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Anatomy and Physiology Chapter 5 Etymological Breakdown of the Term Integumentar y System: • Integument-: Derived from the Latin root integumentum, which means "a covering," "disguise," or "cloak" (stemging from integere, meaning to cover or protect). • -ary: A standard adjectival suffix meaning "pertaining to" or "relating to.” • System: Derived from the Greek systēma, meaning a "organized whole" or a "combination of parts" working together. Put it all together, and the integumentary system literally translates to the system relating to the body's covering (the skin, hair, nails, and associated glands that protect the body as an organized unit). Overview of the Integumentary System The Skin and Beyond: • While commonly called the skin, the integumentary system is actually a complex organ system. • Includes the skin (cutaneous membrane) plus its accessory structures: hair, nails, and sweat and sebaceous (oil) glands. Scale & Importance: • The skin is the largest organ of the body, accounting for about 16 percent of body weight (16 to 20 pounds average adult) and covering a surface area of 1.5 to 2 square meters. Primary Functions: • Acts as the immediate barrier protecting the body from pathogens, chemicals, and mechanical injury. • Prevents fluid loss and regulates body temperature and sensation. Clinical Significance: • Often reflects overall health; changes in color, texture, or integrity can indicate underlying systemic diseases (e.g., cardiovascular, respiratory, or liver conditions). https://www.researchgate.net/ Overview of Skin Layers Dual-Layered Organ: • The skin consists of two main, distinct layers resting on a supportive subcutaneous layer. 1. Epidermis: • The superficial, outermost layer of the skin. • Composed of keratinized stratified squamous epithelium. • Avascular (receives nutrients via diffusion from the dermis below). 2. Dermis: • The deeper layer lying directly beneath the epidermis. • Composed of connective tissue (areolar and dense irregular). • Vascularized; houses blood vessels, lymphatic vessels, nerves, hair follicles, and sweat glands. Overview of Skin Layers 3. Hypodermis (Subcutaneous Layer / Superficial Fascia): • Technically not part of the skin itself, but closely associated. • Composed of loose areolar and adipose tissue; anchors skin to underlying muscle and bone while providing insulation and cushioning. https://quizlet.com/ Thick Skin vs. Thin Skin (Epidermal Layers) Classification Criteria: • Skin is categorized as either "thick" or "thin" based on the number of epidermal layers and the depth of the stratum corneum, not the total thickness of the skin organ as a whole. Thin Skin: • Contains four layers (stratum basale, spinosum, granulosum, and corneum). NOTE: These are listed from deep to superficial • Lacks the stratum lucidum. • Covers the vast majority of the body surface and contains hair follicles and sebaceous glands. Thick Skin: • Contains five layers (features the translucent stratum lucidum). • Found only on areas subject to heavy friction and abrasion: the palms of the hands and the soles of the feet. • Features a much thicker stratum corneum and lacks hair follicles and sebaceous glands. https://med.libretexts.org/ Cells of the Epidermis 1. Keratinocytes: • The most abundant cells in the epidermis (approx. 90%). • Synthesize keratin, a tough, fibrous protein that gives skin its hardness, durability, and water-resistant properties. • Continuously produced by stem cells in the deepest layer, pushing upward and eventually shedding. 2. Melanocytes: • Located in the deepest epidermal layer. • Produce the pigment melanin, which absorbs UV radiation and protects deeper cell DNA; transferred to keratinocytes. 3. Langerhans Cells: • Dendritic cells functioning as macrophages in the epidermis. • Engulf bacteria, foreign particles, and damaged cells to trigger an immune response. 4. Merkel Cells: • Receptor cells located in the deepest layer that function as touch receptors, associating with sensory nerve endings. Cells of the Epidermis Layers (Strata) of the Epidermis Layers (Strata) of the Epidermis 1. Stratum Basale (Basal Layer / Stratum Germinativum): • Deepest single layer; attached to the basement membrane and underlying dermis. • Forms a wavy boundary by interlocking with upward projections of the dermis called dermal papillae, increasing surface area and strengthening the epidermal-dermal bond to prevent shearing (enhancing grip). • The stratum basale is a single layer of cells primarily made of basal cells. • Site of continuous mitotic cell division (cuboidal stem cells) that continually produce new keratinocytes. • Houses melanocytes (pigment producers) and Merkel cells (touch receptors). 