Skin Structure & Function

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Study Tools For Skin Structure & Function

Skin Layers (Image)
Layers of the Skin (Image)
Comparison of Skin Layers (Image)
Skin Functions (Picmonic)
Skin Anatomy (Picmonic)
Skin Anatomy (Cheatsheet)
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Outline

Overview

  1. Layers of the skin
    1. Epidermis
    2. Dermis
    3. Subcutaneous Tissue
      1. Not technically part of the skin

Nursing Points

General

  1. Layers of the skin
    1. Epidermis
      1. Epithelial tissue (keratinized stratified squamous)
    2. Dermis
      1. Connective tissue
      2. Vascular
      3. Nerve endings
      4. Hair follicles
      5. Oil and sweat glands
    3. Subcutaneous tissue
      1. Adipose tissue
      2. Areolar connective tissue
      3. Connects skin to muscle, cartilage, and bone
  2. Functions of the Skin
    1. Protection
      1. Injury
      2. Infection
      3. Fluid balance
        1. Prevents excess absorption
        2. Prevents dehydration
      4. Against UV radiation
    2. Sensory Detection
      1. Neurons in dermis
        1. Light touch (Merkel’s discs)
        2. Deep pressure
        3. Temperature
        4. Pain (nocireceptors)
    3. Thermoregulation
      1. Assists in maintaining constant core body temp
        1. 98.6°F / 37°C
      2. Sources of Heat
        1. Cell metabolism
        2. Muscle contraction
      3. Methods of heat loss
        1. Radiation → heat transfer without contact
        2. Evaporation → heated water vaporizes (sweat)
        3. Conduction → heat transfer through contact
      4. Physiologic mechanisms (via hypothalamus)
        1. Heat loss
          1. Vasodilation  to skin → Heat loss by radiation
          2. Sweating → heat loss by evaporation
        2. Heat gain
          1. Vasoconstriction to skin → LESS heat loss by radiation
          2. Hormones increase temps
          3. Shivering  
    4. Miscellaneous
      1. Vitamin D production
        1. Sunlight + cholesterol = activates vitamin D in the kidneys
        2. Initiated in skin
      2. Excretion of wastes
        1. Loss of urea in sweat
      3. Identification
        1. Fingerprints
        2. Birthmarks

References
Betts, J.G., et al. (2017). Anatomy and physiology. Houston, TX: OpenStax, Rice University. Retrieved from https://openstax.org/details/books/anatomy-and-physiology?Book%20details

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Transcript

Okay guys, in this lesson, we’re going to look at the structure of the skin and its functions.

So, first, let’s look at the different layers of the skin. There are three MAIN layers that we’ll see – the Epidermis, which is the outermost layer. This is a layer of keratinized stratified squamous epithelium. Remember that keratin helps waterproof our skin! Next is a layer of connective tissue called the Dermis. This is where we find our blood vessels, nerve endings, hair follicles, and our oil and sweat glands. You’ll notice the difference here between thick skin and thin skin. Thick skin tends to not have the hair follicles or oil glands, while the thin skin does. Thick skin would be like on the bottom of your feet or the palms of your hands – thin skin is… well… everywhere else! Underneath the dermis is a layer called the subcutaneous layer or subcutaneous tissue. Now… technically this is not actually a part of the skin – but it’s what the skin is connected to and plays a huge role in the benefits of skin. It is made of areolar connective tissue and adipose tissue and it connects our skin to the structures underneath it – whether that’s muscle, cartilage, or bone.

Now, the skin has a lot of really cool functions, so let’s touch on each of them. First is protection – our skin is LITERALLY our barrier against the outside world, right? So it protects our insides from injury, helps keep out infection, and protects us from UV radiation (we hope). We also see skin protecting us in terms of our fluid balance. Not only does it help hold our fluids IN so we don’t get too dehydrated, but it also helps keep water OUT. Remember that keratin we talked about? Over time, with too much water exposure, the skin can start to prune up because we are losing the keratin – that’s a sign that it’s time to get out of the water! Once we dry out, the keratin is restored and we’re protected once again!

