Integumentary System
Skin contains two types of glands that produce important secretions. These glands under the skin are the sebaceous and the sweat glands.
Sebaceous glands produce sebum, an oily secretion, and sweat glands produce sweat, a watery secretion.
Layers of the skin
Integumentary System - Vocabulary
- Epidermis : a thin, cellular membrane layer (Outermost layer of the skin).
- Dermis (Corium) : Middle layer of the skin. Dense, fibrous, connective tissue layer. (Sebaceous glands are located in dermal layer. They secrete an oily substance called sebum)
- Subcutaneous tissue: thick, fat-containing tissue. (Lipocytes are predominant in the subcutaneous layer)
Squamous epithelial cells are flat and scale-like. In the outer layer of the skin, these cells are arranged in several layers (strata) and are therefore called stratified squamous epithelium.
apocrine sweat gland: One of large dermal exocrine glands located in the axilla and genital areas.
Basal layer: The deepest region of the epidermis; it gives rise to all the epidermal cells.
collagen: Structual protein found in the skin and connective tissue.
Stratum corneum: The outermost layer of the epidermis, which consists of flattened, keratinized (horny) cells.
keratin: Hair protein material found in the epidermis, hair, and nails. Keratin means horn and is commonly found in the horns of the animals. The basal layer of the epidermis contains special cells called melanocytes. Melanocytes form and contain a brown-black pigment called melanin.
albino: Person with skin deficient in pigment (melanin)
lunula: is a semilunar (half-moon), white region at the base of the nail plate.
paronychium: is the soft tissue surrounding the nail border.
cuticle: a narrow, band of epidermis (layer of keratin)
epithelium: Layer of skin cells forming the outer and inner surfaces of the body.
hair follicle: Sac within which each har grows.
lipocyte: A fat cell.
melanin: Major pigment that gives the skin color. It is formed by melanocytes in the epidermis.
pors: Tiny opening on the surface of the skin.
sebum: Oily substance secreted by sebaceous glands.
squamous epithelium: Flat, scale-like composing the epidermis.
statified: Arranged in layers.
stratum (plural: strata) : A layer (of cells).
stratum corneum: The outermost layer of the epidermis, which consists of flattened, keratinized (horny) cells.
epidermis: Outer most layer of the skin.
dermis: Middle layer of the skin; also called corium.
subcutaneous tissue: The innermost layer of the skin, containing fat tissue.
Integumentary System - Combining Forms and Suffixes
adip/o - fat
lip /o - fat
steat/o - fat
albin/o - white
leuk/o - white
anthrac/o - black (as coal)
chlor/o - green
cirrh/o - tawny yellow
jaund/o - yellow
xanth/o - yellow
lute/o - yellow
cyan/o - blue
eosin/o - rosy
erythr/o - red
melan/o - black
poli/o - gray
caus/o - burn, burning
cauter/o - heat, burn
cutane/o - skin
derm/o - skin
dermat/o - skin
diaphor/o - profuse sweating
erythem/o - redness
erythemat/o - redness
hidr/o - sweat
ichthy/o - (fish-like) - scaly, dry
kerat/o - hard, horny tissue
lip/o - fat
myc/o - fungus (fungi include yeasts, molds, and mushrooms)
onych/o - nail
ungu/o - nail
phyt/o - plant
pil/o - hair
trich/o - hair
rhytid/o - wrinkle
seb/o - sebum (oily secretion from sebaceous glands)
squam/o - scale-like
steat/o - fat
trich/o - hair
ungu/o - nail
xanth/o - yellow
xer/o - dry
Suffixes
-derma -> skin
Integumentary System - Lesions, Signs and Symptoms, Abnormal Conditions, and Skin Neoplasms
Integumentary System - Cutaneous Lesions
crust: Collection of dried serum and cellular debris.
cyst : Thick-walled, closed sac or pouch containing fluid or semisolid material.
erosion: Wearing away of loss of epidermis.
fissure: Groove or crack-like sore.
polyp: Mushroom-like growth extending on a stalk from the surface of mucous membrane.
ulcer: Open sore on the skin or mucous membrane.
vesicle: Small collection of clear fluid (serum); blister.
wheal: Smooth, slightly elevated, edematous (swollen) area that is redder or paler than the surrounding skin.
macule: Discolored (often reddened) flat lesion.
nodule: Solid, elevated lesion more than 1 cm in diameter. (>1 cm - nodule)
papule: Solid, elevated lesion less than 1 cm in diameter. (<1 cm - papule)
pustule: Small elevation of the skin containing pus.
Integumentary System - Signs and Symptoms
alopecia: Absence of hair from areas where it normally grows.
ecchymosis (plural - ecchymoses): Bluish-black mark (macule) on the skin; black-and-blue mark. (ec- means out and chym/o means pour)
petechia (plural - petechiae): A small, pinpoint hemorrage.
pruritus: Itching.
purpura: Merging ecchymoses and petechiae over any part of the body.
urticaria(hives): Acute allergic reaction in which red, round wheals develop on the skin.
