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The Anatomy of Touch, with a Special

Consideration to Anatomy of Skin
Dr. Sinchan Das

Director, Benevolentia Foundation

Academic-in-charge, Humanity, Institute for Advanced Medical & Cultural Research

Abstract: Skin has been the largest organ in the body and covers the body’s entire external surface made up of
three layers, including epidermis, dermis, and the hypodermis significantly maintaining the anatomy and
physiology of human. In this scenario, understanding the anatomy and organisation of skin requires appropriate
alignment for the evaluation of any internal feature associated with it. As a famous proverb says, “The best
foundation you can wear is glowing healthy skin”, it is essentially to evaluate and understand this largest organ
across the body covering and safeguarding our internals appropriately under any adaptation suffered. Hence,
this paper has based on expert analysis and visualisation of underlying skin anatomy as well as featuring essential
theories of love, hug, and physiological role of touch in social beings.

Keywords: Anatomy of Touch, Anatomy of Skin, Touch sensation, Anatomy, Touch reflex

Introduction:
Skin is the outermost layer of body, characterized by its soft & flexible architecture & is a part of integumentary system
made up of multiple layers of ectodermal tissue and guards the underlying muscles, bones, ligaments, and internal
organs. From birth to older age, the skin's distinctive features change. It is smooth, moist, soft and generally free of
wrinkles and imperfections in infants and children. The integumentary system refers to the skin and its accessory
structures, and it is responsible for much more than simply lending to your outward appearance. In the adult human
body, the skin makes up about 16 percent of body weight and covers an area of 1.5 to 2 m2. Children under two years
of age sweat poorly and irregularly; their sebaceous glands do not function at all. In adolescence, hair grows longer,
thicker, and more pigmented, especially on the scalp, axillae, pubic area, and male face. General skin pigmentation
increases, localized pigmented foci appear mysteriously, and acne lesions often develop. The growth of hair, sweat and
sebaceous glands starts to grow. The skin is left, in particular not protected by clothing, dryness, wrinkled or flaccid, as
a result of ageing and changes to the body's anatomy and physiology due to exposure to sunlight and wind. It carries
out a multitude of essential tasks, including as preventing the body from losing too much water and aiding in
thermoregulation, in addition to providing defence against external physical, chemical, and biological threats. The
mucous membranes that line the surface of the body form a continuous layer of skin. The architecture of skin is made
up of an intricate network which serves as the body’s initial barrier against pathogens, UV light, and chemicals, and
mechanical injury. It also regulates temperature and the amount of water released into the environment.
Human skin consists of a stratified, cellular epidermis and an underlying dermis of connective tissue. The
dermal–epidermal junction is undulating in section; ridges of the epidermis, known as rete ridges, project into the
dermis. The junction provides mechanical support for the epidermis and acts as a partial barrier against exchange of
cells and large molecules. Below the dermis is a fatty layer, the panniculus adiposus, usually designated as
‘subcutaneous’. This is separated from the rest of the body by a vestigial layer of striated muscle, the panniculus
carnosus. There are two main kinds of human skin. Glabrous skin (non-hairy skin), found on the palms and soles, is
grooved on its surface by continuously alternating ridges and sulci, in individually unique configurations known as
dermatoglyphics. It is characterized by a thick epidermis divided into several well-marked layers, including a compact
stratum corneum, by the presence of encapsulated sense organs within the dermis, and by a lack of hair follicles and
sebaceous glands. Hair-bearing skin (Fig. 3.1), on the other hand, has both hair follicles and sebaceous glands but lacks
encapsulated sense organs. There is also wide variation between different body sites. For example, the scalp with its
large hair follicles may be contrasted with the forehead, which has only small vellus-producing follicles, albeit
associated with large sebaceous glands. The axilla is notable because it has apocrine glands in addition to the eccrine
sweat glands, which are found throughout the body. Regional variation is further considered below.

