Chapter 5

The Integumentary System

Integumentary System

The bodys covering

Includes: skin, nails, and hairs, oil & sweat
glands & sensory receptors.
Skin: cutaneous membrane

Structure

Two main parts

Epidermis - surface epithelial layer

Dermis - deeper connective tissue layer

Subcutaneous (subQ) layer or hypodermis

lies deep to dermis; is not part of the skin

Integumentary System

Epidermis

Epidermis

Keratinized stratified squamous epithelium

Cell types (4):

Keratinocytes (90%)
Melanocytes (8%)
Langerhans cells
Merkel cells

Epidermal Cells

Keratinocytes

90% of epidermal cells

4-5 layers
Produce keratin
Protects skin
Waterproofs skin

Epidermal Cells

Melanocytes

Produce melanin that gives color to skin, hairs

Transfer pigment to keratinocytes
Make up 8% of epidermal cells

Epidermal Cells

Langerhans cells

Immune response

Merkel cells

Sense of touch

Consist of tactile disc and neuron for touch sensation

Epidermal Layers

Four Layers (strata)

Stratum basale (aka. Stratum germinativum)

Stratum spinosum: 8-10 cell layer

Losing cell organelles and nuclei

Have waterproofing lipid

Stratum Lucidum

Cells beginning to look flattened

Stratum granulosum makes keratin

Includes stem cells; new cells arise here

Present only in skin of fingertips, soles & palms

Stratum corneum: flattened dead cells

Cells here consist mostly of keratin.

Cells here are shed and replaced from below.

Epidermal Layers

Epidermal Layers

Keratinization & Growth of epidermis

EGF (Epidermal growth Factor)

Plays a role in this mechanism

Dandruff (Seborrheic Dermatitis)

Excessive amount of keratinized cells shed from

the skin of the scalp

CLINICAL CONNECTION:
PSORIASIS

Abnormal division of
keratinocytes
Rapid movement from
stratum basale to stratum
corneum
Flaky, silvery scales at the
skin surface
Topical ointments & UV
phototherapy

Skin Color

Melanin: dark color

Carotene: yellow orange

Darkness depends on amount of melanin

produced.
From melanosome
Provides some protection against UV rays
In stratum corneum and adipose layers-

Hemoglobin in blood: pink-red

Depends on blood flow

Skin Color

Albinism

Vitiligo

Inablity to produce melanin

Inability to synthesize tyronase
Partial or complete loss of melanocytes from
patches of skin. Irregular white spots

Cyanotic

Bluish discoloration of the skin

Skin Color

Erythema

Jaundice

Redness or the skin

Engorgement of the capillaries
Yellowish color

Pallor

paleness

Dermis

Second major skin region containing strong,

flexible connective tissue (Collagen & elastic
fibers)
Stretches & recoils
Cell types include fibroblasts, macrophages,
and occasionally mast cells and white blood
cells
Composed of two layers papillary and
reticular

Layers of the Dermis: Papillary Layer

Papillary layer
1/5 of the total layer

Areolar connective tissue with collagen and elastic

fibers
Its superior surface contains peglike projections
called dermal papillae
Dermal papillae contain capillary loops,
Meissners corpuscles, and free nerve endings

Layers of the Dermis: Reticular Layer

Reticular layer (Net-like)

Accounts for approximately 80% of the thickness

of the skin
Collagen fibers in this layer add strength and
resiliency to the skin
Elastin fibers provide stretch-recoil properties
Striae (stretch marks)

Red silvery white streaks on the surface of the skin

Hypodermis

Subcutaneous layer deep to the skin

Composed of adipose and areolar connective
tissue

Accessory Structures

Hair
Skin glands
Nails

Hair

Found on most skin surfaces

Made of fused keratinized cells

Consists of shaft and root
Surrounded by hair follicle

Not on palmar surfaces of hand and fingers or plantar

surfaces of feet

Base is bulb which includes growing matrix producing

cells

Nerves in hair root plexuses

Muscle that pulls on hair: arrector pili
Causes hair to stand on end

Hair

Hair

Filamentous strands of dead keratinized cells

produced by hair follicles
Contains hard keratin which is tougher and
more durable than soft keratin of the skin
Made up of the shaft projecting from the skin,
and the root embedded in the skin
Consists of a core called the medulla, a
cortex, and an outermost cuticle
Pigmented by melanocytes at the base of the
hair

Hair Function and Distribution

Functions of hair include:

Helping to maintain warmth

Alerting the body to presence of insects on the
skin
Guarding the scalp against physical trauma, heat
loss, and sunlight

Hair is distributed over the entire skin surface

except

Palms, soles, and lips

Nipples and portions of the external genitalia

Hair Follicle

Root sheath extending from the epidermal

surface into the dermis
Deep end is expanded forming a hair bulb
A knot of sensory nerve endings (a root hair
plexus) wraps around each hair bulb
Bending a hair stimulates these endings,
hence our hairs act as sensitive touch
receptors

Hair Follicle

Figure 5.6a

Hair Follicle

Figure 5.6c

Hair growth

Anagen

Catagen

Growth
Cells of the hair matrix divide
Regression stage
Cell division stops, hair follicles atrophies

Telogen

Resting stage
Old hair falls out

Types of Hair

Vellus pale, fine body hair found in children

and the adult female

peach fuzz

Terminal coarse, long hair of eyebrows,

scalp, axillary, and pubic regions

Hair Thinning and Baldness

Alopecia hair thinning in both sexes

True, or frank, baldness

Genetically determined and sex-influenced

condition
Male pattern baldness caused by follicular
response to DHT

Hirsutism

Abnormal hair growth

GLANDS: Sebaceous

A bundle of smooth muscles (arrector pili)

