Holy Name University

College of Health and Science

Department of Nursing

Touch by touch: An Extensive Report on The Integumentary System

A Report Project Presented to the Faculty of the BSNursing Department

of Holy Name University

In Partial Fulfillment of the Requirements of the Subject AnaPhy 100 Anatomy and Physiology
A.Y. 2021 - 2022

Submitted to:
Lim, Alvin Miguel C, RN

Submitted by:
BSN 1 – E
Magdael, Edreign Pete G.
Aguillon, John Carlo B.
Buco, Kristine B.
Capricho, Vicre T.
Dullo, Maia Antoniette
Ewoldt, Jhoana Marie P.
Liwagon, Kieza Lahjen
Melicor, Nicole
Pinoliad, Ma. Jenevae O.
Salise, Kimberley B.
Tagab, Kendrick Jan Royd P.
Villa, Vinz Theodore S.
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Acknowledgement

The reporters’ sincere and heartfelt gratitude is given to the following people who never

failed to support, maneuver, and help the reporters until they completed the study well and

successfully.

First of all, to our Almighty God, for always being there for us and for never leaving our

side especially at times when we feel sad and confused. The reporters are grateful and thankful

for they are blessed by the Almighty God with wisdom and knowledge which are both useful in

completing this endeavor.

The Subject Professor, Mr. Lim, Alvin Miguel C, RN, who helped in every single way he

can. He helped the reporters improve their study and he guided them throughout the process. The

reporters are forever thankful for having him as a professor since he always assisted us in

everything that we do and always looked after us. The reporters would not be here if it was not

for him and for that the team is grateful.

Lastly, to the parents of the reporters, Mr. and Mrs. Magdael, Mr. and Mrs. Aguillon, Mr.

and Mrs. Buco, Mr. and Mrs. Capricho, Mr. and Mrs. Dullo, Mr. and Mrs. Ewoldt, Mr and Mrs.

Melicor, Mr and Mrs. Pinoliad, Mr and Mrs. Salise, Mr and Mrs, Tagab, and Mr and Mrs. Villa

for their unconditional love and care. The reporters are thankful for their support and the team

appreciates their assistance.

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Dedication

The researchers would like to dedicate this report study to the families and their professor

that never failed to help and support the researchers throughout the process of making this study.

The families that energized the reporters really taking shape of this study and the families that

dependably reached out their hand and helped the reporters in achieving this report paper. The

professor was the individual that kept the reporters motivated and was also the one who guided

the rerporters along the way. Also, the reporters dedicate this study to the authors of the book

entitled “Essentials of Human and Physiology”, namely Ms. Elaine N. Marieb and Ms. Suzanne

M. Keller, who helped the researchers accomplish the study by granting them the necessary

information.

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 Table of Contents
Page
Title Page ………………………………………………………………………………………. i
Acknowledgement ……………………………………………………………………………... ii
Dedication ……………………………………………………………………………………… iii
Table of Contents ……………………………………………………………………………… iv

Chapter

1 BODY MEMBRANES ………………………………………………………….... 1 - 3

a. Epithelial Membranes ……………………………………………………… 1 - 2
b. Connective Tissue Membranes ………………………………………….…… 2
c. Reference Pictures ……………………………………………………………. 3
2 INTEGUMENTARY SYSTEM ………………………………………………... 4 – 18
a. Functions ……………………………………………………………………... 4
b. Structure of the Skin ………………………………………………………. 4 – 6
c. Wrinkles ……………………………………………………………………... 6
d. Skin Color …………………………………………………………………... 7 – 8
e. Appendages of the Skin ………………………………………………...… 8 - 10
f. Homeostatic Imbalances of the Skin …………………………………… 10 – 13
g. Reference Pictures ………………………………………………………. 14 – 18
3 DEVELOPMENTAL ASPECTS OF THE SKIN AND THE BODY ……… 19 - 23
a. Homeostatic Relationship ………………………………………….……. 22 -23
4 SUMMARY ……………………………………………………………….…… 24 - 27
a. Body Membranes ………………………………………………………... 24 -25
b. Integumentary System …………………………………………………... 25 - 27
c. Developmental Aspects of the Skin and the Body Membranes ………...... 27
5 REFERENCES …………………………………………………………………… 28

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CHAPTER 1
BODY MEMBRANES
- Bodily membranes form protective (and often lubricating) films around organs, as well as
covering surfaces and lining body cavities.
There are two types of membranes:
- Epithelial membranes, which include cutaneous, mucous, and serous membranes
- Connective tissue membranes, which include synovial membranes.

 The cutaneous membrane, often known as the skin or integumentary system, is the
protective outer layer that we all rely on. The skin will receive the majority of our focus
in this chapter, but we'll start with the other body membranes.

EPITHELIAL MEMBRANES
The cutaneous membrane (skin), mucous membranes, and serous membranes are
epithelial membranes, often known as covering and lining membranes. However, referring to
these membranes as "epithelial" is deceptive because it does not convey the whole story.
Although they all do contain an epithelial layer, it is always coupled with a connective tissue
layer beneath it. As a result, these membranes are merely basic organs.

