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The Integumentary System The Protective Covering PowerPoint Presentation

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Description : Check out this medical presentation on Anatomy of the Skin, which is titled "The Integumentary System: The Protective Covering", to know about the integumentary system which protects body from environmental damage, know how skin forms protective barrier, shielding body from elements and pathogens, as well as performing several other vital functions, and, know how skin is essential to well-being, helps to regulate body temperature, and contains many accessory organs such as nail, hair, and glands.

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Slide 1-

Chapter 8 The Integumentary System: The Protective Covering
Slide 2-

Multimedia Directory Slide 12 Integumentary System Exercise Slide 15 Skin Features Exercise Slide 51 Wound Repair Animation Slide 52 Decubitus Ulcers Video Slide 60 Burn Care Video Slide 73 Hair Exercise Slide 94 Pressure Sore Animation Slide 95 Decubitus Ulcer Video Slide 103 Eczema Video Slide 113 Skin Cancer Video Slide 133 Intradermal Drugs Video Slide 134 Subcutaneous Injections Video
Slide 3-

Multimedia Directory (cont’d) Slide 143 Emergency Medical Technicians Video Slide 144 Nursing Video
Slide 4-

Introduction Integumentary system protects body from environmental damage Skin forms protective barrier, shielding body from elements and pathogens, as well as performing several other vital functions Skin is essential to well-being, helps to regulate body temperature, and contains many accessory organs such as nail, hair, and glands
Slide 5-

Learning Objectives Discuss the functions of the integumentary system List and describe the layers of the skin Explain the healing process of skin Describe the structure and growth of hair and nails
Slide 6-

Learning Objectives (cont’d) Explain how the body regulates temperature through the integumentary system Describe various skin diseases, causative agents, and their related treatments
Slide 7-

Pronunciation Guide Alopecia Apocrine Carotene Corium Ecchymosis Eccrine Epidermis Epithelial cells (al-oh-PEE-she-ah) (APP oh crin) (CARE eh teen) (CORE ee um) (ek ee MOH sis) (EKK rin) (ep ih DER miss) (ep ih THEE lee al) Click on the megaphone icon before each item to hear the pronunciation.
Slide 8-

Pronunciation Guide (cont’d) Keratin Keratinization Lesion Lunula Melanin Melanocytes Pustule Sebaceous gland Seborrheic keratosis (KAIR ah tin) (KAIR ah tin eye ZAY shun) (LEE zhun) (LOO nyoo lah) (MELL an in) (mell AN oh sights) (PUS tyool) (see BAY shuss) (SEB oh REE ik KERR ah TOH sis) Click on the megaphone icon before each item to hear the pronunciation.
Slide 9-

Pronunciation Guide (cont’d) Sebum Scabies Squamous cells Stratum corneum Subcutaneous fascia Tinea Vesicles (SEE bum) (SKAY beez) (SKWAY muss sells) (STRAY tum core NEE um) (sub cue TAY nee us FAY she ah) (TIN e ah) (VES ih koolz) Click on the megaphone icon before each item to hear the pronunciation.
Slide 10-

System Overview Integumentary system is comprised of skin and its accessory components including hair, nails, and associated glands
Slide 11-

System Overview (cont'd) Integumentary system performs several vital functions: Protection from pathogens Balances fluid levels Stores fatty tissue for energy supply Produces vitamin D (with help from sun) Provides sensory input Helps to regulate body temperature
Slide 12-

The Skin Largest organ, weighing approximately 20 pounds and covering area about 20.83 square feet on an adult Cross section of skin reveals three layers: Epidermis Dermis Subcutaneous Fascia
Slide 13-

Figure 8-1 The three layers of the skin.
Slide 14-

Epidermis Layer of skin we see on the outside; made up of five or six even smaller layers of tissue There are no blood vessels or nerve endings in this layer Cells on surface are constantly shedding, being replaced with new cells that grow and arise from deeper region called stratum basale every 2–4 weeks
Slide 15-

Epidermis (cont'd) Outermost layer is layer of dead cells, called stratum corneum, which are flat, scaly, keratinized epithelial cells You slough off 500 million cells every day, or about 1½ pounds of dead skin a year, allowing for rapid repair in case of injuries
Slide 16-