2. Stratum Spinosum ("Spiny Layer"): • 8 to 10 layers of keratinocytes connected by strong desmosomes, giving a spiny appearance under a microscope. • Contains maturing keratinocytes and Langerhans cells. • Keratinocytes in the stratum spinosum begin the synthesis of keratin and release a water-repelling glycolipid. https://www.flickr.com/photos/187096960@N06/51172620298 Layers (Strata) of the Epidermis 1. Stratum Basale (Basal Layer / Stratum Germinativum): • Deepest single layer; attached to the basement membrane and underlying dermis. • Forms a wavy boundary by interlocking with upward projections of the dermis called dermal papillae, increasing surface area and strengthening the epidermal-dermal bond to prevent shearing (enhancing grip). • The stratum basale is a single layer of cells primarily made of basal cells. • Site of continuous mitotic cell division (cuboidal stem cells) that continually produce new keratinocytes. • Houses melanocytes (pigment producers) and Merkel cells (touch receptors). 2. Stratum Spinosum ("Spiny Layer"): • 8 to 10 layers of keratinocytes connected by strong desmosomes, giving a spiny appearance under a microscope. • Contains maturing keratinocytes and Langerhans cells. • Keratinocytes in the stratum spinosum begin the synthesis of keratin and release a water-repelling glycolipid. https://www.flickr.com/photos/187096960@N06/51172620298 Layers (Strata) of the Epidermis 3. Stratum Granulosum ("Granular Layer"): • 3–5 layers deep; cells flatten and fill with keratin, keratohyalin granules, and lamellar granules (waterproofing glycolipids). • Organelles disintegrate and cell death occurs as cells are pushed further from the blood supply. 4. Stratum Lucidum ("Clear Layer"): • Thin, translucent layer of dead, flattened cells packed with eleidin. • Found only in thick skin (palms of hands and soles of feet). 5. Stratum Corneum ("Horny Layer"): • Superficial layer consisting of 15–30 layers of flat, dead, keratin-filled cells. • Provides a durable, waterproof barrier against microbes, dehydration, and mechanical abrasion; continuously sloughed off. Layers (Strata) of the Epidermis The Dermis: Regions & Structure General Characteristics: • The "core" of the cutaneous system; houses blood vessels, sweat glands, oil glands, hair follicles, and nerve endings. • Consists of two layers of connective tissue that compose an interconnected mesh of elastin and collagenous fibers, produced by fibroblasts. 1. Papillary Layer: • Upper 20% of the dermis; composed of loose areolar connective tissue with a loose meshwork of collagen and elastic fibers. • Features dermal papillae that project upward into the epidermis, forming unique epidermal ridges (fingerprints) that enhance grip. • Contains rich capillary loops that nourish the avascular epidermis via diffusion and help regulate body temperature and lymphatic capillaries. • Packed with sensory nerve endings, including Meissner corpuscles (receptors sensitive to light touch) and free nerve endings that detect pain and temperature. • 2. Reticular Layer: • Deeper, thicker 80% of the dermis; composed of dense irregular connective tissue. • Packed with thick bundles of collagen fibers (for structural strength and tensile resilience) and elastic fibers (for skin stretch and recoil). • Contains larger blood vessels, sweat/sebaceous glands, and Pacinian corpuscles (deep pressure receptors). Papillary layer also contains fibroblasts, some fat cells (adipocytes), and phagocytes. Meissner corpuscles https://neuroscientificallychallenged.com/glossary/meissners-corpuscles https://histology.siu.edu/intro/Meissners2.htm The Dermis: Regions & Structure • Papillary layer also contains fibroblasts, some fat cells (adipocytes), mast cells, and phagocytes. https://www.enhance-me-training.com/topic/the-dermis/ The Hypodermis (Subcutaneo us Layer) Position & Anatomy: • Located directly beneath the reticular layer of the dermis. • Technically not part of the skin proper, but rather a connective tissue layer that anchors the skin to underlying bone and muscle. • Composed primarily of loose areolar connective tissue and adipose tissue (fat cells). Vascular Supply: • Highly vascularized; contains large blood vessels that supply the skin and serve as a common site for subcutaneous injections (hypodermic needles). Primary Functions: • Energy Storage: Adipocytes store triglycerides as an energy reserve. • Insulation & Protection: The fat layer provides thermal insulation against heat loss and acts as a shock-absorbing cushion to protect underlying structures from mechanical trauma. Skin Pigmentation & Color Determinants 1. Melanin: • Produced by melanocytes; primary pigment determining skin color. • Exists in two primary forms: eumelanin (brown/black) and pheomelanin (red/yellow). • UV exposure stimulates tyrosinase enzyme activity, increasing melanin production (tanning) to shield cell nuclei from DNA damage. • Freckles and moles represent localized accumulations of melanin. 2. Carotene: • A yellow-orange pigment obtained from plant-based foods (e.g., carrots, sweet potatoes) that can accumulate in the stratum corneum and hypodermis. 