Warm Up

What is the medical term for skin?

To Botox or not to Botox? That is the question Work in your group to complete the Botox

activity Write in complete sentences! Your answers will be graded!

Closing: Granny’s going to a Botox party! Individually, write an email to your

grandmother voicing your opinion of Botox

Then, describe two ways you can prevent wrinkles not including Botox!

Warm Up What are the layers of the skin?

Notes: Body Membranes

Epithelial membranes—includes sheets of epithelial and connective tissue Cutaneous membrane

Aka skin Only dry membrane

Mucous membranes Made up of epithelium tissue on loose connective tissue

called lamina propria Lines all body cavities that open to the exterior

Respiratory, digestive, and reproductive tracts secrete mucus for absorption/secretion

Urinary tract does not secrete mucus—bathed in urine

Notes: Body Membranes Epithelial membranes (continued)

Serous membranes Made up of epithelium tissue on areolar tissue Lines body cavities that do not open to the exterior

Peritoneum—abdominal cavity Pleura—lungs Pericardium—heart

Contains outer parietal layer and inner visceral layer separated by lubricating serous fluid

Connective membranes Synovial membranes

Areolar tissue Line fibrous capsule between joints and produce lubricating synovial fluid

Notes: Skin Functions

Protection from Mechanical/chemical damage using fibrous keratin protein,

fat cells, pain/pressure nerves Bacteria using acidic skin secretions UV light using melanin that shields DNA Thermal damage using thermal receptors

Sweat glands and blood flow to capillaries results in heat loss Reduction of blood flow to capillaries results in heat retention

Drying out using keratin Excretes urea and uric acid in sweat Converts cholesterol into vitamin D (for

metabolism and growth) when exposed to sunlight

Group Work: Skin as a Coat Advertisement Skin is like our own protective coat!

Working in pairs and using printer paper, markers, and colored pencils, create an advertisement for skin as if you were selling a new stylish coat Address at least 5 functions of skin! Be creative! Be neat! It will be turned in and later hung on our

walls!

Notes: Skin Structure

Epidermis Made up of stratified squamous epithelium Contains fibrous keratin that hardens skin as well as

immune cells (epidermal dendritic cells) and nerve cells (Merkel cells)

Avascular

Notes: Skin

5 layers from deep to superficial: cells become flatter and more keratinized toward surface Stratum corneum—actively dividing stem cells Stratum spinosum Stratum granulosum Stratum lucidum—dead cells, only in palms of hands and soles of

feet Stratum basale—20-30 dead cell layers thick

Produces dandruff to feed dustmites Shed 40 lbs of dead cells in a lifetime Have new epidermis every month

Contains melanin pigment that allows for tanning and protects DNA from UV damage Freckles and moles have high concentration of melanin

Notes: Skin Dermis (your “hide”)

Made up of dense connective tissue 2 layers from deep to superficial:

Reticular layer High in collagen and elastic fibers, blood vessels, sweat and oil

glands, hair follicles and roots, nerve cells Papillary layer

Contain tops of blood vessels, nerve cells, and dermal papillae—extensions of dermis into epidermis Form unique ridges on fingers and toes (fingerprints)

Warm Up Do you think twins have identical fingerprints?

Why do you think this? (Consider both fraternal and identical twins)

Twins and FingerprintsIdentical twins generate a lot of curiosity. And a lot of misconceptions!

Parents of multiples have probably not given a great deal of thought to their childrens' fingerprint patterns, but the general public has spent a lot of time wondering about this topic.

So, do identical twins have identical fingerprints? The basic answer is NO. Identical -- or monozygotic -- twins form when a single fertilized egg splits in two after conception. Because they form from a single zygote, the two individuals will have the same genetic makeup. Their DNA is virtually indistinguishable.

However, fingerprints are not an entirely genetic characteristic. Scientists love to use this topic as an example of the old "nature vs. nurture" debate. Fingerprinting, along with other physical characteristics, is an example of a phenotype -- meaning that it is determined by the interaction of an individual's genes and the developmental environment in the uterus.

The ultimate shape of fingerprints are believed to be influenced by environmental factors during pregnancy, like nutrition, blood pressure, position in the womb and the growth rate of the fingers at the end of the first trimester. Thus, you will find similar patterns of whorls and ridges in the fingerprints of identical twins. But there will also be differences -- just as there are differences between the fingers on any individual's hands.

