Chapter 5 - Medical Terminology (Rice)

Learning Outcomes Describe the integumentary system and its accessory structures. List the functions of the skin. Analyze, build, spell, and pronounce medical words. Learning Outcomes Comprehend the drugs highlighted in this chapter. Describe diagnostic and laboratory tests related to the integumentary system. Identify and define selected abbreviations. Multimedia Directory Slide 34 Acne Video Slide 40 Skin Cancer Video Slide 48 Burns Animation Slide 49 Burns Video Slide 58 Decubitus Ulcer Video Slide 68 Eczema Video Slide 75 Inflammation Video Slide 76 Inflammation Animation Slide 111 Wound Repair Animation Slide 112 Wound Care Video Slide 123 TB Testing Video Slide 126 Wound Cultures Video Anatomy and Physiology Overview The integumentary system is composed of the skin and its accessory structures: hair, nails, sebaceous glands, and sweat glands. Functions of the Skin External covering of the body. Largest organ in the body. Supplied with blood vessels and nerves. The four main functions of the skin: Protection Regulation Sensation Secretion Functions of the Skin Protection Protective membrane against invasion by bacteria and other potentially harmful agents. Protects against mechanical injury of delicate cells located beneath outer covering. Functions of the Skin Protection Inhibits excessive loss of water and electrolytes. Provides a reservoir for storing food and water. Guards against excessive exposure to sun’s ultraviolet rays. Helps to produce the body’s supply of vitamin D. Functions of the Skin Regulation To lower body temperature: Blood vessels in the skin dilate, bringing more blood to the surface for cooling by radiation. At the same time, the sweat glands secrete more sweat for cooling by means of evaporation. To raise body temperature: Skin’s blood vessels constrict, allowing more heat-carrying blood to circulate to the muscles and vital organs. Functions of the Skin Sensation The skin contains millions of microscopic nerve endings that act as sensory receptors for pain, touch, heat, cold, and pressure. The nerve endings in the skin are specialized according to the type of sensory information transmitted, and, once this information reaches the brain, it triggers any necessary response. Functions of the Skin Secretion The skin contains millions of sweat glands, which secrete perspiration or sweat, and sebaceous glands, which secrete oil (sebum) for lubrication. Life Span Considerations Before birth, vernix caseosa, a cheeselike substance, covers the fetus. At first, the fetal skin is transparent and blood vessels are clearly visible. In about 13 to 16 weeks, downy lanugo hair begins to develop, especially on the head. Life Span Considerations At 21 to 24 weeks, the skin is reddish,wrinkled, and has little subcutaneous fat. At birth, the subcutaneous glands are developed, and the skin is smooth and pink. Newborns have less subcutaneous fat than adults; therefore, they are more sensitive to heat and cold. Layers of the Skin The skin is essentially composed of two layers, the epidermis and the dermis. Layers of the Skin Epidermis Outer layer of skin, thinnest on the eyelids and thickest on the palms and soles. Divided into five strata: Stratum germinativum Stratum spinosum Stratum granulosum Stratum lucidum Stratum corneum Figure 5.1 The integument: the epidermis, dermis, subcutaneous tissue, and its appendages. Layers of the Skin Dermis Sometimes called the corium or true skin. Composed of connective tissue containing lymphatics, nerves and nerve endings, blood vessels, sebaceous and sweat glands, elastic fibers, and hair follicles. Attached to underlying structures by subcutaneous tissue that supports, nourishes, insulates, and cushions the skin. Life Span Considerations As a person ages, the skin becomes looser as the dermal papilla becomes thinner. Collagen and elastic fibers of the upper dermis decrease and skin loses its elastic tone and wrinkles more easily. Layers of the Skin Dermis Upper or Papillary Layer Arranged into parallel rows of microscopic structures called papillae which produce ridges that are one’s fingerprints or footprints. Lower or Reticular Layer Composed of white fibrous tissue that supports the blood vessels. Accessory Structures of the Skin Hair A thin, threadlike structure formed by a group of cells that