Download CH-5 Lecture - Horizon Medical Institute

Lecture Notes
Classroom Activity to
Accompany Medical
Terminology Systems, Sixth
Edition
Barbara A. Gylys ∙ Mary Ellen Wedding
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Integumentary
System
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INTEGUMENTARY SYSTEM
Structure
• Epidermis
• Dermis
• Subcutaneous tissue
• Accessory organs
• Glands
• Hair
• Nails
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INTEGUMENTARY SYSTEM
Function
• Covers and shields outer body surfaces
• Sweat and oil glands produce secretions
• Contains an intricate network of sensory
receptors
• Regulates body temperature, pain, and
pressure
• Melanocytes produced in basal layer gives
color to the skin
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INTEGUMENTARY SYSTEM
Structure and Function Exercise
Q: What does the term integument mean?
A: Refers to the skin.
Q: What are the accessory structures of the skin?
A: Hair, nails, and glands (sweat and oil)
Q: What are the functions of the subcutaneous layer of tissue?
A: Binds the dermis to underlying structures; stores fats, insulates
and cushions the body, and regulates temperature.
Q: In the basal layer, what specialized cells protect the skin from
damaging effects of the sun?
A: Melanocytes, which produce melanin.
Q: Which accessory organs produce oil?
A: Sebaceous glands.
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INTEGUMENTARY SYSTEM
Basal Cell Carcinoma
Signs and Symptoms
• Malignancy of basal
layer is commonly
caused by repeated
overexposure to the
sun.
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INTEGUMENTARY SYSTEM
Basal Cell Carcinoma
Signs and Symptoms (continued)
• Locally invasive tumor, but rarely
metastasizes.
• Tumors grow slowly, but commonly
ulcerate.
• Tumors usually occur on the face.
• Predominant in fair-skinned men
older than 60 years.
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INTEGUMENTARY SYSTEM
Basal Cell Carcinoma
Treatment
• Size, shape, location, and invasiveness of the
carcinoma determine type of treatment.
• Curettage and electrodessication.
• Cryotherapy and laser therapy.
• Chemotherapeutic drugs.
• Surgical excision (used in 90% of the cases).
• Irradiation or chemosurgery.
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INTEGUMENTARY SYSTEM
Clinically Related Exercise
Q: Mr. T is advised that the basal cell carcinoma on his face will not spread but
will remain local. Nevertheless, it will destroy underlying and adjacent tissue.
The term for spread of CA from one part of the body to another site is called
_____________.
A: metastasis.
Q: A 70-year-old male is diagnosed with basal cell carcinoma due to
overexposure to the sun. He is advised that the most common site of this
skin cancer is the _____________.
A: face.
Q: After closely examining a growth on Ann’s arm, she is informed that it is
noncancerous. The dermatologist charts the noncancerous growth as
(benign, cancerous, malignant).
A: benign
Q: Mr. J is diagnosed with basal cell carcinoma and asks the nurse to explain this
type of cancer.
A: She explains it is a malignancy of the basal layer of skin, commonly caused
by repeated overexposure to the sun.
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INTEGUMENTARY SYSTEM
Abscess
Signs and Symptoms
• Localized collection of
pus at infection site
(characteristically a
staphylococcal
infection).
• A furuncle, or boil, is
an abscess in a hair
follicle and adjacent
subcutaneous tissue.
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INTEGUMENTARY SYSTEM
Abscess
Signs and Symptoms (continued)
• A carbuncle is a cluster of furuncles in the
subcutaneous tissue.
• Affected portion of skin may be extremely
tender, painful, and swollen.
• Abscess may enlarge, soften, and open,
discharging pus and necrotic material.
• Erythema and edema may persist at the site
for days or weeks.
• Mild fever may accompany this condition.
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INTEGUMENTARY SYSTEM
Abscess
Treatment
• Cleaning infected area thoroughly with
soap and water.
• Applying hot, wet compresses to
promote vasodilation and drainage
from lesions.
• Administering topical antibiotics.
• Incision and drainage (I&D) may be
necessary after lesion has matured.
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INTEGUMENTARY SYSTEM
Clinically Related Exercise
Q: Mrs. K presents with redness and edema on the neck. The
term to describe reddening of the skin is ____________.
A: erythema, erythamatous
Q: Upon diagnosis of a furuncle, the nurse explains that this
is an infection caused by a/an (bacterium, injury, virus).
A: bacterium
Q: The physician charts a cluster of furuncles in the
subcutaneous tissue as a ________________.
A: carbuncle
Q: Sue is diagnosed with an abscess on her knee. She asks the
nurse to explain this condition.
A: She explains it is a localized collection of pus at the
infection site, characteristically caused by the bacterium
known as staphylococcus.
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INTEGUMENTARY SYSTEM
Psoriasis
Signs and Symptoms
• Circumscribed red
patches covered by
thick, dry, silvery,
adherent scales.
