Integumentary Lec 1: Overview of the Integument

A- Integumentary (skin) System

- Most accessible organ system
- 16% of TBW
- Surface area: 1.5-2 m²
- Body’s first line of defense against environment

- 2 major components
1- Cutaneous membrane (skin): Epidermis and Dermis
2- Accessory structure:
a- Hair & nails
b- exocrine, sebaceous, sweat glands
c- Sensory receptors & nerve fibers
d- Cutaneous Plexus (network of blood vessels)

B- Skin Layers
- Characterized into thin and thick skin

1- Epidermis : 2- Dermis:
a- Stratified squamous epithelium; derived from ectoderm a- derived from mesoderm
b- Layers of Epidermis b- Layers
i- Stratum Corneum: thicker on palms and soles, i- Elastic Fibers: altered in aging, esp photoaging
and in ichthyosis ii- Collagen: thickened in systemic sclerosis
ii- Granular layer: missing in psoriasis and iii- Nerve Fiber: site of inflammation in leprosy
thickened in lichen planus iv- Blood vessels: vasculitis
iii- Stratum Spinosum c- Clinical correlate: Unilateral Dermatoheliosis- “truck driver
iv- Basal layer face” from sun damage limited to left sidefrom exposure
c- Differentiated keratinocytes require 2 weeks to exit over the years
nucleated compartment and 2 weeks to move thru
stratum corneum
d- Basement Membrane: junction between epidermis and
dermis
e- Melanocyte reside in epidermis along the basal layer,
supply melanin to keratinocytes via melanosomes and
Langerhans cells (APC)

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Integumentary Lec 1: Overview of the Integument

D- Hair
3- Hypodermis (subcutaneous layer):
a- not part of integument - almost everywhere on the body: except palms of hands, soles
b- separates integument from deep fascia, corresponds of feet, sides of fingers and toes, lips, parts of external genitalia
to superficial of gross anatomy - Body has about 2.5 million hairs: 75% on general body surface
c- rich in adipose tissue (not head)
d- Clinical Correlates: - Non-living
i- Lobular Panniculitis & Septal Panniculitis: - hair follicle: complex structure composed of epithelial and CT
group of condition that cause painful bumps that forms a single hair
or nodules to form under the skin- often on - 2 types of Hair
legs and feet arising within hypodermal fat 1- Terminal Hairs
layer i- Large, coarse, darkly pigmented
ii- Eg: Armpit and hair on scalp
C- Age related Changes in the integument: 2- Vellus Hairs
- Fewer melanocytes i- Smaller, shorted, delicate
- Drier and thinner Epidermis ii- Found on general body surface
- Diminished immune response - Hair regions and associated structures:
- Thinning dermis i- Hair shaft: begins deep within hair follicle but can be
- Decreased perspiration seen on surface
- Reduced blood supply ii- Hair root: anchors the hair into skin
- Slower skin repair  Extends from base of follicle to point where hair
- Fewer active follicles shaft loses connection with follicle walls
- Altered hair and fat distribution iii- Root Hair Plexus: collection of sensory nerves,
surrounds base of follicle

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Integumentary Lec 1: Overview of the Integument

iv- Arrector Pili: Smooth muscle attached to hair follicle, c- Eg:

contraction pulls hair erect i- nails pitted and disorted: psoriasis
ii- concave nails: blood disorders
iii- Nail Clubbing: result of low O2, inflammatory
bowel disease, CVD, liver disease, and AIDS
iv- Koilonychia: chronic diarrhea, general weakness,
fatigue

F- Exocrine Glands of Skin

- Sebaceous Glands: produce Sebum

i- Holocrine glands that discharge an oily lipid secretion
ii- Simple branched alveolar glands that secrete onto one
hair follicle
iii- Contractions of arrector pili muscle cause release of
sebum onto follicle and skin surface
Sebum:
 Mixtures of triglycerides, cholesterol, proteins, and
electrolytes
 Lubricates hair shaft
E- Nail  Antimicrobial
- Landmarks of nail structure
a- Nail Body - Apocrine Sweat glands: apex of cells
 Visible portion of the nail i- Limited distribution (axillae, groin, nipples)
 Bordered by lateral nail grooves (depressions) and ii- Secrete into hair follicles
lateral nail folds (ridges) iii- Produce viscuous/ sticky, cloudy, odorous secretion
i- Covers nail bed (underlying with complex composition
epidermis) iv- Possible function in olfactory communication
ii- Lunula (pale crescent on proximal v- Strongly influenced by hormones
part of nail body
iii- Free edge (distal part of the nail - Merocrine Sweat glands: everywhere
body) i- Found in most areas of skin
b- Nail root: Epidermal fold where nail production occurs ii- Highest number on palms (~500 gland/cm) and soles
- Structures associated with nails iii- Produce watery secretions with electrolytes
i- Eponychium (cuticle): portion of stratum corneum of nail iv- Controlled primarily by nervous system
root extending over exposed nail v- Important in thermoregulation and excretion
ii- Hyponchium: area of thickened stratum corneum under vi- Some antibacterial action
free edge vii- Secrete directly onto surface of the skin
- Clinical Correlates:
a- Nail appearance used for diagnosis G- Sensory Receptors in the Integument
b- Cells producing nails can be affected by condition that - ~ 400 cm of nerve fibers per cm2 of skin
alter body metabolism - Receptors in epidermis

