Integumentary

• stratum corneum ➢ consist of dead keratinized cells that render the skin waterproof, serve as barrier between the deeper layers of skin from microorganisms or toxins from entering the body.
• Stratum lucidum is present only in thicker skins such as palms and soles
• Stratum granulosum➢ made up of skin cells containing

  components that contribute to the formation of the outer skin layer.
• Stratum spinosum ➢ Allows keratinocytes (cells that produce keratin) to mature
•  Stratum Basale (stratum germinativum)➢ deepest layer. Only layer that undergoes cell division and contains “melanin” (brown pigment) and “keratin forming cells”.
• MELANIN - major determinant of skin color and helps protect skin 

  from UV rays.
• DERMIS➢ Inner layer of the skin. Well-vascularized, connective 

  tissue layer containing  collagen
• Collagen - most abundant protein in the body providing skin structure and strengthening skin (elasticity and hydration)
• Sebaceous glands - attached to hair follicles, present over most of the body excluding palms and
• sebum -oily substance that waterproofs the hair and skin.
• eccrine glands - located over entire skin that secretes sweat and 

  thermoregulation through evaporation of sweat from the skin surface
•  apocrine glands - associated with hair follicles in the axillae, perineum(groin), and areolae of the breasts, non functional until puberty. In women, it is linked with the menstrual cycle.
• Hair - Provides thermoregulation by wicking sweat away from the body.
• Hair follicle - sheath of epidermal cells. The function is to grow your hair
• Arrector pili muscles - attached to hair follicle which contract in response to cold or fright, decreasing skin surface area and causing the hair to stand erect.
•  Hair bulb-forms the base of hair follicle, living cells divide and grow to build hair shaft
• Hair Papilla located at the base of hair follicle which contains blood supply for the hair
• NAIL - Hard, transparent plates of keratinized epidermal cells that grow from the cuticle
•  Eponychium - living tissue attached to the nail plate that protects area between nail and epidermis from exposure to bacteria
•  Cuticle- nonliving tissue or dead skin cells
• Hyponychium - skin under the free edge of the nail just beyond the distal end of the nail bed
• Changes in sensation may indicate vascular or neurologic 

  problems such as peripheral neuropathy related to DM or arterial occlusive disease
• Asians and Native Americans have mild to no body odor because of decreased sweat production.
• Caucasians and African Americans tend to have a strong body odor
• Bacterial infection cause green, black, or brown nails
•  Fungal infections- cause yellow, thick, crumbling nails
•  Yeast infection cause white color and separation of the nail plate from the nail bed.
• Some skin and hair conditions may be related to hormonal imbalance.
• Depression often occurs in association with dermatologic disease.
• the abnormal growth of skin cells, most often develops on skin exposed to the sun.
• • THREE MAJOR TYPES OF SKIN CANCER - BASAL CELL CARCINOM, SQUAMOUS CELL CARCINOMA, AND MELANOMA   
• BASAL CELL CARCINOMA occurs in sun-exposed areas such as neck and face, appear as pearly or waxy bump, sore that heals and returns
• SQUAMOUS CELL CARCINOMA occurs in sun-exposed areas, appear firm, red nodule, flat lesion
• MELANOMA- can affect any skin tone, large brownish spot with darker speckles like a mole that changes in color, size, texture, or that bleeds and irregular border
• ABCDE mnemonic to assess suspicious lesions: Asymmetry, Border, Color, Diameter, Evolution
• Asians are less susceptible to skin cancer
•  African Americans, Asians, and Hispanics are susceptible to melanoma.
• Asian Americans and African Americans tend to present with more advanced disease at diagnosis 
• Tattoos - Put client at risk for skin infection, painful removal that causes scarring allergic reactions, formation of granulomas, keloid and swelling.
•  Exposure to sun may aggravate the condition of patients with Scleroderma.