Key information about Epithelial Membranes:

- Composed of epithelium that attached to a layer of connective tissue
- Comprised of epithelial tissue and connective tissue
- Serve as linings and covering for various body structures and they also form glands
Consists of four types:
- Cutaneous Membrane
- Serous Membrane
- Mucous Membrane
- Synovial Membrane

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CUTANEOUS MEMBRANE
The superficial epidermis and the underlying dermis are the two layers that make up the
cutaneous membrane. The epidermis is predominantly dense (fibrous) connective tissue, while
the dermis is mostly stratified squamous epithelium. The cutaneous membrane is a dry
membrane that is exposed to air, unlike other epithelial membranes.
- Commonly known as skin or integumentary system
- A kind of membrane that covers body surface
- Consists of a layer of stratified squamous epithelium (epidermis) firmly attached to a
thick layer of dense connective tissue (dermis)
- Differs to other membranes because it is exposed to air and is dry

MUCOUS MEMBRANE
A mucous membrane is made up of epithelium that rests on a lamina propria, a loose
connective tissue membrane. All body cavities that open to the exterior, such as the hollow
organs of the respiratory, digestive, urinary, and reproductive tracts, are lined with this
membrane type. It's important to note that the term mucosa simply refers to the location of
epithelial membranes, not their cellular composition, which varies. Most mucosae, on the other
hand, have either stratified squamous epithelium (as in the mouth and esophagus) or simple
columnar epithelium (as in the mouth and esophagus) (as in the rest of the digestive tract). They
are all moist membranes that are almost continuously bathed in secretions or urine in the case of
the urinary mucosae.
Mucosae epithelium is frequently adapted for absorption or secretion. Mucus is secreted
by many mucosae, but not all of them. The mucosae of the respiratory and digestive tracts
secrete a lot of protective, lubricating mucus; the urinary tract mucosae do not.

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 - Consist of epithelial tissue (usually stratified squamous or simple columnar epithelia) on
a layer of loose connective tissues called the lamina propria (from the Latin, meaning
one’s own layer)
- The mucosae line the body cavities that open to the exterior, such as the digestive,
respiratory, reproductive and urinary tracts.
- These membranes are kept moist by bodily secretions.

SEROUS MEMBRANES
A serous membrane, also known as a serosa, is made up of a thin layer of areolar
connective tissue and a layer of simple squamous epithelium. Serous membranes line body
cavities that are closed to the outside, as opposed to mucous membranes, which line open body
cavities (except for the dorsal body cavity and joint cavities).
The membranes of the serous glands are found in pairs. The parietal layer lines a specific
portion of the ventral body cavity's wall. The visceral layer, which covers the outside of the
organ(s) in that cavity, folds in on itself.
Pushing your fist into a limp balloon only partially filled with air can help you visualize
the relationship between the serosal layers. The visceral serosa clinging to the organ's external
surface is comparable to the section of the balloon that clings to your fist. The parietal serosa that
lines the cavity walls is represented by the balloon's outer wall. Unlike the balloon, the parietal
serosa is never exposed and is always fused to the cavity wall.
The serous layers in the body are separated by a small amount of thin, clear fluid termed
serous fluid, which is secreted by both membranes. Despite the fact that there is a possible space
between the two membranes, they tend to be fairly nearby. As the organs carry out their usual
activities, the lubricating serous fluid permits them to glide effortlessly across the cavity walls
and one another without friction. When it comes to movable organs like the pumping heart and
expanding lungs, this is critical.
The names of the serous membranes are determined by their location. The peritoneum is
the serosa that lines the abdominal cavity and covers its organs. The lungs and heart are
separated in the thorax by serous membranes. Pleurae are the membranes that surround the lungs,
while the pericardia are the membranes that surround the heart.
- Consist of simple squamous epithelium (a mesothelium supported by a layer of
connective areolar tissue)
- These moist membranes lines the closed, internal divisions of the ventral body cavity
The three types of serous membranes are:
1. The pleura – lining the pleural cavities and covering the lungs
2. The peritoneum – lining the peritoneal cavity and covering the abdominal organs

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 3. The pericardium – lining the pericardial cavity and covering the heart
CONNECTIVE TISSUE MEMBRANES
Synovial membranes are made up of loose connective tissue and do not contain any
epithelial cells. These membranes offer a smooth surface and release a lubricating fluid in the
fibrous capsules that surround joints. They also line bursae, which are tiny connective tissue
sacs, and tendon sheaths, which are tube-like tendon sheaths. During muscular activity, such as
the passage of a tendon across the surface of a bone, both of these structures cushion organs
moving against each other.
Key information:
- Is the most common and diversified type of tissue
- Tissue that supports, protects and gives structure to other tissues and organs in the body
Three main components:
- Cells
- Protein fibers
- Ground substance
Synovial Membrane
- Include no epithelial cells and are made up of loose areolar connective tissue
- These membranes line the fibrous capsules surrounding joints where they provide a
smooth surface and secrete a lubricating fluid

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 CHAPTER 2
INTEGUMENTARY SYSTEM

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 Because it maintains water and other valuable molecules in the body, the skin is
absolutely essential. It also keeps excess water (as well as other undesirables) out. (This is why
you can go swimming for hours without getting wet.) The skin is a miracle in terms of structure.
It's malleable but robust, allowing it to withstand constant abuse from outside forces. We would
swiftly succumb to infection and expire from a lack of water and heat if we didn't have skin.
The integumentary system refers to the skin and its appendages (sweat and oil glands,
hair, and nails). Let's take a look at the anatomy and function of this body system that is often
underappreciated.

