Fungsi kulit sebagai Blood Reservoir,

Eksresi, Absorbsi, Termoregulasi

Nura Eky
Bagian Fisiologi FK UNISSULA
Modul Integumen dan Musculoskeletal
2019
 Learning outcomes
protection

Sensation/sensory

Vit D synthesis
Integumentary function
Excretion &
absorbsion

thermoregulation

Blood reservoir
 Excretion
• Excretion : elimination of substances from the body (skin
has small role in excretion)
• Absorption : the passage of materials from the external
environment into body cells.
• Despite the almost waterproof nature of the stratum
corneum, about 400 mL of water evaporates through it
daily. A sedentary person loses an additional 200 mL per
day as sweat; a physically active person loses much more.
• Besides removing water and heat from the body, sweat
also is the vehicle for excretion of small amounts of salts,
carbon dioxide, and two organic molecules that result
from the breakdown of proteins—ammonia and urea.
 Mechanism of sweating

Eccrine sweat glands are the most numerous, distributed across nearly the entire
body surface area, and responsible for the highest volume of sweat excretion. By
contrast, apocrine and apoeccrine glands play a lesser role in overall sweat
production as they are limited to specific regions of the body.
 Eccrine Sweat Glands
• Humans have ~2–4 million eccrine sweat glands in total and
are found on both glabrous (palms, soles) and non-glabrous
(hairy) skin.
• Gland density is not uniform across the body surface area.
The highest gland densities are on the palms and soles (~250–
550 glands/cm2) and respond to emotional as well as thermal
stimuli.
• The density of eccrine glands on non-glabrous/hairy skin, such
as the face, trunk, and limbs are ~2–5-fold lower than that of
glabrous skin, but distributed over a much larger surface area
and are primarily responsible for thermoregulation.
• The secretory coil has three types of cells: clear,
dark, and myoepithelial.
• Clear cells are responsible for the secretion of
primary sweat, which is nearly isotonic with
blood plasma. The clear cells contain a system of
intercellular canaliculi, glycogen, and a large
amount of mitochondria and NaK-ATPase activity.
• The dark cells are distinguishable by the
abundance of dark cell granules in the cytoplasm.
Their function were not yet understood
• The function of the myoepithelial cells is
provision of structural support for the gland
against the hydrostatic pressure generated during
sweat production
• The duct has two cell layers: basal and luminal
cells. Its primary function is reabsorption of Na
and Cl ions as sweat flows through the duct
• Most of the NaCl reabsorption occurs in the
proximal duct, as these cells contain more
mitochondria and Na-K-ATPase activity than that
of the distal segment of the eccrine duct. The
result is a hypotonic final sweat excreted onto the
skin surface.
 Secretion in secretory coil
Na-K-2Cl co-transport model for sweat basic mechanism
• (1) Ach binding to muscarinic receptors
on the basolateral membrane  (2)
release of intracellular Ca stores and an
influx of extracellular Ca into cytoplasm
 (3) efflux of KCl through Cl channels
in the apical membrane and K channels
in the basolateral membrane (4) cell
shrinkage (5) influx of Na, K, and Cl
via Na-K-2Cl cotransporters  (6) Na
and K efflux via Na-K-ATPase and K
channels on basolateral membrane as
well as (7) Cl efflux via Cl channels on
apical membrane.
• ↑ Cl concentration in the lumen  (8)
electrochemical gradient for Na
movement across the cell junction.
• (9) The net KCl efflux from the cell 
an osmotic gradient for water
movement into the lumen via
aquaporin-5 channels.
NaCl reabsorpsion in Ductus

On the apical membrane of the

luminal cells (1) passive influx of Na
occurs through amiloride-sensitive
epithelial Na channels. (2) Active
transport of Na across the
basolateral membrane of the
basal cells occurs via Na-K-ATPase,
which is accompanied by (3) passive
efflux of K through K channels on the
basolateral membrane.
The movement of Cl is largely passive
via cystic fibrosis membrane
channels (CFTR) on both the apical
and basolateral membranes
 Control of eccrine sweating
• Eccrine sweat glands primarily respond to thermal stimuli.
• ↑ body temperature  dikenali oleh central and skin thermoreceptors 
diproses di preoptic area of the hypothalamus  respon sudomotor
• Recent studies suggest that thermoreceptors in the abdominal region and
muscles also play a role in the control of sweating.
• Thermal sweating is mediated predominately by sympathetic cholinergic
stimulation. Sweat production is stimulated through the release of
acetylcholine which binds to muscarinic (subtype 3) receptors on the
sweat gland
• Eccrine glands also secrete sweat in response to adrenergic stimulation,
but to a much lesser extent than that of cholinergic stimulation.
• Eccrine sweat glands juga berespon thd stimuli non-thermal terkait dg
olahraga yang dimediasi oleh feed-forward mechanisms related to central
command, the exercise pressor reflex muscle metabo- and
mechanoreceptors, osmoreceptors, and possibly baroreceptors.
 Apocrine Sweat glands
• Located in subcutaneous
tissue. Larger than eccrine
gland. Size and activity is
greater in men than
that of women
• Composed of coiled
secretory portion and an
excretory duct
• Double layer of cuboidal
cells. Merge distally with
the epithelium of the
hair follicle
• Empty the secretion into
infundibulum of hair
follicle above the
sebaceous gland.
• Does not have any
reabsorptive function
 Distribution
• Axilla,Areola
(Montogomery tubercles),
periumbilical, Perineal,
Circumoral

