Prodi RMIK, Fakultas Ilmu-ilmu Kesehatan TM Integument Pertemuan 5 dr. Mayang Anggraini Prodi RMIK, Fakultas Ilmu-ilmu Kesehatan

KEMAMPUAN AKHIR YANG DIHARAPKAN Memahami letak dan fungsi Roots, Suffix, Prefix istilah sistem integument dengan tepat dan benar. Memahami Root sistem organ tubuh, arti istilah medis, menganalisis istilah terkait berbagai sistem organ tubuh kasus integument dengan tepat dan benar.

Sistem integumentum terdiri dari kulit, rambut, kuku, dan kelenjar-kelenjar. Struktur sistem dan fungsi: (1) Sistem perlindungan seluruh tubuh bagian luar. (2) Memproduksi keringat  medinginkan tubuh. Memproduksi minyak  melumasi permukaan tubuh. (3) Menerima informasi sensoris (perasaan) yang berkaitan dengan: rasa sakit, suhu, tekanan, dan rabaan Setiap bagian struktur berserta keunikannya akan dibahas satu persatu.

Epidermis memiliki 3 (tiga) susun lapisan khusus: Bagian terluar tertutup jaringan sel pipih keras seperti tanduk dan senantiasa mengelupas meremajakan diri. Lapisan sel bawahnya mengandung melanin, substansi penghitam warna kilit. - Lapisan sel terdalam adalah site lapisan pertumbuhan sel dan disebut: basal layer.

Dermis (= the living tissue of skin) Dermis mengandung: - pembuluh darah, - ujung serabut saraf sensoris, - kelenjar minyak, - kelenjar keringat dan - folikel rambut.

STRUKTUR KULIT Struktur kulit terdiri dari: - kulit, - kelenjar, - rambut dan - kuku. Fungsi: alat proteksi penutup tubuh dan membantu pengenalan sensasi panas, dingin, sakit dan rabaan. Kelenjar memproduksi keringat sebagai pendingin tubuh, minyak sebagai pelumas kulit bagian luar. Kuku memprotekdi ujung jari tangan dan kaki.

Kulit & Kelenjar Kulit tersusun atas 2 lapisan yang sangat berbeda: (1) epidermis (lapisan terluar) (2) dermis (lapisan bagian tengah atau dalam) Lapisan ketiga: (3) jaringan subcutaneous, jaringan yang melekat erat ke dermis.

Epidermis Lapisan teratas sel pipih keras mirip tanduk yang mengelupas seraca berkelanjutan, disusul lapisan melanin dan kemudian lapisan basal, tempat sel bertumbuh.

Dermis Bagian kulit yang disebut: bagian yang hidup, banyak pembuluh darah, ujung serabut saraf, kelenjar minyak dan folikel rambut. Kelenjar sebaceous menghasilkan sebum (minyak) ke dalam folikel rambut. Kelenjar keringat (sudoriferous glands) menghasilkan keringat yang keluar pori permukaan kulit.

Jaringan Subkutan Terdiri dari jaringan lemak (adipose), menjadi: - isolator dan - pelindung struktur bagian dalam tubuh

Rambut Rambut berisi protein keratin, tumbuh dari folikel rambut yang ada di lapisan dermis. Otot errector pili menunjang struktur folikel rambut. Akar rambut tertanam di folikel rambut. Helaian rambut adalah jaringan mati tanpa ujung serabut saraf, ataupun aliran darah. Maka dapat dipotong.

ISTILAH UMUM SISTEM PENUTUP TUBUH KULIT AKAR KATA SISTEM INTEGUMENTARI Akar Kata/Root Definisi cut/o-; cutane/o- skin (kulit) derm/o-; dermat/o- kulit hidr/o- sweat (keringat) kerat/o- horny tissue; hard (jaringan mirip tanduk, keras) melan/o- black (hitam) myc/o-; fung-i(o)- fungus (jamur) onyc/o-; ungu/o nail (kuku) pachy/o- thick (tebal) pil/o- hair (rambut) rhytid/o- wrinkles (keriput)