FUNCTIONS
The integumentary system, often known as the integument, or simply “covering,” has a
range of tasks, the majority of which are protective in nature. It protects the entire body from
mechanical (bumps and wounds), chemical (acids and bases), thermal (heat and cold), ultraviolet
(UV) radiation (in sunshine), and germs by insulating and cushioning the deeper body organs. To
help prevent water loss from the body surface, the uppermost layer of the skin is hardened.
The rich capillary network and sweat glands (both controlled by the nervous system) on
the surface of the skin play a significant role in controlling heat loss. Sweating works as a mini-
excretory system, releasing urea, salts, and water. The skin is a chemical plant that produces
many proteins that are crucial for immunity as well as vitamin D. (Sunlight converts modified
cholesterol molecules in the skin to vitamin D.) The acid mantle, which protects the skin from
bacterial invasion, is made up of acidic secretions.
Key information about its functions:

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 - It insulates and cushions the deeper body organs
- Protects the entire body from mechanical damage such as: bumps and cuts
- Protects from chemical damage such as: acids and bases
- Protects from thermal damage which includes: heat and cold
- Protects from ultraviolet (UV) radiation (in sunlight) and also from microbes

STRUCTURE OF THE SKIN

The skin is made up of two types of tissue, as previously stated. The stratified squamous
epithelium of the outer epidermis is capable of becoming hard and tough. Dense connective
tissue makes up the majority of the underlying dermis. The epidermis and dermis are inextricably
linked, and the dermis is relatively tear resistant. A burn or friction (such as rubbing against a
poorly fitting shoe) can cause them to separate, enabling interstitial fluid to collect in the space
between the layers, resulting in a blister.
The subcutaneous tissue, or hypodermis, is adipose (fat) tissue that lies beneath the
dermis. Although it is not considered part of the skin, it anchors the skin to the underlying organs
and serves as a nutrient storage place. The deeper tissues are protected by subcutaneous tissue,
which acts as a shock absorber and insulates them from excessive temperature changes outside
the body. It's also in charge of the curves that are more prominent in a woman's anatomy than in
a man.
Key information about the skin’s structure:
- The skin is subdivided into two parts, namely, Epidermis and Dermis
EPIDERMIS
The majority of cells in the epidermis are keratinocytes (keratin cells), which create
keratin, Keratinocytes are highly specialized. They play an essential role in protection, as they
form a tight barrier that prevents foreign substances from entering the body, while minimizing
the loss of moisture, heat, and other constituents. Keratinocytes are interconnected throughout
the epidermis. Because it lacks its own blood supply, the epidermis is likewise avascular. For
example, even if he tears off numerous cell layers each time he shaves, a man can shave every
day and not bleed.
The stratum Basale, spinosum, granulosum, lucidum, and corneum (excluding the
stratum lucidum, which is only found in thick skin) are the five layers or strata that make up
the epidermis.
The stratum Basale is the epidermis' deepest cell layer, located closest to the dermis and
connected to it by a wavy boder that looks like corrugated cardboard. Because nutrients diffusing
from the dermis reached the bottom layer first, it contained the best-nourished epidermal cells.
The layer's stem cells are constantly dividing, and millions of new cells are produced every day,
earning it the nickname "stratum germanitivum" (germinating layer). Some of the newly formed
cells differentiate into epidermal cells, while others divide to maintain the stem cell population.

7
The epidermal cells are forced higher, away from the source of sustenance, to form part of the
epidermal layers closer to the skin surface. They become flatter and more keratinized as they
travel away from the dermis and into the more superficial layers, the stratum spinosum and
eventually the stratum granulosum. These cells die when they leave the stratum granulosum,
resulting in the formation of the clear stratum lucidum.
The later epidermal layer is not found in all areas of the skin. It only appears on the
palms of the hands and the soles of the feet, where the skin is hairless and extremely thick.
The stratum corneum is the topmost layer of the skin. It has 20-30 layers and makes up
roughly three-quarters of the epidermal thickness. Cornified, or borny, cells are shingle-like dead
cell remnants that are entirely packed with keratin.
The stratum corneum's presence of strong keratin protein permits it to deliver a long-
lasting alarm and active immune system cells to threats such as bacterial or viral invasion.
DERMIS
Between the epidermis and the subcutaneous tissue is the dermis, a connective tissue
layer. The dermis is a fibrous structure that contains vasculature, nerve endings, hair follicles,
and glands. It is made up of collagen, elastic tissue, and other extracellular components. The
dermis' function is to maintain and protect the skin's deeper layers, as well as to help with
thermoregulation and feeling. The dermis' primary cells are fibroblasts, but histiocytes, mast
cells, and adipocytes also play key roles in maintaining the dermis' normal shape and function.
The papillary dermis and the reticular dermis are the two layers that make up the
dermis. The papillary dermis is a superficial layer that lies under the epidermis and is deeper than
the epidermis. The papillary dermis is made up of vascularized loose connective tissue. The deep
layer is the reticular layer, which is made up of a thick layer of dense connective tissue that
makes up the majority of the dermis.

A WRINKLE OUT OF TIME

WRINKLES
Also known as ‘Rhytides’, are the lines and creases that form in your skin. Some
wrinkles can become deep crevices or furrows and may be especially noticeable around your
eyes, mouth and neck.
Skin loses elasticity as we age because collagen production slows down over time. This
process can be exacerbated by a variety of factors, including sun exposure, pollution and
certain lifestyle habits. And as you get older, your skin tends to become thinner and drier or
your skin doesn’t have much moisture as it used to, it can also make it more prone to have
wrinkles.

