Integumentary System

cutio-

skin

integumento

cover

clysis

wash or irrigate

corio-

true skin

maculo

large spot

pilo-, tricho-

hair p

physis-

growth

pruritis-, psoriasis

to itch

rhytido-

wrinkle

sarco-

fleshy

steato-

fat

theleo- , papillo-

nipple, nipple-like

vesico-, cysto-

blister, sac

what is keratin

protein-based substance that gives the outer skin a tough, waterproof, tight, protective layer

what are melanocytes

cells that produce melanin, which is the coloring material of the skin

the upper region of the dermis is composed of

a nipple like structure referred to as the papillary layer, it helps keep the skin stay together and forms ridges and grooves

the connective, elastic tissue within the skin allows

stretching as the body moves

the subcutaneous layer stores

fat for energy, w sweat glands help regulate body temperature

what causes our skim hair to stand up straight

arrector pili muscle when it contracts

meissner’s corpuscles function

detect superficial pressure, such as from an insect on the skin’s surface

stratum corneum:

top horny outer layer contains keratin-disjunction part of the skin that is shed

stratum lucidum

middle transparent layer below corneum and above the granulosm

stratum granulosum

inner or deepest part of epidermis with columnar cells that divide and replace the rest of the epidermis

stratum spinosum

spiny cells above basal layer

stratum basale

deepest with kerato/hyalin granules

what in the sun causes more melanin to be produced

ultraviolet light, gives us the tan

Dermis:

contains connective tissue, blood vessels, nerves, sweat glands, and sebaceous glands

ruffini corpuscle

aka bulbous corpuscles, pick up sensation of heat

krause corpuscles:

aka bulboid corpuscles, pick up sensation of cold

pain receptors

any one of free nerve endings throughout the body that warn of potential harm. Located chiefly in the epidermis and in the epithelial coverings of certain mucous membranes

Meissner’s corpuscles

pick up the sensation of touch

Pacinian corpuscles:

aka lamellar corpuscles, pick up the sensation of pressure deep within the skin

what does the adipose tissue within the dermis do

along w arteries and veins, supplies nutrients

why do smokers have wrinkled skin

smoking causes vasoconstriction and cuts off normal blood supply to the skin

onycho-, unguino-

nail

what are splinter hemorrhages/blood blisters

are under the nails and are usually the result of injury, but it could indicate infectious endocarditis

common procedures of dermatoplasty

blepharoplasty (eyelift)

facioplasty (fcelift)

rhinoplasty (nose job)

Dermabrasion

removal of scars with a revolving wire brush, sandpaper, or chemicals

often used to reduce acne scars, tattoos, or wrinkles

what are the types of skin injections

intramuscular (90* straight down)

subcutaneous ( 45* angle in)

intravenous (25* angle in)

intradermal (15* angle in)

skin turgor

‘swelling’

a test for skin resilience by pinching, compression, or other distortions

if the skin returns to normal appearance at a specific speed then the body has adequate fluid, or it is not dehydrated

ab/rasion

away/scrape

to roughen or remove by friction. a common type is chafing

laceration

to tear. often irregular and jagged

occurs when the skin experiences pressure, stretching or a blow, causing tearing

ex: perineal lacerations occur during birth

Lentigo

freckle

small brown or yellow brown macule on the skin caused by exposure to the sun. It can grow on the surface of the skin and become larger

one form is noninvasice malignant melanotic freckle

Contusion

bruise

any injury caused by a blow, in which the skin is not disrupted or broken. Usually caused by blow to the body and is characterized by swelling, pain, and discoloration.

apply cold and firm bandage to limit swelling. after 48 hrs apply heat and gentle massage

contracture

contraction or shortening of muscle fibers which causes atrophy or shrinking of that particular body tissue

usually causes extreme scar tissue or keloid tissue formation over the body joint, causing joint fixation and partial or total loss of joint flexion and extension

caused by burns, and may lead to body paralysis or muscle spams

Burn

1st degree- similar to sunburn

2nd degree- blisters caused by sunburn or caustics

3rd degree- destruction of skin with charring of underlying tissues; caused by fires

4th degree- causes partial or complete destruction pf epidermis and underlying tissues like muscles, ligaments, tendons and bones