Back to Directory Click here to view an interactive labeling exercise on the features of the integumentary system. Integumentary System Exercise
Slide 17-

Click here to view an interactive labeling exercise of the features of the skin. Skin Features Exercise Back to Directory
Slide 18-

Pathology Connection: Skin Color and Disease Color of skin can indicate disease Yellow skin (jaundice) may indicate liver disease In liver disease, body can’t break down bilirubin Buildup of bilirubin gives skin yellow color Yellowish color may also be seen in whites of eyes Bronze color may indicate adrenal gland disease; malfunctioning adrenal glands can cause skin to produce excessive melanin Bruised skin could indicate skin, blood, or circulatory problems
Slide 19-

Dermis Layer below, or inferior, to epidermis is thicker dermis layer Contains the following: Capillaries Collagenous/elastic fibers Involuntary muscles Nerve endings Lymph vessels Hair follicles Sudoriferous glands (sweat) Sebaceous glands (oil)
Slide 20-

Dermis (cont’d) Small “fingers” of tissue project from surface and anchor layer to epidermal layer Finger and toe prints arise from this layer Nerve fibers allow you to sense what is happening in your environment
Slide 21-

Dermis (cont’d) Vasodilation of capillaries in this layer cause blushing Collagen and elastic fibers allow for elasticity of skin, preventing tearing with movement; allow skin to return to normal shape during periods of rest; older people lose some elasticity, leading to wrinkles
Slide 22-

Sudoriferous Glands Two main types of sudoriferous, or sweat, glands Apocrine sweat glands secrete at hair follicles in groin and anal region as well as armpits; become active around puberty and are believed to act as sexual attractants Eccrine glands are found in greater numbers on palms, feet, forehead, and upper lip; are important in regulation of temperature
Slide 23-

Sudoriferous Glands Body has 3 million sweat glands Sweat has no odor, but bacteria degrades substances in sweat over time into chemicals that give off strong smells commonly known as body odors
Slide 24-

Sweat and Sebaceous Glands Sebaceous glands play important role by secreting oil, or sebum Sebum keeps skin from drying out and (due to its acidic nature) helps destroy some pathogens on skin’s surface
Slide 25-

Figure 8-2 Sweat and sebaceous glands.
Slide 26-

Subcutaneous Fascia Innermost layer of skin is subcutaneous fascia, or hypodermis Composed of elastic and fibrous connective tissue and fatty tissue Lipocytes, or fat cells, produce fat needed to provide padding to protect deeper tissues of body and act as insulation for temperature regulation Fascia attaches to muscles of body
Slide 27-

Pathology Connection: Herpes Lifelong viral infection that produces clusters of small fluid-filled sacs (vesicles/blisters) Signs and symptoms usually come and go; stress and other diseases can temporarily decrease immunity, and lead to symptom flare
Slide 28-

Pathology Connection: Herpes Types of herpes Herpes varicella Also known as chickenpox Can be spread by airborne particles or direct contact Vesicles can be found on face, trunk, and extremities Vesicles associated with intense itching
Slide 29-

Pathology Connection: Herpes (cont’d) Herpes zoster Also known as shingles Develops when dormant chickenpox virus re-activates Causes extremely painful blisters/rashes that follow course of a sensory nerve Symptoms develop when stress, disease, trauma, or aging prevent immune system from keeping virus in check
Slide 30-

Pathology Connection: Herpes (cont’d) Herpes simplex type 1 Causes “cold sores” or “fever blisters” around mouth or nose Commonly develops after common cold or fever
Slide 31-

Pathology Connection: Herpes (cont’d) Herpes simplex type 2 Causes genital herpes Spread by direct contact Most contagious when in active stage; however, can be spread during remission
Slide 32-

Figure 8-3 Herpes types. a) Shingles.
Slide 33-

Figure 8-3 Herpes types. b) typical cold sores or fever blisters.
Slide 34-

Pathology Connection: Human Papilloma Virus (HPV) Causes warts (verruca); hypertrophy of keratin cells in skin; types of warts Common warts Usually found on children’s hands and fingers Spread by scratching and direct contact Often disappear on their own Plantar warts Found on sole of foot Tend to grow inward Have relatively smooth appearance on surface Can cause pain when walking Treatment: removal by surgery or freezing
Slide 35-