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The superficial epidermis is a stratified epithelium largely composed of keratinocytes that are formed by
division of cells in the basal layer, and give rise to several distinguishable layers as they move outwards and
progressively differentiate. Within the epidermis, there are several other cell populations, namely melanocytes, which
donate pigment to the keratinocytes, Langerhans’ cells, which have immunological functions and Merkel cells.
The hair follicles comprise pockets of epithelium that are continuous with the superficial epidermis. They
undergo intermittent activity throughout life. During the active phase, the follicle envelops at its base a small papilla of
dermis. A bundle of smooth muscle, the arrector pili, extends at an angle between the surface of the dermis and a point
in the follicle wall. Above the insertion, the holocrine sebaceous gland opens by a short neck into the pilary canal, and
some follicles in certain areas of the body, notably the axilla, have, in addition, an apocrine gland. Also derived from
the epidermis, and opening directly to the skin surface, are the eccrine sweat glands, present in every region of the body
in densities of 100– 600/cm2 .
The basis of the dermis is a supporting matrix or ground substance in which polysaccharides and protein are
linked to produce macromolecules with a remarkable capacity for retaining water. Within and associated with this
matrix are two kinds of protein fibre: collagen, which has great tensile strength and forms the major constituent of the
dermis, and elastin, which makes up only a small proportion of the bulk. The cellular constituents of the dermis include
fibroblasts, mast cells and histiocytes (monocyte/macrophages). The dermis has a very rich blood supply, although no
vessels pass through the dermal–epidermal junction. The motor innervation of the skin is autonomic, and includes a
cholinergic component to the eccrine sweat glands and adrenergic components to both the eccrine and apocrine glands,
to the smooth muscle and the arterioles and to the arrector pili muscle. The sensory nerve endings are of several kinds:
some are free, some terminate in hair follicles and others have expanded tips. Only in glabrous skin are some nerve
endings encapsulated. Sense organs are described later in this chapter.
The skin of humans, more than any other mammal, shows remarkable topographic differences. For example,
the palm and the back of the hand and fingers are very different.
 The eyebrows are thick, coarse and hairy;
 The eyelids are thin, smooth and covered with barely visible hairs.
 The face rarely shows hair on its forehead and cheekbones;
 The face is completely hairless on its vermilion border at the lips, but coarsely hairy over its chin and jaws as a
male.
 The surfaces of forehead, cheeks and nose are generally oily, as opposed to the relatively greasy lower surface
of its chin and jaws.
 Skin of the chest, the pubic region, the scalp, the axillae, the abdomen, the soles of feet and the ends of your
fingers differ as much in structure and function as if they belonged to different animals.
Embryology of Skin:
The skin emerges by the juxtaposition of two major embryological components: the imminent epidermis, which begins
from a surface region of the early gastrula and the planned mesoderm, which is brought into contact with the internal
surface of the epidermis amid gastrulation. The mesoderm not as it were gives the dermis but is fundamental for
actuating separation of the epidermal structures, such as the hair follicle in well evolved creatures. Undoubtedly, an
impact from the dermis is basic for the upkeep of grown-up epidermis, in spite of the fact that organized dermis is not
in this occurrence obligatory, the property moreover dwelling in powdered dermis or ligament. The neural peak

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moreover makes a critical commitment to the skin, specifically the colour of cells, in spite of the fact that their bulk is
little.
Structures Gestational Month (GM)

Hair peg 4th GM

Exposed hair 5th GM
Nails 4th GM
Sebaceous gland 5th GM
Apocrine gland 6th GM
Eccrine gland 6th GM
Follicular keratinization 5th GM
Interfollicular keratinization 6th GM
Melanocytes in Non-functional state 3rd GM
Melanocytes in active state 4th GM
Langerhans’ Cells 4th GM
Merkel cells 4th GM

Morphological events during fetal skin development. (Data from Holbrook and
Hoff)

 Epidermis:
The development of the epidermis and its appendages relies on specific signals for initiating the process.
Although complex, critical events appear to be governed by opposing interplay between the Notch and Wingless-related
signalling pathways, with β-catenin, Lef1 and Notch peptide all having key roles. Signals from the Sonic hedgehog
pathway and bone morphogenetic proteins (BMPs) also are important in early embryogenesis, notably in determining
whether cells have an ectodermal or neural fate. Specifically, BMP signalling promotes ectodermal development, while
Sonic hedgehog promotes neural tube and central nervous system (CNS) development. Thus, a complex interaction
between these two components, as well as signals from fibroblast growth factors (FGFs) and additional regulatory
control mechanisms from the Wingless-related signalling pathways, underlies the preliminary stages of epidermal
development.

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• The epidermis consists of single layered undifferentiated glycogen

filled cells.
3rd Week

•Two layers of cells can be distinguished:

1. The periderm or epitrichial layer and
2. a stratum germinativum
4 to 6 week

• A middle layer begins to form.

• Hemidesmosomal and desmosomal proteins are demonstrable.
8 to 11 • The development of the hair rudiments seen in eyebrows, upper lip & chin.
weeks

• Development of Intermediate layer, which is characerized by cells contain mitochondria, Golgi complexes and a few tonofilaments, as well as abundant glycogen
both within and between the cells.
• Basal keratins are expressed by the basal cells and skin-differentiation keratins are expressed by cells of the middle layer.
• Filaggrin, the protein of the granular layer, is first detectable
• Development of Sebaceous gland
12 to 16 • The rudiments of eccrine sweat glands are first identifiable as regularly spaced undulations of the stratum germinativum.
• The tips of the eccrine sweat gland rudiments have penetrated deeply into the dermis, and have begun to form the coils. In the overlying epidermis, columns of cells
weeks that are destined to form the intraepidermal sweat ducts are recognizable.
• Langerhans' cells are derived from the monocyte–macrophage– histiocyte lineage and enter the epidermis.

• Microvilli become much more numerous.