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PREVENTION
1. Must have a good gene
2. Avoid smoking
a. Smoking ages the skin by increasing production of an enzyme that destroys
collagen. Collagen supports the skin and keeps the skin hydrated, so with less of
it, wrinkles appear.
3. Use a good sunscreen
a. Too much unprotected exposure to the sun or tanning beds leads to UV radiation
damage, which causes elastic fibers to clump, resulting in leathery skin.
4. Think pleasant thoughts allows for the relaxation of our facial muscles which helps in
preventing wrinkles
BOTOX COSMETIC
Also known as ‘Botulinum Toxin Type A’, is a neurotoxin produced by the bacterium
that causes botulism, a deadly form of food poisoning. Botox Cosmetic was approved in 1989 to
treat two eye muscle disorders;
 Uncontrollable Blinking (Blepharospasm) - is a rare condition that causes your
eyelid to blink or twitch. (Refer to page 15, figure 1)
 Misaligned Eyes (Strabismus) - is a condition in which the eyes do not line up
with one another. (Refer to page 15, figure 2)
The discovery that Botox could be used cosmetically, physician using the toxin to counter
abnormal eye contractions noticed that frown lines between the eyes had softened. The Botox is
a new tool to fight wrinkles having effects that last 3-6 months.
However, the usage of Botox has some risks included. If too much toxin is injected, a
person can end up with droopy eyelid muscles or temporary weakness for weeks and the toxin
can spread to nearby tissues.
SKIN COLOR
There are three pigments that contribute to skin color. These pigments refer to melanin,
carotene, and hemoglobin.
MELANIN
Melanin content and kind (yellow, reddish brown, or black) in the epidermis. Sunlight
causes melanocytes in the skin to create more melanin pigment, resulting in skin tanning.
Melanin accumulates in the cytoplasm of melanocytes in membrane-bound granules called
melanosomes as they make it. These granules subsequently go to the melanocytes' spidery arms'
ends, where they are picked up by neighboring keratinocytes. Melanin forms a pigment umbrella
over the surface, or "sunny," side of keratinocyte nuclei, protecting their genetic material (DNA)
from the destructive effects of UV rays in sunlight. Brown-toned skin is produced by those who
create a lot of melanin, whereas light-toned skin is produced by persons who produce less
melanin.
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CAROTENE
Carotene levels in the stratum corneum and subcutaneous tissue. (Carotene is an orange-
yellow pigment found in many orange, deep yellow, and lush green foods.) The skin of persons
who consume a lot of carotene-rich meals has a yellow-orange tint to it.
HEMOGLOBIN
In the dermal blood arteries, the amount of oxygen-rich hemoglobin (pigment in red
blood cells). The crimson color of oxygen-rich hemoglobin in the dermal blood supply flushes
through the translucent cell layers above, giving the skin a rosy glow in light-skinned people.
HOMEOSTATIC IMBALANCE
Cyanosis is a disorder in which hemoglobin is inadequately oxygenated, causing both the
blood and the skin of light-skinned persons to appear blue. Cyanosis is common in those who
have heart failure or have significant breathing problems. Because of the masking effects of
melanin, dark-skinned people's skin does not seem cyanotic in the same settings, but cyanosis is
visible in their mucous membranes and nail beds.
Emotions have an impact on skin color, and various changes in skin color indicate
disease states:
1. Redness, or erythema. Reddened skin may indicate embarrassment (blushing), fever,
hypertension, inflammation, or allergy.
2. Pallor, or blanching. Under certain types of emotional stress (fear, anger, and
others), some people become pale. Pale skin may also signify anemia, low blood
pressure, or impaired blood flow into the area.
3. Jaundice, or a yellow cast. An abnormal yellow skin tone usually signifies a liver
disorder in which excess bile pigments accumulate in the blood, circulate throughout
the body, and become deposited in body tissues.
4. Bruises. The black-and-blue marks of bruising reveal sites where blood has escaped
from the circulation and has clotted in the tissue spaces. Such clotted blood masses
are called hematomas. An unusual tendency to bruise may signify a deficiency of
vitamin C in the diet or hemophilia (bleeder’s disease).

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 APPENDAGES OF THE SKIN
- Cutaneous glands, hair and hair follicles, and nails are examples of skin appendages.
- Each of these appendages develops from the epidermis
- Has a distinct role in body homeostasis.
CUTANEOUS GLANDS
- Cutaneous glans refer to all exocrine glands that release their secretions to the skin
surface via ducts.
- These glands are formed by the cells of the stratum Basale and pushed into the deeper
skin regions and ultimately reside almost entirely in the dermis.
Furthermore, it is subdivided into two groups namely Sebaceous glands and Sweat glands.
 Sebaceous glands are oil glands that are found all over the skin (excluding the palm of the
hands and sole of the feet).
o Sebum
- Refers to a mixture of oil substance and fragmented cells.
- It is a lubricant that keeps the skin soft and moist
- prevents the hair from becoming brittle
- Contains a chemical that deals bacteria that causes bacterial infections on skin.
o Androgens (male sex hormones)
- Increases in production during adolescences which makes the sebaceous glands active
and skin tends to be oilier during this period.
- In the occurrence of which the sebaceous gland ducts are blocked by sebum acne appears
on the surface.
- Acne is an active infection of the sebaceous glands. Can be mild or extremely severe,
leading to permanent scarring.
- Blackheads tend to appear if the accumulated material oxidizes, dries, and darkens.
- Whiteheads appear if the accumulated material doesn’t dry and darken.
- Seborrhea (fast-flowing sebum), also known as “cradle caps” in infants, is caused by the
overactivity of sebaceous glands that begins on the scalp as pink, raised lesions that
gradually form a yellow-to-brown crust that sheds off oily scales and dandruff.

 Sweat glands also called sudoriferous (sudor =sweat) glands

- Widely distributed in the skin staggering- more than 2.5m per person.
There are two types of sweat glands:
- Eccrine glands
- Apocrine glands

