Anatomy &

Physiology
AN INTEGRATIVE APPROACH
Third Edition

Michael P. McKinley
Valerie Dean O’Loughlin
Theresa Stouter Bidle

See separate PowerPoint slides for all figures and tables pre-inserted into PowerPoint without notes.

© 2019 McGraw-Hill Education. All rights reserved. Authorized only for instructor use in the classroom. No reproduction or further distribution permitted without the prior written consent of McGraw-Hill Education.
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Chapter 06
Lecture Outline

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Integumentary System
Integumentary system
• Covers body and consists of skin and accessary
tissues (nails, hair, sweat glands, sebaceous glands)
• Integument = skin
• Cutaneous membrane

• Barrier to the outside world

• Visual indicator of our physiology and health
• Dermatology, study of skin

© 2019 McGraw-Hill Education

 6.1 Composition and Functions of the 4

Integument
Learning Objectives: 1
1. Describe the five layers (strata) of the
epidermis.
2. Differentiate between thick skin and thin skin.
3. Explain what causes differences in skin color.
4. Characterize the two layers of the dermis.
5. Explain the significance of cleavage lines.

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 6.1 Composition and Functions of the 5

Integument
Learning Objectives: 2
6. Describe how dermal blood vessels function
in temperature regulation.
7. List the functions of the subcutaneous layer.
8. Name ways in which the epidermis protects
the body and prevents water loss.
9. Describe the integument’s involvement in
calcium and phosphorus utilization.

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 6.1 Composition and Functions of the 6

Integument
Learning Objectives: 3
10. Describe the integument’s role in secretion
and absorption.
11. Identify the immune cells that reside in the
integument, and describe their actions.
12. Explain how skin helps cool the body or
retain warmth.
13. List the sensations detected by the skin’s
sensory receptors.
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 6.1 Composition and Functions 7

of the Integument
Layers of the integument:
• Epidermis
• Stratified squamous epithelium
• Dermis
• Deeper layer
• Primarily dense irregular connective tissue
• Deep to dermis
• Subcutaneous layer (hypodermis)
• Layer of alveolar and CT
• Not part of integumentary system

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Layers of the Integument

Figure 6.1

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6.1a Epidermis 1

Epithelium of the integument

• Epidermis
• Keratinized, stratified squamous epithelium
• Layers (strata) from deep to superficial:
1. Stratum basale
2. Stratum spinosum
3. Stratum granulosum
4. Stratum lucidum
5. Stratum corneum
• First three layers composed of living keratinocytes
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6.1a Epidermis 2

Stratum basale
• Deepest epidermal layer
• Single layer of cuboidal to low columnar cells
• Three cell types:
1. Keratinocytes
2. Melanocytes
3. Tactile cells

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6.1a Epidermis 3

Stratum basale (continued)

Keratinocytes
• Found in all layers
• Those in stratum basale are large stem cells
• Divide to regenerate new cells

• Synthesize keratin
• Protein that strengthens epidermis

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6.1a Epidermis 4

Stratum basale (continued)

Melanocytes
• Scattered among keratinocytes in stratum basale
• Produce and store pigment (melanin) in response to
ultraviolet light
• Transfer pigment granules (melanosomes) into
keratinocytes
• Shield nuclear DNA from UV radiation

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6.1a Epidermis 5

Stratum basale (continued)

Tactile cells
• Merkel cells
• Few in number
• Sensitive to touch
• When compressed, release chemicals, stimulate sensory
nerve endings

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6.1a Epidermis 6

Stratum spinosum
• Several layers of polygonal keratinocytes
• Daughter cells from stratum basale pushed into this
layer
• Nondividing keratinocytes attached by intercellular
junctions, desmosomes
• Epidermal dendritic cells (Langerhans cells) found in
stratum spinosum and granulosum
• Initiate immune response
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6.1a Epidermis 7

Stratum granulosum
• 3 to 5 layers of keratinocytes
• Keratinocytes begin keratinization
• Keratinocytes fill with keratin
• Nucleus and organelles to disintegrate, cells are dead

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6.1a Epidermis 8

Stratum lucidum
• Translucent layer, 2 to 3 cell layers thick
• Found only on thick skin on palms and soles
• Cells filled with a translucent protein, eleidin

