Human Anatomy & Physiology: Outline

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CAGAYAN STATE UNIVERSITY HUMAN ANATOMY &
College of Allied Health Sciences
S.Y. 2021-2022
Bachelor of Science in Respiratory Therapy PHYSIOLOGY
01
UNIT 01 – THE HUMAN BODY: AN ORIENTATION Two Basic Approaches to Study Anatomy
OUTLINE 1. Systemic Anatomy is the study of the body systems, such as

I. the cardiovascular, nervous, skeletal and muscular systems.
An Overview of Anatomy and Physiology

2. Regional Anatomy is the study of the organization of the body
A. Definition of Anatomy
by areas. Within each region, such as the head, abdomen, or
1. Two Basic Approaches to Study Anatomy
arm, all systems are studied simultaneously.
2. Two General Ways to Examine Internal
Structures
B. Definition of Physiology Two General Ways to Examine Internal Structures
1. Goals of Physiology
C. Relationship Between Anatomy and Physiology 1. Surface Anatomy is the study of the external features, such as
D. Subspecialties of Anatomy and Physiology bony projections, which serve as landmarks for locating deeper
II. Levels of Structural Organization and Body Systems structures. Surface anatomy involves looking at the exterior of
A. Six Levels of Structural Organization the body to visualize structures deeper inside the body. For
B. Organ System Overview example, the sternum (breastbone) and parts of the ribs can be
III. Characteristics of the Living Human Organism seen and palpated (felt) on the front of the chest. Health
A. Basic Life Processes professionals use these structures as anatomical landmarks to
B. Body’s Survival Needs identify regions of the heart and points on the chest where
certain heart sounds can best be heard.
IV. Homeostasis
A. Definition of Homeostasis
B. Homeostasis and Body Fluids 2. Anatomical Imaging uses radiographs (x-rays), ultrasound,
C. Control of Homeostasis magnetic resonance imaging (MRI), and other technologies to
D. Feedback Systems create pictures of internal structures. It is a non-invasive
1. Components of Feedback System method for examining deep structures. Anatomical imaging has
2. Types of Feedback Systems revolutionized medical science. Imaging techniques contribute
E. Homeostatic Imbalances to the advancement of anatomical knowledge.
V. The Language of Anatomy
A. Body Positions Physiology
B. Regional Terms
C. Directional Terms • physio- means ‘nature’; -logy means ‘study of’
D. Body Planes and Sections • The science of body functions and processes—how the body
E. Body Cavities parts work.
1. Thoracic and Abdominal Cavity
Membranes Goals of Physiology
2. Abdominopelvic Regions and
Quadrants 1. To understand and predict the body’s responses to a stimuli
2. To understand how the body maintains conditions within a
narrow range of values in the presence of continually changing
internal and external environment.
AN OVERVIEW OF ANATOMY AND PHYSIOLOGY
Relationship Between Anatomy and Physiology
Anatomy Anatomy and physiology are always inseparable. The parts of your
body form a well-organized unit, and each of those parts has a job to
• ana- means ‘up’; -tomy refers to the process of cutting do to make the body operate as a whole. Structure determines what
• The science of body structures and the relationships among functions can take place. For example, the lungs are not muscular
them. chambers like the heart and so cannot pump blood through the body,
• It was first studied by dissection (dis- means ‘apart’; -section but because the walls of their air sacs are very thin, they can
refers to the act of cutting), the careful cutting apart of body exchange gases and provide oxygen to the body.
structures to study their relationships.
Because structure and function are so closely related, you will learn
about the human body by studying its anatomy and physiology
together. The structure of a part of the body often reflects its functions.
For example, the bones of the skull join tightly to form a rigid case that
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protects the brain. The bones of the fingers are more loosely joined to Surface The study of the surface markings of the body
allow a variety of movements. The walls of the air sacs in the lungs Anatomy to understand internal anatomy through
are very thin, permitting rapid movement of inhaled oxygen into the visualization and palpation (gentle touch).
blood. Imaging Anatomy The study of body structures that can be
visualized with techniques such as x-rays, MRI,
Your study of this two will make more sense if you continually relate
and CT scans.
the form of the structures you are studying to their function. In order to
understand physiology it is necessary to have some knowledge about Pathological The study of structural changes (gross to
anatomy, and it is important to have an equal understanding of both Anatomy microscopic) associated with disease.
these subjects and it is very important for both of them to learn and PHYSIOLOGY
understand alongside each other. Neurophysiology The study of the functional properties of nerve
cells.
Subspecialties of Anatomy and Physiology Endocrinology The study of hormones (chemical regulators in
the blood) and how they control body functions.
Anatomy can be studied at different levels: Cardiovascular The study of the functions of the heart and
Physiology blood vessels.
1. Gross Anatomy is the study of structures that can be
Immunology The study of the body’s defenses against
examined without the aid of a microscope, can be approached
diseases-causing agents.
either systemically or regionally. It is the study of the larger
structures of the body, those which are seen and observable Respiratory The study of the functions of air passageways
without magnification, it is also referred to as macroscopic Physiology and lungs.
anatomy. Renal Physiology The study of the functions of the kidneys.
Exercise The study of changes in cell and organ
Physiology functions due to muscular activity.
2. In contrast, micro– means “small,” and microscopic anatomy
is the study of structures that can be observed only with the use Pathophysiology The study of functional changes associated with
of a microscope or other magnification devices. Microscopic disease and aging.
anatomy includes the study of cells (cytology) and tissues
(histology).
LEVELS OF STRUCTURAL ORGANIZATION & BODY SYSTEMS
Developmental anatomy studies the structural changes that occur
between conception and adulthood.
Six Levels of Structural Organization
a. Embryology considers changes from conception to the end of
the eighth week of development. The body can be studied at six levels of organization: the chemical,
b. Cytology examines the structural features of cells. cell, tissue, organ, organ system, and whole organism levels.
c. Histology (hist means tissue) examines tissues, which are
composed of cells and the materials surrounding them. 1. Chemical level. The chemical level involves interactions between
atoms, which are tiny building blocks of matter. Atoms combine to
SELECTED BRANCHES OF ANATOMY & PHYSIOLOGY
form molecules, such as water, sugar, lipids, and proteins. The
ANATOMY function of a molecule is intimately related to its structure. For
Embryology The study of the first eight weeks of example, collagen molecules are ropelike protein fibers that give
development after fertilization of the human skin structural strength and flexibility. With old
egg.
Developmental The study of the complete development of an age, the structure of collagen changes, and the skin becomes
Biology individual from fertilization to death. fragile and more easily torn. Certain atoms, such as carbon (C),
Cell Biology The study of cellular structure and functions. hydrogen (H), oxygen (O), nitrogen (N), phosphorus (P), calcium
(Ca), and sulfur (S), are essential for maintaining life. Two familiar
Histology The study of microscopic structures of tissues
molecules found in the body are deoxyribonucleic acid (DNA), the
Gross Anatomy The study of structures that can be examined
genetic material passed from one generation to the next, and
without a microscope. glucose, commonly known as blood sugar.
Systemic Anatomy The study of structure of specific systems of the
body such as nervous system.
Regional Anatomy The study of the specific regions of the body
such as the head or chest.
Radiographic The study of body structures that can be
Anatomy visualized with x-rays.
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organ is part of more than one system. The pancreas, for
example, is part of both the digestive system and the hormone-
producing endocrine system.
6. Organismal level. An organism is any living thing considered as

a whole—whether composed of one cell, such as a bacterium, or
of trillions of cells, such as a human. The human organism is a
network of organ systems, all mutually dependent on one
another.
Organ System Overview
Integumentary System
Components: Skin and associated structures, such as hair,

fingernails and toenails, sweat glands, and oil glands.
Functions: Protects body; helps regulate body temperature;

eliminates some wastes; helps make vitamin D; detects sensations
such as touch, pain, warmth, and cold; stores fat and provides
insulation.
2. Cellular level. Molecules combine to form cells, the basic
structural and functional units of an organism that are composed
of chemicals. Cells are the smallest living units in the human
body. Among the many kinds of cells in your body are muscle
cells, nerve cells, and epithelial cells. Although cell types differ in
their structure and function, they have many characteristics in
common.
3. Tissue level. Tissues are groups of cells and the materials

surrounding them that work together to perform a particular
function. The characteristics of the cells and surrounding
materials determine the functions of the tissue. There are just four
basic types of tissues in your body: epithelial tissue, connective
tissue, muscular tissue, and nervous tissue. Epithelial tissue
covers body surfaces, lines hollow organs and cavities, and forms Skeletal System
glands. Connective tissue connects, supports, and protects
body organs while distributing blood vessels to other tissues. Components: Bones and joints of the body and their associated
Muscular tissue contracts to make body parts move and cartilages.
generates heat. Nervous tissue carries information from one part
of the body to another through nerve impulses. Functions: Supports and protects body; provides surface area for
muscle attachments; aids body movements; houses cells that produce
blood cells; stores minerals and lipids (fats).
4. Organ level. At the organ level different types of tissues are
joined together. Organs are structures that are composed of two
or more different types of tissues; they have specific functions
and usually have recognizable shapes. Examples of organs are
the stomach, skin, bones, heart, liver, lungs, and brain.
5. Organ System level. A system consists of related organs with a

common function. It is a group of organs that together perform a
common function or set of functions and are therefore viewed as
a unit. An example of the system level, also called the organ
system level, is the digestive system, which breaks down and
absorbs food. Its organs include the mouth, salivary glands,
pharynx (throat), esophagus (food tube), stomach, small intestine,
large intestine, liver, gallbladder, and pancreas. Sometimes an
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Endocrine System
Components: Hormone-producing glands (pineal gland,

hypothalamus, pituitary gland, thymus, thyroid gland, parathyroid
glands, adrenal glands, pancreas, ovaries, and testes) and
Muscular System hormoneproducing cells in several other organs.
Components: Specifically, skeletal muscle tissue—muscle usually Functions: Regulates body activities by releasing hormones
attached to bones (other muscle tissues include smooth and cardiac). (chemical messengers transported in blood from endocrine gland or
tissue to target organ).
Functions: Participates in body movements, such as walking;
maintains posture; produces heat.
Nervous System
Components: Brain, spinal cord, nerves, and special sense organs,

such as eyes and ears.
Functions: Generates action potentials (nerve impulses) to regulate

body activities; detects changes in body’s internal and external
environments, interprets changes, and responds by causing muscular
contractions or glandular secretions.
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Respiratory System
Components: Lungs and air passageways such as the pharynx

(throat), larynx (voice box), trachea (windpipe), and bronchial tubes
leading into and out of lungs.
Functions: Transfers oxygen from inhaled air to blood and carbon

dioxide from blood to exhaled air; helps regulate acid–base balance of
body fluids; air flowing out of
lungs through vocal cords
produces sounds.
Cardiovascular System
Components: Blood, heart, and blood vessels.
Functions: Heart pumps blood through blood vessels; blood carries oxygen and
nutrients to cells and carbon dioxide and wastes away from cells and helps regulate
acid–base balance, temperature, and water content of body fluids; blood components help defend against disease and repair
damaged blood vessels.
Digestive System
Components: Organs of gastrointestinal tract, a long tube that includes

the mouth, pharynx (throat), esophagus (food tube), stomach, small
and large intestines, and anus; also includes accessory organs that
assist in digestive processes, such as salivary glands, liver, gallbladder,
and pancreas.
Functions: Achieves physical and chemical breakdown of food;

absorbs nutrients; eliminates solid wastes.
Lymphatic System
Components: Lymphatic fluid and vessels; spleen, thymus, lymph nodes, and tonsils; cells
that carry out immune responses (B cells, T cells, and others).
Functions: Returns proteins and fluid to blood; carries lipids from gastrointestinal tract to
blood; contains sites of maturation and proliferation of B cells and T cells that protect against
disease- causing microbes.
Urinary System
Components: Kidneys, ureters, urinary bladder, and urethra.
Functions: Produces, stores, and eliminates urine; eliminates wastes

and regulates volume and chemical composition of blood; helps
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maintain the acid–base balance of body fluids; maintains body’s mineral balance; helps regulate production of red blood cells.
specific functions. Living things are highly organized. All

organisms are composed of one or more cells. Some cells in
turn are composed of highly specialized organelles, which
depend on the precise organization of large molecules.
Disruption of this organized state can result in loss of functions,
or even death.
2. Metabolism refers to all of the chemical reactions taking place

in the cells and internal environment of an organism. It includes
an organism’s ability to break down food molecules, which the
organism uses as a source of energy and raw materials to
synthesize its own molecules. Energy is also used when one
part of a molecule moves relative to another part, changing the
shape of the molecule. In single-celled organisms and certain
Reproductive Systems human cells, this change in molecular shape can cause the
whole cell to change shape. Sometimes this change in cell
Components: Gonads (testes in males and ovaries in females) and shape can allow the entire organism or cell to move to a
associated organs (uterine tubes or fallopian tubes, uterus, vagina, different location. Metabolism is necessary for other vital
and mammary glands in females and epididymis, ductus or vas functions, such as responsiveness, growth, development, and
deferens, seminal vesicles, prostate, and penis in males). reproduction. One phase of metabolism is catabolism, the
breakdown of complex chemical substances into simpler
Functions: Gonads produce gametes (sperm or oocytes) that unite to components. The other phase of metabolism is anabolism, the
form a new organism; gonads also release hormones that regulate building up of complex chemical substances from smaller,
reproduction and other body processes; associated organs transport simpler components.
and store gametes; mammary glands produce milk.
3. Responsiveness is an organism’s ability to sense changes in

its external or internal environment and adjust to those
changes. Responses include actions such as moving toward
food or water and moving away from danger or poor
environmental conditions. Organisms can also make
adjustments that maintain their internal environment. For
example, if the external environment causes the body
temperature to rise, sweat glands produce sweat, which can
lower body temperature down to the normal range.
4. Growth refers to an increase in the size or number of cells,

which produces an overall enlargement of all or part of an
organism. For example, a muscle enlarged by exercise is
composed of larger muscle cells than those of an untrained
CHARACTERISTICS OF THE LIVING HUMAN ORGANISM muscle, and the skin of an adult has more cells than the skin of
an infant. An increase in the materials surrounding cells can
Basic Life Processes also contribute to growth. For instance, bone grows because of
an increase in cell number and the deposition of mineralized
Humans are organisms, sharing characteristics with other organisms. materials around the cells.
The most important common feature of all organisms is life. These 5. Development includes the changes an organism undergoes
basic life processes distinguish organisms, or living things, from through time, beginning with fertilization and ending at death.
nonliving things. The greatest developmental changes occur before birth, but
many changes continue after birth, and some go on throughout
1. Organization refers to the specific interrelationships among the life. Development usually involves growth, but it also involves
parts of an organism and how those parts interact to perform differentiation and morphogenesis. Differentiation involves
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changes in a cell’s structure and function from an immature, If chemical reactions are to continue at life sustaining levels, normal
generalized state to a mature, specialized state. For example, body temperature must be maintained. If body temperature drops
following fertilization, immature cells differentiate to become below 37°C (98.6°F), metabolic reactions become slower and slower
specific cell types, such as skin, bone, muscle, or nerve cells. and finally stop. If body temperature is too high, chemical reactions
These differentiated cells form tissues and organs. proceed too rapidly, and body proteins begin to break down. At either
Morphogenesis is the change in shape of tissues, organs, and extreme, death occurs. Most body heat is generated by the activity of
the entire organism. the skeletal muscles and dissipated via blood circulating close to the
skin surface or by the evaporation of sweat.
6. Reproduction is the formation of new cells or new organisms. The force exerted on the surface of the body by the weight of air is
Without reproduction of cells, growth and development are not referred to as atmospheric pressure. Breathing and the exchange of
possible. Without reproduction of organisms, species become oxygen and carbon dioxide in the lungs depend on appropriate
extinct. atmospheric pressure. At high altitudes, where the air is thin and
atmospheric pressure is lower, gas exchange may be too slow to
7. Movement includes motion of the whole body, individual support cellular metabolism.
organs, single cells, and even tiny structures inside cells. For
example, the coordinated action of leg muscles moves your The mere presence of these survival factors is not sufficient to
whole body from one place to another when you walk or run. maintain life. They must be present in appropriate amounts as well;
After you eat a meal that contains fats, your gallbladder excesses and deficits may be equally harmful. For example, the food
contracts and releases bile into the gastrointestinal tract to help ingested must be of high quality and in proper amounts; otherwise,
digest them. When a body tissue is damaged or infected, nutritional disease, obesity, or starvation is likely.
certain white blood cells move from the bloodstream into the
affected tissue to help clean up and repair the area. HOMEOSTASIS
When any one of the life processes ceases to occur properly, the Definition of Homeostasis
result is death of cells and tissues, which may lead to death of the
organism. Clinically, loss of the heartbeat, absence of spontaneous Homeostasis is the condition of equilibrium (balance) in the body’s
breathing, and loss of brain functions indicate death in the human internal environment due to the constant interaction of the body’s
body. many regulatory processes. Homeostasis is a dynamic condition. In
response to changing conditions, the body’s equilibrium can shift
Body’s Survival Needs Homeostasis and Body Fluids
The goal of nearly all body systems is to maintain life. However, life is among points in a narrow range that is compatible with maintaining
extraordinarily fragile and requires that several factors be available. life. For example, the level of glucose in blood normally stays between
These factors, which we will call survival needs, include nutrients 70 and 110 milligrams of glucose per 100 milliliters of blood. Each
(food), oxygen, water, and appropriate temperature and atmospheric structure, from the cellular level to the system level, contributes in
pressure. some way to keeping the internal environment of the body within
normal limits.
Nutrients, which the body takes in through food, contain the
chemicals used for energy and cell building. Carbohydrates are the An important aspect of homeostasis is maintaining the volume and
major energy providing fuel for body cells. Proteins and, to a lesser composition of body fluids, dilute, watery solutions containing
extent, fats are essential for building cell structures. Fats also cushion dissolved chemicals that are found inside cells as well as surrounding
body organs and provide reserve fuel. Minerals and vitamins are them. The fluid within cells is intracellular fluid (ICF). The fluid
required for the chemical reactions that go on in cells and for oxygen outside body cells is extracellular fluid (ECF). The ECF that fills the
transport in the blood. narrow spaces between cells of tissues is known as interstitial fluid.
As you progress with your studies, you will learn that the ECF differs
All the nutrients in the world are useless unless oxygen is also depending on where it occurs in the body: ECF within blood vessels is
available. Because the chemical reactions that release energy from termed blood plasma, within lymphatic vessels it is called lymph, in
foods require oxygen, human cells can survive for only a few minutes and around the brain and spinal cord it is known as cerebrospinal
without it. It is made available to the blood and body cells by the fluid, in joints it is referred to as synovial fluid, and the ECF of the eyes
cooperative efforts of the respiratory and cardiovascular systems. is called aqueous humor and vitreous body.
Water accounts for 60 to 80 percent of body weight, depending on the The proper functioning of body cells depends on precise regulation of
age of the individual. It is the single most abundant chemical the composition of the interstitial fluid surrounding them. Because of
substance in the body and provides the fluid base for body secretions this, interstitial fluid is often called the body’s internal environment.
and excretions. We obtain water chiefly from ingested foods or liquids, The composition of interstitial fluid changes as substances move back
and we lose it by evaporation from the lungs and skin and in body and forth between it and blood plasma. Such exchange of materials
excretions. occurs across the thin walls of the smallest blood vessels in the body,
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the blood capillaries. This movement in both directions across 1. A receptor is a body structure that monitors changes in a
capillary walls provides needed materials, such as glucose, oxygen, controlled condition and sends input to a control center. This
ions, and so on, to tissue cells. It also removes wastes, such as pathway is called an afferent pathway, since the information
carbon dioxide, from interstitial fluid. flows toward the control center. Typically, the input is in the
form of nerve impulses or chemical signals. For example,
Control of Homeostasis certain nerve endings in the skin sense temperature and can
detect changes, such as a dramatic drop in temperature.
Homeostasis in the human body is continually being disturbed. Some
disruptions come from the external environment in the form of:
2. A control center in the body, for example, the brain, sets the
range of values within which a controlled condition should be
1. Physical insults such as the intense heat of a hot summer day
maintained (set point), evaluates the input it receives from
or a lack of enough oxygen for that two-mile run.
receptors, and generates output commands when they are
needed. Output from the control center typically occurs as
2. Changes in the internal environment, such as a blood nerve impulses, or hormones or other chemical signals. This
glucose level that falls too low when you skip breakfast. pathway is called an efferent pathway, since the information
flows away from the control center. In our skin temperature
3. Homeostatic imbalances may also occur due to psychological example, the brain acts as the control center, receiving nerve
stresses in our social environment—the demands of work and impulses from the skin receptors and generating nerve
school, for example. impulses as output.
In most cases the disruption of homeostasis is mild and temporary, 3. An effector is a body structure that receives output from the
and the responses of body cells quickly restore balance in the internal control center and produces a response or effect that changes
environment. However, in some cases the disruption of homeostasis the controlled condition. Nearly every organ or tissue in the
may be intense and prolonged, as in poisoning, overexposure to body can behave as an effector. When your body temperature
temperature extremes, severe infection, or major surgery. drops sharply, your brain (control center) sends nerve impulses
(output) to your skeletal muscles (effectors). The result is
Fortunately, the body has many regulating systems that can usually
shivering, which generates heat and raises your body
bring the internal environment back into balance. Most often, the
temperature.
nervous system and the endocrine system, working together or
independently, provide the needed corrective measures. The nervous
system regulates homeostasis by sending electrical signals known as
nerve impulses (action potentials) to organs that can counteract
changes from the balanced state. The endocrine system includes
many glands that secrete messenger molecules called hormones into
the blood. Nerve impulses typically cause rapid changes, but
hormones usually work more slowly. Both means of regulation,
however, work toward the same end, usually through negative
feedback systems.
Feedback Systems
The body can regulate its internal environment through many

feedback systems. A feedback system or feedback loop is a cycle of
events in which the status of a body condition is monitored, evaluated,
changed, remonitored, reevaluated, and so on. Each monitored
variable, such as body temperature, blood pressure, or blood glucose
level, is termed a controlled condition. Any disruption that changes a
controlled condition is called a stimulus.
Components of Feedback System
A feedback system includes three basic components: a receptor, a

