hello and welcome to the second part of the lecture on integumentary system this is Dr Stewart and I'll be stepping you through this part so let's get going there are two Medical Specialties related to the integumentary system Dermatology or Derm is the branch of medicine involving diagnosis and treatment of conditions and diseases of the integumentary system a physician who studies Dermatology is called a dermatologist plastic surgery is a Surgical Specialty involved in the repair reconstruction or Improvement of body structures such as the skin these structures have been damaged missing or misshapen The Physician for this specialty is called a plastic surgeon the following slides describe some of the signs and symptoms of injury or pathology of the integumentary system an abrasion is a scraping away of the Skin's Surface by friction imagine that you're riding a bike and you fall off and you scrape your elbow along the concrete below that's an abrasion and hydrosis is a very serious condition in which the body does not produce enough sweat this is very dangerous In the Heat of the summer when the body cannot naturally lower its temperature by sweating Ebola is a large blister a Commodore is a collection of hardened sebum and a hair follicle it's also commonly known as a blackhead a contusion is an injury caused by a blow to the body it causes swelling pain and bruising however the skin remains con intact a cyst is a fluid-filled Sac under the skin the difference between a cyst and an abscess is that the fluid and assist is not infected here's a simple illustration of a cyst depigmentation is the loss of normal skin color or pigment diaphorous is profuse sweating this is the kind of sweating you see when someone is having a heart attack ecchymosis is skin discoloration caused by Blood collecting under the skin after blunt trauma to the skin it's the medical term for a bruise erythema is redness or flushing of the skin erythroderma is the condition of having reddened or flushed skin escar is a thick layer of dead tissue and tissue fluid that develops over a deep burn area or a deep decubitus ulcer on this slide is a photograph of a male lying supine with a large ecchymosis on his left lateral ribcage and shoulder you can see that there is multiple colors in the bruise itself usually it is understood that as a bruise ages it becomes more yellow you can bet that this particular ecchymosis hurt a lot a fissure is a crack like lesion or groove on the skin here's sutism is excessive hair growth over the body hyperemia is the redness of the skin due to increased blood flow hyperhidrosis literally means abnormal condition of excessive sweat this should not be confused with diaphoresis hyperhidrosis is a chronic condition while diaphoresis is not hyperpigmentation is an abnormal amount of pigmentation in the skin a lesion is a general term for a wound injury or abnormality of the skin for example a scar is a lesion because you were not born with it already on your skin also a tattoo is considered a lesion on this slide is a simple illustration of a fissure leukoderma is having skin that appears white because the normal skin pigment is absent it may be isolated to some areas of the skin or it may affect all of the skin this should not be confused with albinism which we'll discuss in a little bit a lipoma is a fatty Mass immacula is a flat discolored area that is flush with the surface of the skin an example of a macule is a freckle necrosis is an abnormal condition of death it usually refers to cell or tissue death anivis is a pigmented skin blemish birthmark or mole it is usually benign but it may become cancerous a nodule is a firm solid mass of cells and the skin larger than 0.5 centimeters in diameter a nicomalacia is a softening of the nails this slide depicts a macule notice how the macule is flush with the skin here is an illustration of a nodule pallor refers to an abnormal pillness of the skin a papule is a small solid circular raised spot on the skin it's less than 0.5 centimeters petechiae are pinpoint purple or red spots from minute hemorrhages under the skin photosensitivity is a condition in which the skin reacts abnormally when it's exposed to light Puritas is severe itching note the correct spelling of this term as it's often misspelled purpura are hemorrhages into the skin due to fragile blood vessels it's not uncommon to see those in older adults and persons who are taking a blood thinner this slide depicts a papule this slide shows a photograph of purpura purpura is hemorrhaging into the skin due to fragile blood vessels it's very common among the elderly and also individuals who are taking blood thinners purulent means containing pus or an infection that's producing pus pus is made up of dead bacteria white blood cells and tissue debris bustule is a raised spot on the skin that contains pus oderma signifies the presence of pus on or in the layers of the skin and it's a sign of bacterial infection Scleroderma is a condition