Medical Terminology: A Living Language

Eighth Edition

Chapter 3

Integumentary System

Learning Objectives (1 of 3)

3.1 Identify and define the combining forms, prefixes, and

suffixes introduced in this chapter.

3.2 Correctly spell and pronounce medical terms and major

anatomical structures relating to the integumentary system.

3.3 List and describe the four purposes of the skin.

Learning Objectives (2 of 3)

3.4 Describe the layers of the skin and the subcutaneous

layer and their functions.

3.5 List and describe the accessory organs of the skin.

3.6 Identify and define integumentary system anatomical

terms.

3.7 Identify and define selected integumentary system

pathology terms.

Learning Objectives (3 of 3)

3.8 Identify and define selected integumentary system

diagnostic procedures.

3.9 Identify and define selected integumentary system

therapeutic procedures.

3.10 Identify and define selected medications relating to

the integumentary system.

3.11 Define selected abbreviations associated with the

integumentary system.

Integumentary System at a Glance (1 of 2)

• The integumentary system serves four important

functions

– It acts as a two-way protective barrier

– It regulates temperature

– It houses sensory receptors

– It secretes important fluids

Integumentary System at a Glance (2 of 2)

• Organs of integumentary system include

– Skin

– Hair

– Nails

– Sebaceous glands

– Sweat glands

Integumentary System Combining

Forms (1 of 4)

Combining Form

albin/o

Definition

white

cauter/o

to burn

cold

cry/o

cutane/o

skin

derm/o, dermat/o

diaphor/o

skin

profuse sweating

Integumentary System Combining

Forms (2 of 4)

Combining Form

electr/o

erythr/o

hidr/o

Definition

electricity

red

sweat

ichthy/o

kerat/o

scaly, dry

hard, horny

white

leuk/o

lip/o

fat

melan/o

black

Integumentary System Combining

Forms (3 of 4)

Combining Form

myc/o

Definition

fungus

death

nail

necr/o

onych/o

pedicul/o

phot/o

lice

light

py/o

pus

rhytid/o

sarc/o

wrinkle

flesh

Integumentary System Combining

Forms (4 of 4)

Combining Form

scler/o

Definition

hard

seb/o

oil

system/o

trich/o

system

hair

ungu/o

nail

vesic/o

bladder

dry

xer/o

Integumentary System Suffixes

Suffix

Definition

–derma

skin condition

Integumentary System Prefixes

Prefix

allo–

Definition

other, different from usual

foreign

xeno–

Anatomy and Physiology of the

Integumentary System (1 of 5)

• The skin is the largest organ in the body, weighing more

than 20 pounds

• The skin is also called the integument and the cutaneous

membrane

• The skin provides constant protection to the body

Anatomy and Physiology of the

Integumentary System (2 of 5)

• The primary function of the skin is protection

• It forms a 2-way barrier that

– Keeps pathogens and harmful substances out

– Keeps critical body fluids in

• The skin also protects the internal organs and tissues

Anatomy and Physiology of the

Integumentary System (3 of 5)

• Sensory receptors are housed in the middle layer of the

skin

• They detect a number of sensations

– Temperature

– Pain

– Touch

– Pressure

• Messages from receptors travel to the brain and spinal

cord

Anatomy and Physiology of the

Integumentary System (4 of 5)

• Sweat glands produce sweat

– Sweat evaporates off the skin and creates a

cooling effect

• Sebaceous glands produce an oil called sebum

– Sebum lubricates the skin and keeps it from

becoming too dry

Anatomy and Physiology of the

Integumentary System (5 of 5)

