Higher Diploma in General Nursing (Enrolled

Nurse)
School of Nursing, Union Hospital

Life Sciences

L3 Dermatological System

1
 Lecture Outlines
• Body membrane, Skin and its Tissues,
Accessory Structures of skin
• Regulation of Body Temperature
• Healing of Wounds

2
 Body Membranes
• Function of body membranes
– Cover body surfaces
– Line body cavities
– Form protective sheets around organs
• Classified according to tissue types
1 - Epithelial membranes 表皮
a  Cutaneous membranes 角質
b  Mucous membranes 黏膜
c  Serous membranes 漿液

2 - Connective tissue membranes

關節液
a  Synovial membranes
saɪ no.vi.oh 5-3
 Epithelial: Cutaneous Membrane
• Cutaneous membrane = skin
is – Dry membrane
function – Outermost protective boundary 最外層保護層
表皮
• Superficial epidermis is composed of
keratinized stratified squamous epithelium
角化ker rə​t te nīz 分層 正方形
• Underlying dermis is mostly dense
connective tissue
 More about skin will be discussed later

5-4
 Cutaneous
membrane
(skin)

(a) Cutaneous membrane (the skin)

covers the body surface.
 Epithelial: Mucous Membranes
• Surface epithelium type depends on site
– Stratified squamous epithelium (mouth,
stra ti fied
oesophagus)
柱狀
– Simple columnar epithelium (rest of digestive tract)
• Underlying loose connective tissue (lamina
propria) 固有層 鬆散啲
• Lines all body cavities that open to the exterior
body surface
• Often adapted for absorption or secretion
 Vulnerable in infection?
more vulnerable to infection 因為黏膜薄，容易被細菌入侵
5-6
 Mucosa of
nasal cavity
Mucosa of
mouth
Esophagus
lining

Mucosa of
lung bronchi 支氣管

(b) Mucous membranes line body cavities

open to the exterior. 對外開放
5-7 （risk: 感染）
Figure 4.1b
 Epithelial: Serous Membranes
• Surface is a layer of simple squamous epithelium
• Underlying layer is a thin layer of areolar connective
tissue 蜂窩組織

• Lines open body cavities that are closed to the exterior of

the body
• Serous membranes occur in pairs separated by serous
fluid 包住身體organ(摩擦、震盪 --> 保護organ)
內臟 – Visceral layer covers the outside of the organ
v ser ro– Parietal layer lines a portion of the wall of ventral
body cavity 外壁層

5-8
 拳頭=內臟
Outer balloon wall
漿膜
(comparable to parietal serosa)
Air (comparable to serous cavity)
Inner balloon wall
(comparable to visceral serosa)
拳頭 鬆弛
(d) A fist thrust into a flaccid balloon demonstrates
the relationship between the parietal and visceral
serous membrane layers.

5-9
Figure 4.1d
 Epithelial: Serous Membranes
 Specific serous membranes
Peritoneum: Abdominal
cavity 腹膜 peri ton neum
Pleura: Around the lungs
Pericardium: Around the
heart
Parietal
Parietal
pleura
peritoneum
Visceral
Visceral pleura
peritoneum
膜狀 Parietal Visceral
pericardium pericardium
with serous membrane
(c) Serous membranes line body cavities
closed to the exterior.

5-10
Figure 4.1c
 Connective Tissue Membrane
關節液
Synovial
membrane
-Connective Ligament 帶
tissue only
Joint cavity
-Lines fibrous
纖維囊 (contains
capsules synovial fluid) saɪ no.vi.oh
Articular (hyaline) 關節軟骨
surrounding cartilage （透明質酸）
joints Fibrous
capsule
- Secretes a Synovial
Articular
capsule
lubricating fluid membrane

潤滑劑

5-11
Figure 4.2
 Integumentary System

角質
• Skin (cutaneous membrane)
• Skin Accessory Structures
– Sweat glands
– Oil glands
– Hair
– Nails

5-12
 Dermatology

• Study and medical treatment of

integumentary system

• Provides clues to health

身體狀態

5-13
5-14
 Functions of skin
• Protects deeper tissues from: protection
– Mechanical damage (bumps)
– Chemical damage (acids and bases)
– Bacterial damage
– Ultraviolet radiation (sunlight)
– Thermal damage (heat or cold) 溫度傷害
乾燥 – Dessication (drying out)
des sic cation
• Aids in body heat loss or heat retention as
controlled by the nervous system heat regualtion
• Aids in excretion of urea and uric acid 尿素、尿酸
• Synthesizes vitamin D
5-14
 Skin and Its Tissues

•Epidermis 表皮 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproductionor display.

