX (GROWTH)
DISTAL END IS FREE EDGE
TRANSPARENT & NEARLY NO COLOR
NOURISHED AT MATRIX THEN LESS AS THEY
GROW UNTIL ARE DEAD TISSUE AT EDGE
ALTERATIONS TO SKIN
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ATHLETE’S FOOT
BOILS AND CARBUNCLES
COLD SORES
CONTACT DERMATITIS
IMPETIGO
PSORIASIS
OBSERVATIONS OF THE SKIN
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COLOR
PIGMENT
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DISCOLORATION
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• MELANIN
• ALBINISM
• PALLOR
• JAUNDICE
• CYANOSIS
COLOR OF SKIN
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MELANIN IN SKIN = YELLOW,
REDDISH BROWN, OR BLACK
CAROTENE – GETS DEPOSITED IN
STRATUM CORNEUM & SUBQ FAT
AMOUNT OF O2 RICH HEMOGLOBIN=
PINK LIPS & NAIL BEDS
CONTINUED
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ERYTHEMA = RED SKIN
PALLOR / BLANCHING = PALE
JAUNDICE = YELLOW
ECCHYMOSIS = BRUISES - BLACK
AND BLUE MARKS
LESIONS
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SUPERFICIAL
• RASH, ERUPTION, MACULE, PAPULE,
VESICLE/ BULLAE, PUSTULE
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DEEP
• EXCORIATION
• LACERATION
• ULCER
• FISSURE
BURNS
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RULE OF 9
1ST DEGREE – RED SKIN
2ND DEGREE – BLISTERS
1ST AND 2ND = PARTIAL THICKNESS
3RD DEGREE – CAN SEE MUSCLE
FULL THICKNESS
CRITICAL BURNS
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>25% BODY HAS 2ND DEGREE
>10% BODY HAS 3RD DEGREE
3RD DEGREE OF HANDS, FACE, FEET
OR GENITALS
TISSUE REPAIR
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NEW VESSELS BRANCH FROM
CAPILLARIES & GROW INTO INJURED
AREA. FIBROBLASTS HELP BUILD
NEW STRUCTURES.
SCAR, KELOID MAY RESULT.
WOUND REPAIR NEEDS NUTRITION,
BLOOD SUPPLY AND BE FREE OF
INFECTION. YOUNG HEAL FASTER.
WOUND HEALING
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Primary intention; initial union of edges of a wound,
progressing to complete healing without granulation.
Secondary intention; wound closure in which edges
are separated , granulation tissue develops to fill the
gap, and epithelium grows in over the granulations,
producing a scar.
Tertiary intention; wound closure in which granulation
tissue fills the gap between edges of the wound, with
epithelium growing over the granulation at a slower
rate and producing a larger scar than results from
secondary intention, with suppuration.
AGE EFFECTS ON SKIN
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Cell division slows
Thinner layers
Wrinkles-collagen and elastin deteriorate
Sweat and sebaceous glands decrease
function
Skin is dry
Temperature regulation is poor
Melanocytes die; gray hair
SKIN CANCER
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BASAL CELL – MOST COMMON &
LEAST MALIGNANT (SLOW GROWTH)
SQUAMOUS CELL – SEEN ON SCALP,
EARS, BACK OF HANDS AND LOWER
LIP. GROWS RAPIDLY & METS. FAST
MALIGNANT MELANOMA – 5% &
INCREASING; OFTEN DEADLY; FROM
ACCUMULATED DNA DAMAGE
CANCER RULES
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A = ASYMMETRY
B = BORDER IRREGULARITY
C = COLOR
D = DIAMETER
DEVELOPMENTAL
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LANUGO – FINE BABY HAIR AT BIRTH
MILIA – BABY ACNE ON NOSE
DERMATITIS – SKIN INFLAMMATION
ALOPECIA – HAIR LOSS
MALE PATTERN BALDNESS –
GENETIC LOSS OF HAIR; CHECK OUT
MOTHER’S FATHER TO SEE IF THE
SON WILL KEEP HIS HAIR!!
BODY HEAT
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Normal body heat is balanced between
production and loss
Sources; oxidation occurs when oxygen is
combined with glucose or other substances,
and organs which mostly comes from muscles
and the large organ, the liver.
Heat loss; skin, lungs, urine and feces.
Controlled by the hypothalamus in the brain.
OF INTEREST: ONE SQUARE INCH
OF SKIN CONTAINS….
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Sweat glands- 500
Oil glands- 100
Nerve endings- over 1000, 150 senses
for pressure, 75 sensors for heat, 10
sensors for cold.
Tiny blood vessels- yards
Cells- millions
MEDICAL TERMINOLOGY
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DERM/OMELAN/OAP/OALB/ICYAN/OBILI
ERYTH
SCLER/O-
CORNE/OSUBPIL/O-ISM
-SIS
-EMIA
DERMAT/O-