Pawan Dhaliwal
WEEK 1 – CASE 1
“SCHOOL SORES”
Student #: 2
The Body
Systems
Questions
PATH 417A
Januar y 2016
THE CASE
6-year-old Stephanie O. has developed red sores
around her mouth and nose. At the start of class
her teacher noticed the rash and called her
parents to take her home. Her parents take her to
the family doctor who examines Steph. She is
afebrile and does not have any swollen lymph
nodes. There is no rash on her hands or feet or
inside her mouth. He prescribes an antibiotic and
tells her parents that she needs to stay at home
for a couple of days. He swabs the rash and
sends the swab to the Microbiology Laboratory.
BODY SYSTEMS QUESTION 1
What are the signs and
symptoms?
DEFINING THE TERMS
Let’s first look more closely at what is
meant by a sign versus a symptom…
SIGN VS. SYMPTOM
Table 1: Differences between a sign and a symptom1
Sign
Symptom
Taken note of by…
Healthcare professional Patient
Characteristics
are…
Objective
Subjective
Examples
• High blood pressure
• Abnormal densities
in lungs detected on
x-ray
• Feelings of tiredness
or pain
• Observation of skin
rash
SIGN VS. SYMPTOM
 An illness characteristic can be a sign, symptom (or both)
depending on the obser ver(s): 2
Illness characteristic is (a):
Doctor
Patient
Sign
Symptom
Doctor and Patient
Both sign and symptom
STEPHANIE’S SIGNS
Can you define
this medical
Afebrile:
sign?
absence of
fever3
Click for the
answer!
STEPHANIE’S SYMPTOMS
As noted before, the observer of a
symptom is the patient.
In this case, there are no symptoms to
report as Stephanie, the patient, has not
mentioned anything to her parents, or to
her family doctor.
Although the teacher noticed
Stephanie’s rash at school, I did not
include this as a symptom because
Stephanie’s teacher is not the patient.
BODY SYSTEMS QUESTION 2
Which body system is affected, in
what specific area and what is the
normal physiological function of
this area of the body?
WHICH BODY SYSTEM IS AFFECTED
In Stephanie’s case, the body system that is
affected is the Integumentary System.
The Integumentary System is comprised of:
the skin, and
its accessory structures, including hair, nails and
sweat glands. 4
In this case, the Integumentary System of the
face is affected, specifically around the mouth
and nose.
THE INTEGUMENTARY SYSTEM
Figure 1: The layers of the skin
 The skin has 2
layers: 5
 (1) epidermis
 (2) dermis
 Both have a
protective function
 Below these 2 layers
is the hypodermis,
made up of fat and
connective tissue. It
functions as
insulation and to
store fat. 6
NORMAL OVERALL PHYSIOLOGICAL
FUNCTIONS OF INTEGUMENTARY SYSTEM
 Functions: 7
 Retain body fluids
 Act as barrier to protect against:
 Elements – UV, wind, water
 Diseases – microbes, parasites,
fungi
 Harmful chemicals
 Eliminate waste products
 Regulate body temperature
 Sensory function
 Vitamin D synthesis
Let’s focus on this
function for the next
question
BODY SYSTEMS QUESTION 3
In what ways has the normal
physiological functioning of this
area of the body been disturbed
by the infection?
DISTURBANCE OF NORMAL
PHYSIOLOGICAL FUNCTION
v
Keep microbes
out!
Figure 3: Barrier function of skin
 The skin is able to act as
a barrier against the
elements and diseases
because: 8
(1) cells of the epidermis,
called keratinocytes, are
tightly connected to one
another so that bacteria
can not pass between them
(2) the dermis produces anti-bacterial substances to
prevent colonization by harmful microbes
DISTURBANCE OF NORMAL
PHYSIOLOGICAL FUNCTION
 In Stephanie’s case, the barrier function of the skin
has been breached, possibly by a cut, scrape or other
wound, and bacteria have caused an infection,
resulting in red sores around her mouth and nose
 In an infection, the affected skin is no longer able to
serve as a protective barrier against the elements
and disease 9
 Bacteria are able to penetrate the protective barrier
and cause an infection
Figure 4: Bacteria, allergens and chemicals may penetrate skin if barrier is breached
BODY SYSTEMS QUESTION 4
Are there are any secondary sites
of infection and, if so, what
enables the bacteria to (a) travel
to; and (b) affect these areas of
the body?
PRIMARY VS. SECONDARY SITES OF
INFECTION
In order to know what a secondary site is, we
must first know what a primary site of
infection is
A primary site of infection is defined as the
site where the infection is first established 10
A secondary site of infection is defined as a
site other than the point of entry where an
infection is established 11
PRIMARY VS. SECONDARY SITES OF
INFECTION
Larger than life bacteria
Primary site of infection
(“point of entry”)
This will spread the
bacteria from her face to
her hands.
The bacteria can then travel,
either on or in the body, to
establish infection at a
secondary site.
For example, Stephanie may
use her hand to scratch the
sores around her mouth and
nose.
SECONDARY SITES OF INFECTION
 In Stephanie’s case, the primary site of
infection is around her mouth and nose
 However, there is no secondary site of infection
because in the case it is noted that the doctor
did not observe a rash anywhere else on
Stephanie’s body:
“there is no rash on her hands or feet or inside
her mouth”
BODY SYSTEMS QUESTION 5
Why did the doctor suggest that
Stephanie stay at home for a few
days?
