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INTEGUMENTARY SYSTEM
Anatomy & Physiology Week 2
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INTEGUMENTARY SYSTEM
Anatomy & Physiology Week 2
Homeostatic Imbalance!
Despite melanin’s protective effects, excessive exposure to UV light (via sunlight or tanning beds)
eventually damages the skin, leading to a leathery appearance. It also depresses the immune system.
This may help to explain why people infected with the human herpesvirus 1, which causes cold sores,
are more likely to have an eruption after sunbathing. Overexposure to the sun can also alter the DNA
of skin cells, leading to skin cancer. People with very dark skin seldom have skin cancer, attesting to
melanin’s amazing effectiveness as a natural sunscreen.
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INTEGUMENTARY SYSTEM
Anatomy & Physiology Week 2
•Homeostatic Imbalance!
SKIN COLOR
Three pigments contribute to skin color: melanin, carotene, and hemoglobin.
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CAROTENE the amount of carotene deposited in the stratum corneum and subcutaneous
tissue. In people who eat large amounts of carotene-rich foods, the skin tends to take on a
yellow-orange cast.
Homeostatic Imbalance!
When hemoglobin is poorly oxygenated, both the blood and the skin of light-skinned people appear
blue, a condition called cyanosis. Cyanosis is common during heart failure and severe breathing
disorders. In dark-skinned people, the skin does not appear cyanotic in the same situations because of
the masking effects of melanin, but cyanosis is apparent in their mucous membranes and nail beds.
Pallor, or blanching Under certain types of emotional stress, some people become pale. Pale
skin may also signify anemia, low blood pressure, or impaired blood flow into the area.
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.
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).
APPENDAGES OF SKIN
include cutaneous glands, hair and hair follicles, and nails. Each of these appendages arises
from the epidermis and plays a unique role in maintaining body homeostasis.
A. CUTANEOUS GLANDS
All are exocrine glands that release their secretions to the skin surface via ducts. They fall into
two groups: sebaceous glands and sweat glands.
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Sebaceous (Oil) Glands the product of the sebaceous glands, sebum (grease), is a mixture of
oily substances and fragmented cells. Sebum is a lubricant that keeps the skin soft and moist
and prevents the hair from becoming brittle.
Homeostatic Imbalance!
When sebaceous gland ducts are blocked by sebum, acne appears on the skin surface. Acne is an
active infection of the sebaceous glands. If the accumulated material oxidizes and dries, it darkens,
forming a blackhead. If the material does not dry or darken, a whitehead forms. Acne can be mild or
extremely severe, leading to permanent scarring. Seborrhea (seb0o-re9ah; “fast-flowing sebum”),
known as “cradle cap” in infants, is caused by over activity of the sebaceous glands. It begins on the
scalp as pink, raised lesions that gradually form a yellow-to-brown crust that sloughs off oily scales
and dandruff. Careful washing to remove the excessive oil often helps cradle cap in a newborn baby.
APPENDAGES OF SKIN
Sweat Glands also called sudoriferous glands, are widely distributed in the skin. Their
number is staggering—more than 2.5 million per person. There are two types of sweat glands,
eccrine and apocrine.
Eccrine glands produce sweat, a clear secretion that is primarily water plus some salts,
vitamin C, traces of metabolic wastes, and lactic acid. Sweat is acidic, a characteristic that
inhibits the growth of certain bacteria, which are always present on the skin surface. Eccrine
sweat glands are supplied with nerve endings that cause them to secrete sweat when the
external temperature or body temperature is too high.
Apocrine glands are largely confined to the axillary and genital areas of the body. Their
secretion contains fatty acids and proteins, as well as all the substances present in eccrine
sweat; consequently, it may have a milky or yellowish color. The secretion is odorless, but
when bacteria that live on the skin use its proteins and fats as a source of nutrients for their
growth, it can take on a musky, sometimes unpleasant odor. Apocrine glands begin to
function during puberty under the influence of androgens.
B. HAIR AND HAIR FOLLICLE
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Hairs A hair is a flexible epithelial structure. The part of the hair enclosed in the hair follicle
is called the root, and the part projecting from the surface of the scalp or skin is called the
shaft.
Each hair is made up of a central core called the medulla, consisting of large cells and air
spaces, surrounded by a bulky cortex layer composed of several layers of flattened cells. The
cortex is, in turn, enclosed by an outermost cuticle formed by a single layer of cells that
overlap one another like shingles on a roof. The cuticle is the most heavily keratinized region;
it provides strength and helps keep the inner hair layers tightly compacted.
Hair Follicles are compound structures. The inner epithelial root sheath is composed of
epithelial tissue and forms the hair. The outer fibrous sheath is dermal connective tissue. This
dermal region supplies blood vessels to the epidermal portion and reinforces it.
Arrector pili “raiser of hair” connect each side of the hair follicle to the dermal tissue.
When these muscles contract the hair is pulled upright, dimpling the skin surface with “goose
bumps.”
Homeostatic Imbalance!
Certain events can cause hair to gray or fall out prematurely. For example, many people have claimed
that they turned gray nearly overnight because of some emotional crisis in their life. In addition, we
know that anxiety, protein-deficient diets, therapy with certain chemicals (chemotherapy), radiation,
excessive vitamin A, and certain fungal diseases (ringworm) can cause both graying and hair loss.
However, when the cause of these conditions is not genetic, hair loss is usually not permanent.
