Integumentary System

Integumentary System

Jonel D. Mallari, RN,MN

Integumentary System Functions

• ​Protection

• Sensation

• Vitamin D Production

• Temperature

• Excretion

Multiple Choice

Which of the following is NOT a true statement about epithelial tissue?

• EPITHELIAL TISSUE IS VASCULAR

• EPITHELIAL TISSUE PROVIDES PHYSICAL PROTECTION FOR ORGANS

• EPITHELIAL TISSUE FUNCTIONS IN ABSORPTION & SECRETION

• EPITHELIAL TISSUE CONTROLS THE PERMEABILITY INTO OUT OF AN AREA OR ORGAN

Multiple Choice

Layer with production of keratin fibers; formation of lamellar bodies; limited amount of cell division

• stratum basale

• stratum corneum

• stratum granulosum

• stratum lucidum

• stratum spinosum

Multiple Choice

Layer where there is Sloughing occurs; 25 or more layers of dead squamous cells

• stratum basale

• stratum corneum

• stratum granulosum

• stratum lucidum

• stratum spinosum

Multiple Choice

Layer where there is production of cells; melanocytes produce and contribute melanin;hemidesmosomes present

• stratum basale

• stratum corneum

• stratum granulosum

• stratul lucidum

• stratum granulosum

Multiple Choice

Layer with production of keratohyalin granules; lamellar bodies release lipids; cells die

• stratum basale

• stratum corneum

• stratum granulosum

• stratum lucidum

• stratum spinosum

Multiple Choice

Layer with dispersion of keratohyalin around keratin fibers; layer appears transparent; cells dead

• stratum basale

• stratum granulosum

• stratum corneum

• stratum spinosum

• stratum lucidum

Epidermal Layers

• Come

• Lets

• Get

• Sun

• Burn

• Come Lets Get StarBucks

Epidermis

• Excessive sloughing of stratum corneum cells from the surface of the scalp is called dandruff.

• skin subjected to friction, the number of layers in the stratum corneum greatly increases, producing a thickened area called a callus.

• Over a bony prominence, the stratum corneum can thicken to form a cone-shaped structure called a corn.

Multiple Choice

The outer layer of the skin made up of keratinized stratified squamous epithelium

• dermis

• epidermis

• hypodermis

• basal layer

Multiple Choice

Which statement best contrasts the characteristics of the stratum basale cells with the stratum corneum cells?

• S. Corneum cells are usually cuboidal or columnar cells, whereas s. basale cells are usually squamous

• S. Corneum cells are living cells, but s. basale cells are dead

• S. Corneum cells are dead cells, but s. basale cells are living

• S. Corneum cells are all dead keratinocytes, but s. basale cells are all melanocytes

Multiple Choice

The function of melanin in the skin is to

• lubricate the skin

• prevent skin infections

• protect the skin from ultraviolet light

• reduce water loss

• help regulate body temperature

Multiple Choice

All of the following have an increase melanin concentration, EXCEPT:

• genitalia

• nipple

• mole

• palms

Skin Color 

• Factors that determine skin color include pigments in the skin, blood circulating through the skin, and the thickness of the stratum corneum. The two primary pigments are melanin and carotene.

• Melanin is the group of pigments primarily responsible for skin, hair, and eye color. Carotene is a yellow pigment found in plants such as squash and carrots.

Skin Color 

• Exposure to ultraviolet light—for example, in sunlight— stimulates melanocytes to increase melanin production. The result is a suntan.

• Large amounts of melanin form freckles or moles in some regions of the skin. Melanin production is determined by genetic factors, exposure to light, and hormones.

• Genetic factors are responsible for the amounts of melanin produced in different races.

• Although many genes are responsible for skin color, a single mutation can prevent the production of melanin and cause albinism.

Multiple Choice

Layer of dermis responsible for most of the structural strength of

the skin

• papillary layer

• reticular layer

Multiple Choice

Layer of dermis responsible for fingerprints and footprints

• papillary layer

• reticular layer

Multiple Choice

Layer of dermis responsible for cleavage lines and stretch marks

• papillary layer

• reticular layer

Dermis

• The dermis is composed of dense collagenous connective tissue containing fibroblasts, adipocytes, and macrophages.

• Nerves, hair follicles, smooth muscles, glands, and lymphatic vessels extend into the dermis.

• If the skin is overstretched for any reason, the dermis can be damaged, leaving stretch marks.

• The dermal papillae in the palms of the hands, the soles of the feet, and the tips of the digits are arranged in parallel, curving ridges that shape the overlying epidermis into fingerprints and footprints.

