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PART I
Wound Care Concepts

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 Lecture outlines
What is integumentary Functions of Skin

physical therapy Hair

Integumentary System Nails

Its Components Functions of Integumentary

Skin System

Anatomy of Skin

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 What is Integumentary Physical Therapy
Physical therapists can specialize in the examination and

treatment of the integumentary system and the

diseases/conditions associated with this system.
Diagnoses include wounds, burns, skin ulcers, traumatic

injuries, and scars.

Physiotherapist specializing in integumentary physical

therapy will have likely undergone post-graduate training

to gain the skills necessary to provide patients population
with optimal care.
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 INTEGUMENTARY PHYSICAL THERAPY
However, even if you do not intend to specialized
in integumentary physical therapy of patient care
you must have the knowledge to work with patients
who may have integument diagnoses secondary to
medical conditions.
As a professional you must be able to examine
various integumentary diagnoses, include your
findings in your patient's plan of care, and make
appropriate specialist or physician referrals if
necessary.
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 INTEGUMENTARY SYSTEM
“The integumentary sytem is the organ system
consisting of skin & its associated structures such as ,
the hair , nails and glands.”

The word integument means “cover”.

“Integument” refers to the outer membrane of the

body.

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In humans , Integumentary system accounts for

about 12 to 15 % of total body weight.

It distinguishes , separates & protects the

organism from its surroundings.

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 Components of Integumentary System
 Following are the main
components of integumentary
system :
Hairy Skin
1. Skin.
2. Hair.
3. Nails.
4. Glands.
Nails

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 “SKIN”
Skin is the “soft outer covering of vertebrates.”

It is the largest organ of the body, made up of

multiple layers of ectodermal tissue.

Guards the underlying muscles, bones, ligaments

& internal organs.

It weighs about 10 pounds & has a surface area of

almost 15 to 20 sq. feet normally.
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 Layers of Skin
The human skin is composed of 3 major layers:

1. Epidermis (outermost layer).

2. Dermis.

3. Hypodermis (deepest layer).

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Skin and its layers

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Skin has pigmentation, “melanin” , provided by
melanocytes, which absorbs some of the
potentially dangerous radiations in sunlight.

It also contains DNA

repair enzymes which
reverse UV damage.

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 EPIDERMIS
•Epidermis is the top layer of skin,
made up of epithelial cells.
•It consists of a keratinized
squamous epithelium comprising of
four types of cells:
•Keratinocytes,Melanocytes,Merkel
cells, & Langerhans's cells.
•It contains no blood vessels, & is
nourished by diffusion from the
dermis.
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The epidermis can be further divided into the
following strata:

1. Stratum Corneum.

2. Stratum Lucidum.

3. Stratum Granulosum.

4. Stratum Spinosum.

5. Stratum Basale.

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• Functions of Epidermis:-
1. Epidermis forms a protective barrier over the
body’s surface.

2. It is responsible for preventing pathogens from

entering in the body.

3. It also helps the skin to regulate body

temperature.

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 DERMIS

The dermis is the middle layer of skin, composed

of dense irregular connective tissue & areolar
connective tissue (such as collagen).

The dermis has two layers which serve to give

elasticity to the integument.

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One is the papillary layer which
is the superficial layer & consists
of the areolar connective tissue.

The other is the reticular layer

which is the deep layer of the
dermis & consists of the dense
irregular connective tissue.

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Dermis and its layers

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• Functions of Dermis:-

1. The dermal layer provides a site for the endings

of blood vessels & nerves.

2. It provides strength & elasticity to the skin.

3. Many chromatophores are also stored in this

layer.

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 HYPODERMIS
The hypodermis is basically not a layer of skin.

It lies below the dermis of skin. It is also called as

sub-cutaneous tissue.

It invaginates into the dermis & consists of loose

connective tissue & elastin.

It is essentially composed of adipocytes which are

grouped together in lobules.

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• Functions of Hypodermis:-

1. Its purpose is to attach the skin to underlying

bone & muscle.

