L63 CTE - HST LPL.vp

Understand Nails as an Accessory

Organ of the Integumentary System

Unit. Human Structure and Function: The Integumentary System

Problem Area. Identify the Structures of the Integumentary System

Lesson. Understand Nails as an Accessory Organ of the Integumentary System

Student Learning Objectives.

Instruction in this lesson should result in students

achieving the following objectives:

Identify the anatomy and physiology of nails.

Identify the growth and development of nails.

¢ List of Resources.

The following resources may be useful in teaching this lesson:

Badasch, S., and Chesebro, D. (2004). Introduction to Health Occupations,

6th ed. Upper Saddle River, NJ: Prentice Hall.

Black, J., and Matassarin-Jacobs, E. (1993). Luckmann and Sorenson’s

Medical-Surgical Nursing: a Psychophysiologic Approach, 4th ed. Philadel-

phia: W.B. Saunders.

Gerdin, J. (2003). Health Careers Today, 3rd ed. St. Louis: Mosby.

Miller, B., and Keane, C. (1992). Encyclopedia and Dictionary of Medicine,

Nursing, and Allied Health, 5th ed. Philadelphia: W.B. Saunders.

Simmers, L. (2004). Diversified Health Occupations, 6th ed. Clifton Park, NY:

Delmar Learning.

Smeltzer, S., and Bare, B. (2004). Textbook of Medical-Surgical Nursing,

10th ed. Philadelphia: Lippincott Williams & Wilkins.

Lesson: Understand Nails as an Accessory Organ of the Integumentary System

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Sorrentino, S. (2000). Mosby’s Textbook for Nursing Assistants, 5th ed. St.

Louis: Mosby.

List of Equipment, Tools, Supplies, and Facilities

Overhead or PowerPoint projector

Visual(s) from accompanying master(s)

Copies of sample test, lab sheet(s), and/or other items designed for duplication

Materials listed on duplicated items

Computers with Internet access

Classroom resource and reference materials

Terms.

The following terms are presented in this lesson (shown in bold italics):

anemia

cuticle

cyanosis

eponychium

free edge

lunula

matrix

nail bed

> nail body

nail plate

nail root

onycholysis

root

Interest Approach.

Use an interest approach that will prepare the students for the

lessons. Teachers often develop approaches for their unique class and student situation. A

possible approach is included here.

Have students measure their longest fingernail with a ruler. Then have each

student state his or her longest nail measurement. Ask if anyone knows what

factors influence nail growth. If no one answers correctly, explain to the students

that diet, protein, internal health, age, and blood circulation all affect nail

growth. Ask if anyone would like to guess the length of the longest nails on

record. After students have answered, use VM–A to discuss the longest nails on

record and go to http://www.guinnessworldrecords.com for more information and

photographs.

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SUMMARY OF CONTENT AND

TEACHING STRATEGIES

Objective 1: Identify the anatomy and the physiology of nails.

Anticipated Problem: What is the anatomy and physiology of nails?

I. Identify the anatomy and physiology of nails.

A. Nails are a substructure of the epidermis and are made of the hard protein

keratin.

B. Nails are found on the ends of fingers and toes.

C. Nail structure is divided into specific parts.

1. The nail begins in the nail root.

a. Also known as the matrix

b. In the dermis, which is under the skin

2. The nail bed is the flat surface under the nail.

a. Layer of epithelial tissue that extends from the edge of the matrix

b. Contains nerves, melanocytes, and blood vessels

c. Nourished by blood vessels, which give nails their pink color

3. Lunula is the white, crescent-shaped area at the nail bed, which is nearest

the root.

a. Formed by air mixed in the keratin

b. Known as “little moon”

c. Easiest to see on thumbnail

d. Tends to disappear with age

e. Individualized size and shape; varies from well marked to undefined

4. The nail plate is the actual nail.

a. It is made of translucent keratin.

b. The underneath surface of the nail plate has grooves along the length of

the nail that anchor it to the nail bed.

c. The nail body and free edge are the plate regions that hang over the end

of fingers and toes.

5. Cuticle is where the nail plate meets the skin and fuses them.

a. Also called the eponychium

b. Provides a waterproof barrier

c. Protects the new nail as it grows from the nail root

6. Nails have two primary functions.

a. Aid in grasping and manipulating small objects

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b. Protect fingers and toes from injury

Many techniques can be used to help students master this objective. Use VM–B

to illustrate the parts of a nail.

