ANATOMY AND PHYSIOLOGY OF THE SKIN

Functions of the Skin:

 Skin is a sensory organ that acts as the first line of defense
 Has 6 major functions
o Protection
 Trauma
 Infection
 Excessive loss of fluids and proteins
 Mechanical injury
 Immune cells: Langerhans cells, tissue macrophages, and mast
cells
 Pigmentation: protects against UV radiation
 Melanin protects against UV-A
o Sensation
 Filled with nerve endings
 Nerve fibers follow dermatome pattern
o Thermoregulation
 Involves: nerves, blood vessels, and glands
 When skin is exposed to cold or internal body temperature
drops: blood vessels constrict, blood flow is reduced, and heat
is conserved
 When the skin gets too hot: arteries dilate, blood flow and
sweat production increases and allows body to cool
o Eliminate Waste products / Excretion
 Excretion of waste products, electrolytes, and water assist with
thermoregulation
 2 million pores
 Adult loses 500mL of water through the skin everyday
o Vitamin D production / Metabolism
 Skin synthesizes Vitamin D when exposed to the sun
 Assists in the mineralization of bones and teeth
 Vit D is then transmitted to other areas of the body
o Social Interaction
 Closely linked to aspects of body image, physical attraction,
and communication
 Damage to skin can have functional, physiologic, or
psychosocial effects

Layers of the Skin:

 Epidermis
o Thin outermost layer of skin
o Functions:
 Barrier to water loss
 Protects against mechanical damage, chemicals, and pathogens
  Continually regenerated (every 21-28 days) from basal cell
layer
 Sheds the outermost cell layer during hand washing
o 5 layers:
 Corneum – touch outer-layer of skin with acid basement
 Lucidum – only present when corneum is thick
 Granulosum – contains langerhans cells
 Spinosum – several layers of spine-like progections from the
basal level
 Basale – only layer with ability to regenerate
o Did you know?
 The epidermis contains the cells responsible for skin
pigmentation called melanocytes
 Dermis
o Thickest layer
o Strong structural matrix
o Composed of three major protein fibers
 Collagen & Elastin
 Provide support
 Determine the skin’s physical characteristics
 Collagen
 Located in papillary layer of the dermis
 Nonelastic
 Give dermis high tensile strength
 70% of the skin’s dry weight is composed of collagen
 Elastin
 Interact with collagen in lower dermis and epidermal
margin
 Allows skin to remain pliable
 Enables extensibility in the dermis
 Reticular
o Consists of: blood vessels, nerves, hair, nail, and skin glands
o Supplies support and nutrition to epidermis
o Regulates heat, immune response, and receptors for pain an cold
o
o Appendages found here
 Hair
 Nails
 Grow indefinitely
 Keratin
 Glands
 Sebaceous – found on scalp, face, upper body, and
genital
o Produce sebum
  Apocrine – sweat gland
o Axilla, perineum, and genitals
 Eccrine
o Found throughout the body
o Connect to skin through pores
o Help with thermoregulation
 Subcutaneous (Adipose) Tissue
o What is it?
 Composed of adipose CT
 Located beneath dermis
 Houses major vessels, lymphatics, and nerves
o What does it do?
 Insulates from heat and cold
 Absorbs shock
 Caloric reservoir used during sickness or starvation
 Thins with aging
 Fascial Layer
o What is it?
 Tough but flexible layer
 Consists of fiber creators
o What does it do?
 Connects subcutaneous and above layers to muscle
 Muscle Tissue
o What is it?
 High metabolic demand
 Sensitive to reduced blood flow
o What does it do?
 Keeps muscles moving by absorbing oxygen
 Did you know?
o One centimeter of skin contains:
 15 sebaceous glands
 3 yards of vessels
 100 sweat glands
 3000 sensory cells
 4 yards of nerves
 300,000 epidermal cells
 10 hair follicles

Maintaining Skin Integrity

 What does skin need?
o To maintain homeostasis:
 Keratinization
 Continuous pH
 Equalization of the water content of epidermis
 What alters skin integrity?
o Age
 At birth: skin and nails are thin (thicken with age)
 Adolescence: hormones stimulate increased activitiy of
sebaceous glands and hair follicles (acne is normal)
 Adulthood: skin thins and the formation of lines and wrinkles
being (new cell production slows)
o Sun overexposure:
 Dry, tough skin
 Increases risk of skin cancer
 Wrinkling and irregular pigmentation
 Thickening of epidermal cells
 Dilated dermal vessels
 Reduction of Langerhans cells by 50%
o Soaps / Cleansers
 Excessive use can reduce skin’s water-holding ability
 Soap emulsifies and removes lipid coating of skin
 Alkaline soaps reduce thickness and number of cell layers in
corneum
 Alkaline soap increases skin’s pH – change ability to resist
bacteria
o Nutrition
 Protein, carbs, fats, vitamins, and minerals all help maintain
skin
 Damaged skin requires increased dietary intake for repair and
restoration
o Medication
 Corticosteroids interfere with epidermal regeneration and
collagen synthesis
 Antibacterial, oral steroids, and hormones alter flora
 Analgesis, antihistamines, and NSAIDs alter inflammatory
reactions
o Disease / Illness
 Arteriosclerosis, venous insufficiency, HTN, obesity, and DM
affect circulation, interfere with nutrition, and oxygenation
 Diminish body’s ability to transport leukocytes and
macrophages
 Skin integrity is also altered by immobility, incontinence, and
increases body temperature