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Chapter 11

Would you be enticed by an advertisement for a coat that is waterproof, stretchable, washable, and permanent press, that is guaranteed to last a lifetime with reasonable care?. Chapter 11. The Integumentary System. Learning Outcomes. List the functions of skin.

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Chapter 11

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  1. Would you be enticed by an advertisement for a coat that is waterproof, stretchable, washable, and permanent press, that is guaranteed to last a lifetime with reasonable care?

  2. Chapter 11 The Integumentary System

  3. Learning Outcomes List the functions of skin. Explain the role of skin in regulating body temperature. Describe the layers of skin and the characteristics of each layer. Explain the factors that affect skin color. Identify and describe common skin lesions.

  4. Learning Outcomes(cont.) List the accessory organs of skin and describe their structures and functions. Explain the process of skin healing, including scar production. Describe the effects of aging on skin. List the different types of burns and describe their appearances and treatments.

  5. Learning Outcomes(cont.) Describe the causes, signs and symptoms, and treatments of various types of skin cancer. Describe the causes, signs and symptoms, and treatments of common skin disorders. Explain the ABCD rule and its use in evaluating melanoma. Using the acronym CAUTION, list the seven warning signs of cancer.

  6. Integumentary system consists of skin and its accessory organs Accessory organs: Hair follicles Nails Skin glands Introduction Skin is the body’s outer covering and its largest organ.

  7. Functions of the Integumentary System • Protection • First line of defense against • Bacteria • Viruses • Protects underlying structures from • Ultraviolet (UV) radiation • Dehydration

  8. Functions of the Integumentary System (cont.) • Body temperature regulation • If too hot • Dermal blood vessels dilate • Vessels carry more blood to surface so heat can escape • If too cold • Dermal blood vessels constrict • Prevents heat from escaping

  9. Functions of the Integumentary System (cont.) • Vitamin D production • Needed for calcium absorption • Sensation • Sensory receptors • Excretion • Small amounts of waste products are lost through perspiration

  10. Super! Apply Your Knowledge What are the functions of the integumentary system? ANSWER: The functions of the integumentary system are protection, regulation of body temperature, vitamin D production, sensation, and excretion.

  11. Structure of Skin • Epidermis • Dermis • Hypodermisor subcutaneouslayer Back

  12. Skin Structure: Epidermis • Most superficial layer • Two parts • Stratum corneum • Outermost layer • Mostly dead cells form an impermeable layer • Stratum basale(stratum germinativum) • Deepest layer • Cells constantly dividing and pushing older cells outward To Figure of Skin

  13. Skin Structure: Epidermis (cont.) • Keratinocyte– most common • Makes and accumulates keratin • Durable protein that makes the epidermis waterproof and resistant to pathogens • Melanocyte • Makes the pigment melanin • Traps UV radiation and prevents damage to underlying layers of the skin

  14. Skin Structure: Dermis • Deeper of the two skin layers • Contains all major tissue types, plus • Sudoriferous (sweat) glands • Sebaceous (oil) glands • Hair follicles and arrector pili muscles • Collagen, elastic, and nerve fibers • Blood vessels • Binds the epidermis to the subcutaneous tissue To Figure of Skin

  15. Skin Structure: Subcutaneous Layer • Hypodermis • Composed of • Adipose (fat) and loose connective tissue • Blood vessels and nerves • Functions • Storage in adipose tissue • Cushions and insulates underlying structures To Figure of Skin

  16. Apply Your Knowledge Where are melanocytes and keratinocytes, and what is their function? ANSWER: Both are located in the epidermis of the skin. Keratinocytes make and accumulate keratin, which is a durable protein that makes the epidermis waterproof and resistant to pathogens. Melanocytes make the pigment melanin, which traps UV radiation and prevents damage to underlying layers of the skin. Excellent!

  17. Skin Color • Determined by amount of melanin in the epidermis of skin • The more melanin, the darker the skin color • Range is from yellowish to brownish

  18. Skin Color (cont.) • Oxygenated blood • Amount of oxygen dissolved in the hemoglobinof the red blood cells • Hemoglobin – a pigment in the RBCs • If blood is well-oxygenated, skin will be pink • If oxygen level in blood is low, skin will be pale or have a bluish color (cyanosis)

  19. Nice Job! Apply Your Knowledge What affects skin color? ANSWER: The amount of melanin produced by the melanocytes and the oxygenation of the blood.

