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PHYSIOLOGY OF THE

SKIN

INTRODUCTION
Organ terbesar di tubuh
Menutupi area permukaan tubuh hingga 1,6 m2
Kira-kira 16% dari total berat badan dewasa

FUNGSI ???

Fungsi Proteksi
Melindungi bagian dalam tubuh manusia
terhadap

gangguan fisik&mekanik : tekanan, gesekan,


tarikan, panas/dinginlemak subkutis,
tebalnya lapisan kulit, & serabut penunjang
gangguan sinar UV melanin
gangguan jamur, bakteri/virus kelenjar2 kulit
yang mempunyai pH 5,0 - 6,5

Fungsi Absorpsi
Kulit yang sehat tidak mudah menyerap air,
larutan.
Kemampuan absorpsi kulit dipengaruhi : tebal
tipisnya kulit, hidrasi, kelembaban udara,
metabolisme dan jenis vehikulum zat yang
menempel di kulit.

Penyerapan dapat melalui celah antar sel,


saluran kelenjar atau saluran keluar
rambut.

Fungsi Ekskresi
Kelenjar kulit mengeluarkan zat yang tidak
berguna/sisa metabolisme tubuh : NaCl, urea,
amonia, dan sedikit lemak.
Kelenjar lemak pada fetus, atas pengaruh hormon
androgen dari ibunya, akan menghasilkan sebum
untuk melindungi kulitnya terhadap cairan amnion
yang pada waktu lahir disebut vernix caseosa.

Sebum yg diproduksi kelenjar lemak melindungi


kulit : meminyaki kulit & menahan penguapan
berlebihan, kulit tidak kering.
Produk kelenjar lemak & keringat, di permukaan
kulit membentuk keasaman kulit pada pH 5 - 6,5.

Penguapan air dari dalam tubuh dapat


secara difusi melalui sel-sel epidermis,
tetapi karena sel epidermis baik fungsi
sawarnya, maka kehilangan air melalui sel
epidermis (transepidermal water loss)
dapat dicegah agar tidak melebihi
kebutuhan tubuh.

Fungsi Pengindra (Sensori)


Kulit mengandung ujung-ujung saraf sensorik di
dermis dan subkutis.
Badan Ruffini yang terletak di dermis, menerima
rangsangan dingin
rangsangan panas diperankan oleh badan Krausse.
Badan taktil Meissner yang terletak di papil
dermis menerima rangsang rabaan & badan
Merkel-Renvier di epidermis.

Fungsi Termoregulasi
Dengan cara mengeluarkan keringat dan mengkontraksikan
otot dinding pembuluh darah kulit.

Fungsi Pembentukan Pigmen


(Melanogenesis)
Sel pembentuk pigmen kulit (melanosit) terletak
di lapisan basal epidermis
Pajanan sinar matahari mempengaruhi produksi
melanin. Bila pajanan bertambah, produksi melanin
akan meningkat

Fungsi Keratinisasi
Untuk menggantikan sel kulit mati, shg kulit dapat
melakukan rehabilitasi dan menjalankan fungsinya dengan
baik secara terus menerus

The Architecture of the Skin


Tdd 3 lapisan :
1. Epidermis
2. Dermis
3. Subcutaneous
tissues

Epidermal Cell Layers


Stratum basale (Basal
cell layer)
Lapisan selapis sel
cuboidal/columnar
Tdp Stem cells, melanocytes,
dan Merkel cells

Stratum spinosum
8-10 lapisan sel bentuk
poligonal
Tdp sel Langerhans

Epidermal Cell Layers


Stratum granulosum
3-5 layers of flattened,
beginning breakdown of
nucleus, cell death initiated

Stratum lucidum
only in thick skin (palms,
feet)
3-5 layers of clear, flat dead
cells with keratin

Stratum corneum
20-30 layers of flattened,
dead, keratin-filled cells
continuously shed and
replaced

3-4 weeks for each cell to


form and to move from
the stratum basale to the

The Epidermis
Stratified Squamous Epithelium
4 cell types
1. Keratinocytes - 95%

filled with keratin (protein)


waterproof barrier

2. Melanocytes

produce melanin (pigment)

3. Langerhans cells

phagocytes (from immune


system)
easily damaged by UV light

4. Merkel cells

in deepest layer of hairless


skin
sensory transduction - touch

Keratinocytes
Memproduksi keratin yg mengalami
diferensiasi dan migrasi ke lapisan atas setelah
dewasa (keratinization)
Turut berperan dalam pertahanan kulit
Mensekresi sitokin billa terjadi cidera sel kulit
sehingga dapat menginduksi respon inflamasi

Melanocytes and melanin


synthesis
Melanocytes dpt
ditemukan di lapisan
sel basal dan matrix
1000-1500
melanocytes
ditemukan tiap mm2
kulit
Melanin diproduksi dr
aa tyrosine di dalam
melanosom

Biosynthesis of melanin

Functions of melanin
Melindungi kulit dr sinar UV dan mencegah
cidera sinar matahari ke kulit
Memberikan warna gelap pada kulit.
Jumlahnya yang rendah berhubungan dengan
risiko meningkatnya insidensi Malignancy
Dapat mengabsorbsi enzim aktif yg
berbahaya, metal dan drugs

Langerhans cell
Is a bone marrow-derived
dendritic cell specific to stratified
squamous epithelia
Frequently seen isolated in the
middle and suprabasal cell layers
400/mm2 1000/mm2
Involved in cell-mediated
hypersensitivity, antigen
processing and recognition,
stimulation of immune-competent
cells, and graft rejection.