Bulla

thin walled, fluid filled lesion

larger than 1 cm

ruptures easily

associated w noninfectious diseasest

Tumor

firm mass or swelling

may be malignant or benign

macule

round, flat pigmented area

associated q measles and scarlet fever

noninfectious types are freckles, and petechia

Nodule

a large, solid, raise area of skin

larger than1 cm

xanthomas and fibromas

papule

round, solid, and raised

less than -.5 cm

seen in rubella

plaques

flat, solid lesion planes

may be formed by mass of papules

2 or more cm in diameter

psoriasis and lichen

pustule

round raised pus filled lesion

acne produces pustules called comedones

patch

distinguished from a macule through size

larger than 0/5 cm

vitiligo

vesicle

clear fluid filled lesion

less than 0.5cm

closely spaced

seen in contact dermatitis and herpes

wheals

aka hives

raised red itchy areas with clearly defined edges that are transient

caused by allergic reactions

fissure

secondary lesions

linear crack that extends into the dermis

develop cracked lips and athlete’s foot

keloids

secondary lesion

excessive scar tissues

raised often red and on the surface of the skin

lichenification

secondary lesion

thickened area of skin that forms after intense scratching

scales

secondary lesion

flaky, dry, silvery or white forms of shredding keratin cells

seen in eczema, seborrhea. dermatitis, psoriasis and ichthyosis

scars

secondary lesion

connective tissues that remain after a skin lesion has healed

aka cicatrix

result from trauma

ulcer

secondary lesion

deep depression that extends into the dermis

decubitus ulcers are pressure ulcers

ulcerations are related to STIs

crusts

secondary lesion

thickened, dried areas of broken pustules or vesicles

viewed as scabs that form over vesicles

appear in impetigo and chicken pox

erosion

secondary lesion

superficial, scooped out areas that do not extend into the dermis

excoriation

secondary lesion

reddened abrasion, usually from itching

seen w insect bites and scabies

Blister

fluid below or within the epidermis often caused by fever or friction

cheilosis are lip and mouth blisters scales and fissures. cheilitis is inflamed and cracked skin

treatment: mild antiseptic, protective dressing, may be punctured to relieve pressure

Boil

necrotic or inflamed tissue forming a core of material that is either extruded, reabsorbed, or surgically removed

common cause is staphylococcus bacteria

pain, swelling, redness. irritation or squeezing spreads infection

treatment: moist heat, bed rest, topical and or systemic antibiotics, surgical incision, drainage

acne

inflammatory disease of the skins sebaceous glands and hair follicles

increase in androgen in both sexes increases these pilosebaceous glands i=activity, causing juvenile acne

pimples and pustules form comedones (blackheads) = discolored dried sebum plugs of the excretory skin ducts or hair follicles

skin debris and waxy oil cause acne with cysts, nodules, and scars

treatment: benzoyl peroxide, salicylic acid, clindamycin, erythromycin, uv light. cleansing, peels, incision and drainage

Types of cysts

conjunctival: develop under the conjunctiva covering of the global portion of the global portion of this eye membrane over the sclera

epidermal: caused by hair follicle blockage and contain large amounts of epidermal tissue, hair, and oil

mucoid: caused by degenerating connective tissue and usually occur in the vertebra or distal finger joints

Epidermoid cyst

common benign cavity lines by keratinizing epithelium and filled w cheesy material composed of sebum and epithelium debris

caused by closure of oil gland, oil duct, and poor circulation

usually on head or near anus, common in scalp or neck

excised surgically and antibiotic may be used drainage not advised

Pilonidal cyst

abscess or cyst of the head or anal areas

recognized by a depression or dairy dimple

sinus of fistula often develops and becomes infected draining through the sinus and or into a cavity

fistula may develop in spinal tract

treatment: antibiotics for infection or surgical excision

Milium

white pinhead papules on face or trunk that are keratin filled cysts

form below the skin

often disappear

Striae Gravidarum

aka stretch marks

red or purple depression in skin

treatment for rash

antihistamines

urticaria

hives or nettles

pruritic skin eruption w severe itchy pale wheals

caused by allergy, insect bites, pollens, drugs, exercise, inhalants, stress, heat or cold, physical, neurologic factors

treatment: avoid triggers, antihistamines, steroids

Eczema

noninfectious superficial dermatitis of u/k cause

vesicles, redness, swelling, itching, pustules appear and lead to dry scales, crusts, and scabs. characterized by itching and burning

exacerbation BY TEMP CHANGE, HUMIDITY, STRESS, PERFUMES, DETERGENTS

Psoriasis

pink or dull red lesion and silvery scaling

associated w arthritis

idiopathic and not controlled by topical agents.

