Principles of Anatomy and

Physiology
The
Integumentary
System

Miss Eva Alexis Ceballos, PTRP,PTA

Learning Outcomes:
Define word parts and identify common Explain how the integumentary system as a
1 abbreviations related to the integumentary 7 basis of diagnosis
system

2 Describe the general functions of the skin 8 Differentiate the types of burns and types of
cancer

Identify and describe the different parts of the

3 skin and its important functions from epidermis
to dermis
9 List the age-related changes in the
integumentary system

Explain how melanin, blood, carotene, and

4 collagen affect skin color

5 Describe the structure and function of

subcutaneous tissue

6 Name the accessory skin structures and its

functions
Skin/ Cutaneous Membrane
Largest organ of the body in weight; weighs 4.5–5 kg (10–11 lbs.), about
7% of total body weight (adults)

The integumentary system consists of the skin, hair, oil and sweat
glands, nails, and sensory receptors

The integumentary system:

❑ Helps the body maintain its temperature
❑ Stores blood
❑ Converts inactive vitamin D to its active form
❑ Provides sensory information
❑ Protects body from external environment
❑ Excretes and absorbs substances

DERMATOLOGY
Animation
 Structures of the Skin

EPIDERMIS- the most superficial layer

DERMIS- a layer deep to the epidermis

*HYPODERMIS- subcutaneous layer;

located deep to the dermis but not a
layer of the skin; composed of areolar
and adipose tissue
Components
The Epidermis
Contains four major types of cells:

Keratinocytes- 90%; produce the protein keratin

Melanocytes- 8%; produce the pigment melanin

Intraepidermal macrophage/Langerhans cells- immune

responses

Tactile epithelial cells/ Merkel disc- detect touch

sensations
Thin skin vs. Thick skin
THIN SKIN
❖ stratum basale, stratum
spinosum, stratum granulosum,
and a thin stratum corneum
❖ covers all body regions except
the palms, palmar surfaces of
digits, and soles
THICK SKIN
❖ stratum basale, stratum
spinosum, stratum granulosum,
stratum lucidum, and a thick
stratum corneum
❖ exposure to friction is greatest,
such as in the fingertips, palms,
and soles
Thin skin vs. Thick skin
 THE EPIDERMIS
o The epidermis is composed of
four layers in thin skin and five
layers in thick skin. They are (from
deep to superficial):

1. The stratum basale/germinativum

2. The stratum spinosum
3. The stratum granulosum
4. The stratum lucidum (only present in
thick skin)
5. The stratum corneum

MNEMONICS: C-L-G-S-B (Can Love Get So Boring?)

THE EPIDERMIS
THE EPIDERMIS

Keratinization and Growth of the Epidermis

❑ Keratinization
*whole process- four to six weeks in an
average epidermis of 0.1 mm (0.004 in.)
thickness
❑ Epidermal Growth Factor (EGF)
❑ Dandruff
 Clinical Connection

Psoriasis

Psoriasis is common and chronic skin

disorder in which keratinocytes divide
and move more quickly than normal
from the stratum basale to the stratum
corneum.
 The Dermis
❖ The dermis is composed of connective tissue containing collagen
and elastic fibers

❖ Blood vessels, nerves, glands, and hair follicles (epithelial

invaginations of the epidermis) are embedded in the dermal layer

Based on tissue structure, it is divided into:

Papillary region
*dermal papillae
*corpuscles of touch or Meissner corpuscles
*free nerve endings

Reticular region
-contains bundles of thick collagen fibers, scattered
fibroblasts, and various wandering cells
-Some adipose cells & along with some coarse elastic fibers
- Extensibility & Elasticity
Clinical Connection

Stretch Marks

o Striae or stretch marks- a form of internal

scarring
o initially appear as reddish streaks and later,
after scar forms at these sites of dermal
breakdown, the stretch marks appear as
silvery white streaks
o often occur in the abdominal skin during
pregnancy, on the skin of weight-lifters,
stretched skin accompanying gross obesity
 THE DERMIS
❖ The surfaces of the palms, fingers, soles, and
toes have a series of ridges and grooves.
❖ Epidermal ridges- produced during the third
month of fetal development as downward
projections of the epidermis into the dermis
between the dermal papillae of the papillary
region
❖ Because the ducts of sweat glands open on the
tops of the epidermal ridges as sweat pores, the
sweat and ridges form fingerprints (or
footprints) on touching a smooth object.
❖ The epidermal ridge pattern is in part
genetically determined and is unique for each
individual.
❖ Dermatoglyphics
 Clinical Connection

