ANATOMY AND

PHYSIOLOGY
CHAPTER 5 : THE INTEGUMENTARY
SYSTEM
 THE INTEGUMENTARY
SYSTEM
• Consists of the skin and accessory structures such as the
hair, glands, and nails
• The appearance of the skin can indicate physiologic
imbalances in the body
• Functions
• Protection
• Sensation
• Vitamin D production
• Temperature regulation
• Excretion
 SENSATION
An important
function of the
skin dermis is to detect the
different sensations of
heat, cold, pressure,
contact and pain.
 PROTECTION
❖Skin is an elastic covering.
It protects you (animals) against
exposure to dangerous things in
the environment such as bacteria.
❖Also repels water, minimizes
water loss from the
body and protects underlying
structures such as blood vessels,
nerves and organs.
 THERMOREGULATION
❖Is a process that allows the body
to maintain its core internal
temperature.

❖ How is skin involved in

thermoregulation?
 SECRETION
▪The skin plays a part
in the secretory
functions in the body.
Sebum (oil) secreted
by sebaceous glands
has antifungal
and antibacterial
properties and helps
maintain the texture
of the skin.
 THE SKIN LAYERS
▪The skin consists of
two layers: the
epidermis, and a
deeper layer of
dense irregular
connective tissue,
the dermis (also
known as the
corium).
SKIN LAYERS
EPIDERMIS
Epidermis.
This is the outer, relatively
thin layer of the skin that
is composed of
closely packed cells with
little intercellular
material.
It is composed of
stratified squamous
epithelium that in
most areas can be
divided into different
sub-layers.
SUB – LAYER OF
EPIDERMIS
 STRATUM CORNEUM
It forms
the outermost
layer of the
epidermis
and consists
of dead cells
completely
filled with
protein called
keratin.
▪These keratinized cells are
constantly in the process
of flaking off the surface of
the skin in the form of
dandruff. And exposed to the
outside environment.
 STRATUM LUCIDUM
The Stratum Lucidum is a
smooth, seemingly translucent
layer of the epidermis located
just above the stratum
granulosum and below the
stratum corneum.
The keratinocytes that compose
the stratum lucidum are dead
and flattened. These cells are
densely packed with eleiden, a
clear protein rich in lipids,
derived from keratohyalin.
STRATUM GRANULOSUM
• The Stratum Granulosum is a Latin
term, which literally
means granular layer. This layer is
found in between the stratum
corneum (or stratum
lucidum,when present) and
the stratum spinosum. These
keratinocytes are particularly
referred to as granular cells.
STRATUM GRANULOSUM
• They contain keratohyalin
granules, which aid in the binding
of the keratin filaments together.
These cells also have lamellar
bodies filled with lipids, which are
released into the extracellular
space through exocytosis.
LIPIDS
These diverse compounds that
make up the lipid family are
grouped because they are
insoluble in water. They are
also soluble in other organic
solvents such as ether,
acetone, and other lipids.
 STRATUM SPINOSUM

❑ The keratinocytes in the

Stratum Spinosum are referred
to as prickle cells. This layer is
found in between the stratum
basale and the stratum
granulosum.
These keratinocytes are
polyhedral in shape and with
large pale-staining nuclei.

➢They are actively synthesizing

fibrillary proteins that are
essential for the formation
of desmosomes.
STRATUM BASALE
oThe Stratum Basale (also called
the stratum germinativum) is the
deepest epidermal layer and
attaches the epidermis to the
basal lamina.
DERMAL PAPILLAE
 DERMIS
• Composed of dense collagenous connective tissue
containing fibroblasts, adipocytes, and macrophages

• Nerves, hair follicles, smooth muscles, glands, and

lymphatic vessels extend into the dermis

• Collagen and elastic fibers are responsible for the

structural strength of the dermis
HYPODERMIS
❖The hypodermis is composed of
loose connective tissue that
separates the dermis from
underlying structures such as bone
and deep fascia.

❖It permits a layer of fat to

be interposed between the skin and
deeper structures.
CLEAVAGE LINES
CLEAVAGE LINES
BLEPHAROPLASTY
 INJECTIONS
• Intradermal injection – skin test
• Subcutaneous injection – insulin injection
• Intramuscular injection - vaccines
INTRADERMAL INJECTION
SUBCUTANEOUS INJECTION
INTRAMUSCULAR INJECTION
 SKIN COLOR
• Factors that determine skin color

1. Skin pigments
2. Blood circulating through the skin
3. Thickness of the stratum corneum
 MELANIN
• Pigments primarily responsible for skin,hair, and eye
color
• Protects against UV light
• Produced by Melanocytes
MELANOCYTE
WHAT CONDITION?
VITILIGO
 VITILIGO
• Non-contagious, non-life-threatening

