Anatomy and Physiology Chapter 05 - The Integumentary System

The integumentary system consists of skin, hair, oil, and sweat glands, nails, and sensory receptors. It
1. Helps the body maintain its temperature
2. Converts inactive vitamin d to its active form
3. Provides sensory information
4. Helps maintain homeostasis in a number of ways.

Functions of skin
1. Thermoregulation
a. Sweat
b. Blood flow to the dermis
2. Blood reservoir
a. The dermis has so many blood vessels that it can hold about 8-10% of total blood flow
while the adult is at rest.
3. Protection
a. Keratin
b. Lipids released by lamellar granules
c. Sebum
d. Acidic sweat
e. Melanin
f. macrophages
4. Cutaneous sensations - the skin contains different types of sensory receptors found in
different layers.
a. Tactile sensations - touch pressure, vibration, tickle
b. Thermal sensation - warm, cool
c. pain
5. Excretion and absorption
a. Excretion - elimination of substances from the body
b. Absorption - passage of materials from the external environment into body cells.
c. Transdermal - drug administration
6. Synthesis of vitamin d
a. Ultraviolet rays activate the precursor molecule (calcitriol) allowing vitamin d to be made.
b. Vitamin d aids in the absorption of calcium from foods in the gastrointestinal tract.

Maintenance of homeostasis contribution of the integumentary system for all body systems
1. Skin and hair provides barriers that protect all internal organs from damaging agents in the
external environment.
2. Sweat glands and skin blood vessels regulate body temperature, needed for proper functioning
of other body systems.
Nervous system
a. nerve endings in skin and subcutaneous tissue provide input to the brain for touch, pressure,
thermal, and pain sensations.
Endocrine system
a. Keratinocytes in skin help activate vitamin d to calcitriol, a hormone that aids in absorption of
dietary calcium and phosphorus.
Cardiovascular system
a. Local chemical changes in dermis cause widening and narrowing of skin blood vessels, which
help adjust blood flow to skin.
Lymphoid (lymphatic) system and immunity
a. Skin is the first line of defense in immunity, providing mechanical barriers and chemical
secretions that discourage penetration and growth of microbes.
b. Dendritic cells in epidermis participate in immune responses by recognizing and processing
foreign antigens.
c. Macrophages in dermis phagocytose microbes that penetrate the skin surface.
Respiratory system
a. Hairs in nose filter dust particles from inhaled air
b. Stimulation of pain nerve endings in skin may alter breathing rate.
Digestive system
a. Skin helps activate vitamin d to the hormone calcitriol, which promotes absorption of dietary
calcium and phosphorus in the small intestine.
Urinary system
a. Kidney cells receive partially activated vitamin d hormone from skin and convert it to calcitriol
b. Some waste products are excreted from the body in sweat, contributing to excretion by the
urinary system.
Genital (reproductive) systems
a. Nerve endings in skin and subcutaneous tissue respond to erotic stimuli, contributing to sexual
pleasure.
b. Suckiling of a baby stimulates nerve endings in skin, leading to milk ejection.
c. Mammary glands (modified sweat glands) produce milk.
d. Skin stretches during pregnancy as the fetus enlarges.
Skeletal system
a. Skin helps activate vitamin d, needed for proper absorption of dietary calcium and phosphorus
to build and maintain bones.
Muscular system
a. Skin helps provide calcium ions, needed for muscle contractions
The skin has two major layers
1. Epidermis - the most superficial layer
2. Dermis - a layer deep to the epidermis
Hypodermis - also called the subcutaneous (subQ)
layer, located deep to the dermis but not a layer
of the skin, composed of areolar and adipose
tissue.

Components of the integumentary system

The epidermis contains four major types of cell

1. Keratinocytes
2. Melanocytes
3. Intraepidermal macrophages (Langerhans
cell)
4. Tactile epithelial cells (Merkel cell)

Types of skin
1. Thin (hairy) skin covers all body regions
except the palms, palmar surfaces of digits, soles.
2. Thick (hairless) skin covers the palms, palmar
surfaces of digits, and soles
The epidermis is composed of four layers in thin skin and five layers in thick skin. They are from
deep to superficial.
1. Stratum basale - deepest layer, composed of a single row of cuboidal or columnar
keratinocytes that contain scattered keratin intermediate filaments (tonofilaments), epidermal
stem cells undergo cell division to produce new
keratinocytes. Melanocytes and tactile epithelial cells
associated with non encapsulated sensory corpuscles are
scattered along epidermal stem cells.
2. Stratum spinosum - eight to ten rows of many sided
keratinocytes with bundles of keratin intermediate
filaments, contains projections of melanocytes and
dendritic cells.
3. Stratum granulosum - three to five rows of flattened
keratinocytes, in which organelles are beginning to degenerate, cells contain the protein
 keratohyalin (concerts keratin intermediate filaments into
keratin) and lamellar granules (release lipid rich, water repellant
secretions.
4. Stratum lucidum (only present in thick skin) - present
only in the skin of palms, palmar surfaces of digits, soles, and
plantar surfaces of toes, consists of four to six rows of
clear, flat, dead keratinocytes with large amounts of keratin.
5. Stratum corneum - few to 50 or more dead, flat
keratinocytes that contain mostly keratin.