Objective 2: Identify the growth and development of nails.

Anticipated Problem: What is the growth and development of nails?

II. Identify the growth and development of nails.

A. As with hair, nails are formed by keratinization.

1. When cells at the nail root (matrix) grow, the new nail cells push out the old

nail cells.

2. These old cells become flattened, hardened, and pressed tightly together due

to keratin.

3. Each cell develops into a thin plate; these plates are piled in layers to form the

nail.

4. When the nail cells accumulate, the newly formed nail is pushed forward, slid-

ing along the nail bed.

B. The growth of nails is slow and continuous.

1. Healthy fingernails grow an average of 0.5 mm per week or about 1/10 of an

inch each month.

2. It can take four to six months for a fingernail to grow from the root to the free

edge.

3. Fingernails grow about three or four times more quickly than toenails.

4. Toenails may take 12 to 18 months to grow from root to free edge.

5. Both grow faster in summer than winter due to the heat.

6. Fingernails will grow faster on the more active hand due to the heat used dur

ing activities.

7. If the nail is torn off, it will regrow if the matrix is not severely injured.

8. Onycholysis is loosening of the nail from the nail bed.

C. The rate of nail growth depends greatly on a person’s health and diet.

1. Poor internal health often affects nail growth and appearance.

a. White nails may be a result of anemia, which is a decrease of hemoglobin

in the blood.

b. Blue discoloration of nails is called cyanosis and is caused by lack of

oxygen in the blood.

c. Horizontal furrows are caused by malnutrition or illness.

2. A high-protein diet builds stronger, healthier nails.

3. The growth rate decreases with age and poor circulation.

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Many techniques can be used to help students master this objective. Use VM–C

to illustrate healthy nails and VM–D to illustrate unhealthy nails.

Review/Summary.

Use the student learning objectives to summarize the lesson.

Have students explain the content associated with each objective. Student responses can

be used in determining which objectives need to be reviewed or taught from a different

angle. Questions at the ends of the chapters in the textbook may also be used in the

review/summary.

Application.

Application can involve one or more of the following student activities:

Use VM–B to make an overhead of the illustration. Project the overhead before the

class and ask the students to identify the parts of a nail.

Evaluation.

Evaluation should focus on student achievement of the objectives for the

lesson. Various techniques can be used, such as student performance on the application

activities. A sample written test is provided.

¢ Answers to Sample Test:

Part One: Multiple Choice

1. b

2. d

3. c

4. c

5. b

6. a

7. b

8. d

Part Two: Completion

1. one-tenth of an inch

2. four to six

3. 12 to 18

4. anemia

5. cyanosis

6. blue

Part Three: Short Answer

1. Nails aid in grasping and manipulating small objects and protect toes and fingers

from injury.

2. The blood vessels under the nail bed are responsible for the pink color.

3. Onycholysis means loosening of the nail from the nail bed.

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Sample Test

Name ________________________________________

Understand Nails as an Accessory

Organ of the Integumentary System

Part One: Multiple Choice

Instructions: Write the letter of the correct answer.

_____1. A nail begins to develop at the

a. nail bed

b. nail root

c. nail plate

d. cuticle

_____2. The nail root is also known as the

a. cuticle

b. lunula

c. eponychium

d. matrix

_____3. The “little moon” of the nail is called the

a. matrix

b. cuticle

c. lunula

d. eponychium

_____4. The actual nail is called the

a. nail bed

b. eponychium

c. nail plate

d. nail root

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_____5. The eponychium is more commonly called the

a. lunula

b. cuticle

c. free edge

d. nail body

_____6. Nails are made of

a. keratin

b. calcium

c. carotene

d. muscle tissue

_____7. The diet recommended for healthier, stronger nails is a diet high in

a. calcium

b. protein

c. fruits and vegetables

d. vitamin D

_____8. The nail bed contains

a. blood vessels

b. nerves

c. melanocytes

d. all of the above

u Part Two: Completion

Instructions: Provide the word(s) to complete the following statements.

1. Healthy fingernails grow an average of 0.5 mm per week or about ____________ each

month.

2. It can take __________ to __________ months for a fingernail to grow from the root to the

free edge.

3. Toenails may take __________ to ___________ months to grow from the root to the free

edge.

4. White nails may be a result of ___________________.

5. Lack of oxygen in the blood causes _______________________, which is a

6. ________________ discoloration of nails, skin, and tissues.

