Download - Ch 05 Lecture Outline
![Page 1: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/1.jpg)
PowerPoint® Lecture Slides prepared by Janice Meeking, Mount Royal College
C H A P T E R
Copyright © 2010 Pearson Education, Inc.
5
The Integumentary System
![Page 2: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/2.jpg)
Copyright © 2010 Pearson Education, Inc.
Skin (Integument)
• Consists of three major regions
1. Epidermis—superficial region
2. Dermis—middle region
3. Hypodermis (superficial fascia)—deepest region
• Subcutaneous layer deep to skin (not technically part of skin)
• Mostly adipose tissue
![Page 3: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/3.jpg)
Copyright © 2010 Pearson Education, Inc. Figure 5.1
Epidermis
Hair shaft
Dermis Reticularlayer
Papillarylayer
Hypodermis(superficial fascia)
Dermal papillae
Pore
Subpapillaryvascular plexus
Appendagesof skin • Eccrine sweat gland• Arrector pili muscle• Sebaceous (oil) gland• Hair follicle• Hair rootNervous structures
• Sensory nerve fiber• Pacinian corpuscle• Hair follicle receptor (root hair plexus)
Cutaneous vascularplexus
Adipose tissue
![Page 4: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/4.jpg)
Copyright © 2010 Pearson Education, Inc.
Epidermis
• Keratinized stratified squamous epithelium
• Cells of epidermis
• Keratinocytes—produce fibrous protein keratin
• Melanocytes
• 10–25% of cells in lower epidermis
• Produce pigment melanin
• Epidermal dendritic (Langerhans) cells—macrophages that help activate immune system
• Tactile (Merkel) cells—touch receptors
![Page 5: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/5.jpg)
Copyright © 2010 Pearson Education, Inc. Figure 5.2a
Dermis
Stratum corneumMost superficial layer; 20–30 layers of deadcells represented only by flat membranoussacs filled with keratin. Glycolipids inextracellular space.Stratum granulosumThree to five layers of flattened cells,organelles deteriorating; cytoplasm full oflamellated granules (release lipids) andkeratohyaline granules.Stratum spinosumSeveral layers of keratinocytes unified bydesmosomes. Cells contain thick bundles ofintermediate filaments made of pre-keratin.Stratum basaleDeepest epidermal layer; one row of activelymitotic stem cells; some newly formed cellsbecome part of the more superficial layers.See occasional melanocytes and epidermaldendritic cells.
(a)
![Page 6: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/6.jpg)
Copyright © 2010 Pearson Education, Inc.
Layers of the Epidermis: Stratum Basale (Basal Layer)
• Deepest epidermal layer firmly attached to the dermis
• Single row of stem cells
• Also called stratum germinativum: cells undergo rapid division
• Journey from basal layer to surface
• Takes 25–45 days
![Page 7: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/7.jpg)
Copyright © 2010 Pearson Education, Inc.
Layers of the Epidermis: Stratum Spinosum (Prickly Layer)
• Cells contain a weblike system of intermediate prekeratin filaments attached to desmosomes
• Abundant melanin granules and dendritic cells
![Page 8: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/8.jpg)
Copyright © 2010 Pearson Education, Inc.
Layers of the Epidermis: Stratum Granulosum (Granular Layer)
• Thin; three to five cell layers in which the cells flatten
• Keratohyaline and lamellated granules accumulate
![Page 9: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/9.jpg)
Copyright © 2010 Pearson Education, Inc.
Layers of the Epidermis: Stratum Lucidum (Clear Layer)
• In thick skin
• Thin, transparent band superficial to the stratum granulosum
• A few rows of flat, dead keratinocytes
![Page 10: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/10.jpg)
Copyright © 2010 Pearson Education, Inc.
