INTEGUMENTARY

SYSTEM
MARIEJIM

DIANE

O.

PAYOT, RMT, MSMT

SKIN OR CUTANEOUS MEMBRANE

in inward
tegere to cover

Skin, hair, glands, nails, and sensory receptors

Covers the external surface of the body

INTEGUMENTARY SYSTEM VS ANY

OTHER SYSTEMS
The appearance of our
skin frequently determines
the initial impression we
make on others.

SKIN AS AN ORGAN
Largest organ of the body
7,600 sq cm (3,000 sq in) adult
Approximately 7% body weight

Thickness: 1.5 mm (average)

Thickest: 6 mm (soles and palms)
Thinnest: 0.5 mm (eyelids, external genitalia, ear drum)

Texture
Rough or callous: elbows and knuckles
Soft and sensitive: eyelids

LAYERS OF SKIN
Two Main Parts
Epidermis epithelial tissue
Dermis connective tissue

Hypodermis subcutaneous
layer; not part of the skin;
areolar and adipose tissue
Storage depot for fat
Contains blood vessels
Contain nerve endings

EPIDERMIS
Superficial protective layer
Derived from ectoderm
Stratified squamous
epithelium
All but the deepest layers
are composed of dead
cells.

Keratinization new cells

(with keratin) push old cells
to surface

CELLS OF THE EPIDERMIS

Keratinocytes
(90%)
Arranged in 4 or
5 layers
Keratin tough
fibrous protein
Resemble flat
dead scales

CELLS OF THE EPIDERMIS

Melanocytes
(8%)
Melanin skin
color; protection
against UV light
Amount
produced is
determined by
genetics, UV light
and hormones

CELLS OF THE EPIDERMIS

Merkel cells
Sensory receptor
cells
Consist of tactile
disc and neuron
Tactile (touch)
reception

Langerhans
cells
Immune
responses
Epidermal
macrophages
Ingest bacteria

EPIDERMIS

LAYERS OF THE EPIDERMIS

Stratum basale
Deepest; attached to
dermis
Desmosomes &
hemidesmosomes

A row of cuboidal or
columnar
keratinocytes
Mitotic divisions
every 19 days
10-25% melanocytes

LAYERS OF THE EPIDERMIS

Stratum spinosum
8-10 layers of manysided keratinocytes
Spiny extensions of
cells
Strength and flexibility
Melanin granules and
Langerhans cells are
abundant
Melanin taken up by
keratinocytes and protects
the nucleus

LAYERS OF THE EPIDERMIS

Stratum granulosum
3-4 flattened rows of cells
Drastic changes in
keratinocyte
appearance
Keratohyaline chemical
precursor to keratin
Lamellated bodies
Water-proofing

Epithelial cells above the

layer die too far from
the dermis

LAYERS OF THE EPIDERMIS

Stratum lucidum
Clear layer
Few rows of flat,
dead keratinocytes
Nuclei, organelles,
cell membrane not
visible
Lips, soles and palms

LAYERS OF THE EPIDERMIS

Stratum corneum
Keratinized cells
25-30 layers flattened,
scale-like cells
Protects the skin
Protective adaptation:
drying and flattening
Friction stimulates additional
mitotic activity in basale and
spinosum: callus
Dandruff: flaking off scalp

EPIDERMIS

SKIN COLORATION
Melanin
Brown-black pigment
Production and distribution
Protects basal layer against UV

Tanning
Albinism
Normal number of cells
Lacks tyrosinase (tyrosine to
melanin)
Hereditary

Freckles
aggregated patches of
melanin

SKIN COLORATION
Vitiligo
White spots
Lack of cells in local
areas

Liver spots
Exposed portions
Brown, plaque-like
growths

Carotene
Yellow-orange
Corneum and
dermis

SKIN COLORATION
Hemoglobin
Pinkish-red

Erythema
Increased blood
flow

Pale skin
Decreased blood
flow

TANNING AND SUNBURNS

Exposure to UV light stimulates melanocytes to
increase production of melanin
Melanin builds up to help protect skin against UV
radiation (tan)
A sunburn is the skin reacting to UV exposure
UV light causes elastic fibers to clump and
become leathery
UV light can alter DNA in cells causing them to
mutate (cancer)
23

SKIN COLOR AND DISEASE

Redness:
fever, hypertension,
inflammation, allergies
Pallor:
anemia or low blood pressure
Jaundice:
liver disorder (yellow)
Bronzing:
Addisons disease (kidney
disease)
Bruising:
broken blood vessels
24

DERMIS
Dense connective
tissue: collagen
and elastic fibers
Fibroblasts, nerve
endings, smooth
muscle, glands,
blood vessels, and
hair follicles

LAYERS OF THE DERMIS

Papillary Layer
Areolar connective
tissue
Collagen and
elastic fibers
Contains blood
vessels
Nutrients
Remove wastes
Regulates body
temperature