• Keratohyalin granules appear in the uppermost layer. The elevations of the periderm become cast off into the amniotic fluid, the periderm cells start to separate from
the embryo. Together with shed lanugo, sebum and other materials, they form the vernix caseosa.
• Development of the nails start.
16 to 26 • Development of Melanocytesare seen
• Development of Merkel cells.
weeks

Dermis:
It was at one time believed that the mesenchymal cells forming the dermis came from the ventrolateral part of the
somite, which for that reason was named the dermatome. Although some cells may migrate from the dermatome and
take part in the formation of the skin, most of the dermis is formed by mesenchymal cells that migrate from other
mesodermal areas. These mesenchymal cells give rise to the whole range of blood and connective tissue cells, including
the fibroblasts and mast cells of the dermis and the fat cells of the subcutis. Nevertheless, a new type of stem cell from
the dermis, called skin-derived precursor (SKP) cells, has been identified. Such cells are capable of being converted
into several different cell types in vitro (e.g. neurones, smooth muscle cells or adipocytes) and might constitute a highly
accessible source of pluripotential autologous stem cells. The embryonic dermis is at first very cellular, and in the
second month the dermis and subcutis are not distinguishable from each other. Fibrillar components shortly make their
appearance, and regular bundles of collagen fibres are evident by the end of the third month. Later, the papillary and
reticular layers become distinct and, at the fifth month, the connective tissue sheaths are formed around the hair follicles.
Elastic fibres are first detectable at 22 weeks. Beneath the dermis is a looser tissue characterized by fat islands that begin
to form in definite places. In embryos of 6–14 weeks, three types of cell have been described in the dermis: stellate
cells, phagocytic macrophages and a granule-secretory cell, either a melanoblast or a mast cell. From weeks 14–21,
fibroblasts are numerous and active, and perineurial cells, pericytes, melanoblasts, Merkel cells and mast cells can be
individually identified. Another cell, of bone marrow origin, may be ancestral to the Langerhans’ cell and the histiocyte.
At first, the under surface of the epidermis is smooth, but during the fourth month, at the same time as the hair follicle
starts to develop, it becomes irregular. Touch pads become recognizable on the hands and fingers, and on the feet and

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toes, by the sixth week, and reach their greatest development at the 15th week. After this, they flatten and become
indistinct. It is these areas, however, that determine the pattern of dermatoglyphs athe systems of papillary ridges- that
take their place.
Dermo-Epidermal Junction:
A continuous lamina densa of the basement membrane becomes evident in the second month of gestation and
hemidesmosomes appear in the third month.
 Layers of Skin:

Sr. Layer of Characteristics Photograph

No Skin
.
01 Epidermis Cells
The epidermis is a stratified, squamous epithelium layer
that is composed primarily of two types of cells:
keratinocytes and dendritic cells. The keratinocytes differ
from the “clear” dendritic cells by possessing
intercellular bridges and ample amounts of stainable
cytoplasm
Keratinocyt Function: Cornification
es
Non- Melanocyt  Melanocytes are
Keratinocyt es responsible for melanin
es production and pigment
formation.

 Melanocytes are
derived from neural crest
cells and primarily produce
melanin, which is
responsible for the pigment
of the skin. They are found
between cells of stratum
basale and produce melanin.
UVB light stimulates
melanin secretion which is
protective against UV
radiation, acting as a built-in
sunscreen.
 Melanin is
produced during the
conversion of tyrosine to
DOPA by the enzyme
tyrosinase.
 Melanin then
travels from cell to cell by a
process that relies on the
long processes extending
from the melanocytes to the
neighboring epidermal cells.
 Melanin granules
from melanocytes are
transferred via the long
processes to the cytoplasm
of basal keratinocyte.

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 Melanin transferred
to neighboring
keratinocytes by “pigment
donation”; involves
phagocytosis of tips of
melanocyte processes by
keratinocytes.
Langerhan  Antigen-presenting
s’ Cell dendritic cells
 Langerhans cells,
dendritic cells, are the skins
first line defenders and play
a significant role in antigen
presentation.
 These cells need
special stains to visualize,
primarily found in the
stratum spinosum.
 These cells are the
mesenchymal origin,
derived from CD34 positive
stem cells of bone marrow
and are part of the
mononuclear phagocytic
system.
 They contain
Birbeck granules, tennis
racket shaped cytoplasmic
organelles.
 These cells express
both MHC I and MHC II
molecules, uptake antigens
in skin and transport to the
lymph node.

Merkel  Sensory
Cells mechanoreceptors
 Merkel cells are
oval-shaped modified
epidermal cells found in
stratum basale, directly
above the basement
membrane.
 These cells serve a
sensory function as
mechanoreceptors for light
touch, and are most
populous in fingertips,
though also found in the
palms, soles, oral, and
genital mucosa.
 They are bound to
adjoining keratinocytes by
desmosomes and contain
intermediate keratin
filaments and their
membranes interact with

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free nerve endings in the

skin.