• May start at any age, but often appears before age 20

• Of unknown cause, may be autoimmune in nature

• Melanocytes either die or become non-functional

ALBINISM
 ALBINISM
• Congenital disorder caused by lack of skin pigments
• Caused by mutation in the TRP-1 gene leading to
deficiency of an enzyme (Tyrosinase) required in
melanin production
• Two types
• Oculocutaneous
• Cutaneous
• Associated with a number of vision defects, such
as photophobia, nystagmus, and amblyopia
• No treatment, managed through lifestyle adjustments
 MELANIN
• Production is determined by
1. genetic factors
2. exposure to light
3. hormones
CHLOASMA – MASK OF
PREGNANCY
CYANOSIS
BIRTHMARKS
 SUBCUTANEOUS TISSUE
• Supplies the skin with blood vessels and nerves

• Loose connective tissue, including adipose tissue that

contains about half the body’s stored lipids

• Serve as padding and insulation

ACCESSORY SKIN
STRUCTURES
❖The skin of most HAIRS
mammals is covered by
hairs.
❖The visible portion of
the hair is called the
shaft while the cells
embedded in the skin
form the root.
❖Each hair strand is
composed of three
parts: the cuticle,
cortex and medulla.
 TYPES OF HAIRS

• Terminal hair is the type of natural hair to which most

people refer in their everyday lives. It is the type of hair that
grows on your head, in your pubic regions and on almost
all parts of your body.

• Vellus hair, frequently referred to as “peach fuzz,” is the

short, fine, colorless hair found all over the body. During
puberty, vellus hair can turn into intermediate or terminal
hair.

• Lanugo is the special downy hair that completely covers

the human baby inside the womb.
HAIR
HAIR
ANDROGENIC ALOPECIA
ALOPECIA AREATA
HIRSUTISM
 PEDICULOSIS
(LICE INFESTATION)
PEDICULOSIS TREATMENT
 GLANDS
• Sebaceous glands – simple branched acinar glands
which produce sebum by holocrine secretion
• Sweat glands
• Eccrine sweat glands - simple, coiled tubular glands
which release sweat by merocrine secretion
• Apocrine sweat glands – simple, coiled tubular glands
that produce a thick secretion released by merocrine
secretion
GLANDS
Group of cells that remove materials from the blood

•The glands of the skin

are chiefly of two kinds,
sudoriferous and
sebaceous.
 SEBACEOUS
❑Sebaceous gland, small
oil producing
gland present in the skin
of mammals.
Sebaceous glands are
usually attached to hair
follicles and release a
fatty substance, sebum,
into the follicular duct
and thence to the
surface of the skin.
•The glands are distributed
over the entire body with
the exception of the palms
of the hands and the soles
of the feet; they are most
abundant on the scalp
and face.
SUDORIFEROUS
•Sudoriferous sweat glands,
from Latin ‘sudor’ meaning
‘Sweat’, are small tubular
structures of the skin that
produce sweat.
• Sweating leads to a loss of
heat in the body owing to
the fact that heat is
required to evaporate
water in the sweat.
 TWO TYPES OF SWEAT GLANDS

❖Merocrine or Eccrine glands – not associated

with hair follicles and found in most parts
of the body; numerous in the palms and
soles. Eccrine sweat is an important
mechanism for temperature control.

❖Apocrine types – connected to hair follicles

and reach deeply into the subcutaneous
layer of the skin. They are found in certain
regions of the body such as the armpits,
anogenital area , navel and nipples.
SECRETION OF GLANDS
NAILS
BEAU LINES
MEES’ LINES
MUEHRCKE’S LINES
CLUBBING
 PHYSIOLOGY OF THE
INTEGUMENTARY SYSTEM
• Sensation
• Vitamin D production
• Temperature regulation
• Excretion
JAUNDICE
RINGWORM – NOT DUE TO
WORMS
HERPES SIMPLEX INFECTION
HERPES SIMPLEX VIRUS
FUNGAL INFECTION
 VARICELLA
(CHICKENPOX)
SHINGLES
 SHINGLES – DUE TO HERPES
ZOSTER/VARICELLA ZOSTER VIRUS
NEUROFIBROMATOSIS
DECUBITUS ULCER
DECUBITUS ULCER
DECUBITUS ULCER
 PREVENTION OF DECUBITUS
ULCERS (BEDSORES)
• Check the patient’s body everyday from head to toe
• Early signs of pressure ulcers:
1. Skin redness
2. Warm areas
3. Spongy or hard skin
4. Breakdown of the top layers of skin
• Patient’s position must be changed every 1 to 2 hours
to keep the pressure off any one spot
• Sheets and clothing should be dry and smooth, with no
wrinkles
• DO NOT raise the head of the bed to more than a 30-
degree angle. Sliding down may further harm the skin.
BURNS
RULE OF NINES FOR BURN
ASSESSMENT
 SKIN CANCER
• Three main types
• Basal Cell Carcinoma – most common, begins with cells
in stratum basale and extends into the dermis to produce
an open ulcer
• Squamous Cell Carcinoma – develops from cells
immediately superficial to the stratum basale; nodular,
keratinized tumor
• Malignant Melanoma – rare form of skin cancer that
arises from melanocytes
SKIN CANCER
SKIN CANCER