NR 283 Patho Exam 2
Integumentary system
SKIN- largest organ, 20% of body weight
ACCESSORIES
1. hair 3. Gland
2. nails
1. PROTECTION
2. TEMPERATURE REGULATION
3. PROTECT AGAINST MICROOGRANISM
4. LOSS OF BODY FLUIDS
5. STRESS OF MECHANICAL FORCES
6. PRODUCTION OF VITAMIN D
7. IMMUNE SURVEILLENCE
8. PLEASUREABLE SENSATION
EPIDERMIS
Layers
1. superficial outer layer 4. stratum spinosum
, 2. stratum corneum 5. stratum germinativum
3. stratum lucidum 6. Stratum basale
Keratinocytes- keratin
Melanocytes- melanin
* Vitiligo- autoimmune related loss of melanocytes; depigmentation of
patches of skin
Langerhan cells- present processed antigen to T- cells
Merkel cells- function as slowly adapting mechoreceptors
DERMIS
1. deeper layer, true skin
2. collagen, elastin, reticulum, and a gel-like ground substance
3. hair follicles, sebaceous glands, sweat glands, blood vessels, lymphatic
vessels, nerves
4. Fibroblast- secrete collagen
5. mast cells- release histamine
6. macrophages- phagocytic immune cells
* Histocytes- loose connective tissue; phagocytize pigments and debris of
inflammation
SUBCUTANEOUS LAYER
1. fat cell or adipocytes and connective tissue
2. dermal collagen is continuous w/ the subcutaneous collagen
3. macrophages, fibroblast, fat cells, nerves, fine muscles, blood vessels,
lymphatics, and hair root follicles
, DERMAL APPENDAGES
1. hair, nails
2. Sebaceous glands- secrete sebum
3. Eccrine sweat glands- thermoregulate and cool the body through
evaporation
4. Apocrine sweat glands – limited function
Blood supply and innervation
1. papillary capillaries provide a rich supply of blood
2. sympathetic nervous system regulates vasoconstriction and vasodilation
through a- adrenergic receptors
PRIMARY LESIONS
1. Macule- flat, circumscribed area that a change in the color of skin
(freckles, measles)
2. wheal- transient lesion w/ well defined and often changing borders caused
by edema of the dermis ( insect bites, allergic reactions)
3. Papule- elevated, firm, and circumscribed area, measures less than 1 cm
(warts)
4. Pustule- elevated, superficial lesion, filled with fluid ( acne, impetigo)
SECONDARY LESIONS
1. Excoriation- loss of epidermis, linear, hollowed, crusted (scabies,
scratches)
2. Fissure- linear crack or break from the epidermis to the dermis, maybe
moist and dry (athlete’s foot)
, 3. Erosion- loss of a part of the epidermis, depressed area, moist, glisten,
rupture of a vesicle or bulla (chicken pox, diaper dermatitis)
4. Ulcer- loss of epidermis and dermis, concave, varies in size (pressure
sore)
5. pressure ulcer- result of an unrelieved pressure on skin, causing
underlying tissue damage
* shearing forces, friction, moisture
* occlude capillary blood flow w/ resulting ischemia and necrosis
* STAGE 1 – nonblanchable erythema of intact skin
* STAGE 2- partial thickness, skin loss, involves epidermis or dermis
* STAGE 3- full thickness, skin loss, involving damage or
subcutaneous tissue
* STAGE 4- Full thickness, skin loss w/ damage to muscle, bone, or
supporting structures
Decubitis ulcer- results when an individual lies or sits in one position for an
extended period of time
Dermatitis or Eczema
1. most common
2. characterized by pruritus, lesions w/ distinct borders, epidermal changes
3. Chronic eczema- thickened, lethargy, hyperpigmented skin from recurrent
irritation and scratching
Psoriasis- chronic, relapsing, proliferative skin disorder
1. T- cell autoimmune-mediated skin disease
2. scaly, thick, silvery, elevated lesions
