Lecture Guide - Itnegumentary System

SESSION 4: THE
INTEGUMENTARY SYSTEM
COLLEGE OF MEDICAL LABORATORY SCIENCE – VALENZUELA CAMPUS / ANTONIO C. PASCUA JR, RMT, MSMT/ JOSHUA LUIGI D. RAMEL, RMT
UNIT OUTLINE
At the end of this Unit, the student must be able to
1. Discuss completely the relevance of the integumentary system in the maintenance

of homeostasis
2. Explain accurately the anatomy and physiology of the skin including its types
3. Enumerate completely the different accessory structures of the skin and the role
they play as part of the integumentary system
4.Discuss effortlessly the process of aging and its effects on the components of the
integumentary system
I. OVERVIEW
The integumentary system consists of the skin and accessory structures, such as
hair, glands, and nails.
Following are the major functions of the integumentary system:

1. Protection
2. Sensation
3. Temperature regulation.
4. Vitamin D production.
5. Excretion.
6. Sexual signaling
I. OVERVIEW
1. Protection - Covering from external environment; protects against UV
radiation, dehydration and microorganisms
2. Sensation - Numerous sensory receptors in the skin
3. Temperature - Modulating blood flow through skin and the sweat glands
regulation
4. Vitamin D - When irradiated by UV light, Vitamin D is transformed to

production its hormonal form (for Ca+ regulation)
5. Excretion - Small amounts of waste excreted through glands and the skin
6. Sexual signaling - Sex pheromones produced by the apocrine sweat glands and are
involved in the attraction between sexes
I. OVERVIEW
• The skin is made up of two major tissue
layers, the Epidermis and the Dermis
• Epidermis - superficial layer of the skin,

consisting of stratified squamous epithelial
tissue. Contains Multiple cell layers
• Dermis - layer of connective tissue;

responsible for most of the strength of the
skin.
Image Source: VanPutte, Cinnamon L., et al (2016), Seeley’s Essentials of Anatomy and Physiology, 12th Edition, McGraw Hill Education
I. OVERVIEW
• Subcutaneous tissue, or hypodermis

- a layer of loose connective tissue
- Not part of the skin or the integumentary

system, but it does connect the skin to
underlying muscle or bone
II. EPIDERMIS
- Stratified Squamous Epithelium
- No blood vessels; receives nutrients and

excretes waste products by diffusion to the
capillaries of the dermis
Cells of the epidermis:
Keratinocytes
Melanocytes
Merkel Cells
Langerhans Cells
II. EPIDERMIS
Cells of the epidermis:
1. Keratinocytes – Epithelial cells containing keratin; provides resistance to abrasion

and water loss
2. Melanocytes - Produce the pigment melanin; which contributes to skin color.
3. Merkel Cells - Cells associated with nerve endings; detects light touch and
superficial pressure
4. Langerhans Cells – Associated with immune response; Antigen presentation
II. EPIDERMIS
On Keratinocytes:
1. Keratinocytes are constantly lost at the

surface of the epidermis but are
constantly replaced
2. Newer Keratinocytes are produced from

mitosis of the deepest layer of the
epidermis
3. Newer cells push older cells towards the

surface (“sloughing off’)
Image Source: Mechner, A. (2018). Junqueira’s Basic Histology, 15th Ed.. New York : McGraw Hill Education
II. EPIDERMIS
On Keratinocytes:
4. As the newer cells go to the surface, they

undergo keratinization (accumulation of
keratin)
5. During keratinization, cells eventually

die (loss of nucleus and other organelles)
* This process can be viewed through the