develop within a hair follicle or socket. Each hair is composed of a shaft, which is the visible portion, and a root, which is embedded within the follicle. Accessory Structures of the Skin Hair At the base of each follicle is a loop of capillaries, enclosed within connective tissue, called the hair papilla. The pilomotor muscle attaches to the side of each follicle. Hair around the eyes, in the nose, and in the ears serves to filter out foreign particles. Figure 5.2 Cross section of skin and a hair follicle. Accessory Structures of the Skin Nails Fingernails and toenails are horny cell structures of the epidermis and are composed of hard keratin. A nail consists of a body, a root, and a matrix or nailbed. The white, crescent-shaped area of the nail is the lunula (little moon). Nail growth may vary with age, disease, and hormone deficiency. Figure 5.3 The fingernail, an appendage of the integument. Life Span Considerations By age 50, approximately half of all people have some gray hair. Scalp hair thins in women and men and becomes dry and often brittle. Life Span Considerations Some older women may have an increase in facial hair due to hormonal changes, and some men may have an increase in hair of the nares (nostrils), eyebrows, or helix of the ear. Nails can flatten and become discolored, dry, and brittle. Accessory Structures of the Skin Sebaceous (oil) glands The oil-secreting glands of the skin. Tiny ducts open into the hair follicles, and their secretion (sebum) lubricates the hair as well as the skin. The amount of secretion is controlled by the endocrine system and varies with age, puberty, and pregnancy. Accessory Structures of the Skin Sudoriferous (sweat) glands These coiled, tubular glands are distributed over the entire surface of the body, with the exception of the margin of the lips, glans penis, and the inner surface of the prepuce. Accessory Structures of the Skin Sudoriferous (sweat) glands The skin contains two types of sweat glands: apocrine sweat glands are located in the armpits, around the nipples, and in the groin. merocrine sweat glands are most numerous in the palms of the hands and soles of the feet. Accessory Structures of the Skin Sudoriferous (sweat) glands The sweat glands secrete sweat, or perspiration, which: helps to cool the body by evaporation. rids the body of waste through the pores of the skin. Figure 5.4 Acne. (Courtesy of Jason L. Smith, M.D.) Audio Pronunciations Acne Acrochordon Actinic dermatitis Albinism Alopecia acr/o chord -on = extremity = cord = pertaining to Figure 5.5 Acne fulminans. (Courtesy of Jason L. Smith, M.D.) Acne Video Click on the screenshot to view a video on the topic of acne. Back to Directory Figure 5.6 Photodermatitis. (Courtesy of Jason L. Smith, M.D.) Figure 5.7 Alopecia areata. (Courtesy of Jason L. Smith, M.D.) Figure 5.8 Male pattern alopecia. (Courtesy of Jason L. Smith, M.D.) Audio Pronunciations Anhidrosis Autograft Avulsion Basal cell carcinoma Figure 5.9 Basal cell carcinoma. (Courtesy of Jason L. Smith, M.D.) Skin Cancer Video Click on the screenshot to view a video on the topic of skin cancer. Back to Directory Life Span Considerations Premalignant and malignant skin lesions increase with aging and with overexposure to the sun. Carcinomas appear frequently on the nose, eyelid, or cheek. Life Span Considerations Basal cell carcinomas (BCC) account for 80 percent of the skin cancers seen in the older adult. These cancers are generally slow growing but should be surgically removed as soon as possible. Audio Pronunciations Bite Boil Bulla Burn Figure 5.10 Brown recluse spider bites. (Courtesy of Jason L. Smith, M.D.) Figure 5.11 Tick bite. (Courtesy of Jason L. Smith, M.D.) Figure 5.12 Flea bites. (Courtesy of Jason L. Smith, M.D.) Figure 5.13 Bulla. (Courtesy of Jason L. Smith, M.D.) Burns Animation Click on the screenshot to view an animation on the topic of burns. Back to Directory Burns Video Click on the screenshot to view a video on the topic of burns. The video may take a moment to begin playing. Back to Directory Figure 5.14 Burn, second degree. (Courtesy of Jason L. Smith, M.D.) Figure 5.15 Characteristics of burns by depth of thermal injury. Audio Pronunciations Callus Candidiasis Carbuncle Causalgia Cellulitis caus -algia = heat = pain Figure 5.16 Candidiasis. (Courtesy of Jason L. Smith, M.D.) Figure 5.17 