INTEGUMENTARY SYSTEM

SKIN AND ITS ACCESSORY STRUCTURES

Chapter 5
Micrograph of the Skin**
 Pigmentation Hair
The Skin

SKIN

Nails
Aging of the skin
Glands of the Skin
Injury and Repair
INTRODUCTION TO THE INTEGUMENT
 Integumentary system (integument)
– Largest system of the body
• Sixteen percent of body weight
• 1.5 to 2 m2 of surface area
• Two major parts
– Cutaneous membrane (skin)
– Accessory structures
 Components of the  Accessory structures
cutaneous membrane – Originate in the epidermis
– Outer epidermis – Extend into the dermis
• Superficial epithelium • Hair and hair follicles
– Inner dermis • Exocrine glands
• Connective tissues • Nails
INTEGUMENTARY OVERALL FUNCTIONS
1. Protect Underlying tissues & organs
2. Excrete salts, water, & metabolic wastes (excretory organ)
3. Maintain normal body temperature
4. Production of keratin- water repellant
5. Production of melanin
6. Synthesize vitamin D in epidermis
7. Storage of lipids
8. Houses sensory receptors: detection of touch, pressure,
pain, vibration and temperature.
9. Coordination of immune response to pathogens
(macrophages and Langerhans cells)
INTEGUMENTARY SYSTEM FUNCTIONS
Skin Functions
1. Protection:
Physical barrier
a. from water loss and injury;
b. from chemicals and microorganisms.
Chemical barrier
a. pH of 5-6
b. prevents microorganism growth
Biological barrier
a. Langerhan’s cells (epidermis)
b. Macrophages and mast cells (dermis)
2. Excretion (minimal, most through kidneys!)
3. Regulation of body temperature
 INTEGUMENTARY SYSTEM FUNCTION (CON)
4. Cutaneous Sensation:
• Light touch detection = tactile (Meissner’s) corpuscles;
a. egg-shaped; located in dermal papillae;
b. fingertips, palms, soles, eyelids, tip of tongue, nipples,
clitoris, and tip of penis.
• Pressure detection = lamellated (Pacinian) corpuscles;
a. onion-shaped;
b. located in deep dermis and subcutaneous regions;
5. Vitamin D Synthesis:
UV rays in sunlight activate its synthesis;
Vitamin D is required for bone homeostasis.
6. Blood Reservoir:
The dermis houses about 10% of the body's blood vessels.
Skin only requires 1-2% of the body’s blood
7. Immunity:
Langerhan’s cells interact with T-helper cells
I. Skin and its Tissues
5.1 THE EPIDERMIS-PROTECTIVE COVERING
 Epidermis  Two types of skin
– Stratified squamous – Thin skin
epithelium • Covers most of the body
– Avascular, like all epithelia • 4 layers of keratinocytes
– Nutrients and oxygen – Thick skin
diffuse from capillaries in • Covers the palms of the
the dermis hands and soles of the
– Keratinocytes- most feet
abundant contain keratin • 5 layers of keratinocytes
5.1 THE EPIDERMIS- PROTECTIVE COVERING
Epidermis- keratinized and held together by desmosomes

1.Stratum Germinativum – Stratum Basale Shed after 2

 Mitosis, location of melanocytes (skin color) wks
 Deepest layer/row of cuboidal or columnar
 Forms epidermal ridges/ basis of fingerprints