control center, and an effector.
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A group of receptors and effectors communicating with their control Oxytocin causes muscles in the wall of the uterus (effector) to contract
center forms a feedback system that can regulate a controlled even more forcefully. The contractions push the fetus farther down the
condition in the body’s internal environment. In a feedback system, uterus, which stretches the cervix even more. The cycle of stretching,
the response of the system “feeds back” information to change the hormone release, and ever-stronger contractions is interrupted only by
controlled condition in some way, either negating it (negative the birth of the baby. Then, stretching of the cervix ceases and
feedback) or enhancing it (positive feedback). oxytocin is no longer released.
Another example of positive feedback is what happens to your body

when you lose a great deal of blood. Under normal conditions, the
heart pumps blood under sufficient pressure to body cells to provide
them with oxygen and nutrients to maintain homeostasis. Upon severe
blood loss, blood pressure drops and blood cells (including heart cells)
receive less oxygen and function less efficiently. If the blood loss
continues, heart cells become weaker, the pumping action of the heart
decreases further, and blood pressure continues to fall. This is an
example of a positive feedback cycle that has serious consequences
and may even lead to death if there is no medical intervention. Blood
clotting is also an example of a positive feedback system.
These examples suggest some important differences between positive

and negative feedback systems. Because a positive feedback system
Types of Feedback Systems continually reinforces a change in a controlled condition, some event
outside the system must shut it off. If the action of a positive feedback
system is not stopped, it can “run away” and may even produce
A negative feedback system reverses a change in a controlled lifethreatening conditions in the body. The action of a negative
condition. Consider the regulation of blood pressure. Blood pressure feedback system, by contrast, slows and then stops as the controlled
(BP) is the force exerted by blood as it presses against the walls of condition returns to its normal state. Usually, positive feedback
blood vessels. When the heart beats faster or harder, BP increases. If systems reinforce conditions that do not happen very often, and
some internal or external stimulus causes blood pressure (controlled negative feedback systems regulate conditions in the body that
condition) to rise, the following sequence of events occurs. remain fairly stable over long periods.
Baroreceptors (the receptors), pressure-sensitive nerve cells located
in the walls of certain blood vessels, detect the higher pressure. The Homeostatic Imbalances
baroreceptors send nerve impulses (input) to the brain (control
center), which interprets the impulses and responds by sending nerve You’ve seen homeostasis defined as a condition in which the body’s
impulses (output) to the heart and blood vessels (the effectors). Heart internal environment remains relatively stable. The body’s ability to
rate decreases and blood vessels dilate (widen), which cause BP to maintain homeostasis gives it tremendous healing power and a
decrease (response). This sequence of events quickly returns the remarkable resistance to abuse. The physiological processes
controlled condition—blood pressure—to normal, and homeostasis is responsible for maintaining homeostasis are in large part also
restored. Notice that the activity of the effector causes BP to drop, a responsible for your good health.
result that negates the original stimulus (an increase in BP). This is
why it is called a negative feedback system. For most people, lifelong good health is not something that happens
effortlessly. The many factors in this balance called health include the
Unlike a negative feedback system, a positive feedback system following:
tends to strengthen or reinforce a change in one of the body’s
controlled conditions. In a positive feedback system, the response • The environment and your own behavior.
affects the controlled condition differently than in a negative feedback • Your genetic makeup.
system. The control center still provides commands to an effector, but • The air you breathe, the food you eat, and even the thoughts
this time the effector produces a physiological response that adds to you think.
or reinforces the initial change in the controlled condition. The action
of a positive feedback system continues until it is interrupted by some The way you live your life can either support or interfere with your
mechanism. body’s ability to maintain homeostasis and recover from the inevitable
stresses life throws your way.
Normal childbirth provides a good example of a positive feedback
system. The first contractions of labor (stimulus) push part of the fetus Many diseases are the result of years of poor health behaviour that
into the cervix, the lowest part of the uterus, which opens into the interferes with the body’s natural drive to maintain homeostasis. An
vagina. Stretch-sensitive nerve cells (receptors) monitor the amount of obvious example is smoking-related illness. Smoking tobacco
stretching of the cervix (controlled condition). As stretching increases, exposes sensitive lung tissue to a multitude of chemicals that cause
they send more nerve impulses (input) to the brain (control center), cancer and damage the lung’s ability to repair itself. Because
which in turn releases the hormone oxytocin (output) into the blood. diseases such as emphysema and lung cancer are difficult to treat
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and are very rarely cured, it is much wiser to quit smoking— or never your hands up above your head, your fingers would be above your
start—than to hope a doctor can “fix” you once you are diagnosed with wrists. To prevent this kind of confusion, anatomists use a standard
a lung disease. Developing a lifestyle that works with, rather than anatomical position and a special vocabulary for relating body parts to
against, your body’s homeostatic processes helps you maximize your one another.
personal potential for optimal health and well-being.
Body Positions
As long as all of the body’s controlled conditions remain within certain
narrow limits, body cells function efficiently, homeostasis is Descriptions of any region or part of the human body assume that it is
maintained, and the body stays healthy. Should one or more in a standard position of reference called the anatomical position. In
components of the body lose their ability to contribute to homeostasis, the anatomical position, the body is erect with the feet parallel and the
however, the normal balance among all of the body’s processes may arms hanging at the sides with the palms facing forward (thumbs
be disturbed. If the homeostatic imbalance is moderate, a disorder or pointing away from the body). The position of the body can affect the
disease may occur; if it is severe, death may result. description of body parts relative to each other. To avoid confusion,
relational descriptions are always based on the anatomical position,
A disorder is any abnormality of structure or function. Disease is a no matter the actual position of the body.
more specific term for an illness characterized by a recognizable set
of signs and symptoms. A local disease affects one part or a limited Two terms describe a reclining body. If the body is lying facedown, it is
region of the body (for example, a sinus infection); a systemic in the prone position. If the body is lying faceup, it is in the supine
disease affects either the entire body or several parts of it (for position.
example, influenza). Diseases alter body structures and functions in
characteristic ways. A person with a disease may experience
symptoms, subjective changes in body functions that are not
apparent to an observer. Examples of symptoms are headache,
nausea, and anxiety. Objective changes that a clinician can observe
and measure are called signs. Signs of disease can be either
anatomical, such as swelling or a rash, or physiological, such as fever,
high blood pressure, or paralysis.
The science that deals with why, when, and where diseases occur and
how they are transmitted among individuals in a community is known
as epidemiology. Pharmacology is the science that deals with the
effects and uses of drugs in the treatment of disease.
THE LANGUAGE OF ANATOMY
As you study anatomy and physiology, you will be learning many new
words. Knowing the derivation, or etymology, of these words can
make learning them easy and fun. Most anatomical terms are derived
from Latin or Greek. For example, foramen is a Latin word for “hole,”
and magnum means “large.” The foramen magnum is therefore a
large hole in the skull through which the spinal cord attaches to the
brain.
Prefixes and suffixes can be added to words to expand their meaning.

For example, the suffix -itis means an inflammation, so appendicitis is
an inflammation of the appendix. As new terms are introduced in this
text, their meanings are often explained. The glossary and the list of
word roots, prefixes, and suffixes on the inside back cover provide
additional information about the new terms. It is very helpful to learn
these new words, so that your message is clear and correct when you
speak to colleagues or write reports. Additionally, you will find many of
the roots of words appearing over and over again.
Scientists and health-care professionals use a common language of

special terms when referring to body structures and their functions.
The language of anatomy they use has precisely defined meanings
that allow us to communicate clearly and precisely. For example, is it
correct to say, “The wrist is above the fingers”? This might be true if
your upper limbs (described shortly) are at your sides. But if you hold
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Regional Terms
The human body is divided into several major regions that can be identified externally. The
principal regions are the head, neck, trunk, upper limbs, and lower limbs.
1. The head consists of the skull and face. The skull encloses and protects the brain; the
face is the front portion of the head that includes the eyes, nose, mouth, forehead,
cheeks, and chin.
2. The neck supports the head and attaches it to the trunk.
3. The trunk consists of the chest (thoracic), abdomen, and pelvis.
4. Each upper limb attaches to the trunk and consists of the shoulder, armpit, arm (portion
of the limb from the shoulder to the elbow), forearm (portion of the limb from the elbow to
the wrist), wrist, and hand.
5. Each lower limb also attaches to the trunk and consists of the buttock, thigh (portion of
the limb from the buttock to the knee), leg (portion of the limb from the knee to the
ankle), ankle, and foot. The groin is the area on the front surface of the body marked by
a crease on each side, where the trunk attaches to the thighs.
Directional Terms
To locate various body structures, anatomists use specific directional terms, words that
describe the position of one body part relative to another. Most of the directional terms used
to describe the relationship of one part of the body to another can be grouped into pairs that have
opposite meanings. It is important to understand that directional terms
have relative meanings; they make sense only when used to describe the position of one structure relative to another.
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DIRECTIONAL TERM DEFINITION times, it is useful to describe the body as having imaginary flat
Superior/Cephalic/Cranial Toward the head, or the upper part of a surfaces, called planes, passing through it. A plane divides, or
structure. sections, the body, making it possible to “look inside” and observe the
Inferior/Caudal Away from the head, or the lower part body’s structures.
of a structure.
1. A sagittal plane is a vertical plane that divides the body or an
Anterior/Ventral Nearer to or at the front of the body. organ into right and left sides. More specifically, when such a
Posterior/Dorsal Nearer to or at the back of the body. plane passes through the midline of the body or an organ and
Medial Nearer to the midline (an imaginary divides it into equal right and left sides, it is called a midsagittal
vertical line that divides the body into plane or a median plane. The midline is an imaginary vertical
equal right and left sides). line that divides the body into equal left and right sides. If the
Lateral Farther from the midline. sagittal plane does not pass through the midline but instead
Intermediate Between two structures. divides the body or an organ into unequal right and left sides, it
is called a parasagittal plane.
Ipsilateral On the same side of the body as
another structure.
Contralateral On the opposite side of the body from 2. A frontal or coronal plane divides the body or an organ into
another structure. anterior (front) and posterior (back) portions.
Proximal Nearer to the attachment of a limb to
the trunk; nearer to the origination of a 3. A transverse plane divides the body or an organ into superior
structure. (upper) and inferior (lower) portions. Other names for a
Distal Farther from the attachment of a limb transverse plane are a cross-sectional or horizontal plane.
to the trunk; farther from the
origination of a structure.
4. Sagittal, frontal, and transverse planes are all at right angles to
Superficial/External Toward or on the surface of the body. one another. An oblique plane, by contrast, passes through
Deep/Internal Away from the surface of the body. the body or an organ at an oblique angle (any angle other than
a 90-degree angle).
Organs are often sectioned to reveal their internal structure. A

Body Planes and Sections section is a cut of the body or one of its organs made along one of
the planes just described. Planes divide the body in various ways to
produce sections. It is important to know the plane of the section so
you can understand the anatomical relationship of one part to
another.
Body Cavities
Body cavities are spaces that enclose internal organs. Bones,

muscles, ligaments, and other structures separate the various body
cavities from one another. Body cavities have two essential
functions:
1. Protect organs from accidental shocks

2. Permit changes in size and shape of internal organs
Anatomy and physiology textbooks typically describe two sets of

internal body cavities, called the dorsal and ventral body cavities
that provide different degrees of protection to the organs within them.
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2. The abdominopelvic cavity extends from the diaphragm to the
groin and is encircled by the abdominal muscular wall and the
bones and muscles of the pelvis. As the name suggests, the
abdominopelvic cavity is divided into two portions, even though
no wall separates them. The superior portion, the abdominal
cavity, contains the stomach, spleen, liver, gallbladder, small
intestine, and most of the large intestine. The inferior portion, the
pelvic cavity, contains the urinary bladder, portions of the large
intestine, and internal organs of the reproductive system. Organs
inside the thoracic and abdominopelvic cavities are called
viscera.
The dorsal body cavity has two subdivisions, which are continuous
with each other.
1. The cranial cavity is the space inside the bony skull. The brain
is well protected because it occupies the cranial cavity.
2. The spinal/vertebral cavity extends from the cranial cavity to

the end of the spinal cord. The spinal cord, which is a Thoracic and Abdominal Cavity Membranes
continuation of the brain, is protected by the bony vertebrae,
which surround the spinal cavity and form the spine. The cranial A membrane is a thin, pliable tissue that covers, lines, partitions, or
cavity and vertebral cavity are continuous with one another. connects structures. One example is a slippery, double-layered
Three layers of protective tissue, the meninges, and a membrane associated with body cavities that does not open directly to
shockabsorbing fluid surround the brain and spinal cord. the exterior called a serous membrane. It covers the viscera within the
thoracic and abdominal cavities and also lines the walls of the thorax
The ventral body cavity is much larger than the dorsal cavity. It and abdomen.
contains all the structures within the chest and abdomen, that is, the
visceral organs in those regions. Like the dorsal cavity, the ventral body The parts of a serous membrane are (1) the parietal layer, a thin
cavity is subdivided: the thoracic and abdominopelvic cavities. epithelium that lines the walls of the cavities, and (2) the visceral
layer, a thin epithelium that covers and adheres to the viscera within
1. The thoracic cavity or chest cavity is formed by the ribs, the the cavities. Between the two layers is a potential space that contains
muscles of the chest, the sternum (breastbone), and the thoracic small amount of lubricating fluid (serous fluid). The fluid allows the
portion of the vertebral column. viscera to slide somewhat during movements, such as when the
lungs inflate and deflate during breathing.
Within the thoracic cavity are the pericardial cavity, a fluidfilled
space that surrounds the heart, and two fluid-filled spaces called
pleural cavities, one around each lung. The central part of the
thoracic cavity is an anatomical region called the mediastinum.
It is between the lungs, extending from the sternum to the
vertebral column and from the first rib to the diaphragm. The
mediastinum contains all thoracic organs except the lungs
themselves. Among the structures in the mediastinum are the
heart, esophagus, trachea, thymus, and several large blood
vessels that enter and exit the heart. The diaphragm is a dome-
shaped muscle that separates the thoracic cavity from the
abdominopelvic cavity.
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1. The serous membrane of the pleural cavities is called the
pleura. The visceral pleura clings to the surface of the lungs,
and the parietal pleura lines the chest wall, covering the
superior surface of the diaphragm. In between is the pleural
cavity, filled with a small amount of lubricating serous fluid.
The serous membranes can become inflamed, usually as a result of an

infection. Pericarditis is inflammation of the pericardium, pleurisy is
inflammation of the pleura, and peritonitis is inflammation of the
peritoneum.
The abdominopelvic cavity also has other specialized membranes in

2. The serous membrane of the pericardial cavity is the addition to the parietal and visceral membranes, called mesenteries.
pericardium. The visceral pericardium covers the surface of The mesenteries anchor the organs to the body wall and provide a
the heart; the parietal pericardium lines the chest wall. pathway for nerves and blood vessels to reach the organs. The
Between them is the pericardial cavity, filled with a small mesenteries consist of two layers of peritoneum fused together. They
amount of lubricating serous fluid. connect the visceral peritoneum of some abdominopelvic organs to the
parietal peritoneum on the body wall. The mesenteries also connect
certain organs’ visceral peritoneum to the visceral peritoneum of other
abdominopelvic organs. Other abdominopelvic organs are more closely
attached to the body wall and do not have mesenteries.
Parietal peritoneum covers these other organs, which are said to be

retroperitoneal. Most abdominal organs are surrounded by the
peritoneum. Some are not surrounded by the peritoneum; instead they
are posterior to it [to limit repetition of peritoneum]. Such organs are
said to be retroperitoneal. The kidneys, adrenal glands, pancreas,
duodenum of the small intestine, ascending and descending colons of
the large intestine, and portions of the abdominal aorta and inferior
vena cava are retroperitoneal.
In addition to the major body cavities other body cavity include the oral
3. The peritoneum is the serous membrane of the abdominal (mouth) cavity, which contains the tongue and teeth; the nasal cavity in
cavity. The visceral peritoneum covers the abdominal the nose; the orbital cavities (orbits), which contain the eyeballs; the
viscera, and the parietal peritoneum lines the abdominal wall, middle ear cavities (middle ears), which contain small bones; and the
covering the inferior surface of the diaphragm. Between them synovial cavities, which are found in freely movable joints and contain
is the peritoneal cavity, which contains a small amount of synovial fluid.
lubricating serous fluid.
Abdominopelvic Regions and Quadrants
To describe the location of the many abdominal and pelvic organs more
easily, anatomists and clinicians use two methods of dividing the
abdominopelvic cavity into smaller areas.
In the first method, two horizontal and two vertical lines, aligned like a
tictac-toe grid, partition this cavity into nine abdominopelvic regions.
• The top horizontal line, the subcostal line, is drawn just inferior
to the ribs, across the inferior portion of the stomach;
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• The bottom horizontal line, the trans-tubercular line, is drawn 1. Human Anatomy & Physiology Unit 1 Module
just inferior to the tops of the hip bones. 2. Unit 1 Lecture Powerpoint Presentation of Prof. Lily Ann C.
Mallabo, RN, MSN
3. Tortora & Derrikson (2016). Principles of Anatomy and
• Two vertical lines, the left and right midclavicular lines, are
Physiology, 15th Edition.
drawn through the midpoints of the clavicles (collar bones), just
medial to the nipples.
4. VanPutte C., Regan J., Russo A. (2019). Seeley’s Essentials
The four lines divide the abdominopelvic cavity into a larger middle of Anatomy and Physiology 10th Edition
section and smaller left and right sections. The names of the nine 5.
abdominopelvic regions are right hypochondriac, epigastric, left
Marieb E. & Keller S., (2019). Essentials of Human
hypochondriac, right lumbar, umbilical, left lumbar, right inguinal
Anatomy & Physiology,12th Ed, Pearson
(iliac), hypogastric (pubic), and left inguinal (iliac).
The second method is simpler and divides the abdominopelvic cavity

into quadrants. In this method, a midsagittal line (the median line)
and a transverse line (the trans-umbilical line) are passed through
the umbilicus or belly button. The names of the abdominopelvic
quadrants are right upper quadrant (RUQ), left upper quadrant
(LUQ), right lower quadrant (RLQ), and left lower quadrant (LLQ).
The nine-region division is more widely used for anatomical studies,

and quadrants are more commonly used by clinicians for describing
the site of abdominopelvic pain, a tumor, or another abnormality.
REFERENCES
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UNIT 02 – INTEGUMENTARY SYSTEM The skin, or integument, is considered an organ because it consists
of all four tissue types. The word integument means a covering, and
the skin of an average adult covers well over 3000 square inches of
OUTLINE surface area of the body. The skin weighs about 6 pounds (this is
I. nearly twice the weight of the brain or the liver). It receives
The Integumentary System approximately one-third of all the blood circulating through the body. It
is flexible yet rugged and under normal conditions can repair and
A. Definition of the Integumentary System
regenerate itself. Our skin is almost entirely waterproof. It protects us
B. Functions of the Integumentary System
from the harmful ultraviolet rays of the sun through special
II. Structure of the Skin
pigmentproducing cells. It is an effective barrier to most harmful
A. Epidermis chemicals, keeping them from entering our internal environment. It
1. Types of Epidermal Cells participates in the dissipation of water through sweating and helps
2. Layers of Epidermis regulate our body temperature.
3. Keratinization and Growth of Epidermis
B. Dermis Dermatology is the medical specialty that deals with the structure,
1. Layers of the Dermis function, and disorders of the integumentary system.
III. Subcutaneous Tissue
IV. Types of Skin Functions of the Integumentary System
V. Appendages of the Skin
A. Hair 1. Thermoregulation
1. Anatomy of Hair
2. Hair Growth The skin plays a major role in regulating body temperature through the
3. Types of Hair modulation of blood flow through the skin and the activity of sweat
4. Hair Color glands. The skin contributes to thermoregulation in two ways:
B. Skin Glands
a. By liberating sweat at its surface
1. Sebaceous Gland
b. By adjusting the flow of blood in the dermis
2. Sudoriferous Gland
3. Ceruminous Gland In response to high environmental temperature or heat produced by
C. Nails exercise, sweat production from eccrine sweat glands increases; the
VI. Structural Basis of Skin Color evaporation of sweat from the skin surface helps lower body
A. Melanin temperature. In addition, blood vessels in the dermis of the skin dilate
B. Carotene (become wider); consequently, more blood flows through the dermis,
C. Hemoglobin which increases the amount of heat loss from the body. In response to
VII. Development of the Integumentary System low environmental temperature, production of sweat from eccrine
VIII. Maintaining Homeostasis: Skin Wound Healing sweat glands is decreased, which helps conserve heat. Also, the
A. Epidermal Wound Healing blood vessels in the dermis of the skin constrict (become narrow),
B. Deep Wound Healing which decreases blood flow through the skin and reduces heat loss
IX. Homeostatic Imbalances of the Skin from the body. And, skeletal muscle contractions generate body heat.
A. Infections and Allergies
B. Burns Normal body temperature is maintained at approximately 98.6°F
(37°C). Temperature regulation is critical to our survival because
C. Skin Cancer
changes in temperature affect the functioning of enzymes. The
X. Tattooing and Body Piercing
presence of enzymes is critical for chemical reactions to occur in our
XI. Effects of Aging on the Integumentary System
cells, since enzymes act as protein catalysts to speed up chemical
reactions under normal cellular conditions. When people get high
fevers, they can die because the heat of a fever destroys the enzymes
by breaking up their chemical structure. Without enzymes, chemical
THE INTEGUMENTARY SYSTEM reactions cannot occur and our cellular machinery breaks down and
death results.
Definition of the Integumentary System When external temperatures increase, blood vessels in the dermis
dilate to bring more blood flow to the surface of the body from deeper
The integumentary system is the largest organ system of the body tissue beneath. In the dermis of the skin, this blood with its warm
that forms a physical barrier between the external environment and temperature can be lost by either radiation, convection, or conduction
the internal environment. It consists of the skin and its appendages – as applicable. When we sweat, the water in sweat evaporates, which
glands, hair, and nails. It provides a barrier between the vital, requires energy and thus carries away heat to reduce body
lifesustaining organs and the influence of outside elements that could temperature.
potentially damage them.
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When external temperatures decrease, the first response is for blood thermal sensations such as warmth and coolness. Another cutaneous
vessels in the dermis is to constrict to bring heat to the surface to sensation, pain, usually is an indication of impending or actual tissue
warm our extremities. Light-skinned individuals will have rosy cheeks damage. There is a wide variety of nerve endings and receptors
when they first go out in the cold. Excessive exposure to the cold distributed throughout the skin, including the tactile discs of the
cannot be maintained for long, so blood vessels then constrict to bring epidermis, the corpuscles of touch in the dermis, and hair root
the heat inside to preserve the vital organs of the body. Frostbite plexuses around each hair follicle.
occurs when the skin of the extremities no longer gets a blood supply
due to the maintained constriction of the blood vessels in the dermis to Receptor sites in the skin detect changes in the external environment
conserve heat. The tissues in the tips of these extremities die and turn for temperature and pressure. Receptor sites are in contact with
black. sensory neurons that transmit the impulse to the brain and spinal cord
for interpretation.
2. Blood Reservoir
• Temperature receptors produce the sensations of hot and
The dermis houses an extensive network of blood vessels that carry cold.
8–10% of the total blood flow in a resting adult. For this reason, the
skin acts as a blood reservoir.
• Pressure receptor sites allow us to interpret excessive
pressure that results in the sensation of pain as when we get
pinched. They also detect mild pressure that results in the
3. Protection
sensation of pleasure as from a gentle massage or a petting
The skin is an elastic, resistant covering. It prevents passage of stroke.
harmful physical and chemical agents. It provides protection to the
body in various ways. • Combinations of varying degrees of those stimulations at these
receptor sites produce other sensations that we call burning,
• Keratin protects underlying tissues from microbes, abrasion,
itching, or tickling.
heat, and chemicals, and the tightly interlocked keratinocytes
resist invasion by microbes. These receptor sites allow us to react to external stimuli and to
interpret what is occurring in the outside world.
• Lipids released by lamellar granules inhibit evaporation of
water from the skin surface, thus guarding against dehydration; 4. Excretion and Absorption
they also retard entry of water across the skin surface during
The skin normally has a small role in excretion, the elimination of
showers and swims.
substances from the body, and absorption, the passage of materials
from the external environment into body cells. Despite the almost
• The oily sebum from the sebaceous glands keeps skin and waterproof nature of the stratum corneum, about 400 mL of water
hairs from drying out and contains bactericidal chemicals evaporates through it daily. A sedentary person loses an additional
(substances that kill bacteria). 200 mL per day as sweat; a physically active person loses much
more. Besides removing water and heat from the body, sweat also is
the vehicle for excretion of small amounts of:
• The acidic pH of perspiration retards the growth of some
microbes. 1. Salts
2. Carbon dioxide
• The pigment melanin helps shield against the damaging effects 3. Two organic molecules that result from the breakdown of
of ultraviolet light. proteins—ammonia and urea.
The absorption of water-soluble substances through the skin is

