Unit-VII

Topic- Anatomy and Physiology of

Skin
Year-I, Semester –I
Class Generic BSN-(Session2019-
2023)
By
Muhammad Shahid
MSN, BSN, DPBCN, RN, BSc
Program Coordinator
School Of Nursing
Kharadar General Hospital Karachi
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At the end of this unit, learners will be able to:
1. Describe the structure of two layers of skin, Epidermis and Dermis.
2. Briefly discuss the structure & function of skin derivatives.
I. Sweat gland
II. Sebaceous gland
III. Hair
IV. Nail
3. Discuss the following functions of skin
V. Protection
VI. Regulation of body temperature
VII. Sensation
VIII.Absorption
IX. Excretion

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 Introduction
1. Largest organ of the body.
2. Surface area 1.5 to 2. sq. meter.
3. Varies in thickness at different parts
(< 0.5 mm at eyelids to > 5 mm on
middle of upper back).
4. 7 % of body weight.
5. Consist of:
I. Epidermis
II. Dermis

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 Anatomy of Skin
S k in

D e rm is E p i d e r m is

B e n e a t h e p i d e r m is O u t e r m o s t la y e r
T h ic k e r la y e r E p it h e lia l t is s u e
C o n n e c t iv e t is s u e

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 Epidermis
1. Stratified squamous epithelium
2. No blood vessels
3. In palms of hand and soles of
feet, epidermis is thicker
4. Composed of five layers:
I. Stratum corneum
II. Stratum lucidum
III. Stratum granulosum
IV. Stratum spinosum
V. Stratum basale
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 Cells of the Epidermis
1. Keratinocytes:
a. Produce keratin, and are responsible for the formation of the epidermal water barrier by
making and secreting lipids.
b. Keratinocytes also regulate calcium absorption by the activation of cholesterol precursors
by UVB light to form vitamin D.
2. Melanocytes:
a. Melanocytes are derived from neural crest cells and primarily produce melanin, which is responsible for the
pigment of the skin.
3.Langerhans’ cells:
a. Langerhans cells, dendritic cells, are the skins first line defenders and play a significant role in antigen
presentation.
4.Merkel’s cell:
a. Merkel cells are oval-shaped modified epidermal cells found in stratum basale, directly above the basement
membrane.
b. These cells serve a sensory function as mechanoreceptors for light touch, and are most populous in
fingertips, though also found in the palms, soles, oral, and genital mucosa.

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 1-Stratum Corneum (Horny Layer)
1. Thick layer of dead cells.
2. Soft keratin (keep skin elastic).
3. Cells below contain fatty substrate  keep skin waterproof +
prevent skin cracking and allowing bacteria inside.

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 2-Stratum Lucidum
1. Transparent layer.
2. Flat + translucent dead cells.
3. Protection against UV.
4. Lucidum appears in palm of hands and soles of feet to
protect against sun burn.

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 3-Stratum Granulosum
1. Granular + 2 to 4 cells thick.
2. Cells contain keratohyaline in granules.
3. Final stages of keratinization occur.
4. Loss of fluid, nucleus disintegrates.

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 4-Stratum Spinosum
1. Prickle cell layer.
2. Several layers of polyhedral (many-sided) cells.
3. Interlocking spine-like projections help binding of this layer.
4. Active protein synthesis takes place (indicates cell growth and
division).
5. Obtain nutrients through fine elements.
6. Keratinization begins in this layer.
7. Nuclei-containing cells change into flat cells composed of hard
durable protein).

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 Stratum Basale
1. Single layer of columnar or cuboidal cells

2. Lower surface of cells attached to dermis

3. Receives nutrients from blood in the dermal vessels

4. Mitosis occurs in this layer

5. Older cells expelled to outer layer

6. Melanin is produced in this layer

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 Dermis
a. True skin.
b. Highly elastic, tough and flexible
tissue.
c. Meshwork of collagenous, reticular
and elastic fibres.
1.Collagenous Fibres
I. Provide support for skin
2.Reticular Fibres
I. Thinner, yet still provide support
3.Elastic Fibres
I. Skin flexibility
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 Cells Of The Dermis
1. Fibroblasts
2. Macrophages
Dermis subdivided into two main layers:
I. Upper papillary layer.
II. Reticular layer
I. Upper Papillary Layer:
a. Loose connective tissue.
b. Contain protrusions into epidermis called “PAPILLAE”
c. Fine capillaries to carry waste away + provide nourishment and oxygen
d. Nerve endings for heat, pain, cold, pressure and touch (Meissner’s corpuscles.
e. Double row of papillae  better gripping by hands and feet + distinctive
fingerprint patterns

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 Reticular Layer
a. Elastic network of tough collagen fibres interwoven with elastic fibres
b. Collagenous fibres arranged in special pattern
c. Incisions made parallel to these lines during surgery  wound heals
faster
d. Contains sebaceous and sweat glands, arrector pili muscle and hair
follicle
e. Pacinian corpuscles are distributed through the dermis and function as
pressure receptors
f. Stretch marks and pregnancy due to breaks in collagen and elastic
fibres