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Integumentary Lec 1: Overview of the Integument

i- Free nerve endings - Immunity functions

a- Sensitive to touch & pressure a- Activated mast cells: release histamine, prostaglandins,
b- Between epidermal cells leukotrienes, cytokines and chemokines, which increase
ii- Tactile discs cutaneous blood flow and capillary permeability
a- Detect texture & steady pressure b- Macrophages: phagocytic and aid in # of immune related
b- Found in deepest layer of epidermis responses
c- Dermal Dendrocytes: APCs, similar to epidermal
- Receptors in dermis Langerhans; integral to cutaneous adaptive immunity
i- Meissners corpuscles responses
a- Detect light touch, pressure and vibration d- Fibroblasts: synthesize & degrade fibrous and non fibrous
b- Found in papillary layer CT proteins ; involved in wound healing and scarring
ii- Lamellated (Pacinian) corpuscles
a- Detect deep pressyre and vibration - Regulates Body Temperature ***
b- Found in both dermal layers and in hypodermis a- Passive or unregulated heat transfer
iii- Ruffini Corpuscles: b- Steady State: Rate of heat production by body core
a- Sensitive to pressure and stretching of skin matches the flow of heat from core to skin to environment
b- Found in reticular layer c- Certain CNS commands are not directly involved in
temperature regulation can affect heat flow
H- Main Functions i- Temperature sensitive neurons in the preoptic
area (in thalamus- which contain central
thermoreceptors and thermoregulatory control
center) play major role in detecting changes in
deep body temperature
ii- Thermal effectors that modulate heat transfer are
under control of sympathetic NS. Adjust smooth
muscle tone of cutaneous arterioles and of
arteriovenous anastomoses (shunts) controls
cutaneous blood flow
d- Skin circulation: blood flow to skin
i- In apical skin, glomus bodies (A-V anastomoses )
can reach density of ~500 per cm2 in the nail bed
ii- Non apical skin: lacks glomulus bodies
 Post ganglionic sympathetic fibers release NorE 
vasoconstriction  decrease in cutaneous blood
flow and increases sweat gland production 
cold & clammy (diaphoretic) skin
 Pre ganglionic fibers release ACh  vasodilation,
- Barrier function mediated by bradykininstimulates muscarinic
a- Normal: tightly packed keratinocytes forming a natural receptors on acinar cells secrete into lumen a
barrier clear, odorless solution, similar in composition to
b- Clinical correlate: Dermatitis: Skin cells less tightly held protein free plasma
together, allergens penetrate, loss of water and fat

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Integumentary Lec 1: Overview of the Integument

iii- Anterior Hypothalamus regulates temperature  loosen intercellular connection

and controls activity of sympathetic Nerves that  reduce epidermis effectiveness as a barrier
innervate SM of cutaneous arteriovenous ii- Sex hormones:
anastomoses  Increase epidermal thickness
iv- Skin temperature is directly propionate to blood  inc # of dendritic cells protecting against cancer
flow to the skin cells and pathogens
v- Eccrine (not apocrine) sweat glands contribute to iii- Epidermal growth factor:
temp regulation  peptide that has widespread effects on epithelial
vi- Clinical Correlates: Sweating and CF  produced by salivary glands and glands in
duodenum
 Accelerates production of keratin
 Stimulates epidermal development and repair
 Stimulates synthesis and secretion in glands
iv- Growth hormones
 Stimulates basal growth
 Thickens epidermis
 Promotes wound repair

e- Vitamin D Metabolism
i- 80-100% of Vitamin D is gotten through casual
exposure to sunlight
ii- 7-dehydrocholestrol is manufactured in the skin
through exposure to sunlight
J- Skin regeneration after injury:
f- Melanocyte Biology - 4 phases
i- Creates pigment i- Inflammatory phase:
 Mast cells trigger inflammatory response
I- Interactions between skin and various hormones  Bleeding occurs at the site of injury
- Circulating hormones: allow communication between skin and ii- Migratory phase:
rest of the body  Scab forms at surface
i- Steroid Hormones (glucocorticoids):  Patrolling macrophages remove debris and
pathogens

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Integumentary Lec 1: Overview of the Integument

 Rapid cell division and migration along wound

edges to replace missing cells
 Formation of granulation tissue
iii- Proliferation phase
 Deeper portions of the clot dissolve
 Fibroblast produce new collagen fibers and
ground substance
iv- Scarring phase : scar tissue formation

K- Skin and Age