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6.1a Epidermis 9

Stratum corneum
• Superficial stratum composed of 20 to 30 layers of
dead, interlocking, keratinized cells
• Dry, thickened surface is protective against abrasion
and infection

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Epidermal Strata

Figure 6.2

© 2019 McGraw-Hill Education (a) ©Ed Reschke/Getty Images

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6.1a Epidermis 10

Variations in the epidermis

• Thickness, color, and skin markings
Thick versus thin skin
• Thick skin
• Palms of hands, soles of feet
• Contains all five layers of epidermal strata
• Sweat glands but no hair follicles or sebaceous glands
• Thin skin
• Covers most of body
• Lacks a stratum lucidum
• Sweat glands, hair follicles, and sebaceous glands
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Thick Skin and Thin Skin

Figure 6.3

© 2019 McGraw-Hill Education (a, b) ©Carolina Biological Supply Company/Medical Images

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6.1a Epidermis 11

Skin color
• Normal color from hemoglobin, melanin, carotene
• Hemoglobin
• Oxygen-binding protein in red blood cells
• Bright red color upon binding oxygen
• Melanin
• Dark pigment produced in melanocytes, transferred to keratinocytes
• Amount in skin varies (heredity, UV exposure)
• Albinism: Melanocytes unable to produce melanin
• Carotene
• Yellow-orange pigment acquired from some vegetables

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Production of Melanin by Melanocytes

Figure 6.4

© 2019 McGraw-Hill Education (b) ©John Burbidge/Science Source

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6.1a Epidermis 12

Skin markings:
Nevus (mole)
• Localized overgrowth of melanocytes
• Should be monitored for changes suggesting malignancy
Freckles
• Yellowish or brown spots
• Localized areas of increased melanocyte activity
Hemangiomas
• Skin discoloration due to benign blood vessel tumor
Friction ridges
• Large folds and valleys of dermis and epidermis
• Fingerprints
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Friction Ridges of Thick Skin

Figure 6.5

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 Clinical View: UV Radiation, 25

Sunscreens, and Sunless Tanners

Sun generates UVA, UVB, UVC radiation
• UVC rays absorbed and do not reach earth

Sunscreens block UVA and UVB rays

• Protect skin if used correctly
• Need high enough SPF (sun protection factor)

Sunless tanners create tanned skin without UV light

exposure.
• No protection against UV rays

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Section 6.1a What did you learn?

As you trim your roses, a thorn penetrates your
palm through all epidermal strata. What are the
layers of the epidermis penetrated, starting from
the surface of the skin?
Briefly describe the process of keratinization.
Where does it occur? Why is it important?
How does hemoglobin contribute to skin color?
What is the function of friction ridges?

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6.1b Dermis 1

Dermis
• Deep to epidermis
• Composed of CT proper
• Other structures present: Blood vessels, sweat glands,
sebaceous glands, hair follicles, nail roots, sensory nerve
endings, arrector pili

• Papillary and reticular layers

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6.1b Dermis 2

Papillary layer of dermis

• Superficial region of dermis, deep to epidermis
• Areolar connective tissue
• Named for projections of dermis, dermal papillae
• Interlock with epidermal ridges to increase area of
contact between layers

Reticular layer of dermis

• Deeper, major portion of dermis
• Dense irregular connective tissue
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Layers of the Dermis

Figure 6.6

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6.1b Dermis 3

Collagen and elastic fibers oriented in parallel bundles

at specific locations
• Bundles function to resist stress during routine movement
• Orientation indicated by lines of cleavage (tension lines)
• Incisions parallel to cleavage lines more likely to heal quickly

• Incisions perpendicular to cleavage lines are more likely to

open due to cut elastic fibers

• If skin stretched beyond its capabilities

• Some collagen fibers torn

• Stretch marks, striae

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Lines of Cleavage

Figure 6.7

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Clinical View: Tattoos

Permanent images produced on integument
Dye injected into dermis
Permanent part of dermis layer
Usually impossible to completely remove a
tattoo
Lasers used to break down pigments
Newer inks are available that allow for removal

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6.1c Subcutaneous Layer

Subcutaneous layer (hypodermis, superficial
fascia)
• Not part of integument
• Areolar and adipose CT
• Functions: Protection, energy storage, and insulation
• Common drug injection site
• Extensive vascular network promotes rapid absorption

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Sections 6.1b-c What did you learn?

