Wk 3-Integumentary System

1. General structure. 2. Structure: cells of the epidermis 3. Structure: layers of the epidermis 4. Funcon 5. Sudoriferous (sweat) and sebaceous (oil) glands 6. Hair 7. Common Bacterial Condions—Folliculis, Furuncles/Carbuncles, Impego 8. Common Bacterial Condions— Cellulis, Erysipelas 9. Common Viral Condions—Warts 10. Common Superficial Fungal Condions—Tinea 11. Common Superficial Fungal Condions—Candidiasis 12. Summary.

Presented by Karoline Y. Ren

1 1. General structure

The 3 layers of the skin are: the epidermis, the dermis and the subcutaneous fat layer (hypodermis).

The purpose of the skin is to protect the body from damaging external agents, extremes of temperatures and viral and bacterial agents

This most extensive organ system has the skin and accessory structures. The accessory structures include hair, nails, sweat glands and sebaceous glands, and specialized nerve receptors for smuli (changes in internal or external environment) such as touch, cold, heat, pain, and pressure. 2 3 Summary

The purpose of the skin = to protect the body from damaging external agents, extremes of temperatures and viral and bacterial agents

The 3 layers of the skin are: the epidermis, the dermis and the subcutaneous fat layer (hypodermis).

The nerve receptors in skin enable the feeling of temperature, touch and pain

It take 4 weeks for cells in the boom layer of the epidermis to reach the skin surface

Melanocytes produce Melanin

The 2 types of sweat glands in the skin are the eccrine and apocrine

Impego is a bacterial infecon in the skin, it is high contagious and appears as red blisters.

4 2. Structure: cells of the epidermis The epidermis has several strata/layers that contain four cell types. 1. Keranocytes makes keran. Keran is a protein that gives skin its flexibility and strength. It waterproofs the skin’s surface. 2. Melanocytes makes melanin. Melanin is the dark pigment that gives skin its colour. 3. Merkel's cells are thought to help with touch recepon. 4. Langerhans' cells help the immune system by processing angens, which is also known as foreign bodies.

The nerve receptors in skin enable the feeling of temperature, touch and pain

5 3. Structure: layers of the epidermis The skin is the largest organ of the body.

Its 2 main layers are the epidermis (outer layer) and dermis (inner layer).

The epidermis has several strata/layers that contain four cell types. They are: 1. 2. 3. 4.

6 1. Structure: layers of the epidermis

7 3. Structure: layers of the epidermis • Millions of these dead cells are worn off daily, creang a new epidermis every 35 to 45 days. It take 4 weeks for cells in the boom layer of the epidermis to reach the skin surface

8 4. Funcon of the skin: Apart from protecon as previously menoned…

• Sensory input — the skin has millions of nerve endings, which allow us to respond to the sensaons of pain, heat and cold.

• Temperature regulaon — the skin has an lots of blood supply. This is mainly for temperature regulaon. For example, when we become hot, the blood supply rushes to the skin surface and heat is lost through radiaon. The skin also regulates temperature by perspiraon: when we perspire heat is lost through evaporaon.

• Excreon of water and waste products.

• Making of vitamin D.

9 5. Sudoriferous (sweat) and sebaceous (oil) glands

The 2 types of sweat glands in the skin are the eccrine and apocrine

The skin produces structures such as sudoriferous (sweat) glands and sebaceous (oil) glands. It also produces hair, fingernails and sensory receptors that help to feel pain, pressure and temperature.

Sudoriferous glands (sweat glands) can be categorised into 2 types: 1. eccrine glands=coiled ducts deep in the skin that connect to the surface 2. apocrine glands are in armpits, areolae of nipples, and the genital region.

1. Eccrine glands secrete sweat, a mixture of 1% salts and fats and 99% water. In warm temperatures with low humidity, sweang/ perspiraon cool the body down.

10 5. Sudoriferous (sweat) and sebaceous (oil) glands 2. Apocrine glands become acve at ,. They are larger, deeper, and produce thicker secreons than eccrine glands.

The apocrine glands secreons contain . Pheromones are substances that enable olfactory (smell) communicaon with the species. This communicaon provokes certain behavioral responses such as sexual arousal. Whereas eccrine glands respond to heat, apocrine glands respond to stress and sexual acvity by secreng sweat with a characterisc . This odor differs from body odor that results from decomposing skin secreons on the skin.

Note: • Cerumen ()= modified apocrine glands.

• Mammary glands in female =modified apocrine glands. These glands are secrete milk rather than sweat.

11 5. Sebaceous (oil) glands

• Sebaceous glands (oil glands) are all over the body except on the palms of hands and soles of feet! • The glands secretes/empty via ducts into the bases of hair follicles and secrete sebum (a mixture of fats, waxes, and hydrocarbons).

12 5. Sebaceous (oil) glands

• Sebum moistens hair and prevents skin from drying. It is mostly located at the face and scalp. • During puberty, increased levels of hormone in the blood may make too much sebum. This extra smount of sebum may plugs the gland and hair follicle, producing .