3. Hemoglobin: • The red oxygen-transporting protein in red blood cells. • Imparts a pinkish or red tint to the skin as blood flows through the dermal capillaries, particularly visible in lighter-skinned individuals when oxygenated. Carotenodermia https://www.nejm.org/doi/abs/10.1056/NEJMicm950425 https://en.wikipedia.org/wiki/Jaundice https://www.azolifesciences.com/ Integumentary System Disorders Overview of Accessory Structures Definition: • Structures that originate from the epidermis and extend down into the dermis or hypodermis. Key Components: • Hair • Nails • Sweat (Sudoriferous) Glands • Sebaceous (Oil) Glands General Function: • While embedded in the skin, these structures play critical roles in protection, sensory input, thermoregulation, and excretion. https://www.mayoclinichealthsystem.org/ https://www.harleystreethairtransplants.org/ Hair Structure and Growth Anatomy of a Hair: • Shaft: The portion of the hair exposed above the skin surface (completely dead, keratinized cells). • Root: The portion of hair anchored within the follicle below the skin surface. • Hair Bulb: The expanded base of the root surrounding the hair papilla (which contains blood vessels and nerves). Layers of the Hair: • Medulla: The central core of the hair. • Cortex: The middle layer providing strength and pigment. • Cuticle: The outermost layer of overlapping, single cells protecting the inner layers. Follicle & Arrector Pili: • Surrounded by a root sheath and connected to an involuntary smooth muscle called the arrector pili, which contracts to pull hair upright ("goosebumps" in response to cold or fear) and is controlled by the sympathetic nervous system. • This traps a layer of air to add insulation https://www.toppik.com/ Internal Root Sheath Layers of the Hair Follicle External Root Sheath • Structure: Surrounds the growing hair root up to the hair shaft. • Origin: Derived from the basal cells of the hair matrix. Wall • Structure: Encloses the hair root as a direct extension of the epidermis. • Characteristics: Composed of basal cells at the base; becomes increasingly keratinous toward the upper regions. Glassy Membrane • Structure: A thick, clear connective tissue sheath covering the hair root. • Function: Connects the hair follicle directly to the surrounding dermal tissue. Root Hair Plexuses (Hair Follicle Receptors) • Histological Definition: Specialized networks of unmyelinated sensory nerve fibers that wrap intricately around and entwine within the external root sheath of hair follicles. • Anatomical Position: Located in the dermal portion of the hair follicle wall, typically positioned just inferior to the entrance of the sebaceous gland ducts. • Functional Role: Act as rapid-adapting mechanoreceptors (tactile receptors) responsible for detecting fine, light-touch stimuli. • Mechanism of Action: • Deflection of the hair shaft (from wind, clothing, or a crawling insect) acts as a mechanical lever. • Movement physically shifts the follicular wall and deforms the entwined nerve endings. • Mechanical deformation opens mechanically- gated ion channels, triggering action potentials that travel via sensory neurons to the central nervous system. • Clinical/Physiological Significance: Highly sensitive to initial directional movement, providing early cutaneous awareness of external environmental contact before deeper touch receptors are engaged. https://quizlet.com/ca/443370620/hair-and-nails-flash-cards/ https://www.nisenet.org/catalog/scientific-image-human-hair Hair Growth Cycle & Dynamics • Anagen Phase (Growth): Rapid cell division at the root pushes the hair shaft upward at ~0.3 mm/day; lasts 2 to 7 years. • Catagen Phase (Transition): A brief 2 to 3 week transitional period marking the end of active follicular growth. • Telogen Phase (Resting): Lasts 2 to 4 months with no new growth, culminating in a new anagen phase that sheds the old hair. • Shedding & Loss: Average daily loss is 50 hairs; excessive loss exceeding replacement results from aging, hormonal fluctuations, or dietary changes. https://www.pinterest.com/pin/halloween-hair--417638565445540250/ Sweat (Sudoriferous) Glands Function: • Produce sweat to cool the body via evaporative cooling and excrete metabolic wastes. 1. Eccrine (Merocrine) Sweat Glands: • More common; distributed across nearly the entire skin surface (especially palms, soles, and forehead). • Produce a hypotonic fluid (water, salts, metabolic wastes) released via exocytosis directly onto the skin surface for thermoregulation. 