The dermis is composed of connective tissue containing collagen

and elastic fibers
1. Papillary - superficial portion of the dermis (about 1/5th), consists of areolar connective tissue
with thin collagen and fine elastic fibers, contains dermal ridges that house blood capillaries,
tactile corpuscles, and free nerve endings.
2. Reticular - deeper portion of the dermis (about 4/5ths), consists of dense irregular connective
tissue with bundles of thick collagen and some coarse elastic fibers. Space between fibers
contain some adipose cells, hair follicles, nerves, sebaceous glands, and sudoriferous glands.

Skin pigments
1. Melanin - produced by the melanocytes in the stratum basale
a. Pheomelanin (yellow to red)
b. Eumelanin (brown to black)
2. Hemoglobin - red pigment in red blood cells
3. Carotene - yellow to orange pigments stored in the stratum corneum and adipose tissue

Clinical Connection
1. Albinism - the
inherited inability to
produce melanin.
Results in complete or
partial absence of
pigment in the skin, hair,
and eyes.
2. Vitiligo - is a chronic disorder characterized by partial
or complete loss of melanocytes from patches of skin
producing irregular white spots. The loss of
melanocytes is related to an immune system malfunction
where antibodies attack melanocytes.
Hair
1. Present on most body surfaces except the nipples,
palms, palmar surfaces of fingers, the soles of the
toes, labia minora and prepuce of penis.
2. Composed of dead, keratinized epidermal cells
bonded by extracellular proteins.
3. Genetic and hormonal influences determine the
thickness and distribution of our hair.
The parts of the hair include
1. Shaft (above the skin surface)
2. Follicle (below the level of the skin)
3. Root (that penetrates into the dermis
a. Epithelial root sheath
b. Dermal root sheath
Hair growth stages are
1. Growth stage - cells of
matric divide
2. Regression stage - hair
moves away from blood
supply in papillary and
follicle atrophies
3. Resting stage - old hair
root falls out, new growth
begins.
Types of hair
1. Languo - covers the fetus
2. Terminal - long, coarse,
heavily pigmented hairs
3. Vellus - short, fine, pale
hairs
Hair colour - primarily due to the
amount and type of melanin
present in the keratinized cells of
the hair.
1. Dark coloured hair - mostly
eumelalin
2. Blonde and red hair -
variants of phenomelanin
3. Gray hair - proggresive decline in melanin production
4. White hair - lack of melanin, accumulation of air bubbles in shaft
The skin contains three types of gland
1. Sebaceous (oil) glands - connected to hair follicles.
2. Sudoriferous glands - sweat glands
a. Eccrine - most numerous
b. Apocrine - located mainly in hairy skin areas
3. Ceruminous glands - modified sweat glands located in the ear canal

Nails
1. Nails are made of keratinized epidermal cells
2. Nail structures
Epidermal wound healing - occurs when superficial wounds affect only the epidermis.

Deep wound healing - additional steps occur when injury extends to the dermis and subcutaneous layer.

1. Inflammatory phase - clot forms

2. Migratory phase - clot becomes a scab
3. Proliferative phase - growth of epithelial cells beneath scab
4. Maturation phase - scabs sloughs off once epidermis restored

Age associated changes

1. Wrinkles
2. Dehydration and cracking
3. Sweat production decreases
4. The numbers of functional melanocytes decrease which results in gray hair and atypical skin
pigmentation.
5. Subcutaneous fat is lost and skin thickness decreases
 6. Nails may become more brittle

Skin cancer
1. Excessive exposure to ultraviolet light (from the
sun or tanning salons) is the most common
cause of skin cancer
2. The three major types are basal cell carcinoma
(78%), squamous cell carcinoma (20%), and
malignant melanoma (2%)
3. Early warning signs of malignant melanoma
a. A - Asymmetry
b. B - Border is irregular
c. C - Colour is uneven
d. D - Diameter is >6mm (pencil eraser)
e. E - Evolving and changing in size
and shape

Burns
1. A burn is tissue damage caused by
excessive heat, electricity, radioactivity,
or corrosive chemicals that denature

(break down)the proteins in the skin cells.

2. Burns are graded according to the severity.
3. The rule of nines is used to estimate the surface area
of an adult affected by a burn.

Pressure ulcers
1. With age, there is an
increased susceptibility to
pressure ulcers (bed sores)
2. When shedding of epithelium caused by deficiency of blood
flow to tissues occurs, pressure ulcers can develop.