• Two types of cells carry out protective functions that are negligible, but certain lipid-soluble materials do penetrate the skin.
immunological in nature. These include fat-soluble vitamins (A, D, E, and K), certain drugs, and
the gases oxygen and carbon dioxide.
• Intraepidermal macrophages alert the immune system to the Toxic materials that can be absorbed through the skin include:
presence of potentially harmful microbial invaders by
recognizing and processing them, and macrophages in the • Organic solvents such as acetone (in some nail polish
dermis phagocytize bacteria and viruses that manage to bypass removers) and carbon tetrachloride (dry-cleaning fluid);
the intraepidermal macrophages of the epidermis.
3. Cutaneous Sensations • Salts of heavy metals such as lead, mercury, and arsenic; and
Cutaneous sensations are sensations that arise in the skin, including

tactile sensations—touch, pressure, vibration, and tickling—as well as • The substances in poison ivy and poison oak.
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Since topical (applied to the skin) steroids, such as cortisone, are lipid While the epidermis is avascular, the dermis is vascular. For this
soluble, they move easily into the papillary region of the dermis. Here, reason, if you cut the epidermis there is no bleeding, but if the cut
they exert their anti-inflammatory properties by inhibiting histamine penetrates to the dermis there is bleeding.
production by mast cells (recall that histamine contributes to
inflammation). Certain drugs that are absorbed by the skin may be Deep to the dermis, but not part of the skin, is the subcutaneous
administered by applying adhesive patches to the skin. (subQ) layer. Also called the hypodermis, this layer consists of
areolar and adipose tissues. Fibers that extend from the dermis
5. Synthesis of Vitamin D anchor the skin to the subcutaneous layer, which in turn attaches to
underlying fascia, the connective tissue around muscles and bones. It
Synthesis of vitamin D requires activation of a precursor molecule in anchors the skin to underlying organs and provides a site for nutrient
the skin by ultraviolet (UV) rays in sunlight. Enzymes in the liver and storage. Serves as a shock absorber and insulates the deeper tissues
kidneys then modify the activated molecule, finally producing calcitriol, from extreme temperature changes occurring outside the body. It is
the most active form of vitamin D. Calcitriol is a hormone that aids in also responsible for the curves that are more a part of a woman’s
the absorption of calcium from foods in the gastrointestinal tract into anatomy than a man’s. The subcutaneous layer serves as a storage
the blood. Only a small amount of exposure to UV light (about 10 to 15 depot for fat and contains large blood vessels that supply the skin.
minutes at least twice a week) is required for vitamin D synthesis. This region (and sometimes the dermis) also contains nerve endings
People who avoid sun exposure and individuals who live in colder, called lamellated corpuscles or pacinian corpuscles that are
northern climates may require vitamin D supplements to avoid vitamin sensitive to pressure.
D deficiency. Most cells of the immune system have vitamin D
receptors, and the cells activate vitamin D in response to an infection,
especially a respiratory infection, such as influenza. Vitamin D is
believed to enhance phagocytic activity, increase the production of
antimicrobial substances in phagocytes, regulate immune functions,
and help reduce inflammation.
The skin is actively involved in the production of vitamin D. Exposure

to the ultraviolet rays of the sun stimulates our skin to produce a
precursor molecule of vitamin D that then goes to the liver and kidneys
to become mature vitamin D. Vitamin D is necessary for our bodies
because it stimulates the intake of calcium and phosphorus in our
intestines.
• Calcium is necessary for muscle contraction and bone

development.
• Phosphorus is an essential part of adenosine triphosphate.
Because we live indoors, and in colder climates wear heavy clothing,

we sometimes do not get enough exposure to the sun to adequately
produce enough vitamin D. We also should ingest vitamin D through
our diets. Good sources of vitamin D are milk, other dairy products,
and fish oils. Epidermis
STRUCTURE OF THE SKIN The epidermis is the superficial layer of the skin, composed of
keratinized stratified squamous epithelium It is separated from the
The skin, also known as the cutaneous membrane, covers the underlying dermis by a basement membrane. The epidermis is not as
external surface of the body and is the largest organ of the body in thick as the dermis and contains no blood vessels. The living cells of
weight. the epidermis receive nutrients and excrete waste products by the
diffusion of substances between the epidermis and the capillaries of
The skin consists of two main parts: the dermis.
1. The superficial, thinner portion, which is composed of epithelial

tissue, is the epidermis. Types of Epidermal Cells
2. The deeper, thicker connective tissue portion is the dermis. Epidermis contains four principal types of cells: keratinocytes,
melanocytes, intraepidermal macrophages, and tactile epithelial cells.
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• About 90% of epidermal cells are keratinocytes, which are
arranged in four or five layers and produce the protein keratin.
Keratin is a tough, fibrous protein that helps protect the skin and
underlying tissues from abrasions, heat, microbes, and
chemicals. Keratinocytes also produce lamellar granules,
which release a water-repellent sealant that decreases water
entry and loss and inhibits the entry of foreign materials.
Keratinocytes give the epidermis its ability to resist abrasion
and reduce water loss.
• About 8% of the epidermal cells are melanocytes, which

develop from the ectoderm of a developing embryo and
produce the pigment melanin. Their long, slender projections
extend between the keratinocytes and transfer melanin
granules to them. Melanin is a yellow-red or brown-black
pigment that contributes to skin color and absorbs damaging
ultraviolet (UV) light. Once inside keratinocytes, the melanin
granules cluster to form a protective veil over the nucleus, on
the side toward the skin surface. In this way, they shield the
nuclear DNA from damage by UV light. Although their melanin Layers of Epidermis
granules effectively protect keratinocytes, melanocytes
themselves are particularly susceptible to damage by UV light. The epidermis, which is not vascularized, rests on a basement
membrane of connective tissue. The lowermost cells on this
• Intraepidermal macrophages or Langerhans cells arise from membrane divide by mitosis, so new cells push older cells up toward
red bone marrow and migrate to the epidermis, where they the surface. As they move up, they change shape and chemical
constitute a small fraction of the epidermal cells. They composition because they lose most of their water and eventually die.
participate in immune responses mounted against microbes that This process is called keratinization because the cells become filled
invade the skin, and are easily damaged by UV light. Their role with keratin, a protein material. These dead, outermost cells are
in the immune response is to help other cells of the immune constantly being shed. This outermost layer forms an effective barrier
system recognize an invading microbe and destroy it. to substances that would penetrate the skin, and this layer is very
resistant to abrasion. Although keratinization is a continual process,
distinct transitional stages can be recognized as the cells change.
• Tactile epithelial cells, or Merkel cells, are the least
numerous of the epidermal cells. They are located in the The process of keratinization produces distinctive layers of the
deepest layer of the epidermis, where they contact the flattened epidermis called strata or stratum. There are five layers from
process of a sensory neuron (nerve cell), a structure called a outermost to deep. They are the stratum corneum, commonly called
tactile disc or Merkel disc. Tactile epithelial cells and their the horny or leathery layer; the stratum lucidum, commonly called
associated tactile discs detect touch sensations. Merkel cells the clear layer; the stratum granulosum, commonly called the
are specialized epidermal cells associated with the nerve granular layer; and the stratum spinosum, commonly called the spiny
endings responsible for detecting light touch and superficial or prickly layer. The innermost layer and the most important is the
pressure. stratum germinativum or the regenerative layer, also called the
stratum basale.
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keratin are responsible for the structural strength of the stratum
corneum. The type of keratin found in the skin is soft keratin. Another
type of keratin, hard keratin, is found in nails and the external parts of
hair. Cells containing hard keratin are more durable than cells with soft
keratin, and they are not shed.
2. Stratum Lucidum
The stratum lucidum is a thin, clear zone above the stratum

granulosum. The stratum lucidum is present only in the thick skin of
areas such as the fingertips, palms, and soles. It consists of four to six
layers of flattened clear, dead keratinocytes that contain large
amounts of keratin and thickened plasma membranes. This probably
provides an additional level of toughness in this region of thick skin.
3. Stratum Granulosum
At about the middle of the epidermis, the stratum granulosum consists

of three to five layers of flattened keratinocytes that are undergoing
apoptosis. Apoptosis is an orderly, genetically programmed cell death
in which the nucleus fragments before the cells die. The nuclei and
other organelles of these cells begin to degenerate as they move
1. Stratum Corneum farther from their source of nutrition (the dermal blood vessels). Even
though keratin intermediate filaments are no longer being produced by
The stratum corneum forms the outermost layer of the epidermis that these cells, they become more apparent because the organelles in the
consists of dead cells converted to protein. They are called cells are regressing. A distinctive feature of cells in this layer is the
keratinized cells because they have lost most of their fluid. The presence of darkly staining granules of a protein called keratohyalin,
organelles of the cell are now just masses of the hard protein keratin which assembles keratin intermediate filaments into keratin. Also
that gives this layer its structural strength. These cells are also present in the keratinocytes are membrane-enclosed lamellar
covered and surrounded with lipids to prevent any passage of fluids granules, which fuse with the plasma membrane and release a
through this layer. These cells have only about 20% water as lipidrich secretion. This secretion is deposited in the spaces between
compared to cells in the lowermost layer that have about 70%. The cells of the stratum granulosum, stratum lucidum, and stratum
cells resemble scales in shape and can consist of up to 25 layers. By corneum. The lipid-rich secretion acts as a water-repellent sealant,
the time cells reach this layer, the desmosomes have broken apart retarding loss and entry of water and entry of foreign materials. As
and, therefore, these cells are constantly being sloughed off. This their nuclei break down during apoptosis, the keratinocytes of the
process is referred to as excessive desquamation. The shedding of stratum granulosum can no longer carry on vital metabolic reactions,
these cells from the scalp produces what we call dandruff. and they die. Thus, the stratum granulosum marks the transition
between the deeper, metabolically active strata and the dead cells of
Consists on average of 25 to 30 layers of flattened dead keratinocytes, the more superficial strata.
but can range in thickness from a few cells in thin skin to 50 or more
cell layers in thick skin. The cells are extremely thin, flat, plasma 4. Stratum Spinosum
membrane–enclosed packages of keratin that no longer contain a
nucleus or any internal organelles. They are the final product of the Superficial to the stratum basale is the stratum spinosum. This stratum
differentiation process of the keratinocytes. The cells within each layer mainly consists of numerous keratinocytes arranged in 8–10 layers.
overlap one another like the scales on the skin of a snake. Cells in the more superficial layers become somewhat flattened. The
Neighboring layers of cells also form strong connections with one keratinocytes in the stratum spinosum, which are produced by the
another. The plasma membranes of adjacent cells are arranged in stem cells in the basal layer, have the same organelles as cells of the
complex, wavy folds that fit together like pieces of a jigsaw puzzle to stratum basale, and some retain their ability to divide. The
hold the layers together. In this outer stratum of the epidermis, cells keratinocytes of this layer produce coarser bundles of keratin in
are continuously shed and replaced by cells from the deeper strata. Its intermediate filaments than those of the basal layer. Although they are
multiple layers of dead cells help the stratum corneum to protect rounded and larger in living tissue, cells of the stratum spinosum
deeper layers from injury and microbial invasion. Constant exposure of shrink and pull apart when prepared for microscopic examination so
skin to friction stimulates increased cell production and keratin that they appear to be covered with thornlike spines. At each spinelike
production that results in the formation of a callus, an abnormal projection, bundles of keratin intermediate filaments insert into
thickening of the stratum corneum. desmosomes, which tightly join the cells to one another. This
arrangement provides both strength and flexibility to the skin.
The stratum corneum consists of cornified cells, which are dead cells, Intraepidermal macrophages and projections of melanocytes are also
with a hard protein envelope, filled with the protein keratin. Keratin is a present in the stratum spinosum.
mixture of keratin fibers and keratohyalin. The envelope and the
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5. Stratum Basale off and are replaced by underlying cells that in turn become
keratinized. The whole process by which cells form in the stratum
The deepest layer of the epidermis is the stratum basale, composed basale, rise to the surface, become keratinized, and slough off takes
of a single row of cuboidal or columnar keratinocytes. Some cells in about four to six weeks in an average epidermis of 0.1 mm (0.004 in.)
this layer are stem cells that undergo cell division to continually thickness. Nutrients and oxygen diffuse to the avascular epidermis
produce new keratinocytes. The nuclei of keratinocytes in the stratum from blood vessels in the dermis. The epidermal cells of the stratum
basale are large, and their cytoplasm contains many ribosomes, a basale are closest to these blood vessels and receive most of the
small Golgi complex, a few mitochondria, and some rough nutrients and oxygen. These cells are the most active metabolically
endoplasmic reticulum. The cytoskeleton within keratinocytes of the and continuously undergo cell division to produce new keratinocytes.
stratum basale includes scattered intermediate filaments, called
keratin intermediate filaments (tonofilaments). The keratin As the new keratinocytes are pushed farther from the blood supply by
intermediate filaments form the tough protein keratin in its more continuing cell division, the epidermal strata above the basale receive
superficial epidermal layers. Keratin protects the deeper layers from fewer nutrients and the cells become less active and eventually die.
injury. Keratin intermediate filaments attach to desmosomes, which The rate of cell division in the stratum basale increases when the outer
bind cells of the stratum basale to each other and to the cells of the layers of the epidermis are stripped away, as occurs in abrasions and
adjacent stratum spinosum, and to hemidesmosomes, which bind the burns. The mechanisms that regulate this remarkable growth are not
keratinocytes to the basement membrane positioned between the well understood, but hormonelike proteins such as epidermal growth
epidermis and the dermis. Melanocytes and tactile epithelial cells with factor (EGF) play a role. An excessive amount of keratinized cells
their associated tactile discs are scattered among the keratinocytes of shed from the skin of the scalp is called dandruff.
the basal layer. The stratum basale is also known as the stratum
germinativum to indicate its role in forming new cells. Dermis
The epidermis is anchored to the basement membrane by The second, deeper part of the skin, the dermis, also known as the
hemidesmosomes. In addition, desmosomes hold the keratinocytes corium, lies directly beneath the epidermis and is often referred to as
together. The connections formed by the hemidesmosomes and the true skin. It is composed of dense irregular connective tissue
desmosomes provide structural strength to the epidermis. containing collagen and elastic fibers. This woven network of fibers
Keratinocytes are strengthened internally by keratin fibers has great tensile strength (resists pulling or stretching forces). The
(intermediate filaments) that insert into the desmosomes. Keratinocyte dermis also has the ability to stretch and recoil easily. It is much
stem cells of the stratum basale undergo mitotic divisions thicker than the epidermis, and this thickness varies from region to
approximately every 19 days. One daughter cell remains a stem cell in region in the body, reaching its greatest thickness on the palms and
the stratum basale and divides again, but the other daughter cell is soles. Leather, which we use for belts, shoes, baseball gloves, and
pushed toward the surface and becomes keratinized. It takes basketballs, is the dried and treated dermis of other animals. The few
approximately 40–56 days for the cell to reach the epidermal surface cells present in the dermis include predominantly fibroblasts, with
and slough off. some macrophages, and a few adipocytes near its boundary with the
subcutaneous layer. Blood vessels, nerves, glands, and hair follicles
(epithelial invaginations of the epidermis) are embedded in the dermal
layer. The dermis is essential to the survival of the epidermis, and
these adjacent layers form many important structural and functional
relations.
Layers of the Dermis
Based on its tissue structure, the dermis can be divided into a thin
superficial papillary region and a thick deeper reticular region.
The papillary region makes up about one-fifth of the thickness of the