Multiple Choice

the subcutaneous tissue just deep to the skin made up of mostly adipose tissue. stores fat, anchors the skin, and acts as a shock absorber

• epidermis

• dermis

• hypodermis

• integument

Multiple Choice

The subcutaneous tissue:

• Is loose connective tissue that attaches the skin to underlying bone & muscle

• Is important for padding and insulation

• Contains about half of the body’s stored lipids

• All of the choices are correct

Subcutaneous Tissue 

• The subcutaneous tissue attaches the skin to underlying bone and muscle and supplies it with blood vessels and nerves. It is loose connective tissue, including adipose tissue that contains about half the body’s stored lipids.

• Adipose tissue in the subcutaneous tissue functions as padding and insulation. The subcutaneous tissue can be used to estimate total body fat.

• The acceptable percentage of body fat varies from 21% to 30% for females and from 13% to 25% for males.

Multiple Choice

After birth, the type of hair on the scalp, eyelids, and eyebrows is

• lanugo

• terminal hair

• vellus hair

Multiple Choice

Hair:

• is produced by the dermal root sheath.

• consists of living, keratinized epithelial cells.

• is colored by melanin.

• contains mostly soft keratin.

• grows from the tip.

Multiple Choice

Concerning hair growth,

• hair falls out of the hair follicle at the end of the growth stage.

• most of the hair on the body grows continuously.

• cutting or plucking the hair increases its growth rate and thickness.

• genetic factors and the hormone testosterone are involved in “pattern

  baldness.”

• eyebrows have a longer growth stage and resting stage than

  scalp hair.

Hair

• In humans, hair is found everywhere on the skin, except on the palms, soles, lips, nipples, parts of the genitalia, and the distal segments of the fingers and toes.

• Hair is produced in cycles, with a growth stage and resting stage.

• During the growth stage, hair is formed by mitosis of epithelial cells within the hair bulb; these cells divide and undergo keratinization.

• During the resting stage, growth stops and the hair is held in the hair follicle.

• When the next growth stage begins, a new hair is formed and the old hair falls out.

Hair

• The duration of each stage depends on the individual hair.

• Eyelashes grow for about 30 days and rest for 105 days, whereas scalp hairs grow for 3 years and rest for 1 to 2 years.

• The loss of hair normally means that the hair is being replaced because the old hair falls out of the hair follicle when the new hair begins to grow.

Multiple Choice

A 55-year old, American patient came to the ER with noted jaundice symptoms by the triage nurse with history of 20 years alcoholic drinker. Suddenly the patient ask what is the yellowish seen in his skin and sclera. The prudent nurse and resident doctor would say.

• Altered blood flow to the skin (overall in small areas)

• Increased number of active melanocytes

• Collection of abnormal bile pigment in the skin

• Decreased oxygen content of blood

• Increased production of melanin by normal number of melanocytes

Multiple Choice

Concerning skin color, which pair of statements is not correctly matched?

• Skin appears yellow – carotene present

• No skin pigmentation (albinism) – genetic disorder

• Skin tans – increased melanin production

• Skin appears blue (cyanosis) – oxygenated blood

• African americans darker than Caucasians – more melanin in African American skin

The Integumentary System as Diagnostic Aid

• Cyanosis

• Erythema

• Jaundice

• Rashes and lesions - assessment of bed sores and /or Incontinence Associated Dermatitis (IAD)

• Vitamin A Deficiency - sandpaper texture 

• Iron deficiency - nails become flat or concave (spoon shaped)

• Assessment of skin turgor.  
  

Multiple Choice

Alveolar glands that produce a white, oily substance; usually open into

hair follicles

• apocrine gland

• eccrine sweat gland

• sebacios gland

Multiple Choice

Coiled, tubular glands that secrete a hyposmotic fluid that cools the

body; most numerous in the palms of the hands and soles of the feet

• apocrine sweat glands

• eccrine sweat glands

• sebaceous gland

Multiple Choice

Secretions from these coiled, tubular glands are broken down by bacteria to produce body odor; found in the axillae, in the genitalia, and around the anus

• apocrine sweat gland

• eccrine sweat glands

• sebaceous glands

Glands

• Sebaceous glands are simple, branched acinar glands, with most being connected by a duct to the superficial part of a hair follicle. They produce sebum, an oily, white substance rich in lipids.

• The sebum is released by holocrine secretion and lubricates the hair and the surface of the skin, which prevents drying and protects against some bacteria.

Glands

• There are two kinds of sweat glands: eccrine and apocrine.

• Eccrine sweat glands are simple, coiled, tubular glands and release sweat by merocrine secretion. Eccrine glands are located in almost every part of the skin but most numerous in the palms and soles. They produce a secretion that is mostly water with a few salts.

• Sweat can also be released in the palms, soles, armpits, and other places because of emotional stress.

Glands

• Apocrine sweat glands are simple, coiled, tubular glands that produce a thick secretion rich in organic substances. The glands open into hair follicles in the armpits and genitalia.

