Integumentary System

What is the largest sensory organ of the body????

A. Eye

B. Ear

C. Tongue

D. Nose

E. Skin

Integumentary System

• Name for the skin and its structures

• Called a membrane because it covers the body

• Called an organ because it contains several kinds of tissues

• Called a system because it has organs and other parts that work together for a particular function

Functions Protection

Sensory perceptionRegulation of body temperatureStorageAbsorptionExcretionProduction

Components of the Skin

Layers of the Skin

• Epidermis—outermost layer

• Dermis—“true skin”• Subcutaneous fascia or

hypodermis— the innermost layer

The Layers of Skin

• Sudoriferous glands (sweat glands)

• Sebaceous glands (oil glands)

• Hair• Nails

Glands & Other Parts of the Skin

Hair Functions

Varies by location

Scalp: insulates head; grows @ 1 mm/day

Nostril: filters

Eyebrow/lash: protects; keeps dust and perspiration out of eyes

Body: none

Arrector pili: pilomotor muscle; stimulated by cold and emotions. Attached to base of dermal papilla and side of follicle. Contraction = goose bumps.

Alopecia = hair loss

NAILS

Protects the distal ends of phalanges

Provides ability to grip, pick up tiny objects

HCW observe for cyanosis to assess blood O2 if pulse ox not available

Skin Color—Pigmentation

Skin color is inherited and is determined by pigments in the epidermisa. Melaninb. Carotene

Skin Color—Albino

Absence of skin pigmentsSkin has pinkish tintHair is pale yellow or whiteEyes are red in color and sensitive to light

Skin Color—AbnormalErythema

Jaundice

Cyanosis

Skin Lesions

Any measurable variation in tissue structure

Not always a sign of disease

Can be flat, depressed or elevated

Elevated LesionsPapule: firm, raised; wart

Plaque: large,raised region; psoriasis

Vesicle: fluid filled; blister

Pustule: filled w/ pus; acne

Crust: scab

Wheal/hive: firm, raised, reddened w/ whiter center; insect bite

Depressed Lesions Excoriation: scratch exposing the dermisLaceration: tearing of the skin

Abrasion: scraping

Pressure Ulcer: Decubutis ulcer bedsore

Fissure: deep crack

Skin Eruptions

Macules (macular rash)

Papules (papular rash)

Vesicles

Pustules

Wheals

Crusts

Ulcer

Chicken Pox

Skin infections

Impetigo: staph, strept. Erythema then vesicles. Contagious. Tx: antibiotics

Tinea: Mycoses (fungal). Erythema, scaling and crusting. Ex: Ringworm (tinea capitis), athletes foot (tinea pedis). Tx: antifungal

Warts: verruca, caused by papilloma virus. Contagious. Tx: removal

Boils: furnacle. Staph inf of hair follicle. Lg pustule. Tx: topical antibiotic

Scabies: itch mite. Contagious. Tx: scabicide and antihistamine

Impetigo

Ringworm

Inflammatory Conditions Scleroderma: autoimmune. Affects blood vessels & connective tissue that causes hardening. Localized or Systemic

Psoriasis: chronic inflammation. Scaly patches. Tx: topical steroids

Eczema: most common. Papules, vesicles and crusts. Symptom of underlying condition. Tx: cause & topical steroids

Hives: urticaria (transient wheals) due to allergy or irritant.

Pruritits (itching). Tx: varies, treat the cause

BURNS Caused by fire, ultraviolet rays, electricity, chemicals. Cause will

influence tx

Severity: extent (total body surface area involved-%) + depth (layers involved)

Extent of injury: Rule of 9’s to determine; 11 body areas 9% each

Depth of inj: 1st, 2nd, 3rd degree

http://www.nlm.nih.gov/medlineplus/tutorials/burns/htm/_no_50_no_0.htm -

Rule of 9’s Estimation of body surface area involved

Ant head: 4.5% / Post head:4.5%

Ant arm: 4.5% / Post arm 4.5%

Ant leg: 9% / Post leg 9%

Ant trunk: 18% / Post trunk 18%

Modified in infants due to larger head size

Rule of 9’s

I ST DEGREE Surface layers of epidermis

Some reddening and discomfort

No blistering

Sunburn

Partial thickness

2nd Degree Deep epidermal and upper dermis

Severe pain and blistering

May damage hair, sweat and oil glands

Swelling (edema) and fluid loss occurs

Scarring results

Partial thickness

Partial thickness

2nd Degree

3rd Degree

Complete destruction of epidermis and dermis; may extend to SQ layer: full thickness burn (4TH degree if underlying bone/muscle tissue destroyed)

Little pain d/t destruction of nerve endings

Severe fluid loss

If it covers a large extent, the pt is critically ill; ultimately may die due to sepsis

3rd Degree

Diseases and Abnormal Conditions

Dermatitis what is this??

Eczema

Impetigo

Psoriasis

Ringworm

Verrucae/warts/plantar warts

Diseases and Abnormal Conditions

Acne vulgaris

Athlete’s foot

Burns

Skin cancerBasal cell carcinomaSquamous cell carcinomaMelanoma