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Lecture Notes 5Integumentary
System
Classroom Activity to Accompany Medical Terminology Systems, Sixth Edition Barbara A. Gylys ∙ Mary Ellen Wedding
2
Structure •Epidermis•Dermis• Subcutaneous tissue
•Accessory organs•Glands•Hair•Nails
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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
INTEGUMENTARY SYSTEM5
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Structure and Function ExerciseQ: 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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Basal Cell CarcinomaSigns and
Symptoms• Malignancy of
basal layer is commonly caused by repeated overexposure to the sun.
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Basal Cell CarcinomaSigns 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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Basal Cell CarcinomaTreatment• 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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Clinically Related ExerciseQ: 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 Ann’s arm, she is informed that it is
noncancerous. The dermatologist charts the noncancerous growth as (benign, cancerous, malignant).
A: benignQ: 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.
INTEGUMENTARY SYSTEM5
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AbscessSigns 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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AbscessSigns 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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AbscessTreatment• 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 (I&D) may be
necessary after lesion has matured.
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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, erythamatousQ: Upon diagnosis of a furuncle, the nurse explains that this
is an infection caused by a/an (bacterium, injury, virus).A: bacteriumQ: The physician charts a cluster of furuncles in the
subcutaneous tissue as a ________________.A: carbuncleQ: 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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PsoriasisSigns and
Symptoms• Circumscribed red
patches covered by thick, dry, silvery, adherent scales.
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PsoriasisSigns 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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PsoriasisTreatment• 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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PsoriasisTreatment (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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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 genitaliaQ: 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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Medical Vocabulary•acne•allograft•alopecia•autograft•contusion•debridement•dermatomycosis•diaphoresis
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Medical Vocabulary(continued)
• gangrene• hematoma• hirsutism• impetigo• macule• petechia• pilonidal
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Medical Vocabulary (continued)
• pyoderma• scabies• sebaceous• steatoma• subcutaneous• vulgaris• xenograft
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Diagnostic Procedures•Biopsy•Skin test• Intradermal allergy test reactions.
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Word Building ExerciseQ: Inflammation of skin: A: dermatitisQ: Instrument to cut skin:A: dermatome, dermatotomeQ: Tumor (consisting) of fat: A: adipoma, lipoma, steatomaQ: Excision or removal of a nail:A: onychectomyQ: Skin that is blue (in color):A: cyanoderma
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Medical and Surgical Procedures
•Debridement• I&D•Mohs surgery•Skin graft• allograft• autograft• synthetic• xenograft
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Clinically Related ExerciseQ: 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: debridementQ: 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: I&D
INTEGUMENTARY SYSTEM5
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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 surgeryQ: Mr X, a burn patient, is given a transplant of healthy
tissue from his son. What type of transplant is this known as?
A: allograftQ: 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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Pharmacology•Antibiotics•Antifungals •Antipruritics •Corticosteroids
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Clinically Related ExerciseQ: To treat a skin infection, the physician prescribes
a/an (antifungal, antibiotic, corticosteroid).A: antibioticQ: 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: corticosteroidQ: Mrs. K is diagnosed with ringworm and is treated
with a/an (antifungal, antibiotic, corticosteroid).A: antifungal
INTEGUMENTARY SYSTEM5