CHAPTER I

PRELIMINARY
1.1. Background
In the current era of globalization, various methods are applied in the world of education.
Especially in STIKES Wira Medika PPNI Bali, in learning with KBK system there is one
method that is DL (Discovery Learning) which requires its students to make presentations and
create papers to support maturation understanding of his students. Moving from it, then made a
paper entitled Anatomy and Skin Physiology to support the application of methods and
deepening understanding of it. Where in it includes an understanding of the meaning of Skin,
skin anatomy and physiology.
1.2.Problem Formulation
1. What is the understanding of the skin?
2. What are the anatomies of the skin?
3. What is the physiology of the skin?
1.3. Purpose of Writing
1. To know the understanding of the skin.
2. To know the anatomy of the skin.
3. To know the physiology of the skin.

CHAPTER II
DISCUSSION
2.1. SKIN SKINNING
Skin is a layer / tissue that covers the whole body and protects the body of danger coming from
outside. Leather is also called the integument / cutis which growing from two kinds of tissue that
is epithelial tissue that grows layer epidermis and connective tissue (supporting) that grow the
dermis layer (deep skin). Skin description in general:

2.2. SKIN ANATOMY

Whole skin weighs about 16% of body weight, in adults about 2.7-3.6 kg and the extent of about
1.5-1.9 m2. The thickness of the skin varies from 0.5mm to 6mm depending on location, age
and gender. The thin skin lies in the eyelids, penis, minium labium and part skin medial upper
arm. While the thick skin in the palm of the hand, soles of feet, back, shoulders and buttocks.
Sharing:
1. EPIDERMIS (Ari Skin)
Thin and avascular skin layers. Consists of flattened epithelium horned, containing melanocyte
cells, lengerhans and merkel. Thick The epidermis varies in different places in the body, the
thickest on palms and feet. The thickness of the epidermis is only about 5% of the entire
thickness of the skin occurs 4-6 weeks saip reviewer. The epidermis consists of 5 layers (top -
bottom):
1. Stratum corneum.
Consists of keratinocyte cells that can peel and change.
 2. Stratum lusidum.
Translusen line, usually found on the thick skin of the soles of the feet and soles hand. Not
visible on thin skin.
3. Stratum granulosum.
Characterized by 3-5 layered polygonal cell layers in the center and cytoplasm filled by a rough
basophilic granule called keratohialin granule contains a protein rich in histidine contain
Langerhans cells.
4. Stratum spinosum.
There are filamentous files called tonofibrils, considered filaments - Such filaments play an
important role in maintaining cell cohesion and protect against abrasion effects. Epdermis in a
place that continues to experience friction and pressure have a stratum spinosum called a layer
malpighi. There are Langerhans cells.
5. Stratum basale (stratum germinativum).
There is a great mitotic activity and is responsible for renewal epidermal cells constantly. The
epidermis is updated every 28 days for migration surface, this depends on location, age and
other factors. Is one layer of cells which contains melanocytes.

Epidermal Function:
1. Barrier protection.
2. Cell organization.
3. Synthesis of vitamin D and cytokines.
4. Cell division and mobilization.
5. Pigmentation (melanocyte) and the introduction of allergens (Lengerhans cells).
2. DERMIS (Hideskin)
It is the most important part of the skin that is often considered as "True Skin". Consists of a
connective tissue that supports the epidermis and connect it to the subcutical network. The
thickness varies, the thickest on the sole of the foot about 3mm. The dermis consists of two
layers:
1. Capillary coating: thin contains rare connective tissue.
2. Reticular layer: thick consists of solid connective tissue. The collagen fibers thicken and the
collagen synthesis is reduced by age. Elastic fibers continue to increase and thicken, the elastic
content of human skin increases approximately 5 times from the fetus up adult. In the elderly
collagen cross each other in large numbers and Elastic fibers are reduced causing skin loss his
anxiety and appear to have many wrinkles. The dermis has many blood vessel tissues. Dermis
too contains several epidermal derivatives of hair follicles, glands sebaceous and sweat
glands.Skin quality depends on whether or not epidermal derivatives in the dermis.