Akar Kata/Root Dedinisi seb/o- sebum (sekresi kelenjar lemak) squam/o- scale (sisik) sud/o-; sudor/o- sweat (keringat) trich/o- hair (rambut) xer/o- dry (kering) Contoh istilah: ARTI dermatologist = xeroderma = sudoriferous gland = mycoses (mycosis) = squamation =

Reading DISORDERS OF THE SKIN The skin is the largest and most vulnerable organ of the body. Although skin conditions are seldom life-threathening, many can be severely debilitating and cause psychological problems. Congenital Disorders A birthmark (Q82.5) is a type of nevus (pigmented skin blemish) present from birth. Nevi (M8720/0) D22.9 include moles (M8720/0), freckles , Mongolian spot and hemangiomas ((M9120/0) D18.0, such as port- wine stains (Q82.5) and strawberry marks (Q82.5) .

Infection & Inflammation Viral infections of the skin include cold sores (Coldsore, B00.1) warts (B07), chickenpox (B01.9), molluscum contagiosum (B08.1), and herpes zoster (shingles) (B02.9). Bacterial infections include boils (L02.9), cellul- itis (L03.9), erysipelas (A46), and impetigo (L01.0) Fungal infections, such as tinea (B35.9), cause athlete’s foot (B35.3) and ringworm (B35.9).

Inflamamtion: Inflammation of the skin occurs in dermatitis (L30 Inflamamtion: Inflammation of the skin occurs in dermatitis (L30.9) and eczema (L30.9); it may be caused by allergic reaction to a substance (nickle), a detergent, a plant, or a drug. Psoriasis (L40.9) is a common and persistent skin disease of unknown cause that consists of large, red, patches with silvery, scaly surfaces. Prickly heat (L74.0) is irritating rash that is caused by blockage of sweat glands.

Tumors Benign (non cancerous) tumors of skin are extremely common; these includes seborrheics keratoses (L82) and most types of nevi (M8720/0). (D22.9) Bowen’s disease (M8081/2) is a skin disorder that may slowly become cancerous. Three common forms of skin cancers are: - basal cell carcinoma (M8090/3) , - squamous cell (M8070/3) carcinoma, - and malignant melanoma (M8720/3) C43.9 Note: .Except where ....

Less common skin cancerous include: - Paget’s disease of nipple, (M8540/3) C50.0 - mycoses (mycosis) fungoides (C84.0) (C84 Mature T/NK-cell lymphomas) mycosis fungoides M9700/3 and - Kaposi’s sarcoma (M9140/3)

Injury : The skin is vulnerable to many minor injuries Injury : The skin is vulnerable to many minor injuries. Including cuts and bites (animal, insect) as well as more serious wounds. Burns can be among the most serious of all skin injuries and may cause extensive scarring or death. Hormonal disorders Acne (L70.9) is partially related to the action of androgens on the sebaceous glands; it is common among adolescents.

Nutritiional disorders: Deficiency of vitamin B and C can cause rashes Nutritiional disorders: Deficiency of vitamin B and C can cause rashes. (E53  E54) Impaired Blood Supply: Leg ulcers (L97), which are particularly common in the elderly, may be caused by poor blood flow to the skin as a result of atherosclerosis, by poor drainage of blood through varicose veins, (I83.9, lower limb) or by the leg swelling associated with heart failure (I50.9, acute, sudden, senile)

Drugs Many drugs, including antibiotics, barbiturates, and sulfonamides, may cause a rash (R21). Some cause urticaria (hives) (L50.9), other cause eczema (L30.9) or a rash similar to the measle rash, and some cause photosensitivity (L56.8) (light other than sun L59.8). Radiation: All forms of radiation are potentially damaging to the skin. Overexposure to sunlight (Ultraviolet) causes prematire aging of the skin and increases the risk of skin cancer.

Erythema (L53. 9) simply means redness and has many possible causes Erythema (L53.9) simply means redness and has many possible causes. Petechiae ( are pinpoints of blood in the skin) (R23.3); in certain conditions petechiae give rise to purpura (D69.2) or a large bruises (T14.0) Xanthelasma (H02.6) are yellowish patches that tend to occur on the eyelids; they are a result of the depositiion of cholesterol.