Warm Up

List 5 functions of your cutaneous membrane!

Notes: Skin Hypodermis

Aka subcutaneous tissue Made up of adipose tissue Not part of skin! Just connects skin to organs Also a shock absorber and insulates from extreme

temperature

 

Skin Diagram

Check Point: Write at Bottom of Notes Sheet Trifle is a dessert dish made from thick custard, fruit,

sponge cake, fruit juice or jelly, and whipped cream. These ingredients are usually arranged in layers.

If you had to choose 3 ingredients to create a trifle that represented the layers of skin, which would you choose and why?

Notes: Appendages of Skin Appendages of Skin

Hair and hair follicles Originally for insulation, now not necessary other

than shielding eyes (eyelashes and brows) and trapping particles (nose and ear hairs)

Hair follicles Parts

Epidermal sheath—on inside, provides structure Dermal sheath—on outside, provides blood vessels Papilla—at bottom of hair follicle, provides blood

supply to matrix Matrix—sits above papilla, made of stratum basale,

acts as growth zone Arrector pili—smooth muscle cells that connect hair

follicle, when cold, pili contract and fair follicle is pulled upright

Notes: Appendages of Skin Hair

More superficial=more keratinized=more dead Three parts from least to most keratinized

Medulla--innermost Cortex—middle layer Cuticle—outer layer

When cuticle damaged=split ends Hair Color

Determined by amount of melanin Hair Texture

Determined by shape of hair shaft Round=straight hair Oval=wavy hair Flat=curly hair

Notes: Appendages of Skin Nails

Visible portion of nail—body of nail Lunule—white crescent at proximal end of nail

Non-visible portion of nail—root Nail bed—portion of stratum basale under body of nail Nail matrix—proximal nail bed that is responsible for

growth Longer portion of nail=more keratinized=more dead

Nail folds—skin folds around body of nail Lateral Proximal—cuticle

Group Work Label diagrams

Check for Understanding Questions Will be turned in!

Warm Up What are razor bumps?

Group Work Label diagrams

Check for Understanding Questions Will be turned in!

Notes: Appendages of Skin (continued) Cutaneous glands—formed in stratum basale of

epidermis, but reside in dermis Sebaceous (oil) glands

Produce sebum (oil and cells) Moistens skin and hair Kills bacteria

Everywhere except palms and soles of feet Sudoriferous (sweat) glands—2.5 million per person

Eccrine Produces sweat (water, salts, wastes) mostly for heat regulation

Acidic to fight bacteria Exits through pores all over body

Different from face “pores” that are actually hair follicle pores Apocrine

Produces sweat during pain, stress, sexual foreplay Exits through pores in armpits and genitals

Actually odorless until skin bacteria consume, releasing stench

 

Sweat Lab! Follow the directions on your lab!

Will be turned in for a grade!

Warm Up What does “skin flush” refer to?

What should you write if your dots are indistinguishable? Infinity

What should you write if you have NO dots? 0

Sweat Lab! Follow the directions on your lab!

Will be turned in for a grade!

Warm Up

For centuries, people have undergone different procedures in order to modify their skin. Can you name some?

Notes: Skin Color Skin Color

Determined by Melanin—brown pigment in epidermis Carotene—orange-yellow pigment in epidermis and

hypodermis Hemoglobin—red pigment that in RBCs in dermis

Changes in skin color: Red: fever, hypertension, inflammation, allergic reaction,

embarrassment White: anemia, hypotension, fear Yellow: liver disorder where bile is absorbed into bloodstream Blue: cyanosis—hemoglobin is poorly oxygenated like in CHF,

breathing disorders Brown/Black: bruises! Blood has escapes vessels into tissues,

need Vitamin C to help in synthesis of collagen

Notes: Skin Color Tanning

Beds/booths—emit same UV light as sun, but at higher levels DANGEROUS

Spray/airbrush—usually fatty acid DHA sprayed to produce chemical reaction with amino acids in skin, can also be stain Not free of issues: inhale DHA or if use enough, soak into

blood stream and cause health issues, skin reactions, asthma, stain clothes, smells

Lotions—stain Skin reactions, stains clothes, smells

Activity: The History of Body Modification

Fill out your worksheet as you move around the room and read about the history of body modification

Closing

Did you learn anything today that surprised you?

Warm Up

Anyone know who this is?

Warm Up

How was yesterday? What did we get done?

