Chapter 3 The Integumentary System PDF

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These notes cover Chapter 3 of Medical Terminology with Prof. Jody Morris....

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Chapter 3: The Integumentary System Introduction and Overview of Dermatology: ❖ Skin serves as protection to the body ➢ First line defense from germs and irritants ➢ First point of contact with its surroundings ➢ Regulate body temperature in extreme heat or cold ❖ Skin: ➢ Word Root: cutane/o, derm/o, dermat/o ■ It’s basically what the sounds the best ➢ Suffix: -derma, -dermis Word Parts of the Integumentary System ❖ The integumentary system is made up of: ➢ Skin ■ Epi(above)dermis ● Made up of squamous (square) cells ■ Dermis (True Skin Layer) ● Made up of a few cells and many thick fibers ● Strong and flexible ● Contains hair follicles, nerves, and glands ■ Subcutaneous Layer ● Sits right above the dermis, connects true skin (dermis component) to the muscle layer ➢ Hair Follicles ■ Functions ● Hold the hair into the dermis ● Nourish the hair ➢ Nerves ■ Detect pressure, temperature, and pain ➢ Glands ■ Sweat glands release sweet ■ Sebaceous glands release sebum (oil) ● Helps keep skin soft ➢ Nails ❖ Subcutaneous Layer: Connective & Fatty (adipose) tissue ➢ 3 WRs for fat: ■ LIP/O ● LIPOMA (fatty tumor → ex. Back tumor or Head tumor ● LIPOSUCTION (suctioning off the fat)

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● LIPASE (-ASE (S) ENZYME→ biological enzyme that speeds up reactions) ■ ADIP/O ● Adipose (-ose full of, p/t) ■ STEAT/O ● Steato/rrehea → Flow or discharge of fat ● hWhen you cook steak, the fat is visible when raw, but when it cooks it becomes shiny and shrinks Accessory Organs: Hair ➢ WR: trich/o; pil/o ➢ Trichomycosis: ■ -osis (s) “abnormal condition” ■ Trich/o (wr) “hair” ■ Myc (wr) “fungus” ➢ 2 Conditions ■ Alopecia: Baldness ■ Hirsutism: Excessive hair/abnormal hair growth ● Or Hypotrichosis: Excessive Hairiness Sweat Glands (Sudoriferous) ➢ 2 WRS: Hidr/o & diaphor/o ➢ AN (no/not/without) /HIDRO/SIS: Doesn’t sweat ■ Can be determinantal, their body doesn’t have a way to cool down ➢ DIAPHOR/ESIS ■ Esis (s) “condition, state of” diaphor (wr) ➢ HYPERHIDROSIS ■ Excessive sweating ➢ HYPOHIDROSIS ■ Not enough sweating Nails ➢ WR: Onycho/o & Ungu/o ➢ Onycho/lysis: Breakdown of nail ➢ Ungu/al: Pertaining to the nail ■ Subungual: Pertaining to below the nail Oil ➢ WR: seb/o and sebace/o ➢ Pilosebaceous: The sweat glands around each hair follicle Word Parts associate with Pathology: ➢ Unusual Skin Texture ■ Ichthyo (Isiyo): Very scaly skin

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■ Kerato: Hardness or “horny” skin ■ Pachyo: Very thick skin like Elephants ■ Xero: Dry skin ■ Rhytido: Wrinkly Skin ➢ Unusual Skin Color: ■ Leuko: White ■ Erythro: Red ■ ■ Melano: Black Match Words to Definition ➢ Keratoderma: Hard Skin ➢ Onychocryptosis: Hidden nail ➢ Rhytidoplasty: Surgical Repair of Wrinkles ➢ Xeroderma: Dry Skin ➢ Pachyderma: Thick Skin ➢ Albinism: Lack of Skin Pigment ➢ Melanoma: Black-colored tumor ➢ Leukotrichia: White Hair ➢ Erythroderma: Redness of the skin ➢ Xanthopsia: Unable to see the color yellow Skin color is due to the amount of melanin produced Pigmentation Disorders: ➢ Albinism: Melanocytes have died off or do not function correctly which leaves condition where there is lack of pigment in skin causing patients to look white ➢ Vitiligo: In certain spots of the body, white spots appear where melano sights are not functioning/working Common complaint in regard to the skin is a new rash ➢ Pruritus: Itching ➢ Seborrhea: Discharge of oil ➢ Xerosis: Condition of dryness ➢ Macerate: To soften the skin ➢ Hyperhidrosis: Excessive sweating ➢ Anhidrosis: No sweating Subjective Terms that describe a change from normal skin color ➢ Depigmentation: Lack/loss of pigment in the skin ➢ Hypermelanosis: Excessive amount of pigment in the skin (very dark skinned individual) Subjective terms associated with hair problems ➢ Alopecia: Baldness