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 o Eccrine glands
- are far more numerous and are found all over the body
- This gland is known to produce sweats.
 Sweat is clear secretion that is primarily water plus salts (sodium
chloride), Vitamin C, traces of metabolic wastes (ammonia, urea, uric
acid), and lactic acid (chemical that accumulates during vigorous muscle
activity). It is likely acidic (pH from 4 to 6), inhibits the growth of bacteria
which are present on skin surfaces. It reaches the ducts that opens
externally as funnel-shaped sweat pore.
o Apocrine glands
- Are glands that are largely confined to the axillary (armpit) and genital areas of the body
- These glands are larger than eccrine glands and its ducts empty into hair follicles.
 Secretion contains u, proteins and all substances present in eccrine sweat
which consequently may have milky or yellowish in color. This gland is
known to have odorless secretions, however, when bacteria is living on the
skin that use proteins and fats as a source of nutrients, these glands can
take on musky and sometimes unpleasant odor.
 It is important to note that apocrine glands begin to function during
puberty under the androgens influence. They are activated by nerve fibers
during pain, stress, and during sexual arousal.
HAIR AND HAIR FOLLICLES
 HAIR
- An important part of the body that plays a big role in our body image.
- Millions of hairs are produced by hair follicles are found all over the body excluding the
palm of the hands, soles of feet, nipples and lips.
- Humans are born as many hair follicles they will ever have and hairs are among the fast-
growing tissues.
Protective functions
- It safe-guards the head against bump.
- It shields the eyes (eyelashes)
- It helps keep the foreign particles out of the respiratory tracts (nasal hair).
- Helps attract sexual partners.
- Hormones account for the development of hairy regions.
- Hair served early humans and animals by providing insulation to cold weathers.
Structure
- Hairs, described explicitly, are a flexible epithelial structure.
- It contains the roots, which is the part of the hair enclosed in the hair follicle, and the
shaft, which refers to the part projecting from the surface of the scalp or skin.

12
 o Hair forms by division of well-nourished stratum Basale epithelial cells in the
matrix (growth zone) of the hair bulb at the deep end of the follicle. Daughter
cells becomes keratinized and die when they are being pushed farther away the
growing regions. Thus, the bulk of the hair shaft is dead materials and almost
entirely proteins.
o Each hair is made up of a central core called medulla, consisting of large cells and
air spaces, surrounded by bulky cortex layer composed of several layers of
flattened cells. The cortex, enclosed by an outermost cuticle formed by a single
layer cell that overlap one another like shingles on a roof. This arrangement helps
keep the hairs apart and keeps them from matting.
o Hair pigment is made by melanocytes in the hair bulb, and varying amounts of
different types of melanin: yellow, rust, brown, black – combined to produce all
varieties of hair color from pale blond to red to pitch black.
Hair comes from different sizes and shapes
- Hair shaft is oval, hair is smooth, silky, and wavy.
- Hair shaft is flat and ribbonlike, the hair is curly or kinky.
- Perfectly round, the hair is straight and tends to be coarse.

 CUTICLE
- This refers to the most heavily keratinized region which provides strength
- Helps keep the inner hair layers tightly compacted.
- Subject to abrasion because cuticles tend to wear away at the tip of the shaft, allowing
keratin fibrils in the inner regions to frizz out, the phenomenon is called “split ends”.

 HAIR FOLLICLES
o Hair follicles are compound structures.
- The inner epithelial root sheath is composed of epithelial tissue and forms the hair.
- The outer fibrous sheath is actually dermal connective tissue. This dermal region
supplies blood vessels to the epidermal portion and reinforces it.
- Its nipple-like hair papilla provides the blood supply to the matrix in the hair bulb (the
deepest part of the follicle).
NAILS
- Nails are scale like modification of the epidermis that corresponds to the hoof or claw of
other animals.
- Each of which have a free edge, a body, (visible attached portion), the root (embedded
in the skin).
- Nail folds refer to the borders of the nails that are overlapped by the folds of the skin
- Cuticles are the edge of the thick proximal nail folds.

13
 - The stratum Basale of epidermis extends beneath the nails as the nail beds.
- Its thickened proximal area, nail matrix is responsible for nail growth.
- The matrix produces nail cells, they become heavily keratinized and die.
- Thus, nails like hairs, are mostly nonliving material.
- Nails are transparent and nearly colorless, but they look pink because of the rich blood
supply in the underlying dermis.
- The exception to this is the region over the thickened and nail matrix that appears as a
white crescent and is called the lunule (lunul = crescent).
- When the supply of oxygen in the blood is low the nail beds take on a cyanotic (blue)
cast.

HOMEOSTATIC IMBALANCES OF THE SKIN

- Loss of homeostasis in human cells and organs manifests itself on the skin in unexpected
ways.
- More than 1,000 different diseases can affect the skin.
- Infections with pathogens such as bacteria, viruses, or fungi are the most frequent skin
illnesses.
- Allergies, which are characterized by abnormally powerful immune reactions, are
frequently observed on the skin.
- Burns and skin cancers are less common but significantly more dangerous to one's health.
INFECTIONS AND ALLERGIES
Infections and allergies cause the following commonly occurring skin disorders:
 Athlete's foot is a condition that affects athletes
- An infection with the fungus Tinea pedis causes an itchy, red, peeling condition of the
skin between the toes.
 Boils and carbuncles.
- Inflammation of hair follicles and surrounding tissues causes boils, which most typically
occur on the dorsal neck.
- Carbuncles are clumps of boils caused by the Staphylococcus aureus bacteria.
 Cold sores (fever blisters).
- Small fluid-filled blisters that itch and sting, caused by human herpesvirus 1 infection.
- The virus localizes in a cutaneous nerve, where it remains dormant until activated by
emotional upset, fever, or UV radiation.
- Cold sores usually occur around the lips and in the oral mucosa of the mouth and nose.
(Refer to page 17, figure a)
 Contact dermatitis.
- Itching, redness, and swelling of the skin, with blistering as a result.
- It is caused by the skin being exposed to chemicals (such as those found in poison ivy)
that trigger allergic reactions in sensitive people.