Skin also plays a huge role in sensory detection – there are specialized neurons, or nerve endings, in the dermis that help us to detect light touch, deep pressure, temperature, and pain. Without that, it’s really difficult to get our bearings or prevent injury.

Another main function of skin is thermoregulation – so there’s 3 main ways our bodies lose heat. One is by radiation – that’s when the heat gets transferred without having to be in contact. So think about your radiator at home or a fire place – that’s heat transfer by radiation. You’re not actually touching it, but you’re getting heat from it. There’s also evaporation – when water gets hot, it vaporizes and takes the heat with it, so the surface is left cooler than it was. And last is conduction – this is when the heat transfers through contact. So if you touch a hot stove or use an ice pack – we’re using the principle of conduction to regulate temperature.

So let’s see what this looks like in the body. Let’s say we need to LOSE some heat – our temperature is too hot. Remember our bodies want to be at about 98.6 fahrenheit or 37 degrees celsius. So if we’re too hot, our blood vessels in the skin are goign to vasodilate – that means they get bigger and we get MORE blood flow to the skin. That blood is hot – so we end up losing some of that heat by radiation off the skin. Think about when you’re hot – you get really flushed and your skin gets hot – so you can get rid of some of your heat that way. We’ll also start sweating so we can lose some heat by evaporation. The whole goal is to get back to a normal temperature.

So what if we need to GAIN some hat – our temp is too cold. Well we’ll do just the opposite – the vessels constrict to keep whatever warm blood we have inside the body so we have LESS heat loss at the skin. We also see shivering because muscle contraction is a great way to product more heat. And of course there are other hormonal activities going on in the body to help us increase our temp.

A few other miscellaneous functions of skin – the skin is responsible for vitamin D production – when we take in sunlight through our skin, it tells the liver to convert cholesterol to vitamin D. We also see excretion of wastes in the form of urea in our sweat. And we also see identification through the skin with things like fingerprints and birthmarks.

So let’s recap – the skin has 3 layers – the epidermis, dermis, and subcutaneous tissue. The primary functions of skin are protection, sensory detection, and thermoregulation, plus a couple miscellaneous ones. We see radiation, evaporation, and conduction as ways to transfer heat and the skin plays a role in that – especially through radiation with vasodilation and constriction, sweating, and shivering.

Okay guys, those are the basics you need to know about skin. Now, go out and be your best self today. And, as always, happy nursing!!

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Concepts Covered:

  • Cardiac Disorders
  • Musculoskeletal Trauma
  • Integumentary Disorders
  • Neurologic and Cognitive Disorders
  • Oncology Disorders
  • EENT Disorders
  • Respiratory Disorders
  • Gastrointestinal Disorders
  • Hematologic Disorders
  • Communication
  • Test Taking Strategies
  • Pregnancy Risks
  • Fundamentals of Emergency Nursing
  • Concepts of Mental Health
  • Basics of NCLEX
  • Prioritization
  • Emotions and Motivation
  • Tissues and Glands
  • Skeletal System
  • Muscular System
  • Nervous System
  • Sensory System
  • Circulatory System
  • Hematologic System
  • Respiratory System
  • Digestive System
  • Urinary System
  • Endocrine System
  • Reproductive System
  • Labor Complications
  • Disorders of Pancreas
  • Eating Disorders
  • Neurological Emergencies
  • Noninfectious Respiratory Disorder
  • Vascular Disorders
  • Upper GI Disorders
  • Lower GI Disorders
  • Liver & Gallbladder Disorders
  • Urinary Disorders
  • Sexually Transmitted Infections
  • Female Reproductive Disorders
  • Renal Disorders
  • Integumentary Disorders
  • Integumentary Important Points
  • Immunological Disorders
  • Shock
  • Endocrine and Metabolic Disorders
  • Musculoskeletal Disorders
  • Musculoskeletal Disorders
  • Neurological Trauma
  • Central Nervous System Disorders – Brain
  • Central Nervous System Disorders – Spinal Cord
  • Peripheral Nervous System Disorders
  • Emergency Care of the Neurological Patient
  • Respiratory Emergencies
  • Infectious Respiratory Disorder
  • Oncologic Disorders
  • Studying
  • Cardiovascular Disorders
  • Basic
  • Adult
  • Pediatric
  • Neonatal
  • Emergency Care of the Trauma Patient
  • Emergency Care of the Cardiac Patient
  • Emergency Care of the Respiratory Patient

