CHAPTER 1: INTEGUMENTARY SYSTEM

Integument or Skin
- The external covering of the body (skin)
- The skin together with its associated structures are called integumentary system
- Main function of integumentary system: To cover and protect the body against
abrasion and puncture, excessive water loss, invasion of bacteria, and the damaging
action of the ultraviolet rays of the sun

- Some animals: have their skin for regulation of body temperature, sensation,
excretion, respiration, and secretion
- Others: find the skin to provide a clue as to its sex, while skin secretions allow
some animals to attract or repel other animals

Human Integument
- It is made up of:
o outer thin epidermis derived from the ectoderm
o inner thicker dermis derived from mesoderm

Epidermis
- A layer of keratinized stratified squamous epithelium
- In its deepest layers, cells are produced by mitosis
- It prevents water loss and resist abrasion
- As new cells are formed, they push older cells to the surface, where they slough, or
flake off
o During their movement, the cells change shape and chemical composition.
This process is called keratinization because the cells become filled with
the protein keratin, which makes the cells hard
- Consisting of four distinct cell types and four or five layer
o Cell types: Keratinocytes, Melanocytes, Merkel cells, and Langerhans'
Cells

Cell Types in Epidermis

Keratinocytes Melanocytes
- Most abundant cell type - Produce the brown pigment
- Produce the fibrous protein melanin
keratin - Found in the deepest layers of the
- Gives skin its protective epidermis
properties Langerhans’ Cells
Merkel Cells - Epidermal macrophages
- Touch receptors in association - Help activate the immune system
with sensory nerve endings
Layers of Epidermis

Stratum Basale (Basal Layer)

- Deepest stratum or deepest epidermal layer firmly attached to the dermis
o Structural strength is provided by desmosomes and hemidesmosomes
- Consists of a single row of the youngest keratinocytes
- Cells (cuboidal or columnar cells) undergo mitotic divisions every 19 days
- 10-25% are melanocytes

Stratum Spinosum
- Melanin granules and Langerhans' cells are abundant in this layer
o Melanin is taken up by the keratinocytes and accumulates on the "sunny
side" to protect the nucleus from UV damage

Stratum Granulosum
- Drastic changes in keratinocyte appearance occurs
- Keratohyaline and lamellated bodies (waterproofing) accumulate in the cells of this
layer
- Above this layer the epithelial cells die because they are too far from the dermis

Stratum Lucidum
- Thin, transparent band superficial to the Stratum
Granulosum
- Consists of a few rows of flat, dead
keratinocytes
- Present only in thick skin

Stratum Corneum
- The most superficial stratum of the epidermis. It
consists of dead, squamous cells filled with hard
protein keratin
- Outermost layer of keratinized cells
- Accounts for three quarters of the epidermal thickness
- 20-30 cell layers thick, all dead.
- Millions rub off every day. Totally new every 25-45 days.
- Functions include:
o Waterproofing
o Protection from abrasion and penetration
o Rendering the body relatively insensitive to biological, chemical, and
physical assaults

Dermis
 - A layer of dense collagenous connective tissue that contains fibroblasts, fat cells,
and macrophages
- Second major skin region containing strong, flexible connective tissue
- Cell types: fibroblasts, a few adipose cells and macrophages
- Two layers: papillary and reticular

Layers of Dermis

Papillary Layer
- Areolar connective tissue with collagen and elastic fibers
- Its superior surface contains peg-like projections called dermal papillae
o Genetically determined
o Responsible for fingerprints and footprints (films of sweat)
- Contains blood vessels that supply the overlying epidermis
o With nutrients
o Remove waste products
o Aid in regulating body temperature

Reticular Layer
- Dense irregular connective tissue
- 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), the dermis ruptures and leaves visible lines
- Elastin and collagen fibers are oriented more in one direction than in others and
produce cleavage or tension lines

Subcutaneous Tissues
- Deep to the skin
- Composed of adipose and areolar connective tissue
- Not really part of the skin
- Mostly adipose tissue
- Stores fat and connects the skin to the underlying structures (mainly muscles)
- Shock absorber and insulator
- Increases greatly during weight gain

Callus (Hard Skin)

- In skin subjected to friction, the number of layers in the stratum corneum greatly
increases, producing a thickened area called callus
 - Over a bony prominence, the stratum corneum can thicken to form a cone-shaped
structure called corn

