Integumentary

The Integumentary System
Lecture slides prepared by Curtis DeFriez,

Weber State University
Copyright John Wiley & Sons, Inc. All rights reserved.
Introduction
The organs of the integumentary system

include the skin and its accessory structures
including hair, nails, and glands, as well as
blood vessels, muscles and nerves.
Introduction
The integument can also be thought of as a
cutaneous membrane that covers the outer
surface of the body.
It is the largest organ by surface area and
weight.
Its area is about 2 square meters (22 square
feet) and weighs 4.55kg (1011 lb), about
16% of body weight.
It is 0.54 mm thick, thinnest on the eyelids,
thickest on the heels.
We lose almost a kg of skin epithelium a year
that becomes a major part of household
dust.
Introduction
Functions of the skin:
a. Protection- physical barrier
b. Regulation of body temperaturethrough perspiration and evaporation from
the body surface
c. Sensory perceptions- due to nerve
endings that and receptors that detect
stimuli from the environment
d. Excretion production of perspirationby the

sweat glands
e. Synthesis of Vitamin D- exposure to ultraviolet
radiation converts precursor molecules in the
skin to vit.
Structures of the Skin
The skin has 3 major layers:

The outer, thinner layer is called the
epidermis and consists of epithelial tissue.
The inner, thicker layer is called the dermis
and consists of Cutaneous tissue
The subcutaneous (subQ) layer (also called
the hypodermis) is located underneath the
dermis.
It is a loose areolar/adipose C.T. that
attaches the skin to the underlying tissues
and organs.
Structures of the Skin
The Epidermis
Keratinocytes make up 90% of the cells. They

produce keratin - a tough fibrous protein that
provides protection.
Melanocytes produce the pigment melanin that

protects against damage by ultraviolet radiation.
Langerhans cells are macrophages that

originated in the red bone marrow. They are
involved in the immune responses.
Merkel cells function in the sensation of touch

along with the other adjacent tactile
discs
The Epidermis
The epidermis is composed of keratinized

stratified squamous epithelium
which contains four
major types of cells:
Keratinocytes
Melanocytes
Langerhans cells
Merkel cells
The Epidermis
The epidermis is composed of four layers in thin

skin, and five layers in thick skin.
The stratum basale or stratum
germinativum is always the bottom (deepest)
layer. Continuous cell division occurs here and
produces all the other layers.
The stratum spinosum is a layer of 810
keratinocytes
The non-dividing cells of the 3rd layer
(stratum granulosum) are filled with
granules of keratin.
The Epidermis
The stratum lucidum is the 4th layer but is

only present in thick skin (the skin of the
fingertips, palms, and soles).
The stratum corneum is always outermost,
composed of approximately 20 layers of flat
cell-remnants that are like bags of turtle wax
(dead keratinocytes with no cellular organelles
filled with only keratin protein.)
They are continuously shed and replaced by
cells from deeper strata.
The Epidermis
Keratinization is the process of replacing

viable cells in the stratum basale with more and
more of the waxy keratin protein as cells move
from the deepest layer to the surface layer.
Constant friction can stimulate the process
and produce a callus (an even thicker buildup
of keratinocytes in the stratum corneum).
Dandruff is an excess of keratinized cells
shed from the scalp.
The Epidermis
The Epidermis
Types of skin:
Thin (hairy) skin covers all body regions
except the palms, palmar surfaces of digits,

and soles.
Thick (hairless)
skin covers the

palms, palmar
surfaces of
digits, and
The Epidermis
Skin Pigments
Melanin is produced by melanocytes in the
stratum basale- brown black pigment
Carotene- yellowish pigment
Freckles are clusters of concentrated melanin
triggered
by exposure to sunlight.
Having more freckles is a genetic trait.
The Epidermis
Skin Pigments
Nevi (birthmarks or moles) are chronic
lesions of the skin they are, by definition,
benign.
Malignant melanoma is a cancer
of melanocytes.
The Epidermis
Skin Pigments
Vitiligo is a chronic disorder that causes
depigmentation patches in the skin. The
precise pathogenesis, or cause, is not known,
but is most likely a combination of
genetic factors coupled with a disorder of the
immune system (autoimmune disease).
The Epidermis
Skin Pigments
Albinism is a congenital disorder
characterized by the complete or partial
absence of pigment in the skin, hair, and
eyes due to a defect of an enzyme involved
in the production of melanin.
The Dermis
The dermis is composed of connective tissue

containing collagen and elastic fibers.
Well supplied with nerves and blood vessels
Blood vessels supply nutrients to the adjacent

epidermal cells
The blood vessels play an important role in

temperature regulation .
The Dermis
The Subcutaneous Layer
The subcutaneous layer is also called the

hypodermis, and it attaches the skin to
underlying tissues and organs.
It contains blood vessels and nerves in transit
to the more superficial layers.
It also contains lamellated
(pacinian) corpuscles
that detect external
pressure applied to the skin.
subQ
Benefits of Multiple Layers
Multiple layers in the skin allow for

specialization.
Adapted to fast turn-over, the epidermis
resists damage and offers protection to
underlying tissues.
The dermis provides temperature stability
and prevents dehydration, and yet is
capable of limited healing.
The subcutaneous tissues insulate,
store fat, and anchor the skin.
Accessory Structures of
the Skin
Hair
Hair is associated with the word pili.