Day 7-10
contains tactile or Merkel cells in hairless skin
2.Stratum Spinosum (spiny layer)
 Some cells still divide/8 to 10 layers
 Look like pin cushions histologically
 House dendritic cells known as Langerhans cells
3.Stratum Granulosum (granular layer)
 3 to 5 layers very active in keratinization
 keratin (protein): water resistant, durable
 No more mitosis
4.Stratum Lucidum: palms & soles only (clear layer)
5.Stratum Corneum (superficial) leathery layer
 Flattened, dead, keratinized cells –up to 30 layers
 Physical barrier / all exposed surfaces except the eyes Day 1
 site of callus and corns/ perspiration (sensible and insensible)
5.1 THE EPIDERMIS-PROTECTIVE COVERING
Epidermal Ridges :Fingerprints  Epidermal growth factor (EGF)
Ridge Shaped determined by: – A peptide growth factor
• Genes
– Produced by salivary glands
• Intrauterine Environment
and duodenum
• Amniotic fluid, the
– Used in laboratories to grow
uterine wall, another fetus
• Interface between the dermal skin grafts
papilla of the dermis and the  Functions of EGF
conical pegs of the epidermis – Promotes division of basal
Fingerprint are unique and do not
cells
change during your lifetime
– Accelerates keratin
production
– Stimulates epidermal repair
– Stimulates glandular
secretions
Layers of the Epidermis
Come Lets Get Sun Burned
EPIDERMAL FUNCTIONS
Vitamin D synthesis
 Stratum spinosum &
germinativum
 UV light + provitamin D
Vitamin D3 or cholecalciferol
 Vitamin D Purpose:
 Assist in Ca2+ & P absorption
for bones
 Ricketts: bone disease
5.2 THE DERMIS – SUPPORTS EPIDERMIS
 Located between epidermis and subcutaneous layer
 Anchors epidermal accessory structures (e.g., hair follicles
and sweat glands)
 Two components
1. Papillary Layer
 Areolar connective tissue
 Rich in capillaries, lymphatic vessels &
nerves
 Dermal papillae: extensions into
epidermis
 Becomes inflamed in dermatitis
2. Reticular Layer
 Dense, irregular connective tissue
 Support, attachment, & allows flexibility
 Contains hair follicles, muscle fibers,
sebaceous and sweat glands
5.2 THE DERMIS – SUPPORTS EPIDERMIS
 Dermal strength and elasticity
– Collagen fibers -strength
– Elastic fibers -stretching
– Fibers and water provide flexibility
and resilience = skin turgor
 Wrinkles and sagging skin result from
the loss of elastin as we age
 Stretch marks result from weight gain
 Tension lines (cleavage lines)
– Produced by parallel bundles of
collagen and elastic fibers in the
dermis
– Resist forces applied to skin
– A cut made parallel to a tension line
remains shut, heals well
DECUBITUS ULCERS: BED SORES
Decubitus Ulcer = Pressure Sore
1. Population most effected
bed ridden
wheel chaired bound
2. Most common: over bony areas-
heel, pelvic bones, sacrum
3. Cut off blood supply decrease
nutrients & O2 to tissue
5.3 SUBCUTANEOUS LAYER: HYPODERMIS
Structure: loose connective tissue w/ abundant
adipocytes
 In babies: more adipose (brown fat vs white fat)
 Adults: fat located differently in male, female
determined by hormones
Function: stabilizes skin, store energy, insulate
 Very elastic
 Good for medical injection/ subcutaneous injection
 Slow, steady infusion
 No vital organs & limited # of capillaries
NERVE ENDING OF THE SKIN
1. Free Nerve Endings: Pain &
Temp. (epidermis & dermis)
2. Merkel’s discs: touch
(epidermis)
3. Meissner’s Corpuscles:
touch and pressure
(dermis)
4. Ruffini corpuscles
Skin stretching
5. Pacinian Corpuscles: deep
pressure & vibration (deeper
tissue- subcutaneous)
5.4 EPIDERMAL PIGMENTATION
Skin color is influenced by two pigments in the epidermis
1. Melanin 2. Carotene
– Red-yellow (pheomelanin) or brown- – Orange-yellow pigment
black (eumelanin)pigment – Accumulates in epidermal cells,
– Produced by melanocytes from tyrosine deep dermis, and subcutaneous
– layer
Stored in intracellular vesicles
(melanosomes) – Can be converted to vitamin A,
• Dark-skinned people have large, required for
numerous melanosomes • Maintenance of epithelia
– Protects skin from ultraviolet (UV) • photoreceptor pigments
radiation
5.4 . Skin Color** – 3 Factor
1. Genetic Factors – difference in melanin production
2. Environmental Factors – sunlight, UV*, x rays
3. Physiological Factors
a. State of the blood vessels
b. Blood adds color – hemoglobin
Oxygenated –bright red (pink skin)
Deoxygenated – dark red (bluish skin)
known as cyanosis
c. Pigments
1. Carotene: yellow orange pigment
– precursor to vitamin A
2. Melanin:
Melanocytes (basale & dermis): made from
tyrosine
3. Bilirubin – yellow pigment
5.4 EPIDERMAL PIGMENTATION- DISEASES
 Illness and skin color
– Jaundice
• Buildup of bile produced by liver
• Skin and whites of eyes may turn
yellow
– Pituitary tumor
• Excess MSH increases
production of melanin
– Addison’s disease
• Causes pituitary gland to release
excess ACTH, which has an effect
similar to MSH
– Vitiligo
• Loss of melanocytes causing loss
of color
Cyanosis Xeroderma Pigmentosum Vitiligo
5.6 Accessory Structures of the Skin- HAIR
A. Hair – 90% in growth phase (2-6 years)- 2.5 million
1. Hairs found everywhere except palms, soles, lips, sides of fingers
& toes
2. Function: protection, insulation and sensory
reception
3. Hair Structure:
a. Shaft: size, shape, color of hair
b. Root: encloses matrix anchors hair to the skin
c. Hair Follicle: organ that houses the hair bulb
1). Papilla: areolar tissue w/ capillaries & nerves
2). Matrix: epithelial cells at base of hair bulb
a). Medulla- division (inner layer)
b). Cortex- begin keratinizing
c). Cuticle- fully keratinized (outer layer)
4. Arrector pili muscle: smooth muscles- goosebumps
5. Root hair plexus– detect slightest pull
HAIR FOLLICLE AND HAIRS
5.6 HAIR TYPES & COLORS
Types:
1. Vellus: soft fine, “peach fuzz” (most of body)
2. Terminal: heavy, colored (head, eyebrows,
eyelashes and other parts after puberty)
Colors:
1. Determined by melanocytes at papilla
2. Genetic – pigment produced
a. eumelanin – brownish black
b. pheomelanin – blond or red
c. albinism – no melanin
– Pigment production slows w/ age graying
– White hair lack of pigment and presence of air bubbles
5.7 ACCESSORY STRUCTURES EXOCRINE:
SEBACEOUS GLANDS
1. Sebaceous glands
 Holocrine glands
 Associated with hair follicle: secrete sebum
 Sebum- fat, cholesterol, proteins, salts
 Sebum: prevents drying & inhibits bacterial
growth
 Shampoo: removes natural oilstiff, dry hair
2. Sebaceous Follicle
 Secretes directly to epidermis, no hair
 face, back, chest, nipples
 Acne: (caused by hormone changes)
 Glands blocked, secretions accumulate
 inflammation bacterial infection
5.7 EXOCRINE: SWEAT GLANDS OR SUDORIFEROUS
1. Apocrine Sweat Glands
• Secrete through hair
• Armpits & groin
• 1st secrete at puberty
• Sexual state & identity
• + envmt for bacteria odor
2. Eccrine Sweat Glands
• Widespread (esp. palms/ soles)
• Most common gland
• Secrete to skin surface
• Function:
• Regulate body temperature
• Protection: dilute chemicals, Eccrine
• wash away bacteria Apocrine
5.7 REGULATION OF BODY TEMPERATURE
1. Sweat Glands
• Cooling effect
2. Muscles
• Mostly skeletal & arrector pili
3. Blood Flow
• Superficial: heat transfer
• Deeper: maintain heat