Figure 8-4 Examples of warts. a) Common wart
Slide 36-

Figure 8-4 Examples of warts. b) plantar wart.
Slide 37-

Pathology Connection: Human Papilloma Virus (HPV) (cont’d) Genital warts Sexually transmitted, and highly contagious Some types of HPV have been associated with cervical cancer Recently developed vaccine may help prevent cervical cancer associated with certain types of HPV
Slide 38-

Pathology Connection: Fungal Infections Tinea: General term for fungal skin infections Usually located in warm, moist regions of body Signs and symptoms: cracking, weeping, and itching skin
Slide 39-

Pathology Connection: Fungal Infections (cont’d) Types of tinea Tinea Pedis (athlete’s foot) Fungal infection of foot Spread by direct contact with contaminated surfaces (like locker room floors) Most commonly develops in warm, moist area between toes Tinea cruris (jock itch) Fungal infection of groin and scrotal areas Mainly affects men Aggravated by increased perspiration, and tight fitting shorts/pants/undergarments
Slide 40-

Pathology Connection: Fungal Infections (cont’d) Tinea corporis (ringworm) Fungal infection of smooth skin on arms, legs and body Appearance: red, ring-shaped structure with pale center THERE IS NO ACTUAL WORM involved Tinea unguium Fungal infection under finger or toenails If untreated, results overgrown and thick nails with white/brittle appearance
Slide 41-

Figure 8-5 Examples of fungal infections. a) Athlete’s foot (tinea pedia)
Slide 42-

Figure 8-5 Examples of fungal infections. b) Nail fungus (tinea unguium).
Slide 43-

Pathology Connection: Bacterial Infections Cellulitis Infection of skin and subcutaneous tissue Caused by Staphylococcus Source of infection often wound of some kind
Slide 44-

Pathology Connection: Bacterial Infections (cont’d) Lyme disease Bacterial infection spread by deer tick bites Signs and symptoms: “Bull’s eye” rash: red circle with lighter center; often very first presenting sign of infection; appears few days to several weeks following tick bite Flu-like symptoms, fever, and chills Malaise Joint inflammation
Slide 45-

Pathology Connection: Bacterial Infections (cont’d) Lyme disease If untreated, can lead to neurological, cardiovascular problems, arthritis Diagnosis: blood test can confirm presence of infection
Slide 46-

How Skin Heals Everyone has skin injuries from time to time If skin is punctured and wound damages blood vessels, wound fills with blood; blood contains substances that cause clotting; top part of clot exposed to air hardens to form scab, nature’s band-aid, forming barrier and preventing pathogens from entering
Slide 47-

How Skin Heals Next, white blood cells enter and destroy any pathogens, while fibroblasts come and begin pulling edges of wound together; basale layer hyper-produces cells for repair of wound
Slide 48-

How Skin Heals (cont’d) If wound is deep, scar, composed of collagen fibers, develops; scars don’t contain any accessory organs or nerve endings; stitches, adhesive strips (butterflies), or special glue reduce scarring
Slide 49-

How Skin Heals (cont’d) Note, wound ideally starts to heal from inside out; this aids in preventing pathogens from becoming trapped between healed surface and deeper layer of skin where they could develop into pocket of infection
Slide 50-

Figure 8-6 Wound repair.
Slide 51-

Click here to view an animation on the topic of Wound Repair. Wound Repair Animation Back to Directory
Slide 52-

Click here to view a video on the topic of decubitus ulcers. Decubitus Ulcers Video Back to Directory
Slide 53-

Pathology Connection: Burns Can be caused by heat, chemicals, electricity, or radiation Two factors affect assessments of damage: Depth Amount of area damaged
Slide 54-

Pathology Connection: Burns (cont’d) Depth of burn relates to layer or layers of skin affected by burn First degree burns damage only outer layer, or epidermis Symptoms include redness and pain, but no blister Pain subsides in 2–3 days; there is no scarring Complete healing takes about one week
Slide 55-

Pathology Connection: Burns (cont’d) Second degree burns involve entire depth of epidermis and portion of dermis Symptoms include redness, pain, and blistering Extent of blistering dependent on depth of burn Blistering extends after initial burn Blisters heal within 10–14 days if there are no complications, with deeper second degree burns taking 1–3½ months Scarring in second degree burns is common
Slide 56-