• Outer layer Stratified

• Stratified squamous epithelium squamous

層狀
epithelium
• Dermis 真皮層
• Inner layer 骨膠原
•Contains collagenous and Dense irregular
connective
elastic fibers 皮下 tissue

• Subcutaneous layer (hypodermis)

• Beneath dermis
• Areolar and adipose tissues.
-sweat gland
- oil gland
- 毛髮
Adipose tissue

- blood vessel © The McGraw-Hill Companies, Inc./Al Telser, photographer

5-15 16
- nervous ending
 Hair shaft

Dermal papillae
Epidermis 乳突狀 pat pe li

Papillary Pore
layer 附加物
Appendages of skin
• Eccrine sweat gland
• Arrector pili muscle豎毛肌
Dermis • Sebaceous (oil) gland
Reticular
layer • Hair follicle
• Hair root

Hypodermis
(superficial fascia)
- adipose
-- vascular 血管 Cutaneous vascular plexus
Nervous structures
• Sensory nerve fiber
層狀小體 • Lamellar corpuscle Adipose tissue
•Hair follicle receptor
(root hair plexus)
神經叢

5-16
Figure 4.3
 Epidermis （5層）
• Lacks blood vessels
• Keratinized to prevent water loss • Five layers: (top to bottom)
•Most cells are keratinocytes 角質形成細胞 •Stratum corneum (dead,角質層con ni
um
keratinized cells)
• Thickest on palms and soles (0.8-1.4mm)
--》 最厚 •Stratum lucidum (only in thick
skin – palms, soles) 透明層
黑色素細胞 me lan no cyte 黑色素
• Melanocytes provide melanin •Stratum granulosum grand niu lor some, 顆
•Stratum spinosumspin粒層no some, 棘細胞層
• Rests on basement membrane •Stratum basale (mitotic layer)
bay sale, 基底層
• Stratified squamous epithelium
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction ordisplay.

Stratum corneum

Stratum lucidum

Stratum granulosum

Stratum spinosum

Stratum basale

生長層
Basement
membrane

Dermal papilla

Dermis

(a)
5-17 (b) 18
b: © The McGraw-Hill Companies, Inc./Al Telser, photographer
 Layers of the Epidermis

jer me-nə-ˈtai tum

• Stratum basale (stratum germinativum)
– Deepest layer of epidermis
– Lies next to dermis
– Wavy borderline with the dermis anchors the two
together
– Cells undergoing mitosis
– Daughter cells are pushed upward to become the
more superficial layers
• Stratum spinosum
• Stratum granulosum

5-18
 Layers of the Epidermis
知道名is ok,

• Stratum lucidum
– Formed from dead cells of the deeper strata
– Occurs only in thick, hairless skin of the palms of
hands and soles of feet
• Stratum corneum
– Outermost layer of epidermis
– Shingle-like dead cells are filled with keratin
(protective protein prevents water loss from skin)

5-19
 Layers of the Epidermis

• Summary of layers from deepest to most

superficial
– Stratum basale
– Stratum spinosum
– Stratum granulosum
– Stratum lucidum (thick, hairless skin only)
– Stratum corneum

5-20
 Keratinocytes 角質細胞
Epidermal
Desmosomes dendritic cell

Stratum corneum. Cells are dead;

represented only by flat membranous
sacs filled with keratin. Glycolipids in
extracellular space. 甘油質地
Stratum granulosum. Cells are
flattened, organelles are deteriorating;
cytoplasm full of granules.

Stratum spinosum. Cells contain thick

bundles of intermediate filaments
made of pre-keratin.

Stratum basale. Cells are actively

Merkel dividing stem cells; some newly
cell formed cells become part of themore
superficial layers.