Layers

Stratum  Stratum basale is the deepest

basale layer, connected to the basement
(Stratum membrane by hemidesmosomes and
germinavitu divided from the dermis by the basal
m) lamina. The cuboidal to columnar
mitotically active stem cells that make
up this layer are continuously generating
keratinocytes.
 Melanocytes are also present in
this stratum.
 Stratum basale layer is
responsible for mitosis of the
keratinocytes. Stratum basale

Stratum  8-10 cell layers, also known as

spinosum the prickle cell layer contains irregular,
polyhedral cells with cytoplasmic
processes, sometimes called “spines”,
that extend outward and contact
neighboring cells by desmosomes.
Dendritic cells can be found in this layer.
 In the layer of Stratum
spinosum, keratinocytes are joined by
tight intercellular junctions called
desmosomes.
Four Layers of Skin
Stratum  3-5 layers of cells with lamellar
granulosum and keratohyalin granules inside
diamond-shaped cells. Keratin
precursors found in keratohyalin
granules eventually agglomerate,
crosslink, and form bundles. The
glycolipids found in the lamellar
granules are secreted onto the cell
surface where they act as a glue to hold
the cells together.
 Cells of this layer secrete lipids
and other waterproofing molecules in
this layer.
Stratum  In the Stratum lucidum, cells
lucidum lose nuclei and drastically increase Layers of Epidermis
keratin production.


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 2-3 cell layers, present in thicker

skin found in the palms and soles, is a
thin clear layer consisting of eleidin
which is a transformation product of
keratohyalin.

Stratum  Cells of this layer will lose all

corneum organelles, continue to produce keratin.
 20-30 cell layers, is the
uppermost layer, made up of keratin and
horny scales made up of dead
keratinocytes, known as anucleate
squamous cells.
 This is the layer which varies
most in thickness, especially in callused
skin.
 Within this layer, the dead
keratinocytes secrete defensins which
are part of our first immune defense.

02 Basement The basement membrane is a thin, pliable sheet-like type

Membrane of extracellular matrix that provides cell and tissue
support and acts as a platform for complex signalling.

Layers Basal Lamina Lighter colored

lamina lucida layer closer to
the epithelium.
The lamina
lucida layer is
made up of
laminin,
integrins,
entactins, and
dystroglycans.

Lamina Denser colored

densa layer closer to
the connective
tissue.
Thickness: 30 –
70 nm

Reticular Reticular fiber is composed

lamina of one or more types of very
thin and delicately woven
strands of type III collagen.
These strands build a highly
ordered cellular network
and provide a supporting
network. Many of these
types of collagen have been
combined with
carbohydrate. Thus, they
react with silver stains and
with periodic acid-Schiff
reagent but are not

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demonstrated with ordinary

histological stains such as
those using hematoxylin.

Organization
 Epithelial/mesothelial/endothelial tissue (outer
layer)
 Basement membrane
 Basal lamina
 Lamina lucida
Reticulin Stain
 laminin
 integrins (hemidesmosomes)
 nidogens
 dystroglycans
 Lamina densa
 collagen IV (coated with perlecan, rich in
heparan sulfate)
 Attaching proteins (between the basal and
reticular laminae)
 collagen VII (anchoring fibrils)
 fibrillin (microfibrils)
 Lamina reticularis
 collagen III (as reticular fibers)
 Connective tissue (Lamina propria)

03 Epidermo-
Dermal The dermal papillae (DP) (solitary papilla, minute of
Junction Latin papula, 'pimple') are little, nipple-like expansions
(or interdigitations) of the dermis into the epidermis. At
the surface of the skin in hands and feet, they show up as
epidermal, papillary or contact edges (colloquially
known as fingerprints).
Blood vessels in the dermal papillae nourish all
hair follicles and bring nutrients and oxygen to the lower
layers of epidermal cells. The ridges that develop in the
hands and feet are partly genetically determined traits that
develop before birth. They remain substantially unaltered
(except in size) throughout life, and therefore determine Papilla of the hand, treated with acetic acid. Magnified 350 times. A.
Side view of a papilla of the hand. a. Cortical layer. b. Tactile corpuscle. c.
the patterns of fingerprints, making them useful in certain Small nerve of the papilla, with neurolemma. d. Its two nervous fibers
running with spiral coils around the tactile corpuscle. e. Apparent
functions of personal identification termination of one of these fibers. B. A tactile papilla seen from above so
. as to show its transverse section. a. Cortical layer. b. Nerve fiber. c.
Outer layer of the tactile body, with nuclei. d. Clear interior substance.
The dermal papillae is part of the uppermost layer
of the dermis, the papillary dermis, and the ridges that
form are very large, increasing the surface area between
the dermis and the epidermis. This significantly increases
the exchange of oxygen, nutrients and waste products
between these two layers as a result of the main function
of the dermis is to support the epidermis. Additionally,
the increase in the surface area prevents the dermal and
epidermal layers from separating by strengthening the
junction between them. With age, the papillae tend to
flatten and sometimes increase in number.

04 Dermis Cells
Fibroblast Macropha Mast Cells
ges

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Matrix components
Collagen Elastin Extra fibrillar matrix
Function: It Function: Function: Extra fibrillar
provides It provides matrix is an extracellular
Strength Elasticity gel-like substance
primarily composed of
glycosaminoglycans
(most notably
hyaluronan),
proteoglycans, and
glycoproteins. Matrix Components
Layers
Papillary The papillary dermis is the superficial
Dermis layer, lying deep to the epidermis. The
papillary dermis is composed of loose
connective tissue that is highly
vascular.