in which the skin has lost its elasticity and becomes hardened Sabria means oily discharge superlative means containing or producing pus an ulcer is an open sore or lesion in the skin or mucous membrane this illustration depicts a pustule on this slide we have an illustration of an ulcer urticaria is commonly known as hives it's a skin eruption of pale reddish Wheels with severe itching it's usually associated with a food allergy with stress or with the drug reaction a vesicle is also known as a blister it's a small fluid-filled raised spot on the skin a wheel is a small round swollen area on the skin it's typically seen in allergic skin reactions such as hives it's usually accompanied by urticaria seroderma is a condition in which the skin is abnormally dry this illustration depicts a vesicle here is a drawing of a wheel to pause for just a minute to practice building the terms for two of the signs and symptoms we just discussed consider the term erythroderma which means condition of having red skin the combining form erythro means red and the suffix Derma means skin in this term the combining vowel is retained because the suffix begins with a consonant now let's look at annikomalacia which means softening of the nail the combining form anico means nail and the suffix malacia means softening because the suffix begins with a consonant the combining vowel o is kept before the word root and the suffix let's move on to pathology terms specific to the skin an abscess is a collection of pus under the skin acne is an inflammatory disease of the sebaceous glands and hair follicles that result in papules and pustules there are two types of acne acne rosacea is a chronic form of adult acne that involves redness tiny pimples and broken blood vessels primarily on the nose and cheeks acne vulgaris is a common form of acne seen in teenagers that's characterized by comedos papules and pustules albinism is a genetic condition in which the body is unable to make any melanin milky white skin and hair characterize this condition as do eyes that appear red or pink albinism can occur in any ethnicity basal cell carcinoma is a cancerous tumor that occurs in the basal cell layer of the epidermis is a frequent type of skin cancer that rarely spreads these cancers often occur on sun Exposed Skin a burn is damaged to the skin as a result of exposure to open fire electricity caustic chemicals or ultraviolet light from the sun the seriousness of a burn depends upon the amount of body surface involved and the depth of the ver the burn as determined by the damage to each skin layer burns are categorized as superficial partial thickness or full thickness the extent of a burn is estimated using the rule of nines this slide shows a photograph of a basal cell carcinoma remember these carcinomas are frequent but they rarely metastasize to other parts of the body this slide compares the level of skin damage as a result of the three different degrees of burns beginning at the top of the figure and moving down we see a superficial or first degree burn a partial thickness or second degree burn and a full thickness or third degree burn on this slide is demonstrated the rule of nines it's a method for determining the percentage of the body burned each different color-coded section represents a percentage of the body surface when all the sections are added together then you get 100 percent for example if the entire left arm is burned then the burn covers nine percent if the entire back is burned and the back of the head is burned then 27 percent of the body is burned cellulitis is a diffuse acute infection and inflammation of the connective tissue found in the skin the term psychatrix refers to a normal scar a decubitus ulcer is an open sore caused by pressure under bony prominences this cuts off the blood supply to the overlying skin these can appear in patients who are bedridden and lie in one position for too long making it difficult for the source to heal that is why decubitus ulcers are sometimes called bed sores or pressure sores dermatitis is inflammation of the skin there are many different causes and types of dermatitis the doctor will try to identify the cause in order to correctly treat the dermatitis however dermatitis can be used alone as a diagnosis if the calls can't be determined dermatosis is a general term that indicates that there is abnormal skin condition present dry gangrene is the term used for the late stages of gangrene the affected area becomes dead blackened and shriveled skin in this state is sometimes referred to as being mummified eczema is a superficial dermatitis characterized by redness vesicles itching and crusting gangrene is tissue necrosis usually due to deficient blood flow ichthyosis is a condition in which the skin becomes dry scaly and keratinized impetigo is a highly infectious bacterial infection of the skin it has pustules that rupture then crust over sarcoma is a form of skin cancer frequently seen in AIDS patients brownish