different layers or strata of the epidermis
II. EPIDERMIS
From the deepest to the most
superficial, the five strata:
1. Stratum Basale
2. Stratum Spinosum
3. Stratum Granulosum
4. Stratum Lucidum
5. Stratum Corneum
II. EPIDERMIS
1. Stratum Basale
- Single Layer of Cuboidal or Columnar Cells
- Anchored to a basement membrane by hemidesmosomes
- Keratinocyte stem cells undergo mitosis every 19 days
- Melanocytes (melanin producing cells) are seen here
II. EPIDERMIS
2. Stratum Spinosum
- 8–10 layers of many-sided cell
- Appear “spiny” upon preparation for microscopic observation
- “Spines” are actually desmosomes that come out of cell due to cell shrinkage
- Lipid filled, membrane bound organelles called lamellar bodies form inside
keratinocytes
- Langerhans Cells are also present
II. EPIDERMIS
3. Stratum Granulosum
- 2-5 layers of flattened, diamond-shaped cells.
- Presence of kerato-hyaline granules accumulating in the cytoplasm of
keratinocytes
- Nucleus and organelles of keratinocytes degenerate; cells die.
II. EPIDERMIS
4. Stratum Lucidum
- Several layers of dead keratinocytes with indistinct boundaries.
- Kerato-hyaline granules have dispersed out of cell; cell appears transparent
- Stratum lucidum is present in only a few areas of the body called Thick Skin
Thick skin – palms of the hand, soles of the feet and fingertips
Thin skin - rest of the body
II. EPIDERMIS
5. Stratum Corneum
- 25 or more layers of dead squamous cells
- Outer layers sheds off due to breaking of desmosomes
- Cornified Cells – dead keratinocytes with protein envelope made of keratin
II. EPIDERMIS
II. EPIDERMIS
Epidermal Layers and Keratinization
II. EPIDERMIS
On Melanocytes:
Irregularly shaped cells with many

long processes that extend between the
keratinocytes of the stratum basale and
the stratum spinosum
Melanocytes produce and package

melanin into vesicles called
melanosomes, which will be engulfed
by Keratinocytes by phagocytosis
II. EPIDERMIS
On Melanocytes:
Melanin production is facilitated by
the enzyme tyrosinase
Skin color is determined by:

1. Types of melanin produced
2. Amount of melanin produced
3. Size of melanosomes
4. Number of melanosomes
5. Distribution of melanosomes
II. EPIDERMIS
On Langerhans Cell:
• Involved in Immune Response; Antigen

presenting cells
• Only a migrant to the skin (macrophage)
• Also called dendritic cells
• Display a dense nucleus, pale cytoplasm,

and long slender processes that radiate out
from the cell body into the intercellular
spaces between keratinocytes
II. EPIDERMIS
On Merkel Cells:
• Scattered among cells of stratum basale
• Abundant in the fingertips and oral

mucosa and at the base of hair follicles
• Tonic receptors for sustained light touch

and for sensing an object’s texture.
III. DERMIS
- Connective Tissue
- Provides Mechanical Support
Cells of the Dermis:

1. Fibroblast
2. Adipocytes (few)
3. Macrophages
Protein Fibers of the Dermis

1. Collagen (predominant)
2. Elastic
3. Reticular
III. DERMIS
- Connective Tissue
Other Structures in the Dermis:
1. Blood Vessels
2. Hair Follicles
3. Smooth Muscle
4. Glands
5. Lymphatic Vessels
6. Nerve Endings
III. DERMIS
- Connective Tissue
Types of Nerve Endings in the Dermis:
1. Free Nerve Endings

2. Hair Follicle Receptors
3. Pacinian Corpuscle
4. Meissner Corpuscle
5. Ruffini Corpuscle
III. DERMIS
Layers of the Dermis
1. Papillary Layer
- Superficial layer; immediately next to
epidermis
- Forms projections called Dermal Papillae
- Connects with epidermal ridges
- Loose Connective Tissue

- Contains blood vessels that supply
nutrients, remove waste products and
regulate temperature of the epidermis
III. DERMIS
Layers of the Dermis
2. Reticular Layer
- Deep Layer
- Main Layer of the Dermis
- Dense Irregular Connective Tissue
III. DERMIS
A deep plexus with larger blood and lymphatic

vessels lies near the interface of the dermis and the
subcutaneous layer.
Thermoregulatory Function of the dermis is

done by arteriovenous anastomoses located
between both plexuses
IV. SUBCUTANEOUS TISSUE
Beneath the Dermis
Also called Hypodermis or Superficial Fascia
- Loose Connective Tissue
Cells in the Subcutaneous Tissue