Reticular The reticular layer is the deep layer,

Dermis forming a thick layer of dense
connective tissue that constitutes the
bulk of the dermis.

Contents
Blood Vessels The blood vessels supply nutrients and
oxygen to the skin and take away cell
waste and cell products. The blood
vessels also transport the vitamin D
produced in the skin back to the rest of
the body.

Lymph The lymph vessels bathe the tissues of

Vessels the skin with lymph, a milky substance
that contains the infection-fighting cells
of the immune system. As the lymph
moves to its lymph nodes, these cells
seek to destroy any infection or invader
organisms.

Hair Follicles The hair follicle is a tube shaped sheath

that surrounds part of the hair beneath
the skin, nourishing it.

Sweat Glands The average person has about 3 million Sebaceous gland
sweat glands. Sweat glands are
classified according to two types:
 Apocrine glands are specialized
sweat glands that can be found only in
the
axilla and pubic region. These glands
secrete a milky sweat that encourages
the growth of the bacteria responsible
for body odour.

 The real sweat glands are the

eccrine gland. These glands, which are
found all over the body, allow water to

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pass through its pores into the surface of

the skin where it is dissolved and
reduced in temperature. These glands
are capable of producing up to two liters
of sweat an hour, but they produce
mostly water, which is not conducive to
the growth of odor producing bacteria.

Sebaceous Sebaceous glands, also known as oil

glands glands, attach to hair follicles. They can
be found anywhere on the body except
on the palms of your hands and on the
soles of your feet. The sebaceous glands
release oil that keeps your skin soft and
supple. This oil also helps keep your
skin hydrated and prevents the growth
of harmful bacteria and fungi on your Layers of Dermis
skin.

Nerve There are also pain and touch receptors

Endings on the dermis layer that send sensations
of pain, itching, pressure and
temperature information to the brain for
processing. When needed, shivering
(voluntary contractions and relaxation
of the muscles) occurs, producing body
heat.

Collagen & Fibroblasts make collagen, the protein

Elastin that holds the dermis together. The skin
is made up of many different types of
cells, but it’s the skin cells that make up
the dermis. Collagen helps keep the skin
strong and resilient. It’s an insoluble
protein that’s found in connective
tissues throughout the body, where
muscles and organs attach to each other.
In your skin, collagen holds your
epidermis together and gives your skin
the durability it needs.

Elastin is another type of protein that

holds your skin together. When you
stretch your skin, it stretches back into
place and keeps your skin flexible.

05 Hypoderm Function
is Insulator
Shock Absorber

Structure 
 Fibrous bands anchoring the skin
to the deep fascia.
 Collagen and elastin fibers
attaching it to the dermis.

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 Fat is absent from the eyelids,

clitoris, penis, much of pinna, and scrotum.
 Blood vessels on route to the
dermis.
 Lymphatic vessels on route from
the dermis.
 The glandular part of some sweat
glands; mammary glands lie entirely
within the subcutaneous tissue (which are
modified apocrine sweat glands).
 Cutaneous nerves and free endings
 Hair follicle roots
 Ruffini and Pacinian corpuscles
 Mast cells
 Bursae, in the space overlying
joints in order to facilitate smooth passage
of overlying skin
 Fine, flat sheets of muscle, in
certain locations, including the scalp, face,
hand, nipple, and scrotum, called the
panniculus carnosus

06 Skin Eccrine / Apocrine sweat glands

Appendag Sebaceous glands.
es Hair Follicles. –Nails

 Comparison between the Thick & Thin Skin:

Sr. Points Thick Skin Thin Skin
No.
01 Area covered The skin from the palms & soles having Other portions of the body having
thicker epidermis thinner epidermis

02 Epidermis  Thick: Thick Malpighian layer  Thin: Thin Malpighian layer

& granular layer & granular layer
 Very thick horny layer  Very thin horny layer
 Posses a Lucidium layer  Lacks a Lucidium layer

03 Hair Follicles Lacks hair follicles Contains hair follicle

04 Arrector pili Absent Present
05 Dermis Thin Thick
06 Sebaceous gland Lacks Contains
07 Sweat Glands Has numerous, spirally coiled Fewer sweat glands
08 Sensory Receptors Denser Sparser
09 Characteristics of Surface Contains both ridges & furrows Lacks in both ridges & furrows
10 Dermal papillae Regular Irregular

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Comparison Between Thick & Thin Skin

 Vascular Supply & Lymphatic Drainage:

 The two plexuses that make up the blood supply to the skin are located between the dermis's papillary and
reticular layers and between the dermis and subcutaneous tissues.

 The superficial arteriovenous plexus, also known as the subepidermal/papillary plexus, provides supply to the
epidermis. These containers are crucial for controlling temperature. The body's highly efficient system for controlling
temperature through the skin transfers heat from the body to the surroundings by increasing blood flow to the skin.