Layers of the Epidermis: Stratum Corneum (Horny Layer)
• 20–30 rows of dead, flat, keratinized membranous sacs
• Three-quarters of the epidermal thickness
• Functions
• Protects from abrasion and penetration
• Waterproofs
• Barrier against biological, chemical, and physical assaults
![Page 11: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/11.jpg)
Copyright © 2010 Pearson Education, Inc. Figure 5.2b
MelanocyteMelanin granule
Tactile(Merkel) cell
Sensorynerve ending Epidermal
dendritic cell
Dermis
KeratinocytesStratum corneumMost superficial layer; 20–30 layers of dead cells represented only by flat membranous sacs filled with keratin. Glycolipids in extracellular space.Stratum granulosumThree to five layers of flattened cells, organelles deteriorating; cytoplasm full of lamellated granules (release lipids) and keratohyaline granules.Stratum spinosumSeveral layers of keratinocytes unified by desmosomes. Cells contain thick bundles of intermediate filaments made of pre-keratin.Stratum basaleDeepest epidermal layer; one row of actively mitotic stem cells; some newly formed cells become part of the more superficial layers. See occasional melanocytes and epidermal dendritic cells. Desmosomes
(b)
![Page 12: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/12.jpg)
Copyright © 2010 Pearson Education, Inc.
Dermis
• Strong, flexible connective tissue
• Cells include fibroblasts, macrophages, and occasionally mast cells and white blood cells
• Two layers:
• Papillary
• Reticular
![Page 13: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/13.jpg)
Copyright © 2010 Pearson Education, Inc. Figure 5.1
Epidermis
Hair shaft
Dermis Reticularlayer
Papillarylayer
Hypodermis(superficial fascia)
Dermal papillae
Pore
Subpapillaryvascular plexus
Appendagesof skin • Eccrine sweat gland• Arrector pili muscle• Sebaceous (oil) gland• Hair follicle• Hair rootNervous structures
• Sensory nerve fiber• Pacinian corpuscle• Hair follicle receptor (root hair plexus)
Cutaneous vascularplexus
Adipose tissue
![Page 14: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/14.jpg)
Copyright © 2010 Pearson Education, Inc.
Layers of the Dermis: Papillary Layer
• Papillary layer
• Areolar connective tissue with collagen and elastic fibers and blood vessels
• Dermal papillae contain:
• Capillary loops
• Meissner’s corpuscles
• Free nerve endings
![Page 15: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/15.jpg)
Copyright © 2010 Pearson Education, Inc.
Layers of the Dermis: Reticular Layer
• Reticular layer
• ~80% of the thickness of dermis
• Collagen fibers provide strength and resiliency
• Elastic fibers provide stretch-recoil properties
![Page 16: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/16.jpg)
Copyright © 2010 Pearson Education, Inc.
Skin Markings: Friction Ridges
• Epidermal ridges lie atop deeper dermal papillary ridges to form friction ridges of fingerprints
![Page 17: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/17.jpg)
Copyright © 2010 Pearson Education, Inc. Figure 5.4a
Friction ridges
(a)
Openings ofsweat gland ducts
![Page 18: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/18.jpg)
Copyright © 2010 Pearson Education, Inc.
Skin Markings: Cleavage Lines
• Collagen fibers arranged in bundles form cleavage (tension) lines
• Incisions made parallel to cleavage lines heal more readily
![Page 19: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/19.jpg)
Copyright © 2010 Pearson Education, Inc. Figure 5.4b
(b)
![Page 20: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/20.jpg)
Copyright © 2010 Pearson Education, Inc.
Skin Color
• Three pigments contribute to skin color:
1. Melanin
• Yellow to reddish-brown to black, responsible for dark skin colors
• Produced in melanocytes; migrates to keratinocytes where it forms “pigment shields” for nuclei
• Freckles and pigmented moles
• Local accumulations of melanin
![Page 21: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/21.jpg)
Copyright © 2010 Pearson Education, Inc.
Skin Color
2. Carotene
• Yellow to orange, most obvious in the palms and soles
3. Hemoglobin
• Responsible for the pinkish hue of skin
![Page 22: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/22.jpg)
Copyright © 2010 Pearson Education, Inc.
Appendages of the Skin
• Derivatives of the epidermis
• Sweat glands
• Oil glands
• Hairs and hair follicles
• Nails
![Page 23: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/23.jpg)
Copyright © 2010 Pearson Education, Inc.