purple papules spread from the skin to internal organs here's a photograph of the highly contagious impetigo a keloid is a thickened raised scar these can get very large they don't cause any actual harm but they can be unsightly keratosis is a term for any skin condition that involves an overgrowth and thickening of the epidermis layer a laceration is a torn or Jagged wound a malignant melanoma is a dangerous form of skin cancer caused by an uncontrolled growth of melanocytes it can spread rather quickly to internal organs pediculosis is a lice infestation the eggs laid by the lice are called nits and cling tightly to hair lice are the parasites they can occur anywhere on the body where hair is found head lice are notoriously contagious among school kids psoriasis is a chronic inflammation condition with papules forming silvery scale patches with circular borders this illustration depicts a keloid this is a picture of a malignant melanoma you notice that it has a highly characteristic color associated with it rubella is a contagious viral skin infection it's also commonly called German Measles scabies is a contagious skin disease caused by a Mite infestation the mites burrow through the skin and cause redness and intense itching a sebaceous cyst is a sebum filled Sac under the skin squamous cell carcinoma is a cancer of the epidermis layer of the skin it may invade deeper tissue and spread it often begins as a store that doesn't heal a Strawberry Hemangioma is a congenital collection of dilated blood vessels causing a red birthmark here's a photograph of a squamous cell carcinoma systemic lupus erythematosus is a chronic disease of the connective tissue that injures the skin joints kidneys nervous system and mucous membranes it is an autoimmune condition which means the body's own immune system attacks the normal body tissue it can produce a characteristic red scaly butterfly rash across the nose and cheeks tinea is a fungal skin disease that results in itching and scaling lesions there are two common types of tinea tinea capitis is a fungal infection of the scalp it is commonly called ringworm tinea Pettis is a fungal infection of the foot it's commonly knows as athlete's foot varicella is a contagious viral infection it's called the chickenpox Veruca is the medical term for a wart it's a benign growth caused by a virus this slide shows a photograph of varicella or chickenpox in this Photograph you can see that the rash is beginning to form scabs Vitiligo is The Disappearance of pigment from the skin in patches this causes a milk-white appearance also called leukoderma wet gangrene is an area of gangrene that has become secondarily infected by pus-producing bacteria now let's move on to pathology of the hair alopecia is the absence or loss of hair especially on the head it's commonly called baldness the term itself does not tell the reason for the baldness however it may apply to men or to women a carbuncle is a foruncle involving several hair follicles a farunco is a bacterial infection of a hair follicle it's characterized by redness pain and swelling it's commonly called a boil trichomycosis is a fungal infection of the hair there are also pathology terms specific to the nails for example a Nikia is an infected nail bed onychomycosis is a fungal infection of the nail onycophagia literally means nail eating it's more commonly referred to as nail biting paronychia is an infection of the skin fold around the nail let's consider how some of the newly learned pathology terms are built dermatitis is inflammation of the skin it's built from the combining form dermato meaning skin and the suffix itis meaning inflammation the combining vowel is dropped because the suffix begins with a vowel trichomycosis is an abnormal condition of hair fungus the term has two roots and one suffix the combining form tricho means hair the combining form Myco means fungus and the suffix osis means abnormal condition the combining vowel is used between the two word roots but is dropped between the second word root and the suffix because the suffix already contains the beginning of a vowel a variety of diagnostic tests can be used to determine the cause of various skin conditions a Clinical Laboratory test that's often used is a culture and sensitivity this test grows up colony of bacteria removed from an infected area in order to identify the bacteria once the bacteria are identified clinicians can determine the correct antibiotic to prescribe biopsy procedures are another important diagnostic tool for treating skin conditions a biopsy is the removal of a piece of tissue by a syringe and needle a knife a punch or a brush to examine under a microscope an excisional biopsy goes farther than a regular biopsy because it removes an entire suspicious area of tissue for examination exfoliative cytology is the scraping of cells from tissue to examine under a microscope a frozen section is a thin piece of tissue cut from a frozen specimen for Rapid examination under