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APPENDAGES OF SKIN
C. NAILS
a scale like modification of the epidermis that corresponds to the hoof or claw of other
animals. Each nail has a free edge, a body, and a root. The borders of the nail are overlapped
by folds of skin called nail folds. The edge of the thick proximal nail fold is commonly called
the cuticle.
The stratum basale of the epidermis extends beneath the nail as the nail bed. Its thickened
proximal area, called the nail matrix. The region over the thickened nail matrix that appears
as a white crescent and is called the lunule. When the supply of oxygen in the blood is low,
the nail beds take on a cyanotic cast.
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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.
• Contact dermatitis Itching, redness, and swelling of the skin, progressing to blistering. It is caused
by exposure of the skin to chemicals (such as those in poison ivy) that provoke allergic responses in
sensitive individuals.
• Impetigo (impet = an attack) Pink, fluid-filled, raised lesions (commonly around the mouth and
nose) that develop a yellow crust and eventually rupture. Caused by highly contagious staphylococcus
or streptococcus infections, impetigo is common in elementary school–aged children.
• Psoriasis Characterized by reddened epidermal lesions covered with dry, silvery scales that itch,
burn, crack, and sometimes bleed. A chronic condition, psoriasis is believed to be an autoimmune
disorder in which the immune system attacks a person’s own tissues, leading to the rapid
overproduction of skin cells. Attacks are often triggered by trauma, infection, hormonal changes, or
stress. When severe, psoriasis may be disfiguring.
CUTANEOUS LESIONS
BURNS
There are few threats to life more serious than burns. A burn is tissue damage and cell death
caused by intense heat, electricity, UV radiation (sunburn), or certain chemicals (such as
acids), which denature proteins and cause cell death in the affected areas.
Two life-threatening problems: First, without an intact boundary, the body loses its precious
supply of fluids containing proteins and electrolytes as these seeps from the burned surfaces.
Dehydration and electrolyte imbalance follow and can lead to a shutdown of the kidneys
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and circulatory shock. To save the patient, lost fluids must be replaced immediately. The
volume of fluid lost can be estimated indirectly by determining how much of the body surface
is burned (extent of burns), using the rule of nines. This method divides the body into 11
areas, each accounting for 9 percent of the total body surface area, plus an additional area
surrounding the genitals (the perineum) representing 1 percent of body surface area. Second
Infection the most important threat and is the leading cause of death in burn victims. Burned
skin is sterile for about 24 hours. But after that, pathogens easily invade areas where the
skin has been destroyed and multiply rapidly in the nutrient-rich environment of dead tissues.
Worse, the patient’s immune system becomes depressed within one to two days after
severe burn injury.
B. Second-degree burns (Superficial partial-thickness burns), involve injury to the epidermis and
the superficial part of the dermis. The skin is red, painful, and blistered. Because enough epithelial
cells are still present, regrowth (regeneration) of the epithelium can occur. Ordinarily, no permanent
scars result if care is taken to prevent infection.
C. Third-degree burns (Full-thickness burns), destroy both the epidermis and the dermis and often
extend into the subcutaneous tissue, reflecting their categorization as full thickness burns. Blisters are
usually present, and the burned area appears blanched (gray-white) or blackened. Because the nerve
endings in the area are destroyed, the burned area is not painful. In third degree burns, regeneration is
not possible, and skin grafting must be done to cover the underlying exposed tissues.
D. Fourth-degree (Full-thickness burns with deep-tissue involvement) but they extend into deeper
tissues such as bone, muscle, or tendons. These burns appear dry and leathery, and they require
surgery and grafting to cover exposed tissue. In severe cases, amputation may be required 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.
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SKIN CANCER
Skin Cancer Numerous types of neoplasms (tumors) arise in the skin. Most skin neoplasms
are benign and do not spread (metastasize) to other body areas. For example, warts are caused
by human papilloma viruses but are benign and do not spread. However, some skin
neoplasms are malignant, or cancerous, and they tend to invade other body areas.
Skin cancer is the single most common type of cancer in humans. The most important risk
factor is overexposure to UV radiation in sunlight and tanning beds. Frequent irritation of the
skin by infections, chemicals, or physical trauma also seems to be a predisposing factor.
The three most common types of skin cancer: basal cell carcinoma, squamous cell
carcinoma, and malignant melanoma.
A. Basal Cell Carcinoma is the least malignant and most common skin cancer. Cells of the
stratum basale, altered so that they cannot form keratin, no longer honor the boundary
between epidermis and dermis. They proliferate, invading the dermis and subcutaneous tissue.
The cancerous lesions occur most often on sun-exposed areas of the face and often appear as
shiny, dome-shaped nodules that later develop a central ulcer with a “pearly” beaded edge,
relatively slow-growing, and metastasis seldom occurs before the lesion is noticed. When the
lesion is removed surgically, 99 percent of cases are completely cured.
B. Squamous Cell Carcinoma arises from the cells of the stratum spinosum. The lesions appear
as scaly, reddened papules (small, rounded swellings) that gradually form shallow ulcers with
firm, raised borders. This variety of skin cancer appears most often on the scalp, ears, back of
the hands, and lower lip. It grows rapidly and metastasizes to adjacent lymph nodes if not
removed. This epidermal cancer is also believed to be induced by UV exposure. If it is caught
early and removed surgically or by radiation therapy, the chance of complete cure is good.
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