Tension Lines & Surgery

o Tension lines (lines of cleavage) in the

skin indicate the predominant direction
of underlying collagen fibers.
o Knowledge of tension lines is especially
important to plastic surgeons.
*surgical incision running parallel to the
collagen fibers will heal with only a fine scar
Skin Pigments (Structural Basis of Skin Color)
Melanin is produced by melanocytes in the stratum basale
o Pheomelanin (yellow to red)
o Eumelanin (brown to black)
*freckles
*age (liver) spots
*nevus

Hemoglobin – oxygen-carrying pigment in red blood cells

Carotene – a yellow-orange pigment stored in the stratum

corneum and adipose tissue
 Clinical Connection

Albinism

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.
 Clinical Connection

Vitiligo

Vitiligo is a chronic disorder that

causes depigmentation patches in the
skin. The precise cause, is not known,
but is most likely a combination of
genetic factors coupled with a disorder
of the immune system (autoimmune
disease).
 Clinical Connection

CYANOTIC ERYTHEMA
-skin appears bluish -redness of the skin
-blood is not picking up an
adequate amount of
oxygen from the lungs

JAUNDICE PALLOR

-due to a buildup of the -paleness of the skin, may

yellow pigment bilirubin occur in conditions such
in the skin as shock and anemia
-gives a yellowish
appearance to the skin
and the whites of the
eyes and usually
indicates liver disease
The Hypodermis
❖ The hypodermis can also be called the subcutaneous layer
and it attaches the skin to underlying tissues and organs.
 Accessory Structures of the Skin

HAIR/PILI NAILS
-present on most skin surfaces -plates of tightly packed, hard, dead,
except the palms, palmar surfaces keratinized epidermal cells that form a
of the fingers, the soles, and SKIN GLANDS clear, solid covering over the dorsal
surfaces of the distal portions of the
plantar surfaces of the feet
-glands are epithelial cells that secrete a digits
substance
-several kinds of exocrine glands are
associated with the skin: sebaceous (oil)
glands, sudoriferous (sweat) glands, and
ceruminous glands
Hair
o Composed of dead, keratinized epidermal cells
o Genetic and hormonal influences determine the
Anatomy of the Hair includes:
thickness and distribution of our hair
The parts of a hair include:
▪ The shaft (above the skin surface)
▪ The follicle (below the level of the
skin)
▪ A root that penetrates into the dermis
o Epithelial root sheath
o Dermal root sheath
 Clinical Connection

Hair removal

❑ Depilatory- a substance that removes hair

- It dissolves the protein in the hair shaft , turning
it into a gelatinous mass that can be wiped away
- regrowth of the hair occurs
❑ Electrolysis- an electric current is used to
destroy the hair matrix so the hair cannot regrow
❑ Laser treatments
 Hair Growth
Hair growth stages are:
1. Growth stage- cells of the hair matrix divide
2. Regression stage- when the cells of the hair matrix stop dividing, the hair follicle
atrophies (shrinks) & the hair stops growing
3. Resting stage

❖ Scalp hair is in the growth stage for 2 to 6 years, the regression stage for 2 to 3 weeks,
and the resting stage for about 3 months.
❖ Normal hair loss in the adult scalp is about 70–100 hairs per day.
❖ The rate of shedding also increases for three to four months after childbirth.
❖ Alopecia
 Clinical Connection

HIRSUTISM
- excessive body hair or body hair in areas that
usually are not hairy

ANDROGENIC ALOPECIA

-male-pattern baldness
- first drug approved for
enhancing scalp hair growth was minoxidil (Rogaine)
 Types of Hair
➢ Hair follicles develop at about 12 weeks after
fertilization.
TYPES OF HAIR:
➢ Usually by the fifth month of development,
the follicles produce very fine, nonpigmented,
downy hairs called lanugo that cover the body
of the fetus.
➢ Prior to birth, the lanugo of the eyebrows,
eyelashes, and scalp are shed and replaced by
long, coarse, heavily pigmented hairs called
terminal hairs.
➢ The lanugo of the rest of the body are
replaced by vellus hairs, commonly called
“peach fuzz,” which are short, fine, pale hairs
that are barely visible to the naked eye.
 Hair Color
-due primarily to the amount and type of melanin in
its keratinized cells
-dark-colored hair contains mostly eumelanin
-blonde and red hair contain variants of
pheomelanin (yellow to red)
-hair becomes gray because of a progressive
decline in melanin production
-gray hair contains only a few melanin granules
-white hair

❑ Hair coloring is a process that adds or removes pigment.