It is present on most surfaces except the
palms, anterior surfaces of fingers, and the
soles of the feet.
It is composed of dead, keratinized epidermal
cells.
Genetics determines thickness and
distribution.
Hair helps with touch sensations and protects
the body against the harmful effects of the sun
and against heat loss.
Hair
Skin Glands
Sebaceous (oil) glands are connected to hair

follicles.
They secrete an oily substance called
sebum which does 2 important things:
Prevents dehydration of hair
and skin
Inhibits growth of certain bacteria
Skin Glands
In addition to oil glands, there are 2 types of

skin sweat glands (also called sudoriferous
glands). Both are simple, coiled tubular glands.
Eccrine sweat glands are the most
numerous. They secrete a watery solution

(600 ml per day) that helps to cool the body
and eliminates small amounts of waste.
Apocrine sweat glands are located mainly
in the skin of the axilla, groin, areolae, and

bearded facial regions of adult
males. They
Skin Glands
Eccrine sweat glands release sweat in

response to an emotional stress such as fear or
embarrassment. This type of sweating is
referred to as emotional sweating or a cold
sweat.
The secretory portion of apocrine sweat
glands is located mostly in the subcutaneous
layer, and the excretory duct opens into hair
follicles, with sweat secreted during emotional
stress and sexual excitement.
Much of body odor is due to apocrine sweat.
Skin Glands
Ceruminous glands are modified sweat

glands located in the ear canal.
Along with nearby sebaceous glands, they
are involved in producing a waxy secretion
called cerumen (earwax) which provides a
sticky barrier that prevents entry of foreign
bodies into the ear canal.
Nails
Nails are composed of hard, keratinized

epidermal cells located over the dorsal
surfaces of the ends of fingers and toes.
Wound Healing
Two kinds of wound-healing processes can

occur, depending on the depth of the injury.
Epidermal wound healing occurs following
superficial wounds that affect only the
epidermis.
Return to normal function is the rule.
Deep wound healing occurs when an injury
extends to the dermis and subcutaneous
layer.
Loss of some function and development of
scar tissue is the rule.
Burns
A burn is tissue damage caused by excessive

heat, electricity, radioactivity, or corrosive
chemicals that denature (break down) the
proteins in the skin cells.
Burns destroy some of the skin's important
contributions to homeostasisprotection
against microbial invasion and desiccation,
and thermoregulation.
Burns are graded according to their severity.
Burns
A first-degree burn involves only the

epidermis
It is characterized by mild pain and erythema
(redness) but no blisters and skin functions
remain intact.
Burns
A second-degree burn destroys the

epidermis and part of the dermis - some skin
functions are lost.
Redness, blister formation, edema, and pain
result.
Burns
A third-degree burn is a full-thickness burn

(destroys the epidermis, dermis, and
subcutaneous layer).
Most skin functions are lost, and the region is
numb because sensory nerve endings have
been destroyed.
Burns
According to the American Burn Association's

classification of burn injury, a major burn
includes:
3o burns over 10% of body surface area; or
2o burns over 25% of body surface area; or
Any 3o burns on the face, hands, feet, or
perineum (which includes the anal and
urogenital regions)
When the burn area exceeds 70%, more than
half the victims die.
INFECTIONS AND ALLERGIES
Infectious Disorders:
Acne: plugged hair follicles , caused by
bacteria, often appears during puberty
Boils: painful staphylococcus infection of hair
follicles and their sebaceous glands
Carbuncle: made up of several boils
Athlete's Foot: caused by fungus, flaky, itchy
usually between and under the toes.
Infections and Allergies
Fever Blisters: or cold sores are clusters of

fluid filled vessicles that occur on the lips or
oral membranes. Caused by herpes simplexcan be transferred by oral or respiratory
exposure
Genital herpes: similar disorder form on
the genitals as a result of infection transmitted
via sexual intercourse.
Impetigo: highly contagious caused by

bacteria, occurs in children- characterized by
fluid filled pustules that rupture, forming a
yellow crust over the infected area.
Warts: skin tumors, caused by virus that
stimulates exessive growth of epithelial cells
Noninfectious Disorders:
Alopecia: loss of hair, most common in males,
mostly inherited, if non inherited it is due to
poor nutrition, sensitivity to drugs and eczema
Bedsores: ( decubitus ulcers) due to
chronic deficiency of blood circulation in the
dermis and subcutaneous layers- most
common in bedridden patients
Blisters: fluid filled pockets
Burns:
Calluses and corns: thickened areas of skin
that result from chronic pressure often occur on
palms and balls of the feet.
corns: are smaller usually occur on the
upper surface of the toes.
Cancers: due to excessive cell division by cells
that have lost control of the process. Cancers of
the skin are called carcinomas involving
epidermal cells.
Melanomas are cancers of the melanocytes