Pathology Connection: Burns (cont’d) Third degree burns affect all three layers of skin Surface of burn has leathery feel and will range in color from black, brown, tan, red, or white Patient feels no pain because pain receptors are destroyed Also destroyed are sweat and sebaceous glands, hair follicles, and blood vessels
Slide 57-

Pathology Connection: Burns (cont’d) Fourth degree burns are worst burns Penetrate bone and cause bone damage Rule of nines used to estimate extent of area damaged by burns
Slide 58-

Pathology Connection: Burns (cont’d) Body divided into following regions, each given percentage of body surface area value: Head and neck: 9% Each upper limb: 9% (2 x 9 = 18%) Front of trunk: 18% Back of trunk and buttocks: 18% Front of legs: 18% Back of legs: 18% Perineum (including anus and urogenital region): 1%
Slide 59-

Figure 8-8 Assessing the degree of the burn.
Slide 60-

Click here to view a video on the topic of burn care. Burn Care Video Back to Directory
Slide 61-

Pathology Connection: Burns (cont’d) Clinical concerns for burn victims relate to functions of skin already discussed, including: Bacterial infections Fluid loss Heat loss
Slide 62-

Pathology Connection: Burns (cont’d) Severe burns require healing steps at intensity level body can’t manage on its own Damaged skin must be removed as soon as possible and skin grafting must be started
Slide 63-

Pathology Connection: Burns (cont’d) Autografting is using patient’s own skin, while heterografting is required if patient suffered large area of burn and has little healthy skin to graft
Slide 64-

Pathology Connection: Burns (cont’d) Grafting requires many trips to OR because large areas can’t be done all at once and often grafts don’t “take” It is possible to grow sheets of skin tissue in laboratory from patient cells or utilization of synthetic materials
Slide 65-

Nails Specialized epithelial cells originating from nail root form nails As cells grow out and over nail bed, they become keratinized forming substance similar to horns on a bull Cuticle is fold of tissue that covers nail root Portion that we see is called nail body Nails normally grow 1 mm every week
Slide 66-

Nails (cont’d) Pink color of nail comes from vascularization of tissue under nails, while white half-moon shaped area, or lunula is result of thicker layer of cells at base
Slide 67-

Figure 8-9 Structures of the fingernail.
Slide 68-

Hair Body hair is normal and serves important purposes Helps to regulate body temperature and functions as sensor to help detect things on skin such as bugs or cobwebs Eyelashes help to protect eyes from foreign objects while hair in nose helps filter out particulate matter
Slide 69-

Hair Visible hair composed of fibrous protein called keratin Hair you see is called shaft with root extending down into dermis to follicle
Slide 70-

Hair (cont’d) Follicle is formed by epithelial cells with rich source of blood provided by dermal blood vessels Cells divide and grow in base of follicle, older cells are pushed away and die, so shaft of hair is comprised of dead cells Shaving or cutting hair doesn’t make it grow quicker or thicker
Slide 71-

Hair (cont’d) There is a sebaceous gland associated with each hair follicle, secreting sebum that coats hair follicle and works its way to skin’s surface to prevent drying of hair, acting as anti-bacterial, and lubricating hair shaft Sebum production decreases with age, explaining why older people have drier skin and more brittle hair
Slide 72-

Figure 8-10 Diagram of a hair follicle.
Slide 73-

Click here to complete an interactive labeling exercise of the hair. Hair Exercise Back to Directory
Slide 74-

Hair Color and Texture Hair color is dependent on amount and type of melanin you produce The more melanin, the darker your hair White hair occurs in absence of melanin Red hair is result of hair that has melanin with iron in it Flat hair shafts produce curly hair, while round hair shafts produce straight hair
Slide 75-

Hair Color and Texture (cont’d) Alopecia is term for any type of hair loss and can be acute or chronic Some forms, such as male pattern baldness, do not represent a disease, but are inherited traits Hair loss can also be a result of chemotherapy for cancer treatments, hormonal imbalance, scale infections, severe emotional or physical stress, or side effects of other medications
Slide 76-