2. Apocrine Sweat Glands: • Confined to areas with hair follicles (e.g., armpits and genital regions). • Larger glands that release a thicker, organic-rich (in addition to water and salts) secretion into hair follicles, which is metabolized by bacteria to produce body odor; become active starting at puberty. • The release of this sweat is under both nervous and hormonal control https://en.wikipedia.org/wiki/Apocrine_sweat_gland Sebaceous (Oil) Glands Definition: • Exocrine glands associated with hair follicles found all over the body except on the palms and soles. Secretion (Sebum): • Produce sebum, a mixture of lipids, cholesterol, and proteins. Functions of Sebum: • Lubricates and waterproofs the skin and hair, preventing them from drying out. • Possesses antibacterial properties to inhibit the growth of microorganisms on the skin surface. Mode of Secretion: • Holocrine secretion: cells accumulate sebum until they rupture and destroy themselves, releasing their product (replaced by mitotic division of basal cells). https://quizlet.com/ca/443370620/hair-and-nails-flash-cards/ Nails Structure & Composition: • Specialized accessory structures composed of densely packed, dead, heavily keratinized epidermal cells. Key Anatomical Features: • Nail Body (Plate): The visible hard plate covering the dorsal surface of the fingertip/toe. • Nail Bed: The specialized skin underlying the nail body, richly supplied with blood vessels (giving it a pink color). • Nail Root: The deep epidermal fold under the skin where nail production begins. • Eponychium (Cuticle): The fold of epithelial tissue that overlaps the proximal edge of the nail body. • Lunula: The thick, crescent-shaped whitish area at the base of the nail body overlying the thick nail matrix. Primary Functions: • Protects the distal tips of fingers and toes from trauma and enhances precision grip for picking up small objects. Overview of Integumentary Functions Primary Role: • The skin and its accessory structures function as an integrated organ system that maintains homeostasis and protects the body. Core Physiological Functions: • Protection: Acts as a physical and chemical barrier against external elements. • Sensation: Detects environmental stimuli via specialized receptors. • Thermoregulation: Modulates body temperature through sweat and blood vessel adjustments. • Vitamin D Synthesis: Produces a crucial hormone essential for calcium absorption. Protection (The Body's Armor) Physical & Chemical Barrier: • Protects underlying vital organs from mechanical injury, UV radiation, wind, and water. Dehydration Prevention: • Layers of tough keratin and water-resistant glycolipids in the stratum corneum prevent excessive fluid loss. Microbial Defense: • Acts as a first line of defense against pathogens, abrasive grit, and harmful chemicals. • Sweat contains dermcidin, which possesses antibiotic properties to deter microbe over-colonization. Immune Protection: • Langerhans (dendritic) cells patrol epidermal layers to intercept foreign invaders and trigger immune responses. https://uen.pressbooks.pub/anatomyphysiology/chapter/epidermis/ Langerhan s (Dendritic) Cells (APC’s) https://courses.lumenlearning.com/wm-biology2/chapter/antigen-presenting-cells/ Sensation (Sensory Function) Environmental Awareness: • The integumentary system contains a rich network of specialized nerve endings and receptors across the epidermis, dermis, and hypodermis. Key Sensory Receptors: • Meissner (Tactile) Corpuscles: Highly concentrated in fingertips; respond to light touch. • Pacinian (Lamellated) Corpuscles: Detect deep pressure and vibration. • Merkel Cells & Hair Root Plexuses: Detect fine touch and minor hair disturbances (e.g., sensing an insect crawling on the skin). Pain & Temperature: • Free nerve endings distributed throughout the skin monitor noxious stimuli, temperature shifts, and physical trauma. Sensation (Sensory Function) • Merkel cells (Tactile discs): Located in the deep layer of the epidermis (stratum basale), these are slow-adapting receptors that excel at detecting sustained touch, fine detail, texture, and edges. When pressed, they release signaling molecules that excite adjacent nerve endings, providing high-resolution tactile feedback (like reading Braille or feeling a smooth surface). • Meissner corpuscles (Tactile corpuscles): Situated in the dermal papillae of hairless (glabrous) skin, such as your fingertips and lips, these are rapid-adapting receptors. They fire intensely when skin first makes contact with an object and when it loses contact, making them exceptionally sensitive to light touch, low-frequency vibration, and slippage (helping you adjust your grip on a moving object). • Pacinian corpuscles (Lamellar corpuscles): Found deep in the dermis and subcutaneous layer, these large, onion-shaped receptors are rapidly adapting and exquisitely sensitive to deep pressure and high-frequency vibration. Because of their layered capsule, steady pressure is filtered out, allowing them to fire only when vibration or sudden mechanical shifts occur (such as feeling a drill vibrate or walking on a rough surface). • Hair root plexus (Hair follicle receptors): A web of sensory nerve fibers wrapped around the base of hair follicles. These rapid-adapting mechanoreceptors detect the bending or movement of hairs. Even a light breeze or an insect crawling across your arm displaces a hair, triggering the surrounding nerve plexus and providing an early warning system for tactile movement across hairy skin. Pacinian