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CHAPTER 4 Skin & Body Membranes Body Membranes Function of body membranes Line or cover body surfaces Protect body surfaces Lubricate body surfaces Classification of Body Membranes Epithelial membranes * Cutaneous membranes Skin or Integumentary Mucous membranes Serous membranes Connective tissue membranes Synovial membranes Epithelial Membranes #1: Cutaneous membrane = SKIN Dry membrane Outermost protective boundary Superficial epidermis Keratinizing stratified squamous epithelium Underlying dermis Mostly dense connective tissue Epithelial Membranes #2: Mucous Membranes Surface epithelium Type depends on site Underlying loose connective tissue lamina propria Lines all body cavities that open to the exterior body surface Often adapted for absorption or secretion Epithelial Membranes #3: Serous Membranes Simple squamous surface epithelium Underlying areolar connective tissue Line open body cavities that are closed to the exterior of the body Serous layers separated by serous fluid Serous Membranes Specific serous membranes Peritoneum Abdominal cavity Pleura Surrounds the lungs Pericardium Surrounds the heart Connective Tissue Membranes Synovial membranes Connective tissue only Line fibrous capsules surrounding joints Integumentary System (Skin) Would you be enticed by an advertisement for a coat that is… Waterproof, stretchable, washable, permanentpress, that invisibly repairs small cuts, rips and burns, and that is guaranteed to last a life-time with reasonable care? You already have such a coat… Your cutaneous membrane SKIN!! Integumentary System Skin (cutaneous membrane) Skin derivatives Sweat glands Oil glands Hair Nails Basic Skin Functions Protects deeper tissues from: Mechanical damage Chemical damage Bacterial damage Thermal damage Ultraviolet radiation Desiccation Skin Functions Aids in heat regulation Aids in excretion of urea and uric acid Synthesizes Vitamin D Linked now to cancer protection HOMEWORK- VITAMIN D ARTICLES & CORRESPONDING QUESTIONS * Need to know Table 4.1 (pg 111)- Functions of skin and how those functions are accomplished Structure of the Skin Epidermis Outer layer Stratified squamous epithelium Often keratinized (hardened by keratin) Dermis Underlying layer Dense connective tissue Skin Structure Epidermis and dermis are firmly connected Unless, a burn or friction causes them to separate Interstitial fluid accumulates in the cavity between the layers Blisters Skin Structure Deep to the dermis is the hypodermis Subcutaneous tissue Essentially adipose tissue Not considered part of the skin Anchors skin to underlying organs Skin Structure… Let’s Label! Epidermis Avascular Contains keratinocytes Composed of up to 5 layers called strata From the outside in 1. 2. 3. 4. 5. Stratum corneum Stratum lucidum Stratum granulosum Stratum spinosum Stratum basale **Every 25-45 days we have a “new” a epidermis!! Melanin Melanocytes Cells found mostly within the stratum basale of the epidermis Produce melanin (pigment) Ranges in color from yellow to brown to black Acts as a natural sunscreen Amount of melanin produced depends upon genetics and exposure to sunlight Dermis- “Hide” Dense Connective Tissue Consists of two major regions Papillary layer- Upper dermal region Projections called dermal papillae Fingerprints Houses pain & touch receptors Capillary loops Reticular layer- Deepest skin layer Blood vessels Sweat & oil glands Pressure & nerve receptors Fingerprint Activity! Put on a latex free glove Get your hand nice and sweaty Carefully look under the dissecting microscope at the ridges of your fingertips ** The ridges of your fingertips are lined with sweat pores that leave unique, identifying films of sweat FINGERPRINTS!! Touch & Temperature Receptors Touch Receptors There are more touch receptors in some areas of our bodies compared to other areas Size and density of receptors varies in different areas of the body 2-point threshold will be smaller for areas that are more sensitive Temperature Receptors Temperature sensitivity is not uniform Cold receptors are unevenly distributed throughout the dermis and subcutaneous layer of the skin Warmth receptors are deeper & less numerous. Temperature Receptors • Temperature receptors show adaptation over time as the body adjusts (acclimation / habituation) • Cutaneous thermoreceptors • Free nerve endings that respond to particular ranges of temperatures and changes within those ranges • Separate locations on the skin are sensitive to hot or to cold, or