Sweat Glands
• Two main types of sweat (sudoriferous) glands
1. Eccrine (merocrine) sweat glands—abundant on palms, soles, and forehead
• Sweat: 99% water, NaCl, vitamin C, antibodies, dermcidin, metabolic wastes
• Ducts connect to pores
• Function in thermoregulation
![Page 24: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/24.jpg)
Copyright © 2010 Pearson Education, Inc. Figure 5.5b
(b) Photomicrograph of a sectioned eccrine gland (220x)
Secretory cells
Dermal connectivetissue
DuctSebaceousgland
Sweat pore
Eccrinegland
![Page 25: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/25.jpg)
Copyright © 2010 Pearson Education, Inc.
Sweat Glands
2. Apocrine sweat glands—confined to axillary and anogenital areas
• Sebum: sweat + fatty substances and proteins
• Ducts connect to hair follicles
• Functional from puberty onward (as sexual scent glands?)
• Specialized apocrine glands
• Ceruminous glands—in external ear canal; secrete cerumen
• Mammary glands
![Page 26: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/26.jpg)
Copyright © 2010 Pearson Education, Inc.
Sebaceous (Oil) Glands
•Widely distributed
• Most develop from hair follicles
• Become active at puberty
• Sebum
• Oily holocrine secretion
• Bactericidal
• Softens hair and skin
![Page 27: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/27.jpg)
Copyright © 2010 Pearson Education, Inc. Figure 5.5a
(a) Photomicrograph of a sectioned sebaceous gland (220x)
Sebaceousgland ductHair inhair follicleSecretory cells
Dermalconnectivetissue
Sebaceousgland
Sweatpore
Eccrinegland
![Page 28: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/28.jpg)
Copyright © 2010 Pearson Education, Inc.
Hair
• Functions
• Alerting the body to presence of insects on the skin
• Guarding the scalp against physical trauma, heat loss, and sunlight
• Distribution
• Entire surface except palms, soles, lips, nipples, and portions of external genitalia
![Page 29: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/29.jpg)
Copyright © 2010 Pearson Education, Inc.
Hair
• Consists of dead keratinized cells
• Contains hard keratin; more durable than soft keratin of skin
• Hair pigments: melanins (yellow, rust brown, black)
• Gray/white hair: decreased melanin production, increased air bubbles in shaft
![Page 30: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/30.jpg)
Copyright © 2010 Pearson Education, Inc. Figure 5.6a
Hair shaft
ArrectorpiliSebaceousglandHair root
Hair bulb
(a) Diagram of a cross section of a hair within its follicle
• Connective tissue root sheath• Glassy membrane• External epithelial root sheath• Internal epithelial root sheath
Follicle wall
• Cuticle• Cortex• Medulla
Hair
![Page 31: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/31.jpg)
Copyright © 2010 Pearson Education, Inc.
(b) Photomicrograph of a cross section of a hair and hair follicle (250x)
• Connective tissue root sheath
Follicle wall
• Cuticle
• Glassy membrane
• Cortex• Medulla
• Internal epithelial root sheath
• External epithelial root sheath
Hair
Hair shaft
ArrectorpiliSebaceousglandHair root
Hair bulb
Figure 5.6b
![Page 32: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/32.jpg)
Copyright © 2010 Pearson Education, Inc.
Hair Follicle
• Extends from the epidermal surface into dermis
• Two-layered wall: outer connective tissue root sheath, inner epithelial root sheath
• Hair bulb: expanded deep end
![Page 33: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/33.jpg)
Copyright © 2010 Pearson Education, Inc.
Hair Follicle
• Hair follicle receptor (root hair plexus)
• Sensory nerve endings around each hair bulb
• Stimulated by bending a hair
• Arrector pili
• Smooth muscle attached to follicle
• Responsible for “goose bumps”
![Page 34: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/34.jpg)
Copyright © 2010 Pearson Education, Inc. Figure 5.6c
Hair shaft
ArrectorpiliSebaceousglandHair root Hair bulb
(c) Diagram of a longitudinal view of the expanded hairbulb of the follicle, which encloses the matrix
• Internal epithelial root sheath• External epithelial root sheath
• Connective tissue root sheathFollicle wall
Hair matrix
MelanocyteHair papilla
Subcutaneous adipose tissue
• Medulla• Cortex• Cuticle
• Glassy membrane
Hair root
![Page 35: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/35.jpg)
Copyright © 2010 Pearson Education, Inc.