5. Compare and contrast the papillary versus reticular
layer of the dermis, with respect to their tissue type
and the structures they contain.
6. What is indicated by the lines of cleavage in the skin,
and why is this medically important?
7. What types of tissue form the subcutaneous layer?

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6.1d Functions of the Integument 1

Protection
• Protects body from injury, harmful substances, microbes,
extreme temperatures, and UV radiation
Prevention of water loss/gain
• Epidermis is water resistant, not waterproof
• Water lost by sweat and transpiration
Metabolic regulation
• Formation of vitamin D3, a precursor to calcitriol
• Calcitriol increases absorption of calcium and phosphate from diet;
regulates blood calcium levels

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6.1d Functions of the Integument 2

Secretion and absorption

• Waste products secreted onto skin surface during sweating
• Skin absorbs some chemicals / drugs but blocks others
• Selectively permeable
• Suitable for transdermal administration of some drugs

Immune function
• Dendritic cells in epidermis and dermis capable of initiating immune
response
Temperature regulation
• Dermal blood vessels capable of vasoconstriction to conserve heat or
vasodilation to release heat
Sensory reception
• Extensive innervation allows for detection of stimuli
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Section 6.1d What did you learn?

8. How does the skin produce vitamin D?
9. Is the skin entirely waterproof? Explain.
10. What are some ways the skin can dissipate excess
heat?

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 6.2 Integumentary Structures Derived 38

from Epidermis
Learning Objectives:
14. Describe the function of nails.
15. List the main components of the nail.
16. Describe the structure of a hair and a follicle.
17. List the functions of hair.
18. Differentiate between the two types of sweat
glands.
19. Describe the function of sebaceous glands.
20. Name two other modified integumentary glands.
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6.2a Nails 1

Structure of nails
• Scalelike modifications of stratum corneum
• Dorsal edges of fingers and toes
• Protect distal tips of digits
• Assist in grasping objects
• Distal whitish free edge (no underlying capillaries)
• Pinkish nail body (underlying capillaries)
• Nail root (part embedded in skin)
• These three constitute nail plate
• Nail bed
• Layer of living epidermis covered by nail body

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6.2a Nails 2

Structure of nails (continued)

• Nail matrix
• Actively growing part of nail at proximal end of nail body
• Lunula
• Whitish semilunar area on proximal end of nail body
• Nail folds
• Folds of skin overlapping nail

• Eponychium (cuticle)
• Narrow band of epidermis from margin of nail wall onto nail body
• Hyponychium
• Thickened stratum corneum over which free nail edge projects

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Structure of a Fingernail

Figure 6.9

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Clinical View: Nail Disorders

Nails are indicative of overall health
• Brittle nails are prone to vertical splitting and separation of
nail plate layers
• Ingrown nails with edge of nail digging into skin
• Onchomycosis is a fungal infection
• Yellow nail syndrome occurs when growth and thickening
slows
• Spoon nails outer surface of nail is concave
• Beau’s lines indicate temporary interference with nail growth
• Vertical ridging common and usually harmless

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6.2b Hair 1

Hair found almost everywhere on the body

Keratinized cells form slender filament
Grows from hair follicles
Three types of hair
• Lanugo: fine, unpigmented, downy hair
• Appears in last trimester
• Vellus: fine hair
• Primary human hair
• Found on upper and lower limbs
• Terminal hair: coarser, pigmented, longer
• On scalp, eyebrows, and eyelashes, men’s beards
• During puberty, replaces vellus hair in axillary and pubic regions
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6.2b Hair 2

Hair structure and follicles

3 zones along length of a hair
• Hair bulb
• Swelling at base where hair originates in dermis
• Surrounds hair papilla, composed of CT
• Only region containing living epithelial cells
• Root
• Zone of hair from bulb to skin surface
• Shaft
• Portion of hair beyond skin surface

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6.2b Hair 3

Hair components
• Hair matrix
• Structure at base of the hair bulb
• Epithelial cells divide here
• Produce new cells, gradually pushed toward surface
• Medulla
• Remnant of matrix
• Flexible, soft keratin
• Cortex
• Flattened cells closer to outer hair surface
• Relatively hard
• Cuticle
• Single cell layer around cortex
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6.2b Hair 4