Sensory Dermis
Melanocytes Melanin nerve
granules ending
黑色素
5-21
Figure 4.4
 Cells of the Epidermis
• Stem Cells 幹細胞
– Produce keratinocytes
– Only in deep layer of epidermis

• Keratinocyte
– Synthesize keratin
– Majority of visible epidermal cells

• Melanocytes 黑色素
– Stratum basale
– Brown to black pigment
– Same amount in all people
but shape, colour will be different according to race, behavior
5-22
 Cells of the Epidermis (cont)
• Tactile (Merkel) cells
– Sense receptors

• Dendritic (Langerhans)
cells 樹突狀
– Macrophage cells
巨噬細菌- 噬外來細菌，防衛

5-23
 00:08 Epidermis
Melanin Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

• Melanocytes located in
the stratum basale Pigment
granule

produce the dark Nucleus

pigment melanin Cell

membrane

• Melanin gives skin color (a)

and also absorbs UV light

• Color is yellow to brown
to black
• Amount of melanin Cellular
extension
ofmelanocyte Epidermis

produced depends upon Pigment

Stratum
genetics and exposure to granules

Basale
sunlight Golgi
apparatus

Melanocyte
nucleus
Basement
membrane

Dermis

5-24 (b) 25
a: © M. Schliwa/VisualsUnlimited
 00:13
Epidermis
遺傳 (quantity & size of melanin)
• Heredity and environment determine skin color
• Genetic Factors • Physiological Factors
•Varying amounts of •Dilation of dermal blood
melanin vessels --> red
• Varying size of melanin • Constriction of dermal blood
granules vessels --> pale
• Albinos lack melanin • Accumulation of carotene
白化病（皮膚入面無黑色素，容易 uv傷害） • Jaundice 紅蘿蔔素
• Environmental Factors 黃疸
• Sunlight
• UV light from sunlamps
• X-rays 太陽燈

5-25 26
多melanin

5-26
 Skin structure
• Which part of epidermis in our body is the
thickest?  palm & soles
having stratum lucidum *手掌 掌無皮脂腺
paplla
多sweat gland
--> that's why we have finger print

Keratin Fingerprints Hair Sebaceous Sweat

glands glands
Thin skin Thin    less

Thick skin thick    more

5-27 27
 Think
• Are there any Nerve endings or blood vessels
in the epidermis?

no,
nerve ending only exist in dermis & hypodermis

5-28 28
 Interesting fact
• The surface of the epidermis is ridged by
projections of cells in the dermis called
papillae. The pattern of the ridges on the
fingertip is UNIQUE to everyone.
 fingerprint

5-29 29
 Dermis 真皮層

• On average 1.0-2.0mm thick Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

• Contains dermal papillae 乳突 Hair shaft

Sweat gland pore

•Binds epidermis to underlying Sweat

Stratum corneum
Stratum basale
tissues Epidermis
Dermal papilla
Basement
membrane

• Dense irregular connective tissue Dermis

Capillary
Tactile (Meissner’s)
corpuscle

• Muscle cells 黏住&控制毛髮

Sweat gland duct
皮脂腺
Sebaceous gland
se bay ceous
Arrector pili muscle
Sweat gland

• Nerve cell processes Sub-

cutaneous
Lamellated
(Pacinian) corpuscle
Hair follicle
layer

• Specialized sensory receptors Adipose tissue

Nerve cell process

感官細胞 Blood vessels

• Blood vessels (a)

Muscle layer

• Hair follicles 毛囊
• Glands （sweat + oil）
5-30 30
 Dermis
Dermis
• Two layers
– Papillary layer (upper dermal region)
• Projections called dermal papillae
– Some contain capillary loops
– Others house pain receptors and
touch receptors 觸感+痛楚
– Reticular layer (deepest skin layer)
• Blood vessels
• Sweat and oil glands
• Deep pressure receptors
感受壓力

5-31
 Dermis
Dermis

• Overall dermis structure

– Collagen and elastic fibers located throughout the
彈性纖維
dermis
• Collagen fibers give skin its toughness 度
• Elastic fibers give skin elasticity 彈性
– Blood vessels play a role in body temperature
regulation dermal blood vessels