13 6. Hair

• Arrector pili muscles= smooth muscle cells aached to hair follicles. When they contract, they pull the hair into an upright posion, causing skin dimples (goose bumps). The nervous system controls these muscles. These muscles contract when fright and or cold temperature happens.

14 7. Bacterial Condions—Folliculis, Furuncles/Carbuncles, Impego 1. Folliculis=bacterial infecon of hair follicles Common cause: Staphylococcus aureus but occasionally Pseudomonas aeruginosa (hot tub folliculis) or other organisms. Hot tub folliculis happen due to not enough treatment of water with chlorine or bromine. Symptoms: mild pain, pruritus (itchy skin) & irritaon. Signs: superficial pustule /inflammatory nodule around a hair follicle. Infected hairs comes off skin easily, but new papules tend to develop.

Folliculis manifests as superficial pustules or inflammatory nodules surrounding hair follicles:

15 7.Bacterial Condions—Folliculis, Furuncles/Carbuncles, Impego

2. Furuncles: Furuncles, also known as boils=skin abscesses caused by staphylococcal infecon, which involve a hair follicle and surrounding ssue. Treatment is warm compresses and oen oral an-staphylococcal anbiocs.

Furuncle:

16 7.Bacterial Condions—Folliculis, Furuncles/Carbuncles, Impego 2. Carbuncles are clusters/groups of furuncles connected subcutaneously (deeper into the skin), causing deeper pus formaon and scarring.

17 7.Bacterial Condions—Folliculis, Furuncles/Carbuncles, Impego 3.Impego= a bacterial infecon in the skin, it is highly contagious!! It appears as red blisters. Cause: streptococci, staphylococci, or both. Ecthyma= an ulcerave form of impego. Both give mild pain/discomfort. Pruritus /itchiness is common. Scratching may spread infecon, inoculang (spread) to nearby and or non-nearby skin!! Impego (non-bullous): Impego (bullous):

18 8. Common Bacterial Condions— Cellulis, Erysipelas

1. Cellulis=acute bacterial infecon of the skin and subcutaneous ssue Cause: streptococci or staphylococci. Symptoms & signs: pain, rapidly spreading redness/erythema, & edema. Fever may occur, and regional lymph nodes may enlarge!! Prognosis: excellent with mely treatment.

19 8. Common Bacterial Condions— Cellulis, Erysipelas • Cellulis connues…

Differentiating Cellulitis and Deep Venous Thrombosis Feature Cellulitis Deep Venous Thrombosis Skin temperature Hot Normal or cool

Skin color Red Normal or cyanotic

Skin surface Peau d'orange Smooth Lymphangitis and Frequent Nonexistent regional lymphadenopathy

20 8. Common Bacterial Condions— Cellulis, Erysipelas

• 2. Erysipelas=a type of superficial cellulis , with dermal lymphac involvement. Caused: β-hemolyc streptococci Locaon: oen on the legs and face. Signs: Raised, shiny, hardened, and tender plaque-like disnct margined lesions.

21 9. Common Viral Condions—Warts • Warts= common, benign, epidermal lesions. Cause: papillomavirus infecon. They can appear anywhere on the body in a variety of shapes & sizes. Warts are usually self limited. It may be treated by destrucve methods (eg, excision and liquid nitrogen) and topical or injected substances.

22 9. Common Viral Condions—Warts

23 10. Common Superficial Fungal Condions—Tinea • Tinea/ringworm (please note ringworm is just a name, no worm is involved in this fungal disease)= a contagious fungal skin infecon. Commonly affected areas: • feet (athlete's foot) • groin (jock itch) • scalp & beneath the breasts. • Nail/ nea unguium. Tinea can be spread indirectly or skin-to-skin contact. Treatment includes anfungal medicaon and good . Signs and sympons: • Red scaly rash that is shaped like a ring • Itching and snging • Yellow or white discoloraon of the nails • Cracking, spling and peeling in the toe web spaces • Blisters • Bald spots on the scalp.

24 10. Common Superficial Fungal Condions—Tinea

25 11. Common Superficial Fungal Condions—Candidiasis

Candidiasis (candidosis/moniliasis/yeast infecon)=infecon caused by several species of Candida, typically by Candida albicans.

Most common type of candidias= a superficial infecon of the mouth, vagina, or skin àred or white patches and itching, irritaon, or both.

People whose immune system is weakened may have serious infecons of the esohagus and other internal organs! Patches in the esophagus cause pain during swallowing!

26 11. Common Superficial Fungal Condions—Candidiasis

Infecon of the mouth ( also known as thrush or trench mouth) can have the following signs & symptoms: • Creamy, white, painful patches inside the mouth • Cheilis=Cracking at the corners of the mouth • A red, painful, smooth tongue Some types of diaper rash are caused by Candida.

27 Common Superficial Fungal Condions —Candidiasis

• Chronic hyperplasc candidiasis.

28 Some extra resources..

• hp://www.cancercouncil.com.au/wp- content/uploads/2012/07/Massage-and- Cancer.pdf • hp://www.abmp.com/massagemarketplace/ downloads/TenForToday_ND10.pdf

29