INVESTIGATION Most skin disorders can be diagnosed from their physical characteristics. A skin biopsy (removal of a tissue sample for microscopic analysis) may also be performed, usually to aid in the diagnosis of a skin problem or to exclude skin cancer.

LATIHAN (1) Gunakan akarkata untuk menyusun istilah yang definisinya seperti di bawah ini: 1. melan/o- cyte________(sel penghasil pigmen hitam) 2. trich- ____________(bulu mata tumbuh ke dalam) 3. onych/o- ____________(gangguan kuku) 4. cutane/o ____________(yang berkaitan dengan kulit) 5. sud/o- ____________(kelenjar keringat) 6. hydr/o- ____________(kondisi banyak berkeringat) 7. xer/o- ____________(kulitnya kering kurang vit. A) 8. myc/o- ____________(sakit kulit akibat jamur) 9. pachy/o ____________(kondisi kulit menebal) 10 rhytid/o- ____________(operasi plastik menghilang- kan kerut kulit muka)

LATIHAN (2) Tulis Akarkata dan arti istilah di bawah ini: Contoh: (nomor dalam kurung adalah ICD-10, Vol.3) Dermatitis Akar kata: derma-. Arti = radang kulit. cutaneous  = … keratoderma (387) = … rhytidoplasty  = … dermatomycosis (198) = … seborrhea capitis (571) = … pachydermatous (495) = … paronychia  (504) = … onychophagia  (488) = … scleroderma  (567) = … hiperhidrosis (hyperidrosis)  (330) = …

LATIHAN (3) Tulis akarkata yang berarti sesuai kata di bawah ini: Contoh: skin (kulit) = derm/o-; dermat/o- 1. black (hitam) = 2. fungus ( ) = 3. hair ( ) = 4. horny tissue ( )= 5. nail ( ) = 6. scale ( ) = 7. sweat ( ) = 8. thick ( ) = 9. dry ( ) = 10. wrinkles ( ) =

LATIHAN (4) Cocokkan istilah di kiri dengan definisi di kanan: Istilah Definisi 1. errector pili a. penghasil sebum 2. cuticle b. jaringan kulit yang “hidup” 3. dermis c. penghasil keringat 4. epidermis d. plat penutup yang rata 5. follicle e. lapisan terluar kulit 6. rambut f. bagian tumbuhnya rambut 7. lunula g. menimbulkan warna hitam kulit 8. melanin h. serabut sel berprotein 9. nail i. area dasar kuku 10. sebacous gland j. jaringan pembatas sekitar kuku 11. sweat gland k. menopang folikel rambut

LATIHAN (5) Tuliskan istilah bagian struktur kulit bagi definsi di bawah ini: 1. mengandung pem. darah, ujung saraf dan kelenjar = 2. bagian epidermal di dasar dan keliling kuku = 3. terdiri dari keratin, berasal dari epidermis = 4. bagian terluar kulit = 5. berasal dari dermis; terdiri dari keratin = 6. menghasilkan keringat = 7. menimbulkan warna kulit = 8. mengsekresi minyak = 9. bentuk seperti bulan sabit di dasar kuku = 10. bagian yang mengandung akar rambut =

UNSUR KATA ISTILAH MEDIS SISTEM INTEGUMENTUM PREFIXES ARTI SUFFIXES ARTI epi- = on; upon; over -ectomy = excission. hypo- = beneath; below -ia;-iasis = abnormal con- -osis dition intra- = within - itis = inflammation para- = around; beside - malacia = softening per- = through -(o)logy = ilmu tentang sub- = under; below - oma = tumor, swelling - plasty = surgical repair -(r)rhea = flow; excessive discharge -tome = cutting instrument

LATIHAN (6) (...) = halaman di ICD-10 Vol.3 Tulis arti istilah di bawah ini, dan uraikan menjadi masing unsur kata pembentuknya: 1. intramuscular =  2. percutaneous =  3. epidermal =  4. seborrhea (571) =  5. hypodermic =  6. melanoma (417-419) =  7. Keratoma (387) =  8. mycosis (430) =  9. onychomalacia (488) =  10. rhytidectomy =  11. paronychia (504) = 