are not sensitive to temperature at all Skin & Sensory Perception Many receptor sites for cutaneous sensations to stimuli such as touch, pressure, temperature, and pain A receptive field is the area on the skin that activates a sensory neuron Receptive fields may be small and numerous or large and overlapping Skin Color 3 Pigments Contribute to Skin Color 1. Melanin – Yellow, reddish-brown, or black pigment 2. Carotene – Orange-yellow pigment found in carotene- rich foods • Carrots and other orange, deep yellow or leafy green vegetables • • Yellow Babies?? Jaundice Yellowish cast; Signifies a liver disorder 3. Hemoglobin – Red coloring from the blood cells in the dermis capillaries • Oxygen content determines extent of red coloring • Cyanosis Did Veggies Turn My Baby's Skin Yellow? The other night, when I removed my toddler's socks, I was shocked to see that her feet were a yellowish color. My pediatrician said that she is eating too many orange veggies. However, she only eats one form of these vegetables per day and the other vegetables she eats are green. Carotenemia- Accumulation of the yellow coloring that the body converts to Vitamin A Consuming a lot of vegetables that contain carotene Green vegetables (broccoli/spinach), carrots, sweet potatoes and squash Not harmful – it’s just not pretty!! It will go away if you reduce the amount of carotene in her diet. Your baby will get all the Vitamin A she needs if you give high-carotene vegetables every other day, or every two days. Did Veggies Turn My Baby's Skin Yellow? CAROTENEMIA- Can also happen in adults. I will never forget my high school friend who went on a diet, and ate bags of carrots in an attempt to quiet her hunger. Her skin turned a pale shade of yellow and the palms of her hands and bottoms of her feet were of much greater intensity! Needless to say, when this started to happen, she changed her diet strategy. Appendages of the Skin Skin Appendages Include… Cutaneous Glands (Exocrine) Sweat & sebaceous glands Hair & hair follicles Nails Arise from the epidermis Role in maintaining homeostasis Appendages of the Skin Sebaceous (oil) glands All over the skin, except palms of hands & soles of feet Produce sebum (oily substance) Lubricant for skin & hair Kills bacteria Ducts usually empty into a hair follicle Glands are activated at puberty Acne Active infection of sebaceous glands Appendages of the Skin Sweat glands (Sudoriferous glands Sudor = sweat) Widely distributed in the skin Two types Eccrine Glands All over the body Sweat reaches the skin via a duct that opens externally as a pore on the skin surface Apocrine Glands Confined to axillary & genital areas Ducts empty into hair follicles Composition Sweat Mostly water; some salts (NaCl) Some metabolic waste (Urea, ammonia, uric acid) Fatty acids & proteins (Apocrine glands only) Function Helps dissipate excess heat Excretes waste products Acidic nature inhibits bacteria growth Odor is from associated bacteria… Sweat Glands! Appendages of the Skin Hair Produced by a hair follicle Consists of hard keratinized epithelial cells Melanocytes provide pigment for hair color Hair Anatomy Central medulla Cortex surrounds medulla Cuticle on outside of cortex Most heavily keratinized Associated Hair Structures Hair follicle Dermal and epidermal sheath surround hair root Arrector pilli Smooth Muscles- “Goose bumps”! Sebaceous gland (oil) Sweat gland Hair Follicles! Appendages of the Skin Nails Scale-like modifications of the epidermis Heavily keratinized Stratum basale extends beneath the nail bed Responsible for growth Colorless- Lack of pigment Nail Structures Free edge Body Root- Embedded in the skin Heavily keratinized Homeostatic Imbalances of Skin Infections & Allergies Athletes foot Caused by fungal infection Tinea pedis Itchy, red, peeling condition Homeostatic Imbalances of Skin Infections & Allergies Boils and carbuncles Inflammation of the hair follicles & sebaceous glands Common on the dorsal neck Caused by bacterial infection Staphylococcus aureus Homeostatic Imbalances of Skin Infections & Allergies Cold sores (fever blisters) Small, fluid filled blisters on or around the lips Itch and sting Caused by the herpes simplex virus Remains dormant until activated by emotional stress, fever, or UV radiation Homeostatic Imbalances of Skin Infections & Allergies Contact Dermatitis Itching, redness, swelling of the skin, progressing to blistering Caused by exposure of the skin to chemicals Poison Ivy Homeostatic Imbalances of Skin Infections & Allergies