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➢ Hypertrichosis: Excessive hairiness, predominantly in women than in men Some parts cannot be broken into word parts ➢ Comedo: Clogged hair follicle that leads to a white head or a black head ➢ Macerate: To soften the skin ➢ Urticaria: Swollen area/red area as it relates to the skin Break the medical term into smaller word parts to determine its meaning: ➢ Dermatalgia: Painful skin, often time because a rash or itching ➢ Dermatodynia: Painful skin ➢ Dermatolysis: Breakdown of the skin, like losing weight very quickly, which leaves skin hanging ➢ Hematidrosis: Sweating blood (pink droplets within the perspiration) Define Each Medical Term: ➢ Xanthoderma: Yellow skin/jaundice ➢ Rhytidermia: Wrinkled skin ➢ Onychophagia: Nail biting ➢ Hypomelanosis: Diminished melanin Objective terms are used by the practitioner to describe what he or she detects, can measure, see, feel, and test. ➢ Macule/Macula; Freckle ➢ Patch: Vitiligo ➢ Papule: A small, solid mass Skin Lesions: ➢ Lesion: Pathologic change of tissue due to disease or injury ➢ Described by location, appearance, size and color Surface Lesions: ➢ Macule: Small flat spot (typically, less than one centimeter) ■ Ex. Freckle ➢ Patch: Larger Flat Spot (typically, greater than one centimeter) ■ Ex. Vitiligo, “cafe ay lait” spot ➢ Papule: Small, solid, raised lesion ■ Ex. Moles, Warts, Skin Tags, Birthmarks Birthmarks Nevus (Nevi) ➢ Papule: (Less than ½ a centimeter) Slightly raised, dark brown or black with hair Nodule: Small, solid bump, larger than a papule (greater than a centimeter) ➢ Felt under skin or raised ➢ Similar to a mosquito bite Wheal: Domed shaped, red lesion; lower in center ➢ Ex. Hives ( urticaria) ➢ Intradermal injection

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➢ Allergy skin testing Fluid Filled Lesions: ➢ Vesicle: Small lesion filled with clear fluid ■ Ex: Blister ■ Bulla (Bullae): Big blister ➢ Pustule: Small lesion filled with pus ■ Ex: Acne ➢ Cyst: Thick walled sac containing fluid ■ Located anywhere Lesions through the skin: ➢ Abrasion (erosion): Superficial layer of skin scraped or rubbed away ➢ Fissure: Groove or crack-like sore ■ Ex: Athlete’s foot ➢ Ulcer: Open sore on skin or mucous membrane ■ Ex: Canker sore ➢ Decubitus (Decubitus) Ulcer: Also called a bed sore. If a patient does not move frequently enough, the weight of the upper portion of their body pushes down on the bones, which leads to an ulcer. Surface Lesions: ➢ Crust: Exudate (drainage) which dries on the skin ■ Ex: Scab Vascular Lesions: ➢ Ecchymosis (ecchymoses) ➢ Petechia (Petechiae) ■ Pinpoint Hemorrhagic Lesions ■ Typically from inflammation of the blood vessels ➢ Purpura: ■ Purpur: “Purple” ■ Larger than petechia (ae) Skin Growths ➢ Keloid: Hypertrophied thickened scar ■ Cut themselves with a large gap in between, so the two portions of the skin don’t line up perfectly, so the scar tissue forms thicker ➢ Polyp: Mushroom like growth on a stem or stalk ■ Little growth typically coming off a mucous membrane. ● Like when leaves grow off the trees, there is a stem to hang off the actual branch Skin Cancer: 3 Types

