Integumentary
System
Three main layers of tissue
make up the skin
• Epidermis
• Dermis
• Hypodermis
Epidermis
•The Outermost
layer of skin
•Avascular
•Complete
regeneration
approximately 35
days
Dermis
• Also called
corium or “true
skin”.
• Contains blood
vessels, nerves,
involuntary
muscle, sweat
and oil glands and
hair follicles.
Hypodermis
(Subcutaneous Fascia)
• Innermost layer of
skin
• Made of elastic
and fibrous
connective tissue
and adipose tissue
• Connects skin to
underlying
muscles
Two main types of glands
•Sudoriferous Glands
•Sebaceous Glands
Sudoriferous Glands
(Sweat Glands)
• Coiled tubes.
• Extend through
dermis and
open on surface
of skin at pores.
• Sweat
eliminated by
these glands.
Sebaceous Glands
• Oil glands.
• Usually open to
hair follicles.
• Produces sebum
which is an oil
that keeps skin
and hair from
becoming dry and
brittle.
Hair & Nails
Hair
• Each hair
consists of root
which grows in
hollow tube
(follicle) and a
hair shaft.
• Helps protect
body.
Hair & Nails
Nails
• Consist of dead
epithelial cells
packed closely
together to
form thick,
dense surface.
• Formed in
nailbed.
Function of Integumentary
System
Protection
• Serves as barrier
to sun’s ultraviolet
rays and invasion
of pathogens
(germs).
• Hold moisture in .
• Prevents deeper
tissues from
drying out.
Sensory
Perception
• Nerves in skin
help body to
respond to
pain,
pressure,
temperature,
and touch
sensations.
Body Temperature
Regulation
•Blood vessels
dilate- excess heat
from blood
escapes through
skin.
•Blood vessels
constrict – heat is
retained in body.
Waste
Disposal
•Excretion
of oil,
water,
sodium
and
carbon
dioxide.
•
•Vitamin D production.
Pigmentation
Melanin
• Only pigment
made in skin.
• Yellow to
reddish-brown
to black
• Absorbs
ultraviolet light
to tan skin.
• Gives color to
hair, skin, and
the iris
Karotene
•Yellowishred
pigment
•Can help
determine
skin color.
Abnormal Skin Colors
Jaundice
• Yellow
discoloration
of skin.
• Can indicate
bile in blood
due to liver or
gallbladder
disease
Erythema
•Reddish
color of
skin.
•Due to
burns or
congestion
of blood
vessels
Cyanosis
• Bluish
discoloration of
skin.
• Caused by
insufficient
oxygen.
• Associated
with heart,
lung, and
circulatory
diseases or
disorders.
Skin Diseases and Disorders
• Acne – overactive
secretion of sebaceous
glands.
• Pimples and
blackheads.
• Teens to early twenties.
• Rx: Thorough washing,
steroid creams, UV
light, avoidance of
certain foods, chemical
face peel.
Eczema
• Vesicles or reddened skin which burst and weep
a crust ( dried pus and blood)
• Most common inflammatory disorder of the skin
• Rx: Tranquilizers, antihistamines, wet dressings,
starch baths.
Psoriasis
• Psoriasis – Red thick
areas covered with
white or silver scales
• Chronic,
noncontagious,
inherited skin
disease
• Rx: No Cure
• Cortisone Ointments
• Ultraviolet Light
• Removal of Scales
A-J display appearances of psoriasis
lesions on typical areas of the skin.
Lesions can be present on any area of the
body. D is an example of minimal
psoriasis. K-M are examples of psoriasis
affecting fingernails. Although psoriasisaffected toenails can look very similar to
this, people with athlete's foot may have
similar-appearing toenails; therefore it is
better to judge psoriasis by fingernail
appearance alone. K and L display nail
pits. M shows characteristic yellowish or
brown color known as an "oil spot."
Contact Dermatitis
• Redness, itching, blisters, edema
• Caused by poison ivy, poison oak, cleansing
agents, cosmetics, etc.
• Rx: Wash with soap and water then apply
alcohol and antipruritic (relieves itching) lotions.
Impetigo
• Erythema, vesicles with sticky yellow crusts
• Very contagious.
• Infection with staph or strep
• Rx: Remove crusts and apply antibiotic
ointment
Warts
• Caused by virus.
• Painless except for plantar warts.
• Rx: Nitric or sulfuric acid deep into root of wart
or freezing with liquid nitrogen.
Scleroderma
• systemic autoimmune disease of skin, muscles,
bones, heart, lungs. Skin becomes hard and tight.
• Progressive disease. Mainly affects women in child
bearing years. Considered an auto immune
disease
• Rx: Ointment, heat, massage, steroids.
Skin Cancer
• Definition: neoplasms or abnormal
growth of cells that originate in the
epidermis.
• More than 800,000 new cases each year in
the USA
• One in five people in the US will develop
skin cancer in his/her lifetime. This
number jumps to one in three in the
Sunbelt states.