Skin Color
- Melanocytes produce melanin inside melanosomes and then transfer the melanin to
keratinocytes (melanocytes - melanosomes - melanin)

o The size and distribution of melanosomes determine skin color

o Melanin production is determined genetically but can be influenced by UV
light (tanning) and hormones
- Increased blood flow produces a red skin color
(Erythema), whereas a decreased flow causes
pale skin
o Decreased oxygen content in the blood
results in a bluish color called cyanosis
- Carotene, an ingested plant pigment, can cause
the skin to appear yellowish
- Pigments in the skin, blood circulating through
the skin, and the thickness of the stratum
corneum determine skin color

Thick vs Thin Skin

- Thick: has all five epithelial strata
- Thin: contains fewer cell layers per stratum
o Stratum lucidum is usually absent
o Hair is found only in thin skin

Melanin
- a group of pigments responsible for skin, hair, and eye color
- Most melanin molecules are brown to black pigments, but some are yellowish or
reddish
- Melanin provides protection against ultraviolet light from the sun

Melanocytes
- These are irregularly shaped cells with many long processes that extend between
the epithelial cells of the deep part of the epidermis
- The Golgi apparatuses of the melanocytes package melanin into vesicles called
melanosomes, which move into the cell processes of the melanocytes
- Epithelial cells phagocytize the tips of the melanocyte cell processes, thereby
acquiring melanosomes
Heavy Pigmentation
- Large amounts of melanin occur in some regions of the skin, such as freckles;
moles; the genitalia; the nipples; and the pigmented circular areas around the
nipples.
- Other areas such as the lips, palms of the hands, and soles of the feet, have less
melanin
- Racial variations in skin color are determined by the amount, kind, and distribution
of melanin.
- All races have about the same number of melanocytes

Melanin Production
- Melanin production is determined by genetic factors, exposure to light, and
hormones
- Genetic factors are responsible for the amounts of melanin produced in different
races
- Exposure to ultraviolet light stimulates melanocytes to increase melanin production
- During pregnancy, certain hormones, such as estrogen and MSH, cause an increase
in melanin production, so that there is darkening of cheekbones, neck, forehead,
and chest, resulting in “the mask of pregnancy,” and a dark line of pigmentation can
appear on the midline of the abdomen

Cleavage or Tension Lines of the Dermis

- The collagen fibers of the dermis are oriented in many directions and can resist
stretch
- More collagen fibers are oriented in some directions than in others, producing
cleavage, or tension lines in the skin, and the skin is most resistant to stretch along
these lines

Skin Incision
- It is important for surgeons to be aware of cleavage lines
- An incision made across the cleavage lines is likely to gap and produce
considerable scar tissue, but an incision made parallel with the lines tends to gap
less and produce less scar tissue
Striae (Stretch Marks)
- If the skin is overstretched for any reason, the dermis can be damaged, leaving lines
that are visible through the epidermis.
- These lines, called striae, or stretch marks, can develop on the abdomen and breasts
of a woman during pregnancy

Accessory Skin Structures

- Accessory skin structures are hair, smooth muscles called arrector pili, glands, and
nails
Hair
 - The presence of hair is one of the characteristics common to all mammals.
- If the hair is thick and covers most of the body surface, it is called fur.
- In humans, some hair is found everywhere in the skin except the palms, soles, lips,
nipples, parts of the genitalia, and the distal segments of the fingers and toes.

- The shaft of the hair protrudes above the surface of the skin, whereas the root and
hair bulb are below the surface
- A hair has a hard cortex (bark), which surrounds a softer center, the medulla
- The cortex is covered by the cuticle, a single layer of overlapping cells that holds
the hair in the hair follicle
- The hair follicle is an extension of the epidermis deep into the dermis, and it can
play an important role in tissue repair

- 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
- Hairs are columns of dead, keratinized epithelial cells
o Each hair consist of
 A shaft above the skin
 A root below the skin
 A hair bulb the site of hair formation
- Hairs have a growth stage and a resting stage
- Contraction of the arrector pili, which are smooth muscles, causes hair to "stand on
end" and produces "goose flesh”

Hair Growth
- Hair is produced in the hair bulb, which rests on a dermal papilla. Blood vessels on
the papilla supply the hair bulb with nourishment needed to produce the hair
- Hair is produced in cycles
- The duration of each stage depends on the individual hair: eyelashes grow for about
30 days and rest for 105 days; scalp hairs grow for 3 years and rest for 1-2 years
Hair Lost
- The loss of hair normally means that the hair is being replaced, because the old hair
falls out of the hair follicle when the new hair begins to grow.
- In some men, a permanent loss of hair of hair results in “pattern baldness”.
- These occur when male sex hormones act on the hair follicles of men who have the
genetic predisposition for “pattern baldness”