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Part Three: Short Answer

Instructions: Respond to the following in complete sentences.

1. List the two primary functions of nails.

2. What gives nails their pink color?

3. What does the medical term onycholysis mean?

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Assessment

Tough as Nails Medical Terminology

Crossword Puzzle

Overview

From a word list of medical terminology associated with the nails, the student will identify the

meaning of unfamiliar medical terminology and develop a crossword puzzle using the meanings

and medical terms accordingly:

Develop a Final Definition: Provide a definition; create clues from formal definitions (e.g.,

synonym of, antonym of); create clues from technical context.

Create a Puzzle Format: Provide squares for each letter of a word; spell words correctly;

design words down and across; number words and clues; align number of clue with

number of word.

Procedures

1. In order to apply word analysis and vocabulary skills to comprehend selections, students

should experience sufficient learning opportunities to develop the following skills:

Use word origins and derivations to understand meanings of new words.

Apply knowledge of structural analysis to construct meaning of difficult or unfamiliar

words.

Infer the appropriate meaning of a word in context when the word has multiple

meanings.

Recognize specialized vocabulary/terminology.

Students entering health occupations need to understand medical terminology and the

meaning of medical terms. Health Science Technology students should be able to provide

a definition, create clues from formal definitions (e.g., synonym of, antonym of), and use

word origins and derivations to understand meanings of medical terms.

2. Have students review and discuss the assessment task and how the rubric will be used to

evaluate their work.

3. Health Science Technology students will be assigned words to define from a word list

taken from lecture notes.

4. Using lecture notes, the student will read the vocabulary in context.

5. The student will determine the definition of the medical terminology as used in context.

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6. The student will create a crossword puzzle using the medical terms assigned (Nail

Terminology word list).

7. The student will use the definitions (developed from context) to create the clue list for the

crossword puzzle.

8. The student will create an answer key for the puzzle.

9. Health Science Technology students can exchange puzzles and complete each other’s

puzzles. (Optional)

10. Evaluate each student’s performance using the rubric. Add each student’s scores to

determine the performance level.

Time Requirements

One to two class periods

Resources

Lecture notes

Nail Terminology word list

Grid paper

Tough as Nails Medical Terminology Crossword Puzzle rubric

t Writing utensil

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Student Instructions

Tough as Nails Medical Terminology

Crossword Puzzle

Your assignment is to create a nail terminology puzzle using the terms from the Nail Terminology

word list assigned. Using your notes from the lesson, you will identify and define the assigned

terms. You should develop an understanding of unfamiliar medical terminology associated with the

nails. This will enable you to create your own crossword puzzle using the meanings as a “clue list.”

The assigned terms will be your answers to the crossword puzzle. The meanings and medical

terms must correspond with each other. Spell correctly.

Steps to create your puzzle:

1. Identify the assigned medical terms in the context of your notes.

Nail Terminology word list:

anemia

cuticle

cyanosis

eponychium

free edge

lunula

matrix

onycholysis

nail bed—May leave off the word “nail” and use only the second word in the cross

word puzzle.

nail body—May leave off the word “nail” and use only the second word in the cross

word puzzle.

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nail plate—May leave off the word “nail” and use only the second word in the cross

word puzzle.

nail root—May leave off the word “nail” and use only the second word in the cross

word puzzle.

2. Define the assigned terms using your lesson notes.

3. Create a crossword puzzle using the grid paper supplied and all of the terms in the Nail

Terminology word list.

a. Provide a square for each letter of the word.

b. Design words down and across on the puzzle.

c. Number the first square of each word.

4. Use your term definitions to make the “clue list” for the crossword puzzle.

a. Number the clues to correspond with the squares numbered.

b. Clues may include synonyms and anonyms.

5. Create an “Answer Key” for the puzzle.

a. The answer key must be on a separate page.

b. Page should be stapled to the puzzle and the clue list page.

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Scoring Rubric

Student’s Name ______________________________________

Tough as Nails Medical Terminology

Crossword Puzzle

Exceeds standard (7–8 total points)

Meets standard (5–6 total points)

Approaches standard (3–4 total points)

Begins standard (2 total points)

Final Definition Puzzle Format

Consistently:

•

It provides a clear definition.

•

It creates effective clues from formal

definitions (e.g., synonym of,

antonym of).

• It creates effective clues from a

technical context.

Consistently:

•

It provides squares for each letter of the word. (Words

are spelled correctly.)

