Health Occupations
Integumentary System
SKIN
Largest organ in the body
 17 –26 square feet
 Varies in thickness

– Eyelid – 0.5 mm
– Soles of feet – 6.6 mm
Three layers of Skin
Epidermis
 Dermis
 Subcutaneous

Epidermis

Outer layer, also called cuticle
 Surface is layer of dead cells with living cells
underneath
 5 layers of cells
– Stratus corneum – sheds
– Stratus germinativum – rebuilds
– No blood vessels or nerve cells but has nerve
endings for
• Light touch
• Pain

90% of cells are water repellent
Hair follicles
 Melanocytes – make melanin, the
pigment that gives skin its color

– Inherited characteristic
– Freckles – concentrated melanin

Surface – covered with sweat, oil, &
epithelial cells that
– Lubricate
– Hydrate
– Provide antibacterial protection
– Block toxins
Dermis
“True” skin
 Contains blood vessels & nerves

– Nerve endings
• Pressure
• Heat & cold

Each square inch of skin has 15 ft. of blood
vessels
 Is 15-40 times as thick as epidermis
 Contain fingerprints – ridges or striations in
this layer that are unique to each person
 Contains sebaceous glands – oil glands
Subcutaneous or hypodermis
Innermost layer
 Adipose – fatty tissue that cushions &
insulates organs
 Connects skin to muscle
 Made of up elastic & fibrous tissue as
well
 Contains sudoriferous glands

Hair
Pili – found everywhere except soles of
feet & palms of hand
 Hair in nose & mouth block foreign
particles from entering
 Hair root originates in dermis
 Shaft - visible portion of hair
 Follicle – hair root with its covering

– Has 1-2 sebaceous glands attached to it

Arrector pili – small muscle attached to
hair shaft
– Causes goose bumps or hair to stand on
end due to cold or fear
Color & texture of hair is inherited
 Color dependant on melanin

Glands
Sebaceous glands
 Sudoriferous glands
 Ceruminous glands

Sebaceous glands

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
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
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Oil glands
Found everywhere except palms & soles
2,000-2,000,000 glands in each square inch
of skin
Causes skin to be soft & waterproof
Usually open onto hair follicles
Sebum – oil
– Antibacterial & antifungal, prevents infections
– When gland is plugged, get pimple
Sudoriferous glands

Sweat glands
 Originate in subcutaneous layer & opens at
pores in epidermis
 Apocrine
– Attached to hair follicles
– Found in axilla, breasts, pubic area

Eccrine
– Empty directly onto skin

Regulate body temp & excretes wastes
 Skin loses 500 ml of water each day,
increases with exercise
Ceruminous glands
In auditory canal of eat
 Secretes wax

– Protects ear from infection
– Prevents foreign body entry
Nails
Protect fingers & toes from injury
 Formed from dead, keratinized
epidermal cells
 Root – where nail grows, covered by
skin where it attaches
 Lunula – crescent shaped white area
near root
 Nails regrow unless root is damaged

Function of integumentary
system

Protection
– Barrier to UV rays & pathogens
– Keeps moisture in

Sensory perception
– Helps body respond to pain, pressure,
temperature, & touch

Body temperature regulation
–
–
–
–
Helps skin retain or lose heat
Blood vessels dilate – heat escapes
Blood vessels constrict – heat is retained
Sudoriferous glands cool through perspiration

Storage
– Tissues for temporary storage of fat, glucose,
water, vitamins, & salt
– Adipose – source of energy

Absorption
– Substances absorbed through skin
– Transdermal meds
•
•
•
•

Nitroglycerine – heart
Scopolamine – motion sickness
Hormones – birth control
Nicotine – smoking cessation
Excretion
– Eliminates salt, wastes, excess water through
sweat

Production
– Vitamin D – uses UV rays to form Vitamin D that
matures in the liver
Arector pili
Sebaceous gland
Hair follicle
Root
Artery
Vein
Adipose tissue
Sudoriferous gland
Subcutaneous tissue
Nerve
Dermis
Epidermis
Assessment
Dermatology – study of skin
 Dermatitis – inflammation of skin,
usually non-life threatening
 Skin lesions – visually inspected

– Look for size, shape, texture, color
– Biopsy or culture for diagnosis
Color

Erythema
– Reddish color
• Burns
• Congestion in blood vessels

Jaundice
– Yellowish color
• Liver or gall bladder disease or RBC destruction

Cyanosis
– Bluish color
• Insufficient oxygen – heart, lung, or circulatory disease
Eruptions

Macules
– Flat spots on skin
• Freckles
Papules

Firm raised areas
– Pimples
– End stage of chicken pox
Vesicles

Blisters or fluid filled sacs
– Early chicken pox or small pox
Pustules

Pus filled sacs
– Acne
– Fire ant bites
Crusts

Areas of dried pus & blood
– scabs
Wheals

Itchy, elevated areas with irregular
shape
– Hives or bites
Ulcer
Deep loss of skin surface, extends into
dermis
 May see scarring & bleeding

Diseases & Abnormal Conditions

Acne Vulgaris
– Increased secretion of sebaceous glands
– Bacteria grows & blocks hair follicle
– Causes papules, pustules, & blackheads
– Treat with
• UV light
• Antibiotics
• dermabrasion
Albinism
Melanocytes don’t produce melanin
 Pale skin
 White hair
 Light eyes
 Sensitivity to light
 Decreased visual acuity