(d) Photomicrograph of longitudinal view of the hair bulb in the follicle (160x)
Follicle wall
Hair matrix
Hair papilla
Subcutaneousadipose tissue
Hair root
• Connective tissue root sheath• Glassy membrane• External epithelial root sheath• Internal epithelial root sheath
• Cuticle• Cortex• Medulla
Hair shaft
ArrectorpiliSebaceousglandHair root
Hair bulb
Figure 5.6d
![Page 36: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/36.jpg)
Copyright © 2010 Pearson Education, Inc.
Types of Hair
• Vellus—pale, fine body hair of children and adult females
• Terminal—coarse, long hair of eyebrows, scalp, axillary, and pubic regions (and face and neck of males)
![Page 37: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/37.jpg)
Copyright © 2010 Pearson Education, Inc.
Types of Hair
• Hair Growth
• Growth phase (weeks to years) followed by regressive stage and resting phase (1–3 months)
• Growth phase varies (6–10 years in scalp, 3–4 months in eyebrows)
![Page 38: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/38.jpg)
Copyright © 2010 Pearson Education, Inc.
Hair Thinning and Baldness
• Alopecia—hair thinning in both sexes after age 40
• True (frank) baldness
• Genetically determined and sex-influenced condition
• Male pattern baldness is caused by follicular response to DHT
![Page 39: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/39.jpg)
Copyright © 2010 Pearson Education, Inc.
Structure of a Nail
• Scalelike modification of the epidermis on the distal, dorsal surface of fingers and toes
![Page 40: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/40.jpg)
Copyright © 2010 Pearson Education, Inc. Figure 5.7
Lateralnail fold
Lunule
Nailmatrix
Root of nail
Proximalnail fold
Hyponychium
Nail bed
Phalanx (bone of fingertip)
Eponychium(cuticle)
Bodyof nail
Free edgeof nail
(a)
(b)
![Page 41: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/41.jpg)
Copyright © 2010 Pearson Education, Inc.
Functions of the Integumentary System
1. Protection—three types of barriers
• Chemical
• Low pH secretions (acid mantle) and defensins retard bacterial activity
![Page 42: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/42.jpg)
Copyright © 2010 Pearson Education, Inc.
Functions of the Integumentary System
• Physical/mechanical barriers
• Keratin and glycolipids block most water and water- soluble substances
• Limited penetration of skin by lipid-soluble substances, plant oleoresins (e.g., poison ivy), organic solvents, salts of heavy metals, some drugs
• Biological barriers
• Dendritic cells, macrophages, and DNA
![Page 43: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/43.jpg)
Copyright © 2010 Pearson Education, Inc.
Functions of the Integumentary System
2. Body temperature regulation
• ~500 ml/day of routine insensible perspiration (at normal body temperature)
• At elevated temperature, dilation of dermal vessels and increased sweat gland activity (sensible perspirations) cool the body
3. Cutaneous sensations
• Temperature, touch, and pain
![Page 44: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/44.jpg)
Copyright © 2010 Pearson Education, Inc.
Functions of the Integumentary System
4. Metabolic functions
• Synthesis of vitamin D precursor and collagenase
• Chemical conversion of carcinogens and some hormones
5. Blood reservoir—up to 5% of body’s blood volume
6. Excretion—nitrogenous wastes and salt in sweat
![Page 45: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/45.jpg)
Copyright © 2010 Pearson Education, Inc.
Skin Cancer
• Most skin tumors are benign (do not metastasize)
• Risk factors
• Overexposure to UV radiation
• Frequent irritation of the skin
• Some skin lotions contain enzymes in liposomes that can fix damaged DNA
![Page 46: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/46.jpg)
Copyright © 2010 Pearson Education, Inc.
Skin Cancer
• Three major types:
• Basal cell carcinoma
• Least malignant, most common
• Squamous cell carcinoma
• Second most common
• Melanoma
• Most dangerous
![Page 47: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/47.jpg)
Copyright © 2010 Pearson Education, Inc.
Basal Cell Carcinoma
• Stratum basale cells proliferate and slowly invade dermis and hypodermis
• Cured by surgical excision in 99% of cases
![Page 48: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/48.jpg)
Copyright © 2010 Pearson Education, Inc. Figure 5.8a
![Page 49: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/49.jpg)
Copyright © 2010 Pearson Education, Inc.
