medical terminology slides - the skin

8/10/2019 Medical Terminology Slides - The skin

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Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chapter 21:The Skin




Learning Objectives• Define and list the functions of the integumentary system.• Compare the location and structure of the epidermis,

dermis, and subcutaneous tissues.• Describe the roles of keratin and melanin in the skin.• Name and describe the glands in the skin.• Describe the structure of hair and of nails.• Identify and use roots pertaining to the skin.• Describe the main disorders that affect the skin.• Interpret abbreviations used in the study and treatment of

the skin.




Pretest

1. The uppermost portion of the skin is called the :

(a) fossa

(b) cuticle

(c) epidermis

(d) epiphysis




Pretest

2. A hair grows within a sheath called the :

(a) follicle

(b) hyaline

(c) fascia

(d) vesicle


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Pretest

3. The glands that secrete an oily substance that lubricatesthe skin are the :

(a) sweat glands

(b) sebaceous glands

(c) mammary glands

(d) foramina



Pretest

3. The glands that secrete an oily substance that lubricatesthe skin are the :

(a) sweat glands

(b) sebaceous glands

(c) mammary glands

(d) foramina



Pretest

4. The rule of nines is a system used to evaluate:

(a) burns

(b) fever

(c) inflammation

(d) immunity



Pretest

5. A pigmented skin tumor is a(n):

(a) chondrosarcoma

(b) melanoma

(c) lymphoma

(d) adenoma



Pretest

6. The root hidr/o pertains to:

(a) tears

(b) saliva

(c) blood

(d) sweat



Pretest

7. Onychomycosis is a fungal infection of a(n):

(a) eyelid

(b) nail

(c) hair

(d) bone



Roots Pertaining to the Skin

Root Meaning Example Definition of Example

derm/o,dermat/o

skin dermabrasion surgical procedure used to resurfacethe skin and remove imperfections

kerat/o keratin, hornylayer of the skin

keratinous containing keratin; horny

melan/o dark, black,melanin

melanosome a small cellular body that producesmelanin

hidr/o sweat,

perspiration

anhidrosis absence of sweating

seb/o sebum,sebaceous gland

seborrhea excess flow of sebum

trich/o hair trichomycosis fungal infection of the hair

onych/o nail onychia inflammation of the nail and nail bed



Anatomy of the Skin

• Skin is part of integumentary system

• Epidermis is the outermost layer

–

Four to five layers of epithelial cells– Stratum basale

• Deepest layer of epidermis

• Produces new skin cells

• New skin cells gradually rise to surface

• As skin cells rise:

• Cells die

• Cells fill with keratin



Anatomy of the Skin (cont’d)

– Stratum corneum is the outermost layer of epidermis

•

Flat, dead, protective cells• Constantly shed and replaced

• Some cells produce melanin

•

Gives color to skin• Protects against sunlight



Dermis and Subcutaneous Tissue• Dermis is the layer beneath epidermis

– Connective tissue

– Nerves– Blood vessels

– Lymphatics

–

Supports and nourishes skin• Subcutaneous tissue is the layer beneath dermis

– Connective tissue

– Fat




Cross Section of the Skin





Associated Skin Structures

• Sudoriferous glands (sweat glands)

–

Regulate temperature– Release watery fluid (sweat)

– Sweat evaporates cooling the body

•

Sebaceous glands– Release sebum (oily fluid)

– Lubricates hair and skin to prevent drying




Associated Skin Structures (cont’d) • Hair

– Nonliving material, mainly keratin

– Develops within follicle– Grows from base within deep layers of skin

– Functions as protection

• Nails– Nonliving material, mainly keratin

– Develops from growing region at proximal end

– Functions as protection




Key TermsNormal Structure and Function

Term Meaning

cutaneous Pertaining to the skin (from Latin cutis , meaning “skin”)

derma Skin (from Greek) dermis The layer of the skin between the epidermis and the

subcutaneous tissue; the true skin or corium

epidermis The outermost layer of the skin (from epi -, meaning “upon or over”and derm , meaning “skin”)

hair A threadlike keratinized outgrowth from the skin (root: trich/o )

hair follicle The sheath in which a hair develops

integumentary system The skin and its associated glands, hair, and nails

keratin A protein that thickens and toughens the skin and makes up hairand nails (root: kerat/o )




Key TermsNormal Structure and Function (cont’d)

Term Meaning

melanin A dark pigment that gives color to the hair and skin and protects theskin against the sun's radiation (root: melan/o )

nail A plate-like keratinized outgrowth of the skin that covers the dorsalsurface of the terminal phalanges (root: onych/o )

sebaceous gland A gland that produces sebum; usually associated with a hair follicle(root: seb/o )

sebum A fatty secretion of the sebaceous glands that lubricates the hair and

skin (root: seb/o )

skin The tissue that covers the body; the integument (root: derm/o,dermat/o )

subcutaneous tissue The layer of tissue beneath the skin; also called the hypodermis

sudoriferous gland A sweat gland (root: hidr/o )




