Skin, Hair, Nails including the other systems of our body. | Study notes Anatomy

INTEGUMENTARY

SYSTEM

Functions of the Integumentary S. (STEP V)

▪ It consists of the skin, and accessory structures such

as hair, glands, and nails.

1. Sensation

2. Temperature regulation

3. Excretion

4. Protection

5. Vitamin D production

Skin

1. Epidermis

Most superficial layer

Avascular

Stratified squamous epithelium

In deepest layers, mitosis occurs

oNew cells are produced by mitosis in its deepest

layers, as these new cells form, older cells are

pushed superficially causing it slough and flake

off

Keratinization – cells change shape and chemical composition;

cells become filed with the protein keratin (becomes hard)

Epithelial cells die and produce and outer layer of

dead, hard cells that resists abrasion and forms a

barrier

Different Strata

Distinct layers of the skin

Stratum basale – deepest; cuboidal & columnar cells,

undergo mitosis every 19 days

oCells from this stratum take 40-56 days to

reach the surface

oAs cells from this layer are pushed, it forms

the intermediate strata

oAKA stratum germinativum (germinativum

means growth)

Stratum corneum – most superficial stratum; dead

squamous cells filled with keratin (structural strength);

lipids (prevent fluid loss); joined by desmosomes—

mechanical link that bind adjacent cells together

Callus – “kalyo” thickened area

Produced when skin is subjected to friction

↑in the number of layers of the stratum corneum

Corn – bony prominence, thickened corn shaped structure

Also, d/t thickening of the stratum corneum

Dandruff

Excessive stratum cells sloughed from the surface

of the scalp

2. Dermis

Dense collagenous connective tissue, contains

fibroblasts, adipocytes, macrophages

Already has supply of blood vessels (vascular)

Nerves, hair follicles, smooth muscles, glands,

lymphatic vessels extend into the dermis

Abundant in collagen and elastic fibers

oCollagen (resist stretching) & elastic fibers

– structural strength

oCollagen start to reduce in production at 40

or 60 years of age

Cleavage lines/Tension lines – collagen fibers are oriented

in some directions; skin is most resistant to stretch along

these lines

Stretch marks (striae) – skin is overstretched, leaving lines

that are visible

Rapid weight gain and pregnancy may cause this

Dermal papillae – finger-like projections in the

upper part of the dermis which extend toward

the epidermis. It contains blood vessels that supply the

epidermis with nutrients, remove waste products, and

regulate body temperature

The dermal papillae in the palms of the hands and

soles of the feet are arranged in definite patterns

that form looped ridges in the epidermal surface

(fingerprints and footprints)

These ridges increase friction and enhance the

grasping or gripping ability of the hands and feet

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INTEGUMENTARY

SYSTEM

Functions of the Integumentary S. (STEP V) ▪ It consists of the skin , and accessory structures such as hair, glands, and nails.

S ensation
T emperature regulation
E xcretion
P rotection
V itamin D production **Skin
Epidermis**  Most superficial layer  Avascular  Stratified squamous epithelium  In deepest layers, mitosis occurs o New cells are produced by mitosis in its deepest layers, as these new cells form, older cells are pushed superficially causing it slough and flake off Keratinization – cells change shape and chemical composition; cells become filed with the protein keratin (becomes hard)  Epithelial cells die and produce and outer layer of dead, hard cells that resists abrasion and forms a barrier Different Strata  Distinct layers of the skin  Stratum basale – deepest; cuboidal & columnar cells, undergo mitosis every 19 days o Cells from this stratum take 40-56 days to reach the surface o As cells from this layer are pushed, it forms the intermediate strata o AKA stratum germinativum (germinativum means growth)  Stratum corneum – most superficial stratum; dead squamous cells filled with keratin (structural strength); lipids (prevent fluid loss); joined by desmosomes— mechanical link that bind adjacent cells together Callus – “kalyo” thickened area  Produced when skin is subjected to friction  ↑in the number of layers of the stratum corneum Corn – bony prominence, thickened corn shaped structure  Also, d/t thickening of the stratum corneum Dandruff  Excessive stratum cells sloughed from the surface of the scalp 2. Dermis  Dense collagenous connective tissue, contains fibroblasts, adipocytes, macrophages  Already has supply of blood vessels (vascular)  Nerves, hair follicles, smooth muscles, glands, lymphatic vessels extend into the dermis  Abundant in collagen and elastic fibers o Collagen (resist stretching) & elastic fibers - structural strength o Collagen start to reduce in production at 40 or 60 years of age Cleavage lines/Tension lines – collagen fibers are oriented in some directions; skin is most resistant to stretch along these lines Stretch marks (striae) – skin is overstretched, leaving lines that are visible  Rapid weight gain and pregnancy may cause this