DERMIS: PAPILLARY LAYER

Dermal Papillae
Projections that
extend to
epidermis
Ridges
Fingerprints
Footprints

Genetically
determined

LAYERS OF THE DERMIS

Reticular Layer
Deepest
80% of dermis
Dense collagenous
connective tissue
Collagen: strength
Elastin: recoil

Striae (stretch
marks)
Skin is overstretched
and the dermis
ruptures

DERMIS

Reticular layer
Elastin and
collagen fibers
are oriented
more in one
direction than in
others and
produce
cleavage, or
tension, lines

HYPODERMIS
Adipose tissue
Heat insulator and fat
storage
Increases as you gain
weight

Areolar connective
tissue
Allows skin to be
bound with muscles

Large blood vessels

Arteries and veins

ACCESSORY STRUCTURES OF
THE SKIN
HAIR, SKIN GLANDS AND NAILS

HAIR
Protection
Scalp, nostrils,
brows, external
genitalia
Thread of fused,
dead, keratinized
epidermal cells
Shaft superficial
Root into the
dermis

HAIR
Lanugo (fetal hair) is
replaced near the
time of birth by
terminal hairs (scalp,
eyelids, and eyebrows)
and vellus hairs
At puberty, vellus hairs
can be replaced with
terminal hairs

HAIR
Hair follicle
External and internal
root sheaths

Hair bulb
Papilla contains
blood vessels;
nourishment
Matrix produces
new hair; cell division

Smooth muscle
Goosebumps

HAIR

HOW IS HAIR PRODUCED?

Hair is produced in hair bulb

Hair bulb rests on blood vessels to supply it

with nutrients

Hair grows longer as cells are added to base

of hair bulb

39

HAIR FACTS
Testosterone and good nutrition promote hair
growth
Growth occurs in cycles: active and resting
Scalp hair grows for 3 years and rests for 1 year
Eyelashes grow for 30 days and rest for 105 days
We lose about 90 scalp hairs/day
Grey hair is the loss or fading of melanin
Male pattern baldness is from the loss of the hair
follicle
40

HAIR OR PILI
Melanin synthesized by melanocytes
in the matrix of the bulb
Dark-colored brown to black
Blonde and red yellow to red
Iron and more sulfur

Gray decline melanin synthesis

White accumulation of air bubbles in
the hair shaft

Hirsutism excessive body hair

androgens

Androgenic alopecia
Male-pattern baldness

HAIR

GLANDS
Single or groups of
epithelial cells that
secrete a substance

Sebaceous Glands
Sudoriferous Glands
Eccrine sweat glands
Apocrine sweat glands

Ceruminous Glands
Mammary Glands

SUDORIFEROUS GLANDS
Sweat glands
Release sweat, or
perspiration into
hair follicles, onto
the skin surface
(pores)
Eccrine more
common
Apocrine simple,
coiled tubular
Odorless; bacteria
(body odor)

SUDORIFEROUS
GLANDS

FEATURES

ECCRINE GLAND

APOCRINE GLAND

Distribution

Widely distributed
(forehead, palms, soles)

Axilla, groin, areolae,

bearded regions of the face

Secretory portion

Dermis

Hypodermis

Excretory portion

Epidermis

Hair follicle

Nature of secretion

Water, ions, urea, uric

acid, amino acid,
glucose, lactic acid

Slightly viscous, milky or

yellowish; lipids and proteins

Function

Regulates body
temperature

Emotional stress and sexual

excitement; cold sweat

Onset of function

After birth

During puberty

SEBACEOUS GLANDS
Oil glands
Increases during
adolescence
Connected to hair follicles
Secreting portions dermis
None in the palms and soles
Secrete sebum
Keeps hair from drying out
Prevents excessive evaporation of
water from the skin
Keeps the skin soft
Inhibits growth of certain bacteria

SEBACEOUS GLANDS
Whiteheads
Blackheads enlarged
glands in the face
Color due to melanin and
oxidized oil, not dirt

Pimples or boils sebum

is nutritive to bacteria
Acne inflammation of
glands

CERUMINOUS GLANDS
External auditory
canal
Cerumen secretion
of ceruminous and
sebaceous
Earwax
Plus hairs of the external
auditory canal sticky
barrier
Waterproofs the canal
Prevents bacteria and fungi
from entering

Sweat pores
Duct of eccrine
sweat gland

Duct of
apocrine
sweat gland

Arrector pili
(smooth muscle)

Hair follicle

Sebaceous gland

Hair bulb

Apocrine
sweat gland

Eccrine
sweat gland

NAILS
Plates of tightly
packed, hard, dead,
keratinized cells of
epidermis
Grasp and manipulate
small objects
Provide protection to
the ends of fingers and
toes
Allows to scratch
various parts of the
body