Integumentary System - Abnormal Conditions
acne: Papular and pustular eruption of the skin.
burns: Injury to tissues caused by heat.
- first-degree burns: superficial epidermal lesions, erythema, hyperesthesia, and no blisters. (Ex: Sunburn).
- second-degree burns: partial-thickness burn injury.
- third-degree burns: full-thickness burn injury.
cellulitis: Diffuse, acute infection of the skin marked by local heat, redness, pain, and swelling.
eczema: Inflammatory skin disease with erythematous, papulovesicular lesions.
exanthematous viral diseases: Rash (exanthem) of the skin due to a viral infection.
gangrene: Death of tissue associated with loss of blood supply.
impetigo: Bacterial inflammatory skin disease characterized by vesicles, pustules, and crusted-over lesions.
psoriasis: Chronic, recurrent dermatosis marked by itchy, scaly, red plaques covered by silvery gray scales.
scabies: A contagious, parasitic infection of the skin with intense pruritus.
scleroderma: A chronic progressive disease of the skin with hardening and shrinking of connective tissue.
systemic lupus erythematosus(SLE): Chronic inflammatory disease of collagen in the skin, of joints, and of internal organs.
tines: Infection of the skin caused by a fungus.
vitiligo: Loss of pigment (depigmentation) in areas of the skin (milk-white patches). Also known as leukoderma.
Integumentary System - Skin Neoplasms
callus: Increased growth of cells in the keratin layer of the epidermis caused by pressure or friction.
keloid: Hypertrophied, thickened scar that occurs after trauma or surgical incision.
keratosis: Thickened area of the epidermis.
leukoplakia: White, thickened patches on mucous membrane tissue of the tongue or cheek.
nevus (plural - nevi): Pigmented lesion of the skin.
verruca: Epidermal growth caused by a virus(wart).
Integumentary System - Cancerous Lesions
basal cell carcinoma: Malignant tumor of the basal cell layer of the epidermis.
Kaposi sarcoma: Malignant, vascular, neoplastic growth characterized by cutaneous nodules. Frequently on the lower extremities.
malignant melanoma: Cancerous growth composed of melanocytes.
squamous cell carcinoma: Malignant tumor of the squamous epithelial cells of the epidermis.
Integumentary System - Clinical Procedures
cryosurgery: Use of subfreezing temperature via liquid nitrogen application to destroy tissue.
curettage: Use of sharp dermal curet (curette) to scrape away a skin lesion.
electrodesiccation: Tissue is destroyed by burning with an electric spark.
Mohs surgery: Thin layers of malignant growth are removed, and each is examined under a microscope.
skin biopsy: Suspected malignant skin lesions are removed and sent to the pathology laboratory for microscopic examination.
skin test: The reaction of the body to a substance by observing the results of injecting the substance intradermally or applying it topically to the skin.
Integumentary System - Abbreviations
ABCD - asymmetry, border, color, diameter; characteristics associated with skin cancer.
bx - biopsy.
Derm. - dermatology.
DLE - discoid lupus erythematosus.
PPD - purified protein derivative; skin test for tuberculosis.
PUVA - psoralen-ultraviolet (A light therapy).
SLE - systemic lupus erythematosus
subcut - subcutaneous.
Medical Transcription Questions
TRUE or FALSE and MULTIPLE CHOICE
True or False?
- Dermatitis is a painful condition of the eyes. T/F
- An eschar is a thick, coagulated crust. T/F
- Quiescent means to become very active. T/F
- Intramuscular means within the vein. T/F
- Tonsillitis is an inflammation of the tonsils. T/F
- Erythema means blueness of the skin. T/F
- Tinea pedis is a fungal infection of the hands. T/F
- Hyperpigmentation means decreased pigment in a tissue or body part. T/F
- Paroxysm means occurring at night. T/F
- Etiology means a visionary theory. T/F
- A laceration is a surgical incision made by a physician. T/F
- Cyanosis is a dark reddish coloration of the skin and mucous membranes. T/F
- The term carotid refers to a vein. T/F
- The definition of cholelithiasis is inflammation of the gallbladder. T/F
- The term normoactive would mean abnormally active. T/F
- The term hematuria means blood in the urine. T/F
- The peritoneum is the space between the anus and the scrotum or vaginal opening. T/F