2. It also supplies the skin with blood vessels &

nerves.

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 Functions of Skin

1. Protection: It acts as an anatomical barrier from

pathogens,chemicals & UV radiations,etc.

2. Thermoregulation: Skin plays a great role in

vasodilation & vasoconstriction.

3. Evaporation: The skin provides a relatively dry &

semi-impermeable barrier to fluid loss.

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4. Storage: It acts as a storage centre for lipids & water.

5. Water resistance: The skin acts as a water resistant

barrier, so that essential nutrients aren’t washed out
of the body.

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 “HAIR”
Hair is an accessory organ of the skin made of
columns of tightly packed, dead keratinocytes,
found in most regions of the body.

The structure of hair can be broken down into 3

major parts:

The Follicle, Root & Shaft.

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1. Follicle:
Hair follicle is a depression of epidermal
cells deep into the skin. It is a
pouch-like tube in appearance.
2. Root:
Root is the portion of hair in the follicle
below the skin’s surface where the
growth of hair begins through
multiplication of cells.
3. Shaft:
Shaft is that portion of the hair which
is present outside the skin. i.e., visible
portion of the hair.

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• Functions:-

1. Protection: Hair helps to protect the body from UV

radiations.

2. Insulation: Hair also insulates the body by trapping

warm air around the skin.

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 “NAILS”
Nails are accessory organs of the skin, made of sheets
of hardened keratinocytes.

These are found on the distal ends of the fingers &

toes.
Growth of nails is 1 mm per week on average.

The structure of nail is divided into the following

specific parts:

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Nail Root:
This portion of the nail is actually beneath the skin
& extends several millimeters into the fingers.
Nail Bed:
Nail bed is a part of nail matrix. It contains blood
vessels, nerves & melanocytes.
Nail Plate:
Nail plate is the actual finger nail, made up of
translucent keratin.
Lunula:
The lunula is the cresent-shape area at the base of
the nail.
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Different views of Nails

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• Function:-

1. Nail serves as a protective plate as it protects the

censors in our fingers & toes.

2. The nail acts as a counterforce to the fingertip

providing even more sensory input when an
object is touched.

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 GLANDS PRESENT
IN
INTEGUMENTARY SYSTEM

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1. Sudoriferous Glands
 Sudoriferous glands are the exocrine glands found in the

dermis of skin.
They are commonly known as ‘sweat glands’.

They are of two types:

 Eccrine & Apocrine.

 They are important in

maintaining body
temperature.
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2. Sebaceous Glands
Sabaceous glands are also the exocrine glands
found in the dermis of skin.
They produce an oily secretion known as “sebum”.

They help to inhibit bacteria,

keep us waterproof & prevent
our hair and skin from drying.

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3. Ceruminous Glands
Ceruminous glands are the special exocrine glands

found only in the dermis of ear canal.

They produce cerumen (ear wax) which keeps the outer

surface of the ear drum pliable & prevents

drying.
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 Functions of Integumentary System
 Protects the body’s internal living tissues & organs.
 Protects the body from dehydration.
 Maintains homeostasis.
 Helps excrete waste materials through perspiration.
 Acts as a receptor for touch, pressure, pain, heat and
cold.
 Generates vitamin D through exposure to light.
 Stores water, fat and glucose.
 Formation of new cells from stratum basale to repair
minor injuries.

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Coordination with other Systems of body
 Our body is a complicated system that consists of
many subsystems.

 The integumentary system works with other systems

of our body to make them function properly.

 The skin is one of the first defense mechanisms in our

immune system.

 By helping to synthesize & absorb vitamin D, the

integumentary system works with the digestive system
to encourage the uptake of calcium in our diet.
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 The skin plays a vital role as regards the sense of touch.
The nervous system depends on neurons embedded in
our skin to sense the outside world.

 The integumentary system also contributes to

numerous physiological processes, especially those
involved in the regulation of the body’s internal
environment.

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Thank You

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