Special Sub-Topic: I've Got You Under My Skin
|Before we begin our journey of the largest organ in the human body, part of the integumentary system, or skin, we need to discover who you would see if you had skin diseases, such as severe acne, eczema, or nasty looking moles. What type of doctor specializes in treating skin diseases?|
dermatologist. Dermatologist is derived from the Latin dermis, meaning skin and -logy from Ancient Greek, meaning knowledge. After medical school, a dermatologist will usually spend one year in a standard internship followed by three years in a dermatologist residency. After that, he or she may spend one or two more years in a dermatology specialty fellowship, such as immunodermatology or laser medicine.
|OK, now that we've defined skin, let's start at the head and work our way down. Underneath all that hair (or lack of it), is your skull. What strong lightweight metal is usually used to replace damaged portions of the skull?|
titanium. Titanium makes for an effective implant for three main reasons. First, it is biocompatible, meaning the body won't reject it. Second, it can osseointegrate, or connect directly to living bone for function and structure. Third, titanium is non-ferromagnetic, meaning that patients with implants can still have MRIs (magnetic resonance imaging).
|Now we come to the shoulders. I would venture that many of us have had sunburn at one time or another, especially on the shoulders. However, sunburn rarely causes damage under the skin. What degree of burn actually does get under your skin, causing subcutaneous tissue damage?|
third & 3rd & three & 3 & III. While some sources reference fourth degree burns to describe severe subdermal damage, it is not technically used by the medical profession. Third degree burns often create little to no sensation since the nerve endings are usually destroyed. Often, these types of burns can be fatal and more than likely require skin grafts.
|Moving down from the shoulders to the upper arm, we come to the site of substantial mental anguish for needle-phobic people. Often considered the first vaccination, a procedure that involves injecting the vaccinia virus, or cowpox, just under the epidermis may temporarily prevent what lethal disease?|
smallpox. The first reliable record of a smallpox vaccine came from China during the middle of the 16th century. Since then, scientists, particularly an Englishman named Edward Jenner, discovered that those exposed to cowpox did not contract smallpox. Therefore, he began intentionally (and controversially) giving people the much less dangerous cowpox to prevent them from getting the lethal smallpox.
|Let's now move in a medial direction toward the thoracic cavity. Adrenaline (epinephrine) is usually the drug of choice to treat anaphylaxis. In a field environment, adrenaline is usually injected directly into the heart to treat anaphylaxis.|
f. While injecting into the heart, "Pulp Fiction" (1994) style, used to be a practiced method for getting adrenaline into the circulatory system, modern practice calls for subcutaneous injection just under the skin of the upper arm. If that does not work, then the patient is usually sedated and intubated to get an airway. If all else fails, there's always the tracheotomy.
|Now let's take a trip below the diaphragm and into the abdomen. In many people there is a substantial fat layer between the skin and muscle tissue. The removal of some of this layer using a cannula and aspirator is called what?|
liposuction. Liposuction, or "sucking the muck," has two basic techniques: wet and dry. Wet lipo involves injecting a combination of anesthetic (lidocaine), vasoconstrictor (adrenaline/epinephrine), and fluid (saline), into the tissue to numb the area, prevent bruising, and keep the body's fluid levels within range. Dry lipo, although seldom practiced, does not involve injecting any fluid.
|Continuing to move down the body, we come to the pelvic region. On the back side of the pelvis is a body part that starts out as five separate bones that begin fusing together in people at about 16 years old, usually completely fused by the mid-20s. What bone is this, derived from the Latin for "sacred" due to its close proximity to the procreative organs?|
sacrum. The sacrum connects to both sides of the ilium (large upper pelvic bone), the last lumbar vertebra, and the coccyx. The sacrum and pelvis are usually the first indicators for forensic anthropologists to determine the sex of the skeleton, since both are noticeably sexually dimorphic.
|Moving further down the body, the ZZ Top song "Legs" comes to mind. Just under the skin of the leg are superficial veins. When the leaflets of the valves of these veins no longer meet to prevent the backflow of blood, the veins become enlarged. What is this unattractive and sometimes painful condition called?|
varicose veins. Since about 90% of the leg's blood flow returns to the heart via the deep veins (veins underneath the muscle tissue), surgical procedures to remove the superficial vericose veins do not drastically limit the blood flow. A non-surgical treatment for vericose (spider) veins is injecting them with polidocanol or sodium tetradecyl sulphate through a process called sclerotherapy.
|As soccer (futbol) and American football players can tell you, the knee is one of the most susceptible joints to sports injuries. What steroidal hormone has historically been injected into the knee for short-term pain relief and to reduce swelling and inflammation?|
cortisone. Recent long-term side effects of cortisone have decreased its use since the turn of the 21st century. Such side effects can include diabetes, loss of bone mass, high blood pressure, and erectile dysfunction. The other answers are not steroids. Oxycodone is an opiate pain killer, usually offered in pill form. Attenuvax is the brand name part of the MMRV vaccine to prevent measles. Valacyclovir is the generic name for Valtrex, the herpes medication.
|Finally, we come to the feet; the support for our mobility. Unfortunately, some people don't treat their feet very well, instead using them as vessels for opiate injections. Which opiate is commonly injected into the veins that run through the feet, particularly in the webbing between the toes?|
heroin. Heroin, or diacetylmorphine, is derived from the pods from opium poppy plants. Around the turn of the 20th century, the Bayer company actually marketed heroin as a cure for morphine addiction until it was later discovered that heroin quickly metabolizes into morphine in the human body, actually making it a faster acting form of morphine. Tetrahydrocannabinol (THC) is found in marijuana. Lysergic acid diethylamide is more commonly known as LSD. Naproxen sodium is the active ingredient in the trade name drug Aleve, an over-the-counter NSAID (non-steroidal anti-inflammatory drug).
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