- The term syncope means to faint or swoon. T/F
- The term atraumatic means to have suffered abnormally severe trauma. T/F
- The term esophagitis means inflammation of the esophagus. T/F
- A fibroadenoma is a benign neoplasm. T/F
- The term febrile means without a fever. T/F
- The term urosepsis means infection from obstruction of contaminated urine. T/F
- The term intercostal means between the ribs. T/F
- The term "in extremis" means to be extremely weak. T/F
Multiple Choice
1. Leukocytes are what types of cells?
A. Red blood cells B. Malignant cells C. White blood cells D. Plasma cells
2. The term labile, as in labile hypertension, means
A. unstable B. tagged C. explosive D. hard
3. The definition of hematemesis is
A. blood in the stool B. a blood cell C. vomiting of blood D. blood in the urine
4. The term excision means
A. cut into B. cut out C. cut off D. cut open
5. The abbreviation p.c. means
A. after a meal B. by mouth (orally) C. as required D. poison control
6. A physician may say, "I was unable to ______ a response to the Babinski reflex."
A. elicit B. illicit C. ellicit D. solicit
7. The term supine means
A. face downward B. face upward C. head flexed backward D. lying on the side
8. The term diaphoretic means
A. perspiration B. percutaneous C. diaphragm D. translucent
9. The term hepatocellular refers to cells within the
A. kidney B. gallbladder C. liver D. pancreas
10. The term suppuration is best defined as
A. above a crest B. above the maxilla C. formation of pus D. above the urinary tract
11. The term thrombosis is best defined as
A. serotonin B. clotting within a blood vessel C. megakaryocyte D. blockage
12. The term decubitus means
A. extending downward B. position of patient in bed, or dorsal C. decortication D. clubbing
13. The term atrophy means
A. abnormal sound B. wasting of tissues or organs C. inability to ambulate D. without levels
14. Ecchymosis is a term that means
A. blue patch B. purplish patch C. red patch D. black patch
15. Which one of the following measurements would not be included in arterial blood gases?
A. pH B. creatinine C. pCO2 D. pO2
Referencing Refinements
Sound everything out and look up the sounds you are hearing based on many different ways of spelling the sounds, as in "f" or "ph," and as in "k" or "ch."
Remember, too, to work your way through the vowels after the main sound: if "ch" is the main sound you would then look up words with a-e-i-o-u-and y following "ch."
Examples:
> You hear --"a-k"--as in acanthosis; check ac, acc, ach, ak, aq
> You hear--"ace"--as in acebutolol; check ace, aci, ase, asy
> You hear--"acu"--as in acute; check in acu, accu
> You hear--"ad-e"--as in adenovirus; check ade, adi, ady
> You hear--"aero"--as in aerobic; check aro, arro, ary, ero, ery
> You hear--"alla"--as in allachesthesia; check alla, alle, allo, ala, ale, ali, allyl, alo
> You hear--"ambi"--as in ambient; check ambi, ambly, ambe
> You hear--"am-e"--as in ametropia; check ame, ami, amy
> You hear--"ank"--as in ankyloglossia; check anch, ank
> You hear--"ante"--as in antegrade; check ante, anti
> You hear--"a-f"--as in aphasia; check aph, af
> You hear--"apo"--as in apoplexy; check api, apo, ape, appe, appi, appo, apy
> You hear--"antree"--as in antresia; check antre, antri
Word Research Techniques
Word Research Techniques
The ability to research medical terms that you are not familiar with is the paramount skill that will be called on each day you practice medical transcription.
There will constantly be new terms that need to be researched in reference books, along with a need to look up potential words when the word has been dictated in a manner that makes it unclear, i.e. the physician cuts off either the first part or last part of a word.
1. Always look under the noun first.
In the following examples, the word to look up is in bold.
postsphenoidal bone / Unna's boot / tardive dystonia
submantle layer / appendiceal mass / suppurative mastitis
olivary nucleus / Hodgkin's sarcoma / growth quotient
2. If the term to be researched is a syndrome, also check under these terms: sign / disease / symptom / process / phenomenon
3. Don't forget to look up anatomical terms under their Latin names. Many physicians will give the Latin names for muscles, veins, arteries, etc. See below for a listing of several Latin names and their English equivalents.
| LATIN | ENGLISH |
| vena | vein |
| musculus | muscle |
| arteria | artery |
| ligamentum | ligament |
| nervus | nerve |
4. If you can't find the term you need under the noun, then look under each word you hear. You will eventually run into the term you are looking for. In time, this will be accomplished faster and easier with the use of Google or Yahoo opposed to the use of books.
5. A trick I have always used in researching a word is to work my way through the vowels (a, e, i, o, u, and y) in order to eventually locate the correct spelling of the word I need. In medicine, there are many words that might sound like they begin with an "a," but that really begin with another vowel. Use this trick of working your way through the vowels to eventually find the correct spelling of the word you are researching.
6. Always sound out what you are hearing and research according to every phonetic way possible of spelling the word.
For example:
If you hear "fima"... don't forget that "phy" has the same sound, so the word is "phyma."
If you hear "condro"... don't forget that this could also be "chondro" or "kondro."
If you hear "terigoid"... don't forget that in medicine, there are several terms that have the "t" sound that start with "pt." The word is "pterygoid