Chapter

8
Ski Fasciae

diterenty. -WilliamJarm
"Winners don t do difterentthings They do things

SKIN
Synonyms
Cornpare with the terrs
1. Cutis (L), 2. Derma (G), 3. Integument.
Cutaneous, derrnatoiogy and derrnatornes.
Definition
general covering of the entire external surface of te
Skin is the auditory meatus and the outer surface
body, including the external
of tympanic membrane.
mernbrane at the orifices of the
It is contínuous with the mucous
body.
Because ofa large number of its furnctions, the skin is regarde:
as arn important organ of the body (Fig. 8.1).
SURFACE AREA
In an adult the surface area of the skin is 1.5-2 (average 1.7)S
metres. Inorder to assess the area involved in burns, one can follow
the rule of nine: Head and neck 9%; each upper limb 9%; the frot
of the trunk 18%;the back of the trunk (including buttoks) 15*
each lower limb 18%; and perineum 1% (Fig. 8.2a). The percentag
of areaín a chíld is shownin Fig. 8.2b.
The surface area of an individual can be calculated by Du Bos
formula. Thus, A= WxH*71.84, where A=surface area in sq. T
W= weight in kg, and H= height in cm.
238
 Skin and Fasciae |239

Shaft of hair

Thin epidermis
Arrector pilorum
muscle between
connective tissue
Duct
of sheath of hair and
Sweat
papillary layer of
gland dermis

Sebaceous gland

Capillary
Aciniof
Sweat
gland

Fig. 8.1:Histological structure of thin skin

Rule of nines

( 9% (Entire head
nd neck)

18% front 18% Back

9%
18%
9%

18% Back

18%
1%
9% 9%

1%

18%

13.5%
18% 13.5%

Adult percentages Percentages in a child

|a
Fig. 8.2: Percentages of area in burn: (a) Adult, and (b) child 8
240| Handbook of General
PIGMENTATION OF SKIN
Anatomy
Ahe colour of theskiniss determined
by at
at different levels and places of the skin. least five
1 Melanin These
(brown), present in tne germinative
epidermis.
are:
,. pigneTtS
2. Melanoid (resembless
melanin),
present diffusely
epidermis.
3. Carotene (yellow to orange), present in throwg
fat cells of dermis and superficial fascia.stratum
4. Haemoglobin (purple). COneurn
and,
5. Oxyhaemoglobin(red), present in the
The amounts of first three
pigrments
cutaneous
vary with the:
vessels.
theskin race, age,chy
part of the body. In white races, the colour of
on the vascularity of the dermis and
thickness depends
keratin.The colour is red where keratin
where keratin is thick (palms and soles). (translucency)
isthin (lips), and it is whof:

Thickness
The thickness of the skin varies
from about 0.5 to 3 mm.
Competency achievermer: The student should be able to:
AN 42 Describe structure arnd function of skin with its
appendages
STRUCTURE OF SKIN
The skin is
dermis. composed of two distinct layers, epidermis and
Epigeiuis
It is the
It is
ectodermal (Ecpaery
superficial,inavascular layer of stratified
IsquamousSepitheliun
origin and gives rise to the
skin, namnely hair, nails,
sweat glands and appendages ofthe
Structurally, the epidermis is made
comprising (i) stratum basale, (ii) up of adeep
sebaceous glands.
granulosum and a stratum germinativeZo
and (v) stratum corneum.
superficial cornified spinosum,
ZOne, (iv)
(iii) strat
stratum luci
The cells of the deepest layer dead eas)
surlace to replace the cornified cellsproliferate
lost due toandWearpass towa
cells migrate superficially, they become more and
tear
and more fl