•

Words are designed down and across on the puzzle.

• Words and clues are numbered.

• The number of the clue corresponds with the number of

the word.

Usually:

• It provides a clear definition.

• It creates effective clues from formal

definitions (e.g., synonym of,

antonym of).

• It creates effective clues from a

technical context.

Usually:

• It provides squares for each letter of the word. (Words

are spelled correctly.)

• Words are designed down and across on the puzzle.

• Words and clues are numbered.

•

The number of the clue corresponds with the number of

the word.

Occasionally:

•

It provides a clear definition.

•

It creates effective clues from formal

definitions (e.g., synonym of,

antonym of).

•

It creates effective clues from a

technical context.

Occasionally:

•

It provides squares for each letter of the word. (Words

are spelled correctly.)

•

Words are designed down and across on puzzle.

•

Words and clues are numbered.

•

The number of the clue corresponds with the number of

the word.

Seldom/Never:

•

It provides a clear definition.

•

It creates effective clues from formal

definitions (e.g., synonym of,

antonym of).

•

It creates effective clues from a

technical context.

Seldom/Never:

•

It provides squares for each letter of the word. (Words

are spelled correctly.)

•

Words are designed down and across on the puzzle.

•

Words and clues are numbered.

•

The number of the clue corresponds with the number of

the word.

Score

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VM–A

LONGEST FINGERNAILS

http://www.guinnessworldrecords.com/records/human_body/body_

parts/longest_fingernails_-_female.aspx

Lee Redmond (USA), who hasn’t cut her nails since

1979, has grown and carefully manicured them to reach

a total length of 7 m 51.3 cm (24 ft 7.8 in).

t The measurements of each fingernail are as follows:

n Right hand

l Thumb—76.4 cm (30.1 in)

l Index finger—72.3 cm (28.5 in)

l Middle finger—74.1 cm (29.2 in)

l Ring finger—73.6 cm (29 in)

l Little finger—71.6 cm (28.2 in)

n Left Hand

l Thumb—80 cm (31.5 in)

Index finger—76.4 cm (30.1 in)

Middle finger—76.7 cm (30.2 in)

Ring finger—76.2 cm (30 in)

Little finger—73.6 cm (29 in)

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VM–B

ANATOMY OF NAILS

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Cuticle

Nail plate

Lunula

Nail root

Nail body

Cuticle

Phalanx (bone)

Hyporychlum

VM–C

HEALTHY NAILS

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VM–D

UNHEALTHY NAILS

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LS–A: Teacher Information

Nail Growth and Repair:

Pair and Share

Purpose

The purpose of this activity is to reinforce the concepts related to nail growth and repair.

Objectives

1. Identify the process of nail growth and repair to a peer.

2. Listen to a peer’s description of nail growth and repair.

3. Quiz and remediate one another orally using notes from lecture.

Materials

lab sheet

writing utensil

lecture notes related to nail growth and repair

Procedure

1. Instruct students to partner with the peer to their right.

2. Ask students to describe the process of nail growth and repair to one another.

3. Instruct the students that this should be done without referencing notes or books.

4. Instruct students to be as thorough as possible and to quiz one another orally.

5. After this is completed, ask student pairs to open their notes and compare notes for

accuracy.

6. Instructor should facilitate the activity by moving between pairs and monitoring

discussions.

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LS–B: Teacher Information

Nail Sing-Along

Purpose

The purpose of this activity is to reinforce the medical terms used to identify the anatomy of a

nail.

Objectives

1. Identify the medical terms used to identify the anatomical parts of a nail.

2. Create a simple song using the medical terms used to identify the anatomical parts of a

nail.

Materials

lab sheet

colored markers

large sheet of paper or dry erase board

Procedure

1. Divide the students into equal groups of three or four.

2. Ask the students to name the medical terms used to identify the parts of a nail.

3. Write the medical terms on the large blank paper or dry erase board as students list

them.

4. When the list is complete, instruct the students to create a simple song (as a group) by

inserting all of the medical terms listed into a familiar tune.

5. Explain the purpose of this activity to the students.

6. Emphasize that popular Christmas songs, childhood songs, and television songs with a

simple, familiar tune work best.

7. Emphasize that the song content does not have to make sense; the important element is

to use each of the terms at least once in the song.

8. Inform the students that groups have 20 minutes to create their song.

9. Instruct the groups that they will each perform their song before the class at the end of

the 20 minutes.

10. Have each group perform their song before the class.

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