 The autonomic nervous system regulates blood flow, with sympathetic stimulation leading to vasoconstriction
(heat retention) and vasodilation (heat loss).

Vascular Supply of Skin

 Nerve Supply:
Sr. Area of Structures Name of the Nerve Diagrammatic view
No. Supply supplied

01 Superior Arms &  Supraclavicular

Extremity Shoulders nerve
 Axillary Nerve
 Inferior lateral
cutaneous nerve of arm
 Intercostobrachial
nerve

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 Medial cutaneous
nerve of arm
 Posterior
cutaneous nerve of arm

Forearms  Lateral cutaneous

nerve of forearm
 Medial cutaneous
nerve of forearm
 Posterior
cutaneous nerve of
forearm

Hands  Superficial
branch of the radial nerve
 Median nerve
 Superficial
branch of ulnar nerve

02 Inferior Pelvis &  Lumboinguinal

Extremity Buttock nerve
 Medial cluneal
nerves
 Inferior cluneal
nerves
 Perforating
cutaneous nerve
 Superior cluneal
nerves
 Iliohypogastric
nerve
 Subcostal nerve

Thighs  Lateral cutaneous

nerve of thigh
 Anterior
cutaneous branches of the
femoral nerve
 Cutaneous branch
of the obturator nerve
 Posterior
cutaneous nerve of thigh

Legs  Common fibular

nerve
 Saphenous nerve
 Superficial fibular
nerve
 Sural nerve

Feet  Deep fibular

nerve
 Medial calcaneal
branches of the tibial
nerve

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 Medial plantar
nerve
 Lateral plantar
nerve

03 Trunk  Ventral cutaneous

branches
 Lateral cutaneous
branches
 Dorsal cutaneous
branches

04 Neck &  Supraorbital

Head nerve
 Infraorbital nerve
 Mental nerve
 Buccal nerve
 Auriculotemporal
nerve
 Supraclavicular
nerves (C3, C4)
 Great auricular
nerve (C2, C3)
 Greater occipital
nerve (C2)

Sr. Structures Characteristics Image

No.
01 Free Nerve Neuronal receptors in the epidermis.
Endings • Terminate in the stratum
[Link] numerous.

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• Lack a connective tissue or Schwann

cell investment, “free.”
• Heat, cold, itch, and pain.
• Surround most hair follicles -
mechanoreceptors (“whiskers”
Neuronal receptors in the epidermis.
• Terminate in the stratum
[Link] numerous.
• Lack a connective tissue or Schwann
cell investment, “free.”
• Heat, cold, itch, and pain.
• Surround most hair follicles -
mechanoreceptors (“whiskers”
 Neuronal receptors in the epidermis.
 Terminate in the stratum granulosum.
Most numerous.
 Lack a connective tissue or Schwann
cell investment, “free.”
 Heat, cold, itch, and pain.
 Surround most hair follicles -
mechanoreceptors (“whiskers”).

02 Pacinian  Deep pressure receptors for mechanical

Corpuscle and vibratory pressure;
enclosed in connective tissue capsule.
 Found in deeper dermis, hypodermis,
and associated with joints, periosteum, organs.
 Myelinated nerve ending surrounded by
a capsule.
 “Onion” appearance on microscope.
 Responds to pressure and vibration by
displacement of the capsule lamellae which
causes depolarization of the axon.

03 Meisner’s  Touch receptors within dermal papillae.

Corpuscle • Especially responsive to low-frequency
stimuli in papillary layer of
• Appear like a twisted string on
microscopy.

• Touch receptors within dermal papillae.

• Especially responsive to low-frequency stimuli

in papillary layer of hairless skin (lips, palmar
surfaces, etc.).

• Appear like a twisted string on microscopy

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04 Ruffini’s  In the dermis.

Corpuscle • Mechanical displacement of collagen
fibers
 Location: Dermis and hypodermis of
both hairy and glabrous skin & in the dermis.
 Mechanical displacement of collagen
fibers
 Respond to stretch and movement
stimuli

Neuronal receptors in the epidermis.

• Terminate in the stratum [Link] numerous.
• Lack a connective tissue or Schwann cell investment, “free.”
• Heat, cold, itch, and pain.
• Surround most hair follicles - mechanoreceptors (“whiskers”

 Muscles:
 Arrector Pili Muscle:

• A bundle of smooth muscle fibers that attach to the connective tissue sheath of the hair follicle.
• When muscle contracts, pull hair follicle outward and makes the hair stand up. Hairs do not exit perpendicular but at
an angle.
• Produce Goosebumps or dimpling of the skin.
• Also, produces a squeezing of sebaceous glands causing their secretions to be emptied.

