S4: INTEGUMENTARY SYSTEM

Integumentary System
- Integument means “covering”
Components:
- Skin
- Hair
- Nails
- Glands
Major Functions of the Integumentary System:
1. PROTECTION (first line of defense)
- The skin plays an important role in reducing water loss
- The stratified squamous epithelium protects structures from abrasion
- Melanin absorbs UV light
2. SENSATION (heat, cold, pressure, touch, pain)
- Sensory receptors around the hair follicle can detect the movement of a hair
3. VITAMIN D PRODUCTION (important regulator of calcium homeostasis)
- UV light causes skin to produce a precursor molecule of Vitamin D (7-Dehydrocholesterol)
Precursor is carried by blood to be modified in the liver
Carried by blood to the kidney for further modification
Formation of active Vitamin D
4. TEMPERATURE REGULATION (blood flow and activity of sweat glands)
- Body temperature normally is maintained at about 37 degrees Celsius (98.6 degrees Fahrenheit)
- The rate of chemical reactions (metabolism) is altered by the changes in temperature
- High temp = Hyperthermia
- Low temp = Hypothermia
 When the body is too cold; blood vessels constrict to reduce blood flow to the skin and heat is
retained
 To cool the body: blood vessels dilate and heat is transferred from the deep tissues into the skin,
thus sweat is produced

Types of Heat Loss:

I.
RADIATION
- Heats is lost through infrared energy
II. CONVECTION
- Heat is lost through air movement
III. CONDUCTION
- Heat is lost through direct contact with an object (skin to skin)

5. EXCRETION
- Skin glands can remove large amounts of sweat, but only a small amount of waste products
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SKIN
- Made up of two major tissue layers: Epidermis (superficial layer) and Dermis (structural
strength)
- Subcutaneous tissue (not part of the skin but its able to connect the skin to the muscle or bone)
 This is used to determine the body fat
 Skin weighs approximately 9 lbs.
 Skin is usually referred to as “thin skin”. “Thick skin” is usually found only on the palms of the
hands and soles of feet.
EPIDERMIS (stratified squamous epithelium)
- It is the most superficial layer of skin
- It prevents water loss and resist abrasion
- It is composed of 5 Epidermal Strata
Keratinization:
- Process in which new cells (with keratin) push old cells to surface
- 40 – 56 days for new cells to reach surface
- Keratin gives strength of the stratum corneum
FIVE (5) EPIDERMAL STRATA
Mnemonics:
Corneum
Lucidum
Granulosum
Spinosum
Basale
1. Stratum Corneum
- consists of dead squamous cells filled with keratin (protein)
- coated and surrounded by lipids (fats) which help them prevent fluid loss in the skin
- 25 or more layers of dead squamous cells joined by desmosomes (mechanical links/bind)
2. Stratum Lucidum
- Smooth, seemingly translucent layer that is found only on thick skin of palms, soles, & digits.
3. Stratum Granulosum
- Grainy appearance due to further changes to the keratinocytes as they are pushed from the spinosum
- Generates large amounts of keratin, which is fibrous
4. Stratum Spinosum
- Spiny in appearance due to the protruding cell processing that join the cells
- Composed of 8 to 10 layers of keratinocytes
5. Stratum Basale/ Stratum Gervinatum
- Deepest layer
- consists of cuboidal or columnar cells they undergo mitosis every 19 days
- this stratum is single layer of cells and firmly attached to dermis
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Conditions Associated with Stratum Corneum:

Dandruff – excessive sloughing of corneum from the surface of the scalp
Callus – hard skin
Corn – occurs when the corneum thickens to form a cone-shaped structure over a bone prominence
DERMIS
- the 2nd major skin region
- contains collagen and elastic fibers (responsible for the structural strength)
Cleavage lines/Tension lines
- areas of the skin where it is most resistant to stretching
- caused by orientation of collagen fibers
- vital in scarring
Stretch Marks/Striae Gravidarum
- visible lines through the epidermis that result from overstretched
skin
- common when a person increases in size quite rapidly
Layers of the Dermis:
1. PAPILLARY LAYER
- Thin connective tissue layer which contains blood vessels
- Blood vessels supply the overlying epidermis w/ nutrients, remove waste producst and help regulate
body temperature
Dermal Papillae
- Projections that extend up into the epidermis
- Remove waste and help regulate body temperature
- Ridged on hands (palms) and feet (soles) (fingerprints) grip objects by creating friction
- Pattern is genetically determined
2. RETICULLAR LAYER
- Deepest layer of the dermis
- Accounts for 80% of dermis
Skin Color and Variations
Determined by:
- Genetics
- Blood circulation
- Thickness of stratum corneum
Melanocytes of darker-skinned people produce more and darker melanin than fairer skinned people
All races have the same number of melanocytes
MELANIN (group of pigments)
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- Produced by melanocytes (irregular shaped cells w/ many long processes that extend between the
epithelial cells of the deep part of the epidermis)
- Ranges from yellow to reddish-brown to black
- Responsible for hair, skin, and eye color
- Provides protection against UV light
- Amount produced is determined by genetics, UV light, hormones (estrogen MSH(melanocyte
stimulating hormone)
- Freckles & Moles are the accumulation of melanin
- Albinism is the absence of melanin
Melanin Transfer to Epithelial Cells