Dermis function:
1. Structure supporting cmechanical strength.
2. Nutritional supply.
3. Withhold shering forces.
4. Inflammatory response.
3. SUBKUTIS
Forget a layer under the dermis or hipodermis consisting of layers fat. This layer is a connective
tissue that connects the skin loosely with the network underneath. The number and size vary by
region body and individual nutritional state. Serves to support blood supply to the dermis for
regeneration.
Subcutical / hypodermic Functions:
1. Attached to the basic structure.
2. Heat insulation.
3. Backup calories.
4. Control of body shape.
5. Mechanical control shock absorber.
4. SKIN VASCULARITY
The arteries that nourish the skin form the plexus lying between capillary coating and dermis
reticulum and in addition between the dermis and tissues subcutis. The small branch leaves the
plexus, bleeding the dermis papilla but dermal papilla has one asedent artery and one branch of
vein. In the epidermis not There are blood vessels but get nutrients from the dermis through the
membrane epidermis.
2.3. SKIN PHYSIOLOGY
The skin is an organ that serves very important for the body among them is possible to survive in
various conditions environment, as barrier to infection, controlling body temperature
(thermoregulation), sensation, eskresi and metabolism. The skin protection function is to protect
against electrolyte fluid losses, trauma of mechanik, ultraviolet and as a barrier of invasion of
microorganisms pathogens. Sensation has been known to be one of the deep skin functions
respond to stimuli touch because many nerve endings like in the area lips, nipples and fingertips.
The skin plays a role in temperature regulation and electrolyte fluid balance. Thermoregulation is
controlled by the hypothalamus.
Peripheral temperatures undergo balance through sweat insessible loss of the skin, lungs and
buccal mucosa. Skin temperature controlled by dilation or constriction of the blood vessels of
the skin. When increased temperature occurs vaso dilation of blood vessels then body will
experience temperature by releasing heat from the skin in a way send chemical signals that can
increase the blood flow in the skin. On Temeperatur that decreases the blood vessels of the skin
will vaso the constricting then it will retain heat.
ADDITIONAL MATERIALS
CLASSIFICATION OF THE OPEN
Injury can occur in trauma, division, neuropathic, vascular, penekana and ferocity.
Classification:
1. Acute injuries: traumatic injuries that are usually promptly handled and usually can heal
well if no complications occur. Criterion Acute injuries are new wounds, sudden and heal
accordingly with estimated time, for example: cuts, burns, punctures. Wounds oprasi can be
considered as an acute wound made by a surgeon, for example : sewing wounds.
2. Chronic wounds: long lasting or recurring injuries (recurrent) where disturbance occurs in
the healing process usually caused by multifactor problems of the patient. On the wound
chronic wounds fail to heal at the estimated time of no response both to therapy and have a
tendency to recur. Example: decubitus ulcer, diabetic ulcers, venous ulcers, burns.
WOUND HEALING
A form of business process to repair the damage to the component major in the process of
wound healing is collagen in addition to epithelial cells. Fibroblasts are cells responsible for
collagen synthesis. Physiology wound healing naturally will experience the following phases:
a. The phase of imflamation: starts from the wound up to the day fifth.
b. Phase proliferation / fibroplation: fibroblasts are very prominent role, that is synthesize
collagen
c. Remodeling phase / maturation: the last and longest phase of the process wound healing.
The above three phases run normally as long as there is no interference with either external
factors as well as in.
Local factors
• Less supply of blood vessels.
• Denervation.
• Hematoma.
• Infection.
• Irradiation.
• Mechanical stress.
• Dessing material.
• Surgical technique.
• Network type.
Common factors
• Age.
• Anemia.
• Obesity.
• Hormone.
• DM.
• Infectious diseases.
• Temperature.
• Uremia.
• Trauma.
• Vit. C and A
• Systemic infection

CHAPTER III
COVER
3.1. CONCLUSION
Skin is a layer / tissue that covers the whole body and protects the body of danger coming from
outside.
1. SKIN ANATOMY
Whole skin weighs about 16% of body weight, in adults about 2.7-3.6 kg and the extent of about
1.5-1.9 m2. The thickness of the skin varies from 0.5mm to 6mm depending on location, age
and gender. The thin skin lies in the eyelids, penis, minium labium and part skin medial upper
arm. While the thick skin in the palm of the hand, soles of feet, back, shoulders and buttocks.
Sharing:
A. Epidermis (epidermis).
B. Dermis (skin hides).
C. Subcutis.
D. Skin Vascularization.
2. PHYSIOLOGY
The skin is an organ that serves very important for the body among them is possible to survive
in various conditions environment, as barrier to infection, controlling body temperature
(thermoregulation), sensation, eskresi and metabolism.
3. ADDITIONAL MATERIALS
· Wound Classification Injury can occur in trauma, division, neuropathic, vascular, penekana
and malignancy. Sharing:
a. Acute injury.
b. Chronic wounds.
· Wound healing
A form of business process to repair the damage that occurred the main component in the wound
healing process is collagen in addition to epithelial cells. Physiology of wound healing naturally
will experience phases as below this:
1. Phase of Imflamation.
2. Phase proliferation / fibroplation.
3. Remodeling phase / maturation.
The above three phases run normally as long as there is no interference either external and
internal factors.
Local factors
• Less supply of blood vessels.
• Denervation.
• Hematoma.
• Infection.
• Irradiation.
• Mechanical stress.
• Dessing material.
• Surgical technique.
• Network type.
Common factors
• Age.
• Anemia.
• Obesity.
• Hormone.
• DM.
• Infectious diseases.
• Temperature.
• Uremia.
• Trauma.
• Vit. C and A
• Systemic infection
SUGGESTION
We recommend that after the paper pembutan finished, students directly presenting to further
strengthen his / her understanding of understanding, anatomy and skin physiology.

BIBLIOGRAPHY
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Practice. Hamburg: Beiersburg: Beirsdorf medical Bibliothek, pp. 9-14.
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eds). Wound Care Essentials Practice Principles. Philadelphia: Lippincott William
& Wilkins, pp.47-60.
3. Dealey C, 2005. The Care of the Wound. A Guide for Nurses. Oxford: Blackwell Science
Ltd, pp.1-12.
4. Diegelmann RF, 2001. Introduction to Wound Healing. One Day Educational
Course. Wound Healing in the New Millenium: The basics of care. Albuquerque,
New Mexico.
5. Fowler E, 1990. Chronic Wound: an Overview. In: Krasner D (ed). Chronic
Wound Care: A clinical Sourcebook for Healthcare Professional. Pennsylvania,
Health Management Publications Inc.
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