Hair Color
- Hair color is determined by varying amounts and types of melanin.
- The production and distribution of melanin by melanocytes occurs in the hair bulb
by the same method as in the skin.
 - With age, the amount of melanin in hair can decrease, causing the hair to become
faded in color, or the hair can have no melanin and be white.
- Gray hair is usually a mixture of unfaded, faded, and white hairs

Skin Muscle
- Associated with each hair follicle are smooth muscle cells, the arrector pili.
- Contraction of arrector pili causes the hair to become more perpendicular to the
skin’s surface, or to “ stand on end”, and produces a raised area of skin called
“goose flesh.”
Glands
- Mammalian skin contains sweat glands which cools the body, and sebaceous glands
which secrete a fatty, oily substance (sebum) that keeps the skin and hair pliable.
- Sebaceous glands are simple, branched acinar glands. Most are connected by a duct
to the superficial part of a hair follicle.
- Sebaceous glands secrete sebum, an oily, white substance rich in lipids.

Sebaceous Glands
- Simple or compound alveolar glands found all over the body except on the palms
and soles
- Soften skin when stimulated by hormones
- Secrete an oily secretion called sebum
- Acne is an active inflammation of the sebaceous glands.

Sweat Glands
- There are two kinds of sweat glands: merocrine and apocrine sweat glands.
- Merocrine are simple, coiled tubular glands located in almost every part of the skin
and are most numerous in the palms and soles. They produce a secretion that is
mostly water and less salts, cools the body.
- Apocrine are simple, coiled tubular glands that produce a thick secretion rich in
organic substances. They open into hair follicles, found in axillary and genital
areas, produce an organic secretion that can be broken down by bacteria to cause
body odor. Ducts empty into hair follicles.
- Prevent overheating of the body
- Secrete cerumen and milk
- Ceruminous glands: modified merocrine glands in external ear canal that secrete
cerumen (ear wax)
- Mammary glands: specialized sweat glands that secrete milk

Nails
- It is a Stratum Corneum containing hard keratin
- The nail root is covered by skin
- The nail body is the visible part of the nail
- Nearly all of the nail is formed by the nail matrix, but the nail bed contributes
- The lunula is the part of the nail matrix visible through the nail body
 - The distal ends of the digits in humans and other primates have nails.
- The nail is a thin plate, consisting of layers of dead stratum corneum cells that
contain a very hard type of keratin.
- The visible part of the nail is the nail body, and the part that is covered by skin is
the nail root.
- The eponychium or cuticle, is the stratum corneum that extends onto the nail body

Nail Growth
- The nail root extends distally from the nail matrix.
- The nail also attaches to the underlying nail bed, which is located distal to the nail
matrix.
- The nail matrix and bed are epithelial tissues with a stratum basale that gives rise to
the cells that form the nail.
- Unlike hair, nails grow continuously and do not have a resting stage.
- A small part of the nail matrix, the lunula, can be seen through the nail body as a

whitish, crescent-shaped area at the base of the nail.

Integumentary System Functions

Protection
- Skin- against abrasion and UV light, prevents the entry of microorganisms, regulate
body temperature, prevents water loss
- Hair- against abrasion and UV light, heat insulator
- Nails- protects the ends of the digits
Sensation
- Skin contains sensory receptors for: heat, cold, touch, pressure, and pain
Temperature Regulation
 - Skin- controls heat loss from the body by dilation and constriction of blood vessels
- Sweat glands- produce sweat, which evaporates and lowers body temperature
Vitamin D Production
- UV light stimulates the production of a precursor molecule in the skin that is
modified by the liver and kidneys into vitamin D
- Vitamin D increases calcium uptake in the intestines
Excretion
- Skin glands remove small amounts of waste products but are not important in
excretion

The Integumentary System as a Diagnostic Aid

- The integumentary system is useful in diagnosis because it is observed easily and
often reflects events occurring in other parts of the body.
- Good examples: cyanosis and jaundice

Rashes and Lesions

- Rashes and lesions in the skin can be signs of problems elsewhere in the body.
- Good examples are scarlet fever and allergic reactions

Burns
- Burns are classified according to the depth of the burn.
- In partial thickness burns some part of the stratum basale remains viable, and
regeneration of the epidermis occurs from within the burn area as well as from the
edges of the burn.
- Partial-thickness burns are divided into first- and second-degree burns

First-Degree Burns
- First-degree burns involve only the epidermis and are red and painful, and slight
edema, or swelling, can be present.
- They can be caused by sunburn or brief exposure to hot or cold objects, and they
heal without scarring in about a week.