• Three Major Types of Skin Cancer
• Basal Cell, Squamous Cell, Malignant
Melanoma
Skin Cancer
• Basal Cell Carcinoma
• Most common type of skin cancer
• Malignancy begins in cells at the base of the
epidermis and most often appears on the nose and
face
• Incidence increases after age 40
• Basal cell tumors rarely metastasize but may cause
wide-spread destruction of normal tissue if left
untreated
Skin Cancer
• Squamous Cell Carcinoma
• Slow-growing
• Arises from the epidermis
• Most frequently occurs in middle-aged and elderly
individuals
• Typically found on sun-exposed areas of skin
• May metastasize but is not likely to spread to other
body areas.
Skin Cancer
• Malignant Melanoma
• Most deadly of all skin
cancers
• Steady increase in
incidence of 4% per year
over last 20 years
• Median age of diagnosis is
53 years
• Sometimes develops from
a pigmented Nevus (mole)
to become a dark
spreading lesion
• Most likely to metastasize
Skin Cancer
• Malignant Melanoma
Skin Cancer http://www.skincancer.org/
• “ABCD” Rule of Self-Examination
of Moles
• Asymmetry: Lesion halves are
not mirror images of each
other giving a lopsided
appearance
• Border: Irregular or indistinct
borders
• Color: Unevenly colored,
exhibiting a mixture of shades
or colors
• Diameter: By the time lesions
exhibit characteristics A, B, and
C, it is probably larger than
6mm or ¼ inch
BURNS
• Burn is an injury that
can be caused by
fire, heat, chemical
agents, radiation
and/or electricity
• Classification of
burns: Severity of
burn is determined
by depth of lesion
and percent of body
surface burned.
Burns
• First-degree or superficial
• Least severe type of burn
• Involves only top layer of skin,
the epidermis
• Usually heals in 5 to 6 days
without permanent scarring
• Skin is reddened or discolored
• May have some mild swelling
• Victim feels pain
• Three common causes
• Overexposure to sun or mild
sunburn
• Brief contact with hot objects or
steam
• Exposure of skin to weak acid or
alkali
Burns
• Second-degree or partialthickness
• Usually causes injury to top
layers of skin and involves
both epidermis and dermis
• Blister or vesicle forms
• Skin is red or has mottled
appearance
• Swelling occurs along with
severe pain
• Surface of skin appears to be
wet
• Painful burn that may take 3
to 4 weeks to heal
• Three common causes
• Excessive exposure to
sunlamp or artificial
radiation or severe sunburn
• Contact with hot or boiling
liquids
• Burns from fires
Burns
• Third-degree or full-thickness
• Third-degree or full-thickness
• Most severe type of burn
• Involves injury to all layers of skin
in addition to underlying tissue
• Area has a white or charred
appearance
• Can be extremely painful or
relatively painless if nerve endings
are destroyed
• Can be life-threatening because of
fluid loss, infection, and shock
• Common causes
• Exposure to fire or flames
• Prolonged contact with hot
objects
• Contact with electricity
• Immersion in hot or boiling
liquids
Burns
• Methods to Determine
Percent of Body Surface
Burned
• “Rule of Palms”: Based
on the assumption that
palm size of burn
victim is about 1% of
body surface.
Estimating the number
of “palms” burned will
approximate the
percentage of body
surface involved.
Burns
• Methods to Determine
Percent of Body Surface
Burned
• “Rule of Nines”:
• 9% of total skin area covers
head and each upper
extremity, including front
and back surfaces
• 18%of total skin area covers
each of the following:
• front of trunk
• back of trunk
• each lower extremity including
front and back surfaces
Burns
• Methods to Determine
Percent of Body
Surface Burned
• Lund-Browder Charts:
• Permits more accurate
estimates of burned
surface area in children
• Makes allowances for
large percent of surface
are in certain body
regions in children such
as the head
Burns
• Medical help for burns
• Usually not required for first-degree or superficial burns
• Should be obtained if:
• More than 15% of adult’s body is burned
• More than 10% of child’s body is burned
• Rule of nines is used to calculate the percentage of body
surface burned
• Burns affect face or respiratory tract
• Victim is having difficulty breathing
• Burns cover more than one body part
• Victim has a partial-thickness burn and is under 5 or over 60
years of age
• Burns result from chemicals, explosions, or electricity
Burns
• All third-degree or full-thickness burns should
receive medical care
• First aid for superficial and mild partial-thickness
burns with closed blisters
• Cool area by flushing with large amounts of cool water
• Do not use ice or ice water because it causes body to lose
heat
• Use dry, sterile gauze to blot area dry
• Apply dry, sterile dressing (nonadhesive or nonstick is best)
to prevent infection
• Elevate affected part if possible to reduce swelling
• Do not apply oils, grease, butter or other substances unless
instructed to do so by physician
• Do not break or open any blisters as this creates an open
wound prone to infection
Burns
• First aid for severe seconddegree and full-thickness or
third-degree burns
• Call for medical help immediately
• Cover burned area with thick,
sterile dressings
• Elevate Hands or feet if they are
burned
• Do not allow victim to walk if
feet or legs are burned
• Do not attempt to remove
particles of clothing from burn
• Watch for respiratory distress or
signs of shock
Burns
Breakdown of Major Causes of Burns
Flame
33%
Scald
30%
Contact
15%
Flash
10%
Electrical 5%
Friction
1%
Radiation 1%