total layer. It contains thin collagen and fine elastic fibers. Its surface
area is greatly increased by dermal papillae, small, nipple-shaped
structures that project into the undersurface of the epidermis. It is the
superficial dermal region. It is uneven and has peglike projections from
its superior surface, called dermal papillae, which indent the
epidermis above. All dermal papillae contain capillary loops (blood
Keratinization and Growth of Epidermis vessels). Some also contain tactile receptors called corpuscles of
touch or Meissner corpuscles, nerve endings that are sensitive to
Newly formed cells in the stratum basale are slowly pushed to the touch. Still other dermal papillae also contain free nerve endings,
surface. As the cells move from one epidermal layer to the next, they dendrites that lack any apparent structural specialization. Different free
accumulate more and more keratin, a process called keratinization. nerve endings initiate signals that give rise to sensations of warmth,
Then they undergo apoptosis. Eventually the keratinized cells slough coolness, pain, tickling, and itching.
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The reticular region, which is attached to the subcutaneous layer, SUBCUTANEOUS TISSUE
contains bundles of thick collagen fibers, scattered fibroblasts, and
various wandering cells (such as macrophages). It is the deepest skin Deep to the skin is the subcutaneous tissue that attaches the skin to
layer. It contains dense irregular connective tissue, as well as blood underlying bone and muscle and supplies the skin with blood vessels
vessels, sweat and oil glands, and deep pressure receptors called and nerves. The subcutaneous tissue consists of loose connective
lamellar corpuscles. Some adipose cells can be present in the tissue with collagen and elastic fibers. The main types of cells within
deepest part of the layer, along with some coarse elastic fibers. The the subcutaneous tissue are fibroblasts, adipocytes, and
collagen fibers in the reticular region are arranged in a netlike manner macrophages. The subcutaneous tissue, which is not part of the skin,
and have a more regular arrangement than those in the papillary is sometimes called the hypodermis.
region. The more regular orientation of the large collagen fibers helps
the skin resist stretching. Blood vessels, nerves, hair follicles, Approximately half the body’s stored lipids are in the subcutaneous
sebaceous (oil) glands, and sudoriferous (sweat) glands occupy the tissue, where they function in insulation and padding and as a source
spaces between fibers. of energy. The subcutaneous tissue can be used to estimate total
body fat by pinching the skin at selected locations and measuring the
The combination of collagen and elastic fibers in the reticular region thickness of the skin fold and underlying subcutaneous tissue. The
provides the skin with strength, extensibility, the ability to stretch, and thicker the fold, the greater the amount of total body fat.
elasticity, the ability to return to original shape after stretching. The
extensibility of skin can be readily seen around joints and in The amount of adipose tissue in the subcutaneous tissue varies with
pregnancy and obesity. age, sex, and diet. Most babies have a chubby appearance because
they have proportionately more adipose tissue than adults. Women
The surfaces of the palms, fingers, soles, and toes have a series of have proportionately more adipose tissue than men, especially over
ridges and grooves. They appear either as straight lines or as a the thighs, buttocks, and breasts, which accounts for some of the
pattern of loops and whorls, as on the tips of the digits. These differences in body shape between women and men. The amount of
epidermal ridges are produced during the third month of fetal adipose tissue in the subcutaneous tissue is also responsible for some
development as downward projections of the epidermis into the of the differences in body shape between individuals of the same sex.
dermis between the dermal papillae of the papillary region. The
epidermal ridges create a strong bond between the epidermis and TYPES OF SKIN
dermis in a region of high mechanical stress. The epidermal ridges
also increase the surface area of the epidermis and thus increase the Although the skin over the entire body is similar in structure, there are
grip of the hand or foot by increasing friction. Finally, the epidermal quite a few local variations related to thickness of the epidermis,
ridges greatly increase surface area, which increases the number of strength, flexibility, degree of keratinization, distribution and type of
corpuscles of touch and thus increases tactile sensitivity. Because the hair, density and types of glands, pigmentation, vascularity (blood
ducts of sweat glands open on the tops of the epidermal ridges as supply), and innervation (nerve supply).
sweat pores, the sweat and ridges form fingerprints (or footprints) on
touching a smooth object. The epidermal ridge pattern is in part Two major types of skin are recognized on the basis of certain
genetically determined and is unique for each individual. Even structural and functional properties:
identical twins have different patterns. Normally, the ridge pattern does
not change during life, except to enlarge, and thus can serve as the 1. Thin (hairy) skin and
basis for identification. The study of the pattern of epidermal ridges is 2. Thick (hairless) skin
called dermatoglyphics.
Thin skin covers most of the body, except on the soles of the feet and
In addition to forming epidermal ridges, the complex papillary surface palms of the hands, and contains fewer cellular layers than thick skin.
of the dermis has other functional properties. The dermal papillae The epidermis of thin skin ranges from 0.07–0.15 millimeters (mm).
greatly increase the surface contact between the dermis and Thin skin can vary in thickness in different parts of the body and is
epidermis. This increased dermal contact surface, with its extensive particularly thin across the eyelids. Thin skin is thickest on the upper
network of small blood vessels, serves as an important source of back. Thin skin also contains hair follicles, sweat glands, and
nutrition for the overlying epidermis. Molecules diffuse from the small sebaceous glands.
blood capillaries in the dermal papillae to the cells of the stratum
basale, allowing the basal epithelial stem cells to divide and the Thick skin is present on the soles of the feet and palms of the hands.
keratinocytes to grow and develop. As keratinocytes push toward the This is because these areas receive more friction than other areas of
surface and away from the dermal blood source, they are no longer the body, and thicker skin helps to protect from potential damage. The
able to obtain the nutrition they require, leading to the eventual epidermis of thick skin can be up to 1.5 mm. Thick skin does not
breakdown of their organelles. contain any hair follicles or sebaceous glands. Thick skin also contains
no arrector pili muscles, which cause goosebumps.
The dermal papillae fit together with the complementary epidermal
ridge to form an extremely strong junction between the two layers. Thick skin is thicker due to it containing an extra layer in the epidermis,
This jigsaw puzzle–like connection strengthens the skin against called the stratum lucidum. Thick skin actually has a thinner dermis
shearing forces (forces that laterally shift in relation to each other) that layer than thin skin, but is still thicker due to the stratum lucidum layer
attempt to separate the epidermis from the dermis. present in the epidermis.
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The greatest contributor to epidermal thickness is the increased root is the portion of the hair deep to the shaft that penetrates into the
number of layers in the stratum corneum. This arises in response to dermis, and sometimes into the subcutaneous layer. The shaft and
the greater mechanical stress in regions of thick skin. root of the hair both consist of three concentric layers of cells: medulla,
cortex, and cuticle of the hair. The inner medulla, which may be
In most regions of the body, the epidermis has four strata or layers— lacking in thinner hair, is composed of two or three rows of irregularly
stratum basale, stratum spinosum, stratum granulosum, and a thin shaped cells that contain large amounts of pigment granules in dark
stratum corneum. This is called thin skin. Where exposure to friction hair, small amounts of pigment granules in gray hair, and a lack of
is greatest, such as in the fingertips, palms, and soles, the epidermis pigment granules and the presence of air bubbles in white hair. The
has five layers—stratum basale, stratum spinosum, stratum middle cortex forms the major part of the shaft and consists of
granulosum, stratum lucidum, and a thick stratum corneum which is elongated cells. The cuticle of the hair, the outermost layer, consists
called thick skin. Hair is found only in thin skin. of a single layer of thin, flat cells that are the most heavily keratinized.
Cuticle cells on the shaft are arranged like shingles on the side of a
The terms thin and thick, which refer to the epidermis only, should not house, with their free edges pointing toward the end of the hair.
be used when total skin thickness is considered. Variation in the
Surrounding the root of the hair is the hair follicle, which is made up
thickness of the dermis accounts for most of the difference in total skin
of an external root sheath and an internal root sheath, together
thickness. For example, the skin of the back is thin skin, whereas that referred to as an epithelial root sheath. The external root sheath is
of the palm of the hand is thick skin; however, because the dermis of a downward continuation of the epidermis. The internal root sheath is
the skin of the back is thicker, the total skin thickness of the back is produced by the matrix and forms a cellular tubular sheath of
greater than that of the palm. epithelium between the external root sheath and the hair. Together,
the external and internal root sheath are referred to as the epithelial
In skin subjected to friction or pressure, an area called a callus often root sheath. The dense dermis surrounding the hair follicle is called the
forms when the stratum corneum of the epidermis increases in dermal root sheath.
thickness. The increased number of cell layers provides added
protection in the area that experiences more mechanical stress. The The base of each hair follicle and its surrounding dermal root sheath is
skin over bony prominences develop a cone-shaped structure called a an onion-shaped structure, the bulb. This structure houses a
corn. The base of the cone is at the surface, but the apex extends nippleshaped indentation, the papilla of the hair, which contains
deep into the epidermis, and pressure on the corn may be quite areolar connective tissue and many blood vessels that nourish the
painful. Calluses and corns can develop in both thin and thick skin. growing hair follicle. The bulb also contains a germinal layer of cells
called the hair matrix. The hair matrix cells arise from the stratum
basale, the site of cell division. Hence, hair matrix cells are responsible
for the growth of existing hairs, and they produce new hairs when old
APPENDAGES OF THE SKIN hairs are shed. This replacement process occurs within the same
follicle. Hair matrix cells also give rise to the cells of the internal root
Accessory structures or appendages of the skin include the hair, skin sheath.
glands, and nails— develop from the embryonic epidermis. They have
a host of important functions.
Hair
Hairs, or pili, are present on most skin surfaces except the palms,
palmar surfaces of the fingers, the soles, and plantar surfaces of the
feet. In adults, hair usually is most heavily distributed across the scalp,
in the eyebrows, in the axillae (armpits), and around the external
genitalia. Genetic and hormonal influences largely determine the
thickness and the pattern of hair distribution. Although the protection it
offers is limited, hair on the head guards the scalp from injury and the
sun’s rays. It also decreases heat loss from the scalp. Eyebrows and
eyelashes protect the eyes from foreign particles, similar to the way
hair in the nostrils and in the external ear canal defends those
structures. Touch receptors (hair root plexuses) associated with hair
follicles are activated whenever a hair is moved even slightly. Thus,
hairs also function in sensing light touch.
Anatomy of Hair
Each hair is composed of columns of dead, keratinized epidermal cells Sebaceous (oil) glands and a bundle of smooth muscle cells are also
bonded together by extracellular proteins. The shaft is the superficial associated with hairs. The smooth muscle is the arrector pili. It
portion of the hair, which projects above the surface of the skin. The extends from the superficial dermis of the skin to the dermal root
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sheath around the side of the hair follicle. In its normal position, hair nonpigmented, downy hairs called lanugo that cover the body of the
emerges at a less than 90° angle to the surface of the skin. Under fetus. Prior to birth, the lanugo of the eyebrows, eyelashes, and scalp
physiological or emotional stress, such as cold or fright, autonomic are shed and replaced by long, coarse, heavily pigmented hairs called
nerve endings stimulate the arrector pili muscles to contract, which terminal hairs. The lanugo of the rest of the body are replaced by
pulls the hair shafts perpendicular to the skin surface. This action vellus hairs, commonly called “peach fuzz,” which are short, fine, pale
causes “goose bumps” or “gooseflesh” because the skin around the hairs that are barely visible to the naked eye. During childhood, vellus
shaft forms slight elevations. hairs cover most of the body except for the hairs of the eyebrows,
eyelashes, and scalp, which are terminal hairs. In response to
Surrounding each hair follicle are dendrites of neurons that form a hair hormones (androgens) secreted at puberty, terminal hairs replace
root plexus, which is sensitive to touch. The hair root plexuses vellus hairs in the axillae (armpits) and pubic regions of boys and girls
generate nerve impulses if their hair shafts are moved. and they replace vellus hairs on the face, limbs, and chests of boys,
which leads to the formation of a mustache, a beard, hairy arms and
legs, and a hairy chest. During adulthood, about 95% of body hair on
males is terminal hair and 5% is vellus hair; on females, about 35% of
body hair is terminal hair and 65% is vellus hair.
Hair Color
The color of hair is due primarily to the amount and type of melanin in
its keratinized cells. Melanin is synthesized by melanocytes scattered
in the matrix of the bulb and passes into cells of the cortex and
medulla of the hair. Dark-colored hair contains mostly eumelanin
(brown to black); blond and red hair contain variants of pheomelanin
(yellow to red). Hair becomes gray because of a progressive decline in
Hair Growth melanin production; gray hair contains only a few melanin granules.
White hair results from the lack of melanin and the accumulation of air
Each hair follicle goes through a growth cycle, which consists of a bubbles in the shaft.
growth stage, a regression stage, and a resting stage. During the
growth stage, cells of the hair matrix divide. As new cells from the Hair coloring is a process that adds or removes pigment. Temporary
hair matrix are added to the base of the hair root, existing cells of the hair dyes coat the surface of a hair shaft and usually wash out within 2
hair root are pushed upward and the hair grows longer. While the cells or 3 shampoos. Semipermanent dyes penetrate the hair shaft
of the hair are being pushed upward, they become keratinized and moderately and do fade and wash out of hair after about 5 to 10
die. Following the growth stage is the regression stage, when the
cells of the hair matrix stop dividing, the hair follicle atrophies shampoos. Permanent hair dyes penetrate deeply into the hair shaft
(shrinks), and the hair stops growing. After the regression stage, the and don’t wash out but are eventually lost as the hair grows out.
hair follicle enters a resting stage. Following the resting stage, a new
growth cycle begins. The old hair root falls out or is pushed out of the Skin Glands
hair follicle, and a new hair begins to grow in its place. Scalp hair is in
the growth stage for 2 to 6 years, the regression stage for 2 to 3 Glands are epithelial cells that secrete a substance. Several kinds of
weeks, and the resting stage for about 3 months. At any time, about exocrine glands are associated with the skin: sebaceous (oil) glands,
85% of scalp hairs are in the growth stage. Visible hair is dead, but sudoriferous (sweat) glands, and ceruminous glands.
until the hair is pushed out of its follicle by a new hair, portions of its
root within the scalp are alive.
Normal hair loss in the adult scalp is about 70–100 hairs per day. Both
the rate of growth and the replacement cycle may be altered by
illness, radiation therapy, chemotherapy (described next), age,
genetics, gender, and severe emotional stress. Rapid weight-loss
diets that severely restrict calories or protein increase hair loss. The
rate of shedding also increases for three to four months after
childbirth. Alopecia, the partial or complete lack of hair, may result
from genetic factors, aging, endocrine disorders, chemotherapy, or
skin disease.
Types of Hair
Hair follicles develop at about 12 weeks after fertilization. Usually by

the fifth month of development, the follicles produce very fine,
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throughout the skin of most regions of the body, especially in the skin
of the forehead, palms, and soles. Eccrine sweat glands are not
present, however, in the margins of the lips, nail beds of the fingers
and toes, glans penis, glans clitoris, labia minora, or eardrums. The
secretory portion of eccrine sweat glands is located mostly in the deep
dermis (sometimes in the upper subcutaneous layer). The excretory
duct projects through the dermis and epidermis and ends as a pore at
the surface of the epidermis.
The sweat produced by eccrine sweat glands (about 600 mL per day)
consists primarily of water, with small amounts of ions (mostly Na and
Cl–), urea, uric acid, ammonia, amino acids, glucose, and lactic acid.
The main function of eccrine sweat glands is to help regulate body
temperature through evaporation. As sweat evaporates, large
quantities of heat energy leave the body surface. The homeostatic
regulation of body temperature is known as thermoregulation. This
role of eccrine sweat glands in helping the body to achieve
thermoregulation is known as thermoregulatory sweating. During
thermoregulatory sweating, sweat first forms on the forehead and
scalp and then extends to the rest of the body, forming last on the
palms and soles. Sweat that evaporates from the skin before it is
perceived as moisture is termed insensible perspiration. Sweat that
is excreted in larger amounts and is seen as moisture on the skin is
called sensible perspiration.
Sebaceous Glands
The sweat produced by eccrine sweat glands also plays a small role in
Sebaceous glands or oil glands are simple, branched acinar eliminating wastes such as urea, uric acid, and ammonia from the
(rounded) glands. With few exceptions, they are connected to hair body. However, the kidneys play more of a role in the excretion of
follicles. The secreting portion of a sebaceous gland lies in the dermis these waste products from the body than eccrine sweat glands.
and usually opens into the neck of a hair follicle. In some locations,
such as the lips, glans penis, labia minora, and tarsal glands of the Eccrine sweat glands also release sweat in response to an emotional
eyelids, sebaceous glands open directly onto the surface of the skin. stress such as fear or embarrassment. This type of sweating is
Absent in the palms and soles, sebaceous glands are small in most referred to as emotional sweating or a cold sweat. In contrast to
areas of the trunk and limbs, but large in the skin of the breasts, face, thermoregulatory sweating, emotional sweating first occurs on the
neck, and superior chest. palms, soles, and axillae and then spreads to other areas of the body.
As you will soon learn, apocrine sweat glands are also active during
Sebaceous glands secrete an oily substance called sebum, a mixture emotional sweating.
of triglycerides, cholesterol, proteins, and inorganic salts. Sebum coats
the surface of hairs and helps keep them from drying and becoming Apocrine Sweat Glans
brittle. Sebum also prevents excessive evaporation of water from the
skin, keeps the skin soft and pliable, and inhibits the growth of some
Apocrine sweat glands are also simple, coiled tubular glands but
(but not all) bacteria. Because sebum is released by the lysis and
have larger ducts and lumens than eccrine glands. They are found
death of secretory cells, sebaceous glands are classified as holocrine mainly in the skin of the axilla (armpit), groin, areolae (pigmented
glands. areas around the nipples) of the breasts, and bearded regions of the
face in adult males. These glands were once thought to release their
Sudoriferous Glands secretions in an apocrine manner—by pinching off a portion of the cell.
We now know, however, that their secretion is via exocytosis, which is
There are three million to four million sweat glands, or sudoriferous characteristic of eccrine glands. Nevertheless, the term apocrine is still
glands in the body. The cells of these glands release sweat, or used. The secretory portion of these sweat glands is located in the
perspiration, into hair follicles or onto the skin surface through pores. lower dermis or upper subcutaneous layer, and the excretory duct
Sweat glands are divided into two main types, eccrine and apocrine, opens into hair follicles.
based on their structure and type of secretion.
Compared to eccrine sweat, apocrine sweat appears milky or
Eccrine Sweat Glands yellowish in color. Apocrine sweat contains the same components as
eccrine sweat plus lipids and proteins. Sweat secreted from apocrine
sweat glands is odorless. However, when apocrine sweat interacts
Eccrine sweat glands are simple, coiled tubular glands that are much with bacteria on the surface of the skin, the bacteria metabolize its
more common than apocrine sweat glands. They are distributed components, causing apocrine sweat to have a musky odor that is
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often referred to as body odor. Eccrine sweat glands start to function of the nail wall. It occupies the proximal border of the nail and consists
soon after birth, but apocrine sweat glands do not begin to function of stratum corneum.
until puberty.
Apocrine sweat glands, along with eccrine sweat glands, are active
during emotional sweating. In addition, apocrine sweat glands secrete
sweat during sexual activities. In contrast to eccrine sweat glands,
apocrine sweat glands are not active during thermoregulatory
sweating and, therefore, do not play a role in thermoregulation.
Ceruminous Glands
Modified sweat glands in the external ear, called ceruminous glands,

produce a waxy lubricating secretion. The secretory portions of
ceruminous glands lie in the subcutaneous layer, deep to sebaceous
glands. Their excretory ducts open either directly onto the surface of The portion of the epithelium proximal to the nail root is the nail
the external auditory canal (ear canal) or into ducts of sebaceous matrix. The superficial nail matrix cells divide mitotically to produce
glands. The combined secretion of the ceruminous and sebaceous new nail cells. The growth rate of nails is determined by the rate of
glands is a yellowish material called cerumen, or earwax. Cerumen, mitosis in matrix cells, which is influenced by factors such as a
together with hairs in the external auditory canal, provides a sticky
barrier that impedes the entrance of foreign bodies and insects.
Cerumen also waterproofs the canal and prevents bacteria and fungi
from entering cells.
Nails
Nails are plates of tightly packed, hard, dead, keratinized epidermal