Hypodermis/Subcutaneous Tissue
- Composed of loose connective tissue, including adipose tissue
- Estimate total body fat with the use of caliper
- Attaches skin to underlying tissue and bone
- Supplies the area with blood vessels and nerves
- The amount and location of adipose tissue (stored half of the bodies lipids) varies with age, sex, and
diet
- Body fats in Women 21 – 30% and Men 13 – 25%
HAIR (crowning glory)
- It is found everywhere
- Except on the palms, soles, lips, nipples, parts of the genitalia, and the distal segments of the
fingers and toes
Hair components:
Hair shaft – flexible strands of keratinized cells; protrudes above the surface of the skin
Hair root – protrudes below the surface
Hair bulb – this is where the hair is produced (rests above the hair papilla)
Hair papilla – an extension of the dermis that protrudes into the hair bulb
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Hair follicle – an invagination of the epidermis that extends deep into the dermis
Arrector pili – made up of smooth muscle that surrounds each hair follicle (contracts: hair becomes
perpendicular; stand) goose bumps
Hair medulla – soft; center surrounded by cortex
Hair cortex – a hard covering of hair that is surrounded by the cuticle
Cuticle – surrounds the cortex (single layer of overlapping cells that hold the hair in the hair folicle)
ex: eyelashes grow for about 30 days; rest for 105 days
scalp hair grows for 3 years; rest for 1-2 years
men hair loss is pattern baldness

GLANDS
There are 2 major glands of the skin, the sebaceous and sweat glands
1. SEBACEOUS GLANDS
- Secrete sebum (oily white substance rich in lipids), released by holocrine secretion
- Sebum prevents drying and protection from bacteria
2. SWEAT GLANDS
Eccrine Sweat Glands
- Simple coiled tubular glands and released through
merocrine secretion
- Located in almost every part of the skin but are numerous
in the palms and soles
- They produce a secretion that is mostly water with a few
salts.
- Opens into sweat pores
Apocrine Sweat Glands
- Simple coiled tubular glands and released primarily in
merocrine secretion
- Produce a thick secretion rich in organic substances (odorless)
- Open into hair follicles in the armpits and genitalia
NAILS
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- A thin plate with layers of dead stratum corneum cells with very hard type of keratin
- Nails do not have a resting stage, they continue to grow
Nail Structure:
Nail body – the visible part of the nail
Nail root – part of the nail covered by the skin
Cuticle/Eponychium – a stratum corneum that extends onto the nail body
Nail matrix – made up of epithelial cells that gives rise to most of the nail
Nail bed – located distally to the nail matrix
Lunula – whitish, crescent-shaped area seen at the base of the nail
Hyponychium – under the free edge

INTEGUMENTARY SYSTEM AS A
DIAGNOSTIC AID
Sandpaper texture skin – associated
with Vitamin a deficiency in which the
skin produces excess keratin
Spoon-shaped nails – associated with
iron-deficiency anemia in which the nails lose their normal contour and become flat and concave
Ex: Hepatitis – liver buildup bile in the blood (yellow color)
Rashes – allergy
Variations in skin color:
REDNESS/BLUSHING
- caused by increased blood flowing through the skin
- Associated with fever, hypertension, inflammation, and allergies
- “itis” inflammation
Ex. Scarlet fever – bacteria infecting the throat releasese toxins in the blood that causes a reddish rash on
the skin
PALLOR/PALENESS
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- Associated with anemia, low blood pressure, shock