Study Plan Lessons

The 5-Minute Assessment (Physical assessment)
General Assessment (Physical assessment)
Integumentary (Skin) Assessment
Neuro Assessment
Head/Neck Assessment
EENT Assessment
Heart (Cardiac) and Great Vessels Assessment
Thorax and Lungs Assessment
Abdomen (Abdominal) Assessment
Lymphatic Assessment
Peripheral Vascular Assessment
Musculoskeletal Assessment
Genitourinary (GU) Assessment
Communicating with Patients
SATA
Absolute Words
Nursing Process
What do you want me to know?
Duplicate Facts
Repeating Words
Denying Feelings
NCLEX® Question Traps
Opposites
Same
Priority
Acute vs Chronic
Hierarchy of O2 Delivery
Nutrition Assessments
Abuse
Therapeutic Communication
Nurse-Patient Relationship
Thinking Like a Nurse
Critical Thinking
Prioritization
Triage
Maslow’s Hierarchy of Needs in Nursing
Overview of the Nursing Process
Skin Structure & Function
Skeletal Anatomy
Bone Structure
Development of Bones
Joints
Muscle Anatomy (anatomy and physiology)
Muscle Cytology
Skeletal Muscle
Muscle Contraction
Muscle Physiology
Nervous System Anatomy
Membrane Potentials
Nerve Transmission
Autonomic Nervous System (ANS)
Spinal Cord
Cranial Nerves
Sensory Basics
Intro to Circulatory System
The Heart
Cardiac Cycle
Electrical Activity in the Heart
Cardiac (Heart) Physiology
Blood Vessels
Blood Pressure (BP) Control
Blood Plasma
Blood Grouping
Vessels & Fluid
Respiratory Structure & Function
Breathing Movements
Breathing Control
Respiratory Functions of Blood
Digestive System Anatomy
Mouth & Oropharynx
Esophagus
Stomach Video
Small Intestine
Large Intestine
Liver & Gallbladder
Urinary System Anatomy (Anatomy and Physiology)
Renal (Kidney) Structure & Function
Renin Angiotensin Aldosterone System (RAAS)
Formation & Excretion of Urine
Renal (Kidney) Fluid & Electrolyte Balance
Renal (Kidney) Acid-Base Balance
Pituitary Gland
Thyroid Gland
Adrenal Gland
Pancreas
Male Reproductive Anatomy (Anatomy and Physiology)
Female Reproductive Anatomy (Anatomy and Physiology)
Epithelial (Skin) Tissues
Types of Epithelial (Skin) Tissue
Glands
Connective Tissues
Membranes
Fluid Compartments
Fluid Pressures
Fluid Shifts (Ascites) (Pleural Effusion)
Isotonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Potassium-K (Hyperkalemia, Hypokalemia)
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Phosphorus-Phos
Heart (Cardiac) Sound Locations and Auscultation
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Aortic Aneurysm
Venous Disorders (Chronic venous insufficiency, Deep venous thrombosis/DVT)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
GERD (Gastroesophageal Reflux Disease)
Nursing Care and Pathophysiology for Pancreatitis
Nursing Care and Pathophysiology for Diverticulosis – Diverticulitis
Nursing Care and Pathophysiology for Hemorrhoids
Nursing Care and Pathophysiology for Appendicitis
Nursing Care and Pathophysiology for Cholecystitis
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care and Pathophysiology of BPH (Benign Prostatic Hyperplasia)
Nursing Care and Pathophysiology for Syphilis (STI)
Nursing Care and Pathophysiology for Herpes Simplex (HSV, STI)
Nursing Care and Pathophysiology for Menopause
Nursing Care and Pathophysiology of Glomerulonephritis
Pressure Ulcers/Pressure injuries (Braden scale)
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Skin Cancer
Integumentary (Skin) Important Points
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Breast Cancer
Diabetes Management
Nursing Care and Pathophysiology for Sepsis
Fluid Volume Deficit
Fluid Volume Overload
