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CHAPTER 5 THE INTEGUMENTARY SYSTEM AND BODY MEMBRANES RENITA K HOLMES MSN RN KAPLAN UNIVERSITY INTEGUMENTARY SYSTEM Unit 3 Activities • Reading: Chapter 5 • Discussion Questions • Pre-Quiz • Assignment • Post-Quiz Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 2 INTEGUMENTARY SYSTEM This system is called the integumentary system. • Integument is another name for the skin • The skin itself is the principal organ of the integumentary system. • The skin is the largest organ in the body • The skin is one of a group of anatomically simple but functionally important sheet-like structures called membranes. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 3 THE SKIN Membranes • Cover and protect the body surface • Line body cavities • Cover the inner surfaces of the hollow organs such as the digestive, reproductive, and respiratory passageways. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 4 THE SKIN Membranes • Some membranes anchor organs to each other or to bones • others cover the internal organs. • In certain areas of the body, membranes secrete lubricating fluids that reduce friction during organ movements such as the beating of the heart or lung expansion and contraction. • Membrane lubricants also decrease friction between bones in joints. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 5 CLASSIFICATION OF BODY MEMBRANES • Classification of body membranes There are 2 main types of membranes • Epithelial membranes—composed of epithelial tissue and an underlying layer of connective tissue • Connective tissue membranes—composed largely of various types of connective tissue Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 6 Types of body membranes. A, Epithelial membranes, including cutaneous membrane (skin), serous membranes (parietal and visceral pleura and peritoneum), and mucous membranes. B, Connective tissue membranes, including synovial membranes. Slide 7 CLASSIFICATION OF BODY MEMBRANES • Epithelial membranes • Cutaneous membrane—the skin • Serous membranes—simple squamous epithelium on a connective tissue basement membrane • Types • Parietal—line walls of body cavities • Visceral—cover organs found in body cavities • Examples • Pleura—parietal and visceral layers line walls of thoracic cavity and cover the lungs • Peritoneum—parietal and visceral layers line walls of abdominal cavity and cover the organs in that cavity • Diseases • Pleurisy—inflammation of the serous membranes that line the chest cavity and cover the lungs • Peritonitis—inflammation of the serous membranes in the abdominal cavity that line the walls and cover the abdominal organs Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 8 SEROUS MEMBRANE Line ventral body cavities (pleural, peritoneum, pericardium); transparent, thin, prevents friction Serous Membrane Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 9 THE SKIN The skin; covers the outer surface of the body. In contrast to serous or mucous membranes, the cutaneous membrane is thick, relatively waterproof, and usually dry. Cutaneous Membrane Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 10 CLASSIFICATION OF BODY MEMBRANES • Epithelial membranes (cont.) • Mucous membranes • Line body surfaces that open directly to the exterior • Produce mucus, a thick secretion that keeps the membranes soft and moist Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 11 MUCOUS MEMBRANE Mucous membranes are coated with the secretions of mucous glands. Mucous Membrane They line most of the digestive and respiratory tracts and portions of the urinary and reproductive tracts. Line passageways that communicate with exterior Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 12 CLASSIFICATION OF BODY MEMBRANES • Connective tissue membranes • Do not contain epithelial components • Produce a lubricant called synovial fluid • Examples are the synovial membranes in the spaces between joints and in the lining of bursal sacs Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 13 SYNOVIAL MEMBRANE Line join cavities (articulations) and produces the synovial fluid within the joint. The synovial fluid lubricates the cartilages in the joint, distributes oxygen and nutrients, and cushions shocks at the joint. Synovial Membrane Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 14 THE SKIN • Structure: two primary layers called epidermis and dermis • Epidermis • Outermost and thinnest primary layer of skin • Composed of several layers of stratified squamous epithelium • Stratum germinativum—innermost layer of cells that continually reproduce; new cells move toward the surface • As cells approach the surface, they are filled with a tough, waterproof protein called keratin; eventually cells flake off of body • Stratum corneum—outermost layer of keratin-filled cells Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 15 THE SKIN • Skin pigment—produced by deepest epidermal layer; gives color to the skin • The brown pigment melanin is produced by specialized cells in deepest epidermal layer • Blisters—caused by breakdown of union between cells or primary layers of skin Dermal-epidermal junction—specialized area between two primary skin layers Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 16 Microscopic view of the skin. The epidermis, shown in longitudinal section, is raised at one corner to reveal the ridges in the dermis. Slide 17 THE SKIN Dermis • Deeper and thicker of the two primary skin layers; composed largely of connective tissue • Upper papillary layer of dermis characterized by parallel rows of tiny bumps called dermal papillae • Ridges and grooves in dermis form pattern unique to each individual • Basis of fingerprinting • Improves grip for tool use and walking Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 18 THE SKIN • Deeper reticular layer of dermis filled with network of tough, interlacing, collagenous and stretchable elastic fibers • Number of elastic fibers decreases with age and contributes to wrinkle formation • Dermis also contains nerve endings, muscle fibers, hair follicles, sweat and sebaceous glands, and many blood vessels Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 19 THE SKIN Accessory structures of the skin Hair Lanugo soft hair of fetus and newborn Hair follicle epidermal tubelike structure required for hair growth Hair papilla structure from which hair growth begins Hair root lies hidden in follicle Hair shaft visible part of hair Arrector pili specialized smooth muscle that produces “goose bumps” and causes