Hair components (continued)

• Hair follicle
• Oblique tube surrounding hair root
• Extends into dermis and sometimes subcutaneous layer
• Outer CT root sheath originating in dermis
• Inner epithelial tissue root sheath originating from
epidermis
• Arrector pili
• Thin ribbons of smooth muscle
• Extend from hair follicle to dermal papillae
• Elevates hair with contraction, “goosebumps”
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Hair

Figure 6.10

© 2019 McGraw-Hill Education (top b, bottom b) ©McGraw-Hill Education/Al Telser; (c) ©SPL/Science Source
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6.2b Hair 5

Functions include:
• Protection
• Facial expression
• Heat retention
• Sensory reception
• Visual identification
• Chemical signal dispersal
• pheromones
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6.2b Hair 6

Hair color
• Synthesis of melanin in matrix adjacent to hair papillae
• Lightens with age as pigment production decreases
• Gray hair results from gradual reduction in melanin
• White hair occurs due to complete stoppage of melanin production

Hair growth
• Three phases of hair growth cycle
1. Anagen—active phase
2. Catagen—brief regression period
3. Telogen—resting phase

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6.2b Hair 7

Hair loss
• Normally 10 to 100 hairs lost per day
• Thinning of hair, alopecia
• Due to aging
• Diffuse hair loss
• Hair shed from all parts of scalp
• Primarily in women
• Due to hormones, drugs, iron deficiency
• Male pattern baldness
• Loss of hair first from only crown region of scalp
• Genetic and hormonal factors
Hirsutism
• Excessive male pattern hairiness
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6.2c Exocrine Glands of the Skin 1

Sweat glands and sebaceous glands

Sweat glands include two types
• Merocrine
• Apocrine

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6.2c Exocrine Glands of the Skin 2

Merocrine sweat glands

• Most numerous and widely distributed
• Simple, coiled tubular glands
• Discharge secretions onto skin surface
• Produce secretion by exocytosis
• Secrete sweat
• Composed of 99% water and 1% other chemicals
• Includes: electrolytes, metabolites, and waste products

• Major role in thermoregulation

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6.2c Exocrine Glands of the Skin 3

Apocrine sweat glands

• Coiled, tubular glands
• Discharge secretions into hair follicles located axillae, around
nipples, in pubic and anal region
• Produce secretion by exocytosis
• Produce viscous cloudy secretions
• Contain proteins and lipids

• Produce odor when acted on by bacteria

• Start producing secretions during puberty

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6.2c Exocrine Glands of the Skin 4

Sebaceous glands
• Holocrine glands
• Produce oily secretion, sebum
• Lubricant for skin and hair
• Bactericidal
• Discharges into a hair follicle

• Secretion stimulated by hormones, especially androgens

• Activated during puberty

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6.2c Exocrine Glands of the Skin 5

Other integumentary glands

Ceruminous glands
• Modified apocrine sweat glands
• Located only in external ear canal
• Secretions of waterproof earwax, cerumen
• Traps foreign material
• Lubricates acoustic meatus and eardrum

Mammary glands
• Modified apocrine sweat glands of breast
• Only function in pregnant and lactating females
• Produce milk
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Exocrine Glands of the Skin

Figure 6.11a

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Clinical View: Acne and Acne Treatments

Acne
• Plugged sebaceous ducts
• Typically begins during puberty
• Increased activity gland secretions may block pores
• Treatments
• Benzoyl peroxide, salicylic acid, antibiotics, vitamin A–like
compounds, systemic retinoinds

• May lead to scarring if untreated

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Section 6.2 What did you learn?

11. What is the difference between the eponychium
and the hyponychium of a fingernail?
12. What are the three zones of a hair?
13. How does hair function in protection and heat
retention?
14. How do apocrine sweat glands differ from
merocrine sweat glands in terms of their location,
secretions, and function?
15. What do sebaceous glands secrete, and where is
this material secreted?
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 6.3 Repair and Regeneration of the 59

Integumentary System
Learning Objectives:
21. Distinguish between regeneration and fibrosis.
22. Describe the process of wound healing.