Ex. Hypotension, Tachychardia, Tachypnea
CYANOSIS
- bluish color of the skin caused by a decrease in the blood oxygen content
- associated with impaired circulation or respiratory functions
Ex. peripheral cyanosis (extremities) and central cyanosis ex. Mouth
JAUNDICE
- a yellowish discoloration of the skin
- asssociated with liver disorder or too much consumption of carotene (yellow pigment found in
plants ex. Carrots & squash)
BRONZING
- a darkened skin pigmentation usually caused by stimulant effect of excess adrenocorticotropic
hormone (ACTH) on the melanocytes
- associated with addison’s disease
BRUISING or HEMATOMA
- a blue to purple discoloration caused by broken blood vessels
- associated with trauma, blood disorders
BURN
- an injury to a tissue caused by heat, cold, friction, chemicals, electricity, or radiation
Classifications of burns:
Partial-thickness burn
- the part of the stratum basale remains viable, and regeneration
of the epidermis occurs from within the burn area, as well as
from the edges of the burn
a. first-degree burn
 involves only the epidermis
 presence of redness, slightly swelling (edema), pain
 heals within 2-3 days or about a week with no scarring
 usually caused by sunburn or brief exposure to very hot or
very cold
b. second-degree burn
 damages both the epidermis and dermis
 in all 2nd degree burns, the epidermis regenerate from epithelial tissue in hair follicles, sweat
glands, edges of the wound
 symptoms may include redness, pain, swelling, and blosters
 if minimal dermal damage, heals about 2 weeks with no scarring
 if burn goes deep into the dermis, the wound appears red, tan, or whiet and heals for several
months with some scarring
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Full-thickness Burn
c. third-degree burn
 the epidermis and dermis are completely destroyed
 usually painless as the sensory receptors have been destroyed
 the burned areas appear white, tan, brown, black, or deep cherry red
 recovery occurs from the edges of the burn wound
 skin graft may be necessary
Burn Treatments:
Split skin Graft or artificial skin
- a burn treatment procedure in which the epidermis and part of the dermis are removed from aohter
part of the body and placed over the burn area
Debridement
- a procedure that involves removal of dead tissue from the burn area that helps prevent infections by
cleaning the wound
DISEASES AND DISORDERS: SKIN

Condition Description
Ringworm Fungal infection that produces patchy scaling and inflammatory response in
the skin
Eczema and dermatitis Inflammatory conditions of the skin caused by allergy, infection, poor
circulation, or exposure to chemical or envirnomental factors
Psoriasis Chronic skin disease characterized by thicker than normal epidermal layer
(stratum corneum) that sloughs to produce large, silvery scales bleeding
may occur if the scales are scraped away

Bacterial infections descriptions

Impetigo Small blisters containing pus; easily rupture to
form a thick, yellowish crust, usually affects
children
Decubitus ulcers (bedsores or pressure sores) Develop in people who are bedridden or
confined to a wheelchair; compression of tissue
Turn the patient every 2 hrs and reduced circulation result in the destruction
of the subcutanous tissue and skin, which later
become infected by bacteria; forming ulcers
Viral infections Descriptions
Rubeola (measles) Skin lesions; caused by a virus contracted through
the respiratory tract; may develop into pnumonia
or infect the brain, causing damage
Rubella (german measles) Skin lesions; usually mild viral disease contracted
through the respiratory tract; if cintracted during
pregnancy, it can cross the placenta and damage
the fetus
Chicken pox Skin lesions; usually mild viral diseas contracted
through the respiratory tract
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Shingles Painful skin lesions that can recur when the

dormant virus is activated by trauma, stress, or
anohter illness; caused by the chicken pox virus
after childhood infection
Cold sores (fever blisters) Skin lesions; caused by herpes simplex I virus;
Caused bu HSUI transmitted by oral or respiratory routes; lesions
recur
Genital herpes (STD) Genital lesions; caused by herpes complex III
Caused by HSUII virus; transmitted by sexual contact

SKIN CANCER
- most common type of cancer
- fair-skinned people or older than 50 years old are at risk
- prevented by limiting sun exposure and using sunscreeens that block UVA and UVB rays
 UVA rays can cause tanning of the skin (longer wavelenth than UVB)
Associated with Malignant Melanoma
 UVB rays can cause burning of the skin
Associated with basal cell carcinoma and squamous cell carcinoma
Types of skin cancer:
Basal cell carcinoma
- Most frequent type
- From stratum basele to dermis to produce an open ulcer
- Readily treatable with surgery
Squamous Cell Carcinoma (Result is nodular, keratinzied tumor confined to the epidermis)
- Develops from cells superficial to stratum basale
- May spread (metastasize) and lead to death
Malignant Melanoma
- Rare form that arises from melanocytes
- Comes from pre-existing mole (an aggregiation or nest of melanocytes)
- Metastasis is common and fatal
Effects of Aging:
- Blood flow to the skin is reduced
- Skin becomes thinner and elasticity is lost
- Sweat and sebaceous glands are less active
- Gray or white hair is evident