WHY DOES STEPHANIE HAVE TO STAY AT
HOME?
(1) To protect her classmates
 Whatever Stephanie has may be contagious, and may easily spread
to others around her
 Thus, her family doctor suggests Stephanie stay at home to protect
her classmates and others at her school
(2) To protect herself
 Infections, or any ailments, clear up
faster when the body is at rest and
not under stress12
 Therefore, sleep and a wellbalanced nutrition at home will
make Stephanie feel better sooner
THE END!
SOURCES
 [1]
Niamh, K., & Lowe, C. (n.d.). Signs and Symptoms.
Retrieved January 12, 2016, from
https://connect.ubc.ca/webapps/blackboard/execute/content/bla
nkPage?cmd=view
 [2]
Niamh, K., & Lowe, C. (n.d.). Signs and Symptoms.
Retrieved January 12, 2016, from
https://connect.ubc.ca/webapps/blackboard/execute/content/bla
nkPage?cmd=view
 [3]
Merriam-Webster Medical Dictionary. ( n.d.). Definition of
afebrile Retrieved January 12, 2016, from http://www.merriamwebster.com/medical/ afebrile
SOURCES
 [4]
OpenStax College, Anatomy & Physiology Chapter 5 The
Integumentar y System (pages 171 – 187). OpenStax College. 25
April 2013. Retrieved January 12, 2016, from
https://openstaxcollege.org/files/textbook_version/low_res_pdf/1
3/AnatomyAndPhysiology -LR.pdf
 [5]
OpenStax College, Anatomy & Physiology Chapter 5 The
Integumentar y System (pages 172). OpenStax College. 25 April
2013. Retrieved January 12, 2016, from
https://openstaxcollege.org/files/textbook_version/low_res_pdf/1
3/AnatomyAndPhysiology -LR.pdf
SOURCES
 [6]
OpenStax College, Anatomy & Physiology Chapter 5 The
Integume ntar y System (page 178). OpenStax College. 25 April 2013.
Retrieved Januar y 1 2, 2016, from
https://openstaxcollege.org/files/textbo ok_ ver si on/l ow_res_pdf/1 3/Anatom
yAndPhysi ol ogy -LR.pdf
 [7]
Ope n St a x Co l lege, An a tomy & P hy s i o l o gy C h a p te r 5 T h e I n te gume nt ar y
S y s te m ( pa g e s 1 87 - 190) . Ope n St a x Co l lege. 2 5 Apri l 2 01 3 . Retri eve d Ja n ua r y
1 2 , 2 016 , fro m
h t t ps : / /openst a xc olleg e.org /files/tex t book _ver sio n/low _res_pdf/ 1 3/Anatomy And
P hy s iology - LR. pdf
 [8]
Ope n St a x Co l lege, An a tomy & P hy s i o l o gy C h a p te r 5 T h e I n te gume nt ar y
S y s te m ( pa g e s 1 87 ) . Ope n St a x Co l lege. 2 5 Apri l 2 01 3 . Ret ri eved Ja n ua r y 1 2 ,
2 016 , fro m
h t t ps : / /openst a xc olleg e.org /files/tex t book _ver sio n/low _res_pdf/ 1 3/Anatomy And
P hy s iology - LR. pdf
SOURCES
 [9]
Dr yden, M. S. (2010). Complicated skin and sof t tissue
infection. Journal of Antimicrobial Chemotherapy, 65(Supplement 3),
Iii35-Iii44.
 [10]
Marcovitch, H. (2010). Primar y site (of infection). In Black's
medical dictionar y. London: A . & C. Black .
 [11]
Marcovitch, H. (2010). Secondar y site (of infection). In Black's
medical dictionar y . London: A . & C. Black .
 [1 2]
Opp, M. R. (2009). Sleeping to fuel the immune system:
Mammalian sleep and resistance to parasites. BMC Evol Biol BMC
Evolutionar y Biology, 9(1), 8.
FIGURES
 Figure 1: The layers of the skin
Lecture 7: Integumentary System. ( n.d.). Retrieved
January 16, 2016, from
http://www.rci.rutgers.edu/~uzwiak/AnatPhys/APFallLect7. html
 Figure 2: The layers of the epidermis
Epidermis. (2011). Retrieved January 16, 2016, from
http://kreativestudios.com/Tooltip/05Integument/ 02epidermis
.html
FIGURES
 Figure 3: Barrier function of the skin
Information for Patients: Treatments For Eczema. (2015).
Retrieved January 16, 2016, from http://epiceramus.com/patient-information/
 Figure 4: Bacteria, allergens and chemicals may penetrate
skin if barrier is breached
Understanding Eczema. (2015). Retrieved January 16,
2016, from http://www.childrensskindoctor.com/ eczema.html
IMAGES
 All images used in this presentation are Public Domain Images
 Doctor:
 http://www.clipartpanda.com/categories/doctor -clip-art-pictures
 Little girl:
 https://www.pinterest.com/scentsy_bex/preschool-3-year-old/
 Clipboard:
 https://commons.wikimedia.org/wiki/File:Clipboard_01. svg
 Thought bubble:
 http://www.clker.com/clipart-cartoon-thought-bubble.html
 Group of bacteria:
 http://www.clipartpanda.com/clipart_images/bacteria-clipart-item-2-41791106
 House:
 http://www.123rf.com/stock -photo/home_clipart.html