Pathology Connection: Lice Tiny insect parasites that live on scalp/skin Lice infestation is called pediculosis Lice spread by direct contact with infested person or infested objects (hair brushes, etc).
Slide 77-

Pathology Connection: Lice (cont’d) Types of lice Head lice: extremely common; checked for in schools Body lice: result of poor personal hygiene and can carry disease Pubic lice: spread through sexual contact; also known as “crabs”
Slide 78-

Pathology Connection: Lice (cont’d) Treatments for lice Bathing or shampooing with medicated shampoo; shampoo eliminates lice and their eggs (called “nits”) Thorough cleaning of all bedding, towels, clothing, hats, combs and hairbrushes (alternatively, these items can be discarded)
Slide 79-

Pathology Connection: Scabies (cont’d) Tiny mite that burrows into skin to lay eggs Transmitted via direct contact with infected individual Mites typically lodge in folds of skin (wrist, underarms, groin, under breasts, etc) Symptoms: intense itching, vesicles, and pustules
Slide 80-

Pathology Connection: Scabies (cont’d) Without treatment, cycle develops: Eggs are laid under skin Eggs hatch in 3-5 days and young mature in 2-3 weeks Mites mate and start process over again Treatment: specially formulated cream is applied to skin
Slide 81-

Figure 8-11a Examples of lice.
Slide 82-

Figure 8-11b Example of scabies.
Slide 83-

Temperature Regulation Integumentary system plays major role in regulation of body’s temperature Part of regulation of temperature is accomplished by changes in size of blood vessels Vasodilation exposes heated blood to external cooling air Vasoconstriction keeps cooling of blood to minimum when it’s cold outside
Slide 84-

Sweat glands excrete water onto skin’s surface, allowing cooling through evaporation; requires adequate hydration to continue to produce sweat By the time you feel thirsty you’re already dehydrating; you can potentially secrete 12 liters of sweat in a 24 hour period Temperature Regulation (cont’d)
Slide 85-

Temperature Regulation (cont’d) Shivering causes muscle activity that produces heat to warm you when you’re cold Hairs on skin stand erect when arrector pili muscles contract; known as goose bumps; these hairs create dead space insulating you from cooler surroundings, like a goose down jacket
Slide 86-

Figure 8-12 Integumentary regulation of body temperature.
Slide 87-

Pathology Connection: Skin Lesions Pathologically altered piece of tissue Types of lesions include Macule: discolored spot on skin Wheal (urticaria): localized evanescent elevation of skin that is often accompanied by itching Papule: solid, elevated area on skin Nodule: larger papule Vesicle: small fluid filled sac (blister)
Slide 88-

Pathology Connection: Skin Lesions (cont’d) Types of lesions include Bulla: large vesicle Pustule: pus-filled lesion Ulcer: eating or gnawing away of tissue Crust: dry, serous, brown, yellow red or green exuadation Scale: think, dry flack of cornified epithelial cells Fissure: crack-like slit that extends through epidermis into dermis
Slide 89-

Figure 8-13 Various types of skin lesions.
Slide 90-

Diseases of the Integumentary System Abrasion Etiology: mechanical removal of skin tissue Signs and symptoms: loss of skin surface integrity, redness, swelling, inflammation Diagnostic tests: visual examination Treatment: proper cleansing technique, removal of any foreign matter, antiseptic, bandage if necessary
Slide 91-

Diseases of the Integumentary System (cont’d) Acne Etiology: metabolic condition, allergies, various drugs or endocrine disorders are possible causative agents Signs and symptoms: inflammation of hair follicles/sebaceous glands especially on face, neck, chest, upper back/shoulders; can form blackheads, cysts, nodules, pustules, and pimples
Slide 92-

Diseases of the Integumentary System (cont’d) Acne Diagnostic tests: visual examination Treatment: Mild: proper cleansing techniques and OTC treatments Severe: proper cleansing techniques including prescribed medications, antibiotics, steroids and/or all-trans retinoic acid (tretinoin)
Slide 93-

Diseases of the Integumentary System (cont’d) Decubitus ulcer (pressure ulcers; bedsores) Etiology: tissue injury resultant of unrelieved pressure placed upon a specific area Signs and symptoms: red, inflamed, crater-like lesion usually located over bony prominence Diagnostic tests: visual inspection, culturing of site for infection Treatment: preventative measures such as turning and padding important; treat infection of the sore
Slide 94-