1. Adipocytes (Half of the body’s stored lipids are here)
2. Fibroblasts
3. Macrophages
Remember: The Hypodermis is not considered a part of the skin
V. SENSORY RECEPTORS
Simple nerve endings with no Schwann

cell or collagenous coverings
(Uncapsulated)
More complex structures with sensory

fibers enclosed by glia and delicate
connective tissue capsules (Capsulated)
Uncapsulated Receptors
1. Merkel cells - tonic receptors for sustained

light touch and for sensing an object’s texture.
2. Free Nerve Endings - in the papillary

dermis; respond primarily to high and low
temperatures, pain, and itching.
3. Root Hair Plexuses – surrounding the bases

of hair follicles in the reticular dermis that
detects movements of the hairs.
Capsulated Receptors
1. Meissner Corpuscles - initiate impulses

when light-touch or low-frequency stimuli
against skin; numerous in the fingertips, palms,
and soles
2. Lamellated (Pacinian) Corpuscles - for

detection of pressure or firm touch.
3. Ruffini Corpuscles - collagenous, fusiform

capsules anchored firmly to the surrounding
connective tissue.
VI. ACCESSORY SKIN STRUCTURES
1. HAIR
2. NAILS
3. GLANDS
a. Sweat Glands
b. Sebaceous Glands
1. HAIR:
- Hair is found everywhere on the skin except the palms, the soles, the lips, the nipples, parts of
the external genitalia, and the distal segments of the fingers and toes.
Hair Development
• 5th to 6th week of fetal development – lanugo (unpigmented)

• At Birth – terminal hairs replace lanugo of scalp, eyelids and eyebrows
• Vellus Hairs – shorter, finer hairs that replace lanugo of the rest of the body
• Puberty – Terminal Hairs replaces vellus hair in the body, esp. pubic and axillary regions
1. HAIR
- Keratinized Structures forming within

epidermal evaginations called hair follicles
- Rapidly undergoing keratinization to form

the medulla, cortex, and cuticle of a hair
root
1. HAIR
Hair Shaft
- Protrudes above the surface of the skin
Hair Root
- Below the surface of the skin
- The base of the hair root is called the Hair
Bulb
1. HAIR
Layers of the Hair Root and Hair Shaft
1. Medulla
- Center, has 2 layers of soft keratin
2. Cortex
- Covers Medulla; layers of hard keratin
3. Cuticle
- Covers Cortex; 1 layer of hard keratin
Image Source: : Lecture Notes, Salazar, Romaenia S. RMT, MAT (2019)
1. HAIR
Hair Follicle
- Tubelike invagination of the epidermis that
extends into the dermis.
- Hair develops and grows within each hair

follicle
1. HAIR
Layers of the Hair Follicle
1. Dermal Root Sheath

2. Epithelial Root Sheath
- Internal Root Sheath
- External Root Sheath
Image Source: : Lecture Notes, Salazar, Romaenia S. RMT, MAT (2019)
1. HAIR
Arrector pili muscle
- Smooth muscle inserts on hair follicle and

base of epidermis
- When contracting, it pulls the follicle into a

more perpendicular position, causing the
hair to “stand on end”
- Common response to cold temperatures
2. NAILS
- Thin plate consisting of layers of dead

stratum corneum cells that contain a very
hard type of keratin
- Located on the distal ends of the digits

(fingers and toes).
2. NAILS
Nail Root – Proximal portion of nail; covered by skin
Nail Body – Distal portion of nail; visible portion
Nail Fold – Skin that covers lateral and proximal edges

of a nail
Nail Groove –Holds the edges of the nail in place
2. NAILS
Cuticle – Part of the nail fold that grows onto the nail body
Nail Matrix – Area of cell division of nails; newly formed cells move distally and become
keratinized
Lunula - visible portion of nail matrix
3. GLANDS
Sebaceous Glands
Sweat Glands
3. GLANDS
Sebaceous Glands
- Located at Dermis; releases secretions

into upper portion of Hair Follicles
- Compound Acinar (alveolar)
- Produces Sebum (rich in lipids)
- Holocrine Secretion
3. GLANDS
Sweat Glands
- A.K.A. Sudoriferous Glands
- Two types, eccrine and apocrine
- Despite their name, both use merocrine

secretion
3. GLANDS
Eccrine Sweat Glands

- Most common sweat gland
- Not found in lips, labia minora, tips of
clitoris and penis
- Simple, coiled, tubular
Duct:
- Less coiled, leads to epidermis
- Stratified cuboidal epithelium
Secretory segment:
- In deep dermis or hypodermis
3. GLANDS
Eccrine Sweat Glands
- Secretory segment produces fluid

containing mostly water but also
contains the ff:
1. Salts (Sodium Chloride)
2. Ammonia
3. Uric Acid
4. Urea
5. Lactic Acid
- Cooling Effect on the body