Clinical Aspects of the Skin

• Dermatology is the study of skin and skin diseases

•

Observation of skin, hair, nails part of every physicalexamination

– Skin observed for color, unusual pigmentation,lesions

– Palpated to evaluate texture, temperature, moisture,firmness, tenderness




Wounds

• Caused by:

– Trauma

– Surgery

• Complicated by:

– Infection

– Hemorrhage

– Dehiscence is a disruption of wound layers

– Evisceration is the protrusion of internal organs throughlesion




Wound Healing

• As wound heals:

–

Fluid and cells drain from damaged tissue– Exudate may be:

• Clear

• Bloody• Pus-containing




Wound Healing (cont’d)

• Proper wound healing:

– Cleanliness and care of lesion

– Proper circulation

– Good general health and nutrition

– Accompanied by cicatrization (scar formation)




Promotion of Healing

• Vacuum-assisted closure uses negative pressure to closetissues

• Debridement is the removal of dead or damaged tissue

– Cutting or scrubbing

– Enzymes

– Escharotomy (removal of scar)




Promotion of Healing (cont’d)

• Skin graft

– For deep wounds

– Full thickness skin graft (FTSG)

• Epidermis and dermis

– Split-thickness skin graft (STSG)

• Epidermis

– Done with dermatome




Burns• Caused by:

– Hot objects

– Explosions

– Scalding

– Electrical malfunctions

– Contact with harmful chemicals

– Abrasion• Assessed by:

– Depth of damage

– Percentage of body surface area affected




Burn Categorization• Superficial involves the epidermis only

– Skin is red and dry; there is minimal pain

• Superficial partial thickness

– Involves epidermis, and a portion of the dermis

– Tissue reddens, may blister and is painful

• Deep partial thickness

– Involves epidermis and dermis

– Tissue blisters, has weeping surface and may be lesspainful because of nerve damage




Burn Categorization (cont’d)

• Full thickness

– Involves full skin, possibly subcutaneous tissue

– Broken, dry, and pale or charred tissue

– May result in loss of digits or limbs

– May require skin grafting




Burn Categorization (cont’d)

• Percentage of body surface area

– Rule of nines

• Areas of body surface assigned percentages inmultiples of nine

– Lund and Browder

• More accurate

• Divides body into small areas

• Estimates proportion each area contributes




Burn Treatment• Includes:

– Respiratory care

– Administration of fluids

– Wound care

– Pain control

– Monitoring for complications• Infections

• Cardiovascular

• Respiratory

• Posttraumatic stress




Pressure Ulcers

• Necrotic skin lesions• Body resting on skin covering bony projections

– Sacrum– Heel– Elbow– Ischial bone of pelvis– Greater trochanter of femur




Pressure Ulcers (cont’d)

• Interrupts circulation– Thrombosis– Ulceration– Death of tissue

• Contributing factors:– Malnutrition– Age– Obesity– Infection





• Progression

– First appear as redness of skin

– If ignored may penetrate:

• Skin

• Underlying muscle

• Bone

– May require months to heal





• Prevention

– Pads or mattresses to relieve pressure

– Regular cleansing and drying of skin

– Frequent change in position

– Good nutrition




Dermatitis

• Inflammation of skin

• Example: Atopic dermatitis (eczema)

– Chronic allergic form

– Exact cause unknown, but made worse by:• Allergies

• Infection

• Temperature extremes

• Skin irritants




Dermatitis (cont’d)

• Other forms:

– Contact dermatitis

– Seborrheic dermatitis

– Stasis dermatitis




Autoimmune Disorders

• Pemphigus– Characterized by formation of blisters

• Occurs in skin and mucous membranes• Caused by separation of epidermal cells from

underlying layers

– Deep skin unprotected from infection and fluid loss– Caused by autoimmune reaction– Fatal unless immune system is suppressed




Autoimmune Disorders (cont’d) • Lupus Erythematosus

– Chronic inflammatory autoimmune disease of connectivetissue

• Discoid• Involves only the skin

• Systemic lupus erythematosus• Involves skin and other organs

– Symptoms• Rough, raised, violet-tinted papules• Worsened by exposure to UV rays




Scleroderma

• Thickening and tightening of skin

• Unknown cause

• Overproduction of collagen

• Involves hair follicles and sweat glands

• Early signs:

– Raynaud disease

– Skin symptoms first appear on forehead, aroundmouth




Skin Cancer

• Most common type of human cancer

•

Increasing rate due to UV rays• Common types

– Squamous cell carcinoma–

Basal cell carcinoma– Malignant melanoma– Kaposi sarcoma




Skin Cancer (cont’d)

• Squamous cell carcinoma– Cancer of epithelial cell

•

Occurs in areas exposed to sunlight• Painless, firm red nodule• May invade underlying tissue• Tends not to metastasize• Treatment

• Surgical removal• X-irradiation• Chemotherapy





• Basal cell carcinoma– 75 percent of all skin cancers– Cancer of epithelial cell

• Occurs in areas exposed to sunlight• Smooth, pearly papule• After excision, cure rate 95 percent

•

Easily seen• Tends not to metastasize





• Malignant melanoma– Overgrowth of melanocytes

– Metastasizing tendency

– First appears as lesion

– May spread superficially before invading deeper tissues

– Prognosis good if lesion removed before reaching deepertissues





• Kaposi sarcoma

– Frequently associated with AIDS

– Distinct brownish area on legs

– As tumor progresses:

• Plaques become raised and firm

– Cancer can metastasize




Key TermsDisorders

Term Meaning

atopic dermatitis Hereditary, allergic, chronic inflammation of the skin with pruritus(itching); eczema

basal cellcarcinoma

An epithelial tumor that rarely metastasizes and has a high cure ratewith surgical removal

cicatrization The process of scar formation; a scar is a cicatrix

debridement Removal of dead or damaged tissue, as from a wound

dehiscence Splitting or bursting, as when the layers of a wound separate

dermatitis Inflammation of the skin, often associated with redness and itching;may be caused by allergy, irritants (contact dermatitis), or a variety ofdiseases

dermatology Study of the skin and diseases of the skin

dermatome Instrument for cutting thin sections of skin for skin grafting




Key TermsDisorders (cont’d)

Term Meaning

eczema A general term for an inflammation of the skin with redness, lesions,and itching; atopic dermatitis

erythema Diffuse redness of the skin

escharotomy Removal of scab tissue (eschar) resulting from burns or other skininjuries

evisceration Protrusion of internal organs (viscera) through an opening, as througha wound

exudates Material, which may include fluid, cells, pus, or blood, that escapesfrom damaged tissue

Kaposi sarcoma Cancerous lesion of the skin and other tissues seen most often inpatients with AIDS

keloid A raised, thickened scar caused by tissue overgrowth during scarformation





Term Meaning

lupuserythematosus (LE)

A chronic, inflammatory, autoimmune disease of connective tissuethat often involves the skin; types include the more widespreadsystemic lupus erythematosus (SLE) and a discoid form (DLE) thatinvolves only the skin

malignantmelanoma

A metastasizing pigmented tumor of the skin

pemphigus An autoimmune disease of the skin characterized by sudden,intermittent formation of bullae (blisters); may be fatal if untreated

pressure ulcer An ulcer caused by pressure to an area of the body, as from a bed orchair; decubitus ulcer, bedsore, pressure sore

pruritus Severe itching





Term Meaning

psoriasis A chronic hereditary dermatitis with red lesions covered by silveryscales

rule of nines A method for estimating the extent of body surface area involved in aburn by assigning percentages in multiples of nine to various regionsof the body

scleroderma A chronic disease that is characterized by thickening and tightening

of the skin and that often involves internal organs in a form calledprogressive systemic sclerosis (PSS)

squamous cellcarcinoma

An epidermal cancer that may invade deeper tissues but tends not tometastasize




Supplementary TermsSymptoms and Conditions

Term Meaning

acne An inflammatory disease of the sebaceous glands and hair folliclesusually associated with excess secretion of sebum; acne vulgaris

actinic Pertaining to the effects of radiant energy, such as sunlight, ultravioletlight, and x-rays

albinism A hereditary lack of pigment in the skin, hair, and eyes

alopecia Absence or loss of hair; baldness

Beau lines White lines across the fingernails; usually a sign of systemic diseaseor injury

bromhidrosis Sweat that has a foul odor because of bacterial decomposition; alsocalled bromidrosis

carbuncle A localized infection of the skin and subcutaneous tissue, usuallycaused by staphylococcus, and associated with pain and discharge ofpus




Supplementary TermsSymptoms and Conditions (cont’d)

Term Meaning

comedo A plug of sebum, often containing bacteria, in a hair follicle; ablackhead (plural: comedones)

dermatophytosis Fungal infection of the skin, especially between the toes; athlete'sfoot (root: phyt/o means “plant”)

diaphoresis Profuse sweating

dyskeratosis Any abnormality in keratin formation in epithelial cells

ecchymosis A collection of blood under the skin caused by leakage from smallvessels

erysipelas An acute infectious disease of the skin with localized redness andswelling and systemic symptoms

erythema nodosum Inflammation of subcutaneous tissues resulting in tender,erythematous nodules; may be an abnormal immune response to asystemic disease, an infection, or a drug