5-32
 知道accessory muscle is
ok

Epidermis

Papillary layer
of dermis

Reticular layer
of dermis

5-33
Figure 4.5
Subcutaneous tissue (hypodermis)
皮下

Subcutaneous tissue (hypodermis) is deep

to dermis
-Technically NOT a true layer of the skin
-part of the skin
- Anchors skin to underlying organs
-Composed mostly of adipose tissue
肥膏

Functions: support, binds the dermis to

deeper tissue and adipose storage
儲存脂肪

脂肪細胞係固定， 但容量不同
5-34
 Normal Skin Color Determinants
決定因素
• Melanin 00:31:00

– Yellow, brown, or black pigments

• Carotene 胡蘿蔔素
– Orange-yellow pigment from some vegetables
• Haemoglobin 紅血球 hae mo globin
– Red coloring from blood cells in dermal capillaries
– Oxygen content determines the extent of red coloring
血含 量

5-35
 變化 Alterations in Skin Color
eryth: red
紅斑
• Redness (erythema)—due to embarrassment,
inflammation, hypertension, fever, or allergy
(blood vessel dialiation)
• Pallor (blanching)—due to emotional stress
蒼白

such as fear, anemia,

貧血
low blood pressure,
impaired blood flow to an area
• Jaundice (yellowing)—liver disorder
• Bruises—hematomas
瘀 血腫

5-36
 Skin Markings
因為摩擦而產生
「枕」
• Friction ridges • Moles (nevus) 墨、痣
摩擦
– Characteristic of primates 靈長類 – Elevated patch of
– Aid in manipulating objects melanized skin
– Unique pattern for all – “Beauty marks”（有可能係色
素細胞病變）
individuals • Hemangiomas
• Flexion lines (creases) 皺紋 (birthmarks) 血管瘤
• Freckles 雀斑 – Discolored skin
– Flat, melanized patches – Caused by benign 良性
tumors of capillaries
– Vary with heredity and UV
exposure 遺傳

5-37
5-38
 Skin Accessory Structures

• Cutaneous glands are all exocrine glands

外分泌
– Sebaceous glands
– Sweat glands
• Hair
• Hair follicles
• Nails

5-38
 Skin Accessory Structures

皮脂
• Oil (sebaceous) glands
– Produce oil (sebum)
• Lubricant for skin 潤滑劑
• Prevents brittle hair易碎
• Kills bacteria （pH5.5 可以殺死部分細菌）
– Most have ducts that empty into hair follicles;
others open directly onto skin surface
– Glands are activated at puberty

5-39
 Sweat
pore

Sebaceous Eccrine
gland gland

Dermal connective
tissue

Sebaceous
gland duct
Hair in
hair follicle
Secretory cells

(a) Photomicrograph of a sectioned

sebaceous gland (14×) 5-40
Figure 4.7a
 Skin Accessory Structures

• Sweat (sudoriferous) glands

– Produce sweat
– Widely distributed in skin

Function of sweating:
cooling effect
secretion of waste

5-41
 Skin Accessory Structures

• Two types of sudoriferous glands

– Eccrine
• Open via duct to pore on skin surface
• Produce sweat (clear)
– Apocrine 大汗腺
• Ducts empty into hair follicles (由毛囊出)
• Begin to function at puberty
• Release sweat that also contains fatty acids and
proteins (milky/yellowish color)

5-42
 Sweat
pore

Sebaceous Eccrine
gland gland

Dermal connective
tissue
Eccrine
gland duct

Secretory cells

(b) Photomicrograph of a
sectioned eccrine
5-43 gland (180×)
Figure 4.7b
 Sweat and Its Function

• Composition
– Mostly water
– Salts and vitamin C
– Some metabolic waste
– Fatty acids and proteins (apocrine only)
• Function
排走
– Helps dissipate excess heat
– Excretes waste products
– Acidic nature inhibits bacterial growth 抑制細菌生長
• Odor is from associated bacteria

01:04：00
5-44
 香氣

恥毛

蒸發
Eccrine

耳仔--> 產生耳垢

乳汁 5-45
 Skin Accessory Structures

• Hair
– Produced by hair follicle
– Consists of hard keratinized epithelial cells
– Melanocytes provide pigment for hair color
– Hair grows in the matrix of the hair bulb in
stratum basale

