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IN THE NAME OWNER OF BEAUTY

IN THE NAME OWNER OF BEAUTY. The Integumentary System. Instructor: Shahnaz pouladi Bushehr Medical Science University Nursing and Midwifery Faculty. Three Layers of skin:. Epidermis : Stratified squamous epithelium; outer layer is "keratinized" or "cornified" Dermis:

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IN THE NAME OWNER OF BEAUTY

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  1. IN THE NAME OWNER OFBEAUTY

  2. The Integumentary System Instructor: Shahnaz pouladi Bushehr Medical Science University Nursing and Midwifery Faculty

  3. Three Layers of skin: Epidermis: Stratified squamous epithelium; outer layer is "keratinized" or "cornified" Dermis: Dense irregular connective tissue Hypodermis: Adipose connective tissue (technically not part of system)

  4. Epidermis:Avascular. Depends on blood vessels in underlying dermis for its nutrition Cells formed by mitosis in deepest, or basal layer, then get pushed into more superficial layers or "strata"

  5. (Epidermis) Stratum Basale = Single row of dividing cells Stratum Spinosum = Three or four layers of cells; Some cell division Stratum Granulosum = Three or four layers of cells; Actively synthesizing protein keratin Stratum Lucidum = One or two layers of dying cells Stratum Corneum = Many layers of flat, dead, scale-like cells full of keratin

  6. Primary cell type in epidermis = keratinocytes which produce large amounts of protein keratin Other cell types: Melanocytes produce pigment melanin & transfer it to keratinocytes Langerhans cells(really macrophages) clean up debris Merkel cells detect touch and pressure; transfer this information to sensory receptors in the dermis

  7. Dermis: Dense irregular connective tissue Separated from epidermis (stratified squamous epithelium) by basement membrane Highly vascular Highly innervated Two Layers: Papillary layer just below epidermis Reticular layer forms deep 80%

  8. Dermis = Dense irregular connective tissue. Thus: Cells = Fibroblasts / Fibrocytes Macrophages Mast cells Lymphocytes etc. Fibers = Collagen (therefore strong, flexible) Elastic (therefore stretchable) Weight gain tears collagen fibers producing striae (stretch marks)

  9. Hypoderm (Subcutaneous Tissue) • Primarily is adipose tissue • Provides a cushion

  10. Appendages of the skin

  11. Appendages of the skin Hair follicles and hair Sweat glands Sebaceous (oil) glands Nails on fingers and toes

  12. Hair - Distribuled over all skin except: palms of hands soles of feet nipples glans of penis & clitoris minor labia - Formed in follicles located deep in dermis - Consists of layers of dead, highly keratinized keratinocytes

  13. Shaft Root Bulb

  14. Each hair is associated with: One or more sebacious (oil) glands An arrector pili muscle A plexus of nerves around the root

  15. Hair • The rate of growth varies • Hair loss • Hair growth by sex hormone • Different functions of hairs • Hair color • Hair quantity and distribution

  16. Nails

  17. Nails: - Tips of fingers and toes - Thick layer of densely packed keratinocytes - Produced by nail matrixat proximal end, hidden under eponychium or cuticle Average growth: 0.5 mm per week

  18. Glands of the skin

  19. Sebaceous (oil) glands: - Branched tubular glands - Duct opens into opening of hair follicle - Secretes sebum, consisting of lipids, proteins, carbohydrates,

  20. Sweat Glands - 2 to 3 million - Two types: Merocrine: Distributed over all skin except nipples (Eccrine) Simple coiled glands in dermis Duct leads to sweat pore on surface Secreted watery sweat for cooling Apocrine: Located only in axillary, pubic, anal regions Larger than eccrine glands Duct opens into opening of hair follicle Secretes thicker sweat, high content of proteins and fats.

  21. Sweat is usually 99% water with a pH between 4 and 6 Sweat glands produce 500ml of insensible perspiration (no noticable wetness)daily Two specially modified sweat glands: Ceruminous—found in the external ear canal. Secretion combines with sebum and dead epidermal cells to form earwax (keeps eardrum pliable, canal waterproof and has a bactericidal effect) Mammary --milk producing glands found in the female breast (modified apocrine glands)

  22. Function of the Skin

  23. Functions of the skin • 1. Protection • First line of defense • Keratin: protects body from water loss, barrier for environmental factors (stratum corneum) • Melanin: keeps UV rays from penetrating • Surface film: sweat, oil, etc • Basal layer: composed of collagen(tissue organization and regeneration, selective permeability, physical barrier, bind)

  24. Functions of the skin • 2. Sensation • Pressure, touch, temp, pain, etc • Two specialized receptors: • Meissner corpuscle – detects light pressure • Pacinian corpuscle – detects deep pressure

  25. Functions of the skin • 3. Fluid balance • The stratum corneum has the capacity to absorb water • Skin damage (burn) • The skin is not completely impermeable to water. (evaporation) 600cc/day

  26. Functions of the skin • 4. Body temperature • Body produces heat (metabolism of foods) • Body releases 80% of heat through skin • Three major physical processes for loss of heat [radiation, conduction (evaporation), convection]. • On a hot day the skin releases almost 3000 calories of body heat (enough to boil five gallons of water) • Heat loss is controlled by negative feedback loop • Skin blood flow

  27. Functions of the skin • 3. Produces Vitamin D • Uv rays combine with skin to make cholecalciferol • Cholecalciferol is transported to the liver and kidneys where it is changed to vit D • Vitamin D is essential for preventing osteoprosis

  28. Functions of the skin • Immune response function • Langerhans cells facilitate the uptake of IgE- associated allergens • Plays a pivotal role in the pathogenesis of atopic dermatitis and other allergic disease

  29. Skin and Aging Process

  30. Assessment of the Skin

  31. Preparation • Equipment • Well-lit Room • Comfortable Environment • Hand washing • Appropriate use of Gloves • Privacy/Draping • Organized Assessment • Explanations

  32. Physical Assessment

  33. Physical Assessment • Inspection • Color • Bleeding • Ecchymosis • Vascularity • Lesions

  34. Physical Assessment • Palpation • Moisture • Temperature • Texture • Turgor • Edema

  35. Color • Normal=Uniformed whitish pink or brown • Abnormal • Cyanosis • Jaundice • Carotenemia • Albinism • Vitiligo

  36. Cyanosis

  37. Jaundice

  38. Carotenemia

  39. Albinism

  40. Vitiligo

  41. Physical Assessment • Bleeding, Ecchymosis, Vascularity • Normal=No areas • Abnormal • Spontaneous Bleeding • Petechiae • Ecchymosis • Venous Star • Necrosis

  42. Petechiae

  43. Ecchymosis

  44. Venous Star

  45. Necrosis

  46. Lesions • Lesions • Normal=No lesions except freckles, birthmarks, nevi (flat moles) • Abnormal • Rashes • Pressure Ulcers • Burns

  47. skin lesions

  48. Kind of lesions in dermatology1- Primary Skin Lesions2-Secondary Skin Lesions

  49. PRIMARY LESIONS

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