Lecture Notes

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Lecture Notes
5
Integumentary System

• Classroom Activity to Accompany Medical
  Terminology Systems, Sixth Edition
• Barbara A. Gylys Mary Ellen Wedding

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INTEGUMENTARY SYSTEM
Structure

• Epidermis
• Dermis
• Subcutaneous tissue
• Accessory organs
• Glands
• Hair
• Nails

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INTEGUMENTARY SYSTEM
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Function

• Covers and shields outer body surfaces
• Sweat and oil glands produce secretions
• Contains an intricate network of sensory
  receptors
• Regulates body temperature, pain, and pressure
• Melanocytes produced in basal layer gives color
  to the skin

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INTEGUMENTARY SYSTEM
Structure and Function Exercise

• Q What does the term integument mean?
• A Refers to the skin.
• Q What are the accessory structures of the skin?
• A Hair, nails, and glands (sweat and oil)
• Q What are the functions of the subcutaneous
  layer of tissue?
• A Binds the dermis to underlying structures
  stores fats, insulates and cushions the body, and
  regulates temperature.
• Q In the basal layer, what specialized cells
  protect the skin from damaging effects of the
  sun?
• A Melanocytes, which produce melanin.
• Q Which accessory organs produce oil?
• A Sebaceous glands.

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INTEGUMENTARY SYSTEM
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Basal Cell Carcinoma

• Signs and Symptoms
• Malignancy of basal layer is commonly caused by
  repeated overexposure to the sun.

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INTEGUMENTARY SYSTEM
Basal Cell Carcinoma

• Signs and Symptoms (continued)
• Locally invasive tumor, but rarely
  metastasizes.
• Tumors grow slowly, but commonly ulcerate.
• Tumors usually occur on the face.
• Predominant in fair-skinned men older than 60
  years.

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INTEGUMENTARY SYSTEM
Basal Cell Carcinoma

• Treatment
• Size, shape, location, and invasiveness of the
  carcinoma determine type of treatment.
• Curettage and electrodessication.
• Cryotherapy and laser therapy.
• Chemotherapeutic drugs.
• Surgical excision (used in 90 of the cases).
• Irradiation or chemosurgery.

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INTEGUMENTARY SYSTEM
Clinically Related Exercise

• Q Mr. T is advised that the basal cell carcinoma
  on his face will not spread but will remain
  local. Nevertheless, it will destroy underlying
  and adjacent tissue. The term for spread of CA
  from one part of the body to another site is
  called _____________.
• A metastasis.
• Q A 70-year-old male is diagnosed with basal
  cell carcinoma due to overexposure to the sun. He
  is advised that the most common site of this skin
  cancer is the _____________.
• A face.
• Q After closely examining a growth on Anns arm,
  she is informed that it is noncancerous. The
  dermatologist charts the noncancerous growth as
  (benign, cancerous, malignant).
• A benign
• Q Mr. J is diagnosed with basal cell carcinoma
  and asks the nurse to explain this type of
  cancer.
• A She explains it is a malignancy of the basal
  layer of skin, commonly caused by repeated
  overexposure to the sun.

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INTEGUMENTARY SYSTEM
Abscess

• Signs and Symptoms
• Localized collection of pus at infection site
  (characteristically a staphylococcal infection).
• A furuncle, or boil, is an abscess in a hair
  follicle and adjacent subcutaneous tissue.

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INTEGUMENTARY SYSTEM
Abscess

• Signs and Symptoms (continued)
• A carbuncle is a cluster of furuncles in the
  subcutaneous tissue.
• Affected portion of skin may be extremely tender,
  painful, and swollen.
• Abscess may enlarge, soften, and open,
  discharging pus and necrotic material.
• Erythema and edema may persist at the site for
  days or weeks.
• Mild fever may accompany this condition.

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INTEGUMENTARY SYSTEM
Abscess

• Treatment
• Cleaning infected area thoroughly with soap and
  water.
• Applying hot, wet compresses to promote
  vasodilation and drainage from lesions.
• Administering topical antibiotics.
• Incision and drainage (ID) may be necessary
  after lesion has matured.

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INTEGUMENTARY SYSTEM
Clinically Related Exercise
Q Mrs. K presents with redness and edema on the
neck. The term to describe reddening of the skin
is ____________. A erythema, erythamatous Q
Upon diagnosis of a furuncle, the nurse explains
that this is an infection caused by a/an
(bacterium, injury, virus). A bacterium Q The
physician charts a cluster of furuncles in the
subcutaneous tissue as a ________________. A
carbuncle Q Sue is diagnosed with an abscess on
her knee. She asks the nurse to explain this
condition. A She explains it is a localized
collection of pus at the infection site,
characteristically caused by the bacterium known
as staphylococcus.
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INTEGUMENTARY SYSTEM
Psoriasis

• Signs and Symptoms
• Circumscribed red patches covered by thick, dry,
  silvery, adherent scales.