Nursing Care and Pathophysiology for Rheumatoid Arthritis (RA)
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology for Compartment Syndrome
Fractures
Casting & Splinting
Impulse Transmission
Cerebral Metabolism
Blood Brain Barrier (BBB)
Levels of Consciousness (LOC)
Routine Neuro Assessments
Adjunct Neuro Assessments
Brain Death v. Comatose
Intracranial Pressure ICP
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Parkinsons
Miscellaneous Nerve Disorders
Tension and Cluster Headaches
Migraines
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Stroke Assessment (CVA)
Stroke Therapeutic Management (CVA)
Stroke Nursing Care (CVA)
Seizure Causes (Epilepsy, Generalized)
Seizure Assessment
Seizure Therapeutic Management
Nursing Care and Pathophysiology for Seizure
Neurological Fractures
Spinal Cord Injury
Nursing Care and Pathophysiology for Meningitis
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology for Pulmonary Edema
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology of Pneumonia
Isolation Precautions (MRSA, C. Difficile, Meningitis, Pertussis, Tuberculosis, Neutropenia)
Coronavirus (COVID-19) Nursing Care and General Information
Artificial Airways
Airway Suctioning
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Nursing Care and Pathophysiology for Pulmonary Embolism
Lung Sounds
Alveoli & Atelectasis
Gas Exchange
Wound Care – Assessment
Aortic Aneurysm – Management Nursing Mnemonic (CRAM)
Aortic Aneurysm – Thoracic signs Nursing Mnemonic (PEE BADS)
Bacterial Endocarditis – Symptoms Nursing Mnemonic (Be Joan Of Arc)
Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)
Circulatory Checks (5 P’s) Nursing Mnemonic (The 5 P’s)
Coronary Arteries – Location Nursing Mnemonic (I have a RIGHT to CAMP if you LEFT off the AC)
Cor Pulmonale – Signs & Symptoms Nursing Mnemonic (Please Read His Text)
CHF Treatment Nursing Mnemonic (UNLOAD FAST)
Cyanotic Defects Nursing Mnemonic (The 4 T’s)
Heart Failure-Left-Sided Nursing Mnemonic (CHOP)
Heart Failure-Origin Nursing Mnemonic (Left – Lung|Right – Rest)
Heart Failure – Right Sided Nursing Mnemonic (HEAD)
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
Hypertension- Complications Nursing Mnemonic (The 4 C’s)
Hypertension – Nursing care Nursing Mnemonic (DIURETIC)
Increase MAP Nursing Mnemonic (VAK)
Murmur locations Nursing Mnemonic (hARD ASS MRS. MSD)
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Vascular Disease – Deep Vein Thrombosis Nursing Mnemonic (HIS Leg Might Fall off)
Vascular disease – Raynaud’s symptoms Nursing Mnemonic (COLD HAND)
Digestion & Absorption
Nutrition-related Diseases
CPR-BLS (Basic Life Support)
Advanced Cardiovascular Life Support (ACLS)
Pediatric Advanced Life Support (PALS)
Neonatal Resuscitation Program (NRP)
Prioritizing Assessments
Triage in the ER
Critical Incident Management
Aggressive & Violent Patients
Legal & Ethical Issues in ER
EMTALA & Transfers
Trauma Survey
Blunt Thoracic Trauma
Penetrating Thoracic Trauma
Blunt Abdominal Trauma
Penetrating Abdominal Trauma
Crush Injuries
Head Trauma & Traumatic Brain Injury
Massive Transfusion Protocol
Acute Coronary Syndrome (ACS)
Aneurysm & Dissection
Cardiopulmonary Arrest
Dysrhythmia Emergencies
Heart (Heart) Failure Exacerbation
Hypertensive Emergency
Arterial Pressure Monitoring
Rapid Sequence Intubation
Pulmonary Embolism
Acute Respiratory Distress
Ventilator Settings
Acute Confusion
Intracranial Hemorrhage
Increased Intracranial Pressure
Stroke (CVA) Management in the ER
Seizure Management in the ER
Sodium and Potassium Imbalance for Certified Emergency Nursing (CEN)