Click here to view an animation on the topic of pressure sores. Pressure Sore Animation Back to Directory
Slide 95-

Click here to view a video on the topic of decubitis ulcers. Decubitus Ulcer Video Back to Directory
Slide 96-

Diseases of the Integumentary System (cont’d) Boil (furuncle) Etiology: staphylococcus bacteria Signs and symptoms: inflammation, localized encapsulated pus filled lesion, painful affected site; carbuncles are a large abscess composed of several furuncles Diagnostic tests: visual examination, site culture
Slide 97-

Diseases of the Integumentary System (cont’d) Boil (furuncle) Treatment: proper antiseptic cleansing techniques, antibiotics, application of warm moist heat, depending on severity, may require draining
Slide 98-

Diseases of the Integumentary System (cont’d) Burns (thermal) Etiology: heat or radiation or varying intensities and duration Signs and symptoms: depending on intensity and duration: reddening of affected surface, penetrating additional skin layers as severity increases. Color is dependent on the severity with a deepening red, to black Diagnostic tests: visual examination Treatment: dependent upon severity
Slide 99-

Diseases of the Integumentary System (cont’d) Cellulitis Etiology: bacteria (streptococcus and staphylococcus) Signs and symptoms: inflammation of skin and subcutaneous tissue, red and swollen, painful Diagnostic tests: visual examination, site culture Treatment: antibiotics (oral or intravenously, dependant on the severity)
Slide 100-

Diseases of the Integumentary System (cont’d) Contusion (bruise) Etiology: blunt force or some form of skin injury without the skin surface breaking Signs and symptoms: pain, swelling, discoloration Diagnostic tests: visual inspection; imaging may be needed to check for more severe injury Treatment: cold applications, firm bandage to impede swelling, elevation when possible, heat application, massage
Slide 101-

Diseases of the Integumentary System (cont’d) Dermatitis (contact) Etiology: contact with allergen (extreme range of potential agents including, soaps, cosmetics, metals, drugs, plastics, etc.) Signs and symptoms: small, reddish lesions to larger vesicles, weepy and crusted areas, itching possible Diagnostic tests: visual examination Treatment: avoidance of causative agent; medication to decrease inflammatory process
Slide 102-

Diseases of the Integumentary System (cont’d) Eczema Etiology: genetic predisposition to allergies (in infants it may include reaction to milk/dairy products, other foods), stress Signs and symptoms: skin inflammation, redness, vesicles, scales, crusting, pustules Diagnostic tests: visual examination, history Treatment, no true cure: treat symptoms; eliminate offending food, reduce stress, topical cortiosteroidal creams, skin moisturizers, antihistamines
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Click here to view a video on the topic of eczema. Eczema Video Back to Directory
Slide 104-

Diseases of the Integumentary System (cont’d) Folliculitis Etiology: bacteria (usually staphylococcus) Signs and symptoms: small pustules that form around base of hair follicle Diagnostic tests: visual examination, site culture Treatment: proper daily cleansing with antiseptic cleanser, oral antibiotics (chronic or severe cases)
Slide 105-

Diseases of the Integumentary System (cont’d) Herpes Etiology: Herpes family of viruses Signs and symptoms: clusters of fluid filled vesicles in patterns specific to condition, skin inflammation, rash, pain related to involved sensory nerve; remains dormant until immunosupression Diagnostic tests: visual examination, site culture Treatment: antiviral drugs, usually self-limiting
Slide 106-

Diseases of the Integumentary System (cont’d) Hives (urticaria) Etiology: allergic reaction to external agent such as bee stings, plants, temperature extremes, sunlight, or internal agents such as foods, food additives, medication, antibiotics, or specific disease conditions Signs and symptoms: itchy wheals surrounded by red inflamed area; can cover most of body
Slide 107-

Diseases of the Integumentary System (cont’d) Hives (urticaria) Diagnostic tests: visual examination, patient history Treatment: antihistamines, allergen avoidance
Slide 108-