cells that form a clear, solid covering over the dorsal surfaces of the
distal portions of the digits. Each nail consists of a nail body, a free
edge, and a nail root. The nail body (plate) is the visible portion of the
nail. It is comparable to the stratum corneum of the epidermis of the
skin, with the exception that its flattened, keratinized cells fill with a
harder type of keratin and the cells are not shed. Below the nail body
is a region of epithelium and a deeper layer of dermis. Most of the nail
body appears pink because of blood flowing through the capillaries in
the underlying dermis. The free edge is the part of the nail body that
may extend past the distal end of the digit. The free edge is white
because there are no underlying capillaries. The nail root is the
portion of the nail that is buried in a fold of skin. The whitish,
crescentshaped area of the proximal end of the nail body is called the
lunula. It appears whitish because the vascular tissue underneath
does not show through due to a thickened region of epithelium in the
area. Beneath the free edge is a thickened region of stratum corneum
called the hyponychium, which secures the nail to the fingertip. The
nail bed is the skin below the nail plate that extends from the lunula to
the hyponychium. The epidermis of the nail bed lacks a stratum
granulosum. The eponychium or cuticle is a narrow band of
epidermis that extends from and adheres to the margin (lateral border)
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person’s age, health, and nutritional status. Nail growth also varies melanin serves a protective function. In response to DNA damage,
according to the season, the time of day, and environmental melanin production increases. Exposing the skin to a small amount of
temperature. The average growth in the length of fingernails is about UV light is actually necessary for the skin to begin the process of
1 mm (0.04 in.) per week. The growth rate is somewhat slower in vitamin D synthesis. However, repeatedly exposing the skin to a large
toenails. The longer the digit the faster the nail grows. amount of UV light may cause skin cancer. A tan is lost when the
melanin containing keratinocytes are shed from the stratum corneum.
Nails have a variety of functions:
Hemoglobin
1. They protect the distal end of the digits.
2. They provide support and counterpressure to the palmar Dark-skinned individuals have large amounts of melanin in the
surface of the fingers to enhance touch perception and epidermis, so their skin color ranges from yellow to reddish brown to
manipulation. black. Light-skinned individuals have little melanin in the epidermis.
3. They allow us to grasp and manipulate small objects, and they Thus, the epidermis appears translucent, and skin color ranges from
can be used to scratch and groom the body in various ways. pink to red depending on the oxygen content of the blood moving
through capillaries in the dermis. The red color is due to hemoglobin,
STRUCTURAL BASIS OF SKIN COLOR the oxygen-carrying pigment in red blood cells.
Melanin, hemoglobin, and carotene are three pigments that impart a Carotene
wide variety of colors to skin.
Carotene is a yellow-orange pigment that gives egg yolks and carrots
Melanin their color. This precursor of vitamin A, which is used to synthesize
pigments needed for vision, is stored in the stratum corneum and fatty
The amount of melanin causes the skin’s color to vary from pale areas of the dermis and subcutaneous layer in response to excessive
yellow to reddish-brown to black. The difference between the two dietary intake. In fact, so much carotene may be deposited in the skin
forms of melanin, pheomelanin (yellow to red) and eumelanin (brown after eating large amounts of carotene-rich foods that the skin actually
to black), is most apparent in the hair. turns orange, which is especially apparent in light-skinned individuals.
Decreasing carotene intake eliminates the problem.
Melanocytes, the melanin-producing cells, are most plentiful in the
epidermis of the penis, nipples of the breasts, area just around the DEVELOPMENT OF THE INTEGUMENTARY SYSTEM
nipples (areolae), face, and limbs. They are also present in mucous
membranes. Because the number of melanocytes is about the same The epidermis is derived from the ectoderm, which covers the
in all people, differences in skin color are due mainly to the amount of surface of the embryo. Initially, at about the fourth week after
pigment the melanocytes produce and transfer to keratinocytes. In fertilization, the epidermis consists of only a single layer of ectodermal
some people who are genetically predisposed, melanin accumulates cells.
in patches called freckles. Freckles typically are reddish or brown and
tend to be more visible in the summer than the winter. As a person At the beginning of the seventh week the single layer, called the basal
ages, age (liver) spots may develop. These flat blemishes have layer, divides and forms a superficial protected layer of flattened cells
nothing to do with the liver. They look like freckles and range in color called the periderm. The peridermal cells are continuously sloughed
from light brown to black. Like freckles, age spots are accumulations off, and by the fifth month of development secretions from sebaceous
of melanin. Age spots are darker than freckles and build up over time glands mix with them and hairs to form a fatty substance called vernix
due to exposure to sunlight. Age spots do not fade away during the caseosa. This substance covers and protects the skin of the fetus
winter months and are more common in adults over 40. A round, flat, from the constant exposure to the amniotic fluid in which it is bathed.
or raised area that represents a benign localized overgrowth of In addition, the vernix caseosa facilitates the birth of the fetus
melanocytes and usually develops in childhood or adolescence is because of its slippery nature and protects the skin from being
called a nevus, or a mole. damaged by the nails.
Melanocytes synthesize melanin from the amino acid tyrosine in the By about 11 weeks, the basal layer forms an intermediate layer of
presence of an enzyme called tyrosinase. To produce melanin, the cells. Proliferation of the basal cells eventually forms all layers of the
enzyme tyrosinase converts the amino acid tyrosine to dopaquinone. epidermis, which are present at birth. Epidermal ridges form along
Dopaquinone can be converted to a variety of related molecules, most with the epidermal layers. By about the eleventh week, cells from the
of which are brown to black pigments but some of which are yellowish ectoderm migrate into the dermis and differentiate into melanoblasts.
or reddish. Synthesis occurs in an organelle called a melanosome. These cells soon enter the epidermis and differentiate into
Exposure to ultraviolet (UV) light increases the enzymatic activity melanocytes. Later in the first trimester of pregnancy, intraepidermal
within melanosomes and thus increases melanin production. Both the macrophages, which arise from red bone marrow, invade the
amount and darkness of melanin increase on UV exposure, which epidermis. Tactile epithelial cells appear in the epidermis in the fourth
gives the skin a tanned appearance and helps protect the body to sixth months; their origin is unknown.
against further UV radiation. Melanin absorbs UV radiation, prevents
damage to DNA in epidermal cells, and neutralizes free radicals that The dermis arises from mesoderm located deep to the surface
form in the skin following damage by UV radiation. Thus, within limits, ectoderm. The mesoderm gives rise to a loosely organized embryonic
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connective tissue called mesenchyme. By 11 weeks, the inhibition. Migration of the epidermal cells stops completely when
mesenchymal cells differentiate into fibroblasts and begin to form each is finally in contact with other epidermal cells on all sides.
collagen and elastic fibers. As the epidermal ridges form, parts of the
superficial dermis project into the epidermis and develop into the As the basal epidermal cells migrate, a hormone called epidermal
dermal papillae, which contain capillary loops, corpuscles of touch, growth factor stimulates basal stem cells to divide and replace the
and free nerve endings. ones that have moved into the wound. The relocated basal epidermal
cells divide to build new strata, thus thickening the new epidermis.
Hair follicles develop at about 12 weeks as downgrowths of the basal
layer of the epidermis into the deeper dermis. The downgrowths are Deep Wound Healing
called hair buds. As the hair buds penetrate deeper into the dermis,
their distal ends become club shaped and are called hair bulb. Deep wound healing occurs when an injury extends to the dermis and
Invaginations of the hair bulbs, called papillae of the hair, fill with subcutaneous layer. Because multiple tissue layers must be repaired,
mesoderm in which blood vessels and nerve endings develop. Cells in the healing process is more complex than in epidermal wound
the center of a hair bulb develop into the matrix, which forms the hair, healing. In addition, because scar tissue is formed, the healed tissue
and the peripheral cells of the hair bulb form the epithelial root sheath; loses some of its normal function. Deep wound healing occurs in four
mesenchyme in the surrounding dermis develops into the dermal root phases: an inflammatory phase, a migratory phase, a proliferative
sheath and arrector pili muscle. By the fifth month, the hair follicles phase, and a maturation phase.
produce lanugo. It is produced first on the head and then on other
parts of the body, and is usually shed prior to birth. Hemostasis, the first phase of healing, begins at the onset of injury,
and the objective is to stop the bleeding. In this phase, the body
Most sebaceous (oil) glands develop as outgrowths from the sides of activates its emergency repair system, the blood clotting system, and
hair follicles at about four months and remain connected to the forms a dam to block the drainage. During this process, platelets
follicles. Most sudoriferous (sweat) glands are derived from come into contact with collagen, resulting in activation and
downgrowths (buds) of the stratum basale of the epidermis into the aggregation. An enzyme called thrombin is at the center, and it
dermis. As the buds penetrate into the dermis, the proximal portion initiates the formation of a fibrin mesh, which strengthens the platelet
forms the duct of the sweat gland and the distal portion coils and clumps into a stable clot. Platelets are key players in hemostasis, the
forms the secretory portion of the gland. Sweat glands appear at process by which the body seals a ruptured blood vessel and
about five months on the palms and soles and a little later in other prevents further loss of blood. This phase is primarily about
regions. coagulation – formation of a blood clot
Nails are developed at about 10 weeks. Initially they consist of a thick During the inflammatory phase, a blood clot forms in the wound and
layer of epithelium called the primary nail field. The nail itself is loosely unites the wound edges. As its name implies, this phase of
keratinized epithelium and grows distally from its base. It is not until deep wound healing involves inflammation, a vascular and cellular
the ninth month that the nails actually reach the tips of the digits. response that helps eliminate microbes, foreign material, and dying
tissue in preparation for repair. The vasodilation and increased
MAINTAINING HOMEOSTASIS: SKIN WOUND HEALING permeability of blood vessels associated with inflammation enhance
delivery of helpful cells. These include phagocytic white blood cells
Skin damage sets in motion a sequence of events that repairs the skin called neutrophils; monocytes, which develop into macrophages that
to its normal (or near-normal) structure and function. Two kinds of phagocytize microbes; and mesenchymal cells, which develop into
wound-healing processes can occur, depending on the depth of the fibroblasts. A type of white blood cells called neutrophils enter the
injury. Epidermal wound healing occurs following wounds that affect wound to destroy bacteria and remove debris. These cells often reach
only the epidermis; deep wound healing occurs following wounds that their peak population between 24 and 48 hours after injury, reducing
penetrate the dermis. greatly in number after three days. As the white blood cells leave,
specialized cells called macrophages arrive to continue clearing
Epidermal Wound Healing debris. These cells also secrete growth factors and proteins that
attract immune system cells to the wound to facilitate tissue repair.
Even though the central portion of an epidermal wound may extend to This phase often lasts four to six days and is often associated with
the dermis, the edges of the wound usually involve only slight damage edema, erythema (reddening of the skin), heat and pain. This phase
to superficial epidermal cells. Common types of epidermal wounds focuses on destroying bacteria and removing debris—essentially
include abrasions, in which a portion of skin has been scraped away, preparing the wound bed for the growth of new tissue.
and minor burns.
The three phases that follow do the work of repairing the wound. In
In response to an epidermal injury, basal cells of the epidermis the migratory phase, the clot becomes a scab, and epithelial cells
surrounding the wound break contact with the basement membrane. migrate beneath the scab to bridge the wound. Fibroblasts migrate
The cells then enlarge and migrate across the wound. The cells along fibrin threads and begin synthesizing scar tissue (collagen fibers
appear to migrate as a sheet until advancing cells from opposite sides and glycoproteins), and damaged blood vessels begin to regrow.
of the wound meet. When epidermal cells encounter one another, During this phase, the tissue filling the wound is called granulation
they stop migrating due to a cellular response called contact tissue.
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The proliferative phase is characterized by extensive growth of
epithelial cells beneath the scab, deposition by fibroblasts of collagen
• Boils (furuncles) and carbuncles. Boils are caused by
fibers in random patterns, and continued growth of blood vessels.
Once the wound is cleaned out, the wound enters the Proliferative inflammation of hair follicles and surrounding tissues,
commonly on the dorsal neck. Carbuncles are clusters of boils
Phase, where the focus is to fill and cover the wound.The Proliferative
phase features three distinct stages: 1) filling the wound; 2) often caused by the bacterium Staphylococcus aureus.
contraction of the wound margins; and 3) covering the wound
(epithelialization). During the first stage, shiny, deep red granulation • Cold sores (fever blisters). Small fluid-filled blisters that itch
tissue fills the wound bed with connective tissue, and new blood and sting, caused by human herpesvirus 1 infection. The virus
vessels are formed. During contraction, the wound margins contract localizes in a cutaneous nerve, where it remains dormant until
and pull toward the center of the wound. In the third stage, epithelial activated by emotional upset, fever, or UV radiation. Cold sores
cells arise from the wound bed or margins and begin to migrate usually occur around the lips and in the oral mucosa of the
across the wound bed in leapfrog fashion until the wound is covered mouth and nose.
with epithelium. The Proliferative phase often lasts anywhere from
four to 24 days.
• Contact dermatitis. Itching, redness, and swelling of the skin,
Finally, during the maturation phase, the scab sloughs off once the progressing to blistering. It is caused by exposure of the skin to
epidermis has been restored to normal thickness. Collagen fibers chemicals (such as those in poison ivy) that provoke allergic
become more organized, fibroblasts decrease in number, and blood responses in sensitive individuals.
vessels are restored to normal. During the Maturation phase, the new
tissue slowly gains strength and flexibility. Here, collagen fibers • Impetigo. Pink, fluid-filled, raised lesions (commonly around
reorganize, the tissue remodels and matures and there is an overall the mouth and nose) that develop a yellow crust and eventually
increase in tensile strength (though maximum strength is limited to rupture. Caused by highly contagious staphylococcus or
80% of the pre-injured strength). The Maturation phase varies greatly streptococcus infections, impetigo is common in elementary
from wound to wound, often lasting anywhere from 21 days to two school–aged children.
years.
The process of scar tissue formation is called fibrosis. Sometimes, so • Psoriasis. Characterized by reddened epidermal lesions
much scar tissue is formed during deep wound healing that a raised covered with dry, silvery scales that itch, burn, crack, and
scar—one that is elevated above the normal epidermal surface— sometimes bleed. A chronic condition, psoriasis is believed to
results. If such a scar remains within the boundaries of the original be an autoimmune disorder in which the immune system
wound, it is a hypertrophic scar. If it extends beyond the boundaries attacks a person’s own tissues, leading to the rapid
into normal surrounding tissues, it is a keloid scar, also called a overproduction of skin cells. Attacks are often triggered by
cheloid scar. Scar tissue differs from normal skin in that its collagen trauma, infection, hormonal changes, or stress. When severe,
fibers are more densely arranged, it has decreased elasticity, it has psoriasis may be disfiguring.
fewer blood vessels, and it may or may not contain the same number
of hairs, skin glands, or sensory structures as undamaged skin. Burns
Because of the arrangement of collagen fibers and the scarcity of
blood vessels, scars usually are lighter in color than normal skin. There are few threats to life more serious than burns. A burn is tissue
damage and cell death caused by intense heat, electricity, UV
HOMEOSTATIC IMBALANCES OF THE SKIN radiation (sunburn), or certain chemicals (such as acids), which
denature proteins and cause cell death in the affected areas.
Loss of homeostasis in body cells and organs reveals itself on the
skin, sometimes in startling ways. The skin can develop more than When the skin is burned and its cells are destroyed, two
1,000 different ailments. The most common skin disorders are lifethreatening problems result. First, without an intact boundary, the
infections with pathogens such as bacteria, viruses, or fungi. Allergies, body loses its precious supply of fluids containing proteins and
which are caused by abnormally strong immune responses, are also electrolytes as these seep from the burned surfaces. Dehydration and
electrolyte imbalance follow and can lead to a shutdown of the
commonly seen in the skin. Less common, but far more damaging to
kidneys and circulatory shock (inadequate circulation of blood caused
body well-being, are burns and skin cancers. by low blood volume). To save the patient, lost fluids must be
replaced immediately. The volume of fluid lost can be estimated
Infections and Allergies indirectly by determining how much of the body surface is burned
(extent of burns), using the rule of nines. This method divides the
Infections and allergies cause the following commonly occurring skin body into 11 areas, each accounting for 9 percent of the total body
disorders: surface area, plus an additional area surrounding the genitals (the
perineum) representing 1 percent of body surface area.
• Athlete’s foot. An itchy, red, peeling condition of the skin
between the toes, resulting from an infection with the fungus
Tinea pedis.
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• Fourth-degree burns are also full-thickness burns, but they
extend into deeper tissues such as bone, muscle, or tendons.
These burns appear dry and leathery, and they require surgery
and grafting to cover exposed tissue. In severe cases,
amputation may be required to save the patient’s life.
In general, burns are considered critical if any of the following

conditions exists:
• Over 30 percent of the body has second-degree burns.

• Over 10 percent of the body has third- or fourth-degree burns.
• There are third- or fourth-degree burns of the face, hands, feet,
or genitals.
• Burns affect the airway.
• Circumferential (around the body or limb) burns have occurred.
Facial burns are particularly dangerous because of the possibility of

burns in respiratory passageways, which can swell and cause
suffocation. Joint injuries are troublesome because the scar tissue
that eventually forms can severely limit joint mobility. Circumferential
burns can restrict movement, and depending on location, can interfere
with normal breathing.
Later, infection becomes the most important threat and is the leading
cause of death in burn victims. Burned skin is sterile for about 24 Skin Cancer
hours. But after that, pathogens easily invade areas where the skin
has been destroyed and multiply rapidly in the nutrient-rich Numerous types of neoplasms (tumors) arise in the skin. Most skin
environment of dead tissues. To make matters worse, the patient’s neoplasms are benign and do not spread (metastasize) to other body
immune system becomes depressed within one to two days after areas. For example, warts are caused by human papillomaviruses but
severe burn injury. are benign and do not spread. However, some skin neoplasms are
malignant, or cancerous, and they tend to invade other body areas.
Burns are classified according to their severity (depth) as first-degree
(superficial), second-degree (superficial partial-thickness burns), third Skin cancer is the single most common type of cancer in humans.
degree (full-thickness burns), or fourth-degree (full-thickness burns One in five Americans now develops skin cancer at some point in his
with deep-tissue involvement). or her life. The most important risk factor is overexposure to UV
radiation in sunlight and tanning beds. Frequent irritation of the skin
• In first-degree burns, only the superficial epidermis is by infections, chemicals, or physical trauma also seems to be a
damaged. The area becomes red and swollen. Except for predisposing factor. Let’s look in a bit more detail at the three most
temporary discomfort, first-degree burns are not usually serious common types of skin cancer: basal cell carcinoma, squamous cell
and generally heal in two to three days. Sunburn without carcinoma, and malignant melanoma.
blistering is a first-degree burn.
Basal Cell Carcinoma is the least malignant and most common skin
cancer. Cells of the stratum basale, altered so that they cannot form
• Second-degree burns involve injury to the epidermis and the keratin, no longer honor the boundary between epidermis and dermis.
superficial part of the dermis. The skin is red, painful, and They proliferate, invading the dermis and subcutaneous tissue. The
blistered. Because sufficient numbers of epithelial cells are still cancerous lesions occur most often on sun-exposed areas of the face
present, regrowth (regeneration) of the epithelium can occur. and often appear as shiny, dome-shaped nodules that later develop a
Ordinarily, no permanent scars result if care is taken to prevent central ulcer with a “pearly” beaded edge. Basal cell carcinoma is
infection. relatively slow-growing, and metastasis seldom occurs before the
lesion is noticed. When the lesion is removed surgically, 99 percent of
• Third-degree burns destroy both the epidermis and the dermis cases are completely cured.
and often extend into the subcutaneous tissue, reflecting their
categorization as full thickness burns. Blisters are usually Squamous Cell Carcinoma arises from the cells of the stratum
present, and the burned area appears blanched (gray-white) or spinosum. The lesions appear as scaly, reddened papules (small,
blackened. Because the nerve endings in the area are rounded swellings) that gradually form shallow ulcers with firm, raised
destroyed, the burned area is not painful. In third degree burns, borders. This variety of skin cancer appears most often on the scalp,
regeneration is not possible, and skin grafting must be done to ears, back of the hands, and lower lip, but can appear anywhere on
cover the underlying exposed tissues. the skin. It grows rapidly and metastasizes to adjacent lymph nodes if
not removed. This epidermal cancer is also believed to be induced by
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UV exposure. If it is caught early and removed surgically or by estimated that about one in two U.S. college students has had a body
radiation therapy, the chance of complete cure is good. piercing. For most piercing locations, the piercer cleans the skin with
an antiseptic, retracts the skin with forceps, and pushes a needle
Malignant Melanoma is a cancer of melanocytes. It accounts for only through the skin. Then the jewelry is connected to the needle and
about 5 percent of skin cancers, but it is often deadly. Melanoma can pushed through the skin. Total healing can take up to a year. Among
begin wherever there is pigment; most such cancers appear the sites that are pierced are the ears, nose, eyebrows, lips, tongue,
spontaneously, but some develop from pigmented moles. It arises nipples, navel, and genitals. Potential complications of body piercing
from accumulated DNA damage in a skin cell and usually appears as are infections, allergic reactions, and anatomical damage (such as
a spreading brown to black patch that metastasizes rapidly to nerve damage or cartilage deformation). In addition, body piercing
surrounding lymph and blood vessels. The chance for survival is jewelry may interfere with certain medical procedures such as masks
about 50 percent, and early detection helps. The American Cancer used for resuscitation, airway management procedures, urinary
Society suggests that people who sunbathe frequently or attend catheterization, radiographs, and delivery of a baby.
tanning parlors examine their skin periodically for new moles or
pigmented spots and apply the ABCDE rule for recognizing EFFECTS OF AGING ON THE INTEGUMENTARY SYSTEM
melanoma:
As the body ages, the skin is more easily damaged because the
(A) Asymmetry. Any two sides of the pigmented spot or mole do epidermis thins and the amount of collagen in the dermis decreases.
not match. Skin infections are more likely, and skin repair occurs more slowly. A
(B) Border irregularity. The borders of the lesion are not smooth but decrease in the number of elastic fibers in the dermis and a loss of
exhibit indentations. adipose tissue from the subcutaneous tissue cause the skin to sag
(C) Color. The pigmented spot contains areas of different colors and wrinkle.
(black, brown, tan, and sometimes blue or red).
(D) Diameter. The lesion is larger than 6 millimeters (mm) in Retin-A (tretinoin) is a vitamin A derivative that appears to be effective
diameter (the size of a pencil eraser). in treating fine wrinkles on the face, such as those caused by
(E) Evolution. One or more of these characteristics (ABCD) is longterm exposure to the sun; it is not effective in treating deep lines.
evolving, or changing. One ironic side effect of Retin-A use is increased sensitivity to the
sun’s ultraviolet rays. Doctors prescribing this cream caution their
The usual therapy for malignant melanoma is wide surgical excision patients to always use a sunblock when they are going to be
along with immunotherapy, a treatment that involves the patient’s outdoors.
immune system. Large lesions may also require radiation or
chemotherapy after surgical removal. The skin also becomes drier with age as sebaceous gland activity
decreases. Decreases in the activity of sweat glands and the blood
TATTOOING AND BODY PIERCING supply to the dermis result in a reduced ability to regulate body
temperature. Elderly individuals who do not take proper precautions
Tattooing is a permanent coloration of the skin in which a foreign may experience heat exhaustion, which can even lead to death.
pigment is deposited with a needle into the dermis. It is believed that
the practice originated in ancient Egypt between 4000 and 2000 b.c. The number of functioning melanocytes generally decreases;
Today, tattooing is performed in one form or another by nearly all however, in some localized areas, especially on the hands and face,
peoples of the world, and it is estimated that about one in three U.S. melanocytes increase in number, producing age spots. (Age spots are
college students has one or more tattoos. They are created by different from freckles, which are caused by an increase in melanin
injecting ink with a needle that punctures the epidermis, moves production, not an increase in melanocyte numbers.) White or gray
between 50 and 3000 times per minute, and deposits the ink in the hairs also appear because of a decrease in or lack of melanin
dermis. Since the dermis is stable (unlike the epidermis, which is shed production.
about every four to six weeks), tattoos are permanent. However, they
can fade over time due to exposure to sunlight, improper healing, Skin that is exposed to sunlight appears to age more rapidly than
picking scabs, and flushing away of ink particles by the lymphatic nonexposed skin. This effect is observed on areas of the body that
system. Tattoos can be removed by lasers, which use concentrated receive sun exposure, such as the face and hands. However, the
beams of light. In the procedure, which requires a series of effects of chronic sun exposure on the skin are different from the
treatments, the tattoo inks and pigments selectively absorb the effects of normal aging. In skin exposed to sunlight, normal elastic
highintensity laser light without destroying normal surrounding skin fibers are replaced by an interwoven mat of thick, elastic-like material,
tissue. The laser causes the tattoo to dissolve into small ink particles the number of collagen fibers decreases, and the ability of
that are eventually removed by the immune system. Laser removal of keratinocytes to divide is impaired.
tattoos involves a considerable investment in time and money and can
Most of the age-related changes begin at about age 40 and occur in
be quite painful.
the proteins in the dermis. Collagen fibers in the dermis begin to
Body piercing, the insertion of jewelry through an artificial opening, is decrease in number, stiffen, break apart, and disorganize into a
also an ancient practice employed by Egyptian pharaohs and Roman shapeless, matted tangle. Elastic fibers lose some of their elasticity,
soldiers, and a current tradition among many Americans. Today it is thicken into clumps, and fray, an effect that is greatly accelerated in
the skin of smokers. Fibroblasts, which produce both collagen and
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elastic fibers, decrease in number. As a result, the skin forms the
characteristic crevices and furrows known as wrinkles.
The pronounced effects of skin aging do not become noticeable until

people reach their late 40s. Intraepidermal macrophages dwindle in
number and become less-efficient phagocytes, thus decreasing the
skin’s immune responsiveness. Moreover, decreased size of
sebaceous glands leads to dry and broken skin that is more
susceptible to infection. Production of sweat diminishes, which
probably contributes to the increased incidence of heat stroke in the
elderly. There is a decrease in the number of functioning
melanocytes, resulting in gray hair and atypical skin pigmentation.
Hair loss increases with aging as hair follicles stop producing hairs.
About 25% of males begin to show signs of hair loss by age 30 and
about twothirds have significant hair loss by age 60. Both males and
females develop pattern baldness. An increase in the size of some
melanocytes produces pigmented blotching (age spots). Walls of
blood vessels in the dermis become thicker and less permeable, and
subcutaneous adipose tissue is lost. Aged skin (especially the dermis)
is thinner than young skin, and the migration of cells from the basal
layer to the epidermal surface slows considerably. With the onset of
old age, skin heals poorly and becomes more susceptible to
pathological condition such as skin cancer and pressure sores.
Rosacea is a skin condition that affects mostly light-skinned adults
between the ages of 30 and 60. It is characterized by redness, tiny
pimples, and noticeable blood vessels, usually in the central area of
the face.
Growth of nails and hair slows during the second and third decades of
life. The nails also may become more brittle with age, often due to
dehydration or repeated use of cuticle remover or nail polish.
REFERENCES
1.
Human Anatomy & Physiology Unit 2 Module
3.
VanPutte C., Regan J., Russo A. (2019). Seeley’s
Essentials of Anatomy and Physiology 10th Edition
4. Marieb E. & Keller S., (2019). Essentials of Human Anatomy

& Physiology,12th Ed, Pearson
TRANSCRIBED BY: DINVER JAY PEDROSA, BSRT-1C

https://www.facebook.com/dinverjay.pedrosa
`
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UNIT 03 – SKELETAL SYSTEM PART 01 movement. And also function as storage of mineral and are sites of
hematopoiesis.
OUTLINE SKELETAL SYSTEM: BONE & BONE TISSUE