• To cool skin

– Sweat evaporates

– Superficial blood vessels dilate to release heat

through the skin

• To conserve heat

– Superficial blood vessels constrict to prevent heat

escaping through the skin

– Subcutaneous layer serves as insulation

The Skin

• The skin consists of two layers

– Epidermis: The thin, outer membrane layer

– Dermis: The middle, fibrous connective tissue layer

• The subcutaneous layer is an important layer of fatty

tissue below the skin

Figure 3-1 Skin Structure, Including the Layers of the

Skin, the Subcutaneous Layer, and the Accessory

Organs: Sweat Gland, Sebaceous Gland, and Hair

Figure 3-2A Photomicrograph Showing the Two Layers

of Light-Colored Skin and the Subcutaneous Layer

Figure 3.2B Photomicrograph of Epidermis and Dermis

of Dark-Colored Skin. Note Large Amount of Melanin in

Basal Layer of the Epidermis

The Skin: Epidermis (1 of 3)

• The epidermis is composed of stratified squamous

epithelium

– These are flat, scale-like cells

– They are arranged in overlapping layers called strata

• The epidermis has no blood supply or connective tissue

The Skin: Epidermis (2 of 3)

• The basal layer is the deepest layer of the epidermis

– In this layer, cells continuously grow and push old

cells toward the surface

– During this process, cells that are being pushed up

shrink, die, and fill with keratin

• Keratinized cells overlap and allow the skin to act as a

waterproof barrier

The Skin: Epidermis (3 of 3)

• The basal layer also contains melanocytes

– Melanocytes produce the black pigment melanin that

gives skin its color

– Melanin protects skin against ultraviolet (UV) rays of

the sun

The Skin: Dermis (1 of 2)

• The dermis, or corium, is the deeper layer of skin

• It is located between the epidermis and the

subcutaneous layer

• It is living tissue with a good blood supply

• It is made of connective tissue and collagen fibers

that give it strength

The Skin: Dermis (2 of 2)

• Ridges formed in the dermis create unique fingerprints

• A number of structures are housed in the dermis

– Hair follicles

– Sweat and sebaceous glands

– Blood and lymph vessels

– Sensory receptors and nerve fibers

– Muscle fibers

The Skin: Subcutaneous Layer

• The subcutaneous layer, or hypodermis, lies beneath the

skin

• It is composed of fat cells called lipocytes

• It protects the deeper tissues of body and acts as

insulation against heat and cold

Accessory Organs: Hair

• The hair is an accessory organ that consists of the

follicle, root, shaft, and arrector pili muscle

• Hair grows as older, keratinized cells are forced upward

by new cells

• Melanin gives hair its color

• The arrector pili muscle contracts to make the hair shaft

stand up

Figure 3.3 Structure of a Hair and Its

Associated Sebaceous Gland

Accessory Organs: Nails

• The main part of the nail is a flat plate of keratin called

the nail body

• The nail body is connected to the underlying tissue by

the nail bed

• The lunula is at the base of the nail

• Nails grow from the nail root, which is covered by the

cuticle

• The free edge is the exposed part that must be trimmed

Figure 3.4 External and Internal

Structures of Nails

Accessory Organs: Sebaceous Glands

• Sebaceous glands release sebum directly into hair

follicles

• Sebum lubricates hair and skin and prevents drying and

cracking

• Sebaceous secretions increase during adolescence,

leading to acne

• Secretions decrease with age, contributing to wrinkles

and dry skin

Accessory Organs: Sweat Glands

• Sweat glands, or sudoriferous glands, are coiled glands

in the dermis

• Sweat travels to surface via a sweat duct and exits to the

surface via a sweat pore

• Sweat cools the body as it evaporates

• Most sweat is colorless and odorless, but sweat from

apocrine glands produces body odor

Terminology: Combining Forms (1 of 5)

Combining Form

albin/o

Definition

white

angi/o

vessel

the base

life

bas/o

bi/o

carcin/o

cauter/o

chem/o

cis/o

cancer

to burn

chemical

to cut

Terminology: Combining Forms (2 of 5)

Combining Form

cortic/o

Definition

outer layer

cold

cry/o

cutane/o

cyt/o

skin

cell

derm/o, dermat/o

diaphor/o

electr/o

skin

profuse sweating

electricity

red

erythr/o

Terminology: Combining Forms (3 of 5)