Carbuncles. (Courtesy of Jason L. Smith, M.D.) Figure 5.18 Cellulitis. (Courtesy of Jason L. Smith, M.D.) Audio Pronunciations Cicatrix Comedo Corn Cryosurgery Audio Pronunciations Cutaneous Cyst Debridement Decubitus ulcer Dehiscence Decubitus Ulcer Video Click on the screenshot to view a video on the topic of decubitus ulcers. The video may take a moment before playing. Back to Directory Figure 5.19 Decubitus ulcer staging. (Courtesy of Sandra Quigley, Children’s Hospital, Boston, MA) Figure 5.19 (continued) Decubitus ulcer staging. (Courtesy of Sandra Quigley, Children’s Hospital, Boston, MA) Figure 5.20 Wound dehiscence, back. (Courtesy of Jason L. Smith, M.D.) Audio Pronunciations Dermabrasion Dermatitis Dermatologist Dermatology Figure 5.21 Dermatitis, poison ivy. (Courtesy of Jason L. Smith, M.D.) Audio Pronunciations Dermatome Dermomycosis Ecchymosis Eczema Erythema FYI To help prevent contact dermatitis with poison ivy, learn to recognize and avoid poison ivy. If in contact with poison ivy, oak, or sumac, wash skin immediately with soap and water to remove oleoresin within 15 minutes of exposure. FYI Oleoresin, the extract of the plant, can be active for 6 months on surfaces such as clothing. Audio Pronunciations Erythroderma Eschar Excoriation Exudate ex- coriat -ion =out = corium = process Figure 5.23 Erythema infectiosum (Fifth disease). (Courtesy of Jason L. Smith, M.D.) Audio Pronunciations Folliculitis Gangrene Herpes simplex Hidradenitis Hives Inflammation Animation Click on the screenshot to view an animation on the topic of inflammation. Back to Directory Audio Pronunciations Hyperhidrosis Hypodermic Icteric Impetigo Integumentary hypo- derm -ic = under = skin = pertaining to Figure 5.27 Impetigo. (Courtesy of Jason L. Smith, M.D.) Audio Pronunciations Intradermal Jaundice Keloid Lentigo Figure 5.28 Keloid. (Courtesy of Jason L. Smith, M.D.) Audio Pronunciations Leukoderma Leukoplakia Lupus Melanocarcinoma Audio Pronunciations Melanoma Miliaria Mole Onychitis Onychomycosis Audio Pronunciations Pachyderma Paronychia Pediculosis Petechiae Audio Pronunciations Rubella Rubeola Scabies Scar Audio Pronunciations Scleroderma Seborrhea Sebum Senile keratosis Skin signs Figure 5.40 Skin signs are objective evidence of an illness or disorder. They can be seen, measured, or felt. Figure 5.40 (continued) Skin signs are objective evidence of an illness or disorder. They can be seen, measured, or felt. Figure 5.40 (continued) Skin signs are objective evidence of an illness or disorder. They can be seen, measured, or felt. Figure 5.40 (continued) Skin signs are objective evidence of an illness or disorder. They can be seen, measured, or felt. Figure 5.40 (continued) Skin signs are objective evidence of an illness or disorder. They can be seen, measured, or felt. Figure 5.40 (continued) Skin signs are objective evidence of an illness or disorder. They can be seen, measured, or felt. Audio Pronunciations Squamous cell carcinoma Striae Subcutaneous Subungual Audio Pronunciations Taut Telangiectasia Thermanesthesia Tinea Trichomycosis Audio Pronunciations Xanthoderma Xanthoma Xeroderma Xerosis Life Span Considerations Skin conditions can be acute or chronic, local or systemic. Dryness (xerosis) and itching (pruritus) are common in older adults. Certain children’s skin conditions are associated with age, such as miliaria in babies and acne in adolescents. Drug Highlights Emollients Substances that are generally oily in nature. Keratolytics Agents that cause or promote loosening of horny (keratin) layers of the skin. Local anesthetic agents Inhibit the conduction of nerve impulses from sensory nerves and thereby reduce pain and discomfort. Drug Highlights Antihistamine agents Act to prevent the action of histamine. Antipruritic agents Agents that prevent or relieve itching Antibiotic agents Agents that destroy or stop the growth of microorganisms Drug Highlights Antifungal agents Agents that destroy or inhibit the growth of fungi and yeast Antiviral agents Agents that combat specific viral diseases Anti-inflammatory agents Agents used to relieve inflammation Drug Highlights Antiseptic agents Agents that prevent or inhibit growth of pathogens Other drugs Retin-A (tretinoin) Rogaine (minoxidil) Botulinum Toxin Type A (Botox Cosmetic) Diagnostic and Lab Tests Tuberculosis Skin Tests Test