I.
Skeletal System: Bone & Bone Tissue A bone is composed of several different tissues working together:
bone or osseous tissue, cartilage, dense connective tissue, epithelium,
A. Functions of Bone and the Skeletal System
adipose tissue, and nervous tissue. For this reason, each individual
B. Cartilage bone in your body is considered an organ. Bone tissue, a complex
C. Bone Histology and dynamic living tissue, continually engages in a process called
1. Bone Matrix remodeling—the construction of new bone tissue and breaking down
2. Types of Bone Cells of old bone tissue. The entire framework of bones and their cartilages,
3. Origin of Bone Cells along with ligaments and tendons, constitutes the skeletal system.
4. Woven and Lamellar Bone The study of bone structure and the treatment of bone disorders is
5. Compact Bone Tissue called osteology.
6. Spongy Bone Tissue
7. Blood and Nerve Supply of Bone Functions of Bone and the Skeletal System
D. Bone Anatomy
1. Bone Shapes The skeletal system has four components: bones, cartilage, tendons,
2. Structure of a Long Bone and ligaments. The skeleton is usually thought of as the framework of
3. Structure of Flat, Short and Irregular Bones the body, but the skeletal system has many other functions as well,
E. Bone Formation including the following:
1. Initial Bone Formation in an Embryo and Fetus
1. Support. The skeleton serves as the structural framework for
i. Intramembranous Ossification the body by supporting soft tissues and providing attachment
ii. Endochondral Ossification points for the tendons of most skeletal muscles. Rigid, strong
F. Bone Growth, Remodelling and Repair bone is well suited for bearing weight and is the major
1. Bone Growth supporting tissue of the body. Cartilage provides a firm yet
i. Growth in Length flexible support within certain structures, such as the nose,
ii. Growth at Articular Cartilage external ear, thoracic cage, and trachea. Ligaments are strong
iii. Growth in Thickness bands of fibrous connective tissue that hold bones together.
2. Bone Remodelling
i. Mechanical Stress and Bone Strength
2. Protection. The skeleton protects the most important internal
3. Factors Affecting Bone Growth & Remodelling
organs from injury. For example, cranial bones protect the
4. Fracture and Bone Repair
brain, and the rib cage protects the heart and lungs.
G. Calcium Homeostasis
H. Exercise and Bone Tissue
I. Aging and Bone Tissue 3. Assistance in movement. Most skeletal muscles attach to
bones; when they contract, they pull on bones to produce
movement. Skeletal muscles attach to bones by tendons,
which are strong bands of connective tissue. Contraction of the
skeletal muscles moves the bones, producing body movements.
In a science museum they usually display artifacts or fossilized Joints, which are formed where two or more bones come
materials. When you have visited some, did you notice that bone together, allow movement between bones. Smooth cartilage
displays are commonly present? Yes, because bones make good covers the ends of bones within some joints, allowing the bones
fossils. A well-preserved fossil skeleton can give us a good sense of to move freely. Ligaments allow some movement between
the size and shape of an organism, but, unlike a fossil skeleton, your bones but prevent excessive movements.
skeleton is a structure of living tissue that grows, repairs, and renews
itself. 4. Mineral homeostasis (storage and release). Bone tissue
makes up about 18% of the weight of the human body. Some
The living bones in our bodies use oxygen and give off waste products minerals in the blood are stored in bone. If blood levels of these
in metabolism. They contain active tissues that consume nutrients, minerals decrease, the minerals are released from bone into the
require a blood supply and change shape or remodel in response to blood. The principal minerals stored are calcium and
variations in mechanical stress. phosphorus, two minerals essential for many physiological
processes. Adipose tissue is also stored within bone cavities.
Bones provide a rigid framework, known as the skeleton which
If needed, the lipids are released into the blood and used by
particularly functions to support and protect. They work together with
other tissues as a source of energy. It stores several minerals,
muscles as simple mechanical lever systems to produce body
especially calcium and phosphorus, which contribute to the
strength of bone. Bone tissue stores about 99% of the body’s
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calcium. On demand, bone releases minerals into the blood to cartilage. The chondroblasts lay down new matrix and add new
maintain critical mineral balances (homeostasis) and to chondrocytes to the outside of the tissue. In interstitial growth,
distribute the minerals to other parts of the body. chondrocytes in the center of the tissue divide and add more matrix
inbetween the existing cells.
5. Blood cell production. Within certain bones, a connective
Bone Histology
tissue called red bone marrow produces red blood cells, white
blood cells, and platelets, in a process called
hematopoiesis/hemopoiesis. Red bone marrow consists of Bone Matrix
developing blood cells, adipocytes, fibroblasts, and
macrophages within a network of reticular fibers. It is present in Bone is a type of connective tissue. Connective tissue is characterized
developing bones of the fetus and in some adult bones, such as by having spread-out cells separated by a nonliving material called
the hip (pelvic) bones, ribs, sternum (breastbone), vertebrae matrix. In bone, as in other connective tissues, the bone cells produce
(backbones), skull, and ends of the bones of the humerus (arm the bone matrix and become entrapped within it. The cells also break
bone) and femur (thigh bone). In a newborn, all bone marrow is down old matrix so that new matrix can replace it. Bone matrix
red and is involved in hemopoiesis. With increasing age, much composition is responsible for the characteristics of bone.
of the bone marrow changes from red to yellow.
By weight, mature bone matrix is normally about 35% organic and
65% inorganic material. The organic material consists primarily of
6. Triglyceride storage. Yellow bone marrow consists mainly of collagen and proteoglycans. The inorganic material consists primarily
adipose cells, which store triglycerides. The stored of a calcium phosphate crystal called hydroxyapatite. Osteoid is a
triglycerides are a potential chemical energy reserve.
protein mixture secreted by osteoblasts that forms the organic matrix
of bone.
Cartilage
Like other connective tissues, bone, or osseous tissue, contains an
There are three types of cartilage: hyaline cartilage, fibrocartilage, abundant extracellular matrix that surrounds widely separated cells.
and elastic cartilage. Although each type of cartilage can provide The extracellular matrix is about 15% water, 30% collagen fibers, and
support, hyaline cartilage is most intimately associated with bone. An 55% crystallized mineral salts. The most abundant mineral salt is
understanding of hyaline cartilage structure is important because most calcium phosphate [Ca3(PO4)2]. It combines with another mineral
bones in the body start out as a hyaline cartilage model. In addition, salt, calcium hydroxide [Ca(OH)2], to form crystals of
growth in bone length and bone repair often involve making hyaline hydroxyapatite [Ca10(PO4)6(OH)2]. As the crystals form, they
cartilage first, then replacing it with bone. combine with still other mineral salts, such as calcium carbonate
(CaCO3), and ions such as magnesium, fluoride, potassium, and
Most human cells start out in an immature state and then undergo sulfate. As these mineral salts are deposited in the framework formed
changes to mature into their final form. This is not too different than a by the collagen fibers of the extracellular matrix, they crystallize and
baby growing and maturing into an adult. Immature cell names often the tissue hardens. This process, called calcification, is initiated by
end with the suffix -blast, which means “seed” or “bud.” Once the bone-building cells called osteoblasts.
immature cell has grown and differentiated into its mature form, the
suffix –cyte replaces -blast in the name. Hyaline cartilage It was once thought that calcification simply occurred when enough
chondroblasts produce a matrix surrounding themselves. By the time mineral salts were present to form crystals. We now know that the
the matrix has surrounded a chondroblast, the cell has differentiated process requires the presence of collagen fibers. Mineral salts first
into a chondrocyte, a rounded cell that occupies a space called a begin to crystallize in the microscopic spaces between collagen fibers.
lacuna within the matrix. The matrix contains collagen, which After the spaces are filled, mineral crystals accumulate around the
provides strength, and proteoglycans, which make cartilage resilient collagen fibers. The combination of crystallized salts and collagen
by trapping water. fibers is responsible for the characteristics of bone. Although a bone’s
hardness depends on the crystallized inorganic mineral salts, a
Most cartilage is covered by a protective connective tissue sheath bone’s flexibility depends on its collagen fibers. Like reinforcing metal
called the perichondrium. The perichondrium is a double-layered rods in concrete, collagen fibers and other organic molecules provide
outer layer of dense irregular connective tissue containing fibroblasts. tensile strength, resistance to being stretched or torn apart. Soaking a
The inner, more delicate layer has fewer fibers and contains bone in an acidic solution, such as vinegar, dissolves its mineral salts,
chondroblasts. Blood vessels and nerves penetrate the outer layer of causing the bone to become rubbery and flexible. When the need for
the perichondrium but do not enter the cartilage matrix, so nutrients particular minerals arises or as part of bone formation or breakdown,
must diffuse through the cartilage matrix to reach the chondrocytes. bone cells called osteoclasts secrete enzymes and acids that break
Articular cartilage, which is hyaline cartilage that covers the ends of down both the mineral salts and the collagen fibers of the extracellular
bones where they come together to form joints, has no perichondrium, matrix of bone.
blood vessels, or nerves.
The collagen and mineral components are responsible for the major
There are two types of cartilage growth: appositional growth and functional characteristics of bone. Bone matrix can be compared to
interstitial growth. In appositional growth, chondroblasts in the reinforced concrete. Like reinforcing steel bars, the collagen fibers
perichondrium add new cartilage to the outside edge of the existing
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lend flexible strength to the matrix; like concrete, the mineral of nutrients and wastes with the blood. Once an osteoblast has
components give the matrix weight-bearing strength. secreted enough bone matrix to become surrounded by it the
cell is then referred to as an osteocyte. Like osteoblasts,
If all the mineral is removed from a long bone, collagen becomes the osteocytes do not undergo cell division. (Note: The ending cyte
primary constituent and the bone is overly flexible. On the other hand, in the name of a bone cell or any other tissue cell means that
if the collagen is removed from the bone, the mineral component the cell maintains and monitors the tissue.) The osteocytes
becomes the primary constituent and the bone is very brittle retain their connections to neighboring osteocytes through their
cell extensions. Osteocytes become relatively inactive,
Types of Bone Cells compared with most osteoblasts, but it is possible for them to
produce the components needed to maintain the bone matrix.
Four types of cells are present in bone tissue: osteogenic cells,
osteoblasts, osteocytes, and osteoclasts. The spaces without matrix but occupied by the osteocyte cell
bodies are called lacunae, and the spaces occupied by the
1. Osteoprogenitor cells are unspecialized bone stem cells osteocyte cell extensions are called canaliculi. In a sense, the
derived from mesenchyme, the tissue from which almost all cells and their extensions form a “mold” around which the
connective tissues are formed. They are the only bone cells to matrix is formed. Bone differs from cartilage in that the
undergo cell division; the resulting cells develop into extensions of bone cells are in contact with one another through
osteoblasts. Osteoprogenitor cells are found along the inner the canaliculi. Instead of diffusing through the mineralized
portion of the periosteum, in the endosteum, and in the canals matrix, nutrients and gases can pass through the small amount
within bone that contain blood vessels. of fluid surrounding the cells in the canaliculi and lacunae or
pass from cell to cell through the gap junctions connecting the
2. Osteoblasts are bone-building cells/bone forming cells. They cell extensions.
synthesize and secrete collagen fibers and other organic
components needed to build the extracellular matrix of bone 4. Osteoclasts are are bone-destroying cells. These cells perform
tissue, and they initiate calcification. As osteoblasts surround reabsorption, or breakdown, of bone that mobilizes crucial Ca2+
themselves with extracellular matrix, they become trapped in and phosphate ions for use in many metabolic processes. Note
their secretions and become osteocytes. (Note: The ending we use the term reabsorption here because our point of
blast in the name of a bone cell or any other connective tissue reference is the bloodstream. As bone is broken down, the
cell means that the cell secretes extracellular matrix.) Ca2+ goes “back” into the blood. These cells are massive,
multinucleated cells whose differentiation follows a complex
Osteoblasts have an extensive endoplasmic reticulum and pathway. They are derived from the red bone marrow cells that
numerous ribosomes. They produce collagen and also differentiate into monocytes (called macrophages in the
proteoglycans, which are packaged into vesicles by the Golgi tissues). These precursors attach to the bone matrix where
apparatus and released from the cell by exocytosis. direct contact with osteoblasts is required to allow eventual
Osteoblasts also release matrix vesicles, which contain high maturation into functional osteosclasts.
concentrations of Ca2+ and PO4 3−. When the concentration
reaches a critical level, needlelike hydroxyapatite crystals form. Mature osteoclasts carry out bone resorption through a
multistep process. First, the osteoclasts must access the bone
When the hydroxyapatite crystals are released from the matrix matrix. The current model proposes that osteoblasts lining the
vesicles they act as templates, or seeds, which stimulate connective tissue around bone regulate the movement of
further hydroxyapatite formation and mineralization of the mature osteoclasts into a bone remodeling area. Once the
matrix.
osteoclasts have come in contact with the bone surface, they
form attachment structures via interactions with cell-surface
The formation of new bone by osteoblasts is called ossification proteins called integrins. Soon after, structures called
or osteogenesis. Ossification occurs by appositional growth podosomes develop and form a sealed compartment under the
on the surface of previously existing material, either bone or osteoclast. The osteoclast cell membrane then further
cartilage. For example, osteoblasts beneath the periosteum differentiates into a highly folded form called the ruffled border.
cover the surface of preexisting bone. Elongated cell extensions
from osteoblasts connect to the cell extensions of other
osteoblasts through gap junctions. Bone matrix produced by
the osteoblasts covers the older bone surface and surrounds
the osteoblast cell bodies and extensions. The result is a new
layer of bone.
3. Osteocytes, mature bone cells, are the main cells in bone

tissue and maintain its daily metabolism, such as the exchange
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Osteoprogenitor cells undergo cell division and develop into

osteoblasts, which secrete bone extracellular matrix.
The ruffled border is a specialized reabsorption-specific area Bone is not completely solid but has many small spaces between its
of the membrane. Acidic vesicles fuse with the membrane of cells and extracellular matrix components. Some spaces serve as
the ruffled border, while ATP-powered H+ pumps and channels for blood vessels that supply bone cells with nutrients. Other
proteindigesting enzymes are inserted into the membrane of spaces act as storage areas for red bone marrow. Depending on the
the ruffled border. Secretion of H+ creates an acidic size and distribution of the spaces, the regions of a bone may be
environment within the sealed compartment, which causes categorized as compact or spongy. Overall, about 80% of the skeleton
decalcification of the bone matrix. The protein-digestion is compact bone and 20% is spongy bone.
enzymes are secreted into the sealed compartment and digest
the organic, protein component of the bone matrix. After
breakdown of the matrix, the degradation products are removed Origin of Bone Cells
by a transcytosis mechanism, whereby the products enter the
osteoclast and move across the cytoplasm to the other side of Connective tissue develops embryologically from mesenchymal cells.
the osteoclast. There, the degradation products are secreted Some of the mesenchymal cells become stem cells, some of which
into the extracellular space, enter the blood, and are used replicate and become more specialized cell types. Osteochondral
elsewhere in the body. progenitor cells are stem cells that can become osteoblasts or
chondroblasts. Osteochondral progenitor cells are located in the inner
Osteoclasts are huge cells derived from the fusion of as many layer of the perichondrium and in layers of connective tissue that
as 50 monocytes (a type of white blood cell) and are cover bone (periosteum and endosteum). From these locations, they
concentrated in the endosteum. On the side of the cell that are a potential source of new osteoblasts or chondroblasts.
faces the bone surface, the osteoclast’s plasma membrane is
Osteoblasts are derived from osteochondral progenitor cells, and
deeply folded into a ruffled border. Here the cell releases
osteocytes are derived from osteoblasts. Whether or not osteocytes
powerful lysosomal enzymes and acids that digest the protein
and mineral components of the underlying extracellular bone freed from their surrounding bone matrix by reabsorption can revert to
matrix. This breakdown of bone extracellular matrix, termed become active osteoblasts is a debated issue. Osteoclasts are not
resorption, is part of the normal development, maintenance, derived from osteochondral progenitor cells but from stem cells in red
and repair of bone. (Note: The ending -clast means that the bone marrow.
cell breaks down extracellular matrix.) In response to certain
hormones, osteoclasts help regulate blood calcium level. They Woven and Lamellar Bone
are also target cells for drug therapy used to treat osteoporosis.
As bone formation progresses, the newly formed bone goes through
A mnemonic that will help you remember the difference between the
several stages. Ossification occurs in a few situations during life: as a
function of osteoblasts and osteoclasts is as follows: osteoBlasts Build
fetus, when growing, and anytime in life a fracture is repaired.
bone, while osteoClasts Carve out bone.
The first type of bone that osteoblasts form during ossification is fairly
weak bone called woven bone. In woven bone, the collagen fibers
are randomly oriented in many directions. After woven bone formation,
osteoclasts break down the woven bone and osteoblasts build new
matrix. The process of removing old bone and adding new bone is
called bone remodeling. Woven bone is remodeled into a stronger,
more permanent type called lamellar bone.
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Lamellar bone is mature bone that is organized into thin, concentric
sheets or layers approximately 3–7 micrometers (μm) thick called
lamellae. In general, the collagen fibers of one lamella lie parallel to
one another, but at an angle to the collagen fibers in the adjacent
lamellae. Osteocytes, within their lacunae, are arranged in layers
sandwiched between lamellae.
As ossification continues, bone is further molded and shaped into its

final form. Whether bone is woven or lamellar, it can be classified
according to the amount of bone matrix relative to the amount of
space within the bone. Spongy bone, which appears porous, has less
bone matrix and more space than compact bone. In contrast, compact
bone has more bone matrix and less space than spongy bone.
Compact Bone
Compact bone tissue contains few spaces and is the strongest form
of bone tissue. It is found beneath the periosteum of all bones and
makes up the bulk of the diaphyses of long bones. Compact bone The areas between neighboring osteons contain lamellae called
tissue provides protection and support and resists the stresses interstitial lamellae, which also have lacunae with osteocytes and
produced by weight and movement. canaliculi. Interstitial lamellae are fragments of older osteons that have
been partially destroyed during bone rebuilding or growth.
Compact bone tissue is composed of repeating structural units called
osteons, or haversian systems. Each osteon consists of concentric Osteocytes receive nutrients and eliminate waste products through the
lamellae arranged around a central canal or haversian canal. canal system within compact bone. Blood vessels and nerves from
Resembling the growth rings of a tree, the concentric lamellae are the periosteum penetrate the compact bone through transverse
circular plates of mineralized extracellular matrix of increasing perforating canals or Volkmann’s canals. The vessels and nerves
diameter, surrounding a small network of blood vessels and nerves of the perforating canals connect with those of the medullary cavity,
located in the central canal. These tubelike units of bone generally periosteum, and central canals. Perforating canals are not surrounded
form a series of parallel cylinders that, in long bones, tend to run by concentric lamellae but, instead, pass through the concentric
parallel to the long axis of the bone. Between the concentric lamellae lamellae of osteons. The central canals receive blood vessels from
are small spaces called lacunae, which contain osteocytes. Radiating perforating canals. Nutrients in the blood vessels enter the central
in all directions from the lacunae are tiny canaliculi, which are filled canals, pass into the canaliculi, and move through the cytoplasm of
with extracellular fluid. Inside the canaliculi are slender fingerlike the osteocytes that occupy the canaliculi and lacunae to the most
processes of osteocytes. Neighboring osteocytes communicate via peripheral cells at the edge of each osteon. Waste products are
gap junctions. The canaliculi connect lacunae with one another and removed in the reverse direction.
with the central canals, forming an intricate, miniature system of
interconnected canals throughout the bone. This system provides Arranged around the entire outer and inner circumference of the shaft
many routes for nutrients and oxygen to reach the osteocytes and for of a long bone are lamellae called circumferential lamellae. They
the removal of wastes. develop during initial bone formation. The circumferential lamellae
directly deep to the periosteum are called outer circumferential
Osteons in compact bone tissue are aligned in the same direction and lamellae. They are connected to the periosteum by perforating
are parallel to the length of the diaphysis. As a result, the shaft of a (Sharpey’s) fibers. The circumferential lamellae that line the
long bone resists bending or fracturing even when considerable force medullary cavity are called inner circumferential lamellae.
is applied from either end. Compact bone tissue tends to be thickest in
those parts of a bone where stresses are applied in relatively few
Spongy Bone
directions. The lines of stress in a bone are not static. They change
as a person learns to walk and in response to repeated strenuous
physical activity, such as weight training. The lines of stress in a bone In contrast to compact bone tissue, spongy bone tissue, also referred
also can change because of fractures or physical deformity. Thus, the to as trabecular or cancellous bone tissue, does not contain
organization of osteons is not static but changes over time in response osteons. Spongy bone tissue is always located in the interior of a
bone, protected by a covering of compact bone. It consists of lamellae
to the physical demands placed on the skeleton.
that are arranged in an irregular pattern of thin columns called
trabeculae. Between the trabeculae are spaces that are visible to the
unaided eye. These macroscopic spaces are filled with red bone
marrow in bones that produce blood cells, and yellow bone marrow
(adipose tissue) in other bones. Both types of bone marrow contain
numerous small blood vessels that provide nourishment to the
osteocytes. Each trabecula consists of concentric lamellae, osteocytes
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that lie in lacunae, and canaliculi that radiate outward from the compact bone called the nutrient foramen (foramina is plural). On
lacunae. Each osteocyte is associated with other osteocytes through entering the medullary cavity, the nutrient artery divides into proximal
canaliculi. Usually, no blood vessels penetrate the trabeculae, so and distal branches that course toward each end of the bone. These
osteocytes must obtain nutrients through their canaliculi. branches supply both the inner part of compact bone tissue of the
diaphysis and the spongy bone tissue and red bone marrow as far as
Spongy bone tissue makes up most of the interior bone tissue of short, the epiphyseal plates (or lines). Some bones, like the tibia, have only
flat, sesamoid, and irregularly shaped bones. In long bones it forms one nutrient artery; others, like the femur (thigh bone), have several.
the core of the epiphyses beneath the paper-thin layer of compact The ends of long bones are supplied by the metaphyseal and
bone, and forms a variable narrow rim bordering the medullary cavity epiphyseal arteries, which arise from arteries that supply the
of the diaphysis. Spongy bone is always covered by a layer of associated joint. The metaphyseal arteries enter the metaphyses of a
compact bone for protection. long bone and, together with the nutrient artery, supply the red bone
marrow and bone tissue of the metaphyses. The epiphyseal arteries
At first glance, the trabeculae of spongy bone tissue may appear to be enter the epiphyses of a long bone and supply the red bone marrow
less organized than the osteons of compact bone tissue. However, and bone tissue of the epiphyses.
they are precisely oriented along lines of stress, a characteristic that
helps bones resist stresses and transfer force without breaking.
Spongy bone tissue tends to be located where bones are not heavily
stressed or where stresses are applied from many directions. The
trabeculae do not achieve their final arrangement until locomotion is
completely learned. In fact, the arrangement can even be altered as
lines of stress change due to a poorly healed fracture or a deformity.
Spongy bone tissue is different from compact bone tissue in two

respects. First, spongy bone tissue is light, which reduces the overall
weight of a bone. This reduction in weight allows the bone to move
more readily when pulled by a skeletal muscle. Second, the
trabeculae of spongy bone tissue support and protect the red bone
marrow. Spongy bone in the hip bones, ribs, sternum (breastbone),
vertebrae, and the proximal ends of the humerus and femur is the
only site where red bone marrow is stored and, thus, the site where
hemopoiesis (blood cell production) occurs in adults.
Veins that carry blood away from long bones are evident in three
places:
1. One or two nutrient veins accompany the nutrient artery and