Integumentary system
SKIN- largest organ, 20% of body weight
ACCESSORIES
1. hair 3. Gland
2. nails
1. PROTECTION
2. TEMPERATURE REGULATION
3. PROTECT AGAINST MICROOGRANISM
4. LOSS OF BODY FLUIDS
5. STRESS OF MECHANICAL FORCES
6. PRODUCTION OF VITAMIN D
7. IMMUNE SURVEILLENCE
8. PLEASUREABLE SENSATION
EPIDERMIS
Layers
1. superficial outer layer 4. stratum spinosum
, 2. stratum corneum 5. stratum germinativum
3. stratum lucidum 6. Stratum basale
Keratinocytes- keratin
Melanocytes- melanin
* Vitiligo- autoimmune related loss of melanocytes; depigmentation of
patches of skin
Langerhan cells- present processed antigen to T- cells
Merkel cells- function as slowly adapting mechoreceptors
DERMIS
1. deeper layer, true skin
2. collagen, elastin, reticulum, and a gel-like ground substance
3. hair follicles, sebaceous glands, sweat glands, blood vessels, lymphatic
vessels, nerves
4. Fibroblast- secrete collagen
5. mast cells- release histamine
6. macrophages- phagocytic immune cells
* Histocytes- loose connective tissue; phagocytize pigments and debris of
inflammation
SUBCUTANEOUS LAYER
1. fat cell or adipocytes and connective tissue
2. dermal collagen is continuous w/ the subcutaneous collagen
3. macrophages, fibroblast, fat cells, nerves, fine muscles, blood vessels,
lymphatics, and hair root follicles
, DERMAL APPENDAGES
1. hair, nails
2. Sebaceous glands- secrete sebum
3. Eccrine sweat glands- thermoregulate and cool the body through
evaporation
4. Apocrine sweat glands – limited function
Blood supply and innervation
1. papillary capillaries provide a rich supply of blood
2. sympathetic nervous system regulates vasoconstriction and vasodilation
through a- adrenergic receptors
PRIMARY LESIONS
1. Macule- flat, circumscribed area that a change in the color of skin
(freckles, measles)
2. wheal- transient lesion w/ well defined and often changing borders caused
by edema of the dermis ( insect bites, allergic reactions)
3. Papule- elevated, firm, and circumscribed area, measures less than 1 cm
(warts)
4. Pustule- elevated, superficial lesion, filled with fluid ( acne, impetigo)
SECONDARY LESIONS
1. Excoriation- loss of epidermis, linear, hollowed, crusted (scabies,
scratches)
2. Fissure- linear crack or break from the epidermis to the dermis, maybe
moist and dry (athlete’s foot)
, 3. Erosion- loss of a part of the epidermis, depressed area, moist, glisten,
rupture of a vesicle or bulla (chicken pox, diaper dermatitis)
4. Ulcer- loss of epidermis and dermis, concave, varies in size (pressure
sore)
5. pressure ulcer- result of an unrelieved pressure on skin, causing
underlying tissue damage
* shearing forces, friction, moisture
* occlude capillary blood flow w/ resulting ischemia and necrosis
* STAGE 1 – nonblanchable erythema of intact skin
* STAGE 2- partial thickness, skin loss, involves epidermis or dermis
* STAGE 3- full thickness, skin loss, involving damage or
subcutaneous tissue
* STAGE 4- Full thickness, skin loss w/ damage to muscle, bone, or
supporting structures
Decubitis ulcer- results when an individual lies or sits in one position for an
extended period of time
Dermatitis or Eczema
1. most common
2. characterized by pruritus, lesions w/ distinct borders, epidermal changes
3. Chronic eczema- thickened, lethargy, hyperpigmented skin from recurrent
irritation and scratching
Psoriasis- chronic, relapsing, proliferative skin disorder
1. T- cell autoimmune-mediated skin disease
2. scaly, thick, silvery, elevated lesions
