1. Describe anatomy (including histology) & physiology of skin.

(Amanda) SUMMARY 5 main functions: immune, body temp, neuro, excretion, Vit D 5 layers to epidermis: corneum, lucidum, granulosum, spinosum, basale 4 cells types to epidermis: keritonocytes, merkels, melanocytes, Langerhan 2 layers to dermis: papillary and reticular 4 Glands: mammary, eccrine, apocrine, sebaceous Regulation of Body temp: thermosensitive free nerve endings hypothalamus effectors The integument, composed of skin and its appendages, sweat glands, sebaceous glands, hair, and nails, is the largest organ, constituting 16% of the body weight. Besides providing a cover for the underlying soft tissues, skin performs many additional functions, including protection against injury, bacterial invasion, and desiccation regulation of body temperature reception of continual sensations from the environment (e.g, touch, temperature, and pain) excretion from sweat glands absorption of ultraviolet (UV) radiation from the sun for the synthesis of vitamin D. Skin consists of two layers: an outer epidermis and a deeper connective tissue layer, the dermis. The epidermis is composed of stratified squamous keratinized epithelium. Lying directly below and interdigitating with the epidermis is the dermis, composed of dense, irregular collagenous connective tissue. The interface between the epidermis and dermis is formed by raised ridges of the dermis, the dermal ridges (papillae), which interdigitate with invaginations of the epidermis called epidermal ridges. Collectively, the two types of ridges are known as the rete apparatus. Blood vessels of the dermis as well as pain and touch receptors are located in the papillae. Additional down growths of the epidermal derivatives (hair follicles, sweat glands, and sebaceous glands) that come to lie in the dermis cause the interface to have an irregular contour. Nerve endings for pain all lie in the dermis. Receptors for touch may lie in both the dermis and epidermis. EPIDERMIS The epidermis is 0.07 to 0.12 mm in thickness over most of the body, with localized thickening on the palms of the hands and the soles of the feet (0.8 mm - 1.4 mm). Keratinocytes, which form the largest population of cells, are arranged in five recognizable layers; the remaining three cell types (Langerhans cells, Merkel cells, and melanocytes) are interspersed among keratinocytes in specific locations. Keratinocytes are being continually sloughed from the surface and their renewal is accomplished through mitotic activity in the basal layers of the epidermis combined with a slow shift upwards. Along their way to the surface, the cells differentiate and begin to accumulate keratin filaments in their cytoplasm. Eventually, as they near the surface, the cells die and are sloughed off, a process that takes 20 - 30 days. Because of the cytomorphosis of keratinocytes during their migration from the basal layer of the epidermis to its surface, five morphologically distinct zones of the epidermis can be identified. From the inner to the outer layer, these are the (1) stratum basale (germinativum), (2) stratum spinosum, (3) stratum granulosum, (4) stratum lucidum, and (5) stratum corneum. (Californian ladies give superb backrubs or Cher Likes Getting Skin Botoxed) Langerhans cells antigen presenting cells Merkel cells (aka clear cells) - found in stratum basale, have a neuroendocrine role to play in fine touch descrimination Melanocytes absorb UV-B Skin is classified as thick or thin according to the thickness of the epidermis as well as the following: Thick skin (of the palms and soles) is hairless, lacks pigment and has all of the aforementioned skin layers Thin skin has hair and is pigmented but may not have stratum lucidum, stratum basale may be absent or discontinuous

DERMIS The dermis is divided into two layers: the superficial, loosely woven papillary layer (20%) and the deeper, much denser reticular layer (80%). The dermis is composed of dense, irregular collagenous connective tissue, containing mostly type I collagen fibers and networks of elastic fibers, which support the epidermis and bind the skin to the underlying hypodermis (superficial fascia). The interface between the papillary layer and reticular layer of the dermis is indistinguishable. Sweat glands, sebaceous glands, and hair follicles, all derived from the epidermis, invade the dermis and hypodermis during embryogenesis. Groups of smooth muscle cells are located in the deeper regions of the reticular layer at particular sites (e.g. scrotum); contractions of these muscle groups wrinkle the skin in these regions. Other smooth muscle fibers, called arrector pili muscles, are inserted into the hair follicles; contractions of these muscles erect the hairs when the body is cold. Additionally the muscles of facial expression originate in the superficial fascia and insert into the dermis. Cells fibroblasts (produce collagen, fibronectin), macrophages, endothelial cells from vessels HYPODERMIS Subcutaneous fat, ct, sweat glands, muscle and bone. GLANDS The glands of the skin include eccrine (sweat) glands, apocrine sweat glands, sebaceous glands, and the mammary gland. Eccrine (aka merocrine) sweat glands are coiled tubular glands composed of simple cuboidal epithelium located deep in the dermis or in the underlying hypodermis. Open on the surface of the skin at a sweat pore. Apocrine sweat glands are found only in certain locations: the axilla, the areola and the anal region. Modified apocrine sweat glands constitute the ceruminous (wax) glands of the external auditory canal and the glands of Moll in the eyelids. Apocrine sweat glands are much larger than eccrine and unlike the ducts of eccrine sweat glands, which open onto the skin surface, the ducts of apocrine sweat glands open into canals of the hair follicles just superficial to the entry of the sebaceous glands. Sebaceous glands are appendages of hair follicles. Their ducts of the sebaceous glands open into the upper third of the follicular canal, where they discharge their waxy secretory product to coat the hair shaft and, eventually, the skin surface. HAIR FOLLICLES Hair is composed of a shaft outside the body (3 layers) and hair follicle within. Hair shaft = medulla + cortex + cuticle Hair follicle = hair shaft + internal root sheath + external root sheath + glassy membrane Both the medulla and cortex are made of keratin and the cuticle is 5-12 layers of dead cells. Hair arises from invaginations of the epidermis that invade the dermis. Arrector pili muscles are smooth muscle cells extending from midshaft of the hair follicle to the papillary layer of the dermis. They function in elevating the hair and in the formation of goose bumps.

REGULATION OF BODY TEMPERATURE Epidermis acts as a shell to insulate the high temp body from excessive water loss to the environment. Dermis regulates blood flow and thus heat loss. Thermosensitive free nerve endings Distributed over the entire skin surface and in high concentration in the anterior hypothalamus. Anatomically distinct hot and cold receptors that mostly respond to changes in temperature rather than sustained drops. Hypothalamus Info from skin sent to hypothalamus where it integrates skin data with core body temp data. Skin data can be used to anticipate future changes in body temp. (ie if changes to output heat arent made the body will eventually heat to surrounding temp). Th us this is known as anticipatory negative feedback loop. Effectors See pic R. Efferent pathways are mostly autonomic and work mostly to upregulate peripheral SNS activity (conserve heat) or down regulate SNS activity (get rid of excess heat). Shivering is a phenomenon whereby muscle groups around vital organs contract rhythmically to produce heat. This is a somatic motor response from the hypothalamus. References: This is just from the supernotes