Clinical Medical AssistingChapter 8: Integumentary System

Objectives• Identify combining word forms of the integumentary system

and their role for the formation of medical terms

• Identify the most common diseases and disorders of the integumentary system

• Discriminate among first-, second-, and third-degree burns

• List rules to follow to protect sterile areas

• Explain competent wrapping and operation of the autoclave

Objectives (con’t)• Given a variety of surgical instruments, be able to identify

each and describe the intended use of each one

• Demonstrate the ability to select the most appropriate type of dressings for a given situation

• List preoperative concerns to be addressed in patient preparation and education

• List postoperative concerns to be addressed with the patient and the caregiver

Chapter Overview

The integumentary system includes the skin and its accessory organs: the hair, nails, glands, and nerve receptors. The skin is the largest organ in the body and accounts for more than 10% of total body weight. The primary function of the skin is to act as a barrier between humans and the environment. Skin protects the body from loss of water, salt, and heat. Skin also protects the body from chemical, physical, and microbial injury.

Anatomy and Physiology of the Skin

Skin is composed of three layers: the epidermis, the dermis, and the subcutaneous tissue.

Function of the Skin

The skin is the body’s primary defense mechanism.

Diseases and Disorders of the Skin

Lesions are any type of disorder, damage, or abnormality of the skin.

Acne Vulgaris

Acne vulgaris is a common skin disorder.

Signs and Symptoms of Acne Vulgaris

Acne vulgaris results from the overactive production of sebum in the sebaceous glands, which gives the skin an oily appearance.

Treatment of Acne Vulgaris

Gentle cleansing of the skin at least twice daily with mild soap or cleanser is the simplest form of acne treatment.

Eczema and Dermatitis

Most common skin conditions and disorders can be classified as eczema or dermatitis.

Urticaria (Hives)

An acute allergic reaction of the dermis

Psoriasis

Psoriasis is a chronic inflammatory condition of the skin characterized by crusty papules that form patches with circular borders.

Bacterial Infections of the Skin

Bacterial infections can occur in the skin when there is a disruption in the integrity of the skin as a protective mechanism.

Impetigo

A superficial infection of the skin.

Cellulitis

Cellulitis initially infects the epidermis and dermis, but spreads rapidly through the other layers of skin and soft tissue.

Folliculitis, Furuncles, and Carbuncles

Folliculitis is an inflammation of the hair follicle.

Viral Infections of the Skin

Occur when the integrity of the skin as a protective barrier is compromised due to injury or trauma to the skin or a compromised immune system.

Herpes Simplex

An infectious organism that can infect the skin and nervous system.

Herpes Zoster (Shingles)

Occurs in adults and is caused by the varicella-zoster virus—the virus that causes chickenpox in children.

Verrucae (Warts)

Common viral infections of the skin and mucous membranes.

Fungal Infections of the Skin

Fungal infections are among the most common skin disorders.

Tinea

The collection of superficial fungal infections.

Fungal Infections Often Occur Around the Nail Bed

Candidiasis

A common fungal infection and can occur anywhere on the body.

Pediculosis

Lice are wingless insects with well-developed legs.

Tumors of the Skin

Chronic, sharply demarcated lesion of the skin. Nevi are commonly called birthmarks or moles.

Malignant Melanoma

A highly malignant cancer.

Basal Cell Carcinoma

A cancerous skin lesion that rarely metastasizes.

Squamous Cell Carcinoma

The second most common type of skin cancer.

Seborrheic Keratosis

A benign skin tumor

Trauma of the Skin

The skin is vulnerable to injury and trauma.

Lacerations

A cut, tear, or puncture in the skin.

Treatment of Lacerations

Treatment of lacerations begins with cleaning the wound and surrounding skin with an antiseptic cleanser.

Burns

Burns are one of the most serious traumas affecting the skin.

Skills for the Medical Assistant (Labs)

The medical assistant will have the opportunity to assist the physician with minor surgical procedures.

Surgical Instruments

A typical soft tissue tray can contain 11 instruments.

Aseptic Handwashing

Aseptic technique and surgical asepsis require proper handwashing.

Applying Sterile Gloves

Hands must be covered with sterile gloves during surgical procedures.

Preparing a Sterile Field

Disposable sterile field drapes or towels isolate and cover a sterile area.

Pouring a Sterile Solution into a Cup on a Sterile Field

In some procedures, sterile solutions will need to be poured into a sterile cup in the sterile field.

Equipment•Covered sterile surgical tray with sterile cup

•Container of sterile solution

Preparation of Patient Skin for Minor Surgery

The surface of the skin contains many microorganisms that can cause infection if allowed to enter the body through an incision.

Assisting with Minor Surgery

Maintaining sterility during minor surgical procedures is essential to preventing infections and complications related to the surgery.

Dressing Application and Change

After surgical procedures or after trauma to the skin, wounds are often covered with a dry, sterile dressing.

Assisting with a Laceration or Incision

Suturing decreases scarring and decreases the likelihood of infection.

Suture or Staple Removal

Sutures used to promote healing of a wound may not be absorbable.

Application of Adhesive Skin-Closure Strips

Adhesive strips may be used after sutures have been removed or at the same time as sutures.

SummaryThe skin’s primary function is to protect the body from loss of water or nutrients and against invasion by a chemical or biological injury. The skin also maintains temperature and moisture content of the body and contributes to vitamin D synthesis and emotional expression.

Summary (con’t)

Lesions of the skin can be signs and symptoms of underlying medical conditions or exist as normal variations in skin. Skin diseases and disorders can provide significant emotional stress and embarrassment for patients.