Alopecia
Baldness
 Inherited tendency to lose hair
 Androgenic hormones at puberty can
begin hair loss
 May occur in females too

Athlete’s foot
Fungal infection
 Skin itches, blisters, cracks
 Contagious, transmitted by wet floors
 Treatment

– Antifungals
– Clean & dry
– Well ventilated
Cellulitis

Bacterial infection of dermal & subcutaneous
layers
 Symptoms
–
–
–
–
–
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Fever & chills
Vesicles
Warm, red skin
Decreased circulation
lymphedema
Treatment
– Rest, elevation
– Immobilization
– Antibiotics
Chloasma
Patchy discoloration on face
 Due to high hormone levels

– Pregnancy
– Oral contraceptives
– Liver disease
Cleft lip and palate

1 in 700 babies born with this
 Space where nasal processes or palate do
not meet, see open area
 Causes
– 25% heredity
– Environment
– Prematurity

Treatment
– Surgery
– Dental therapy
– Speech therapy
Contact dermatitis

Allergic reaction to anything
– Poison ivy, jewelry, bleach, etc

Symptoms
–
–
–
–

Redness
Swelling
Itching
Blisters
Treatment
– Washing
– Anti inflammatory meds
– Avoid exposure
Dandruff
Scalp itching
 Causes white flakes of dead skin cells
 Treatment

– Scalp massage
– Shampoo
– brushing
Decubitus ulcers

Sores of inflammation over body
prominences
 Due to
– Prolonged pressure & hypoxia to affected area
“Bedsores”
 Prevention

– Frequent position changes
– Good nutrition
– Massage

Described in 4 stages, depending on severity
 Treatment – antibiotics, remove necrotic
tissue, frequent cleaning, maggots
Eczema

Caused by dermatitis
 Symptoms
–
–
–
–
Swelling
Redness
Itching
Weeping/crusting lesion

Familial
 Treatment
– Remove irritant
– Keep skin clean
Fungal infection

Only on epidermis
 Ranges from no symptoms to scaly, red,
swelling, & blisters
 Usually on moist areas
– Athlete’s foot
– Jock itch
– Ringworm

Treatment
– antifungals
Furuncle
Boil
 Sometimes infected hair follicle
 Treatment

– Hot compresses
– Antibiotics
– lancing
Hirsutism or Hypertrichosis

Increased hair growth in abnormal
places
– Hair, back, chest
Hormone related or hereditary
 Treatment – temporary

– Shave
– Wax
– electrolysis
Impetigo
Contagious bacterial infection
 Vesicles to pustules to crusts
 Symptoms

– Itching
– Burning
– Can lead to kidney infection if untreated
Lesions usually clear without damage
 Can be fatal to infants

Kaposi’s Sarcoma

CA that originates in blood vessels and
spreads to the skin
 Round or oval spot
 Red, purple, or brown
 2 types
– Aging
– Diabetes, lymphoma, AIDS
• Spreads to liver, lungs, intestine
• Tx with inteferon or chemotherapy
Lupus

Benign dermatitis or chronic systemic
disorder
 Symptoms
– Scaly rash
– Baldness
– Vascular connective tissue affected
• Butterfly rash

Treatment
– Protect from sun
– Anti-inflammatory meds
Psoriasis

Too many epidermal cells
 Red thick areas covered with scales
– Gray
– Silver

Triggered by stress
 Familial
 Treatment
– Topical cream
– Scale removal
– UV light
Rashes
Usually viral
 Treat symptoms
 Usually childhood disease

Scleroderma
Autoimmune disease
 Affects

– Blood vessels
– Connective tissue
– Epithelial tissues

Treatment
– Anti-inflammatory meds
– PT to avoid muscle contractures
Skin Cancer
Basal cell
 Squamous cell
 Malignant melanoma

Streptococcus
Bacteria that can affect the skin
 Group A may be flesheating

Vitiligo
Loss of pigment
 Leads to formation of white patches

Warts

Papule caused by HPV
 Comes & goes unexpectedly
 Types
– Plantar
– Common
– Flat

Treatment
– Chemicals
– Freezing
– burning
UV light

Skin protects us from this by producing
melanin
 Makes a tan
 Process of damage
– UV light causes damage to dermal cells
– Moisture is lost
– Wrinkled & dry skin

Main cause of skin cancer
 Burns
– 1st degree – sunburn
– 2nd degree – blister
– 3rd degree - full
Basal cell carcinoma

Starts in lower layer of epidermis
 Symptoms
–
–
–
–

Waxy, pearly growths
Red scaly patches
Face, arms, hands
Bleed then heal, over & over
Treatment
– Scraping
– Burn
– Cut out lesion

Most benign form of CA
Squamous Cell Carcinoma
Middle layer of epidermis
 Symptoms

– Spreads more quickly
– Red, scaly patches that don’t heal
– Eventually grows into surrounding tissue

Treatment
– Same as basal cell
Malignant Melanoma

Originates in melanin cells
 SERIOUS
 Symptoms
– Brown, black color
– Can start on back, legs, torso
– ½ develop from moles

Treatment
– Removal
– If spread, survival rate decreases
• Needs chemo