Combining Form

esthesi/o

hem/o

Definition

feeling

blood

hidr/o

sweat

ichthy/o

kerat/o

scaly, dry

hard, horny

white

leuk/o

lip/o

fat

melan/o

black

Terminology: Combining Forms (4 of 5)

Combining Form

myc/o

Definition

fungus

death

nail

necr/o

onych/o

pedicul/o

phot/o

lice

light

py/o

pus

rhytid/o

sarc/o

wrinkle

flesh

Terminology: Combining Forms (5 of 5)

Combining Form

scler/o

Definition

hard

seb/o

oil

septic/o

system/o

trich/o

infection

system

hair

ungu/o

nail

vesic/o

sac

xer/o

dry

Terminology: Suffixes (1 of 3)

Suffix

-al

Definition

pertaining to

skin condition

surgical removal

blood condition

state, condition

abnormal condition

pertaining to

state of

-derma

-ectomy

-emia

-ia

-iasis

-ic

-ism

Terminology: Suffixes (2 of 3)

Suffix

-itis

Definition

inflammation

study of

-logy

-malacia

-oma

-opsy

-osis

abnormal softening

mass or tumor

view of

abnormal condition

pertaining to

eat, swallow

-ous

-phagia

Terminology: Suffixes (3 of 3)

Suffix

-plasty

-rrhea

-tic

Definition

surgical repair

discharge

pertaining to

instrument to cut

small

-tome

-ule

Terminology: Prefixes (1 of 2)

Prefix

allo-

an-

Definition

other

without

against

self

anti-

auto-

de-

without

above

epi-

ex-

outward

Terminology: Prefixes (2 of 2)

Prefix

hyper-

hypo-

intra-

para-

sub-

Definition

excessive

under

within

beside

under

xeno-

foreign

Adjective Forms of Anatomical Terms

Prefix

Definition

cutaneous

dermal

Pertaining to the skin

Pertaining to above the skin

Pertaining to below the skin

Pertaining to within the skin

Pertaining to under the skin

Pertaining to the nail

dermic

epidermal

hypodermic

intradermal

subcutaneous

ungual

Medical Specialties

Specialty

Definition

Branch of medicine involving diagnosis and treatment

of conditions and diseases of the integumentary

system. Physician is a dermatologist.

Dermatology

(DERM, derm)

Surgical specialty involved in repair, reconstruction, or

improvement of body structures such as the skin that

are damaged, missing, or misshapen. Physician is a

plastic surgeon.

Plastic surgery

Signs and Symptoms (1 of 7)

Term

Definition

abrasion

friction scraping away skin surface

anhidrosis

condition of producing no sweat

bulla

a large blister

comedo

hardened sebum in hair follicle; blackhead

injury caused by a blow; causes swelling,

pain, and bruising

contusion

cyst

fluid-filled sac under skin

Figure 3.5A Illustration of a Cyst

Figure 3.5B Photo of a Cyst

Signs and Symptoms (2 of 7)

Term

Definition

depigmentation

loss of normal skin color

diaphoresis

ecchymosis

profuse sweating

blood collecting under skin following blunt

trauma; a bruise

erythema

red flushing of skin

erythroderma

having reddened or flushed skin

thick layer of dead tissue over a deep burn

area

eschar

Figure 3.6A Male Lying Supine With Large

Ecchymosis on Lateral Rib Cage and Shoulder

Figure 3.6B Appearance of Bruised

Darkcolored Skin

Signs and Symptoms (3 of 7)

Term

Definition

fissure

crack-like lesion on the skin

hirsutism

excessive hair growth

hyperemia

redness of skin due to increased blood flow

excessive sweating

hyperhidrosis

hyperpigmentation

lesion

abnormal amount of pigmentation

general term for an injury or abnormality

Figure 3.7A Illustration of a Fissure

Figure 3.7B Photo of a Fissure

Signs and Symptoms (4 of 7)