*Temporary hair dyes
*Semipermanent dyes
*Permanent hair dyes
Skin Glands
The skin contains 3 types of glands:

✓ Sebaceous (oil) glands are simple branched acinar glands

✓ Surodiferous (sweat) glands
*Eccrine sweat glands- help regulate body temperature through
evaporation
*Apocrine sweat glands are located mainly in hairy skin areas
ECCRINE APOCRINE
-active during emotional sweating (cold -appears milky or yellowish in color
sweat) -active during emotional sweating (cold
-start to function soon after birth sweat)
-active during thermoregulatory -same components as eccrine sweat
sweating plus lipids and proteins
*insensible perspiration -odorless→bacteria (musky odor)
*sensible perspiration -do not begin to function until puberty
-secrete sweat during sexual activities

✓ Ceruminous glands are modified sweat glands located in the

external ear
 Clinical Connection

ACNE
❑ Acne is an inflammation of sebaceous glands that
usually begins at puberty, when the sebaceous
glands are stimulated by androgens.
❑ Acne occurs predominantly in sebaceous follicles
that have been colonized by bacteria, some of
which thrive in the lipid-rich sebum.
❑ Cystic acne- the infection may cause a cyst or sac
of connective tissue cells to form, which can destroy
and displace epidermal cells; can permanently scar
the epidermis.
❑ Treatment consists of gently washing the affected
areas once or twice daily with a mild soap, topical
antibiotics, topical drugs such as benzoyl peroxide
or tretinoin, and oral antibiotics

❖ Contrary to popular belief, foods such as chocolate

or fried foods do not cause or worsen acne.
 Clinical Connection

IMPACTED CERUMEN
❑ Abnormally large amount of cerumen in the
external auditory canal.
❑ If it accumulates until it becomes impacted (firmly
wedged), sound waves may be prevented from
reaching the eardrum.
❑ Treatment: periodic ear irrigation with enzymes to
dissolve the wax and removal of wax with a blunt
instrument by trained medical personnel.

❖ The use of cotton-tipped swabs or sharp objects

is not recommended for this purpose because they may
push the cerumen further into the external auditory
canal and damage the eardrum.
Skin Glands
Nails
❑ Nails are made of keratinized epidermal cells
❑ Nail structures:
 Functions of the Skin

Thermoregulation Cutaneous Sensations

Two ways: by liberating sweat tactile sensations—touch,
at its surface and by adjusting pressure, vibration, and
the flow of blood in the dermis tickling—as well as thermal
sensations such as warmth and
coolness; pain

Blood Reservoir Excretion & Absorption

The dermis houses an Sedentary person loses an
extensive network of blood additional 200 mL per day
vessels that carry 8–10% of the as sweat; Certain drugs that are
total blood flow in a resting absorbed by the skin may be
adult. administered by applying
adhesive patches to the skin.

Protection Synthesis of Vit. D

Keratin protects underlying tissues from requires activation of a precursor
microbes, abrasion, heat, and chemicals, molecule in the skin by ultraviolet
and the tightly interlocked keratinocytes (UV) rays in sunlight
resist invasion by microbes.
Skin Wound Healing

Epidermal wound healing

1 -involve only slight damage to superficial epidermal
cells
-common types of epidermal wounds include
abrasions, in which a portion of skin has been
scraped away, and minor burns

Deep wound healing

2
-occurs when an injury extends to the dermis and
subcutaneous layer
-four phases:
a. inflammatory phase
b. migratory phase
c. proliferative phase
d. maturation phase- hypertrophic vs. keloid scar
Development of the Integumentary System
 AGING
Age-Associated Changes
❖ Wrinkles
❖ Dehydration and cracking
❖ Sweat production decreases
❖ The numbers of functional melanocytes decrease which
results in gray hair and atypical skin pigmentation.
❖ Subcutaneous fat is lost and skin thickness decreases
❖ Rosacea is a skin condition that affects mostly light-
skinned adults between the ages of 30 and 60. It is
characterized by redness, tiny pimples, and noticeable
blood vessels, usually in the central area of the face.
❖ Growth of nails and hair slows during the second and third
decades of life.
Focus on Homeostasis
Disorders: Homeostatic Imbalances

SKIN CANCER
❑ Excessive exposure to ultraviolet light
(from the sun or tanning salons) is the
most common cause of skin cancer

❑ The three major types are basal cell

carcinoma, squamous cell carcinoma
and malignant melanoma

A-B-C-D-E
Disorders: Homeostatic Imbalances

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 are graded according to their
severity
Disorders: Homeostatic Imbalances

❑ The rule of nines is used to estimate

the surface area of an adult affected
by a burn
Disorders: Homeostatic Imbalances

PRESSURE ULCERS
❑ With age, there is an increased
susceptibility to pressure ulcers (“bed
sores”)
❑ When shedding of epithelium caused
by a deficiency of blood flow to tissues
occurs, pressure ulcers can develop
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REFERENCES:
Tortora's Principles of Anatomy and Physiology, 15th ed

McGraw Hill Anatomy and Physiology

A Short Course in Medical Terminology 4th ed (Nath & Lindsley)

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