NF-alpha blockers, phototherapy, corticosteroids, cyclosporine

actinodermatisis:

inflammation of skin caused by exposure to radiation, especially from the sun

acrodermatitis

extremities, height, pointed skin inflamed

childhood form of dermatitis

accompanied by diarrhea, hair loss, lesions

if enteropathy, may be fatal for 1-3 yrs old

Cradle cap

thick, yellow, greasy scaling of the scalp

treatment: apply oil or ointment to soften scalp and shampoo frequently

Phytophotodermatitis

inflammation of skin caused by plant oils and a light activated sensitive reaction

most common plants that cause this rash are citrus fruits, wild parsnips, and rue

Photodermatitis

sensitivity of epithelium to light

may occur as a result of an allergic reaction as a symptom of an immune disorder, as a result of chemical exposure, or individual may be born w a predisposition for this condition

Verruca

warts

benign epidermal nipple like skin tumors caused by papillomavirus

can be plana, senilis, carcinoma, acuminata

treatment: removal w sharp spoon curette under local anesthesia, cryotherapy, salicylic acid, electrosurgery

papilloma acuminata: genital form that leads to cervical cancer

callus:

thick or thin horny mass of condensed epithelial cells in stratum corneum which overlie any bony body prominence

usually caused by pressure or friction

conic form: compressed dermis, making it thin and tender

treatment: surgical paring and chemical peels of excess keratin if needed to thicken skim

Corn

cone shaped horny mass of condensed epithelial cells which compress underlying dermis, making it thin and tender

can become soft bc of foot perspiration

treatment: relief from pressure, surgical paring, chemical peels of excess keratin material

caused by long term friction and pressure

Bunion

abnormal enlargement of join at beginning big toe w bursitis

caused by joint inflammation, chronic pressure, degenerative joint, bone diseases, and heredity

Merocine gland

apart/secretes

sweat glands; form i cell and pass through membrane into a duct

a porcine gland

above/secretes

mammary glands and sweat glands in axilla and genital area; form within the cell and the ends break off w secretion

eccrine gland

out/secretes

all sweat glands

holocrine gland

whole/secretes

sebaceous glands; the cell and its secretions are exuded

endocrine gland

within/secretes

7 hormone glands; they are ductile; hormones enter directly into the blood

exocrine gland

out/secretes

saliva and pancreas; the juices flow out of a duct into a new body part, such as from the proximal pancreas into the duodenum

lymph nodes

lymph is a watery fluid originating in organs and tissues that circulate to the lymph vessels and are filtered by lymph glands or nodes

lymph enters the blood stream at the junction of the internal jugular and subclavian veins

lymph contains chyle, erythrocytes, and leukocytes

Capillaritis

inflammation of the body’s capillary beds

results in a distinctive set of dark brown or reddish, flat lesions and across the affected area, generally the legs

does not generally cause any damage to the body and will generally resolve itself within a few months

Dyshidrosis

sweating disorder that leaves vesicle eruption on skin, usually on the hands and feet, that cause intense itching

treatment: to control sweating by use of absorbent socks and well-ventilated socks, corticosteroids applied at night, phototherapy, and immune suppressing lotions like pimecrolimus, box for serve cases

dehydration usually follows..

prolonged diarrhea, fever, vomiting, and diabetic ketoacidosis

caused by fluid deprivation, excess loss, sweating, loss of electrolytes, or injection of hypertonic solution

Gangrene

death of tissue due to insufficient blood supply. May be disrupted due to infection, injury, coagulation i=disorder, boils, frostbite, diabetes, and Raynaud’s disease

types: gas, bacillus, moisture or dryness, previous infection, vasomotor, disturbance, extensive injury

Ichthyosis

fish like skin, which is dry, hyperkeratotic, scaly

may infect older people, frequent bathers, or be acquired as part of several syndromes including lymphoma and multiple myeloma

fungus infections of feet are often referred to as mild pedal ichthyosis

treatment: topical moisturizers, anti-keratinizing meds, potentially skin grafts

Xeroderma

dry/skin

roughness and dryness of skin

xeroderma pigmentosa: found in children, pigment discoloration, ulcers, cutaneous, muscular atrophy, extreme sensitivity to uv light,

Lichen Planus

any papular, scaly, nonmalignant, chronic skin disease

pimples/papules: small flat purplish or white often becoming plaques w fine gray lines

characterized by itchy pinhead read patches