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INTEGUMENTARY SYSTEM
Psoriasis

• Signs and Symptoms (continued)
• Excessive development of the basal layer
• of the skin.
• Affected areas typically appear dry, cracked, and
  encrusted.
• Buildup of skin is composed of living and dead
  tissue.
• Common sites include scalp, knees, elbows,
  umbilicus, and genitalia.

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INTEGUMENTARY SYSTEM
Psoriasis

• Treatment
• Depends on the type of psoriasis, extent of the
  disease, and the effect of the disease on the
  patient.
• No cure treatment is only palliative.
• Topical application of various medications, such
  as coal tar, vitamin D, corticosteroid drugs, and
  wet dressings.

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INTEGUMENTARY SYSTEM
Psoriasis

• Treatment (continued)
• Photochemotherapy called PUVA with exposure to
  ultraviolet-A (UVA) light to slow
  hyperkeratosis.
• Ultraviolet-B (UVB) light therapy or natural
  sunlight to retard cell production.
• Excrimer laser, a more powerful form of UVB light
  therapy, is directed to the plaques to control
  scaling and inflammation.

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INTEGUMENTARY SYSTEM
Clinically Related Exercise

• Q Joan K is diagnosed with psoriasis. The
  physician explains that the most common sites of
  psoriasis are the ________________.
• A scalp, knees, elbows, umbilicus, and genitalia
• Q Mr. M presents for treatment of psoriasis
  with ultraviolet (UV) light therapy. The doctor
  explains that UV therapy retards cell production
  and slows horny  growths on the skin. Overgrowth
  of the horny layer of the epidermis is a
  condition called (keratoid, keratolysis,
  hyperkeratosis).
• A hyperkeratosis
• Q For chronic psoriasis, a powerful form of UVB
  light therapy directed to the plaques is
  effective in controlling scaling and
  inflammation. This type of laser is called
• _____________ ___________.
• A excrimer laser

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INTEGUMENTARY SYSTEM
Medical Vocabulary

• acne
• allograft
• alopecia
• autograft
• contusion
• debridement
• dermatomycosis
• diaphoresis

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INTEGUMENTARY SYSTEM
Medical Vocabulary

• (continued)
• gangrene
• hematoma
• hirsutism
• impetigo
• macule
• petechia
• pilonidal

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INTEGUMENTARY SYSTEM
Medical Vocabulary

• (continued)
• pyoderma
• scabies
• sebaceous
• steatoma
• subcutaneous
• vulgaris
• xenograft

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INTEGUMENTARY SYSTEM
Diagnostic Procedures

• Biopsy
• Skin test
• Intradermal allergy test reactions.

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INTEGUMENTARY SYSTEM
Word Building Exercise
Q Inflammation of skin A dermatitis Q
Instrument to cut skin A dermatome,
dermatotome Q Tumor (consisting) of fat A
adipoma, lipoma, steatoma Q Excision or removal
of a nail A onychectomy Q Skin that is blue
(in color) A cyanoderma
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INTEGUMENTARY SYSTEM
Medical and Surgical Procedures

• Debridement
• ID
• Mohs surgery
• Skin graft
• allograft
• autograft
• synthetic
• xenograft

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INTEGUMENTARY SYSTEM
Clinically Related Exercise
Q Mr. Y presents to have foreign material
removed from his wound and avoid the development
of an infection. The therapeutic procedure is
charted as (allograft, cryotherapy,
debridement). A debridement Q Joan F presents
to the clinic to remove a basal cell carcinoma
from her face. The doctor freezes and destroys
the lesion with nitrogen. This therapeutic
procedure is known as (cryotherapy, debridement,
UV). A cryotherapy. Q Patient X is informed
that pus will be removed from her abscess by
incising and draining it. The procedure is
abbreviated as ______. A ID
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INTEGUMENTARY SYSTEM
Clinically Related Exercise
(continued) Q The surgeon informs Lydia T that
layer by layer her tumor will be excised until it
is removed. What type of surgery is this
called? A Mohs surgery Q Mr X, a burn patient,
is given a transplant of healthy tissue from his
son. What type of transplant is this known as? A
allograft Q John, a fireman who suffers from
chemical burns, is having healthy tissue
transplanted from a pig. What type of transplant
is this called? A xenograft
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INTEGUMENTARY SYSTEM
Pharmacology

• Antibiotics
• Antifungals
• Antipruritics
• Corticosteroids

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INTEGUMENTARY SYSTEM
Clinically Related Exercise
Q To treat a skin infection, the physician
prescribes a/an (antifungal, antibiotic,
corticosteroid). A antibiotic Q Mary broke out
with a poison ivy rash after a camping trip. A
topical drug is prescribed to decrease
inflammation and itching. This drug is called
a/an (antifungal, antibiotic, corticosteroid). A
corticosteroid Q Mrs. K is diagnosed with
ringworm and is treated with a/an (antifungal,
antibiotic, corticosteroid). A antifungal