performed to identify the presence of the Tubercle bacilli. The tine, Heaf, or Mantoux test are used. Diagnostic and Lab Tests Scratch (epicutaneous) or prick test A suspected allergen that causes redness or swelling at the scratch site within 10 minutes indicates allergy to the substance. Sweat Test (chloride) Test performed on sweat to determine the level of chloride concentration on the skin. In cystic fibrosis, there is an increase in skin chloride. Diagnostic and Lab Tests Tzanck Test Microscopic examination of a small piece of tissue that has been surgically scraped from a pustule to identify the type of viral infection. Wound Culture Performed on wound exudate to determine the presence of microorganisms and to identify the specific type. Wound Cultures Video Click on the screenshot to view a video on the topic of wound cultures. Back to Directory Diagnostic and Lab Tests Biopsy (skin) Microscopic examination of a small piece of living tissue obtained surgically, through a needle and syringe, hollow punch, brush, or stereotactically, to distinguish between benign and malignant conditions. Sedimentation rate Blood test to determine the rate blood cells settle in a long narrow tube. Insert abbreviations from chapter Combining Form Match Up Quiz albin/o a. heat caus/o b. thick erythr/o c. dry pachy/o d. white xer/o e. red Review Quiz Inflammation of the skin that is caused by exposure to radiant energy is called: actinic dermatitis alopecia atopic dermatitis cellulitis Inflammation of the skin that is caused by exposure to radiant energy is called: actinic dermatitis alopecia atopic dermatitis cellulitis Another name for a blackhead is: carbuncle comedo eschar folliculitis Another name for a blackhead is: carbuncle comedo eschar folliculitis Hyperhidrosis is a condition of excessive: acne hair sweating wrinkles Hyperhidrosis is a condition of excessive: acne hair sweating wrinkles Which stage of a pressure sore leads to the formation of a crater and tissue damage below the skin? stage I stage II stage III stage IV Which stage of a pressure sore leads to the formation of a crater and tissue damage below the skin? stage I stage II stage III stage IV The ABCDs of melanoma include all of the following mole changes except: asymmetry border color depth The ABCDs of melanoma include all of the following mole changes except: asymmetry border color depth The outer layer of skin is known as the dermis. True False The outer layer of skin is known as the dermis. True False The skin is the largest organ in the body. True False The skin is the largest organ in the body. True False Dry skin is also called xeroderma. True False Dry skin is also called xeroderma. True False Another name for scabies is “the itch.” True False Another name for scabies is “the itch.” True False Excoriation is an abrasion of the dermis caused by chemicals. True False Excoriation is an abrasion of the dermis caused by chemicals. True False A boil is most often caused by the invasion of staphylococci. True False A boil is most often caused by the invasion of staphylococci. True False Sudoriferous glands lubricate the hair and skin. True False Sudoriferous glands lubricate the hair and skin. True False Erythroderma is an abnormal redness of the skin. True False Erythroderma is an abnormal redness of the skin. True False Another name for dryness of the skin, mucous membranes, or the conjunctiva is xerosis. True False Another name for dryness of the skin, mucous membranes, or the conjunctiva is xerosis. True False The abbreviation for biopsy is Bp. True False The abbreviation for biopsy is Bp. True False Chapter 5 Scenario You work for a dermatologist as a medical transcriptionist. You are transcribing a doctor’s dictation about a patient he saw for a skin disorder. The skin disorder consists of a scaly, itchy rash in an 18-month-old child. The child’s mother has asthma. The doctor prescribed a TIM for the patient’s treatment. What is the physician’s diagnosis? eczema psoriasis poison ivy melanoma What is the physician’s diagnosis? eczema psoriasis poison ivy melanoma The most promising treatment for eczema is: nonsteroidal topical immunomodulators (TIMs) Retin-A cyclosporine topical corticosteroids The most promising treatment for eczema is: nonsteroidal topical immunomodulators (TIMs) Retin-A cyclosporine topical corticosteroids