  20. Skin Lesions • Any variation in the skin • As simple as a freckle • As serious as a tumor

  21. Skin Lesions (cont.)

  22. Skin Lesions (cont.)

  23. Skin Lesions (cont.)

  24. Skin Lesions (cont.)

  25. ANSWER: C Apply Your Knowledge Match the following: ___ Keloid A. A blister ___ Vesicle B. A crack in the skin’s surface ___ Crust C. An overgrowth of scar tissue ___ Fissure D. A small, flat scaly area of skin ___ Ulcer E. Dried blood or pus on the skin ___ Plaque F. A wound that results from tissue loss A BRAVO! E B F D

  26. Hair follicles Tube-like depressions in the dermis of skin Generate hairs Alopecia (baldness) occurs when follicles die Arrector pili muscles attached to follicles cause goose bumps Sebaceous glands Produce sebumto keep hair soft Prevent bacteria from growing on skin Nails Protect the ends of fingers and toes Hard keratin Accessory Organs (cont.) Diagram

  27. Sudoriferous (sweat) glands Located in the dermis of skin Types Eccrine Produce watery type of sweat Activated by heat Apocrine Produce thicker type of sweat with more proteins Concentrated in armpit and groin areas Activated by nervousness or stress Accessory Organs (cont.) Diagram

  28. Accessory Organs Sebaceous gland Hair follicle Sudoriferous gland Return

  29. Skin Healing • Injury  inflammation • Redness due to dilation of nearby blood vessels • Swelling because vessels leak fluid into spaces between cells • Pain because excess fluid activates pain receptors

  30. Scab replaces blood clot Clotted blood and other dried tissue Collagen fibers replace scab Bind the edges of wound; major component of scars Skin Healing (cont.) • Inflammation promotes healing • Extra blood to area • Extra nutrients for skin repair • Defensive cells Injury occurs Blood clot forms

  31. Apply Your Knowledge How does inflammation promote healing of the skin? ANSWER: Inflammation promotes healing by bringing extra blood, nutrients for skin repair, and defensive cells to the area of injury. Correct

  32. Skin and Aging • Skin loses firmness due to • Loss of elastic and collagen fibers in dermis • Loss and shifting of underlying adipose tissues • Skin color changes • Dermis becomes thinner and more transparent • Paler due to decrease in circulation

  33. Skin and Aging (cont.) • Melanocytes decrease • Those remaining gather  “age” spots • Hair grays and becomes thinner • Decreased tolerance to temperature changes • Sudoriferous glands decrease in number • Decreased perspiration, hard to adjust to high temperatures • Loss in adipose tissue and decreased circulation • Increased sensitivity to cold

  34. Apply Your Knowledge What happens to the skin in the elderly? ANSWER: As a person ages, the skin loses firmness, skin color changes, melanocytes decrease, and tolerance to temperature changes decreases due to a loss of adipose tissue and sweat glands. Very Good!

  35. Second leading cause of accidental death in the U.S. Rule of nines is used to determine severity (degree) of burn Burn severity: First-degree Second-degree Third-degree Burns Rule of Nines

  36. Rule of Nines • This method divides body into 11 areas, each accounting for 9% of the total body surface area • The volume of fluid lost can be estimated by determining how much of the body surface is burned.

  37. First-Degree Burns • Only the epidermis is damaged • Area becomes red and swollen • Generally, heal in 2 -3 days • Sunburn is usually a first-degree burn

  38. Second-Degree Burns • Involve injury to the epidermis and upper region of the dermis • Skin is red and painful, and blisters appear • Regrowth can still occur • Ordinarily, no permanent scars result if care is taken to prevent infection

  39. Third-Degree Burns • Destroy the entire thickness of the skin • Burned area appears blanched (gray-white) or blackened • Nerve endings are destroyed, therefore, the burned area is not painful • Regeneration is not possible • Skin grafting required

  40. Burns are considered critical if • Over 25% of the body has second-degree burns or • Over 10% of the body has third-degree burns • There are third-degree burns of the face, hands, or feet

  41. Do not remove anything sticking to the burn Do not apply butter, lotions, or ointments Cool with large amounts of water Cover with sterile sheet or plastic bag Burns: Treatment

  42. Skin Cancer Basal cell carcinoma – progresses slowly and rarely spreads to other body parts Squamous cell carcinoma – more likely to spread to surrounding tissues Malignant melanoma – more aggressive and occurs anywhere Most arise from melanocytes

  43. Skin Cancer: Basal Cell Carcinoma • Signs and symptoms • New growth or sore that will not heal • Waxy, smooth, red, pale, flat, or lumpy • May or may not bleed • Treatment: • Curettage and electrodessication Cryosurgery • Mohs’ surgery Laser therapy

  44. Skin Cancer:Squamous Cell Carcinoma • Less common than basal cell carcinoma • Found on face, lips, ears, and backs of hands • Signs and symptoms and treatments are the same as for basal cell carcinoma

  45. Signs and Symptoms From melanocytes Appear on trunk, head, neck of men Appear on arms and legs of women Itches or bleeds Treatment Surgery and biopsy Removal of lymph nodes Chemotherapy and radiation therapy Immunotherapy Skin Cancer: Malignant Melanoma

  46. Skin Cancer: Stages of Melanoma

  47. Skin Cancer: ABCD Rule

  48. Cancer Warning Signs C – Change in bowel or bladder habits A – A sore that will not heal U – Unusual bleeding or discharge T – Thickening or lump I– Indigestion or difficulty swallowing O – Obvious change in wart or mole N – Nagging cough or hoarseness

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