14
  Impetigo.
- Pink, fluid-filled, elevated lesions that acquire a yellow crust and eventually explode
(often around the mouth and nose).
- Impetigo is a highly contagious infection caused by staphylococcus or streptococcus
bacteria.
- It is frequent in primary school–aged children. (Refer to page 17, figure b)
 Psoriasis.
- Reddened epidermal lesions coated in dry, silvery scales that itch, burn, crack, and even
bleed are the hallmarks of this condition.
- Psoriasis is a chronic ailment that is thought to be an autoimmune disorder in which a
person's immune system assaults their own tissues, causing rapid overproduction of skin
cells.
- Trauma, infection, hormonal changes, and stress are all common triggers for attacks.
- Psoriasis can be disfiguring when it is severe. (Refer to page 17, figure c)
BURNS
- Burns are one of the most dangerous dangers to life.
- A burn is tissue damage and cell death caused by high temperatures, electricity,
ultraviolet light (sunburn), or certain chemicals (such as acids), which denature proteins
and induce cell death in the afflicted areas.
Two life-threatening complications arise when the skin is burned and its cells are damaged. First,
without an intact boundary, the body loses its valuable supply of protein and electrolyte-
containing fluids, which seep from the charred surfaces. Dehydration and electrolyte imbalance
ensue, which can result in kidney failure and vascular shock (inadequate circulation of blood
caused by low blood volume). Lost fluids must be replenished as soon as possible to save the
patient. The volume of fluid lost can be determined indirectly by utilizing the law of nines to
determine how much of the body surface is burned (extent of burns). This method divides the
body into 11 regions, each accounting for 9% of total body surface area, plus a perineum area
surrounding the genitals that accounts for 1% of total body surface area.
Burns are classed as first-degree (superficial), second-degree (superficial partial-
thickness burns), third-degree (full-thickness burns), or fourth-degree (full-thickness burns)
depending on their severity (depth) (full-thickness burns with deep-tissue involvement). Only the
surface epidermis is affected in first-degree burns. The affected area becomes bloated and red.
First-degree burns
- Usually not dangerous, causing just minor discomfort, and they heal in two to three days.
- A first-degree burn is one that does not blister.

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Second-degree burns
- The epidermis and the superficial section of the dermis are injured.
- The skin is blistered, red, and painful.
- Regrowth (regeneration) of the epithelium is possible because adequate numbers of
epithelial cells are still present.
- If precautions are followed to avoid infection, there are usually no permanent scars.
Third-degree burns
- Are full-thickness burns because they destroy both the epidermis and the dermis
- Frequently extend into the subcutaneous tissue.
- The burned region is generally covered with blisters and appears blanched (gray-white)
or blackened.
- The burned area is not painful since the nerve endings in the area have been destroyed.
- Regeneration is not possible in third-degree burns;
- Thus, skin grafting is required to cover the exposed structures beneath.
Fourth-degree burn
- Are full-thickness burns that extend into deeper tissues like bone, muscle, or tendons.
- These burns look to be dry and leathery, requiring surgery and grafting to cover exposed
tissue.
- Amputation may be required in severe circumstances to save the patient's life.
In general, burns are considered critical if any of the following conditions exists:
 Over 30 percent of the body has second degree burns.
 Over 10 percent of the body has third- or fourth-degree burns
 There are third- or fourth-degree burns of the face, hands, feet, or genitals
 Burns affect the airway
 Circumferential (around the body or limb) burns have occurred
Burns on the face are especially dangerous because they can create burns in the respiratory
airways, which can enlarge and cause asphyxia. Joint injuries are problematic because the scar
tissue that grows as a result of the injury can drastically restrict joint movement. Circumferential
burns can limit movement and, depending on where they occur, can obstruct regular respiration.
SKIN CANCER
- The most frequent type of cancer in humans.
- Skin cancer currently affects one out of every five Americans at some time in their lives.
- Overexposure to UV radiation from the sun and tanning beds is the most significant risk
factor.
- Infections, toxins, or physical damage that irritate the skin frequently appear to be a risk
factor.

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 Let's look at the three most frequent types of skin cancer:
- Basal cell carcinoma
- Squamous cell carcinoma
- Malignant melanoma in further depth
Basal Cell Carcinoma Basal cell carcinoma
- Is the most common and least malignant type of skin cancer
- The barrier between the epidermis and the dermis is no longer respected by cells of the
stratum Basale, which have been changed so that they can no longer generate keratin.
- They spread throughout the dermis and subcutaneous tissue, proliferating.
- The malignant lesions most commonly show as shiny, dome-shaped nodules that develop
into a core ulcer with a "pearly" beaded edge on sun-exposed parts of the face.
- Basal cell carcinoma is a slow-growing cancer that rarely spreads before the patient
notices it. 99 percent of cases are totally cured when the lesion is surgically removed.
(Refer to page 18, figure a)
Squamous Cell Carcinoma Squamous cell carcinoma
- Develops from the stratum spinosum's cells.
- Scaly, colored papules (small, spherical swellings) develop into shallow ulcers with firm,
elevated borders as the lesions progress.
- This type of skin cancer most commonly affects the scalp, ears, backs of hands, and
lower lip, although it can affect any part of the body.
- If not removed, it develops quickly and spreads to nearby lymph nodes.
- UV radiation is also thought to be a cause of epidermal cancer.
- The chances of a complete cure are favorable if it is identified early and treated surgically
or with radiation therapy. (Refer to page 18, figure b)
Malignant Melanoma
- Is a cancer of melanocytes
- It accounts for just approximately 5% of all skin malignancies, although it is frequently
fatal.
- Melanoma can start anywhere there is pigment; most of these malignancies appear on
their own, but some are caused by pigmented moles.
- It develops as a developing brown to black spot that quickly spreads to adjacent lymph
and blood arteries as a result of cumulative DNA damage in a skin cell.
- The chance of survival is around 50%, and early detection is beneficial.
- People who sunbathe frequently or go to tanning salons should check their skin for new
moles or pigmented patches on a regular basis, according to the American Cancer
Society, and use the ABCDE rule to identify melanoma: (Refer to page 18, figure c)

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  (A) Asymmetry. Any two sides of the pigmented spot or mole do not match
 (B) Border irregularity. The borders of the lesion are not smooth but exhibit
indentations.
 (C) Color. The pigmented spot contains areas of different colors (black, brown,
tan, and sometimes blue or red).
 (D) Diameter. The lesion is larger than 6 millimeters (mm) in diameter (the size
of a pencil eraser).
 (E) Evolution. One or more of these characteristics (ABCD) is evolving, or
changing.
Wide surgical excision combined with immunotherapy, a treatment that includes the
patient's immune system, is the standard treatment for malignant melanoma. Following surgical
excision of large lesions, radiation or chemotherapy may be required.

