Slide 1 Chapter 4: Body Membranes and the Integumentary System Slide 2 Introduction Skin often reveals our inner workings and general health In most manual therapies, the skin is primary interface with clients Therapists may feel many differences in clients skin Clients feel status of their tissue and quality of therapist s touch Slide 3 Membranes Membrane: broad flat sheet of at least 2 layers of tissue Body has 4 primary types of membranes: 1 of primarily connective tissue 3 of epithelial tissue
Slide 4 Connective Tissue Membranes Synovial membranes line fibrous connective tissue capsules in joints Composed of 2 layers: Thick fibrous connective tissue layer on outside Thin internal layer of simple epithelium Synovial fluid secreted by epithelial layer reduces friction and wear to bone ends Slide 5 Epithelial Tissue Membranes Comprised of layer of epithelial tissue attached to connective tissue layer (basement membrane) Capable of rapid regeneration Ideal for protecting organs and lining body cavities and passages 3 types: Mucous Serous Cutaneous Slide 6 Mucous Membranes Line cavities open to external environment Line respiratory, digestive, urinary, and vaginal tracts Secrete mucus Helps protect against invading pathogens Helps warm and humidify air on way to lungs In digestive, urinary, and vaginal tracts, protects against wear or erosion
Slide 7 Serous Membranes Found in cavities without openings to external environment Folded into 2 distinct layers: Parietal layer lines cavity Visceral layer covers organs Space between layers contains serous fluid Serous fluid provides lubrication to reduce friction between layers, allowing smooth movement Slide 8 Cutaneous Membrane Body s outer covering and primary organ of integumentary system Consists of stratified layer of epithelial tissue attached to thick connective tissue layer Slide 9 Integumentary System Comprised of cutaneous membrane and accessory organs, including: Hair Nails Sudoriferous (sweat) glands Sebaceous (oil) glands Sensory receptors
Slide 10 Functions of Skin Protection Temperature regulation Excretion and absorption General sensory organ Synthesis of vitamin D Slide 11 Layers of the Skin External epithelial, deeper dermal, and subcutaneous layers Slide 12 Epidermis Composed of stratified squamous epithelium 90% of cells are keratinocytes 5 strata of epidermis (see Figure 4-5): Horny layer (stratum corneum) Clear or glassy layer (stratum lucidum) Granular layer (stratum granulosum) Spiny layer (stratum spinosum) Germinating layer (stratum germinativum)
Slide 13 Epidermis (cont d) Continually renews and replaces itself Melanocytes produce dark pigment that protects skin from UV Malignant melanoma: serious skin cancer Warning signs (ABCD) for mole: asymmetry, indistinct border, black/brown color, larger diameter Breaks in skin may allow pathogens to enter Slide 14 Epidermis (cont d) Precautions for therapists: Minimize risk of allergic response to emollients Avoid blocking skin pores or glands with emollient Attend to ingredients and purity of products applied during exfoliations and wraps Be cautious with hydrotherapy treatments that open pores and enhance skin absorbency and excretion Slide 15 Dermis Skin layer housing blood and lymph vessels, nerves, and accessory organs (see Figure 4-6) Collagen and elastin fibers make skin extensible and elastic 2 regions: Papillary region Reticular region
Slide 16 Subcutaneous Layer Also known as hypodermis or superficial fascia Attaches skin to underlying tissues and organs Contains adipose tissue that insulates body and stores energy Rich with blood and lymph vessels, nerves, and sensory receptors Slide 17 Accessory Organs: Hair and Nails Hair and nails serve protective function Genetics, hormone production, and nutrition influence pattern of hair distribution over body Shape and color of nails may indicate systemic disorders Nails may be yellow, pitted or ridged, or more concave or convex Signs caused by blood, respiratory, or thyroid disorder Slide 18 Accessory Organs: Sebaceous Glands Sebaceous glands secrete oily or waxy fluid (sebum) Helps keeps skin soft and pliable Inhibits growth of certain bacteria Most sebaceous glands are connected to hair follicles Sebaceous gland activity increases in adolescence
Slide 19 Accessory Organs: Sudoriferous Glands Secrete sweat through pores of skin Support homeostasis by helping regulate body temperature, water balance, and elimination of metabolic byproducts 2 types: Eccrine glands: primary sweat glands for thermal and water regulatory ability Apocrine glands: concentrated in axilla, groin, areolar breast tissue, and beard area Slide 20 Accessory Organs: Sensory Receptors Wide variety of sensory organs sensitive to touch, temperature, pain, vibration, and pressure Receptors in papillary zone sensitive to superficial stimuli Free nerve endings, Merkel discs, Meissner corpuscles Receptors in deeper reticular layer more sensitive to deep tactile stimulation Pacinian corpuscles, Ruffini corpuscles, hair root plexus Slide 21 Links to the Nervous System Sensory receptors in skin connected to nerve cells or fibers that carry information to spinal cord and brain Each region of skin (dermatome) correlated to specific nerves and spinal levels (see Figure 4-9) Connective Tissue Massage (CTM) aims to create systemic changes via dermatome stimulation Brain and skin are intricately linked and cannot be functionally separated
Slide 22 Links to the Nervous System (cont d) Infants and children deprived of tactile and movement stimulus often fail to thrive Research shows profound connection between tactile stimulus, emotional well-being, and physiologic function Infants receiving regular massage: Experienced fewer colds and less diarrhea Grew faster and gained more weight Exhibited less agitation and excitability Slide 23 Skin Conditions and Diseases Therapists should be familiar with skin conditions and diseases You may see skin areas clients do not see You can monitor changes in skin tone or appearance in regular clients Avoid direct contact with any broken skin Refer clients for medical attention when needed Slide 24 Common Contagious Skin Disorders If contagious disorder is suspected, reschedule after medical diagnosis and treatment Always use proper hygiene, sanitary practices, and universal precautions Common contagious disorders (see Figure 4-11): Fungal infections (e.g., tinea or ringworm) Bacterial infections (e.g., staph) Viral infections (e.g., herpes simplex or zoster) Parasitic infections (e.g., scabies or lice)
Slide 25 Common Noncontagious Skin Disorders Direct contact may be contraindicated Common noncontagious disorders (see Figure 4-12): Acne Eczema Hives (urticaria) Psoriasis Vitiligo Slide 26 Aging and the Integumentary System Signs of aging easily recognized in skin and hair General dehydration and breakdown of collagen and elastin fibers Dermis begins to stiffen, wrinkle, and thin Decreases in melanin production cause graying hair and changes in skin pigmentation, including brownish age spots Skin less able to regenerate and repair itself