Ch. 7 Integumentary System Student(4) 4

Chapter 7: The Integumentary System

Introduction

• Presented by: Mrs. Giomara McBee, PTA, MS, BS, Keiser University

Objectives

• Describe primary pathology in the integumentary system.

• Discuss manifestations of other systemic pathologies in the integumentary system.

• Discuss thermal injuries, including classifications of burns.

Skin Overview

• Integumentary System: Also referred to as integument or cutaneous membrane.

• Largest Organ: The skin is the largest organ of the body, fulfilling multiple roles:

  • Protection against pathogens and harmful chemicals.

  • Houses sensory receptors (temperature, pain, touch).

  • Secretes fluids and regulates body temperature.

• Two-way Barrier: Prevents the entry of pathogens while retaining vital fluids.

Skin Structure

Epidermis

• Composed of stratified squamous epithelium.

• Lacks direct blood supply; reliant on deeper skin layers for nourishment.

• Basal Layer:

  • Contains melanocytes producing melanin (skin pigmentation) which provides protection from UV damage.

Dermis

• Composed of living tissue with a rich blood supply, consisting of connective tissue and collagen fibers.

• Houses hair follicles, sweat glands, sebaceous glands, blood vessels, lymph vessels, sensory receptors, and nerve fibers.

Functions of Skin Layers:

• Epidermis:

  • Protection from trauma, immune response.

  • Prevents fluid loss and chemical penetration.

• Dermis:

  • Synthesis of collagen for strength and wound healing.

  • Thermoregulation and perception of temperature.

• Subcutaneous Adipose Tissue:

  • Energy storage, trauma absorption, body shape.

Glands

• Sebaceous Glands: Secrete sebum (oil) for lubrication.

• Sweat Glands: Cool the body through sweat evaporation, with ducts leading to sweat pores.

Accessory Organs

• Hair:

  • Made of keratin, colored by melanin.

  • Influences skin's protection and sensation.

• Nails:

  • Covers the tips of fingers and toes; rich blood supply in nail bed provides health insights (like oxygen levels).

Medical Terminology

• Combining Forms: Relevant terms related to skin:

  • Albin/o: White

  • Cry/o: Cold

  • Cutane/o: Skin

  • Erythr/o: Red

  • Scler/o: Hard

  • Xer/o: Dry

Common Skin Conditions and Pharmacology

Skin Conditions:

• Abrasion: Scraping away of skin surface.

• Anhidrosis: Lack of sweating.

• Contusion: Bruising without breaking skin.

• Erythema: Redness of skin.

Pharmacology:

• Anesthetics: Lidocaine, procaine – relieve pain.

• Antifungals: Lotrimin, Miconazole – treat fungal infections.

• Antipruritics: Benadryl, Caladryl – reduce itching.

Aging and Skin

• Hormonal changes during puberty affect skin characteristics (acne, pigmentation, etc.).

• Aging leads to skin thinning, loss of elasticity, and increased vulnerability to injury.

• Hormonal influences can exacerbate skin changes, particularly in older adults.

Special Implications for Physical Therapists

• Monitor skin changes signaling systemic conditions.

• Adapt interventions for older adults considering skin fragility and vascular changes.

Common Skin Disorders

Atopic Dermatitis

• Common eczema type.

• Symptoms include xerosis and pruritis, often resolves spontaneously.

Contact Dermatitis

• Triggered by exposure to irritants causing localized redness and swelling.

• Treatment involves removing the irritant and may require immunosuppressants.

Burn Classification

Thermal, Chemical, Electrical, Radiation

1. Superficial Burns: Only epidermis involved; heal quickly.

2. Partial-Thickness Burns: Involve epidermis and upper dermis; blisters develop.

3. Full Thickness Burns: Damage extends through all skin layers; may require grafting.

4. Sub-dermal Burns: Extends to fat, muscle, and bone, often lethal.

Pressure Ulcers

• Caused by unrelieved pressure, commonly over bony prominences.

• Cannot be downgraded once classified; may lead to significant tissue damage.

Wound Healing Phases

1. Hemostasis: Immediate reaction to tissue injury; clot formation.

2. Inflammation: Body's response to injury, setting the stage for healing.

3. Proliferation: New tissue formation and contraction leading to coverage of the wound.

4. Maturation: Remodeling of the tissue to increase strength.

Treatment and Therapies

• Pressure relief, advanced wound dressings, and therapeutic interventions are crucial.

• Employ various techniques to manage chronic wounds, such as negative pressure wound therapy.

Conclusion

• Understanding the integumentary system's structure and function is crucial for recognizing pathology and developing effective treatment strategies.