5-46
5-47
Figure 4.8c
 Skin Accessory Structures
• Hair anatomy
– Central medulla 髮芯
– Cortex surrounds medulla
– Cuticle on outside of cortex
• Most heavily keratinized

5-48
Cuticle
Cortex
Medulla

(b) Hair
Figure 4.8b
 Skin Accessory Structures

• Associated hair structures

– Hair follicle
• Dermal and epidermal sheath surround hair root
– Arrector pili muscle
• Smooth muscle 控制毛髮（毛管棟）
• Pulls hairs upright when cold or frightened
– Sebaceous gland
– Sudoriferous gland sweat gland

5-50
 Functions of Hair

軀幹四肢 毛髮

disstribute

吸引異性

鼻孔、外耳道
阻 外物

5-51 汗
 Structure of Hair and Follicle
• Three zones along the length of a hair
– 1. Bulb 毛囊
• Swelling at base where hair originates in dermis
• Dermal papillae - provides nutrition
• Hair matrix – hair’s growth center
– 2. Root 髮根
• Remainder of hair w/in follicle
• Dead tissue
– 3. Shaft 髮幹

• Portion above the skin’s surface

• Dead tissue
5-52
Structure of Hair

5-53
 Skin Accessory Structures
• Notice how the scale-like cells of the cuticle
overlap one another in this hair shaft image
(660×)

5-54
 Hair Follicle 毛囊

• Diagonal tube extending in dermis or as deep as

hypodermis
• Two layers
– Epithelial root sheath
– Connective tissue root sheath
• Hair receptors
– Nerve fibers that respond to hair’s movement
• Piloerector muscle (arrector pili)
– Smooth muscle that causes “goose bumps” 毛管棟

5-55
Hair Texture and Color

細胞產生唔到色素
space變成空氣

5-56
 x

Hair Growth and Loss

5-57 5-58
 Skin Accessory Structures
Hair
• Also called a pilus
絲狀
• Filament of keratinized cells
• Grows from oblique tube called a hair follicle
• Grows almost everywhere, except:
– Lips
– Nipples
– Parts of genitals 部分生殖器
– Palms and soles
– Ventral and lateral surfaces of fingers and toes
– Distal segments of fingers
5-58
5-59
 Skin Accessory Structures

• Nails
鱗片狀
– Scale-like modifications of the epidermis
• Heavily keratinized 角質蛋白
– Stratum basale extends beneath the nail bed
• Responsible for growth
– Lack of pigment makes them colorless

5-59
 Skin Accessory Structures

• Nail structures
– Free edge
– Body is the visible attached portion
– Root of nail embedded in skin
表皮 – Cuticle is the proximal nail fold that projects onto
the nail body

5-60
 Lunule Lateral
nail fold

(a)

Free edge Body Cuticle Root of nail

of nail of nail
Proximal Nail
nail fold matrix

(b) Nail bed Bone of fingertip

5-61
Figure 4.10a-b
 Temperature Regulations
• Heat Production and Loss
• Heat is a product of cellular metabolism e.g oxidation
• The most active body cells are the heat producers
and include: 產生熱能的cell/muscle
• - Skeletal muscle
- Cardiac muscle 心臟肌肉
- Cells of certain glands such as the liver

• The primary means of heat loss is radiation 能量放射

• Also there is conduction, convection and evaporation
接觸 氣流帶走 蒸發

5-62
Regulation of Body Temperature ***Hypothalamus***

- Proper temperature regulation is vital to maintaining

metabolic reactions.
- The skin plays a major role in temperature regulation
with the hypothalamus controlling it.
下丘腦
- Active cells, such as those of the heart and skeletal
muscle, produce heat.
- Heat may be lost to the surroundings from the skin
through radiation. 熱力沿著皮膚發射
- The body responds to excessive heat by dilation of
dermal blood vessels and sweating. 熱：血管擴張、流汗--> 蒸發汗
液
- The body responds to excessive cooling by constricting
dermal blood vessels, inactivating sweat glands, and
shivering. 凍：收縮血管、肌肉收縮-->增加身體熱量
5-63 64
 Regulation of Body
Temperature send signal
send signal

Negative feedback mechanism

•Hyperthermia – 體溫過高 -blood vessel

abnormally high - sweat gland
body temperature
• Heat stroke

•Hypothermia –
abnormally low body
temperature

blood vessel收縮，少熱力流失

1.