Diseases of the Integumentary System (cont’d) Keloid Etiology: tissue trauma or surgical incision Signs and symptoms: overproduction of collagen during tissue repair often creating larger structure than original scar/traumatized area Diagnostic tests: visual inspection Treatment: surgical removal, but there is a great potential for keloids to grow back
Slide 109-

Figure 8-7 Examples of keloids.
Slide 110-

Diseases of the Integumentary System (cont’d) Lyme disease Etiology: tick bite containing a specific spirochetal bacterium Signs and symptoms: “Bull’s eye” macule/papule at site of tick bite, flu-like symptoms, stiff neck, swollen lymph node(s), joint aches, fever, headache, persistent sore throat, dry cough; possible neurologic, cardiac, and arthritic complications if left undiagnosed/untreated
Slide 111-

Diseases of the Integumentary System (cont’d) Lyme disease Diagnostic tests: visual examination, blood test, patient history Treatment: vaccine, antibiotics, treat secondary conditions; repeat infection is possibility
Slide 112-

Diseases of the Integumentary System (cont’d) Malignant melanoma Etiology: occurs in melanocytes, excessive exposure to the sun Signs and symptoms: brown or black irregular patch that appears suddenly. A color or size change in a prexisiting wart or mole may also be an indication Diagnostic tests: biopsy Treatment: surgical removal and the surrounding area; chemotherapy
Slide 113-

Click here to view a video on the topic of skin cancer. Back to Directory Skin Cancer Video
Slide 114-

Diseases of the Integumentary System (cont’d) Pediculosis (lice) Etiology: lice infestation Signs and symptoms: lice and nits (egg deposits) Diagnostic tests: visual inspection Treatment: proper cleansing techniques with medicated soap/shampoo, cleaning of all clothing, bedding, towels, combs, etc. to remove infestation
Slide 115-

Diseases of the Integumentary System (cont’d) Psoriasis Etiology: possible genetic basis with attacks triggered by emotional stress, illness, sunlight, or skin damage Signs and symptoms: red skin with silvery patches, rapid replacement of epidermal cells, dry cracking skin with crusting, can be painful; common to have periods of remission then exacerbation; may be arthritic component
Slide 116-

Diseases of the Integumentary System (cont’d) Psoriasis Diagnostic tests: visual examination, patient history Treatment: supportive, skin applications to deal with symptoms; medications: steroids, ultraviolet light
Slide 117-

Diseases of the Integumentary System (cont’d) Scabies Etiology: mites Signs and symptoms: elevated, grayish-white lines (burrows), vesicle and pustule formation (due to bite, feces, ova of offending mite), intense itching Diagnostic tests: visual inspection Treatment: proper cleaning technique, application of medicated cream, all infected individuals must be treated to prevent re-infection
Slide 118-

Diseases of the Integumentary System (cont’d) Seborrheic keratosis Etiology: unknown agent(s) causing benign overgrowth of epithelial cells Signs and symptoms: well defined, warty-scaled lesion that can present in variety of colors from yellow to brown Diagnostic tests: visual inspection, laboratory examination Treatment: scraping (curettage), or freezing
Slide 119-

Diseases of the Integumentary System (cont’d) Tinea, types Tinea barbae (barber’s itch, affects face) Tinea capitis (affects scalp) Tinea corporis (ringworm, affects body) Tinea cruris (jock itch, affects groin) Tinea pedis (athlete’s foot, affects feet) Tinea unguium (affects nails)
Slide 120-

Diseases of the Integumentary System (cont’d) Ringworm Etiology: fungi Signs and symptoms: case dependent; red ring-shaped patches (mimicking worm), red inflamed skin, cracked and weeping area(s), itch, discoloration of affected nails Diagnostic tests: visual examination, microscopic examination, site culture Treatment: maintain clean dry condition of affected area, antifungal medication (topical or systemic)
Slide 121-

Diseases of the Integumentary System (cont’d) Warts (common, plantar, genital) Etiology: viruses Signs and symptoms: raised, rubbery, scaly growths of varying sizes and colors Diagnostic tests: visual examination Treatment: chemical or physical removal
Slide 122-

Figure 8-14 Various types of integumentary conditions. (a) Urticaria (hives). (Courtesy of Jason L. Smith, MD.)
Slide 123-