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 Cutaneous Receptors:

Cutaneous Receptors

Receptors Type of Receptors Descriptions

Somatosensory Classes Tactile Types
Receptors Mechanoreceptors Proprioceptors Merkel’s Discs: Located near the
Baroreceptors surface of the skin. Merkel’s discs
are found in the upper layers of
skin near the base of the epidermis,
both in skin that has hair and on
glabrous skin; that is, the hairless
skin found on the palms and
fingers, the soles of the feet, and
the lips of humans and other
primates. Merkel’s disks are
densely distributed in the
fingertips and lips. They are slow-
adapting, unencapsulated nerve
endings, which respond to light
touch. Light touch, also known as
discriminative touch, is a light
pressure that allows the location of
a stimulus to be pinpointed. The
receptive fields of Merkel’s disks
are small, with well-defined
borders. That makes them very
sensitive to edges; they come into

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use in tasks such as typing on a

keyboard. Merkel’s discs are
responsible for the transduction &
encoding of tactile stimuli.

Meissner’s corpuscles: Located

near the surface of the skin.
Meissner’s corpuscles are found in
the upper dermis, but they project
into the epidermis. They are found
primarily in the glabrous skin on
the fingertips and eyelids. They
respond to fine touch and pressure,
but they also respond to low-
frequency vibration or flutter.
They are rapidly- adapting, fluid-
filled, encapsulated neurons with
small, well-defined borders which
are responsive to fine details.
Merkel’s disks and Meissner’s
corpuscles are not as plentiful in
the palms as they are in the
fingertips.

Ruffini Endings: Located deeper

to the surface of the skin. They are
found in both glabrous and hairy
skin. These are slow-adapting,
encapsulated mechanoreceptors
that detect skin stretch and
deformations within joints; they
provide valuable feedback for
gripping objects and controlling
finger position and movement.
Thus, they also contribute to

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proprioception and kinaesthesia.

Ruffini endings also detect
warmth. Note that these warmth
detectors are situated deeper in the
skin than are the cold detectors. It
is not surprising, then, that humans
detect cold stimuli before they
detect warm stimuli.

Pacinian corpuscle: Located

deeper to the surface of the skin.
Pacinian corpuscles, located deep
in the dermis of both glabrous and
hairy skin, are structurally similar
to Meissner’s corpuscles. They are
found in the bone periosteum, joint
capsules, pancreas and other
viscera, breast, and genitals. They
are rapidly-adapting
mechanoreceptors that sense deep,
transient (not prolonged) pressure,
and high-frequency vibration.
Pacinian receptors detect pressure
and vibration by being compressed
which stimulates their internal
dendrites. There are fewer
Pacinian corpuscles and Ruffini
endings in skin than there are
Merkel’s disks and Meissner’s
corpuscles.

Krause & Bulbs: found in

specialized regions.

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Thermoreceptors Types Receptors Pathway The

sensing Heat: thermoreceptor
Sensing pathway in the
temperatures brain runs from
sensing between the spinal cord
30 and 45°C through the
Receptors thalamus to the
sensing Cold: primary
Sensing somatosensory
temperatures cortex. Warmth
sensing between and cold
17 and 27°C information from
the face travels
through one of
the cranial nerves
to the brain.

 Anatomy of Touch:

Sensations begin as signals generated by touch receptors in your skin. They travel along sensory nerves made up
of bundled fibers that connect to neurons in the spinal cord. Then signals move to the thalamus, which relays information
to the rest of the brain. Next stop is the somatosensory cortex, where signals are translated into a touch perception.

Somatosensory information from all over the body spreads onto the cortex forming a topographic map that curls around
the brain like headphones. Sensitive areas, like lips and fingertips, stimulate much larger regions of the cortex than less
sensitive parts. A region’s sensitivity depends on the number of receptors per unit area and the distance between them.
Unlike the very sensitive lips and hands, receptors on your back are few and far apart so it’s much less sensitive.

Sensitivity will be measured by examining the minimum distance between two points on the skin a person can identify
as distinct stimuli rather than a single stimulus. Perception is greatest where the two-point threshold is lowest, in the
most densely nerve-packed areas, like fingers and lips. But you can distinguish two stimuli on your back only if the are
several centimeters apart.

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Dorsal Column
on Ipsilateral cross to ascend to the
through the
side,i.e. Synapse in the contralateral ventral postcentral
Afferent Sensory posterior limb of
Sensation on Skin Fasciculus Lower Medulla nucleus gracilis Arcuate Fibres side into posterolateral Synapse gyrus of the
Nerve the internal
gracilis & and cuneatus the medial (VPL) nucleus of cortex.
capsule
Fasciculus lemniscus the thalamus
cuneatus

