integumentary system part 1

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Structure, Function, and Disorders of the Integument : 

Structure, Function, and Disorders of the Integument 1

Layers of the Skin : 

Layers of the Skin Epidermis Dermis Subcutaneous 2

Layers of the Skin : 

Layers of the Skin 3

Layers of the Skin : 

Layers of the Skin Dermis Collagen, elastin, reticulum, and a gel-like ground substance Hair follicles, sebaceous glands, sweat glands, blood vessels, lymphatic vessels, nerves Fibroblasts, mast cells, macrophages Subcutaneous layer Adipocytes Dermal and subcutaneous collagen are continuous 4

Layers of the Skin : 

Layers of the Skin Dermal appendages Nails Hair Sebaceous glands Eccrine and apocrine sweat glands Blood supply Papillary capillaries 5

Nails : 

Nails 6

Aging and Skin Integrity : 

Aging and Skin Integrity The integumentary system reflects numerous changes from genetic and environmental factors The skin becomes thinner, drier, wrinkled, and demonstrates a changes in pigmentation Shortening and decrease in the number of capillary loops Fewer melanocytes and Langerhans cells Atrophy of the sebaceous, eccrine, and apocrine glands Changes in hair color Fewer hair follicles and growth of thinner hair 7

Clinical Manifestations of Skin Dysfunction : 

Clinical Manifestations of Skin Dysfunction Macule Papule Patch Plaque Wheal 8

Clinical Manifestations of Skin Dysfunction : 

Clinical Manifestations of Skin Dysfunction Nodule Tumor Vesicle Bulla Pustule 9

Clinical Manifestations of Skin Dysfunction : 

Clinical Manifestations of Skin Dysfunction Cyst Telangiectasia Scale Lichenification Keloid Scar 10

Clinical Manifestations of Skin Dysfunction : 

Clinical Manifestations of Skin Dysfunction Excoriation Fissure Erosion Ulcer Atrophy 11

Clinical Manifestations of Skin Dysfunction : 

Clinical Manifestations of Skin Dysfunction Pressure ulcers Pressure ulcers result from any unrelieved pressure on the skin, causing underlying tissue damage Pressure Shearing forces Friction Moisture 12

Clinical Manifestations of Skin Dysfunction : 

Clinical Manifestations of Skin Dysfunction Pressure ulcers Stages Nonblanchable erythema of intact skin Partial-thickness skin loss involving epidermis or dermis Full-thickness skin loss involving damage or loss of subcutaneous tissue Full-thickness skin loss with damage to muscle, bone, or supporting structures 13

Clinical Manifestations of Skin Dysfunction : 

Clinical Manifestations of Skin Dysfunction Keloids Elevated, rounded, and firm Clawlike margins that extend beyond the original site of injury Excessive collagen formation during dermal connective tissue repair Common in darkly pigmented skin types and burn scars Type III collagen is increased. 14

Keloids : 

Keloids 15

Clinical Manifestations of Skin Dysfunction : 

Clinical Manifestations of Skin Dysfunction Pruritus Itching Most common symptom of primary skin disorders Itch is carried by specific unmyelinated C-nerve fibers and is triggered by a number of itch mediators The CNS can modulate the itch response Pain stimuli at lower intensities can induce itching Chronic itching can result in infections and scarring due to persistent scratching 16

Disorders of the Skin : 

Disorders of the Skin Inflammatory disorders The most common inflammatory disorder of the skin is dermatitis or eczema There are various types of dermatitis The disorders are generally characterized by pruritus, lesions with indistinct borders, and epidermal changes 17

Inflammatory Disorders : 

Inflammatory Disorders Allergic contact dermatitis Caused by a hypersensitivity type IV reaction The allergen comes in contact with the skin, binds to a carrier protein to form a sensitizing antigen; Langerhans cells process the antigen and carry it to T cells, which become sensitized to the antigen Manifestations Erythema, swelling, pruritus, vesicular lesions 18

Allergic Contact Dermatitis : 

Allergic Contact Dermatitis 19

Inflammatory Disorders : 

Inflammatory Disorders Atopic dermatitis Type I hypersensitivity—activation of mast cells, eosinophils, T lymphs, and other inflammatory cells Causes red, weeping crusts and chronic inflammation, lichenification Irritant contact dermatitis Nonimmunologic inflammation of the skin Chemical irritation from acids or prolonged exposure to irritating substances Symptoms similar to allergic contact dermatitis Treatment—remove stimulus 20

Atopic Dermatitis : 

Atopic Dermatitis 21

Inflammatory Disorders : 

Inflammatory Disorders Stasis dermatitis Occurs in the legs as a result of venous stasis, edema, and vascular trauma Sequence of events: erythema, pruritus, scaling, petechiae, ulcerations Seborrheic (sebōrēik) dermatitis Inflammation of the skin involving the scalp, eyebrows, eyelids, nasolabial folds, and ear canals Scaly, white, or yellowish plaques 22

Stasis and Seborrheic Dermatitis : 

Stasis and Seborrheic Dermatitis 23

Papulosquamous Disorders : 

Papulosquamous Disorders Psoriasis Chronic, relapsing, proliferative skin disorder T cell immune–mediated skin disease Scaly, thick, silvery, elevated lesions, usually on the scalp, elbows, or knees caused by a high rate of mitosis in the basale layer Shows evidence of dermal and epidermal thickening Epidermal turnover goes from 26-30 days to 3-4 days Cells do not have time to mature or adequately keratinize 24

Psoriasis : 

Psoriasis 25

Papulosquamous Disorders : 

Papulosquamous Disorders Pityriasis rosea Benign, self-limiting inflammatory disorder Usually occurs during the winter months Herald patch Circular, demarcated, salmon-pink, 3- to 4-cm lesion 26

Pityriasis Rosea Herald Patch : 

Pityriasis Rosea Herald Patch 27

Papulosquamous Disorders : 

Papulosquamous Disorders Acne vulgaris Inflammatory disease of the pilosebaceous follicles Acne rosacea Inflammation of the skin that develops in adulthood Lesions Erythematotelangiectatic, papulopustular, phymatous, and ocular Associated with chronic, inappropriate vasodilation resulting in flushing and sensitivity to the sun 28

Papulosquamous Disorders : 

Papulosquamous Disorders Lupus erythematosus Inflammatory, autoimmune disease with cutaneous manifestations Discoid lupus erythematosus Restricted to the skin Photosensitivity Butterfly pattern over the nose and cheeks Systemic lupus erythematosus 29

Discoid Lupus Erythematosus : 

Discoid Lupus Erythematosus 30

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