Dermal papillae – finger-like projections in the

upper part of the dermis which extend toward

the epidermis. It contains blood vessels that supply the

epidermis with nutrients, remove waste products, and regulate body temperature  The dermal papillae in the palms of the hands and soles of the feet are arranged in definite patterns that form looped ridges in the epidermal surface (fingerprints and footprints)  These ridges increase friction and enhance the grasping or gripping ability of the hands and feet

3. Subcutaneous Tissue/ Hypodermis  Attaches the skin to underlying bones and muscles  Also called the hypodermis  Loose connective tissue o Storage of our body’s fat (padding, insulation) o Fat in this layer functions as padding and insulation Skin Color  Melanin – pigments responsible for skin, hair, eye color o It is also a protective pigment  Melanin pigments – yellow (Caucasian), brown (Asians), black (African)  Melanocytes – produce melanin; irregularly shaped cells; found mainly in the stratum basale  Melanosomes – vesicles derived from the golgi apparatus where melanin is produced o Packed melanin  Factors of Melanin Production o Genetic factors o Exposure to UV light (e.g., exposure to UV light increases melanin production as a protective mechanism→ suntanned) o Hormones (e.g., estrogen and melanocyte- stimulating hormone (MSH) results to an increase production of melanin during pregnancy→ chloasma “mask of pregnancy”)  Albinism - recessive genetic trait that causes deficiency / absence of melanin  Cyanosis - bluish skin color; decreased blood O  Carotene – yellow pigment in plants (squash, carrots); source of vitamin A o Lipid-soluble and if taken in excessive amounts, the skin may turn yellowish  Birthmarks – congenital disorder of the capillaries in the dermis (dilation of the capillaries e.g., strawberry hemangiomas) Accessory Skin Structure Hair  Columns of dead, keratinized epithelial cells

 Found everywhere on the skin except on the

palms, soles, lips, nipples, parts of the

genitalia, and distal parts of the fingers and

toes

 Hair follicle – where each hair rises o Can play an important role in skin repair o If the surface epidermis is damaged, the epithelial cells within the follicle can divide and become a source of new cells  Shaft – above the skin  Root – below the skin  Hair bulb – site of hair cell formation; “growth zone” o Where distribution of melanocytes occurs  Hair papilla- where hair bulb rests; supplies hair bulb with blood and nourishment needed to produce hair  Cortex – hard keratin, covering of the central core  Medulla – soft central core  Cuticle – single layer of overlapping cells that holds the hair in the hair follicle; heaviest keratinized region and outermost layer of hairs Growth Stage  Hair is formed by epithelial cells within the hair bulb  Divide and undergo keratinization  Hair root + shaft = columns of dead keratinized epithelial cells Resting Stage  Growth stops  Hair is held in the hair follicle Next growth stage  A new hair is formed  The old hair falls out Eyelashes – grow for about 30 days; rest for 105 days Scalp hairs – grow for 3 years; rest for 1 – 2 years Arrector Pili – smooth muscles associated with every hair follicle; contraction = hair to stand more perpendicular to the skin’s surface ; produces goose bumps Glands I. Sebaceous Glands  Simple, branched acinar glands (sac-like)  Connected by a duct to the superficial part of the hair follicle  Sebum – oily, white substance rich in lipids; released by holocrine secretion; lubricates the hair/surface of the skin (prevents drying and protects against bacteria)  White heads- blockage of the sebaceous glands  Blackheads - accumulated material which oxidizes, dries and then darkens  Acne- infection of the sebaceous glands  Seborrhea or seborrheic dermatitis- “cradle cap” in infants – it is caused by the overactivity of the sebaceous glands II. Sweat Glands  Sweat- clear secretion (produced by the sweat glands) that is primarily water, salts, vitamin C and it may contain traces of metabolic wastes and lactic acid  Eccrine Sweat Glands o Simple, coiled, tubular glands located in almost every part of the skin

