THE INTEGUMENTARY SYSTEM

 Skin
 Accessory structures
o Hair
o Nails
o Sweat glands
o Sebaceous glands

SKIN
Multiple layers
o Epidermis
o Dermis
o Hypodermis (Subcutaneous Tissue)

o Epidermis
 Stratum Basale
• Keratinized, stratified squamous epithelium
• Aka Stratum germinativum
• Thin skin - 4 layers
• Deepest epidermal layer
• Thick skin – 5 layers
• most adequately nourished
• Avascular – no blood vessels
• constantly dividing
• daughter cells are pushed upward and
become part of the more superficial
layers

 Basement membrane
• Attach the epidermis to the dermis
• Made up of intertwining collagen

o Stratum Basale Cells

• Basal cell
• cuboidal-shaped stem cell
• precursor of keratinocytes
• Merkel cell
• Melanocyte

 Stratum Spinosum
• Spiny – protruding cellular processes
• 8-10 layers
• Start of keratin synthesis
• Langerhans cell

 Stratum Granulosum
• Granular – grainy
• 3-5 layers
• Flatter, thicker membrane, produce
more keratin and keratohyalin
accumulating as granules

 Stratum Lucidum
• Dead and flattened cells
• Only in thick skin (palms, soles)
• Translucent – Eleidin
• from keratohyalin
• clear protein
 Stratum Corneum o Hypodermis
• Keratinized / Cornified • Subcutaneous layer or superficial fascia
• 15-30 layers • Connect the skin to the underlying
• Protection – dehydration and microbes fascia of the bones and muscle
• Shed periodically • Well vascularized
• Loose areolar connective tissue
o Dermis • Adipose tissue – fat storage, insulation,
• Vascularized cushioning
• nerves, lymph vessels, hair follicles and
sweat glands are present • Pigmentation
• 2 layers: - Melanin
 Papillary - Carotene
 Reticular - Hemoglobin

 Papillary
• Loose areolar connective tissue
(collagen, elastin)
• Dermal papilla – finger-like projections
• Fibroblast, adipose cells, phagocytes
(defense cells), small BV, lymphatic
capillaries, nerve fibers, Meissner
corpuscles (touch receptors)
• Dermal papilla
• At the superficial portion off the dermis
below the basement membrane
• Strength of the connection of the
epidermis to the dermis
• Affect fingerprints
• cells of the stratum basale meet
the papillae of the underlying
dermal layer (papillary layer),
resulting in the formation of the
ridges
- Melanin
• Produced by melanocytes at stratum
basale
• Melanosome – cellular vesicle with
melanin, transported from s. basale to
the keratinocytes
• 2 forms
• Eumelanin – black, brown
• Pheomelanin – red
- Melanin
• UV exposure → inc melanin →
darkening of the skin
• Protects the DNA of epidermal cells
from UV ray damage
• Tanning - impermanent
• Melanosomes are temporary
• Destroyed by lysosomes
• Melanin-filled keratocytes will
eventually be slough off at s.
corneum
• Too much sun exposure → destruction
of cell structure → wrinkling
• If severe: DNA damage → Skin
cancer

 Reticular
• Dense irregular connective tissue
• deepest skin layer
• Appears reticulated (tight meshwork off
fibers)
• Elastin
• Collagen
• Well vascularized, rich sensory and
sympathetic nerve supply
• Lamellar Corpuscles - deep pressure
receptors
ACCESSORY STRUCTURES  Hair Growth
• 3 phases
• Anagen – cells divide rapidly at
the root pushing the hair shaft
up and out
• 2-7 years
• Catagen – transition period; 2-3
weeks
• Telogen – hair follicle at rest; no
new growth
• 2-4 months
• Hair growth rate: 0.3
mm/day during anagen
phase
o o Hair • 50 hairs/day lost and
• Dead keratinized cells replaced
• Hair follicle – origin at dermis • Hair loss – affected by
• Hair shaft – anchored to the follicle, hormones or dietary changes,
exposed part aging
• Hair root – lies below the surface
• Hair bulb
• has a mitotically active basal cells
called hair matrix
• Surrounds the Hair papilla – with
blood vessels and nerve endings

 Hair shaft
• Medulla – central core of the hair
• Not all hair have a medulla
• Cortex – surrounds the medulla
• A layer of compressed,
keratinized cells
• Affects hair texture (straight,
curly)  Hair Color
• Cuticle – covers the cortex • Influenced by melanin
• Very hard keratinized cells • Aging → decrease melanin production
→ gray / white hair
 Hair follicle
• Inner root sheath
• Surround the root of the
growing hair
• Extends up to the hair shaft
• External root sheath
• extension of the epidermis
• Encloses the hair root
• Glassy Membrane
• Thick, clear connective tissue
sheath covering the hair root
connecting it to the dermis