NAILS
Nail body
visible
Pink blood
capillaries

Free edge
extends past
the end of the
finger or toe

NAILS
Nail root
Covered by skin

Nail matrix superficial cells

divide by mitosis
Nail bed attaches to nail; distal
to nail matrix
Lunula whitish (vascular tissue)
semilunar; part of nail matrix
Cuticle stratum corneum
extending to nail body

NAILS

FUNCTIONS OF THE SKIN

Regulates body
temperature
Sweating promotes evaporation
High temperature
Increased sweat (lowers body
temperature)
Vasodilation larger surface area in
blood vessels

Low temperature
Decreased sweat (conserves heat)
Vasoconstriction smaller surface
area in blood vessels

FUNCTIONS OF THE SKIN

Protection
Chemical Factors
Oily sebum prevents hair
from drying
Acidic pH of perspiration
retards growth of microbes
Sweat is slightly hypertonic
flush off bacteria
Melanin protection against
UV light

FUNCTIONS OF THE SKIN

Protection
Physical Factors
Stratified squamous
epithelium prevents
bacteria invasion
Keratinized cells physical
barrier against invasion
Biological Factor
Macrophage destroy
bacteria and foreign
substances

FUNCTIONS OF THE SKIN

Excretion
Ammonia, urea, and excessive
salt
Sweating

Absorption
Oxygen and carbon dioxide
Small amounts of UV light

FUNCTIONS OF THE SKIN

Cutaneous
sensations
Arise in the skin

Receptors for:
Pain free nerve
endings
Temperature hot
and cold receptors
Touch Merkels disks
and Meissners
corpuscles
Pressure Pacinian
corpuscles

FUNCTIONS OF THE SKIN

Synthesis of Vitamin D
Exposure of skin to UV light
activates Vitamin D
Vitamin D is converted to
calcitriol (active hormone)
in the liver and kidney
Metabolism of calcium
and phosphorus

VITAMIN D PRODUCTION
1. UV light causes skin to produce a precursor

molecule of vitamin D
2. Precursor is carried by blood to liver where it
is modified
3. Next to kidneys where it is modified again
to form active vitamin D
Vitamin D can also be ingested through fish
oils, fortified milk, eggs, and butter.
Vitamin D stimulates intestine to absorb
calcium and phosphate (bone growth and
muscle function)

AS A DIAGNOSTIC TOOL
Cyanosis
Jaundice
Rashes and lesions
Condition of skin,
hair, and nails
Vitamin A deficiency
sandpaper texture
of the skin
Iron deficiency
anemia spoonshaped nails

CLASSIFICATION OF BURNS
1st degree:
-

damages only epidermis

redness, slight swelling, pain
heals within 2-3 days (usually no scar)
includes sunburns or exposure to cold

2nd degree:
- damages epidermis and upper dermis
- redness, swelling, pain, blisters
- heals in 2 weeks with some scarring

64

 3rd degree:

- destroys epidermis and dermis

- burned areas are cherry red
to black
- nerve endings are destroyed
- skin graft might be necessary
65

Epidermis

Dermis

Subcutaneous
tissue

Partialthickness

Fullthickness

First- Seconddegree degree

Thirddegree

RULE OF NINES
Estimates the severity of burns
Divides body into areas that
are ~ 9%, or multiples of 9%, of
the total body area
Younger patients are different

Burns 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

SKIN CANCER
Most common cancer
Mainly caused by UV light exposure
Fair-skinned people more prone
Prevented by limiting sun exposure and using
sunscreens
UVA rays cause tan and is associated with
malignant melanomas
UVB rays cause sunburns
Sunscreens should block UVA and UVB rays
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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:
Likely to metastasize
Resistant to chemotherapy

MELANOMA
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)

Treated by wide surgical excision

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

AGING AND THE INTEGUMENTARY

SYSTEM
1. Collagen fibers (dermis)
Decrease in number, stiffen, break apart,
disorganize

2. Elastic fibers
3. Fibroblasts (produce collagen &
elastic fibers)
Decrease in number
Wrinkles

4. Langerhans cells and macrophages

Decrease in number; less-efficient phagocytes

5. Sebaceous glands
Decrease size leads to dry and broken skin;
susceptible to infection

AGING AND THE INTEGUMENTARY

SYSTEM
6. Production of sweat
Diminishes; heat stroke

7. Melanocytes
Decreasing in number; gray hair; increasing
in size (age spots)

8. Hair follicles
Stop producing hairs; hair loss

9. Walls of blood vessels (dermis)

Thicker, less permeable, lost adipose
tissue

10.Migration of cells from basal to

epidermal is slow
Skin heals poorly

AGING AND THE INTEGUMENTARY

SYSTEM

Study the integumentary system

and prepare for a quiz.
mdop/7.1.13