4. Problems of Thermoregulation
Hyperthermia – elevated body temperature
inability of homeostatic mechanisms or immune response
Hypothermia – lowered body temperature
Other Integumentary Glands – Specialized Apocrine
Glands
•Modified to secrete specific fluids
1. Ceruminous glands – secret ear wax
2. Mammary glands- secrete milk
5.8 Accessory Structures - Nails
Function: protection
Structure:
 Nail bed: covered by body of nail
 Nail root: nail production occurs
 Cuticle (eponychium): stratum corneum
 Lunula: white area (obscures blood
vessels)
 Free edge: nail extends past finger
 Hyponychium: stratum corneum under
free edge
Disease Signs*
 Nail shape, structure, appearance
changes
 APPLICATION: SKIN CANCER
Basal cell carcinoma: Most common
 Malignant
 Germinativum (basale) layer
 Common Cause: UV radiation
 Metastasis rare
Squamous Cell Carcinoma: 2nd most
 Malignant
 Common cause: UV radiation
 Metastasis rare
Melanoma: most dangerous & rare
 Malignant
 Cancerous melanocytes
 Common cause: UV radiation
 High Metastasis rate
Diagnosis: ABCDE
 Asymetry, Border, Color, Diameter, Evolving
SKIN CANCER DETECTION-
ABCDES
5.9 HEALING OF WOUNDS AND BURNS
1. Inflammation
 Normal response to injury or stress
 Marked by redness, swelling , heat and pain
B. SKIN LOCAL CONTROL: REGENERATION -
CUTS
2. Migration Phase and Clot
Formation:
Platelets & fibrin (scab)
 Isolates area
 Creates network for new
cell migration
3. Division, Migration, Phagocytosis:
Stratum basale and underlying
Tissues (Connective)
 Cells Divide & Migrate
 Fibroblasts migrate and
4. Scarringform
phasefiber
– Noncellular scar tissue is
produced
• A raised keloid may form
STAGES OF WOUND HEALING
BURNS & SKIN GRAFTS
Depth of Burn
1. First degree
 Superficial epidermis
 sunburn red, swollen, pain
 Heals in few days, no scarring
Partial
2. Second
Thickness degree
 Down to basale & dermis red, moist, blisters, varies in
color
 Painful
 Accessory structures survive injury
 Skin usually completely recovers unless infected
3. Third degree
 Down to subcutaneous white, brown, black, or dry
Full
 Less painful nerve ending destroyed
Thickness
 Hard to heal if extensive through body skin graft may
be needed
 BURNS & TREATMENTS (CON)
Estimation of Burns
•Rule of 9’s
•Lund Browder Method

Skin Grafts
Autograph
Homograph
Other Concerns: Xenograph
1. Fluid & electrolyte balance Bioengineered Tissue
2. Thermoregulation
3. Infection
4. Contractures-muscle shortening
RULE OF 9’S
LUND BROWDER METHOD
5.10 AGING OF THE INTEGUMENT