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➢ Basal Cell Carcinoma: Most frequent, slow growing, no metastasis (doesn’t spread, stays localized) ➢ Squamous Cell Carcinoma: Appears as sore that doesn’t heal; heaped up, crusted appearance. Does metastasize ➢ Malignant Melanoma: (Tumor of black) This is cancerous, and must be removed. ABCDEs of Skin Cancer ➢ A: Asymmetry- Two halves look different. (If they look different, they need to look at it further) ➢ B: Border irregular or poorly circumscribed (to enclose) ➢ C: Color - Varies (Tan, brown, black, white, black, or blue) ➢ D: Diameter - Larger than 6 mm (pencil head) ➢ E: Evolution - Change over time More skin conditions: ➢ Stretch Marks: Stria (striae) Psoriasis: ➢ Autoimmune (Your body thinks you are sick, but you are not sick, so the body attacks healthy tissue/cells, even though you’re fine) ➢ Pruritus & Erythema ➢ Silvery scales & Plaques ➢ Remissions (Still have disease, but not showing signs or symptoms) & Exacerbations (Flare up) Dermatitis: ➢ Contact dermatitis ■ Pruritus ■ Erythema Cellulitis: Inflammation of the cells ➢ Typically see when blood is taken, IV, some sort of puncture in the skin. Bacteria, fungi floating in the air, so the cells become inflamed from the germs. ➢ Can spread through all the body, which can leave an individual in the hospital Gangrene: Necrosis of the tissue ➢ Tissue death ➢ As the result of poor circulation or diabetes Diagnostic Procedures: ➢ The appearance of a rash will help the practitioner diagnose its cause ➢ Description of the rash includes: ■ Location ■ Size ■ Color

■ Texture ■ Filling of the rash (pustules) ➢ Location of a Rash ■ Localized VS. Generalized ■ Spreading ● Centrifugal VS. Centripetal ■ Presence of bumps and their size ● Papules < 1 cm ● Nodules > 1 cm ● Plaques are large and flat ➢ Bumps that are filled with fluid: ■ Vesicles are < 1 cm and filled with clear fluid ■ Bulla are > 1 cm and filled with clear fluid ■ Pustules are filled with pus ■ Abscesses are large pustules > 1 cm ➢ Flat spots: ■ Freckles are small flat spots called macules ■ Large macules are called patches ❖ Skin conditions caused by Blood Vessels ➢ Collection of blood vessels ■ Cherry Angioma: Raised ■ Telangiectasia: Flat * Not on pronunciation exam ➢ Bruises ■ Petechiae: Small ■ Ecchymosis: Large ❖ Diagnostic Procedures: ➢ Skin Biopsy ■ Excisional: Completely remove the lesion ■ Shave: They think the lesion would have cancerous components, so they shave layers of it off, look in a microscope, if there is cancer, they continue to slice off the lesion ■ Punch: They make an incision, reflected the skin back, and use a “hole puncher” to punch out the lesion ➢ Scar Formations ■ Cicatrix: Regular scar ■ Keloid ➢ Epidermal Tumors ■ Nevus: Birthmark ■ Dysplastic Nevus: Abnormal hole

■ Verucca: Warts ➢ Culture and Sensitivity: Give the area medication/apply it on the area ➢ Biopsy (Bx): Take a sampling of the skin ■ Excisional: Remove the entire lesion ■ Incisional: Remove a section of the lesion ➢ Dermatoscope: Instrument used to look at the skin ➢ Dermoscopy: The process of looking at the skin ❖ Pathological Findings ➢ Adipocele: Fatty Hernia ➢ Dermatofibroma: Fibrous Skin tumorous ➢ Keratogenic: Producing horny tissue ❖ Pathological conditions of the nail ➢ Onycholysis: breakdown of the nail ➢ Onychomalacia: Softening of the nail ➢ Onychopathy: pain of the nail ➢ Onychophagia: eating or swallowing of nail ➢ Paronychia Diagnosis and Pathology ❖ Assessment terms are those that describe the diagnosis of the condition ❖ Skin problems ➢ Infections ➢ Inflammations ➢ Tumors ➢ Changes in the skin ❖ General skin changes ➢ Dermatosis: Skin disorder ➢ Decubitus ulcer: Bed sore ➢ Dermopathy: Skin disease ➢ Eczema: Caused by atopic dermatitis, itchy rash, crust/scab, oozing nasty ➢ Psoriasis: Autoimmune disease ❖ Associated with hair: ➢ Hypertrichosis: Excessive growth of hair ➢ Postpartum alopecia: Hair loss after birth ❖ Associated with skin ➢ Atopic dermatitis: inflammation of the skin ➢ Ichthyosis: Condition of dryness of scaliness of the skin ➢ Sclerodermatitis: Inflammation and hardening/thickening of the skin ➢ Xanthosis: Condition of yellowing ❖ Tumors