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Dermo-epidermal Junction

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 Hypodermis

a. Also called“Subcutaneous” layer

b. Thicker than dermis.
c. Thicker in females.
d. Ducts of sweat glands and bases of hair
follicles.
e. Area for formation and storage of fat due to:
I. Adipose tissue – containing fat cells
II. Areolar tissue – tissue elasticity

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 Developmental Anatomy of the Skin
Dermis and epidermis are derived from different embryological
tissues
a. Epidermis derived from “ECTODERM”
b. Dermis derived from “MESENCHYME”

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 Glands Of The Skin
Sweat Glands
a. Sweat - blood filtrate
b. 99% water with some salts
c. Contains traces of metabolic wastes
d. Two types: Eccrine and Apocrine
Eccrine Glands
e. Distributed almost all round the body
f. Secretory portion in hypodermis
Apocrine Glands
g. Arm pits and dark regions of nipple
h. Secretes fatty substances
i. These react to air  YOU STINK
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 Sebaceous Glands
a. Located in the dermis
b. Lubrication and protection
c. Cluster of cells
d. Breakdown of inner cells in the cluster 
sebum formation
e. Connected to hair follicles
f. Blackheads due to blocked glands
g. Sebum  fight bacteria and fungi
h. Functions - Softens & lubricates hair & skin

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 Hair

a. A skin appendage that grows from

follicles in the dermis
b. Contains medulla, cortex, and
cuticle
c. Functions include conservation of
body heat, sensation, and
protection of the skin
d. Most prominent on the scalp,
pubis, axilla, extremities, and face.

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 Hair
a. Root of the hair follicle; located deep in the
dermal papilla
b. Receives blood and nutrients from a capillary
network of vessels to sustain hair growth.
1.Shaft = protrudes from skin
2.Root = embedded in skin
3.Follicle surrounds hair
4.Arrector pili muscle = bundle of smooth
muscle
Arrector pili causes:
I. Hair erection
II. Sebum release from the sebaceous glands

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 Nails
1. Scale-like modification of epidermis on the distal, dorsal surface of
fingers & toes
2. Parts: Free edge, Body, Root, Nail folds, Eponychium, Lunula.

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 Skin color
Determined by 3 factors
1. Pigments
a. Melanin
b. Carotene
c. Albinism: Deficiency or absence of pigment
2. Blood circulating through skin
c. Imparts reddish blue- Hb & Oxy Hb
d. Cyanosis: Blue color caused by decrease in blood oxygen
e. Pale: Anemia
f. Yellow: Jaundice
3. Thickness of stratum corneum.

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 Functions of skin
1. Protection:
a. Barrier and protection against the external environment
b. Against pathogens. Langerhans cells in the skin are part of the
immune system.
2. Storage: Stores lipids (fats) and water.
3. Sensation: Nerve endings detect temperature, pressure, vibration,
touch, and injury.
4. Control water loss: The skin prevents water from escaping by
evaporation.

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 Cont…

5. Water resistance: it prevents nutrients from being washed from the

skin
6. Thermoregulation: by producing sweat and dilating blood vessels,
the skin helps keep the body cool. “Goosebumps” and blood vessel
constriction, help us retain heat.

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 Burns Classification
The rule of nines is a method doctors and emergency medical providers
use to easily calculate the treatment needs for a person who’s been
burned.
1.First-degree (superficial) burns.
Less than 10% of body surface involved.
First-degree burns affect only the outer layer of skin, the epidermis.
2.Second-degree (partial thickness) burns.
More than > 15% of body surface involved (10% for child)
Second-degree burns involve the epidermis and part of the lower layer
of skin, the dermis.
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 Continue
3.Third-degree (full thickness) burns.
Third-degree burns destroy the epidermis and dermis.
Treated by skin graft.
4.Fourth-degree burns.
Fourth-degree burns go through both layers of the skin and
underlying tissue as well as deeper tissue, possibly involving muscle
and bone.
There is no feeling in the area since the nerve endings are destroyed.

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 Continue
Body part Percentage

Arm (including the hand) 9 percent each

Anterior trunk (front of

18 percent
the body)

Genitalia 1 percent

Head and neck 9 percent

Legs (including the feet) 18 percent each

Posterior trunk (back of

18 percent
the body)

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 Du BOIS FORMULA
To calculate surface area of a person.
A = W x H x 71.84
Area: Surface area in square cm.
W: Weight in kilogram.
H: .Height in cm.

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 References
Anne Waugh, et al. (2006). Ross & Wilson: Anatomy and Physiology in
Health and Illness, 11th edition.

All, John E. Guyton, Arthur C. (2011) Guyton and Hall textbook of

medical physiology /Philadelphia, PA : Saunders/Elsevier.

Jenkins, Gail W. Tortora, Gerard J. (2013) Anatomy and physiology :from

science to life Hoboken, NJ : John Wiley & Sons.

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