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INTEGUMENTARY SYSTEM
Psoriasis
Signs and Symptoms (continued)
• Excessive development of the basal layer
• of the skin.
• Affected areas typically appear dry,
cracked, and encrusted.
• Buildup of skin is composed of living and
dead tissue.
• Common sites include scalp, knees,
elbows, umbilicus, and genitalia.
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INTEGUMENTARY SYSTEM
Psoriasis
Treatment
• Depends on the type of psoriasis,
extent of the disease, and the effect of
the disease on the patient.
• No cure; treatment is only palliative.
• Topical application of various
medications, such as coal tar, vitamin
D, corticosteroid drugs, and wet
dressings.
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INTEGUMENTARY SYSTEM
Psoriasis
Treatment (continued)
• Photochemotherapy called PUVA with
exposure to ultraviolet-A (UVA) light to
slow hyperkeratosis.
• Ultraviolet-B (UVB) light therapy or natural
sunlight to retard cell production.
• Excrimer laser, a more powerful form of
UVB light therapy, is directed to the plaques
to control scaling and inflammation.
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INTEGUMENTARY SYSTEM
Clinically Related Exercise
Q: Joan K is diagnosed with psoriasis. The physician explains
that the most common sites of psoriasis are the
________________.
A: scalp, knees, elbows, umbilicus, and genitalia
Q: Mr. M presents for treatment of psoriasis with ultraviolet
(UV) light therapy. The doctor explains that UV therapy
retards cell production and slows horny growths on the
skin. Overgrowth of the horny layer of the epidermis is a
condition called (keratoid, keratolysis, hyperkeratosis).
A: hyperkeratosis
Q: For chronic psoriasis, a powerful form of UVB light therapy
directed to the plaques is effective in controlling scaling
and inflammation. This type of laser is called
_____________ ___________.
A: excrimer laser
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INTEGUMENTARY SYSTEM
Medical Vocabulary
• acne
• allograft
• alopecia
• autograft
• contusion
• debridement
• dermatomycosis
• diaphoresis
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INTEGUMENTARY SYSTEM
Medical Vocabulary
(continued)
• gangrene
• hematoma
• hirsutism
• impetigo
• macule
• petechia
• pilonidal
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INTEGUMENTARY SYSTEM
Medical Vocabulary
(continued)
• pyoderma
• scabies
• sebaceous
• steatoma
• subcutaneous
• vulgaris
• xenograft
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INTEGUMENTARY SYSTEM
Diagnostic Procedures
• Biopsy
• Skin test
• Intradermal allergy
test reactions.
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INTEGUMENTARY SYSTEM
Word Building Exercise
Q: Inflammation of skin:
A: dermatitis
Q: Instrument to cut skin:
A: dermatome, dermatotome
Q: Tumor (consisting) of fat:
A: adipoma, lipoma, steatoma
Q: Excision or removal of a nail:
A: onychectomy
Q: Skin that is blue (in color):
A: cyanoderma
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INTEGUMENTARY SYSTEM
Medical and Surgical Procedures
• Debridement
• I&D
• Mohs surgery
• Skin graft
• allograft
• autograft
• synthetic
• xenograft
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INTEGUMENTARY SYSTEM
Clinically Related Exercise
Q: Mr. Y presents to have foreign material removed from his
wound and avoid the development of an infection. The
therapeutic procedure is charted as (allograft,
cryotherapy, debridement).
A: debridement
Q: Joan F presents to the clinic to remove a basal cell
carcinoma from her face. The doctor freezes and
destroys the lesion with nitrogen. This therapeutic
procedure is known as (cryotherapy, debridement, UV).
A: cryotherapy.
Q: Patient X is informed that pus will be removed from her
abscess by incising and draining it. The procedure is
abbreviated as ______.
A: I&D
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INTEGUMENTARY SYSTEM
Clinically Related Exercise
(continued)
Q: The surgeon informs Lydia T that layer by layer her
tumor will be excised until it is removed. What type of
surgery is this called?
A: Mohs surgery
Q: Mr X, a burn patient, is given a transplant of healthy
tissue from his son. What type of transplant is this known
as?
A: allograft
Q: John, a fireman who suffers from chemical burns, is
having healthy tissue transplanted from a pig. What type
of transplant is this called?
A: xenograft
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INTEGUMENTARY SYSTEM
Pharmacology
• Antibiotics
• Antifungals
• Antipruritics
• Corticosteroids
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INTEGUMENTARY SYSTEM
Clinically Related Exercise
Q: To treat a skin infection, the physician prescribes
a/an (antifungal, antibiotic, corticosteroid).
A: antibiotic
Q: Mary broke out with a poison ivy rash after a
camping trip. A topical drug is prescribed to
decrease inflammation and itching. This drug is
called a/an (antifungal, antibiotic, corticosteroid).
A: corticosteroid
Q: Mrs. K is diagnosed with ringworm and is treated
with a/an (antifungal, antibiotic, corticosteroid).
A: antifungal
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