➢ Malignant cutaneous neoplasms ■ Basal cell carcinoma: does not metastasize, can be contained in one area ■ Malignant melanoma: least common, leading cause of skin cancer ■ Squamous cell carcinoma: Starts as papule, but can metastisize ➢ Benign skin tumors ■ Actinic keratosis: Horny skin from the sun ■ Hidradenoma: Tumor of the sweat gland ❖ Infections ➢ Fungal Infections ➢ Mycosis ➢ Dermatomycosis ➢ Mycodermatitis ➢ Trichomycosis ❖ Miscellaneous Infections ➢ Acne vulgaris: ➢ Impetigo: Bacterial infection of the mouth ➢ Onychodystrophy: Poor nail development (nourishment) ❖ Inflammation: ➢ Seborrheic dermatitis: Inflammation of the skin due to oil production ➢ Dermatoconiosis: Inflammation of the skin due to dirt ■ Not practicing proper hygiene Treatments and Therapies ❖ Plan terms explain how patients will be treated for their conditions ❖ Medications ➢ Anti-infection or cleansing ➢ Anti-immune ➢ Anti-itch or allergy ❖ Procedures to treat the integumentary system: ➢ Chemicals ➢ Vacuums ➢ Cold ➢ Lasers ➢ Electricity ➢ Surgery ➢ Mohs micrographic surgery ➢ Skin grafting ❖ General Terms: ➢ Epidermal ➢ Intradermal: Pertaining to inside the skin

➢ Hypodermic and subdermal: Under the skin ➢ Percutaneous and transdermal: ❖ Procedures: ➢ Chemosurgery ➢ Cryosurgery ➢ Chemotherapy ➢ Dermabrasion ➢ Electrocauterization: Burning something off with electricity ➢ Electrodesiccation: Drying with electricity ➢ Incision and drainage (I & D): Make incision and drain an abscess ➢ Onychectomy: Surgical removal of nail ➢ Onychotomy: Incision of nail ➢ Liposuction ➢ Lipectomy: Removal of fatty tissue ➢ Rhytidoplasty: Surgical treatment of wrinkled skin At first glance, the skin appears to be very simple—just a thin layer of tissue covering our bodies. However, the truth is that the integumentary system (t he skin ) is very complex. Your skin (roots: cutaneo/dermo ) has many structures, each of which has its own special job. The outermost layer, the one that is visible, is the epidermis. It is made of large cells that look like the scales of a fish under the microscope. The term squamous cell refers to this scaly appearance. Under the epidermis lies a deeper layer known as the dermis. This layer, which is much thicker than the epidermis, has fewer cells and more thick fibers to give the skin strength and flexibility. The dermis is also home to hair follicles, nerves, and glands.

● Hair follicles are the roots of your hair (pilo/tricho ) . The follicles anchor the hair to the skin and provide nourishment to it.

● The nerves of the dermis detect fine pressure, deep pressure, temperature, and pain. The vast network of nerves in your skin makes it the largest sensory organ in your body.

● The skin has two types of glands, which are groups of cells that release fluid. Sweat glands (hidro ) release sweat to rid the body of waste and to cool the body. Sebaceous glands (sebaceo ) secrete oil as a natural moisturizer for the skin and hair. At the ends of your fingers and toes are nails, specialized tissue made of a hard substance (keratin ) . Your nails (onycho/unguo ) protect your fingers and toes and provide a good base for movement.

skin roots: example s:

cutane/o, derm/o, dermat/o subcutaneous, epidermal, dermatology

notes:

A patient once sought medical treatment for a rash around the mouth. When the health care professional diagnosed her with perioral dermatitis,  the patient thought to herself, “Duh! You just said the same thing I said—just in a different language.” Think about it: What does perioral dermatitis  mean? You can break it down easily: peri  = around, oral  = mouth, dermat  = skin, and itis = inflammation.

sweat root: example

hidr/o hyperhidrosis, hypohidrosis

s: notes:

Humans have gone to great lengths to keep the environment cool—inventing air conditioning and fans, for example—which suggests that humans do not like to get sweaty. But if you didn't have the ability to sweat, your body would have a very hard time regulating its temperature. In fact, hypohidrosis,  which means a lack of sweat, can be a sign that something is wrong. Unlike humans, dogs cannot sweat. Instead, they pant—their bodies are cooled by the air passing over their moist tongues.