Dermis
The structure
beneath the
epidermis.
It consists of three
layers :
Papillary layer
Subpapillary layer
Reticular layer

Dermis - Structure
Papillary region
(layer) - outer
layer - 20%
Areolar
connective
tissue, elastic
fibers
Dermal papillae
mound-like
projections to
increase the
surface area for
nutrition from
capillaries
Some papillae

Dermis Structure
Reticular region 80%
Dense, irregular
connective tissue
Collagen, elastic
fibers in a
network
surrounding the
various cells
Fibers give
strength,
elasticity,
extensibility

Elastic fibers

Cellular components
Fibroblast
Differentiates from
mesenchymal cell
Produces collagen fibers,
elastic fibers,
glycosaminoglycans

Histiocyte
A kind of macrophage
In the dermis and
subcutaneous tissues

Degrades&phagocytoses
mainly foreign substances

Mast cell
Found in the dermis
around capillaries & in the
periphery of
subcutaneous tissues
Produces & maintain
various vasodilatory &
hyperlucent chemical
mediators
Multiple mast cell
granules distributed in

Plasma cell
Is a differentiated B cell
that has been
stimulated by an
antigen
Produces antibodies &
involved in humoral
immunity
The diameter is twice
as large as a leukocyte

Vascular channels and nerves


Blood vessels
Arteriovenous
anastomosis controls
the peripheral blood
flow and is involved in
body temperature
regulation
Endothelial cells,
pericytes, &
multilayered
basement
membrane(lamina

Lymphatic vessel
Are distributed around the
subpapillary layer, extend
through postcapillary lymph
vessels to dermal&
subcutaneous lymph vessels

Nervous system
The nerve fibers :
Myelinated nerve
fibers
Non-myelinated nerve
fibers
The sensory nerves
transmit tactile,
pressure,
pain&temperature
sensation
The autonomic nerves
control the blood
vessels, sweat glands &
other appendages

Sensory nerve
Free nerve ending
Are

distributed in the dermal upper & papillary


layer
Nonmyelinated nerves transmit pain sensations

End corpuscle
Meissner

end corpuscle :

in the dermal papillae


perceiving tactile & light pressure sensations

Pacinian

corpuscle :

In the dermal deep layer & subcutaneous tissue


Perceiving pain and pressure sensation

Autonomic nerves
Distributed in the sweat glands, arrector pili
muscles, blood vessels & glomus
apparatuses control the functions of these
organs
The cholinergic nonmyelinated sympathetic
nerves are distributed in the eccrine sweat glands
The adrenergic symphathetic nerves are
distributed in the arrector pili muscles and blood
vessels

Subcutaneous fat tissue


The layer between the
dermis and the fascia
Act to preserve neural
fat, cushion against
external physical
pressure, retain
moisture and generate
heat
Is largely composed of
fat cells
Assembled fat cells
separated by connective
fibroid fat septum (fat
lobules)

Appendages
Hair apparatus
Protecting the scalp
from external forces
and light
Moderating heat in
the head
Found throughout
the skin except lips
on the mouth

Hair follicle
Is double bounded
with two layers:
Epithelial

components; are
inner & outer root
sheaths
Connective tissue
component; is called
connective tissue
sheath

Arrector pili
muscle
A smooth muscle
bundle between ORS
and dermal upper
layer.
Cause hair stand
vertically
Controlled by
adrenergic
sympathetic nerves
Contracted by cold
stress & emotional

OIL PRODUCTION
Oil is produced in the sebaceous gland ,
production is stimulated by hormones
Oil flows into the hair follicle then into
the skin surface

42

Sebaceous (Oil) Glands


Connected to hair
follicles; located in the
dermis
Most secrete directly into
follicles; some directly
onto the skin
Gland shape differs
depending on location
Holocrine gland
The Fx of sebum (oil)

keeps hair from drying


prevents water
evaporation from skin
keeps skin soft, supple
inhibits growth of many
bacteria

Sudoriferous (Sweat) Glands

Sweat: a plasma filtrate


consisting of water, salts, urea,
uric acid, amino acids,
ammonia, sugar, lactic acid,
ascorbic acid, and pheromones

pH between 4 and 6

Salty and acidic solution inhibits


most bacterial growth

Maintain body temperature, but


insignificant for waste removal

Two types:
1. Eccrine sweat glands
2. Apocrine sweat glands

Eccrine Sweat Glands

Apocrine Sweat Glands


Secretory portion is
located in the
dermis or the
subcutaneous
region; secrete into
hair follicles
Secrete more during
emotional stress,
sexual arousal

http://faculty.une.edu/com/abell/histo/histolab3g.htm

Modified Sudoriferous (Sweat)


Glands
Two types of modified sweat glands
1. Ceruminous glands protect against
ectoparasites (bugs)

Produce a bitter waxy secretion (cerumen)


Open into the external auditory meatus (ear
canal) or into local sebaceous glands

2. Mammary glands highly specialized for


milk production

Hormonally regulated by estrogens, prolactin,


and oxytocin

THANX YOU