Term

Definition

leukoderma

white skin from lack of skin pigment

lipoma

fatty mass

macule

flat, discolored spot on skin

necrosis

condition of cell or tissue death

pigmented skin blemish, birthmark, or mole;

usually benign

nevus

nodule

firm, solid mass larger than 0.5 cm

softening of nails

onychomalacia

Figure 3.8A Illustration of a Macule

Figure 3.8B Photo of a Macule

Figure 3.9A Illustration of a Nodule

Figure 3.9B Photo of a Nodule

Signs and Symptoms (5 of 7)

Term

Definition

pallor

abnormal paleness of skin

papule

small, solid raised spot smaller than 0.5 cm

petechiae

photosensitivity

pruritus

spots from minute hemorrhages under skin

abnormal skin reaction to light

severe itching

purpura

skin hemorrhage due to fragile blood vessels

Figure 3.10A Illustration of a Papule

Figure 3.10B Photo of a Papule

Figure 3.11 Petechiae, Pinpoint Skin

Hemorrhages

Figure 3.12 Purpura, Hemorrhaging Into

the Skin Due to Fragile Blood Vessels

Signs and Symptoms (6 of 7)

Term

Definition

infection producing pus; pus contains dead

bacteria, white blood cells, and tissue debris

purulent

pustule

raised spot on skin containing pus

pyoderma

scleroderma

seborrhea

having pus on or within the skin

hardened skin

oily discharge

suppurative

ulcer

containing or producing pus

open sore in skin

Figure 3.13A Illustration of a Pustule

Figure 3.13B Photo of a Pustule

Figure 3.14A Illustration of an Ulcer

Figure 3.14B Photo of an Ulcer

Signs and Symptoms (7 of 7)

Term

Definition

urticaria

hives; eruption of wheals with severe itching

vesicle

small, fluid-filled, raised spot; blister

small, round, swollen area; typical of allergic skin

reaction

wheal

xeroderma

abnormally dry skin

Figure 3.15A Illustration of a Vesicle

Figure 3.15B Photo of a Vesicle

Figure 3.16A Illustration of a Wheal

Figure 3.16B Photo of a Wheal. Note That the Raised

Areas Are Solid, Swollen Skin and Not Blisters

Pathology of the Skin (1 of 8)

Term

Definition

abscess

collection of pus in skin

chronic form of adult acne with redness and tiny

pimples, primarily on nose

acne rosacea

acne vulgaris

common form of teenage acne with comedos,

papules, and pustules

abnormal condition of hard, horny, wartlike lesion that

develops on sun-damaged skin; may become

cancerous

actinic keratosis

albinism

genetic condition in which the skin is unable to make

melanin; skin and hair are white and eyes appear red

Pathology of the Skin (2 of 8)

Term

Definition

basal cell

carcinoma

cancerous tumor in the basal cell layer; common

cancer that rarely metastasizes

skin damage caused by fire, electricity, ultraviolet light,

or caustic chemicals; percentage of skin burned is

estimated using the Rule of Nines

burn

cellulitis

diffuse acute infection of connective tissue of skin

Figure 3.17 Basal Cell Carcinoma. A Frequent

Type of Skin Cancer That Rarely Metastasizes

Figure 3.18 Comparison of the Level of Skin Damage

as a Result of the Three Different Degrees of Burns

Figure 3.19 Rule of Nines. A Method for Determining

Percentage of Body Burned. Each Colored Section

Represents a Percentage of the Body Surface. All

Sections Added Together Will Equal 100%

Pathology of the Skin (3 of 8)

Term

Definition

cicatrix

normal scar

decubitus ulcer

(decub)

open sore caused by pressure over bony

prominences; caused by loss of blood flow to skin

dermatitis

inflammation of the skin

dermatosis

presence of a skin condition

late stages of gangrene; affected area becomes

dried, blackened, and shriveled

dry gangrene

Figure 3.20 Very Large, Full-Thickness Decubitus

Ulcer Over Coccyx Region of Buttocks

Pathology of the Skin (4 of 8)