 Iron Deficiency Anemia – nails become flat or concave  Lead Poisoning – high levels of lead in the hair Burns  Burn – injury to a tissue caused by heat, cold, friction, chemicals, electricity, and radiation I. Partial-thickness Burns  S. basale remains viable  Regeneration of the epidermis occurs within the burn area First-degree burns  Epidermis  Red and painful  Slight edema (swelling)  E.g., sunburns, brief exposure to hot and cold objects  Heals within a week without scarring Second-degree burns  Epidermis, minimal damage to the dermis o Epidermis regenerates from the epithelial tissue  Dermal damage is minimal o Redness, pain, edema, blisters o Healing = 2 weeks o Will not produce scars  Deep into the dermis o Pink to red in color o Takes several months to heal o Might scar II. Full-thickness Burns  Third-degree burns o Epidermis, dermis, and underlying tissues are completely destroyed o Recovery occurs from the edges of the burn wound o Region of the 3rd^ degree burn is painless (sensory receptors have been destroyed ) o White, tan, brown, black, deep  Cherry red o Take a long time for burn to heal o Form scar tissue o Skin grafts are used to prevent complications and to speed healing Skin Cancer  Most common type of cancer  Exposure to UV light from the sun  Usually on face, neck, hands  Most like to have skin cancer = fair skinned or older than 50  Limiting exposure to sun, using sunscreen; reduces the likelihood of developing skin cancer  Ultraviolet light o UVA  Longer wavelength  Causes most tanning of the skin  Development of malignant melanoma o UVB  Most burning of the skin  Development of basal cell and squamous cell carcinoma I. Basal cell carcinoma  Most frequent type and least malignant  Begins in the cells of the stratum basale and extends into the dermis to produce an open ulcer  Cure; surgical removal or radiation therapy  Little danger of cancer to spread, metastasize II. Squamous cell carcinoma  Develops from cells immediately superficial to the stratum basale  Cells continue to divide as they produce keratin→ nodular, keratinized tumor confined to the epidermis  Can invade the dermis, metastasize, and cause death III. Malignant melanoma  Cancer of the melanocytes  Rare form of skin cancer (5% of skin cancers) that arises from melanocytes ; usually from a pre-existing mole o Mole – an aggregation or nest of melanocytes o Large, flat, spreading lesion or deeply pigmented nodule  Metastasis is common  Often fatal  ABCD rule for recognizing melanoma: o A- asymmetry o B- border o C- color o D- diameter FX of Aging on the Integumentary S.  Epidermis thins  Amount of collagen in the dermis decreases ▪ Skin infections are most likely  Repair of skin occurs slower  Decrease no. of elastic fibers in the dermis and loss of fat (sagging of skin, wrinkles)  Decrease of activity of sweat glands = reduced ability to regulate body temp.  Decrease sebaceous gland activity = skin becomes drier  Decrease no. of melanocytes  Some areas, the no. of melanocytes increase = age spots  Increased melanin production = freckles; also, gray/white hair  Skin that is exposed to sunlight = shows signs of aging more rapid

Assessment of the skin,

hair, and nails

Skin Assessment

Pediatric Clients Skin Assessment Infants and Children

 Have very smooth skin – lack of exposure to environmental variables  Subcutaneous is poorly developed, thus, predisposing infants to hypothermia Vernix Caseosa  Cheese-like substance (sebum) o Avoids maceration of the skin o Has antimicrobial and moisturizing qualities o Also aids as heat insulator d/t immaturity of the adipose tissue o From the sebaceous glands and desquamated fetal skin  Appears 20 wks AOG Lanugo  Seen abundantly in the shoulders and back of the baby  Fine, downy hair that will disappear in 10-15 days after birth  Preterm- abundant lanugo  Post term- absent lanugo Merocrine  Begins to function about 4 weeks Eccrine Glands  Perspiration – present after 1 hour (after birth) Inspection Skin Color  Should be the first to be observed  Depends on the nationality of the person, may range from pinkish tan, rudy dark red, yellow, or brown  Deviations o Erythema- reddening of the skin o Cyanosis- bluish discoloration of the skin o Pallor- whitish color of the skin d/t ↓blood circulation o Jaundice- yellowing of the skin Skin Uniformity  Should be generally uniform except in areas exposed to the sun and areas prone to friction (e.g., groin and armpit)  Areas with lighter pigmentation—palms, lips, and nail beds Deviations (abnormal findings) Hyperpigmentation  Abnormal distribution of melanin  Freckles, birthmarks o Birthmarks are abnormal distribution of melanin Mongolian blue spots  Bluish purple spots observed in the gluteal area of an infant  Melanin has not reached the upper part of the skin resulting to this discoloration  Disappears at age 1 Cutis Marmorata  Skin has a pinkish blue mottled or marbled appearance when subjected to cold temperatures  Returns to normal once infant is rewarmed Senile Lentigines  Brown spots that start to appear when a person age  May be a result of sun exposure (UV radiation from the sun) Freckles  Indication of sun damage, hypothyroidism o Hypothyroidism can trigger melasma o Changes in hormones if (+) hypothyroidism→ effects on inflammatory cytokines→ stimulation of melanocytes  ↑production of melanin when skin is exposed to UV rays  Light brown spots observed in the face, neck, and/or shoulders  More prominent in Caucasians Addison’s disease  Causes bronze pigmentation of the skin o Accumulation of ACTH (adrenal glands may be to