3. GLANDS
Apocrine Sweat Glands

- Simple, coiled, tubular
- Opens into hair follicles, superficial to
sebaceous glands
- Found in axillae, genitalia and around
the anus
- Does not help in temperature

regulation; active in puberty and
suggested to signal sexual activity
3. GLANDS
Other Skin Glands:
Ceruminous Glands – secretes cerumen (earwax); located in external auditory canal

Mammary Glands – modified apocrine sweat glands; produces milk
VII. PHYSIOLOGY OF THE INTEGUMENTARY SYSTEM
1. Protection
• Epidermis - prevents abrasion

• Dermis – prevents structural strength; prevents tearing
• Glands - secretions produce environment not suitable for some microorganisms
• Melanin – absorbs UV Light
• Hair – insulation, protection from foreign substances (eyelashes , nostrils) protects from
abrasion (axillary and pubic hair)
• Nails – protects distal portions of fingers and toes; may be used for defense
• Intact Skin – reduces water loss, physical barrier against microorganisms
2. Sensation
• Receptors for pain, heat, cold and pressure
3. Temperature Regulation
• To increase heat loss – Dilation of blood vessels in the dermis

- Sweat production
• To decrease heat loss - Constriction of blood vessels in the dermis

- Contraction of the arrector pili muscles causes hair to
stand on end
3. Temperature Regulation
4. Vitamin D Synthesis
• Skin exposed to ultraviolet light produces cholecalciferol, which is modified in

the liver and then in the kidneys to form active vitamin D.
• Vitamin D increases blood calcium levels by promoting calcium uptake from the
small intestine.
5. Excretion
• Skin glands remove small amounts of waste products (e.g., urea, uric acid,and
ammonia) but are not important in excretion
6. Sexual Signaling
• Apocrine Sweat Glands
VIII. PATHOPHYSIOLOGY OF THE INTEGUMENTARY SYSTEM
Image Source: Lecture Notes, Salazar, Romaenia S. RMT, MAT (2019)
Burn – injury to a tissue caused by heat,

cold, friction, chemicals, electricity, or
radiation.
- Classified according to the extent of

surface area involved and the depth of
the burn
Burn
Partial Thickness Burns
• First Degree
• Second Degree
Full Thickness Burns

• Third Degree Burns
Partial Thickness Burns
• First Degree Burns

- Involves only damage to Epidermis
- Redness, pain, and slight edema (swelling)
- Sunburn, brief exposure
- Heals without scarring (Approx 1 week)
• Second Degree Burns

- Damages Epidermis and Dermis
- Redness, pain, and slight edema for minimal dermal damage
- Wound appears red for deep dermal damage
- Heals with scarring (Months)
- Epidermis fully regenerates
Full Thickness Burns
• Third Degree Burns

- Complete destruction of Epidermis and Dermis
- Painless because sensory receptors are destroyed
- Skin can only regenerate from the edges
- Skin grafting is necessary
From left to right: 1st Degree, 2nd Degree and 3rd Degree Burn
Cancer
– abnormal cell mass
Benign - Does not spread
Malignant - Metastasized (moves) to other parts of the body
Skin cancer - most common type of cancer
What Cells are Involved?
1. Basal cell carcinoma

2. Squamous cell carcinoma
3. Melanoma
1. Basal Cell Carcinoma

• Most common skin cancer; Usually arises in
sun exposed skin
• Affects cells in the stratum basale. Basal cell

carcinomas have a varied appearance
• Slow growing but locally destructive

Will not metastasize to distant organs, but it can eat into
things like cartilage, bone. Without treatment, will
continue destroying the surrounding area
2. Squamous Cell Carcinoma