Term

Definition

superficial dermatitis; redness, vesicles, itching,

and crusting

eczema

gangrene

ichthyosis

tissue necrosis due to loss of blood flow

skin becomes dry, scaly, and keratinized

highly infectious bacterial infection with pustules

that rupture and crust over

impetigo

skin cancer seen in AIDS patients; brownish-

purple lesions

Kaposi's sarcoma

keloid

thick hypertrophic scar

Figure 3.21 Impetigo, a Highly

Contagious Bacterial Infection

Figure 3.22A Illustration of a Keloid

Figure 3.22B Photo of a Keloid

Pathology of the Skin (5 of 8)

Term

Definition

condition of excessive growth and thickening of

epidermis layer

keratosis

laceration

torn or jagged wound

malignant melanoma dangerous form of cancer; begins in melanocytes;

(MM)

quickly metastasizes

mokeypox

(m pox)

contagious viral infection that causes flu-like

symptoms and a rash with pustules or blisters

pediculosis

psoriasis

lice infestation

chronic inflammatory condition with papules

forming "silvery scale" patches

Figure 3.23 Malignant Melanoma. This Photograph

Demonstrates the Highly Characteristic Color of This

Tumor

Figure 3.24 A Person with the

Characteristic Monkeypox Rash

Figure 3.25 Photograph of Adult Head

Lice

Figure 3.26 This Photograph Demonstrates

the “Silvery Scale” Circular Patches That Are

Characteristic of Psoriasis

Pathology of the Skin (6 of 8)

Term

Definition

rubella

contagious viral infection; German measles

scabies

skin disease cased by a mite infestation

sebum filled sac under the skin

sebaceous cyst

squamous cell

carcinoma (SCC)

cancer of epidermis layer; may invade deeper

tissue and metastasize

strawberry

hemangioma

congenital collection of dilated blood vessels;

birthmark

Figure 3.27A Photo of Characteristic Rash

Caused by Mite Burrowing Through Skin

Figure 3.27B Photomicrograph of

Scabies Mite

Figure 3.28 Squamous Cell Carcinoma

Figure 3.29 Strawberry Hemangioma, a Birthmark

Caused by a Collection of Blood Vessels in the Skin

Pathology of the Skin (7 of 8)

Term

Definition

chronic disease of connective tissue; injures skin,

joints, and kidneys; produces red, scaly butterfly

rash

systemic lupus

erythematosus (SLE)

tinea

fungal infection; itching and scaling lesions

fungal infection on scalp; ringworm

tinea capitis

tinea pedis

varicella

verruca

fungal infection of foot; athlete's foot

contagious viral infection; chickenpox

warts; benign growth caused by a virus

Figure 3.30 Photo of Tinea on a Lower Leg

Illustrating the Characteristic Ring Pattern

Figure 3.31 Photo Illustrating Severe

Blistering and Peeling of Athlete’s Foot

Figure 3.32 Varicella on Face of Young Girl.

Blisters Are Just Beginning to Form Scabs

Pathology of the Skin (8 of 8)

Term

Definition

disappearance of pigment from skin in patches;

causes milk-white lesions

vitiligo

area of gangrene with secondary bacterial

infection and pus

wet gangrene

Figure 3.33 Photo of a Young Woman

With Vitiligo

Pathology of the Hair

Term

Definition

alopecia

absence or loss of hair; baldness

carbuncle

furuncle

furuncle involving several hair follicles

bacterial infection of hair follicle; redness, pain,

and swelling; a boil

trichomycosis

fungal infection of the hair

Pathology of the Nails

Term

Definition

onychia

infected nail bed

onychomycosis

onychophagia

paronychia

fungal infection of the nail

nail biting

infection of the skin fold around the nail

Figure 3.34 Paronychia

Clinical Laboratory Tests

Term

Definition

grows bacteria removed from infected area to

identify infecting bacteria; also determines the

bacteria’s sensitivity to various antibiotics

culture and sensitivity

(C&S)

Biopsy Procedures (1 of 2)