Squamous Cell Carcinoma
• Involves keratinocytes of stratum spinosum
• Most common on scalp, ears, lower lip, and hands
• Good prognosis if treated by radiation therapy or removed surgically
![Page 50: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/50.jpg)
Copyright © 2010 Pearson Education, Inc. Figure 5.8b
![Page 51: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/51.jpg)
Copyright © 2010 Pearson Education, Inc.
Melanoma
• Involves melanocytes
• Highly metastatic and resistant to chemotherapy
• Treated by wide surgical excision accompanied by immunotherapy
![Page 52: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/52.jpg)
Copyright © 2010 Pearson Education, Inc.
Melanoma
• Characteristics (ABCD rule)
A: Asymmetry; the two sides of the pigmented area do not match
B: Border exhibits indentations
C: Color is black, brown, tan, and sometimes red or blue
D: Diameter is larger than 6 mm (size of a pencil eraser)
![Page 53: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/53.jpg)
Copyright © 2010 Pearson Education, Inc. Figure 5.8c
![Page 54: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/54.jpg)
Copyright © 2010 Pearson Education, Inc.
Burns
• Heat, electricity, radiation, certain chemicals
Burn
(tissue damage, denatured protein, cell death)
• Immediate threat:
• Dehydration and electrolyte imbalance, leading to renal shutdown and circulatory shock
![Page 55: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/55.jpg)
Copyright © 2010 Pearson Education, Inc.
Rule of Nines
• Used to estimate the volume of fluid loss from burns
![Page 56: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/56.jpg)
Copyright © 2010 Pearson Education, Inc. Figure 5.9
Anterior and posteriorhead and neck, 9%
41/2%41/2%
Anterior and posteriorupper limbs, 18%
Anterior and posteriorlower limbs, 36%
100%
Totals
Anterior and posteriortrunk, 36%
Anteriortrunk,18%
9% 9%(Perineum, 1%)
41/2%
![Page 57: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/57.jpg)
Copyright © 2010 Pearson Education, Inc.
Partial-Thickness Burns
• First degree
• Epidermal damage only
• Localized redness, edema (swelling), and pain
• Second degree
• Epidermal and upper dermal damage
• Blisters appear
![Page 58: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/58.jpg)
Copyright © 2010 Pearson Education, Inc. Figure 5.10a
(a) Skin bearing partialthickness burn (1st and 2nd degree burns)
1st degreeburn
2nd degreeburn
![Page 59: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/59.jpg)
Copyright © 2010 Pearson Education, Inc.
Full-Thickness Burns
• Third degree
• Entire thickness of skin damaged
• Gray-white, cherry red, or black
• No initial edema or pain (nerve endings destroyed)
• Skin grafting usually necessary
![Page 60: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/60.jpg)
Copyright © 2010 Pearson Education, Inc. Figure 5.10b
(b) Skin bearing fullthickness burn(3rd degree burn)
3rddegreeburn
![Page 61: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/61.jpg)
Copyright © 2010 Pearson Education, Inc.
Severity of Burns
• Critical if:
• >25% of the body has second-degree burns
• >10% of the body has third-degree burns
• Face, hands, or feet bear third-degree burns
![Page 62: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/62.jpg)
Copyright © 2010 Pearson Education, Inc.
Developmental Aspects: Fetal
• Ectoderm epidermis
• Mesoderm dermis and hypodermis
• Lanugo coat: covering of delicate hairs in 5th and 6th month
• Vernix caseosa: sebaceous gland secretion; protects skin of fetus
![Page 63: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/63.jpg)
Copyright © 2010 Pearson Education, Inc.
Developmental Aspects: Adolescent to Adult
• Sebaceous gland activity increases
• Effects of cumulative environmental assaults show after age 30
• Scaling and dermatitis become more common
![Page 64: Ch 05 Lecture Outline](https://reader036.vdocument.in/reader036/viewer/2022062223/551fd5f04979592e5b8b506c/html5/thumbnails/64.jpg)
Copyright © 2010 Pearson Education, Inc.
Developmental Aspects: Old Age
• Epidermal replacement slows, skin becomes thin, dry, and itchy
• Subcutaneous fat and elasticity decrease, leading to cold intolerance and wrinkles
• Increased risk of cancer due to decreased numbers of melanocytes and dendritic cells