very dangerous because they tend to grow and
spread to other parts of the body rapidly.
Excessive exposure to sunlight is the primary
cause of skin cancers.
Dandruf: excessive shedding of dead
epidermal cells from the scalp.. Usually cuased
by seborrheic eczema
Eczema: inflammation producing redness,

itching, scaling and cracking of skin.
Seborrheic eczema hyperactivity of the
sebaceous glands, mmay appear at the corners
of the mouth, in hairy areas, or in skin exposed
to irritants.
Hives: red, itchy, resulting from an allergic
reaction to certain foods, drugs or pollens
Moles: slow growing skin tumors that are
usually black or brown in color
Psoriasis: chronic, dermatitis, reddish, raised

patches of skin that are covered with whitish
scales. May be triggered by emotional stress or
poor health. Often occurs in the scalp, elbows,
knees, buttocks and lumbar areas.
Aging
The integumentary system changes with age:

Wrinkles develop.
Dehydration and cracking occurs.
Sweat production increases.
An increase in the numbers of functional
melanocytes results in gray hair and atypical
skin pigmentation.
Subcutaneous fat is lost, and there is a
general decrease in skin thickness.
Nails may also become more brittle.
Aging
With age, there is also an increased

susceptibility to pathological conditions (as
demonstrated by this decubitus ulcer).
These type of pressure
ulcers (bed sores)
are an all-to-common
occurrence in
nursing homes.

Integumentary

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The Integumentary System

Lecture slides prepared by Curtis DeFriez,

Copyright John Wiley & Sons, Inc. All rights reserved.

The organs of the integumentary system

Copyright John Wiley & Sons, Inc. All rights reserved.

d. Excretion production of perspirationby the

Copyright John Wiley & Sons, Inc. All rights reserved.

Structures of the Skin

The skin has 3 major layers:

Copyright John Wiley & Sons, Inc. All rights reserved.

Structures of the Skin

Copyright John Wiley & Sons, Inc. All rights reserved.

Keratinocytes make up 90% of the cells. They

Melanocytes produce the pigment melanin that

Langerhans cells are macrophages that

Merkel cells function in the sensation of touch

The epidermis is composed of keratinized

Copyright John Wiley & Sons, Inc. All rights reserved.

The epidermis is composed of four layers in thin

Copyright John Wiley & Sons, Inc. All rights reserved.

The stratum lucidum is the 4th layer but is

Copyright John Wiley & Sons, Inc. All rights reserved.

Keratinization is the process of replacing

Copyright John Wiley & Sons, Inc. All rights reserved.

Copyright John Wiley & Sons, Inc. All rights reserved.

Thin (hairy) skin covers all body regions

except the palms, palmar surfaces of digits,

skin covers the

Copyright John Wiley & Sons, Inc. All rights reserved.

Copyright John Wiley & Sons, Inc. All rights reserved.

Copyright John Wiley & Sons, Inc. All rights reserved.

Copyright John Wiley & Sons, Inc. All rights reserved.

The dermis is composed of connective tissue

Well supplied with nerves and blood vessels

Blood vessels supply nutrients to the adjacent

The blood vessels play an important role in

Copyright John Wiley & Sons, Inc. All rights reserved.

Copyright John Wiley & Sons, Inc. All rights reserved.

The Subcutaneous Layer

The subcutaneous layer is also called the

Copyright John Wiley & Sons, Inc. All rights reserved.

Benefits of Multiple Layers

Multiple layers in the skin allow for

Copyright John Wiley & Sons, Inc. All rights reserved.

Copyright John Wiley & Sons, Inc. All rights reserved.

Hair is associated with the word pili.

Copyright John Wiley & Sons, Inc. All rights reserved.

Copyright John Wiley & Sons, Inc. All rights reserved.

Sebaceous (oil) glands are connected to hair

Copyright John Wiley & Sons, Inc. All rights reserved.

In addition to oil glands, there are 2 types of

numerous. They secrete a watery solution

in the skin of the axilla, groin, areolae, and

Eccrine sweat glands release sweat in

Copyright John Wiley & Sons, Inc. All rights reserved.

Ceruminous glands are modified sweat

Copyright John Wiley & Sons, Inc. All rights reserved.

Nails are composed of hard, keratinized

Copyright John Wiley & Sons, Inc. All rights reserved.

Two kinds of wound-healing processes can

Copyright John Wiley & Sons, Inc. All rights reserved.

A burn is tissue damage caused by excessive

Copyright John Wiley & Sons, Inc. All rights reserved.

A first-degree burn involves only the