Second-Degree Burns
- Second-degree burns damage the epidermis and the dermis.
- If there is minimal dermal damage, signs include redness, pain, edema, and blisters.
healing of this takes about 2 weeks, and there is no scarring.
- If the burn goes deep into the dermis, the wound appears red, tan, or white; can take
several months to heal; and might scar.
- In all second-degree burns, the epidermis regenerates from epithelial tissues in hair
follicles and sweat glands, as well as from the edges of the wound.

Third-Degree Burns or Full-thickness Burns

- The epidermis and the dermis are completely destroyed, and recovery occurs from
the edges of the burn wound.
- Often these are surrounded by areas of first- and second-degree burns. Although the
first- and second-degree burn areas are painful, the region of third-degree burn is
usually painless because sensory receptors in the epidermis and dermis have been
destroyed.
- Third-degree burns appear white, tan, brown, black, or deep cherry red.
CHAPTER 2: SKELETAL SYSTEM

Skeletal System
- made up of bones or skeleton which is a firm framework that gives physical support
and protection for the body and often provides surfaces for the attachment of
muscles.

General Considerations of Bones

- Average adult skeleton has 206 bones

- Bones are paired or unpaired
- Most anatomical terms used to describe the
features of bones are based on the
relationship between the bones and
associated ligaments, muscles, joints,
nerves, and blood vessels
o Processes
o Surfaces
o Holes
- The skeleton is divided into the axial and
appendicular skeletons

Invertebrate Skeleton
- Some aquatic invertebrate and a few land animals have no skeleton, but the
majority is supported by a shell or other external covering (exoskeleton).
- Invertebrates have various ways to support and protect themselves.
- One of the earliest forms of exoskeleton is found in some of the protozoans which
are enclosed in a shell made up of grains of sand held together by a secretion.
- Others have calcium carbonate or silica, and arthropods’ exoskeleton is formed by
chitin.

Vertebrate Skeleton
- The vertebrate endoskeleton is an internal framework of bone and cartilages.
- The intercellular substance that forms the vertebrate skeleton may be a
chondromucoid material and collagenous fibrils (cartilage), or calcium, collagenous
fibrils, and phosphorous salts (bone).
- Most bone develops from cartilage (cartilage replacement bone), but a few bones,
such as certain ones in the face and cranium, are formed directly from sheets of
mesenchyme tissue (membrane bone).
- Skeleton of land vertebrates are generally divided into: axial skeleton and
appendicular skeleton

Axial Skeleton
 - forms the upright axis of the body
- Protects the brain, the spinal cord, and the vital organs housed within the thorax
- Consists of:
o (1) Skull, (2) Auditory ossicles, (3) Hyoid bone, (4) Vertebral column,
and (5) Thoracic cage (rib cage)

Axial Skeleton: Skull

- 22 bones
o Braincase- protects the brain
o Facial bones- protect the
sensory organs of the head,
serve as muscle attachment
sites
o Mandible and Maxillae- hold
the teeth, and the auditory
ossicles that function in
hearing, are located inside the
temporal bones

Axial Skeleton:
Auditory Ossicles
- 6 bones
o Malleus (2), Incus (2), and Stapes (2)

Axial Skeleton: Hyoid Bone

- 1 bone (unpaired)
- which “floats” in the neck, is the attachment site
for throat and tongue
muscles

Axial Skeleton: Vertebral

Column
- Provides flexible
support and protects the spinal cord
 - The vertebral column has four major curvatures: cervical, thoracic, lumbar,
sacral/coccygeal
o Abnormal curvatures:
 lordosis (lumbar), kyphosis (thoracic), scoliosis (lateral)

Axial Skeleton: Thoracic

Cage
- consisting of the ribs, their associated costal cartilages, and the sternum
- protects the thoracic organs and changes volume during respiration
- 12 pairs of ribs attach to the thoracic vertebrae
o 7 pairs- true ribs
o 5 pairs- false ribs
 2 pairs of false ribs are
floating (11th and 12th)
- The sternum is composed of the:
o Manubrium, Body, Xiphoid process

Appendicular Skeleton

- Consists of the bones of the upper and lower limbs and the girdles by which they
are attached to the body
o Pectoral girdle: upper limbs
o Pelvic girdle: lower limbs