Both a sensory and emotional experience, pain signals tissue damage or the potential for damage and makes the
experience feel unpleasant and upsetting. During any exposure, irrespective of the nature of stimuli special sensory
neurons, nociceptors, respond to the impact. Nociceptors are attuned to stimuli that cause tissue damage. They respond
to strong stimuli, telling you when something is truly dangerous. Different nociceptors are sensitive to different painful
stimuli, like thermal (heat or cold), mechanical (wounds), and chemical (toxins or venoms).
Some nociceptors respond only to chemical stimuli causing itch. Histamine receptors activate when skin irritation,
bug bites, or allergies trigger the release of histamine in the body. Itch receptors have molecular channels in their cell
membrane that open when they detect histamine. There are identified other itch-specific receptors that activate when
they detect other molecules including, prostaglandins, neuropeptides, and proteases the body releases in response to
pain and irritants.
Injury triggers the release of various chemicals at the site of damage, causing inflammation. This inflammatory
“soup” prompts nerve impulses that keep you feeling pain, so you’ll protect the injury. Prostaglandins make receptors
more sensitive to pain, so pain feels more intense. A long-lasting injury may lead to nervous system changes that
enhance perceived pain, even without pain stimuli. This neuropathic pain is caused by an over-sensitive nervous system
rather than an injury. In diabetic neuropathy, prolonged exposure to high blood sugar damages nerves in the hands and
feet, sending signals of numbness, tingling, burning, or aching pain.
 The Science of Hugs:
Our bodies are equipped with two distinct touch systems: the rapid touch system and the slow touch system. The
rapid touch system is responsible for our ability to quickly detect and discriminate between different types of touch. It’s
what allows us to feel the texture of a surface or the pressure of a handshake.
In contrast, the slow touch system is responsible for the emotional aspects of touch. It’s what allows feeling
the warmth and comfort of a hug or the gentle caress of a loved one. This system is mediated by a recently discovered
type of nerve fiber called C-tactile afferents, which are unmyelinated and slower-conducting than the myelinated A-
beta afferents of the rapid touch system. The slow stroking involved in grooming stimulates a particular set of nerves –
the afferent c-tactile neurons that are found only in hairy skin and are quite different to the usual nerves that convey
information about touch, pain and pressure. These neurons respond only to light and slow stroking. They have a direct
route into the brain, where they trigger the release of endorphins.
Endorphins are neuropeptides, small molecules that are used by neurons in the brain to signal to each other.
Endorphins are part of the pain control system, and produce an opiate-like analgesic effect. In fact, they are chemically
closely related to opiate drugs like morphine, but differ in two key respects: on a weight for weight basis, they are 30
times more effective as painkillers than morphine, and there is no adverse effects one can encounter in case of morphine
& the chance of its addiction.
Positron emission tomography (PET for short) is useful to show that light stroking of the torso triggers a massive
endorphin response in the human brain. Cuddling, with its concomitant behaviours of stroking, patting and even the
occasional leafing through the hair, is the human form of primate grooming, and is designed to create and maintain the
foundations of relationships. Pain from both psychological & from physical origin are processed by same regions of

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brain, notably part of anterior cingulate cortex & periaqueductal gray, mainly responsible for release of endorphin, used
to resolve the pain with its adverse reaction.
Endorphins, often famous as androgens or endorphins, are morphine-like biochemically generated hormones that
are endogenous (secreted by the pituitary gland). It is an amino molecule (peptide) released by vertebrates’ pituitary
glands and hypothalamus. These are very useful for the secretion of dopamine & also responsible for the commitment,
relationship building, sense of pleasure & reward.

Receptors for Endorphin Action

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Merkel’s Disc, Meissner’s corpuscle

Mechanism of Touch, Love & Engagement

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 Benefits:

Categories Benefits Description

Psychological Oxytocin & Bonding At the heart of the psychological benefits of hugs lies the hormone
benefit oxytocin. Hugging stimulates the release of oxytocin, often
referred to as the “love hormone.” This neurochemical cascade
fosters feelings of bonding, trust, and emotional connection,
solidifying the foundations of relationships.

Stress Reduction Hugs are powerful stress busters. The activation of the slow touch
system and oxytocin release act as a natural antidote for stress.
Cortisol, the stress hormone, will take its place and allow a calmer
state of mind to develop.

Mood Elevation The emotions of hugging are contributing to an increase in mood.

A positive feedback loop, which increases feelings of happiness
and wellbeing, is created by sensory input from a slow touch
system combined with the release of endorphins.

Boosts Self-Esteem Hugs have been demonstrated to increase serotonin and dopamine
levels, neurotransmitters related to mood and wellbeing. The
release of endorphins, natural painkillers which produce feelings
of happiness and wellbeing are also released by hugging. These
positive effects can increase self-esteem and promote a positive
image of oneself.

Strengthens By increasing the level of oxytocin, hugs foster social connection

Relationships and bonding. Oxytocin helps to promote empathy, trust and
attachment, strengthening relationships with loved ones as well as
reducing feeling of loneliness.

Physiological Cardiac Health In addition to its psychological impact, hugging has a tangible
benefit effect on the health of the heart. The calming effect of hugging
can lead to a reduction in blood pressure, and over time it may
also promote the well being of your heart.

Modulation of the The emotional connection facilitated by hugs is not limited to the
Immune system realm of emotions. Oxytocin has an immune modulating effect, as
well as its role in bond formation. A more effective immune
system can be supported by regular embraces.

Pain Relief Natural relief from pain is the release of endorphins, caused by a
gentle touch system in hugs. In particular, individuals who are
uncomfortable with their own bodies may benefit from this.

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