Skin Issues

Scattered around the room are pictures of skin “issues.” Try to match the picture with the appropriate medical term.

Word bank:

1st degree burn 2nd degree burn 3rd degree burn Whiteheads Blackheads Boils Seborrhea Blisters

Athlete’s foot Ringworm Cold sores Warts Contact dermatitis Impetigo Psoriasis

Notes: Burns Burns—cell death caused by heat, electricity,

UV rays, or chemicals Two life-threatening fears:

Infection skin sterile for 24 hours immune system depressed after 24 hours after 24 hours bacteria and fungi multiply in flesh

Dehydration and electrolyte imbalance Fluid seeps out of burned surfaces Can lead to kidney failure and/or circulatory shock (dangerously

low blood volume) Replace fluid by estimating amount of skin burned

Rule of nines—9% of skin made up by 11 regions Plus 1%--genitals

Notes: Burns Degrees

1st degree—affects epidermis Red and swollen Heals 2-3 days EX: sunburn

2nd degree—affects epidermis and upper dermis Red, painful, blisters Regeneration so no scarring

3rd degree—affects epidermis and dermis Gray or black, not painful because nerves destroyed Regeneration not possible so skin graft

Surgically remove healthy skin from another area of body Mesh skin to expand surface area Staple meshed skin to burn site

Critical if >25% 2nd degree or >10% 3rd degree or 3rd degree burns of face, hands or feet Burn of face increases possibility of burn of respiratory tract,

which could lead to swelling and suffocation

Notes: Skin Issues Acne

Oil blockage in oil glands Whitehead—caused by oil blockage in oil gland Blackhead—caused by oil blockage in oil gland that then dries and darkens

Boils Bacterial infection of hair follicles and oil glands, causing large red

bumps Seborrhea

Flaky white to yellowish scales of oil on head or ears caused by overactive oil glands

Blisters Occurs when friction causes epidermis and dermis to separate and fluid

to accumulate in between Athlete’s foot

Fungus causes itchy, red, peeling of area between toes Ringworm

Fungus causes itchy, red, scaly patches that develops into a ring

Notes: Skin Issues Cold sores

Fluid-filled stinging, itchy blisters around the mouth caused by herpes virus Once exposed, virus lays dormant in body until activated by stress, illness,

etc. Wart

Skin growth caused by HPV Contact dermatitis

Itchy, red, swelling of skin seen as an allergic reaction EX: poison ivy

Decubitis ulcers (bedsores) occur when prolonged pressure restricts blood supply, causing cell death

Impetigo Highly contagious bacteria infection that causes pink, fluid-filled raised

lesions that rupture and form a yellow crust Common in elementary school students

Psoriasis Overproduction of skin cells leads to itchy, burning red raised lesions

covered with dry, silvery scales Can be disfiguring Thought to be autoimmune disease

Notes: Development of Skin Baby—this skin so:

Vernix caseosa—white, cheesy-looking substance produced by oil glands that protects baby’s skin in utero

Lanugo—hairy cloak fetuses develop in utero and lose shortly after birth Also a characteristic of anorexia nervosa to retain heat

Milia—small white spots caused by accumulations of oil glands Adolescent

Increase in oil gland production Elderly

Hypodermis decreases Cold intolerance

Oil gland production decreases Dry skin

Thinning of skin/decreased elasticity More susceptible to bruises and other injuries Sagging

Skin Issues Reclassify skin issues using notes!

1st, 2nd, and 3rd degree burns

Whiteheads, Blackheads, and Seborrhea

Boils and Impetigo

Blisters and Decubitus Ulcers

Athlete’s Foot, and Ringworm

Cold Sores and Warts

Contact Dermatitis

Psoriasis

Finish your Review Packet!

Video: Tree Man

Warm Up A patient presents to the ED with a rash of his

BLE from the knees to the ankles. Patient reports spending the first day of hunting season last week in the woods with his friends. However, he swears he had his pants tucked into his socks so is confused as to the origin of the rash. What skin issue does the patient most likely have?

Let’s go over your Review Packet!

Video: Tree Man

Warm Up

Any remaining questions before your test?

Skin Test Put everything away except a writing utensil

Follow the directions and read each question carefully

When you are done, hold on to your quiz and put your head down I will collect all quizzes at the end

Video: Tree Man

Closing Explain tree man’s disease. What is it caused

by? How can it be treated?