Word Parts Associated with Pathology—Change Skin abnormalities are generally categorized into two groups: unusual skin texture and unusual skin color. Problems with skin texture can present as scaliness (ichthyo- ) , hardness or horniness (kerato- ) , thickness (pachyo- ) , dryness (xero- ) , or wrinkled appearance (rhytido- ) . Of course, skin tones differ from person to person and ethnicity to ethnicity, but certain prefixes are used to describe abnormal skin conditions: whiteness (leuko- ) , redness (erythro- ) , yellowness (xantho- ) , and blackness (melano- ) .

hidden root: exampl

crypt/o onychocryptosis

e: notes:

A person who specializes in breaking codes a  nd deciphering secret messages is called a cryptolinguist. Onychocryptosis  is an ingrown, or hidden, toenail. The word crypt  used by itself can refer to a room or vault hidden beneath the floor. It is usually associated with a chamber in which corpses are placed, whether it is located in a church (generally beneath the floor) or a mausoleum (generally above ground).

The most common reason a person seeks medical care in relation to his or her skin is a new rash. The rash may be painful (dermatalgia/dermatodynia ) or itchy (pruritus ) . The rash may appear as hives

(urticaria ) or as an oily secretion (seborrhea ) . The rash may be very dry (xerosis ) or very wet (macerate ) . Patients may also notice that they are producing too much sweat (hyperhidrosis ) or not enough sweat (anhidrosis ) . Sometimes the patient's concern is change in normal skin color. These color changes may involve a loss of pigment (depigmentation ) or darkening of the skin (hypermelanosis ) . Some people lack pigment altogether, as in albinism. Another reason a patient might consult a dermatologist is problems with the hair. Hair falls under the responsibility of a dermatologist because the hair follicles are embedded in the skin. The most common hair complaint for men is hair loss (alopecia ) , but it occurs in women as well. Another hair problem is too much hair (hypertrichosis ) .

dermatological terms Term

Word Analysis

abrasion

ab/   rasion

uh-BRAY-zhun

away/   scrape

Definition scraping away of skin albinism

albin/   ism

AL-bin-ism

white/   condition

Definition lack of pigment in skin causing patient to look white albino

albino

al-BAY-noh Definition a person afflicted with albinism alopecia

from Greek, for fox

a-loh-PEE-sha Definition baldness anhidrosis

     osis an/hidr/

an-ih-DROH-sis

     condition no/sweat/

Definition lack of sweating alopecia

comedo

from Latin, for to eat up

koh-MEE-doh Definition a hair follicle that is plugged with sebum (black head, white head) cyanidrosis

cyan   /idr   /osis

sai-yan-ih-DROH-sis

blue/sweat/      condition

Definition blue sweat comedo

depigmentation

de   /pigment/   ation

DE-pig-men-TAY-shun

away/   pigment    /condition

Definition loss of pigmentation dermatalgia

  algia dermat/

der-mah-TAL-jah

 pain skin      /

Definition skin pain dermatodynia

dermato/   dynia

der-MA-toh-DIH-nee-ah

skin      pain    /

Definition skin pain dermatolysis

  lysis dermato/

der-mah-TAWL-ih-sis

   / skin      loose

Definition loose skin erythema

from Greek, for redness

eh-rih-THEE-ma Definition redness dermatolysi s

erythroderma

erythro/   derma

eh-RIH-throh-DER-ma

red     /skin

Definition red skin hemathidrosis

     osis hemat/hidr/

heh-mat-ih-DROH-sis

blood        condition   /sweat/

Definition sweating blood

hidropoiesis

hidro/   poiesis

hih-droh-poh-EE-sis

sweat/   formation

Definition the formation of sweat hyperhidrosis

  hidr   /osis hyp...