Goose bumps or Goose flesh

Simple alveolar glands found all over the

body
Soften skin when stimulated by hormones
Secrete an oily secretion called sebum

GLANDS: Sebaceous

Acne

Inflammation of sebaceous glands

Cystic Acne

Cyst or a scar of connective tissue

Clindamycin
isotretinoin

Glands: Sweat glands

Sudoriferous (sweat) gland

Eccrine sweat gland (palms, soles, forehead)

emotional Sweating

Wide distribution- thermoregulation

Apocrine sweat gland (axilliary, anogenital
areas)
Mammary glands (specialized sweat glands)
Ceruminous (wax) gland
Wax combines with sebum to produce
earwax
Impacted cerumen

Nails

Plates of packed hard dead keratinized cells

Nail body: major visible portion
Free edge: part extending past finger or toe
Root: cells deep to here (in nail matrix) form
new nail cells

Nails

Nails

Functions of the Integumentary

System

Temperature regulation

Dilation (cooling) and constriction (warming) of

dermal vessels
Increasing sweat gland secretions to cool the
body

Protection (chemical, physical, and

mechanical barrier)
Sensory reception exoreceptors sense
touch and pain

Functions of the Integumentary

System

Metabolic functions synthesis of vitamin D

in dermal blood vessels
Blood reservoir skin blood vessels store up
to 5% of the bodys blood volume
Excretion limited amounts of nitrogenous
wastes are eliminated from the body in sweat

Synthesis of Vitamin D

Requires UV
Calcitriol

Most active form of Vitamin D

Absorption of Calcium

Skin Cancer

Most skin tumors are benign and do not

metastasize
A crucial risk factor for nonmelanoma skin
cancers is the disabling of the p53 gene
Newly developed skin lotions can fix
damaged DNA

Skin Cancer

The three major types of skin cancer are:

Basal cell carcinoma

Squamous cell carcinoma
Melanoma

Basal Cell Carcinoma

Least malignant and most common skin

cancer
Stratum basale cells proliferate and invade
the dermis and hypodermis
Slow growing and do not often metastasize
Can be cured by surgical excision in 99% of
the cases

Squamous Cell Carcinoma

Arises from keratinocytes of stratum

spinosum
Arise most often on scalp, ears, and lower lip
Grows rapidly and metastasizes if not
removed
Prognosis is good if treated by radiation
therapy or removed surgically

Melanoma

Cancer of melanocytes is the most

dangerous type of skin cancer because it is:

Highly metastatic
Resistant to chemotherapy

Melanoma

Melanomas have the following characteristics

(ABCD rule)

A: Asymmetry; the two sides of the pigmented

area do not match
B: Border is irregular and exhibits indentations
C: Color (pigmented area) is black, brown, tan,
and sometimes red or blue
D: Diameter is larger than 6 mm (size of a pencil
eraser)
E: Evolving

Melanoma

Treated by wide surgical excision

accompanied by immunotherapy
Chance of survival is poor if the lesion is over
4 mm thick

Burns

First-degree only the epidermis is damaged

Symptoms include localized redness, swelling,
and pain
Second-degree epidermis and upper regions of
dermis are damaged
Symptoms mimic first degree burns, but blisters
also appear
Third-degree entire thickness of the skin is
damaged
Burned area appears gray-white, cherry red, or
black; there is no initial edema or pain (since
nerve endings are destroyed)

Rule of Nines

Estimates the severity of burns

Burns considered critical if:

Over 25% of the body has second-degree burns

Over 10% of the body has third-degree burns
There are third-degree burns on face, hands, or
feet

Rule of Nines

Figure 5.8a

Rule of Nines

Figure 5.8a

Pressure Ulcers

Aka decibitus ulcers/bedsores

Caused by deficient blood flow to tissues

Developmental Aspects of the

Integument: Fetal

Epidermis develops from ectoderm

Dermis and hypodermis develop from
mesoderm
Lanugo downy coat of delicate hairs
covering the fetus
Vernix caseosa substance produced by
sebaceous glands that protects the skin of
the fetus in the amnion

Developmental Aspects of the

Integument: Adolescent to Adult

Skin and hair become oilier and acne may

appear
Skin shows the effects of cumulative
environmental assaults around age 30
Scaling and dermatitis become more
common

Developmental Aspects of the

Integument:
Old Age

Epidermal replacement of cells slows and skin

becomes thinner
Skin becomes dry and itchy
Subcutaneous fat layer diminishes, leading to
intolerance of cold

Developmental Aspects of the

Integument:
Old Age

Decreased elasticity and loss of subcutaneous

tissue leads to wrinkles
Decreased numbers of melanocytes and
Langerhans cells increase the risk of skin
cancer

Aging

Adolescence: can develop acne

Most effects in dermis, with visible signs of
aging by about age 40. These include:

Loss of collagen fibers

Loss of elasticity
Loss of immune responses
Decreased melanocyte functions:

gray hair, skin blotches

Thinning of skin and hairs

Anti-aging treatments

Anti-aging Treatments

Topical products

Microdermabrasions
Chemical peel

Glycolic acid

Laser resurfacing
Fat transplantation

Hydroquinone
Retinoic acid

Botox

Radio frequency nonsurgical facelift, browlift

Thread lifts

Medical Terminology

Medical Terminology