• MODIFIED APOCRINE
GLANDS
Ceruminous glands in
external ear canal, Ciliary or
Moll’s glands on eyelids,
Mammary glands.
• An apical cap and a
dividing membrane is
formed initially
• Apical cap is then
detached and
discharged into the
lumen of the gland –
APOCOPATION
• Decapitation secretion
– pinching of parts off
the cytoplasm
• Secretion is pulsatile
• Low secretory output
 COMPOSITION OF APOCRINE sweat
• Secretion is milky, protein rich, viscid and
colourless
• Secretion is lipid rich
• Bacterial decomposition is responsible for
characteristic mephitic odour
• Trans 3 methyl 2 hexanoic acid contributes
to the odour
• Secretion is mixed with sebum
 CONTROL OF APOCRINE SECRETION

• Respond to emotional stimuli

• Stimulated by epinephrine or norepinephrine
given locally or systemically
• Affected by hormonal factors such as
pregnancy and menstruation
• Undergo attenuation(penurunan fungsi) with
ageing
 Role of apocrine sweat glands
• Role as odoriferous sexual attractants
(Pheromones), territorial markers and warning
signals
• Increases frictional resistance and tactile
sensibility
• Androgen dependent and shows marked 5α-
reductase activity
• High levels of 15 lipoxygenase 2 in secretory
cells. Its product function as signaling molecule
 Apoeccrine sweat glands
• The apoeccrine sweat gland (AEG) develops during
puberty from eccrine-like precursors, opening directly
unto the skin. Discovered during the isolation of human
axillary sweat from patients with axillary hyperhidrosis, a
condition characterized by abnormally increased rates of
perspiration,
• The AEG is found in the adult axillae; its relative
frequency varies from person to person. Like eccrine
glands, the AEG opens directly to the skin surface. The
AEG has a secretory rate as much as 10 times that of the
eccrine gland and is therefore thought to contribute to
axillary hyperhidrosis.
 Absorpsion
• The absorption of water-soluble substances
through the skin is negligible, but certain lipid-
soluble materials do penetrate the skin.
• These include fat-soluble vitamins (A, D, E,
and K), certain drugs, and the gases oxygen
and carbon dioxide.
• Toxic materials that can be absorbed through
the skin include organic solvents such as
acetone (in some nail polish removers) and
carbon tetrachloride (dry-cleaning fluid);
• Salts of heavy metals such as lead, mercury, and
arsenic; and the substances in poison ivy and poison
oak (tumbuhan dan tanaman beracun).
• Since topical (applied to the skin) steroids, such as
cortisone, are lipid soluble, they move easily into the
papillary region of the dermis. Here, they exert their
anti-inflammatory properties by inhibiting histamine
production by mast cells (recall that histamine
contributes to inflammation). Certain drugs that are
absorbed by the skin may be administered by applying
adhesive patches to the skin
• An alternative route, transdermal (transcutaneous) drug
administration, enables a drug contained within an adhesive
skin patch to pass across the epidermis and into the blood
vessels of the dermis.
• The drug is released continuously at a controlled rate over a
period of one to several days. This method is especially useful
for drugs that are quickly eliminated from the body because
such drugs, if taken in other forms, would have to be taken
quite frequently. Because the major barrier to penetration is
the stratum corneum, transdermal absorption is most rapid in
regions where this layer is thin, such as the scrotum, face, and
scalp.
• Ex: nitroglyserin transdermal, scopolamin (motion sickness),
estradiol, ethinil estradiol, nicotine (to help people stop
smoking), fentanyl
 Blood Reservoir
• The dermis houses an extensive network of
blood vessels that carry 8–10% of the total
blood flow in a resting adult. For this
reason, the skin acts as a blood reservoir.
 Thermoregulation
Thermoregulation is the homeostatic regulation of body temperature.
The skin contributes to thermoregulation in two ways:
by liberating sweat at its surface and by adjusting the flow of blood
in the dermis.
↑ temperature or heat produced by exercise  ↑ sweat production
from eccrine sweat glands; the evaporation of sweat from the skin
surface helps lower body temperature; blood vessels in the dermis of
the skin dilate (become wider)  more blood flows through the
dermis, which increases the amount of heat loss from the body.
↓ temperature sweat production↓ from eccrine sweat glands
helps conserve heat; the blood vessels in the dermis of the skin
constrict (become narrow)  which decreases blood flow through the
skin and reduces heat loss from the body; skeletal muscle contractions
generate body heat.
 TERMOREGULASI

Heat production Heat loss

ToC ↑ ToC ↓

Physics of
Heat Loss
Internal External

1. Basal Metabolism Fisika perpindahan

Rate kalor
2. Extra 1. Konduksi
Metabolisme 2. Radiasi
saat: 3. konveksi
~ makan
~ kontraksi otot
~ shivering
~ efek T3/T4
TERMOREGULASI
 Homeostasis suhu tubuh

Reseptor Suhu di Kulit dan Jaringan tubuh dalam

Reseptor Jaringan
Reseptor Kulit
dalam

• Medula spinalis,
• Viscera abdomen,
• Vena besar di upper
abdomen dan thorax

Reseptor lebih sensitif thd

penurunan suhu karena
Reseptor dingin 10x >> reseptor panas kinerjanya bertujuan
utk cegah tubuh hipotermi
 Homeostasis suhu tubuh

When body too hot

 Homeostasis suhu tubuh

When body too cold

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