hair to stand up straight Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 20 Hair follicle. Relationship of a hair follicle and related structures to the epidermal and dermal layers of the skin. Slide 21 THE SKIN • Accessory structures of the skin (cont.) • Receptors (Figure 5-2) • Specialized nerve endings—make it possible for skin to act as a sense organ • Meissner’s corpuscle—capable of detecting light touch • Pacinian corpuscle—capable of detecting pressure Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 22 Slide 23 THE SKIN • Accessory structures of the skin (cont.) • Nails (Figure 5-6) • Produced by epidermal cells over terminal ends of fingers and toes • Nail body—visible part of nail • Root—lies in a groove; hidden by cuticle • Lunula—crescent-shaped area nearest root • Nail bed may change color with change in blood flow Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 24 Structure of nails. Fingernail viewed from above. Slide 25 Sagittal section of fingernail and associated structures Slide 26 THE SKIN • Accessory structures of the skin (cont.) • Skin glands—two types • Sweat, or sudoriferous, glands • Eccrine sweat glands • Most numerous, important, and wide-spread of the sweat glands • Produce perspiration or sweat, which flows out through pores on skin surface • Function throughout life and assist in body heat regulation • Apocrine sweat glands • Found primarily in axilla and around genitalia • Secrete a thicker secretion quite different from eccrine perspiration • Breakdown of secretion by skin bacteria produces odor Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 27 THE SKIN • Sebaceous glands • Secrete oil or sebum for hair and skin • Level of secretion increases during adolescence • Amount of secretion is regulated by sex hormones • Sebum in sebaceous gland ducts may darken to form a blackhead Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 28 THE SKIN o Functions of the skin • Protection—first line of defense against: • • • • Infection by microbes Ultraviolet rays from sun Harmful chemicals Cuts and tears Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 29 THE SKIN • Functions of the skin (cont.) • Temperature regulation • Skin can release almost 3000 calories of body heat per day • Mechanisms of temperature regulation • Regulation of sweat secretion • Regulation of blood flow close to the body surface • Sense organ activity • Skin functions as an enormous sense organ • Receptors serve as receivers for the body, keeping it informed of changes in its environment Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 30 THE SKIN Skin Cancer The three most common types of skin cancer are • Squamous cell carcinoma, • Basal cell carcinoma • Malignant melanoma Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 31 THE SKIN Exposure to the sun’s ultraviolet (UV) radiation is thought to be the most important factor in causing the common skin cancers. • UV radiation damages the DNA in skin cells, causing the mistakes in mitosis that produce cancer. • Skin cells have a natural ability to repair UV damage to the DNA, but in some people, this inherent mechanism may not be able to deal with a massive amount of damage. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 32 Squamous Cell Carcinoma • A common type of skin cancer, squamous cell carcinoma,is a slow-growing malignant tumor of the epidermis. • Lesions begin as hard, raised nodules that are usually painless (Figure 5-7, A). • If not treated, squamous cell carcinomas will grow in size and eventually metastasize or spread Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 33 THE SKIN • Squamous Cell Carcinoma Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 34 Basal Cell Carcinoma • The most common type of skin cancer, • Usually appears on the upper face • Originating in cells at the base of the epidermis, • Much less likely to metastasize • It often appears first as a small, raised lesion that erodes in the center to form a bleeding, crusted crater Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 35 THE SKIN • Basal Cell Carcinoma Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 36 THE SKIN Melanoma • Malignant melanoma is the most serious form of skin cancer. • This type of cancer sometimes develops from a benign or noncancerous pigmented mole, and then transforms into a dark, spreading cancerous lesion Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 37 THE SKIN • Malignant Melanoma Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 38 THE SKIN • Kaposi sarcoma is a rare form of skin cancer frequently associated with AIDS and other immune deficiencies. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 39 THE SKIN Warning Signs of Malignant Melanoma ABCD Rule Asymmetry Benign moles are usually symmetrical; their halves are mirror images of each other. Melanoma lesions are asymmetrical or lopsided. Border Benign moles are outlined by a distinct border, but malignant melanomal lesions are often irregular or indistinct in shape. Color Benign moles may be any shade of brown but are relatively evenly colored; melanoma lesions tend to be unevenly colored, exhibiting a mixture of shades or colors. Diameter By the time a melanoma lesion exhibits characteristics A, B, and C, it also is probably larger than 6 mm (14 inch). Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 40 THE SKIN • Burns • Treatment and recovery or survival depend on total area involved and severity or depth of the burn • Body surface area is estimated using the “rule of nines” (Figure 5-8) in adults • Body is divided into 11 areas of 9% each • Additional 1% located around genitals Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 41 The “rule of nines.” Dividing the body into 11 areas of 9% each helps to estimate the amount of skin surface burned in an adult. Slide 42 THE SKIN • Burns (cont.) • Classification of burns • First-degree (partial-thickness) burns—only the surface layers of epidermis involved • Second-degree (partial-thickness) burns—involve the deep epidermal layers and always cause injury to the upper layers of the dermis • Third-degree (full-thickness) burns—characterized by complete destruction of the epidermis and dermis • May involve underlying muscle and bone • Lesion is insensitive to pain because of destruction of nerve endings immediately after injury—intense pain is soon experienced • Risk of infection is increased Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 43 QUESTIONS Questions? Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 44