LET ME KNOW: BASIC PRINCIPLES OF ANATOMY AND PHYSIOLOGY

Evaluation form: http://tinyurl.com/LetMeKnow2021EvaluationForm

Lecturer: Prof. Ernesto Mania Jr., DMD, RN, MAN

Experience Sharing from Margarette Anne C. Oriabda

-even with doubt, the experience you learn is the most vital part in learning as a nursing
student

~Physical and Mental Health~

-prioritize rest

-time management (be prepared for anything)

-groupings (try to take initiative to achieve optimum output)

-pressure (use it as a challenge/stepping stone to improve)

-exams (midterms are hard that’s why, you have to read and source out
multiples books) (submission of requirements also come in to exams)

“exam lang yan nursing student ka, wag kang magpatalo”

-wag kang matakot, nursing is not only an art, but a continuous learning
system

-reward yourself, make new friends

-take one step at a time, all will be alright in time, get some peace in
mind, don’t compare your progress with others, we are all unique, take
care of yourself, having a great and stable mind is the best gift for
yourself.

~The Integumentary System~ introduced by Prof. Ernesto Mania Jr., DMD, RN, MAN

Terms:

Integumentary System - Largest organ of the body based on surface area and weight

Blood Supply – I.S. covers 1/3 of blood

Rugged – Uneven Surfaces

Appendages – Hair, Skin Glands, and Nails

Functions:

Protection – against abrasion, against UV Rays through special pigment producing cells, served as
barrier from harmful chemicals, from dehydration

Thermoregulation – Temperature Regulation, prevents dissipation of heat in the form of “sweat”

Due to blood being warm, this helps in regulating body temperature

Sweating – dissipates heat by losing water

Excretion and Absorption

Excretion – letting go of waste materials, sweat has some waste products, the skin also
contributes and removing waste
 Absorption - transfer of nutrients outside to inside of the skin e.g., lotions

Vitamin D Production – when exposed to the sun our skin produces vitamin D, suggested 10-15
minutes of exposure to get vitamin D

Cutaneous Sensation – “feeling”, sensory receptors can detect all physical feelings encountered by the
skin,

Pressure – harder touch

Pain – persistent pressure

Blood Reservoir – in the dermis carry 8-10% of blood flow in a resting adult

Structures of Integumentary System

Epidermis - superficial layer of the skin, contains keratin, prevent water loss and resist abrasion,
stratified Keratinized

Dermis – layer underneath epi, made of fibrous tissue 10-20 times thicker, provide skin structural
integrity

Subcutaneous Fat – aka Hypodermis, before going through the muscle, anchors your skin to your
muscle, serve as shock absorber and storage of fat, serve as an insulator

The epidermis is avascular

Avascular - lack of blood vessels

-Melanocytes is taken in by keratinocytes

-Melanin determines your skin color, the more melanin the darker the skin

-Langerhan cells - serve as immunity

-Merkel Cells - serve as touch, sensory receptors

Layers of the epidermis

Stratum Basale - constantly nourished, deepest layer, Keratin, Merkel and melanocytes are found here

Stratum Spinosum – adequately nourished, Lagerhan cells are found here

Stratum Graniolosum – cell death occurs here, Granulized layer, cells are being flattened, filled with
keratin and filled with cameral granules

Stratum Lucidum - occurs where the skin is hairless, in extra thick skin like palm, sole, composed of
dead keratinocytes

Stratum Corneum - outermost layer, thickest layer of the epidermis, contains dead cells and keratin,
prevents the water loss

Difference of Thick and Thin Skin

Thin Skin- can be seen everywhere in the body except the palm, fingers and sole .1 -.15 mm thickness,
does not have Stratum Lucidum, has sebaceous gland, sensory receptors are sparser

Thick Skin – has Stratum Lucidum, and Corneum and Spinosum is thicker .6 - mm, sensory receptors
are denser

Dermis – vascular, has hair follicles, nerves and is much thicker, contains fibers such as collagen and
elastic fibers

-Skin loses elasticity as a person ages, which in turn shows wrinkles and sagging of the skin

-too much stretching turns to a dermal tearing which causes “stretch marks”, mostly prone in
pregnancy and gaining weight

Layers of Dermis

Papillary Region –

Dermal Papillae – increases friction and gripping of your fingers, helps forms
fingerprints

Meissner corpuscles

Free Nerve Endings

Reticular region – deepest region

Subcutaneous Fats – half of the body lipids are contained here

Melanin – responsible for skin color

Melanocytes contains melanosome which synthesize Melanin

Pheomelanin – color of red to yellow

Eumelanin - color of brown to black

Hemoglobin - produces pink to red color depending on the blood supply and oxygen

Carotene – precursor of vitamin A, produces pigments for good vision

Asians - Melanin and Carotene

Nevus – mole, benign localize overgrowth of melanocytes

Birthmarks – congenital disorders

Erythema – immense redness of the skin, engorgement of the capillaries infection, inflammation