Corpuscle (Sensory Organ) Pacinian Corpuscle Anatomy: Encapsulated, onion-like mechanoreceptor for deep pressure and vibration. • The Capsule & Outer Lamination: Dense connective tissue outer envelope and flattened lamellar cells that filter out steady pressure. • Viscous Gel: Interstitial fluid between layers that shifts hydraulically to dampen sustained forces, driving rapid adaptation. • Inner Lamination: Tightly packed, specialized modified Schwann cells forming a core around the central nerve terminal. • Terminal Non-Myelinated Axon: Bare, uninsulated nerve tip at the center with stretch-sensitive channels that trigger action potentials when compressed. • Myelinated Axon: Insulated nerve fiber exiting the corpuscle to rapidly transmit electrical impulses toward the central nervous system via saltatory conduction. Thermoregulation Sympathetic Nervous System Control : The integumentary system works closely with the autonomic nervous system (involuntary bodily control) to continuously monitor and adjust core body temperature. Response to Overheating (Cooling): • Sweating: Eccrine sweat glands secrete water and electrolytes; evaporative cooling dissipates body heat. (Note: insensible perspiration secretes ~500 mL/day even without noticeable sweating). • Vasodilation: Dermal blood vessels dilate to bring warm blood closer to the body surface, releasing heat into the environment. Response to Cold (Heat Retention): • Vasoconstriction: Dermal arterioles constrict to minimize blood flow to the skin surface, trapping core heat internally (can cause a pale/whitish hue). • Shivering: Involuntary muscle contractions generate metabolic heat (assisted by the contraction of arrector pili muscles). Vitamin D Synthesis The Pathway: • 1. Skin Activation: When epidermal cells are exposed to ultraviolet (UV) radiation, a cholesterol derivative in the skin converts into cholecalciferol (Vitamin 3). • 2. Liver Processing: The liver converts cholecalciferol into an intermediate compound called calcidiol. • 3. Kidney Activation: The kidneys convert calcidiol into calcitriol, which is the active, functional hormone form of Vitamin D. Physiological Importance: • Calcitriol is essential for the normal intestinal absorption of calcium and phosphorus, which are strictly required for bone health, growth, and remodeling. https://www.researchgate.net/ Effects of Aging on the Integumentary System Epidermal & Dermal Changes: • Mitotic activity in the stratum basale slows down, causing the epidermis to thin. • The dermis exhibits a reduced ability to regenerate, leading to a loss of structural elasticity and flexibility (manifesting as wrinkles). • Fibroblast activity declines, resulting in decreased production of collagen and elastic fibers. Vascular & Glandular Decline: • Blood supply to the skin decreases, reducing the skin's capacity to heal quickly and impairing thermoregulation (leading to increased sensitivity to cold). • Functional activity of sweat (sudoriferous) and sebaceous (oil) glands drops, causing dry, scaly skin and a reduced ability to sweat effectively. Subcutaneous & Accessory Alterations: • The hypodermis loses fat storage over time, contributing to a loss of padding, insulation, and a sunken appearance. • Melanocyte and hair follicle activity slows down, resulting in graying or thinning hair and a reduced capacity to protect against UV radiation. • Immune responsiveness declines as the number of Langerhans cells drops, increasing susceptibility to skin infections and damage. Overview of Skin Cancer Definition & Cause: • Cancer caused by abnormal, uncontrollable cell division in the skin. • Primary culprit is overexposure to ultraviolet (UV) radiation from the sun or tanning beds, which damages cellular DNA. The Danger of Metastasis: • Metastasis is the process where cancer cells break away from the primary tumor, enter the bloodstream or lymphatic vessels, and spread to secondary sites (such as lymph nodes, lungs, or liver), making treatment significantly more difficult. Types of Skin Cancer: • Basal Cell Carcinoma (BCC): Starts in the stratum basale and spreads along that boundary; the most common form of skin cancer, highly curable with early treatment (common in areas exposed to the sun). • Treatments include surgery, freezing (cryosurgery), and topical ointments • Squamous Cell Carcinoma (SCC): Affects keratinocytes of the stratum spinosum; presents as lesions on the scalp, ears, and hands; more aggressive than BCC and can metastasize if left untreated. • Surgery and radiation are used to cure SCC • Melanoma: Uncontrolled growth of melanocytes, typically developing from a mole; the most fatal form of skin cancer due to high rates of metastasis. • Treatment typically involves surgical excision and immunotherapy Basal Cell Carcinoma Squamous Cell Carcinoma Melanoma Early Detection of Melanoma (The ABCDE Rule) Clinical Screening Guidelines: • A – Asymmetry: The two sides of the mole or lesion do not match. • B – Borders: The