 Lesions arranged in a line Pedunculated lesions  Benign tumors usually less than 1 cm and has its own blood vessels Size  Measure in centimeters using a ruler Location and distribution  Note the area, region, extremity it is found  Note for exudates (color)  Gently scape a scale on a lesion to see if it comes off or bleeds, if it comes to perform the lesion blanching test Tumbler Test  To check if a lesion is blanchable or not o Meningitis and herpes zoster/ shingles are non- blanchable lesions  Herpes zoster lesions never cross the midline because the spinal nerves are not connected o Lies dormant in the dorsal root ganglia  A non-blanchable erythema may be indicative of pressure ulcer or bed sores Types of Lesions Primary Lesions  Macule o Flat, cannot be palpated, color may range from brown, white, tan, purple, and red o Less than 1 cm with a circumscribed border o Café au lait  Papule o Small and elevated o Containing solid mass o Circumscribed border and are less than 0.5 cm  Plaque o Slightly elevated, scale-like lesion o >0.5 cm to 1cm in diameter o Psoriasis  Pustule o Puss-filled (purulent) vesicle or bulla o Erythema toxicum neonatorum and acne  Nodule o May feels like large pea under the skin o Circumscribed, elevated solid lesion with depth up to 0.5-2 cm e.g., cyst  Cyst o Non-cancerous, closed pockets of tissue that can be filled with fluid, pus, or other material that may extend to the subcutaneous layer o Can develop as a result of infection, clogging of sebaceous glands, or around foreign bodies such as earrings  Tumor o Common as people get older o Larger than a nodule o Seborrheic keratosis is an example of common benign tumors  Vesicles o Small, fluid-filled sacs o Fluid inside may be clear, white, yellow, or mixed with blood o Less than 0.5 cm in diameter

o Herpes simplex  Bulla o Fluid-filled elevated sac that appears when fluids are trapped under a think layer of the skin o A type of blister o Largen than 0.5 cm in diameter o Bullous impetigo Secondary Lesions  Fissure o Linear crack extending to the dermis  Ulcer o May arise d/t poor blood circulation o Common in bony prominences o Affects the epidermis and may extend up to the bones and muscles  Erosion o Superficial and does not extend to the dermis o Depressed moist area Vascular Skin Lesions  Petechiae o Small red or purple macular spots o 1-2 mm in diameter o Tiny, circular, non-raised patches that may appear on the skin or in mucous or serous membranes o Occurs as a result of bleeding under the skin d/t abnormality of the thrombocytes o Pinkish petechiae may be seen at the third day of rubella  Purpura o Purplish spots d/t rupture of blood vessels o Slightly larger than petechiae o E.g., meningitis, snakebites  Ecchymosis o Larger than petechiae o Hemorrhagic blotching d/t pooling of blood under the skin or mucous membrane  Hematoma o Elevated ecchymosis  Cherry angioma o Red moles usually found in the trunk and extremities o Papular, round, and may be blanched; o Usually seen in people aged 10 and older o Collection of small blood vessels inside a cherry angioma gives it the reddish appearance  Spider angioma o D/t increased levels of estrogen Other Lesions  Acne o Clogging of follicles with oil and dead skin cells o May be seen in girls 14-16 years old and 16-19 in boys  Folliculitis o Inflammation of the hair follicles d/t bacterial or fungal infections  Wheals/ hives o Elevated mass with transient borders that are often irregular o Size and color may vary o E.g., allergies, urticaria, and insect bites  Urticaria o Elevated, reddened lesions that results from skin reactions o E.g., allergies  Comedone o Increased sebaceous gland activity o Common skin problem of the adolescent o May be seen in girls ages 14-16 and 16-19 in boys  Acrochordons o Skin tags o Common in areas where there is skin friction o Neck, axillar, cheeks, and trunk  Alopecia areata o Common in autoimmune disorders

Skin, Hair, Nails including the other systems of our body., Study notes of Anatomy

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Download Skin, Hair, Nails including the other systems of our body. and more Study notes Anatomy in PDF only on Docsity!

INTEGUMENTARY

SYSTEM

Dermal papillae – finger-like projections in the

upper part of the dermis which extend toward

the epidermis. It contains blood vessels that supply the

 Found everywhere on the skin except on the

palms, soles, lips, nipples, parts of the

genitalia, and distal parts of the fingers and

toes

Assessment of the skin,

hair, and nails

Skin Assessment