exit through the diaphysis;
2. Numerous epiphyseal veins and metaphyseal veins

accompany their respective arteries and exit through the
Bone tissue is organized in concentric lamellae around a central epiphyses and metaphyses, respectively; and
(haversian) canal in compact bone and in irregularly arranged
lamellae in the trabeculae in spongy bone.
3. Many small periosteal veins accompany their respective
arteries and exit through the periosteum.
Blood and Nerve Supply of Bone
Nerves accompany the blood vessels that supply bones. The
Bone is richly supplied with blood. Blood vessels, which are especially periosteum is rich in sensory nerves, some of which carry pain
abundant in portions of bone containing red bone marrow, pass into sensations. These nerves are especially sensitive to tearing or
bones from the periosteum. tension, which explains the severe pain resulting from a fracture or a
bone tumor. For the same reason there is some pain associated with a
Periosteal arteries, small arteries accompanied by nerves, enter the bone marrow needle biopsy. In this procedure, a needle is inserted
diaphysis through many perforating (Volkmann’s) canals and supply into the middle of the bone to withdraw a sample of red bone marrow
the periosteum and outer part of the compact bone. Near the center of to examine it for conditions such as leukemias, metastatic neoplasms,
the diaphysis, a large nutrient artery passes through a hole in lymphoma, Hodgkin’s disease, and aplastic anemia. As the needle
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penetrates the periosteum, pain is felt. Once it passes through, there
is little pain.
2. The epiphyses are the proximal and distal ends of the bone.
Bone Anatomy This is the part of a long bone that develops from a center of
ossification distinct from that of the diaphysis. Each long bone
Bone Shapes of the arm, forearm, thigh, and leg has one or more epiphyses
on each end of the bone. Each long bone of the hand and foot
has one epiphysis, which is located on the proximal or distal
Individual bones are classified according to shape: long, flat, short, end of the bone.
or irregular.
1. Long bones are longer than they are wide. Most of the bones 3. The metaphyses are the regions between the diaphysis and
of the upper and lower limbs are long bones. the epiphyses. In a growing bone, each metaphysis contains an
2. Flat bones have a relatively thin, flattened shape and are epiphyseal (growth) plate, a layer of hyaline cartilage that
usually curved. Examples of flat bones include certain skull allows the diaphysis of the bone to grow in length. When a bone
bones, the ribs, the breastbone (sternum), and the shoulder ceases to grow in length at about ages 14–24, the cartilage in
blades (scapulae). the epiphyseal plate is replaced by bone; the resulting bony
3. Short bones are round or nearly cube-shaped, as exemplified structure is known as the epiphyseal line.
by the bones of the wrist (carpal bones) and ankle (tarsal
bones).
4. The articular cartilage is a thin layer of hyaline cartilage
4. Irregular bones, such as the vertebrae and facial bones, have
covering the part of the epiphysis where the bone forms an
shapes that do not readily fit into the other three categories.
articulation (joint) with another bone. Articular cartilage reduces
friction and absorbs shock at freely movable joints. Because
articular cartilage lacks a perichondrium and lacks blood
vessels, repair of damage is limited.
5. The periosteum is a tough connective tissue sheath and its

associated blood supply that surrounds the bone surface
wherever it is not covered by articular cartilage. It is composed
of an outer fibrous layer of dense irregular connective tissue
and an inner osteogenic layer that consists of cells. Some of
the cells enable bone to grow in thickness, but not in length.
The periosteum also protects the bone, assists in fracture
repair, helps nourish bone tissue, and serves as an attachment
point for ligaments and tendons. The periosteum is attached to
the underlying bone by perforating fibers or Sharpey’s fibers,
thick bundles of collagen that extend from the periosteum into
the bone extracellular matrix.
6. The medullary cavity, or marrow cavity, is a hollow,

cylindrical space within the diaphysis that contains fatty yellow
bone marrow and numerous blood vessels in adults. This cavity
minimizes the weight of the bone by reducing the dense bony
Structure of a Long Bone material where it is least needed. The long bones’ tubular
design provides maximum strength with minimum weight. The
Macroscopic bone structure may be analyzed by considering the parts cavities of spongy bone and the medullary cavity are filled with
of a long bone, such as the humerus (the arm bone). A long bone is marrow. Red marrow is the site of blood cell formation, and
one that has greater length than width. A long bone is the traditional yellow marrow is mostly adipose tissue. In the fetus, the
model for overall bone structure. A typical long bone consists of the spaces within bones are filled with red marrow. The conversion
following parts: of red marrow to yellow marrow begins just before birth and
continues well into adulthood. Yellow marrow completely
1. The diaphysis is the bone’s shaft or body—the long, cylindrical, replaces the red marrow in the long bones of the limbs, except
main portion of the bone. Composed primarily of compact bone, for some red marrow in the proximal part of the arm bones and
but it can also contain some spongy bone. During bone thighbones. Elsewhere, varying proportions of yellow and red
formation and growth, bones develop from centers of marrow are found. For example, part of the hipbone (ilium) may
ossification. The primary ossification center is in the contain 50% red marrow and 50% yellow marrow. The hipbone
diaphysis.
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is used as a source of donated red bone marrow because it is a Bone Formation
large bone with more marrow than smaller bones and it can be
accessed relatively easily. The process by which bone forms is called ossification or
osteogenesis. Bone formation occurs in four principal situations:
7. The endosteum is a thin membrane that lines the internal
1. The initial formation of bones in an embryo and fetus,
surfaces of all cavities within bones, such as the medullary
cavity of the diaphysis and the smaller cavities in spongy and
2. The growth of bones during infancy, childhood, and
compact bone. It contains a single layer of bone-forming cells
adolescence until their adult sizes are reached,
and a small amount of connective tissue.
3. The remodeling of bone (replacement of old bone by new bone

tissue throughout life), and
4. The repair of fractures (breaks in bones) throughout life.
Initial Bone Formation in an Embryo and Fetus
The embryonic “skeleton,” initially composed of mesenchyme in the

general shape of bones, is the site where cartilage formation and
ossification occur during the sixth week of embryonic development.
Bone formation follows one of two patterns. The two patterns of bone
formation, which both involve the replacement of a pre-existing
connective tissue with bone, do not lead to differences in the structure
The spongy bone tissue of the epiphyses and metaphyses contains of mature bones, but are simply different methods of bone
red bone marrow, and the medullary cavity of the diaphysis contains development. In the first type of ossification, called intramembranous
yellow bone marrow (in adults).
ossification, bone forms directly within mesenchyme, which is
arranged in sheet like layers that resemble membranes. In the second
A long bone is covered by articular cartilage at the articular
type, endochondral ossification, bone forms within hyaline cartilage
surfaces of its proximal and distal epiphyses and by periosteum
that develops from mesenchyme.
around all other parts of the bone.
Intramembranous Ossification
Structure of Flat, Short and Irregular Bones
Intramembranous ossification is the simpler of the two methods of
Flat bones contain an interior framework of spongy bone sandwiched bone formation. The flat bones of the skull, most of the facial bones,
between two layers of compact bone. Short and irregular bones mandible (lower jawbone), and the medial part of the clavicle (collar
have a composition similar to the epiphyses of long bones—compact bone) are formed in this way. Also, the “soft spots” that help the fetal
bone surfaces surrounding a spongy bone center with small spaces skull pass through the birth canal later harden as they undergo
that are usually filled with marrow. Short and irregular bones are not intramembranous ossification, which occurs as follows:
elongated and have no diaphyses. However, certain regions of these
bones, such as the processes (projections), have epiphyseal growth
plates and therefore small epiphyses.
Some of the flat and irregular bones of the skull have airfilled spaces
called sinuses, which are lined by mucous membranes.
1. Development of the ossification center. At the site where the

bone will develop, specific chemical messages cause the cells
of the mesenchyme to cluster together and differentiate, first
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into osteoprogenitor cells and then into osteoblasts. The site
of such a cluster is called an ossification center. Osteoblasts
As the cartilage model continues to grow, chondrocytes in its
secrete the organic extracellular matrix of bone until they are
midregion hypertrophy (increase in size) and the surrounding
surrounded by it.
cartilage extracellular matrix begins to calcify. Other
chondrocytes within the calcifying cartilage die because
2. Calcification. Next, the secretion of extracellular matrix stops, nutrients can no longer diffuse quickly enough through the
and the cells, now called osteocytes, lie in lacunae and extend extracellular matrix. As these chondrocytes die, the spaces left
their narrow cytoplasmic processes into canaliculi that radiate in behind by dead chondrocytes merge into small cavities called
all directions. Within a few days, calcium and other mineral salts lacunae.
are deposited and the extracellular matrix hardens or calcifies
(calcification).
3. Development of the primary ossification center. Primary
ossification proceeds inward from the external surface of the
3. Formation of trabeculae. As the bone extracellular matrix bone. A nutrient artery penetrates the perichondrium and the
forms, it develops into trabeculae that fuse with one another to calcifying cartilage model through a nutrient foramen in the
form spongy bone around the network of blood vessels in the midregion of the cartilage model, stimulating osteoprogenitor
tissue. Connective tissue associated with the blood vessels in cells in the perichondrium to differentiate into osteoblasts. Once
the trabeculae differentiates into red bone marrow. the perichondrium starts to form bone, it is known as the
periosteum. Near the middle of the model, periosteal
4. Development of the periosteum. In conjunction with the capillaries grow into the disintegrating calcified cartilage,
formation of trabeculae, the mesenchyme condenses at the inducing growth of a primary ossification center, a region
periphery of the bone and develops into the periosteum. where bone tissue will replace most of the cartilage.
Eventually, a thin layer of compact bone replaces the surface Osteoblasts then begin to deposit bone extracellular matrix over
layers of the spongy bone, but spongy bone remains in the the remnants of calcified cartilage, forming spongy bone
center. Much of the newly formed bone is remodeled (destroyed trabeculae. Primary ossification spreads from this central
and reformed) as the bone is transformed into its adult size and location toward both ends of the cartilage model.
shape.
Intramembranous ossification involves the formation of bone 4. Development of the medullary (marrow) cavity. As the
within mesenchyme arranged in sheetlike layers that resemble primary ossification center grows toward the ends of the bone,
membranes. osteoclasts break down some of the newly formed spongy bone
trabeculae. This activity leaves a cavity, the medullary
Endochondral Ossification (marrow) cavity, in the diaphysis (shaft). Eventually, most of
the wall of the diaphysis is replaced by compact bone.
The replacement of cartilage by bone is called endochondral

5. Development of the secondary ossification centers. When
ossification. Although most bones of the body are formed in this way,
branches of the epiphyseal artery enter the epiphyses,
the process is best observed in a long bone. It proceeds as follows:
secondary ossification centers develop, usually around the
1. Development of the cartilage model. At the site where the time of birth. Bone formation is similar to what occurs in primary
bone is going to form, specific chemical messages cause the ossification centers. However, in the secondary ossification
cells in mesenchyme to crowd together in the general shape of centers spongy bone remains in the interior of the epiphyses
the future bone, and then develop into chondroblasts. The (no medullary cavities are formed here). In contrast to primary
chondroblasts secrete cartilage extracellular matrix, producing a ossification, secondary ossification proceeds outward from the
cartilage model consisting of hyaline cartilage. A covering center of the epiphysis toward the outer surface of the bone.
called the perichondrium develops around the cartilage model.
6. Formation of articular cartilage and the epiphyseal (growth)
2. Growth of the cartilage model. Once chondroblasts become plate. The hyaline cartilage that covers the epiphyses
deeply buried in the cartilage extracellular matrix, they are becomes the articular cartilage. Prior to adulthood, hyaline
called chondrocytes. The cartilage model grows in length by cartilage remains between the diaphysis and epiphysis as the
continual cell division of chondrocytes, accompanied by further epiphyseal (growth) plate, the region responsible for the
secretion of the cartilage extracellular matrix. This type of lengthwise growth of long bones.
cartilaginous growth, called interstitial (endogenous) growth
(growth from within), results in an increase in length. In contrast,
growth of the cartilage in thickness is due mainly to the
deposition of extracellular matrix material on the cartilage
surface of the model by new chondroblasts that develop from
the perichondrium. This process is called appositional
(exogenous) growth, meaning growth at the outer surface.
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(growth) plate is a layer of hyaline cartilage in the metaphysis of a
growing bone that consists of four zones:
1. Zone of resting cartilage. This layer is nearest the epiphysis

and consists of small, scattered chondrocytes. The term
“resting” is used because the cells do not function in bone
growth. Rather, they anchor the epiphyseal plate to the
epiphysis of the bone.
2. Zone of proliferating cartilage (proliferation). Slightly larger

chondrocytes in this zone are arranged like stacks of coins.
These chondrocytes undergo interstitial growth as they divide
and secrete extracellular matrix. The chondrocytes in this zone
divide to replace those that die at the diaphyseal side of the
epiphyseal plate.
3. Zone of hypertrophic cartilage (hypertrophy). This layer

consists of large, maturing chondrocytes arranged in columns.
4. Zone of calcified cartilage (calcification). The final zone of

the epiphyseal plate is only a few cells thick and consists mostly
of chondrocytes that are dead because the extracellular matrix
around them has calcified. Osteoclasts dissolve the calcified
During endochondral ossification, bone gradually replaces a cartilage, and osteoblasts and capillaries from the diaphysis
cartilage model. invade the area. The osteoblasts lay down bone extracellular
matrix, replacing the calcified cartilage by the process of
Bone Growth, Remodelling and Repair endochondral ossification. Recall that endochondral ossification
is the replacement of cartilage with bone. As a result, the zone
of calcified cartilage becomes the “new diaphysis” that is firmly
Bone Growth cemented to the rest of the diaphysis of the bone.
Unlike cartilage, bones cannot grow by interstitial growth. Bones The epiphyseal (growth) plate allows the diaphysis of a bone to
increase in size only by appositional growth, the formation of new increase in length.
bone on the surface of older bone or cartilage. For example,
trabeculae grow in size when osteoblasts deposit new bone matrix The activity of the epiphyseal plate is the only way that the diaphysis
onto the surface of the trabeculae. can increase in length. As a bone grows, chondrocytes proliferate on
the epiphyseal side of the plate. New chondrocytes replace older
During infancy, childhood, and adolescence, bones throughout the ones, which are destroyed by calcification. Thus, the cartilage is
body grow in thickness by appositional growth, and long bones replaced by bone on the diaphyseal side of the plate. In this way the
lengthen by the addition of bone material on the diaphyseal side of the thickness of the epiphyseal plate remains relatively constant, but the
epiphyseal plate by interstitial growth. bone on the diaphyseal side increases in length. If a bone fracture
damages the epiphyseal plate, the fractured bone may be shorter than
Growth in Length normal once adult stature is reached. This is because damage to
cartilage, which is avascular, accelerates closure of the epiphyseal
plate due to the cessation of cartilage cell division, thus inhibiting
Long bones and bony projections increase in length because of lengthwise growth of the bone.
growth at the epiphyseal plate. In a long bone, the epiphyseal plate
separates the epiphysis from the diaphysis. Long projections of bones, When adolescence comes to an end (at about age 18 in females and
such as the processes of vertebrae, also have epiphyseal plates. age 21 in males), the epiphyseal plates close; that is, the epiphyseal
cartilage cells stop dividing and bone replaces all remaining cartilage.
The growth in length of long bones involves the following two major The epiphyseal plate fades, leaving a bony structure called the
events: (1) interstitial growth of cartilage on the epiphyseal side of the epiphyseal line. With the appearance of the epiphyseal line, bone
epiphyseal plate and (2) replacement of cartilage on the diaphyseal growth in length stops completely. Closure of the epiphyseal plate is a
side of the epiphyseal plate with bone by endochondral ossification. gradual process and the degree to which it occurs is useful in
determining bone age, predicting adult height, and establishing age at
To understand how a bone grows in length, you need to know some of death from skeletal remains, especially in infants, children, and
the details of the structure of the epiphyseal plate. The epiphyseal adolescents. For example, an open epiphyseal plate indicates a
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younger person, while a partially closed epiphyseal plate or a Like cartilage, bone can grow in thickness (diameter) only by
completely closed one indicates an older person. It should also be appositional growth:
kept in mind that closure of the epiphyseal plate, on average, takes
place 1–2 years earlier in females.
Growth at Articular Cartilage
Epiphyses increase in size because of growth at the articular cartilage.

In addition, growth at the articular cartilage increases the size of
bones that do not have an epiphysis, such as short bones. The
process of growth in articular cartilage is similar to that occurring in the
epiphyseal plate, except that the chondrocyte columns are not as
obvious. The chondrocytes near the surface of the articular cartilage
are similar to those in the zone of resting cartilage of the epiphyseal
plate. In the deepest part of the articular cartilage, nearer bone tissue,
the cartilage is calcified and ossified to form new bone. When the
epiphyses reach their full size, the growth of cartilage and its
replacement by bone cease. The articular cartilage, however, persists
throughout and does not become ossified as the epiphyseal plate
does.
Growth in Thickness
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1. At the bone surface, periosteal cells differentiate into extracellular matrix. At any given time, about 5% of the total bone
osteoblasts, which secrete the collagen fibers and other organic mass in the body is being remodeled. The renewal rate for compact
molecules that form bone extracellular matrix. The osteoblasts bone tissue is about 4% per year, and for spongy bone tissue it is
become surrounded by extracellular matrix and develop into about 20% per year. Remodeling also takes place at different rates in
osteocytes. This process forms bone ridges on either side of a different regions of the body. The distal portion of the femur is
periosteal blood vessel. The ridges slowly enlarge and create a replaced about every four months. By contrast, bone in certain areas
groove for the periosteal blood vessel. of the shaft of the femur will not be replaced completely during an
individual’s life. Even after bones have reached their adult shapes and
sizes, old bone is continually destroyed and new bone is formed in its
2. Eventually, the ridges fold together and fuse, and the groove
place. Remodeling also removes injured bone, replacing it with new
becomes a tunnel that encloses the blood vessel. The former
bone tissue. Remodeling may be triggered by factors such as
periosteum now becomes the endosteum that lines the tunnel.
exercise, sedentary lifestyle, and changes in diet.
3. Osteoblasts in the endosteum deposit bone extracellular matrix, Remodeling has several other benefits. Since the strength of bone is
forming new concentric lamellae. The formation of additional related to the degree to which it is stressed, if newly formed bone is
concentric lamellae proceeds inward toward the periosteal subjected to heavy loads, it will grow thicker and therefore be stronger
blood vessel. In this way, the tunnel fills in, and a new osteon is than the old bone. Also, the shape of a bone can be altered for proper
created. support based on the stress patterns experienced during the
remodeling process. Finally, new bone is more resistant to fracture
than old bone.
4. As an osteon is forming, osteoblasts under the periosteum
deposit new circumferential lamellae, further increasing the During the process of bone resorption, an osteoclast attaches tightly to
thickness of the bone. As additional periosteal blood vessels the bone surface at the endosteum or periosteum and forms a
become enclosed as in step 1 , the growth process continues. leakproof seal at the edges of its ruffled border). Then it releases
protein-digesting lysosomal enzymes and several acids into the sealed
As new bone tissue is being deposited on the outer surface of bone, pocket. The enzymes digest collagen fibers and other organic
the bone tissue lining the medullary cavity is destroyed by osteoclasts substances while the acids dissolve the bone minerals. Working
in the endosteum. In this way, the medullary cavity enlarges as the together, several osteoclasts carve out a small tunnel in the old bone.
bone increases in thickness. The degraded bone proteins and extracellular matrix minerals, mainly
calcium and phosphorus, enter an osteoclast by endocytosis, cross
the cell in vesicles, and undergo exocytosis on the side opposite the
ruffled border. Now in the interstitial fluid, the products of bone
resorption diffuse into nearby blood capillaries. Once a small area of
bone has been resorbed, osteoclasts depart and osteoblasts move in
to rebuild the bone in that area.
The structure of a long bone—a hollow cylinder with a medullary cavity

in the center— has two mechanical advantages:
1. A hollow cylinder is lighter in weight than a solid rod, and

Bone Remodelling 2. A hollow cylinder with the same height, weight, and composition
as a solid rod, but with a greater diameter, can support much
more weight without bending.
Like skin, bone forms before birth but continually renews itself
thereafter. And just as our homes must be remodeled when they As a long bone increases in length and diameter, the size of the
become outdated, bone that becomes old is replaced with new bone medullary cavity also increases, keeping the bone from becoming very
in a process called bone remodeling. In this process, osteoclasts heavy. In addition, as the bone grows in diameter, the relative
remove old bone and osteoblasts deposit new bone. Bone remodeling thickness of compact bone is maintained as osteoclasts remove bone
converts woven bone into lamellar bone and is involved in several on the inside and osteoblasts add bone to the outside.
important functions, including bone growth, changes in bone shape,
adjustment of the bone to stress, bone repair, and calcium ion (Ca2+)
regulation in the body.
Bone remodeling is the ongoing replacement of old bone tissue by

new bone tissue. It involves bone resorption, the removal of minerals
and collagen fibers from bone by osteoclasts, and bone deposition,
the addition of minerals and collagen fibers to bone by osteoblasts.
Thus, bone resorption results in the destruction of bone extracellular
matrix, while bone deposition results in the formation of bone
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Factors Affecting Bone Growth and Remodelling
The bones of an individual’s skeleton usually reach a certain length,

thickness, and shape through the processes described in the previous
sections. The potential shape and size of a bone and an individual’s
final adult height are determined genetically, but factors such as
nutrition and hormones can greatly modify the expression of those
genetic factors.
Normal bone metabolism—growth in the young and bone remodelling

in the adult—depends on several factors. These include adequate
dietary intake of minerals and vitamins, as well as sufficient levels of
several hormones.
1. Nutrition and Minerals. Large amounts of calcium and