再唔得
5-64 --> 肌肉收縮 65
generate body heat
 Skin Homeostatic Imbalances
00:29:00

• Burns
組織受損，細胞死亡
– Tissue damage and cell death caused by heat,
electricity, UV radiation, or chemicals
– Associated dangers
• Dehydration 脫水
• Electrolyte imbalance 電解質失衡
• Circulatory shock 循環系統變差

5-65
 Rule ofRule of Nines
Nines for Adults

• Way to determine the extent of burns

• Body is divided into 11 areas for quick
estimation
• Each area represents about 9 percent of total
body surface area

Ref: http://www.halls.md/body-surface-area/bsa.htm

5-66
 頭：前後=9

1手臂前後=9

1 前後=18
會陰

5-67
 Severity of Burns 一二三級燒傷
• First-degree burns
表皮受損
– Only epidermis is damaged
– Skin is red and swollen 腫
• Second-degree burns
– Epidermis and upper dermis are damaged
– Skin is red with blisters 水泡
• Third-degree burns dermis 神經細胞死咗
– Destroys entire skin layer; burned area is painless
– Burn is gray-white or black

5-68
 1ST Degree Burn
(Partial-Thickness Burn) 局部

• Only epidermis
• Usually localized
• Redness, slight edema,
and pain 浮腫

• Sunburn

5-69
 2ND Degree Burn
(Partial-Thickness Burn)
• Epidermis and part of
dermis
• Red, tan, or white
• Blistered and painful
水泡
• May cause damage to
hair follicles, nerve 神經末梢
endings, and cutaneous
glands
• Sunburns and scalds 熱液體

5-70
 3RD Degree Burn
(Full-Thickness Burn)
• Epidermis and dermis
are completely destroyed
收縮
• Contracture and
disfigurement can result
毀容

X 神經末梢、汗腺

5-71
 Critical Burns

• Burns are considered critical if

– Over 25 percent of body has second-degree burns
– Over 10 percent of the body has third-degree
burns
– There are third-degree burns of the face, hands,
or feet

5-72
 Skin Homeostatic Imbalances

• Infections
– Athlete’s foot (tinea pedis) 香港
• Caused by fungal infection （真菌感染）

– Boils and carbuncles

• Caused by bacterial infection
– Cold sores 唇瘡

• Caused by virus

5-73
 Skin Homeostatic Imbalances

• Infections and allergies

– Contact dermatitis 接觸性皮膚炎
• Exposures cause allergic reaction
– Impetigo 小膿皰疹
• Caused by bacterial infection
– Psoriasis 牛皮癬
p不讀
• Cause is unknown
• Triggered by trauma, infection, stress

5-74
 x infection

5-75
Figure 4.12a-c
 Skin Cancer

• Cancer—abnormal cell mass

• Classified two ways
– Benign 良性
• Does not spread (encapsulated) 封閉
– Malignant 惡性mə lɪɡ nənt
• Metastasized (moves) to other parts of the body
• Skin cancer is the most common type of
cancer

5-76
 Basal Cell Carcinoma
=cancer

• Most common
• Least dangerous: hardly
metastasizes 轉移 me·tas·ta·size
• Arises in stratum basale
and invades dermis
由basale開始向下入侵

會發大，但不會擴散至其他system

5-77
 Squamous Cell Carcinoma 癌
• Arises from
keratinocytes of
stratum spinosum
• Can metastasize to
lymph nodes
• Can be lethal 致命

有機會入淋巴擴散

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 Malignant Melanoma
惡性黑色素瘤

• Most deadly, but only

5% of cases
• Arises from melanocyte
of existing mole
• Metastasizes quickly
and often fatal if not
treated quickly

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 ABCD Rule
不對稱，不規則
有邊深色啲、有啲淺色啲

• A = Asymmetry
– Two sides of pigmented mole do not match
• B = Border irregularity
– Borders of mole are not smooth
• C = Color
– Different colors in pigmented area
• D = Diameter
– Spot is larger then 6 mm in diameter