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(1) (2)

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 CHAPTER 3
DEVELOPMENTAL ASPECTS OF SKIN AND BODY MEMBRANES

FETUS DEVELOPMENT: 5TH AND 6TH MONTH

 Lanugo
o The hairy “cloak” of the fetus that covers the body except on the palms, lips, and
soles of the feet.

o
 Vernix caseosa
o An oily coating or white cheesy- looking substance produced by the fetus’s
sebaceous glands.
o Vernix coating on the neonatal skin protects the newborn skin and facilitates
extra-uterine adaptation of skin in the first postnatal week if not washed away
after birth.

o
 Milia
o Small white bumps on the skin of the newborn babies, resulting from
accumulations of sebaceous gland material. It appears across baby’s cheeks, nose
or chin.

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 o

DURING ADOLESCENCE
 Acne
o A common consequence of acceleration of sebaceous glands activity.
o The pores of the skin are clogged with hair, oily substance, air pollutants and
bacteria thus making the hair and skin appear to be oilier.

o
 Dermatitis
o A skin inflammation occurs to be a reaction to an allergen or irritant, such as
abrasion, chemicals, wind and sun.

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DURING OLD AGE
 Cold Intolerance
o Reflects the decrease of insulation subcutaneous tissue.

o
 Drier Skin
o The decrease of oil production and loss of hormones which may become itchy and
bothersome.

o
 Thinning of the skin
o One of the results of aging process that makes it more vulnerable to bruising and
other types of injuries.

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  Bags to form under our eyes and jowls to sag
o The decrease elasticity of the skin along with decreasing subcutaneous fat.

o
 Hair loss.
o Luster with age and at the age of 50 the number of hair follicles decreases
resulting in badness, or alopecia.

- With advancing age, these functions are increasingly impaired.

- Changes occur in the epidermis, dermis and hypodermis leading to thin, dry and sagging
skin, while loss of structure and integrity diminishes the skin's ability to protect the body
and detect changes in temperature and pressure.
- Vernix caseosa is a naturally occurring, complex, lipid-rich substance covering the skin
surface of the fetus in the last trimester of pregnancy, produced in part by fetal sebaceous
glands.

HOMEOSTATIC RELATIONSHIP
The Integumentary System serves all the others system by providing as the physical
barrier against environmental hazards and foreign objects.
 Endocrine System
- The skin protects the endocrine organs. Vitamin D3 has a hormone-like effect.

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- At puberty, sex hormones cause changes in integumentary features, and some hormone
imbalances can cause skin problems.
 Lymphatic System/ Immunity
- Foreign compounds are detected by dendritic cells.
- The lymphatic system regulates fluid balance and helps to prevent edema.
- Immune cells defend the skin from infection and aid in tissue regeneration.
 Digestive System
- Calcium absorption is aided by vitamin D production in the intestine.
- Nutrients required for integumentary development and function; nutritional deficiencies
are frequently manifested in the look of skin, hair, and nails.
 Urinary System
- The urinary system is supplemented by the skin, which excretes salts and certain
nitrogenous wastes in sweat.
- Waste is disposed of, and electrolyte and pH equilibrium are maintained.
 Muscular System
- Skin absorbs heat created by muscles
- Vitamin D production enhances calcium absorption, which is required for muscle
contraction.
 Nervous System
- Skin sensory impulses are transferred to the neurological system.
- Regulates cutaneous blood vessel diameter promotes sweating and piloerector muscle
contraction.
 Respiratory System
- Skin protects respiratory organs.
- Provides oxygen and removes carbon dioxide.
 Cardiovascular System
- Skin protects cardiovascular organs.
- It also serves as blood reservoir.
- Provide substances that is needed by skin glands to make secretion.
 Reproductive System
- Cutaneous receptors respond to erotic stimuli
- Mammary glands provide milk to feed infants
- Apocrine glands generate odors that have minor sexual functions skin growth,
maturation, and maintenance are aided by gonadal sex hormones.
 Skeletal System
- The skin protects the bone.
- Supports the skin on the scalp and other parts of the body when the bone is close to the
surface.
- The skin's role in vitamin D synthesis aids calcium absorption, which is necessary for
bone formation and maintenance.