• Apocrine sweat glands become active at puberty because of the influence of sex hormones. The secretion generally is odorless, but when released quickly breaks down by bacterial action giving body odor.

Multiple Choice

The lunula of the nail appears white because

• it lacks melanin

• blood vessels cannot be seen through the thick nail matrix.

• the cuticle decreases blood flow to the area.

• the nail root is much thicker than the nail body.

• the hyponychium is thicker than the cuticle.

Multiple Choice

Most of the nail is produced by the

• cuticle

• hyponychium

• nail bed

• nail matrix

• dermis

Multiple Choice

Which of the following statements is FALSE?

• Nails grow continually and do not have a resting stage

• The nail consists of layers of living cells from the stratum corneum

• The cells of a nail are filled with a special hard type of keratin

• The nail matrix and nail be have a stratum basale

• The production of cells within the nail matrix results in the growth of the nail

Multiple Choice

Which of the following functions of the integumentary system is NOT correctly matched with an example?

• Sensation-pain, heat, cold, and receptors in the skin

• Temperature regulation-radiation and convection of heat from blood flowing in the dermis

• Excretion-hydrogen ions are moved from the skin into the urine

• Vitamin d production-active vitamin d is produced from a precursor molecule

• All of the choices are correct

Multiple Choice

Which of these processes increase(s) heat loss from the body?

• dilation of dermal arterioles

• constriction of dermal arterioles

• increased sweating

• both dilatation and increase sweating

• both contriction of dermal arterioles and increased sweating

Multiple Choice

The skin helps maintain optimum calcium and phosphate levels in

the body by participating in the production of

• Vitamin A

• Vitamin B

• melanin

• Vitamin D

• keratin

Multiple Choice

Vitamin D:

• Stimulates calcium and phosphate uptake in the small intestine

• Is formed from a precursor molecule that is made when skin is exposed to ultraviolet light

• Is formed from a precursor molecule that is modified in the liver and kidneys

• May be required in the diet if a person is exposed to very little ultraviolet light

• All of the choices are correct

Multiple Choice

One of the participants in nutrition class asked a student nurse regarding Vitamin D synthesis. Which statement of the student nurse was correctly stated?

• “vitamin d enters the body through the skin”

• “sunlight is the only source of

  vitamin d”

• “ultraviolet light stimulates the skin to synthesize vitamin d”

• “skin facilitates absorption of vitamin d”

Vitamin D Production

• 1.UV light causes the skin to produce a precursor  molecule of vitamin D.

• 2.The precursor molecule is carried by the blood to the liver where it is enzymatically converted.

• 3.The enzymatically converted molecule is carried by the blood to the kidneys where it is converted again to the active form of vitamin D.

• 4.Vitamin D stimulates the small intestine to absorb calcium and phosphate for many body functions.

Excretion

• The integumentary system plays a minor role in excretion, the removal of waste products from the body.

• In addition to water and salts, sweat contains small amounts of waste products, such as urea, uric acid, and ammonia.

• Even though the body can lose large amounts of sweat, the sweat glands do not play a significant role in the excretion of waste products.

Multiple Choice

In third-degree (full-thickness) burns, both the epidermis and the dermis are destroyed. Which of the following conditions does not occur as a result of a third-degree burn?

• dehydration (increased water loss)

• increased likelihood of infection

• increased sweating

• loss of sensation in the burned area

• poor temperature regulation in the burned area

Multiple Choice

Chef Sofia suffered a burn on her arm when a kettle of spaghetti sauce exploded. The doctor, using forceps, pulls on hair within the area that is burned. The hair easily pulls out. What degree of burn did the patient have?

• First-degree burn

• Second-degree burn

• Third-degree burn

• None of the choices

Multiple Choice

One of the most immediate life threatening results of burns to large areas of the body is?

• Decreased permeability of remaining capillaries in damaged area

• Dangerously high systemic blood pressure

• Decreased systemic blood pressure and development of cardiovascular shock

• Depression of overall metabolic rate

• Total suppression of immune system

Multiple Choice

Malignant Melanoma?

• Is the least dangerous form of skin cancer

• Usually arises from melanocytes in a preexisting mole

• Rarely metastasizes

• Is the most common type of skin cancer

• Is the least dangerous form of skin cancer & usually arises from melanocytes in a preexisting mole

Multiple Choice

Which of the following is NOT a characteristics of aging of the integumentary system?

• Loss of elastic fibers of the skin

• Increase in activity of sweat glands and sebaceous glands

• Decreased number of melanocytes

• Loss of pigment of hair

• Skin become thinner and more transparent

Open Ended

AFTER PASSING THE ANAPHY. WHAT WOULD BE THE 1ST REWARD THAT WILL GIVE TO YOURSELF?