Pallor - Paleness, caused by shock or anemia

Jaundice - build up yellowish pigment

~Appendages~

Hair Follicles – responsible for hair growth

Hair Shaft – part of the hair not anchored by the hair follicle, exposed to the skin

Parts: Medulla, Cortex, Cuticle

Blondes and fine hair individuals don’t have medulla and is replaced with the cortex

Hair root –

Hair bulb - hair root ends comprise hair matrix and hair papilla

Hair Papilla - comprises blood capillaries and supplying nourishment

Inner root Sheath – surrounds of the growing hair, extends up to the hair shaft

External root sheath - extension of the epidermis

Purpose of Hair – protection and body temperature regulation

Arrector Pilli Muscle – characterize as a smooth muscle, attached to the hair bulb, when contract it
will pull hair, cause of goosebumps (rising of hair), explains the principle of hair pulling due to freezing
and getting scared

Different types of hair

Lanugo - seen at birth

Vellus - body hair during childhood

Terminal Hair - matured hair

Hair Growth

1. Anagen (growth phase)

2. Catagen (transition phase)
3. Telogen (resting phase)

-Hair grows .3-.4 mm per day, half an inch per month

-Once the hair bulb is destroyed it will not grow anymore

-Nails contain hard keratin

-Finger nails grows faster than toe nails

-Nails protects your fingertips, provides support and counter pressure, used to scratch and groom
your body in various ways

Free Edge - when nails go out of the finger

Lunula – white color, most prominent in the thumb, may vary in appearance
 Nail root – germinal matrix, lies bellow the skin extends seminal millimeters, growing area of the
nails

Eponychium - aka cuticle, stratum corneum

Nail Bed – where the nail lays

Phalanx – the finger bone

Mammary Glands – responsible for Lactation

Sebuminous Gland – produces ear wax

Sweat Glands:

Eccrine gland – responsible for sweat, abundant in palm, sole and forehead, regulates body
temperature, activated under stress (activated after birth)

Apocrine gland – abundant in groin area, bearded regions, armpits, sweat is milky yellowish, when
mixed with bacteria causes body odor, stimulated during sexual intercourse (activated at puberty)

Sebaceous Glands - oil producing glands, lips, glans of the penis and labia minora, activated at
puberty, served as lubricant, inhibits the growth of bacteria

Acne - hair follicles clogged with oil, bacteria

Comedo – non inflammatory, clogged pores, contains sebum, maybe open or closed

Closed Comedo - whiteheads, not exposed to the skin

Open Comedo – blackheads, oxidation of the debris exposed

Skin wound Healing

-Applicable in all parts of the body, depending on the damage

-limits further damage

-cleans and seals the wound against infection

-wounds could be epidermal (shallow, only involves the epidermis) or dermal (deep, involves the
dermis, muscles or even bone)

Epidermal wounds

-abrasion

-burns

-thickening of the epidermis served as healing

Blood will fill the affected area, making it clot which will help cover and stop the bleeding

Inflammatory Phase - fight the infection against the wound and help in protection, allows
permeability of substances
Cyanosis – bluish color due to lack of oxygen

Jaundice – Yellowish color, indicates liver damage,

Rashes and Lesions –

vitamin A deficiency – rough skin

iron deficiency anemia – reddish color of skin, lack of oxygen supply

Lead Poisoning – lead could be found in the hair

Addison’s Disease – bronzing of the skin due to excess ACTH, which involves melanocytes,
hyperpigmentation of the skin

Burns can be caused by heat, electricity, radiation, chemical burns

-if not treated can cause dehydration

-according to depth-

Partial Thickness:

First degree burn – only the epidermis, i.e., sunburn, looks red

Second degree burn - both Epidermis and dermis, can be minimal or deep into the dermis, more red
Full Thickness:

Third Degree Burn – Epidermis and dermis is completely destroyed, looks white

Rule of 9 - estimating the severity of burns/estimating the surface area affected by the burn

Burning of the face is considered Critical, due to the danger of suffocation

Most common cause of skin cancer is radiation

Basal cell carcinoma - least dangerous, shiny dome shaped nodules

Squamous cell carcinoma – if not treated can lead to dead

Malignant Melanoma - highly spreading, rare form of cancer, highly resistant to chemotherapy
E- Elevation - evolving characteristics

Pressure ulcers, Occur often in bedridden patients

-Turn your patients 1-2 hours to avoid