Integumentary System

CHAPTER 5

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Integumentary System• Skin

– Integument or cutaneous membrane– Epidermis– Dermis– Subcutaneous layer

• Accessory structures– Hair– Nails – Glands

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Layers and Structures of the Skin

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Skin Lesions• Abrasion

– Scraping or rubbing away of skin or mucous membrane as a result of friction to the area• Example: carpet burn

• Abscess– Localized collection of pus in any body part

that results from invasion of pus-forming bacteria• Example: pustule = small abscess

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Skin Lesions• Bedsore

– Ulcer in skin over a bony prominence– Also known as pressure ulcer

• Example: decubitus ulcer• Blister

– Small, thin-walled lesion containing clear fluid– Also known as a vesicle

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• Bulla– Large blister

• Carbuncle– Circumscribed inflammation of skin and

deeper tissues; contains pus• Comedo

– Typical lesion of acne vulgaris• Example: whitehead = closed comedo• Example: blackhead = open comedo

Skin Lesions

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Skin Lesions• Cyst

– Closed sac or pouch in or within the skin; contains fluid, semifluid, or solid material• Example: hydrocele = fluid-filled cyst• Example: sebaceous cyst = solid-filled cyst

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Skin Lesions• Fissure

– Cracklike sore or groove in the skin or mucous membrane• Example: anal fissure

• Fistula– Abnormal passageway between two tubular

organs; or from an organ to the body surface• Example: recto-vaginal fistula

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Skin Lesions• Hives

– Circumscribed, slightly elevated lesions on skin; paler in center than surrounding edges

– Also called wheals• Example: mosquito bite

• Laceration– Tear in skin; torn, jagged wound

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Skin Lesions• Macule

– Small flat, discoloration of the skin; neither raised nor depressed• Example: bruises, freckles

• Nodule– Small, circumscribed swelling protruding

above the skin

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Skin Lesions• Papule

– Small, solid, circumscribed elevation on the skin

– Example: pimple, wart, elevated mole• Polyp

– Small, stalklike growth, protruding upward or outward from membrane surface

– Example: nasal polyp

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• Pustule– Small elevation of skin filled with pus

• Example: small abscess on the skin• Scales

– Thin flakes of hardened epithelium that are shed from the epidermis

• Ulcer– Circumscribed, open sore or lesion of skin,

accompanied by inflammation• Example: decubitus ulcer

Skin Lesions

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Skin Lesions • Vesicle

– Small, thin-walled, lesion containing clear fluid• Example: blister

• Wheal– Circumscribed, slightly elevated lesion of the

skin – Paler in center than surrounding edges

• Example: hives

PATHOLOGICAL CONDITIONS

Integumentary System

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Acne Vulgaris• Pronounced

– (ACK-nee-vul-GAY-ris)• Defined

– Common inflammatory disorder seen on face, chest, back, and neck

– Appears as papules, pustules, and comedos

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Albinism• Pronounced

– (AL-bin-izm)• Defined

– Condition characterized by absence of pigment in the skin, hair, and eyes

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Burns• Defined

– Tissue injury produced by flame, heat, chemicals, radiation, electricity, or gases

– Extent of damage determined by: • Mode and duration of exposure• Thermal intensity or temperature• Anatomic site of the burn

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• First-degree or superficial burns– Example: sunburn

• Second-degree or partial-thickness burns– Example: flash contact with hot objects

• Third-degree or full-thickness burns– Example: deep burns from a fire

Burns

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Callus• Pronounced

– (CAL-us)• Defined

– Common, usually painless thickening of the epidermis at sites of external pressure or friction, such as weight-bearing areas of the feet and on the palmar surface of the hands• Also known as a callosity

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Carcinoma, Basal Cell

• Pronounced– (car-sih-NOH-mah BAY-sal sell)

• Defined– Most common malignant tumor of epithelial

tissue, occurring most often on areas of skin that are exposed to the sun• Presents as a slightly elevated nodule with a

depression or ulceration in the center that becomes more obvious as the tumor grows

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• Pronounced– (car-sih-NOH-mah SKWAY-mus sell )

• Defined– Malignancy of the squamous, or scalelike,

cells of the epithelial tissue– Much faster growing than basal cell

carcinoma – Greater potential for metastasis if not treated

Carcinoma, Squamous Cell

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Carcinoma, Squamous Cell

• Frequent sites on sun-exposed areas– Top of nose– Forehead– Margin of external ear– Back of hands– Lower lip

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Dermatitis• Pronounced

– (der-mah-TYE-tis)• Defined

– Inflammation of skin, seen in several different forms

– Acute or chronic– Contact or seborrheic

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Eczema• Pronounced

– (EK-zeh-mah)• Defined

– Acute or chronic inflammatory skin condition characterized by erythema, papules, vesicles, pustules, scales, crusts, scabs, and itching

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Exanthematous Viral Diseases

• Pronounced– (eks-an-THEM-ah-tus viral diseases)

• Defined– Skin eruption or rash accompanied by

inflammation, having specific diagnostic features of an infectious viral disease

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Exanthematous Viral Diseases• Examples:

– Rubella = German Measles = 3 day measles– Roseola Infantum– Rubeola = Red Measles = 7-10 day measles– Erythema Infectiosum = Fifth disease

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Gangrene• Pronounced

– (GANG-green)• Defined

– Tissue death due to loss of adequate blood supply, invasion of bacteria, subsequent decay with foul odor

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Herpes Zoster• Pronounced

– (HER-peez ZOS-ter)• Defined

– Acute viral infection, characterized by painful, vesicular eruptions on the skin that follow along nerve pathways of underlying spinal or cranial nerves

– Highest incidence in adults over 50

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Herpes Zoster

Image courtesy of Robert A. Silverman,M.D., Pediatric Dermatology,Georgetown University

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Impetigo• Pronounced

– (Im-peh-TYE-goh)• Defined

– Contagious superficial skin infection characterized by serous vesicles and pustules filled with millions of staphylococcus or streptococcus bacteria • Usually forming on the face