• Less common
• Affects cells in the stratum spinosum and can

appear as a wartlike
• Faster-growing, occasionally metastasizes
Looks like the classic non-healing wound; Removal

or destruction of the tumor cures most cases.
3. Melanoma
• Least common, but most deadly
• Arise from Melanocytes
• Appears black or brown, but also red or pink
• 40% of melanomas develop in preexisting
moles.
Treatment of melanomas when they are confined to the epidermis is almost

always successful. However, if a melanoma invades the dermis and
metastasizes (spreads) to other parts of the body, it is difficult to treat and
can be deadly..
Detection of Melanoma
• Early detection is crucial
• Routine examination of the skin and application of the ABCDE rule, which
states the signs of melanoma:
A – Asymmetry (One side of the lesion does not match the other side)
B – Border Irregularity (Edges are ragged, notched, or burred)
C – Color (Pigmentation is not uniform)
D – Diameter (Greater than 6 mm)
E – Evolving (Changing in size, shape, may bleed, crust, itch or become tender)
IX. REFERNCES
Mechner, A. (2013). Junqueira’s Basic Histology, 13th Ed.. New York : McGraw Hill Education
VanPutte, Cinnamon L., et al (2016), Seeley’s Essentials of Anatomy and Physiology, 12th Edition, McGraw Hill Education
Lecture Notes, Salazar, Romaenia S. RMT, MAT (2019)
Lecture Notes, Ramel, Jonas PTRP (2017)

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SESSION 4: THE

1. Discuss completely the relevance of the integumentary system in the maintenance

Following are the major functions of the integumentary system:

2. Sensation - Numerous sensory receptors in the skin

4. Vitamin D - When irradiated by UV light, Vitamin D is transformed to

• Epidermis - superficial layer of the skin,

• Dermis - layer of connective tissue;

• Subcutaneous tissue, or hypodermis

- Not part of the skin or the integumentary

- No blood vessels; receives nutrients and

Cells of the epidermis:

1. Keratinocytes – Epithelial cells containing keratin; provides resistance to abrasion

2. Melanocytes - Produce the pigment melanin; which contributes to skin color.

4. Langerhans Cells – Associated with immune response; Antigen presentation

1. Keratinocytes are constantly lost at the

2. Newer Keratinocytes are produced from

3. Newer cells push older cells towards the

4. As the newer cells go to the surface, they

5. During keratinization, cells eventually

* This process can be viewed through the

Irregularly shaped cells with many

Melanocytes produce and package

Skin color is determined by:

• Involved in Immune Response; Antigen

• Only a migrant to the skin (macrophage)

• Also called dendritic cells

• Display a dense nucleus, pale cytoplasm,

• Scattered among cells of stratum basale

• Abundant in the fingertips and oral

• Tonic receptors for sustained light touch

Cells of the Dermis:

Protein Fibers of the Dermis

Other Structures in the Dermis:

Types of Nerve Endings in the Dermis:

1. Free Nerve Endings

- Loose Connective Tissue

A deep plexus with larger blood and lymphatic

Thermoregulatory Function of the dermis is

Also called Hypodermis or Superficial Fascia

- Loose Connective Tissue

Cells in the Subcutaneous Tissue

Remember: The Hypodermis is not considered a part of the skin

Simple nerve endings with no Schwann

More complex structures with sensory

1. Merkel cells - tonic receptors for sustained

2. Free Nerve Endings - in the papillary

3. Root Hair Plexuses – surrounding the bases

1. Meissner Corpuscles - initiate impulses

2. Lamellated (Pacinian) Corpuscles - for

3. Ruffini Corpuscles - collagenous, fusiform

• 5th to 6th week of fetal development – lanugo (unpigmented)

- Keratinized Structures forming within

- Rapidly undergoing keratinization to form

Layers of the Hair Root and Hair Shaft

Image Source: : Lecture Notes, Salazar, Romaenia S. RMT, MAT (2019)

- Hair develops and grows within each hair

Layers of the Hair Follicle

1. Dermal Root Sheath

Image Source: : Lecture Notes, Salazar, Romaenia S. RMT, MAT (2019)