Term

Definition

biopsy

removal of piece of tissue to examine under

microscope

(BX, bx)

removal of an entire suspicious area of tissue for

examination

excisional biopsy

scraping cells from tissue to examine under

microscope

exfoliative cytology

frozen section

(FS)

thin piece of tissue cut from a frozen specimen for

rapid examination under microscope

scrapings from lesions that are cultured and

examined under microscope

fungal scrapings

Biopsy Procedures (2 of 2)

Term

Definition

scraping cells from tissue to examine under

microscope

exfoliative cytology

frozen section

(FS)

thin piece of tissue cut from a frozen specimen for

rapid examination under microscope

scrapings from lesions that are cultured and

examined under microscope

fungal scrapings

removal of a small cylinder of tissue by an

instrument that pierces through tissue like a hole

punch

punch biopsy

removal of think layer of epidermis or dermis

tissue using scalpel or razor; performed to remove

tissue elevated above surface of skin

shave biopsy

Skin Grafting (1 of 2)

Term

Definition

skin graft from one person to another; also called

homograft

allograft

autograft

dermatome

dermatoplasty

skin graft from a person's own body

instrument for cutting skin or for producing thin

transplants of skin

skin grafting

Figure 3.35 A Freshly Applied Autograft. Note That the

Donor Skin Has Been Perforated So That It Can Be

Stretched to Cover a Larger Burned Area

Skin Grafting (2 of 2)

Term

Definition

transfer of skin from a normal area to cover

another site

skin graft (SG)

skin graft from an animal of another species,

usually a pig; also called heterograft

xenograft

Surgical Procedures (1 of 2)

Term

Definition

destruction of tissue by using chemicals, electricity,

heat, or freezing

cauterization

cryosurgery

curettage

use of extreme cold to freeze and destroy tissue

removal of superficial skin lesion with a scraper

(curette)

removal of foreign material and dead or damaged

tissue from a wound

debridement

Surgical Procedures (2 of 2)

Term

Definition

electrocautery

using an electric current to destroy tissue

incision and

drainage (I&D)

making an incision to drain material such as pus

surgical removal of a nail

onychectomy

Plastic Surgery Procedures

Term

Definition

chemabrasion

abrasion using chemicals; chemical peel

abrasion using wire brushes or sandpaper; removes

scars, tattoos

dermabrasion

laser therapy

liposuction

removal of lesions using a laser beam

removal of fat beneath skin by means of suction

surgical removal of excess skin to eliminate

wrinkles; face lift

rhytidectomy

Pharmacology (1 of 2)

Drug Type

anesthetic

antibiotic

Use

Example

deaden pain

kill bacteria

kill fungi

lidocaine, procaine

Neosporin

antifungal

antiparasitic

miconazole, clotrimazole

Kwell, Nix

kill mites or lice

Pharmacology (2 of 2)

Drug Type

Use

Example

antipruritic

reduce severe itching Benadryl, Caladryl

isopropyl alcohol,

kill bacteria

antiseptic

hydrogen peroxide

corticosteroid

cream

powerful anti-

Cortaid; Kenalog

inflammatory

Abbreviations (1 of 4)

Term

Definition

#

number

ADN

BCC

BSN

registered nurse with associate’s degree

basal cell carcinoma

registered nurse with bachelor’s degree

biopsy

BX, bx

C&S

culture and sensitivity

CNA

decub

certified nursing assistant

decubitus ulcer

Abbreviations (2 of 4)

Term

Derm, derm

FS

Definition

dermatology

frozen section

I&D

incision and drainage

intradermal

ID

LPN

licensed practical nurse

licensed vocational nurse

malignant melanoma

LVN

MM

Abbreviations (3 of 4)

Term

mpox

MSN

oint

Definition

mokeypox

registered nurse with master’s degree

ointment

qid

four times a day

registered nurse

squamous cell carcinoma

skin graft

RN

SCC

SG

Abbreviations (4 of 4)

Term

SLE

ST

Definition

systemic lupus erythematosus

split-thickness

Subcut

tid

subcutaneous

three times a day

ultraviolet

UV

WHO

x

World Health Organization

times

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