edges are irregular, ragged, notched, or blurred. • C – Color: The color is not uniform and may include different shades of brown or black, or patches of pink, red, white, or blue. • D – Diameter: The lesion is larger than 6 mm (about the size of a pencil eraser), though melanomas can sometimes be smaller. • E – Evolving: The mole is changing in size, shape, color, or elevation, or begins to bleed/itch. Common Skin Disorder s Introduction to Skin Disorders: • Skin disorders range from minor localized irritations to chronic systemic conditions, often involving inflammation, immune responses, or blocked glands. • Disorders include psoriasis, cold sores, impetigo, scabies, hives, and warts. Eczema: • An inflammatory, allergic condition that presents as dry, red, itchy patches resembling rashes. • Often accompanied by swelling, flaking, and skin cracking; managed with moisturizers, corticosteroid creams, and immunosuppressants. Acne: • A skin disturbance involving the overproduction of sebum and keratin that blocks hair follicles. • Most common during puberty due to hormonal surges (androgens) that stimulate sebaceous glands, leading to bacterial infection and inflammation. Skin Injuries & The Healing Process Types of Injuries: • Cuts, punctures, scrapes, and burns caused by physical trauma, heat, chemicals, or electricity. • Step-by-Step Wound Healing Stages: 1. Hemostasis & Clotting: A blood clot forms immediately to stop bleeding and eventually dries into a protective scab. 2. Inflammation: White blood cells (macrophages) clear out debris and fight potential infection. 3. Proliferation: Fibroblasts migrate into the wound bed to produce new collagen and blood vessels (granulation tissue). 4. Remodeling & Scarring: Epithelial cells regenerate across the wound under the scab, while scar tissue (dense collagen) replaces normal tissue depending on the depth of the injury. https://www.shieldhealthcare.com/ https://jetem.org/thermal_burns/ Burns and Classification s Nature of Burns: • Caused by intense heat, radiation, electricity, or chemicals, resulting in massive cell death and fluid loss. Severity Classifications: • First-Degree (Superficial): Affects only the epidermis; results in redness and minor pain (e.g., mild sunburn) that heals within days. • Second-Degree (Partial-Thickness): Damages both the epidermis and upper dermis; results in blistering and significant pain. • Third-Degree (Full-Thickness): Destroys the full thickness of the skin (epidermis and dermis), charring tissue and destroying nerve endings (often requiring skin grafts). • Fourth-Degree (Full-Thickness with Deep Tissue Damage): Extends completely through the skin down to underlying muscle, tendons, and bone; requires extensive surgical intervention and often amputation. Major Systemic Risks: • Severe dehydration, electrolyte imbalance, renal/circulatory failure, and rampant secondary infections due to lost skin barrier function. Fourth degree Burn https://burncenters.com/burns/evaluate-a-burn/ Common Integumentary Abnormalities and Injury Responses Scars & Keloids: • Scars: Formed when the skin repairs deep dermal damage using collagen-rich connective tissue rather than regenerating normal tissue. • Lacks accessory structures (e.g., hair follicles, sweat glands, and sebaceous glands) • Keloids: Result from an overproduction of scar tissue (collagen) that extends beyond the original boundaries of the wound. Bedsores (Decubitus Ulcers): • Caused by constant, long-term pressure on bony areas that cuts off blood supply to the skin, leading to tissue necrosis and breakdown. Stretch Marks (Striae): • Occur when the dermis is stretched beyond its elastic limits (e.g., during rapid growth, weight gain, or pregnancy), causing collagen and elastin fibers to tear. Calluses & Corns: • A protective response where the stratum basale increases mitotic activity in areas subjected to constant friction or pressure, resulting in a thickened, hardened layer of dead cells. https://www.healthline.com/health/keloid-ear https://www.mayoclinic.org/diseases-conditions/corns-and- calluses/multimedia/callus/img-20007285 https://myexpertmidwife.com/blogs/my-expert-midwife/stretch-marks-101 https://blog.xoxoday.com/empuls/get-to-know-you-questions-for-coworkers/