phosphorus are needed while bones are growing, as are smaller
amounts of magnesium, fluoride, and manganese. These minerals are
also necessary during bone remodeling.
Bone remodeling involves a basic multicellular unit (BMU), a
Because bone growth requires chondroblast and osteoblast
temporary assembly of osteoclasts and osteoblasts that travels
proliferation, any metabolic disorder that affects the rate of cell
through or across the surface of bone, removing old bone matrix and
proliferation or the production of collagen and other matrix
replacing it with new bone matrix. The average life span of a BMU is
components affects bone growth, as does the availability of calcium or
approximately 6 months, and BMU activity renews the entire skeleton
other minerals needed in the mineralization process.
every 10 years. In compact bone, the osteoclasts of a BMU break
down bone matrix, forming a tunnel. Interstitial lamellae are remnants
The long bones of a child sometimes exhibit lines of arrested growth,
of osteons that were not completely removed when a BMU formed a
which are transverse regions of greater bone density crossing an
tunnel. Blood vessels grow into the tunnel, and osteoblasts of the
otherwise normal bone. These lines are caused by greater calcification
BMU move in and lay down a layer of bone on the tunnel wall, forming
below the epiphyseal plate of a bone, where it has grown at a slower
a concentric lamella. Additional concentric lamellae are produced,
rate during an illness or severe nutritional deprivation. They
filling in the tunnel from the outside to the inside, until an osteon is
demonstrate that illness or malnutrition during the time of bone growth
formed, with the center of the tunnel becoming a central canal
can cause a person to be shorter than he or she would have been
containing blood vessels. In spongy bone, the BMU removes bone
otherwise.
matrix from the surface of a trabecula, forming a cavity, which the
BMU then fills in with new bone matrix. 2. Vitamins. Vitamin A stimulates activity of osteoblasts.
Mechanical Stress and Bone Strength Vitamin C is needed for synthesis of collagen, the main bone protein.
Vitamin D helps build bone by increasing the absorption of calcium
from foods in the gastrointestinal tract into the blood. Vitamins K and
B12 are also needed for synthesis of bone proteins.
The amount of stress applied to a bone can modify the bone’s strength
through remodeling, the formation of additional bone, alteration in
Certain vitamins are important to bone growth in very specific ways.
trabecular alignment to reinforce the scaffolding, or other changes.
Vitamin D is necessary for the normal absorption of calcium from the
Mechanical stress applied to bone increases osteoblast activity in
intestines. The body can either synthesize or ingest vitamin D. Its rate
bone tissue, and the removal of mechanical stress decreases
of synthesis increases when the skin is exposed to sunlight.
osteoblast activity. Under conditions of reduced stress, as when a Insufficient vitamin D in children causes rickets, a disease resulting
person is bedridden or paralyzed, osteoclast activity continues at a from reduced mineralization of the bone matrix. Children with rickets
nearly normal rate but osteoblast activity decreases, resulting in less may have bowed bones and inflamed joints. During the winter in
bone density. In addition, pressure in bone causes an electrical northern climates, children who are not exposed to sufficient sunlight
change that increases the activity of osteoblasts; therefore, applying can take supplementary vitamin D to prevent rickets. The body’s
weight (pressure) to a broken bone can speed the healing process. inability to absorb lipids in which vitamin D is soluble can also result in
Weak pulses of electric current are sometimes applied to a broken vitamin D deficiency. This condition sometimes occurs in adults who
bone to speed healing. have digestive disorders. Low vitamin D levels can be one cause of
“adult rickets,” or osteomalacia, a softening of the bones due to
calcium depletion.
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Vitamin C is necessary for collagen synthesis by osteoblasts.
Normally, as old collagen breaks down, new collagen is synthesized to
replace it. Vitamin C deficiency results in bones and cartilage with
fewer collagen fibers because collagen synthesis is impaired. In
children, vitamin C deficiency can retard growth. In both children and
adults, vitamin C deficiency can result in scurvy, which is marked by
ulceration and hemorrhage in almost any area of the body because
normal collagen synthesis is not occurring in connective tissues.
Wound healing, which requires collagen synthesis, is hindered in
patients with vitamin C deficiency. In extreme cases, the teeth fall out
because the ligaments that hold them in place break down.
3. Hormones. During childhood, the hormones most important

to bone growth are the insulinlike growth factors (IGFs), which are
produced by the liver and bone tissue. IGFs stimulate osteoblasts,
promote cell division at the epiphyseal plate and in the periosteum,
and enhance synthesis of the proteins needed to build new bone.
IGFs are produced in response to the secretion of human growth
hormone (hGH) from the anterior lobe of the pituitary gland. Thyroid
hormones (T3 and T4) from the thyroid gland also promote bone
growth by stimulating osteoblasts. In addition, the hormone insulin
from the pancreas promotes bone growth by increasing the synthesis
of bone proteins.
Hormones are very important in bone growth. Growth hormone from

the anterior pituitary increases general tissue growth, including overall
bone growth, by stimulating interstitial cartilage growth and
appositional bone growth. Disruptions in normal growth hormone can
cause dramatic changes in an individual’s height. Excessive growth
hormone secretion results in pituitary gigantism, whereas insufficient
growth hormone secretion results in pituitary dwarfism. Thyroid
hormone is also required for normal growth of all tissues, including
cartilage; therefore, a decrease in this hormone can result in a smaller
individual. Reproductive hormones also influence bone growth.
Estrogen (a class of female reproductive hormones) and testosterone
(a male reproductive hormone) initially stimulate bone growth, which
accounts for the burst of growth at puberty when production of these
hormones increases. However, both classes of reproductive hormones
also stimulate ossification of epiphyseal plates, and thus the cessation
of growth. Females usually stop growing earlier than males because
estrogens cause quicker closure of the epiphyseal plate than
testosterone does. Because their entire growth period is somewhat
shorter, females usually do not reach the same height as males.
Decreased levels of testosterone or estrogen can prolong the growth
phase of the epiphyseal plates, even though the bones grow more
slowly. Overall, growth is very complex and is influenced by many
factors besides reproductive hormones, such as other hormones,
genetics, and nutrition.
At puberty, the secretion of hormones known as sex hormones causes

a dramatic effect on bone growth. The sex hormones include
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Thyroid
Hormones (T3 &
03
Secreted by thyroid gland; promote normal bone
growth by stimulating osteoblasts.
estrogens (produced by the ovaries) and androgens such as T4)
testosterone (produced by the testes). Although females have much Insulin Secreted by the pancreas; promotes normal
higher levels of estrogens and males have higher levels of androgens, bone growth by increasing the synthesis of
females also have low levels of androgens, and males have low levels bone proteins.
of estrogens. The adrenal glands of both sexes produce androgens, Sex Hormones Secreted by the ovaries in women (estrogens)
and other tissues, such as adipose tissue, can convert androgens to (Estrogen & and by the testes in men (testosterone);
estrogens. These hormones are responsible for increased osteoblast Testosterone) stimulate osteoblasts and promote the sudden
activity, synthesis of bone extracellular matrix, and the sudden “growth “growth spurt” that occurs during the teenage
spurt” that occurs during the teenage years. Estrogens also promote years; shut down growth at the epiphyseal
changes in the skeleton that are typical of females, such as widening of
plates around age 18–21, causing lengthwise
the pelvis. Ultimately sex hormones, especially estrogens in both
growth of bone to end; contribute to bone
sexes, shut down growth at epiphyseal (growth) plates, causing
remodeling during adulthood by slowing bone
elongation of the bones to cease. Lengthwise growth of bones typically
ends earlier in females than in males due to their higher levels of resorption by osteoclasts and promoting bone
estrogens. During adulthood, sex hormones contribute to bone deposition by osteoblasts.
remodelling by slowing resorption of old bone and promoting Parathyroid Secreted by the parathyroid glands; promotes
deposition of new bone. One way that estrogens slow resorption is by Hormone (PTH) bone resorption by osteoclasts; enhances
promoting apoptosis (programmed death) of osteoclasts. As you will recovery of calcium ions from urine; promotes
see shortly, parathyroid hormone, calcitriol (the active form of vitamin formation of the active form of vitamin D
(calcitriol).
SUMMARY OF FACTORS AFFECTING BONE GROWTH &
Calcitonin (CT) Secreted by the thyroid gland; inhibits bone
REMODELLING
resorption by osteoclasts.
MINERALS
EXERCISE
Calcium and Make bone extracellular matrix hard.
Weight-bearing activities stimulate osteoblasts and, consequently,
Phosphorous
help build thicker, stronger bones and retard loss of bone mass that
Magnesium Helps form bone extracellular matrix.
occurs as people age.
Fluoride Helps strengthen bone extracellular matrix.
AGING
Manganese Activates enzymes involved in synthesis of bone
As the level of sex hormones diminishes during middle age to older
extracellular matrix.
adulthood, especially in women after menopause, bone resorption by
VITAMINS osteoclasts outpaces bone deposition by osteoblasts, which leads to a
Vitamin A Needed for the activity of osteoblasts during decrease in bone mass and anand
Fracture increased risk of osteoporosis.
Bone Repair
remodeling of bone; defi ciency stunts bone
growth; toxic in high doses. D), and calcitonin are other hormones that can affect bone remodelling.
Vitamin C Needed for synthesis of collagen, the main Moderate weight-bearing exercises maintain sufficient strain on bones to
bone protein; defi ciency leads to decreased increase and maintain their density.
collagen production, which slows down bone
growth and delays repair of broken bones.
Vitamin D Active form (calcitriol) is produced by the
kidneys; helps build bone by increasing
absorption of calcium from gastrointestinal tract
into blood; defi ciency causes faulty calcifi
cation and slows down bone growth; may
reduce the risk of osteoporosis but is toxic if
taken in high doses. People who have minimal
exposure to ultraviolet rays or do not take
vitamin D supplements may not have suffi cient
vitamin D to absorb calcium. This interferes
with calcium metabolism.
Vitamins K and Needed for synthesis of bone proteins;
B12 deficiency leads to abnormal protein production
in bone extracellular matrix and decreased
bone density.
HORMONES
Human Growth Secreted by the anterior lobe of the pituitary
Hormone (hGH) gland; promotes general growth of all body A fracture is any break in a bone. Fractures are named according to their
tissues, including bone, mainly by stimulating severity, the shape or position of the fracture line, or even the physician
production of insulinlike growth factors. who first described them.
BSRT-1C
Insulinlike Growth Secreted by the liver, bones, and other tissues Page 15 of 14
Factors (IGFs) on stimulation by human growth hormone;
promotes normal bone growth by stimulating
osteoblasts and by increasing the synthesis of
proteins needed to build new bone.
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In some cases, a bone may fracture without visibly breaking. A stress fracture is a series of microscopic fissures in bone that forms without any
evidence of injury to other tissues. In healthy adults, stress fractures result from repeated, strenuous activities such as running, jumping, or
aerobic dancing. Stress fractures are quite painful and also result from disease processes that disrupt normal bone calcification, such as
osteoporosis. About 25% of stress fractures involve the tibia. Although standard x-ray images often fail to reveal the presence of stress fractures,
they show up clearly in a bone scan.
The repair of a bone fracture involves the following phases:
1 Reactive phase or Hematoma Formation. This phase is an early 2b. Reparative phase: Bony callus formation. In areas closer to
inflammatory phase. Blood vessels crossing the fracture line are well-vascularized healthy bone tissue, osteoprogenitor cells develop
broken. As blood leaks from the torn ends of the vessels, a mass of into osteoblasts, which begin to produce spongy bone trabeculae. The
blood (usually clotted) forms around the site of the fracture. This mass trabeculae join living and dead portions of the original bone fragments.
of blood, called a fracture hematoma, usually forms 6 to 8 hours after In time, the fibrocartilage is converted to spongy bone, and the callus
the injury. Because the circulation of blood stops at the site where the is then referred to as a bony (hard) callus. The bony callus lasts about
fracture hematoma forms, nearby bone cells die. Swelling and 3 to 4 months.
inflammation occur in response to dead bone cells, producing
additional cellular debris. Phagocytes (neutrophils and macrophages) 3. Bone remodeling phase. The final phase of fracture repair is bone
and osteoclasts begin to remove the dead or damaged tissue in and remodeling of the callus. Dead portions of the original fragments of
around the fracture hematoma. This stage may last up to several broken bone are gradually resorbed by osteoclasts. Compact bone
weeks. replaces spongy bone around the periphery of the fracture.
Sometimes, the repair process is so thorough that the fracture line is
When a bone is fractured, the blood vessels in the bone and undetectable, even in a radiograph (x-ray). However, a thickened area
surrounding peri osteum are damaged and a hematoma forms. A on the surface of the bone remains as evidence of a healed fracture.
hematoma is a localized mass of blood released from blood vessels
but confined within an organ or a space. Usually, the blood in a Although bone has a generous blood supply, healing sometimes takes
hematoma forms a clot, which consists of fibrous proteins that stop the months. The calcium and phosphorus needed to strengthen and
bleeding. Disruption of blood vessels in the central canals results in harden new bone are deposited only gradually, and bone cells
inadequate blood delivery to osteocytes, and bone tissue adjacent to generally grow and reproduce slowly. The temporary disruption in their
the fracture site dies. Tissues around the bone often become inflamed blood supply also helps explain the slowness of healing of severely
and swollen following the injury. fractured bones. Some of the common types of fractures are:
COMMON TYPES OF FRACTURE
2a. Reparative phase: Fibrocartilaginous callus formation. The The broken ends of the bone protrude through
reparative phase is characterized by two events: the formation of a Open (Compound) the skin. Conversely, a closed (simple) fracture
fibrocartilaginous callus and a bony callus to bridge the gap between does not break the skin.
the broken ends of the bones.
The bone is splintered, crushed, or broken into
Blood vessels grow into the fracture hematoma and phagocytes begin together; pieces at the site of impact, and
to clean up dead bone cells. Fibroblasts from the periosteum invade Comminuted smaller bone fragments lie between the two
the fracture site and produce collagen fibers. In addition, cells from the main fragments.
periosteum develop into chondroblasts and begin to produce A partial fracture in which one side of the bone
fibrocartilage in this region. These events lead to the development of a is broken and the other side bends; similar to
fibrocartilaginous (soft) callus, a mass of repair tissue consisting of the way a green twig breaks on one side while
collagen fibers and cartilage that bridges the broken ends of the bone. Greenstick the other side stays whole, but bends; occurs
Formation of the fibrocartilaginous callus takes about 3 weeks. only in children, whose bones are not fully
ossified and contain more organic material than
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inorganic material. secrete calcitonin (CT). CT inhibits activity of osteoclasts, speeds
Impacted One end of the fractured bone is forcefully blood Ca2+ uptake by bone, and acceleratesCa2+ deposition into
driven into the interior of the other. bones. The net result is that CT promotes bone formation and
Pott Fracture of the distal end of the lateral leg bone decreases blood Ca2+ level. Despite these effects, the role of CT in
normal calcium homeostasis is uncertain because it can be completely
(fi bula), with serious injury of the distal tibial
absent without causing symptoms. Nevertheless, calcitonin harvested
articulation.
from salmon (Miacalcin®) is an effective drug for treating osteoporosis
Colles Fracture of the distal end of the lateral forearm because it slows bone resorption.
bone (radius) in which the distal fragment is
displaced posteriorly. Release of calcium from bone matrix and retention of calcium by the
kidneys are the two main ways that blood calcium level can be
increased.
Calcium Homeostasis
Bones play an important role in regulating blood Ca2+ levels, which

must be maintained within narrow limits for functions such as muscle
contraction and membrane potentials to occur normally. Bone is the
body’s major calcium reservoir, storing 99% of total body calcium. One
way to maintain the level of calcium in the blood is to control the rates
of calcium resorption from bone into blood and of calcium deposition
from blood into bone. Both nerve and muscle cells depend on a stable
level of calcium ions (Ca2+) in extracellular fluid to function properly.
Blood clotting also requires Ca2+. Also, many enzymes require Ca2+
as a cofactor (an additional substance needed for an enzymatic
reaction to occur). For this reason, the blood plasma level of Ca2+ is
very closely regulated between 9 and 11 mg/100 mL. Even small
changes in Ca2+ concentration outside this range may prove fatal—
the heart may stop (cardiac arrest) if the concentration goes too high,
or breathing may cease (respiratory arrest) if the level falls too low.
The role of bone in calcium homeostasis is to help “buffer” the blood
Ca2+ level, releasing Ca2+ into blood plasma (using osteoclasts)
when the level decreases, and absorbing Ca2+ (using osteoblasts)
when the level rises.
Ca2+ exchange is regulated by hormones, the most important of

which is parathyroid hormone (PTH) secreted by the parathyroid
glands. This hormone increases blood Ca2+ level. PTH secretion
operates via a negative feedback system. If some stimulus causes the
blood Ca2+ level to decrease, parathyroid gland cells (receptors)
detect this change and increase their production of a molecule known
as cyclic adenosine monophosphate (cyclic AMP). The gene for PTH
within the nucleus of a parathyroid gland cell (the control center)
detects the intracellular increase in cyclic AMP (the input). As a result,
PTH synthesis speeds up, and more PTH (the output) is released into
the blood. The presence of higher levels of PTH increases the number
and activity of osteoclasts (effectors), which step up the pace of bone
resorption. The resulting release of Ca2+ from bone into blood returns
the blood Ca2+ level to normal.
PTH also acts on the kidneys (effectors) to decrease loss of Ca2+ in

the urine, so more is retained in the blood. And PTH stimulates
formation of calcitriol (the active form of vitamin D), a hormone that
promotes absorption of calcium from foods in the gastrointestinal tract Exercise and Bone Tissue
into the blood. Both of these actions also help elevate blood Ca2+
level. Within limits, bone tissue has the ability to alter its strength in
response to changes in mechanical stress. When placed under stress,
Another hormone works to decrease blood Ca2+ level. When blood bone tissue becomes stronger through increased deposition of mineral
Ca2+ rises above normal, parafollicular cells in the thyroid gland salts and production of collagen fibers by osteoblasts. Without
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S.Y. 2021-2022
03
mechanical stress, bone does not remodel normally because bone susceptibility to fractures, loss of bone mass also leads to deformity,
resorption occurs more quickly than bone formation. Research has pain, loss of height, and loss of teeth.
shown that high-impact intermittent strains more strongly influence
bone deposition as compared with lowerimpact constant strains.
Therefore, running and jumping stimulate bone remodeling more REFERENCES
dramatically than walking. 1.
Human Anatomy & Physiology Unit 3 Module
The main mechanical stresses on bone are those that result from the
pull of skeletal muscles and the pull of gravity. If a person is bedridden
or has a fractured bone in a cast, the strength of the unstressed bones
diminishes because of the loss of bone minerals and decreased 3.
numbers of collagen fibers. Astronauts subjected to the microgravity of VanPutte C., Regan J., Russo A. (2019). Seeley’s
space also lose bone mass. In any of these cases, bone loss can be Essentials of Anatomy and Physiology 10th Edition
dramatic—as much as 1% per week. In contrast, the bones of
athletes, which are repetitively and highly stressed, become notably
thicker and stronger than those of astronauts or nonathletes. TRANSCRIBED BY: DINVER JAY PEDROSA, BSRT-1C
Weightbearing activities, such as walking or moderate weight lifting, https://www.facebook.com/dinverjay.pedrosa
help build and retain bone mass. Adolescents and young adults
should engage in regular weight-bearing exercise prior to the closure
of the epiphyseal plates to help build total mass prior to its inevitable
reduction with aging. However, people of all ages can and should
strengthen their bones by engaging in weight-bearing exercise.
Aging and Bone Tissue
From birth through adolescence, more bone tissue is produced than is

lost during bone remodeling. In young adults the rates of bone
deposition and resorption are about the same. As the level of sex
hormones diminishes during middle age, especially in women after
menopause, a decrease in bone mass occurs because bone
resorption by osteoclasts outpaces bone deposition by osteoblasts. In
old age, loss of bone through resorption occurs more rapidly than
bone gain. Because women’s bones generally are smaller and less
massive than men’s bones to begin with, loss of bone mass in old age
typically has a greater adverse effect in females. These factors
contribute to the higher incidence of osteoporosis in females.
There are two principal effects of aging on bone tissue: loss of bone
mass and brittleness. Loss of bone mass results from
demineralization, the loss of calcium and other minerals from bone
extracellular matrix. This loss usually begins after age 30 in females,
accelerates greatly around age 45 as levels of estrogens decrease,
and continues until as much as 30% of the calcium in bones is lost by
age 70. Once bone loss begins in females, about 8% of bone mass is
lost every 10 years. In males, calcium loss typically does not begin
until after age 60, and about 3% of bone mass is lost every 10 years.
The loss of calcium from bones is one of the problems in osteoporosis.
The second principal effect of aging on the skeletal system,

brittleness, results from a decreased rate of protein synthesis. The
organic part of bone extracellular matrix, mainly collagen fibers, gives
bone its tensile strength. The loss of tensile strength causes the bones
to become very brittle and susceptible to fracture. In some elderly
people, collagen fiber synthesis slows, in part due to diminished
production of human growth hormone. In addition to increasing the

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OUTLINE 1. Systemic Anatomy is the study of the body systems, such as

An Overview of Anatomy and Physiology

6. Organismal level. An organism is any living thing considered as

Organ System Overview

Components: Skin and associated structures, such as hair,

Functions: Protects body; helps regulate body temperature;

3. Tissue level. Tissues are groups of cells and the materials

5. Organ System level. A system consists of related organs with a

Components: Hormone-producing glands (pineal gland,

Components: Brain, spinal cord, nerves, and special sense organs,

Functions: Generates action potentials (nerve impulses) to regulate

Components: Lungs and air passageways such as the pharynx

Functions: Transfers oxygen from inhaled air to blood and carbon

Components: Blood, heart, and blood vessels.

Components: Organs of gastrointestinal tract, a long tube that includes

Functions: Achieves physical and chemical breakdown of food;

Components: Kidneys, ureters, urinary bladder, and urethra.

Functions: Produces, stores, and eliminates urine; eliminates wastes

specific functions. Living things are highly organized. All

2. Metabolism refers to all of the chemical reactions taking place

3. Responsiveness is an organism’s ability to sense changes in

4. Growth refers to an increase in the size or number of cells,

Body’s Survival Needs Homeostasis and Body Fluids

The body can regulate its internal environment through many

Components of Feedback System

A feedback system includes three basic components: a receptor, a

Another example of positive feedback is what happens to your body

These examples suggest some important differences between positive

THE LANGUAGE OF ANATOMY

Prefixes and suffixes can be added to words to expand their meaning.

Scientists and health-care professionals use a common language of

2. The neck supports the head and attaches it to the trunk.

3. The trunk consists of the chest (thoracic), abdomen, and pelvis.

Organs are often sectioned to reveal their internal structure. A

Body cavities are spaces that enclose internal organs. Bones,

1. Protect organs from accidental shocks

Anatomy and physiology textbooks typically describe two sets of

2. The spinal/vertebral cavity extends from the cranial cavity to

The serous membranes can become inflamed, usually as a result of an

The abdominopelvic cavity also has other specialized membranes in

Parietal peritoneum covers these other organs, which are said to be

The second method is simpler and divides the abdominopelvic cavity

The nine-region division is more widely used for anatomical studies,

The absorption of water-soluble substances through the skin is

Cutaneous sensations are sensations that arise in the skin, including

The skin is actively involved in the production of vitamin D. Exposure

• Calcium is necessary for muscle contraction and bone

• Phosphorus is an essential part of adenosine triphosphate.

Because we live indoors, and in colder climates wear heavy clothing,

1. The superficial, thinner portion, which is composed of epithelial

• About 8% of the epidermal cells are melanocytes, which

The stratum lucidum is a thin, clear zone above the stratum

At about the middle of the epidermis, the stratum granulosum consists

Layers of the Dermis

The papillary region makes up about one-fifth of the thickness of the

Hair follicles develop at about 12 weeks after fertilization. Usually by

Modified sweat glands in the external ear, called ceruminous glands,

Nails are plates of tightly packed, hard, dead, keratinized epidermal

In general, burns are considered critical if any of the following

• Over 30 percent of the body has second-degree burns.

Facial burns are particularly dangerous because of the possibility of

The pronounced effects of skin aging do not become noticeable until