Figure 8-14 (continued) Various types of integumentary conditions. (b) Malignant melanoma. (Source: Biophoto Associates/Photo Researchers, Inc.)
Slide 124-

Figure 8-14 (continued) Various types of integumentary conditions. (c) Erythema infectiosum (fifth disease). (Courtesy of Jason L. Smith, MD.)
Slide 125-

Figure 8-14 (continued) Various types of integumentary conditions. (d) Acne. (Courtesy of Jason L. Smith, MD.)
Slide 126-

Figure 8-14 (continued) Various types of integumentary conditions. (e) Poison ivy (dermatitis). (Courtesy of Jason L. Smith, MD.)
Slide 127-

Figure 8-14 (continued) Various types of integumentary conditions. (f) Herpes simplex. (Courtesy of Jason L. Smith, MD.)
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Figure 8-14 (continued) Various types of integumentary conditions. (g) Burn, second degree. (Courtesy of Jason L. Smith, MD.)
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Pharmacology Corner Transdermal patches Placed on skin in morning and left in place for 24 hours (or more) Allows medication to be slowly absorbed over time Examples of common transdermal patches Nicotine (for smoking cessation) Nitroglycerine (a heart medication) Birth control
Slide 130-

Pharmacology Corner (cont’d) Topical creams For skin irritation: mild preparations stop itching; more powerful preparations containing corticosteroids work as local anti-inflammatory agents; because cream is not fully absorbed into bloodstream, systemic side effects are minimal Antifungal: treat fungal infections like ring worm and athlete’s foot
Slide 131-

Pharmacology Corner (cont’d) Topical creams Anti-viral: used to treat herpes and other viral skin conditions Antibiotic: used to treat bacterial infection; can also be used to prevent wound from becoming infected
Slide 132-

Pharmacology Corner (cont’d) Medicated shampoos: useful in treating lice and dandruff (excessive dry scalp with sloughing skin)
Slide 133-

Click here to view a video on the topic of intradermal drugs. Intradermal Drugs Video Back to Directory
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Back to Directory Click here to view a video on the topic of subcutaneous injections. Subcutaneous Injections Video
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Snapshots from the Journey Skin is largest organ; it acts as barrier to infection and injury; helps to keep you from drying out; stores fat; synthesizes and excretes vitamin D; regulates body temperature; provides minor excretory function in elimination of water, salts, and urea; and provides sensory input
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Snapshots from the Journey Skin is composed of 3 layers, constantly recreating itself; glands secrete oil to moisturize, waterproof, and control body temperature Burns assessed by depth of burn and area covered Nails are protective devices composed of dead material Hair (also dead material) aids in controlling body temperature
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Case Study A 27-year-old female presents to her doctor’s office with complaints of red, itching, and oozing skin for the past 2 days.
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Case Study (cont’d) Physical exam and history reveal a well-nourished, white female who is otherwise in good health, has no known allergies, normal vital signs, pupils are normal and reactive, has good reflexes, normal breath sounds, liquid filled vesicles, and scabbing on both legs from the top of her sock lines to the bottom of her shorts, and new vesicles have formed around her eyes
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Case Study (cont’d) The patient states that she returned from a primitive camping and hiking vacation in Virginia two days ago Based on the case study information, what do you think the diagnosis is? What caused the vesicles to begin to form around her eyes?
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Case Study: Ray’s Story Family education will play an important role for Ray, our quadriplegic, once he gets home. Although proper ventilator care will be crucial for his survival, why do you think skin care is so important? How will Ray’s inability to move potentially cause skin problems? Discuss areas of concern and potential problems involving Ray’s integumentary system. What education/training might be important for members of Ray’s family?
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Case Study: Maria’s Story Maria, our 35 year old diabetic, has been developing a series of integumentary system problems over the past several years. Diabetes can, in some ways, be considered a vascular disease. Research the effects of diabetes as it relates to the integumentary system
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Case Study: Maria’s Story (cont’d) How and why does diabetes affect wound healing? Why is there a high incidence of toe and leg amputations in the diabetic population? What preventative care measures can be taken to ensure good health of the diabetic’s integumentary system?
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Click here to view a video on the topic of emergency medical technicians. Emergency Medical Technicians Video Back to Directory
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Back to Directory Click here to view a video on the topic of nursing. Nursing Video