Vocabulary Match (Each word can only be used once) Tolerant IP Address Internet protocol User Datagram Protocol(UDP) Protocol Path Bandwidth Computing Device Computing SystemComputing Network DataStream Packet Meta Packet Redundancy Transmission Control Protocol(TCP) Router Fault Tolerance Hi, Elijah. When you submit this form, the owner will see your name and email address. 1.Information passed through the internet in packets (2 Points) 2.Data added to packets to help route them through the network and reassemble the original message. (2 Points) 3.The maximum amount of data that can be sent in a fixed amount of time, usually measured in bits per second. (2 Points) 4.The series of connections between computing devices on a network starting with a sender and ending with a receiver (2 Points) 5.A group of interconnected computing devices capable of sending or receiving data. Path. (2 Points) 6.A chunk of data sent over a network. (2 Points) 7.A protocol for sending packets that does error-checking to ensure all packets are received and properly ordered (2 Points) 8.A protocol for sending packets quickly with minimal error-checking and no resending of dropped packets (2 Points) 9.A type of computer that forwards data across a network (2 Points) 10.The inclusion of extra components so that a system can continue to work even if individual components fail, for example by having more than one path between any two connected devices in a network. (2 Points) 11.Can continue to function even in the event of individual component failures. This is important because elements of complex systems like a computer network fail at unexpected times, often in groups. (2 Points) 12.An agreed-upon set of rules that specify the behavior of some system (2 Points) 13.The unique number assigned to each device on the Internet (2 Points) 14.A protocol for sending data across the Internet that assigns unique numbers (IP addresses) to each connected device (2 Points) 15.A machine that can run a program, including computers, tablets, servers, routers, and smart sensors (2 Points) 16.What is a group of computing devices and programs working together for a common purpose (2 Points) 17.Who helped creater the internet (2 Points) Vint Cerf and Bob Kahn The President Bill Gates Google 18.What protocol is used for transmitting web pages over the Internet (2 Points) Internet Protocal HyperText Transfer Protocol File Transfer Protocal Bandwidth 19.DNS stands for (2 Points) Domain Name Service Domain Nervous System Domain Neff Service Domain Name System 20.Differing access to computing devices and the Internet, based on socioeconomic, geographic, or demographic characteristics (2 Points) Internet Dilemma Digital Divide Net Neutrality Internet Censorship 21.What is the attempt to control or suppress what can be accessed, published, or viewed on the Internet by certain people. This can be used to protect people (i.e. to not allow access to child pornography) but can also be used to limit free speech. (2 Points) Internet Dilemma Digital Divide Net Neutrality Internet Censorship 22.While technology is increasingly integrated into daily life, there are still many who lack access to the Internet or digital technology. In rural areas there are challenges building networks to connect geographically sparse populations, but even in cities some groups or areas have relatively less access to the Internet or knowledge of how to use it. (2 Points) Internet Dilemma Digital Divide Net Neutrality Internet Censorship 23.Internet users love services like streaming movies, video chatting, or online gaming. All of this content needs to travel over the Internet, however, and the companies that build and maintain networks are complaining about the increased demands being placed on their networks (2 Points) Internet Dilemma Digital Divide Net Neutrality Internet Censorship 24.What are Packets made up of ? (2 Points) Binary Sequences of X's and O's Binary Sequences of 1's and 0's ASCII Numbers Flippy Do Pro 25.How does an Ip Address relate to a home address? Choose all that apply example 174.256.45.156 (2 Points) House number Street street Country 26.What does ARPANET stand for ? (2 Points) Agency Rest Platform and Network Solutions Aerial Research Probes Network Defense at Work Project Advanced Research Project Agency Network 27.The series of connections between computing devices on a network starting with a sender and ending with a receiver. (2 Points) Bandwidth Path Computing Network Computing Device 28.The maximum amount of data that can be sent in a fixed amount of time, usually measured in bits per second. (2 Points) Bandwidth Path Computing Network Computing Device 29.A machine that can run a program, including computers, tablets, servers, routers, and smart sensors (2 Points) Bandwidth Computing Device Computing Network Computing System 30.Pick the two statements that are true about the Internet Protocol (IP): (2 Points) Each device or computer on the Internet is assigned a unique IP address. IP is a secret protocol shared between the sender and receiver. In order to communicate two devices on the Internet must have the same IP address. IP is the shared way that all devices and computers label their messages with the sender and receiver's addresses. 