172
UNIT 2
Covering, Support, and Movement of the Body
debilitating. Trauma, infection, hormonal changes, or stress
oFen trigger the autoimmune attacks. Cortisone-containing
topicals (medications applied to the skin surface) may control
mild cases. ±or more severe cases, self-injected drugs called
biologicals and/or phototherapy with UV light in conjunction
with chemotherapeutic drugs provides some relief.
Rosacea
(ro-za
9
she-ah) A chronic skin eruption produced by dilated
small blood vessels of the face, particularly the nose and cheeks.
Papules and acne-like pustules may or may not occur. More
common in women, but tends to be more severe when it occurs
in men. Cause is unknown, but stress, some endocrine disorders,
and anything that produces flushing (hot beverages, alcohol,
sunlight, etc.) can aggravate this condition.
Vitiligo
(vit
0
ĭ-li
9
go;
viti
5
a vine, winding) ²e most prevalent skin
pigmentation disorder, characterized by a loss of melanocytes
and uneven dispersal of melanin, so that unpigmented skin
regions (light spots) are surrounded by normally pigmented
areas. An autoimmune disorder.
Scleroderma
(
scler
5
hard) An autoimmune disorder characterized
by stiff, hardened skin due to abnormal amounts of collagen
in the dermis that severely limit joint movements and facial
expressions. A classic sign of the disorder is Raynaud disease in
which the fingers and toes become white and painful because
of poor blood flow to those areas. ²e fibrosis that occurs in
systemic cases may affect a variety of organs including the lungs,
eventually leading to suffocation, and the kidneys, leading to
renal hypertension because of blood vessel constriction and
occlusion. Environmental factors including organic solvents,
asbestos, and even silicone breast implants have all been suspect
scleroderma triggers.
A terrible collision between a trailer
truck and a bus has occurred on
Route 91. Several of the passengers
are rushed to area hospitals for
treatment. We will follow a few of these people in clinical case
studies that will continue through the book from one organ system
to the next.
Examination of Mrs. DeStephano, a 45-year-old woman, reveals
several impairments of homeostasis. Relative to her integumentary
system, the following comments are noted on her chart:
Epidermal abrasions of the right arm and shoulder
Severe lacerations of the right cheek and temple
Cyanosis apparent
The lacerated areas are cleaned, sutured (stitched), and
bandaged by the emergency room (ER) personnel, and
Mrs. DeStephano is admitted for further tests.
Relative to her signs:
1.
What protective mechanisms are impaired or deficient in the
abraded areas?
2.
Assuming that bacteria are penetrating the dermis in these
areas, what remaining skin defenses might act to prevent
further bacterial invasion?
3.
What benefit is conferred by suturing the lacerations? (Hint:
See Chapter 4, p. 149, Related Clinical Terms, healing by first
intention.)
4.
Mrs. DeStephano’s cyanotic skin may hint at what additional
problem (and impairment of what body systems or functions)?
(Answers in Appendix H)
Case Study
Integumentary System
Related Clinical Terms
(continued)
5
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