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Figure 4.13c
 Healing of Wounds 簡單次序

3 Steps:
1-inflammatory phase 2. Proliferative phase 3.remodeling phase

A. Inflammation, in which blood vessels dilate and become

more permeable, causing tissues to become red and 血管擴張-->
swollen, is the body's normal response to injury. 高滲透、充

B. Superficial cuts are filled in by reproducing epithelial 血、body

fluid
cells.
C. The blood clot and dried tissue fluids form a scab. 結痂
D. If the wound is deep, extensive production of
由生長因子控制 collagenous fibers may form an elevation above the
normal epidermal surface forming a scar.增厚
E. Large wounds leave scars and healing may be
accompanied by the formation of granulations

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 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Site of injury

Blood cells

(a) (b)

Scab

Blood
clot

(c) (d) (e)

Scab

Scar
tissue
Scar
colleagen增生 tissue
Fibroblasts

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(f) (g)
 Integumentary System Aging
衰老
• Senescence – age related • Skin and blood supply
degeneration – Fewer and more fragile 脆弱

– Hair turns grayer, thinner vessels

– Melanocyte stem cells die out
黑色素細胞
– Rosacea 玫瑰挫瘡
mai tol ses
– Mitosis slows down • Dilated blood vessels that
皮膚更生速度 causes reddened areas
– Dead hairs not replaced
– Increased bruising 瘀傷
皮脂分泌萎縮
– Atrophy of sebaceous glands
– Skin becomes thinner and
• Thermoregulation 溫度調節
more translucent – Vulnerability to hypothermia
transˈlo͞osnt and heat stroke
半透明，無 結實
低溫症、中暑機會大
（inactive of sweat glands）

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 Learning Outcomes

 Describe what constitutes an organ, and name the large

organ of the integumentary system.
Two or more kinds of tissues grouped together and performing specialized functions
 Discuss the functions of skin.
helps regulate body temperature, retards water loss from deeper tissues, house sensory receptors
 Describe the structure of the layers of the skin.
the epidermis is the outer most layer of skin, and the dermis is the inner layer of the skin
 Summarize the factors that determine skin color.
Specialized cells in the epidermis called melanocytes produce melanin a dark pigment that provides skin color

 Describe the accessory structures associated with the skin.

The assessory structure of the skin are the structures that develop from the epidermis of an embryo they include : Hair, nails, glands
 Explain the functions of each accessory structure of the
in the epidermis...nails, hair follicles, and skin glands
skin. Nail: protective covering on the ends of fingers and toes

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 Learning Outcomes
Regulation of Body Temperature
 Explain how the skin helps regulate body temperature.
The skin plays a key role in homeostatic mechanism
Healing of Wounds and Burns
 Describe the events that are part of wound
Dialated blood vesseles provide the tissue with more nutrients and oxygen,
healing.describe wond healing. which aids healing

 Distinguish among the types of burns, including a

description of healing with each type.
Lifespan Changes
 Summarize lifespan changes in the integumentary system.
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 References:
Summarize lifespan changes in the integumentary system.
• AsChapter 6 of
adults move into laterHole’s Human
life, the overall appearanceAnatomy & dramatically.
of the skin changes
There is less collagen and elastin; skin cells are replaced much more slowly, making the
Physiology
skin by
take longer to heal. David
There is also theShier, Jackie
occurrence of age spotsButler,
on hands, arms, and
face. The skin loses fat as well, which results in wrinkles and sagging. A decrease of oil
Rickiresults
secretion Lewis. McGraw
in dry, rough, Hill
and scaly skin. Sweating declines, resulting in problems
with regulating body temperature. Sun exposure and cigarette smoking are both significant
• experience
factors in aging skin. Hair continues to gray for both males and females; females
Chapter 4 of Marieb, E. N. (2012). Essentials
increased facial hair as estrogen declines. Nails grow slower and become
thicker with deep ridges as calcium deposits increase. th
of Human Anatomy and Physiology. (10 ed.).
San Francisco, C.A.: Pearson.
• Wound Healing Animation
http://www.youtube.com/watch?v=IYL6vg89uds

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