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Anatomy and

Physiology of the Skin


Structure of skin
1 Epidermis
2 Basement membrane (dermoepidermal junction)
3 Dermis
4 Subcutaneous fat

Epidermis: Four layers (from outside inside)


1. Cornified layer
2. Granular layer
3. Spinous layer
4. Basal layer

Dermis contains:
Collagen fibers
Elastic fibers
Ground substances
Blood vessels
Nerves.
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Skin appendages:
Hair follicle
Sebaceous gland
Arrector pili muscle
Eccrine sweat gland
Apocrine sweat glands
Nail

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Dermatology deals with
disorders of skin, hair,
nails, and mucous
membranes.

Structure
Epidermis (thinner
outer layer of skin)
Dermis (thicker
connective tissue layer)
Hypodermis
(subcutaneous layer)
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Dermatological disorder = 10% -15% of
primary care consultations
Skin is the largest organ in human body

Dermatological diseases can cause social and


psychological problems, also it may affect
ability to work (e.g. Chronic hand dermatitis.)
Skin is the gate of the body(might reflect
systemic disease).

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Physiology (function)
1- Protection
- physical barrier that protects underlying
tissues from injury, UV light and bacterial
invasion.
- mechanical barrier and immunity
2- Excretion
- sweat removes water and small amounts of
salt, uric acid and ammonia from the body
surface
3- Synthesis of Vitamin D
4- Regulation of body temperature
- high temperature or strenuous exercise;
sweat is evaporated from the skin surface to
cool it down.
- vasodilation (increases blood flow) and
vasoconstriction (decrease in blood flow)
regulates body temp.

5-Sensation
- nerve endings and receptor cells that
detect stimuli to temp., pain, pressure and touch.
1 Epidermis
2 Basement
membrane
(dermoepidermal
junction)
3 Dermis
4 Subcutaneous fat

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Stratum lucidum :
Found in thick skin
of palms and soles
above granular layer
Epidermis: Consist of several zones

Cornified layer (Stratum corneum )


Granular layer (Stratum granulosum)
Spinous layer (Stratum spinosum)
Basal layer (Stratum basale)

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Basal layer
Rest on the basement
membrane they divide
continuously and move
upwards.
Melanocytes are dendritic
cells lying between basal
cells in a ratio of 1:10 .
Melanocytes synthesize
melanin stored in
melanosomes.
Basal Cell layer
Melanosomes are
transferred to adjacent cells
forming the Epidermal
Melanin unit.
Small, unmelanized,
clumped melanosomes are
found in white skin
Large melanized, dispersed
melanosomes in dark skin
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The Spinous cell layer:
Usually 5 -10 layers
thick .
Adhere to each other by
desmosomes (complex
modification of the cell
membrane ).
Desmosomes appear
like spines.
Granular Cell layer : Diamond
shaped cells.
Cytoplasm is filled with
keratohyaline granules.
In thin skin it is 1 -3- cell
layers and 10 cell layers in
thick skin like palms and
soles.
Stratum Corneum layer:
The cells in this layer
have no nucleous .
Cells have thick envelope
that resist chemicals.

Cells are held together by


desmosomes.
It is 25 cell layer .
Basement Membrane (BM)
Pink homogenous area
between epidermis and
dermis .
Consists of number of
proteins like BP antigens,
collagen 4
The site of attack injury
in blistering diseases.
Skin Structure
Components of BM

Lamina lucida: thin clear


amorphous space
Lamina densa: an electron
dense area containig type4
collagen
Anchoring fibrils : anchors
epidermis to dermis ,type 7
collagen
Skin Structure
Dermis is divided into
Papillary dermis .
Reticular dermis
Consists of :
Collagen fibers Provides
strength .
Elastic Fibers:
Provides elasticity,
protection against shearing
forces.
Skin Structure
Ground substance :
Binds water and maintains
the skin turgor.
Blood vessels:
To nourish the overlying
epidermis.
Skin Structure
The function of dermis:
It provides nourishment
to the epidermis and
interact with it during
wound repair.
It gives the skin its
strength elasticity, and
softness.
Skin structure
Subcutaneous Fat:
Composed of lipocytes
Skin Structure
Skin Appendages
include:
Eccrine/ apocrine sweat

glands.
Sebaceous glands.

Hair Follicles.

Nails
Skin appendages
Eccrine sweat glands
Tubular structures open
freely on the skin ;not
attached to hair follicles.

Under the influence of


cholinergic stimuli.
Skin appendages
Eccrine sweat glands
Present everywhere
except
the vermilion border ; nail
beds ; labia minora ; glans

Abundant in palms ;
soles.
Skin appendages

Apocrine glands:
Present in the axillae ;
anogenital area modified
glands in the external ear
canal the eye lids(molls
glands ) and areolae.
Sebaceous glands:
Attached to hair follicles; or
open freely.
Present in the scalp ; forehead
face upper chest except palms
and soles.
Under the control of
androgens.
Ectopic glands in the mucous
membrane are called fordyce
spots.
Sebaceous glands:.

Present in the areola as


Motgomerys tubercles ;in the
eye lids as Meibomian glands.
Skin appendages
Hair follicles:
The hair follicle with its
attached sebaceous gland
form the Pilosebaceous
Unit.
Structure :
Infundibulum : Region
between skin surface and
sebaceous gland.
Skin Appendages
Isthmus begin at
sebaceous
glands and end at bulge
(site of
insertion of arrector pilli
muscle)
Hair bulb envelopes the
dermal papilla
Skin Appendages
Arrector pili is smooth
muscle located in the
dermis and is attached
to the side of the hair
shaft.
- Cold and emotions
will contract muscle and
pull hair in vertical
position.
Skin Appendages
Hair shaft has:
Cuticle
Cortex contain pigment
cells
Medulla found only in
terminal hair
Skin appendages:
Nails Anatomy
Nail plate made up of
dead keratinized cells of
matrix.
Nail bed is visible
through nail plate.
Nail matrix lies above
the midportion of distal
phalanx
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Skin appendages:
The lunula is the visible
part of the matrix
Proximal nail fold can be

altered in connective tissue


Fingernails grow 3
mm/m
Toenails grow 1 mm/m
Cornification (keratinization)
Occur in the cytoplasm of
epidermal keratinocytes
during their terminal
differantiation into dead
horny cell(corneocyte)
Cornification (keratinization)
The total process takes
approximately 2 months.

It involves the formation


of keratin polypeptides.
Abnormalities in this
process leads to roughness
and scaling of the skin e g
psoriasis.
Skin immune system
Langerhans cells interact
with keratinocytes,
which secrete a number
of immunoregulating
cytokines, and T-cells
forming the skin
immune system.

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