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 6.3 Repair and Regeneration of the 60

Integumentary System 1

Tissue is repaired in one of two ways:

regeneration or fibrosis
• Regeneration
• Replacement of damaged or dead cells with same cell type
• Restores organ function

• Fibrosis
• Gap filled with scar tissue
• Collagen produced by fibroblasts
• Functional activities not restored
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 6.3 Repair and Regeneration of the 61

Integumentary System 2

Stages of wound healing:

1) Cut blood vessels bleed into wound
2) Blood clot forms and leukocytes clean wound

• Clot is a temporary barrier for pathogens

3) Blood vessels re-grow and granulation tissue forms

• Vascular CT initially forms in wound

4) Epithelium regenerates and CT fibrosis occurs

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Stages in Wound Healing

Figure 6.12

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Clinical View: Psoriasis

Chronic autoimmune skin disease
Keratinocytes attacked by T-lymphocytes
Causes rapid overgrowth of new skin cells
Patches of whitish, scaly skin on epidermal surface
Symptoms: severe itching, pain, skin cracking
Treatments
• Corticosteroids, UV light therapy, medications that
interfere with skin cell production

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Clinical View: Burns 1

Major cause of accidental death

Caused by heat, radiation, chemicals, sunlight, electrical
shock
Threat to life from fluid loss, infection, effects of burned
tissue
• First degree burns
• Involve only epidermis
• Slight redness and pain
• Immerse burned area in cool water
• Second degree burns
• Involve epidermis and part of dermis
• Skin blistered and painful
• Slight scarring

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Clinical View: Burns 2

Third-degree burns
• Involve epidermis, dermis, and subcutaneous layer

• Require hospitalization

• Treatment for dehydration and infection

• Require additional caloric intake

• Severe scarring

• May need debridement and skin graft

• Burn severity can be measured by rule of nines

• Estimates surface area of burns
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Clinical View: Burns 3

Treatments for burns

• Manage fluid loss
• Relieve swelling
• Manage pain
• Remove dead tissue
• Control infection
• Increase calorie intake

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Section 6.3 What did you learn?

17. What is granulation tissue, and when does it appear
during wound healing of the skin?

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 6.4 Development and Aging of the 68

Integumentary System
Learning Objectives:
23. Describe how integument develops from two germ
layers.
24. Explain the developmental origins of nails, hair, and
glands.
25. Explain changes to the skin with age.
26. List factors that contribute to skin aging.

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 6.4a Development of the Integument and 69

Its Derivatives 1

Development around week 7

• Ectoderm forms a layer of squamous epithelium
• Becomes periderm and basal layer
• Basal layer forms all epidermal layers

By week 21
• Formation of stratum corneum and friction ridges
• Periderm eventually sloughed off
• Mixes with sebum to produce coating on fetus skin, vernix caseosa

Development around week 11

• Dermis is derived from mesoderm
• Mesoderm becomes mesenchyme
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Its Derivatives 2

By week 32
• Fingernails/toenails form

Between weeks 9 and 12

• Hair follicles appear
• Pockets of cells, hair buds

By week 20
• Sweat and sebaceous glands appear on palms/soles;
later in other regions

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6.4b Aging of the Integument 1

Skin changes with aging

• Reduced number and activity of stem cells
• Skin repair processes slows

• Thin skin less likely to protect from trauma

• Fewer collagen fibers

• Elastic fibers lose elasticity
• Crease lines form (wrinkles)
• Immune response decreased due to fewer dendritic cells
• Hair follicles produce thinner hair or none at all
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6.4b Aging of the Integument 2

Skin changes with aging (continued)

UV radiation
• Damages DNA in epidermal cells
• Accelerates aging

• Predominant factor in skin cancer

Skin cancer
• Most common type of cancer
• Typically on head and neck
• Fair-skinned individuals at highest risk
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Clinical View: Botox and Wrinkles

Botox is a treatment for wrinkles caused by facial
muscle expression
Clostridium botulinum toxin
Blocks nerve impulses to facial expression muscles
Decreases or eliminates wrinkles
Botox injected into specific facial muscles
Temporary effect only
Muscles regain function and procedure must be
repeated
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Section 6.4 What did you learn?

17. What two primary germ layers form the
integument?
18. How do UV rays contribute to skin aging?

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