o Nails

• Found at the tips of fingers and toe

• Nail body – on the nail bed
• Densely packed dead
 Hair Function: keratinocytes
• Protection • Protects the tips of our fingers
• Sensory input and toe
• Thermoregulation • Forms back-support for picking
• Communication up small objects
 • Nail root – where nail body forms
• Matrix of proliferating cells from
s. basale → growth
• Nail folds – overlaps the nail on the
sides, anchors the nail body
• Nail cuticle – aka Eponychium; nail fold
that meets the proximal end of the nail
body
• Lunula – little moon; thick layer of
epithelium over nail forming a crescent
shape
• Hyponychium – thickened layer of s.
corneum; area beneath the free edge of
the nail o Sebaceous Gland

o Sweat Glands

• Oil gland found all over the body

• Function: lubricate, waterproof
• Most are associated with hair follicles
• Excrete Sebum
• Mixture of lipids
• Lubricate dry and dead skin
layer
• Produce sweat to cool off the body • Antibacterial properties
• Develop from epidermal projections into • Prevent water loss
the dermis • Stimulated by hormones (start
• Merocrine glands – secretions are excreted during puberty)
by exocytosis through a duct without
affecting the cells of the gland
• 2 types of sweat glands
• Eccrine
• Apocrine

 Eccrine
• Produces a hypotonic sweat for
thermoregulation
• Water, salt, antibodies, metabolic
waste, dermicidin (antimicrobial
peptide)
• All over skin’s surface
• Abundant at palms, soles, forehead
• Coiled glands with duct rising to a pore
where sweat is released

 Apocrine
• Associated with hair follicles in densely
hairy areas (armpits; genital regions)
• Larger than eccrine and located deeper
• Water, salts, organic compounds
(thicken sweat and responsible for the
smell due to bacterial decomposition)
• Affected by Nervous and Hormonal
control

SKIN FUNCTIONS
 • Epidermis synthesizes vitamin D when
 Protection exposed to UV radiation
 Sensory • Vitamin D
 Thermoregulation • Calcium absorption
 Vitamin D Synthesis • Phosphorous absorption

Rickets – lack of Vit D in children

 Protection • Mishappen bones (bow leggedness)
• Skin – against external environment Osteomalacia – lack of Vit D in adults
• Sweat – Dermicidin deters microbes • Softening of bones
from over-colonizing the skin

 Sensory
• Hairs – sense changes in the
environment
• Hair root plexus – surrounds
the base of the follicle
• Senses disturbance and
transmit the info to the
CNS, which responds to
the stimuli
• Meissner corpuscle – tactile corpuscle
• Light touch
• Pacinian corpuscle – lamellated
corpuscle; vibration
• Merkel cell – at s. basale; touch
receptors

Meissner Corpuscle

 Thermoregulation
• Regulate body temperature
• Assoc with Sympathetic NS ( fight-or flight)
• Sweating → cool off
• Dilation of BV → heat loss (skin redness)
• Constriction of BV → dec heat loss

 Vitamin D Synthesis SKIN DISEASES, DISORDERS & INJURIES

 • Uncontrolled growth of melanocytes
• Develops from a mole
Cancer • Most fatal of all skin cancers
• caused by abnormal cells in the body dividing • Highly metastatic
uncontrollably (DNA mutations) • Difficult to detect before it spreads
• DNA mutations → unlimited cell division → • Asymmetrical brown and black patched with
tumor (benign / cancerous) uneven borders and a raised surface
• Cancer → metastasize • Tx: Surgical excision, immunotherapy

Diagnostics
• Asymmetry
• Borders (irregular)
• Color (varied)
Skin Cancer • Diameter (>6mm)
• 1 in 5 Americans have skin cancer • Evolving
• Overexposure to UV radiation damages DNA
which leads to formation of cancerous lesions

Basal Cell Carcinoma

• Affects mitotically active cells in the stratum
basale
• MC of all cancers in the US
• Frequently at the head, neck, arms, back
• Predisposing factors:
• UV ray exposure
• Radiation
• Arsenic
• Open wounds: tattoo, burns Injuries
• Respond best to treatment if caught early
• Surgery, freezing (cryosurgery), topical • Burns
ointments • Extreme heat, radiation, electricity,
chemicals
• Death of skin cells
• Massive loss of fluid
• Complication: dehydration, electrolyte
imbalance, organ failure, infection

Squamous Cell Carcinoma

• Affects the keratinocytes
• Common in scalp, ears, hands
• 2nd MC skin cancer (2 in 10 skin CA are SCC)
• More aggressive than Basal CC
• If not removed → metastasize
• Tx: Surgery, Radiation

Melanoma
 Stretch marks
• Dermis is stretched beyond its limits of elasticity
• Seen when there is rapid weight gain (puberty,
Scars pregnancy)
• Collagen-rich skin formed after wound healing • Tx: not needed, purely for cosmesis
• Skin fails to regenerate
the original skin
structure Calluses
• No hair follicles, sweat • Formed by constant abrasion on a certain point
glands or sebaceous • Basal stem cells are triggered to divide → inc
glands thickness
Keloid
• Overproduction of scar
tissue
• Collagen production
does not stop when
wound heals

Bedsores
• Aka Decubitus Ulcer
• Constant long term
unrelieved pressure on
bony body parts
reducing the blood
flow to the area casing
necrosis (tissue death)
• MC in elderly with
debilitating conditions
(immobility)
• Prevention: turning px/
change position every
2 hours
• Can be infected if left
untreated