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 CHAPTER 4
SUMMARY

BODY MEMBRANES
 What is Body Membrane
o Body membranes are thin sheets of tissue that cover the body, line body cavities,
and cover organs within the cavities in hollow organs.
 Types and Functions of each Main Membrane
o Epithelial membranes are formed from epithelial tissue attached to a layer of
connective tissue, while the connective tissue membrane is formed solely from
connective tissue. These membranes encapsulate organs, such as the kidneys, and
line our movable joints.
 Types of Body Membrane
o Epithelial Membranes – consist of epithelial tissue and the connective tissue to
which it is attached.
 Parts of Epithelial Membranes
 Mucous Membranes - The moist, inner lining of some organs and
body cavities (such as the nose, mouth, lungs, and stomach).
Glands in the mucous membrane make mucus (a thick, slippery
fluid). Mucous membranes protect the inside parts of your body
that are exposed to air, in a similar fashion to how your skin
protects your external body. Mucous membranes are rich with
mucous glands that secrete mucus to help keep the membranes
moist.
 Serous Membranes - Serous membranes line and enclose several
body cavities, known as serous cavities, where they secrete a
lubricating fluid to reduce friction from muscle movements. Serosa
is not to be confused with adventitia; a connective tissue layer that
binds together structures rather than reduces friction between them.
 Cutaneous Membrane - Cutaneous membrane covers the surface
of the body and consists of stratified squamous epithelium and the
underlying connective tissues. The outer layer of skin (epidermis)
protects the body from invading microorganisms, and the
underlying connective tissue layer (dermis) contains the majority
of the skin appendages.
o Connective Tissue Membranes - The connective tissue membrane is formed
solely from connective tissue. These membranes encapsulate organs, such as the
kidneys, and line our movable joints.
 Parts of Connective Tissue Membranes

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  Synovial Membranes - A synovial membrane is a type of
connective tissue membrane that lines the cavity of a freely
movable joint.

 Why Body Membranes are Important

- It provides an external covering for the body
- Keeps water and other fluids inside the body
- Provides a waterproof barrier, insulates deeper body organs
- Protects the body from bumps and cuts, chemical damage, heat and cold, sunlight, and
bacteria.

INTEGUMENTARY SYSTEM
The Skin and the entire Integumentary System is an essential body part and system
because it keeps water and other precious molecules in the body, likewise it also keeps excess
water and other unnecessary matters out. The Integumentary System is composed of the skin and
its appendages (sweat and oil glands, hair, and nails).
The skin is structured incredibly, it is pliable yet tough, which permits it to take constant
punishment from the external environment. Without our skin, we would quickly fall prey to
bacteria and perish from water and heat loss.
 Functions of the Integumentary System
o Protecting the deeper tissue from
 Mechanical Damage (Bumps, scratches and other physical damage)
 Chemicals Damage
 Microbe Damage (such as bacteria, virus and other pathogens)
 UV radiations
 Drying
o Regulating body temperature through radiation and sweating;
o Aids in excretion of urea and uric acid
o Synthesizing defensive proteins and vitamin D.
o Sensory receptors are located in the skin.
 The Epidermis
o It is the superficial part of the skin
o Is stratified squamous keratinized epithelium and is avascular
o Its layers from superficial to deep are:
 Stratum Corneum
 Stratum Lucidum (In Thick Skin Only)
 Stratum Granulosum
 Stratum Spinosum
 Stratum Basale.

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 o Cells at its surface are dead and continually flake off. They are replaced by
dividing cells in the basal cell layer. As the cells move away from the basal layer,
they accumulate keratin and die.
o Melanin, a pigment produced by melanocytes, protects the nuclei of epithelial
cells from the damaging rays of the sun.
 The Dermis is dense connective Tissue
o It contains the following
 Blood vessels
 Nerves
 Epidermal appendages
o It has two regions
 The papillary
 The papillary layer has ridges, which push outward on the
epidermis to produce fingerprints.
 Uneven and has peg like projections from its superior surface
called dermal papillae.
 The reticular layers
 Deepest skin layer
 Contains irregular connective tissue, blood vessels, sweat and oil
glands, and deep pressure receptor called lamellar corpuscles.
 Skin appendages are formed from the epidermis but reside in the dermis
o Sebaceous glands produce an oily product (sebum), released at a hair follicle via
a duct. Sebum keeps the skin and hair soft and contains chemicals that kill
bacteria.
o Sweat (sudoriferous) glands, under the control of the nervous system, produce
sweat, which is released at the epithelial surface. These glands participate in
regulating body temperature.
 There are two types
 eccrine (the most numerous) and;
 apocrine (their product includes fatty acids and proteins).
o A hair is primarily dead keratinized cells and is produced by the matrix in the
root of the hair bulb. The root is enclosed in a sheath, the hair follicle.
o Nails are hooflike derivatives of the epidermis. Like hair, nails are primarily dead
keratinized cells.
 Most minor afflictions of the skin result from infections or allergic responses
o Serious afflictions interfere with skin’s protective functions, thus represents a
major threat to the body. Examples are burns and skin cancer
 Burns
 Burns are result in loss of body fluids and invasion of bacteria. The
extent of burns is assessed by the rule of nines. The severity
(depth) of burns is described as first-degree (epidermal damage
only), second-degree (epidermal and some dermal injury), third-

31
 degree (epidermis and dermis totally destroyed, may involve some
subcutaneous tissue) and fourth-degree (all of skin and involves
deeper tissue such as bone or muscle). Third- and fourth-degree
burns require skin grafting.
 The most common cause of skin cancer is exposure to ultraviolet (UV)
radiation.
 Basal cell carcinoma and squamous cell carcinoma can be
completely cured if they are removed before metastasis.
 Malignant melanoma, a cancer of melanocytes, is still fairly rare
but metastasizes quickly and is fatal in about half the cases.

DEVELOPMENTAL ASPECTS OF THE SKIN AND THE BODY MEMBRANES

The skin is thick and tough that can even protect and maintain our body healthy in our
youth. As we getting old, our skin losses it’s elasticity. Too much exposure of sunlight can cause
skin cancer. Healthy diet like eating fruits and vegetables and cleaning your body every day to
slow down the process of aging. Balding and/or graying is effect by aging, it maybe also caused
by anxiety, drugs, emotional stress.

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 REFERENCES

Marieb, E. N., & Keller, S. M. (2017). Essentials of human anatomy and physiology. Pearson.

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