Impetigo Pink, water filled raised lesions Commonly around the mouth and nose Develop a yellow crust eventually rupture Caused by highly contagious bacterial infection Staphylococcus Common in elementary school-aged children Homeostatic Imbalances of Skin Infections & Allergies Psoriasis Chronic condition Overproduction of skin cells that results in reddened epidermal lesions covered with dry, silvery scales Can be disfiguring, if severe Autoimmune disorder Immune system attacks a person’s own tissues Triggered by trauma, infection, stress, hormonal changes Burns Tissue damage and cell death caused by intense heat, electricity, UV radiation (sunburn), or chemicals (acids) Associated life-threatening dangers Body loses fluids containing proteins & electrolytes as these seep from the burned surfaces Dehydration & Electrolyte imbalance Kidneys shut down Circulatory shock Infection Burned skin is sterile for 24 hours but after that bacteria & fungi invade the nutrient rich environment of dead tissue 1-2 days after a severe burn – immune system is depressed Rule of Nines Volume of fluid lost can be estimated indirectly by determining the extent of the burn by using the Rule of Nines Body is divided into 11 areas Each area represents about 9% of the total body surface See page 122 textbook Severity of Burns First-degree burns Only epidermis is damaged Skin is red and swollen Heal within 2-3 days, without special attention Sunburn Second-degree burns Epidermis and upper dermis region are damaged Skin is red & painful with blisters No permanent scars result if care is taken to prevent infection Severity of Burns Third-degree burns Destroy the entire skin layer Burn is gray-white or black Nerve endings are destroyed Not painful Regeneration is not possible Skin grafting must be done to cover the underlying exposed tissue Critical Burns Burns are considered critical if: Over 25% of body has second degree burns Over 10% of the body has third degree burns There are third degree burns of the face, hands, or feet Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Cross Sectional View 2nd Degree burn: (Note blisters) McDonalds Coffee Case Perhaps the most well-known, "frivolous lawsuit”, is the story of Stella Liebeck - the woman who was burned by hot coffee from McDonalds. Here are the facts about the McDonald's lawsuit; decide for yourself if the suit was frivolous: • Stella Liebeck was a 79-year-old grandmother who was the passenger in her grandson's car • McDonalds served the coffee at roughly 190 degrees. (190 Degree liquid will cause third-degree burns within 2-7 seconds of contact with the skin.) • Stella was wearing cotton jogging pants, and the 190 degree liquid soaked into the pants. Skin Cancer Neoplasm = Tumor Cancer – abnormal cell growth Two types of Skin Cancer Benign Does not spread (encapsulated) Malignant or cancerous Metastasizes (invade) other parts of the body Skin Cancer Skin cancer is the most common type of cancer Cause is unknown Risk Factor Overexposure to UV radiation Predisposing Factors Frequent irritation of the skin by Infections, chemicals, or physical trauma Skin Cancer Types Basal Cell Carcinoma Least malignant Most common type Slow-growing Cells of the stratum basale (epidermis) no longer form keratin & they start to invade the dermis & subcutaneous tissue Lesions often occur on sun-exposed areas of the face Shiny, domed shaped nodules that may have a central ulcer Skin Cancer Types Squamous Cell Carcinoma Arises from stratum spinosum (epidermis) Lesion: Scaly, reddened papule (small rounded elevation) Gradually forms a shallow ulcer with a firm, raised border Most often on the scalp, ears, dorsum of the hands, lower lip Grows rapidly & metastasizes to lymph nodes Early removal allows a good chance of cure Basal Cell Carcinoma Skin Cancer Types Malignant Melanoma Most deadly of the skin cancers Cancer of melanocytes Arises from accumulated DNA damage in a skin cell and usually appears as a spreading brown, black patch Metastasizes rapidly to lymph and blood vessels Detect using the ABCDE rule Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Malignant Melanoma ABCDE Rule A = Asymmetry Two sides of pigmented mole do not match B = Border irregularity Borders of mole are not smooth; exhibit indentations C = Color Different colors in pigmented area (blacks, browns, tans, blues, reds) D = Diameter Spot is larger then 6 mm in diameter (pencil eraser) E = Elevation Mole is raised above the surface & uneven Skin Cancer Video Tanning Beds & Melanoma