31.The Internet was developed as a result of an experiment the Defense Department. (2 Points) True False 32.A Protocol is a well known set of rules and standards used to communicate between machines with trouble. (2 Points) True False 33.IPv4 was designed in 1973 and widely adopted in the early 80's and provided for more than _______________________ connected to the internet (2 Points) 80 million special devices 1 billion unique devices 4 billion unique devices 8 trillion devices 34.IPv6 use 340 Undecillion unique address to expand the network, that enough for (2 Points) Every grain of sand on earth to have an IP address every person in the USA A&T MIDDLE COLLEGE students Every person in the world 35.The Internet is not made up of many independent networks. (2 Points) True False 36.An Internet Service Provider is a company that provides Internet access to organizations and home users. (2 Points) True False 37.What level does not belong to the IP Address hierarchy? (2 Points) Country Region Mainframe Device 38.The DNS looks up domain names and gets the associated IP address. wich is used to connect your computer to the internet. (2 Points) True False 39.What is a correct IP Address? (2 Points) 174.129.14.120 www.code.org youtube/watch Amazon.com 40.DNS servers are connected in a distributed hierarchy and divided into zones, splitting up the responsibility for the major domains. (2 Points) True False 41.Which is not a major domain zones ? (2 Points) .org .net .dnc .net 42.Which of the following best describes the protocols used on the Internet? (2 Points) The protocols of the Internet are secret to maintain the privacy and security of people using them The protocols of the Internet are open and used by all devices connected to the network Each device connected to the Internet will use a protocol designed by the company that manufactured it The protocols of the Internet are designed by government agencies to ensure they remain free to use 43.Mr. Still purchases a new smartphone and is immediately able to use it to send a photo over the Internet to a friend who lives in a different country. Which of the following is NOT necessary to make this possible? (2 Points) Both devices are using the same shared and open protocols The data of the image is routed through a sequence of directly connected devices before arriving at its destination A single direct connection is established between any two devices connected to the Internet 3 Both devices are directly connected to at least one part of the Internet 44.Which of the following is true of how packets are sent through the Internet? (2 Points) Packet metadata is only included on important packets to indicate they should get access to faster paths through the network Packet metadata is used to route and reassemble information travelling through the Internet Information sent through the internet is only encapsulated in packets if the message is too large to be sent as a datastream Information sent through the internet is split into two packets, one which contains the message and another which contains the metadata 45.Emilee is watching an online video. The video is being sent to her laptop by a server over the Internet which splits the video into packets and sends them in the order they appear in the video. Which of the following is true about how the packets will arrive at her computer? (2 Points) The packets will always be received in the order that they were sent Either every packet will reach her computer or none of them will. Packets that arrive out of order will be sent back to the server The packets may arrive out of order 46.Which of the following best describes the purpose of an IP address? (2 Points) IP addresses provide a unique number for identifying devices that send and receive information on the Internet IP addresses assist in the reconstruction of a message that has been divided into many packets IP addresses indicate the location where an internet-connected computing device was manufactured IP addresses indicate how many times an individual packet has been requested by a router 47. Which of the following Internet protocols is MOST important in reassembling packets and requesting missing packets to form complete messages? (2 Points) Transmission Control Protocol Internet Protocal HyperText Transfer Protocol (HTTP) Used DATA PROTOCOL 48. Two devices are connected to the Internet and communicating with one another. A squirrel chews through one of the wires in the network that is currently being used by the devices to communicate. The network immediately begins using a different path through the network and communication continues as normal. (2 Points) scalability fault-tolerance protocol pathing 49.An Internet Service Provider (ISP) is a company that builds the routers and wired connections that allow individuals to access the Internet. An ISP is considering adding additional redundant connections to its network. Which of the following best describes why the company would choose to do so? (2 Points) It costs less to design a network that is redundant Redundant networks are more reliable Adding additional connections reduces the fault-tolerance of the network The protocols of the Internet only work on networks that are redundant 50.Which of the following can't we trust together to successively deliver informational at scale and reliability. (2 Points) HTTP &DNS TCP/IP & ROUTING INS & UDP WIRE, CABLES & WIFI