Term Meaning

exanthema Any eruption of the skin that accompanies a disease, such as measles;a rash

excoriation Lesion caused by scratching or abrasion

folliculitis Inflammation of a hair follicle

furuncle A painful skin nodule caused by staphylococci that enter through a hairfollicle; a boil

hemangioma A benign tumor of blood vessels; in the skin, called birthmarks or portwine stains

herpes simplex A group of acute infections caused by herpes simplex virus. Type Iherpes simplex virus produces fluid-filled vesicles, usually on the lips,after fever, sun exposure, injury, or stress; cold sore, fever blister. TypeII infections usually involve the genital organs

hirsutism Excessive growth of hair





Term Meaning

ichthyosis A dry, scaly condition of the skin (from the root ichthy/o , meaning“fish”)

impetigo A bacterial skin infection with pustules that rupture and form crusts;most commonly seen in children, usually on the face

keratosis Any skin condition marked by thickened or horny growth. Seborrheickeratosis is a benign tumor, yellow or light brown in color, thatappears in the elderly. Actinic keratosis is caused by exposure tosunlight and may lead to squamous cell carcinoma

lichenification Thickened marks caused by chronic rubbing, as seen in atopicdermatitis (a lichen is a flat, branching type of plant that grows onrocks and bark)

mycosis fungoides A rare malignant disease that originates in the skin and involves theinternal organs and lymph nodes. There are large, painful, ulceratingtumors





Term Meaning

nevus A defined discoloration of the skin; a congenital vascular tumor of theskin; a mole, birthmark

paronychia Infection around a nail. Caused by bacteria or fungi, and may affectmultiple nails

pediculosis Infestation with lice

petechiae Flat, pinpoint, purplish red spots caused by bleeding within the skin ormucous membrane (singular, petechia)

photosensitization Sensitization of the skin to light, usually from the action of drugs, plantproducts, or other substances

purpura A condition characterized by hemorrhages into the skin and othertissues

rosacea A condition of unknown cause involving redness of the skin, pustules,and overactivity of sebaceous glands, mainly on the face





Term Meaning

scabies A highly contagious skin disease caused by a mite

senile lentigines Brown macules that appear on sun-exposed skin in adults; liver spots

shingles An acute eruption of vesicles along the path of a nerve; herpes zoster(HER- pēz ZOS-ter); caused by the same virus that causeschickenpox

tinea A fungal infection of the skin; ringwormtinea versicolor Superficial chronic fungal infection that causes varied pigmentation of

the skin

urticaria A skin reaction marked by temporary, smooth, raised areas (wheals)associated with itching; hives





Term Meaning

venous stasis ulcer

Ulcer caused by venous insufficiency and stasis of venous blood;usually forms near the ankle

verruca An epidermal tumor; a wart

vitiligo Patchy disappearance of pigment in the skin; leukoderma

xerodermapigmentosum

A fatal hereditary disease that begins in childhood with discolorationsand ulcers of the skin and muscle atrophy. There is increasedsensitivity to the sun and increased susceptibility to cancer




Supplementary TermsDiagnosis and Treatment

Term Meaning

aloe A gel from the leaves from the plant Aloe vera that is used intreatment of burns and minor skin irritations

antipruritic Agent that prevents or relieves itchingcautery Destruction of tissue by physical or chemical means; cauterization;

also the instrument or chemical used for this purpose

dermabrasion A plastic surgical procedure for removing scars or birthmarks bychemical or mechanical destruction of epidermal tissue

dermatoplasty Transplantation of human skin; skin grafting




Abbreviations

BSA Body-surface area

DLE Discoid lupus erythematosus

FTSG Full-thickness skin graft

LE Lupus erythematosus

PSS Progressive systemic sclerosis

PUVA Psoralen ultraviolet A

SCLE Subacute cutaneous lupus erythematosus




Abbreviations (cont’d)

SLE Systemic lupus erythematosus

SPF Sun protection factor STSG Split-thickness skin graft

UV Ultraviolet

UVA Ultraviolet A

UVB Ultraviolet B

VAC Vacuum-assisted closure



Post Test

1. The abbreviation BSA means body surface area .

2. The main pigment in the skin is melanin .

3. A hypodermic injection is given under the skin .

4. Lupus erythematosus is a chronic inflammatoryautoimmune disease of the connective tissue.

5. Dermatology is the study of the skin and diseases of theskin.

medical terminology slides - the skin

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