a microscope fungal scrapings are scrapings of tissue from lesions that are taken with a curette or scraper the scrapings are cultured and examined under a microscope to identify fungal growth now let's look at building diagnostic terms the combining form bio means life and the suffix opsy means view therefore biopsy literally translates as view of Life the combining vowel is not needed because the suffix begins with a vowel the combining form cyto means cell and the suffix logee means study of hence cytology is the study of cells the combining vowel is used here because the suffix begins with a consonant let's move on with therapeutic procedures the first type of therapeutic procedure we'll discuss is skin grafting a skin graft is a transplant of skin from a normal area to a damaged site an allograft is a skin graft from one person to another the donor is usually a cadaver the term allograft is interchangeable with homograph an autograft is a skin graft from a person's own body it is a piece of skin taken from one part of the body to another part an instrument used for cutting skin or for producing thin skin transplants is called the dermatome skin grafting is also called dermatoplasty this is a photograph of a freshly applied autographed it looks as though gauze is stretched over the area however that is the donor skin the donor skin has been perforated so that a small piece of skin can be stretched to cover a larger area a spin graft abbreviated SG is the transfer of skin from a normal area to cover another site it's used to treat burn victims and after some surgical procedures a xenograft or heterograft is a skin graft from an animal or another species to a human donor animals are usually pigs surgical procedures may also be used to treat skin conditions cauterization is a destruction of tissue by using caustic chemicals electric currents or heat or even by freezing cryosurgery is the use of extreme cold to freeze and Destroy tissue curettage is the removal of superficial skin lesions with a scraper or a curette which is a surgical instrument shaped like a spoon debridement is a removal of foreign material and dead or damaged tissue from a wound electrocautery is the use of an electric current to destroy tissue an incision in drainage is the process of making an incision to create an opening for the drainage of material such as pus anikectomy is a surgical removant of a nail some surgical procedures on the scan are classified as plastic surgery one type of plastic surgery is chem abrasion commonly called a chemical peel it abrasively removes the epidermal layer of skin with chemicals dermabrasion is abrasion or rubbing using wire brushes or sandpaper it's performed to remove acne scars scar tissue and tattoos laser therapy is a removal of lesions with a laser beam liposuction is a removal of fat beneath the skin by by means of suction righteectomy a surgical removal of wrinkles it's commonly called a facelift let's look at how some of the surgical terms are built dermatoplasty means surgical repair of skin the combining form dermato that means skin and the suffix plasti means surgical repair of the combining vowel is retained because the suffix begin with with a consonant onachectomy is surgical removal of a nail the combining form anico means nail and the suffix ectomy means surgical removal the combining vowel is not used here because the suffix begins with a vowel now let's look at medications used in association with the integumentary system an anesthetic is applied to the skin to deaden pain some examples are lidocaine and procaine an antibiotic is used to kill bacteria that cause skin infections an example is Neosporin an anti-fungal is used to kill fungi infecting the skin examples are miconazole and clotrimazole an anti-parasitic is used to kill mites or lice examples are quell and Nyx an antipuretic reduces severe itching examples include Benadryl and Caladryl an antiseptic is used to kill bacteria in skin cuts and wounds or at a surgical site examples are isopropyl alcohol and hydrogen peroxide cortical steroid creams are powerful anti-inflammatory creams that contain a hormone examples are chordate and Kenalog finally this slide and the two that follow list some integumentary system abbreviations that you should know pound side refers to number or quantity of something BCC basal cell carcinoma bid two times a day BX biopsy CNS culture and sensitivity the cube decubitus ulcer Derm Dermatology FS frozen section I and D incision and drainage ID intradermal mm malignant melanoma oint ointment qid four times a day SCC squamous cell carcinoma SG skin graft SLE systemic lupus erythematosus stsg split thickness skin graft suvc or suvq subcutaneous tid three times a day UV ultraviolet X refers to times congratulations you've reached the end of this lecture be sure to watch any additional lectures on this topic and of course you're able to return to this lecture anytime you may need a refresher until then thanks for watching