Module 5 Integumentary System

Functions of the Integumentary System

• Consists of the skin, hair, glands, and nails
• Functions
1. Protection
□ Against abrasion and UV light
□ Prevents entry of microorganisms
□ Prevents dehydration
2. Sensation
□ Sensory receptors that can detect heat, cold, touch, pressure, and pain
3. Temperature regulation by controlling
□ Blood flow through the skin
□ Sweat gland activity
4. Vitamin D production
5. Excretion of small amounts of waste products

Skin
• SA – 1.2-2.2 m2 and weighs 4-5 kg (9-11 lbs)
• Consists of three major regions
○ Epidermis: outermost region (superficial)
□ Resists abrasion
□ Reduces water loss
○ Dermis: middle region (bulk of skin)
□ Responsible for most of the structural strength of the skin
□ Leather is produced from the dermis of animals
○ Subcutaneous tissue (hypodermis): deepest region
□ Not really part of the skin
□ Connects the skin to underlying muscle or bone

Table 5.1 Comparison of the Skin (Epidermis and Dermis) and Subcutaneous Tissue
Parts Structure Function
Epidermis Superficial part of skin; stratified squamous Barrier that prevents water loss and the entry of
epithelium; composed of four or five strata chemicals and microorganisms; protects against
abrasion and ultraviolet light; produces vitamin D';
gives rise to hair, nails, and glands
Stratum Most superficial strata of the epidermis; 25 or Provision of structural strength by keratin and
corneum more layers of dead squamous cells protein envelope within cells; prevention of water
loss by lipids surrounding cells; sloughing off of
most superficial cells resists abrasion
Stratum Three to five layers of dead cells; appears Dispersion of keratohyalin around keratin fibers
lucidum transparent; present in thick skin, absent in
most thin skin
Stratum Two to five layers of flattened, diamond-shape Production of keratohyalin granules; lamellar
granulosum cells bodies release lipids from cells; cells die
Stratum A total of 8 to 10 layers of many-sided cells Production of keratin fibers; formation of lamellar
spinosum bodies

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Stratum Deepest strata of the epidermis; single
basale layer of cuboidal or columnar cells;
basement membrane of the epidermis
attaches to the dermis
Dermis Deep part of skin; connective tissues
composed of two layers
Papillary Papillae project toward the epidermis;
later loose connective tissue
Reticular Mat of collagen and elastin fibers; dense
layer irregular connective tissue
Subcutaneo Not part of the skin; loose connective
us tissue tissue with abundant fat deposits
Production of cells of the most superficial strata;
melanocytes produce and contribute melanin. Which
protects against ultraviolet light
Responsible for the structural strength and flexibility
of the skin; the epidermis exchange gases, nutrients,
and waste products with blood vessels in the dermis
Brings blood vessels close to the epidermis; dermal
papillae form fingerprints and footprints
Main fibrous layer of the dermis; strong in many
directions; forms cleavage lines
Attaches the dermis to underlying structures; fat
tissue provides energy storage. Insulation, and
padding; blood vessel and nerves from the
subcutaneous tissues supply the dermis

Epidermis
• Composed of keratinized stratified squamous epithelium, consisting of four distinct cell types and four or
five layers
• Cell types include keratinocytes, melanocytes, Merkel cells, and Langerhans’ cells
• Outer portion of the skin is exposed to the external environment and functions in protection

Cells of the Epidermis Layers of the Epidermis

• Keratinocytes • Stratum Basale (Basal Layer)
 Most abundant cell type  Deepest epidermal layer firmly attached to
 Produce the fibrous protein keratin the dermis
 Gives skin its protective properties □ Structural strength is provided by
• Melanocytes desmosomes and hemidesmosomes
 Produce the brown pigment melanin  Consists of a single row of the youngest
 Found in the deepest layers of the epidermis keratinocytes
• Langerhans’ cells  Cells undergo mitotic divisions ~every 19
 Epidermal macrophages days
 Help activate the immune system  10-25% are melanocytes
• Merkel cells • Stratum Spinosum
 Touch receptors in association with sensory  Melanin granules and Langerhans’ cells are
nerve endings abundant in this layer
□ Melanin is taken up by the
Layers of the Epidermis keratinocytes and accumulates on the
“sunny side” to protect the nucleus
• Stratum Basale (Basal Layer)
from UV damage
 Deepest epidermal layer firmly attached to the dermis
□ Structural strength is provided by desmosomes and hemidesmosomes
 Consists of a single row of the youngest keratinocytes
 Cells undergo mitotic divisions ~every 19 days
 10-25% are melanocytes
• Stratum Spinosum
 Melanin granules and Langerhans’ cells are abundant in this layer
□ Melanin is taken up by the keratinocytes and accumulates on the “sunny side” to protect the
nucleus from UV damage

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 • Stratum Granulosum
○ Drastic changes in keratinocyte appearance occurs
○ Keratohyaline and lamellated bodies (waterproofing) accumulate in the cells of this layer
○ Above this layer the epithelial cells die because they are too far from the dermis
• Stratum Lucidum
○ Thin, transparent band superficial to the Stratum Granulosum
○ Consists of a few rows of flat, dead keratinocytes
○ Present only in thick skin
• Stratum Corneum
○ Outermost layer of keratinized cells
○ Accounts for three quarters of the epidermal thickness
○ 20-30 cell layers thick, all dead.
○ Millions rub off everyday. Totally new every 25-45 days.
○ Functions include:
 Waterproofing
 Protection from abrasion and penetration
 Rendering the body relatively insensitive to biological, chemical, and physical assaults
Thick and Thin Skin
• Thick skin has all five epithelial strata
• Thin skin contains fewer cell layers per stratum
 Stratum lucidum is usually absent
 Hair is found only in thin skin

Skin Color
• Melanocytes produce melanin inside
melanosomes and then transfer the melanin to
keratinocytes
 The size and distribution of melanosomes
determine skin color
 Melanin production is determined
genetically but can be influenced by UV light
(tanning) and hormones
• Increased blood flow produces a red skin color
(Erythema), whereas a decreased flow causes pale
skin
 Decreased oxygen content in the blood
results in a bluish color called cyanosis
• Carotene, an ingested plant pigment, can cause
the skin to appear yellowish
Dermis
• Second major skin region containing strong, flexible connective tissue
• Cell types include fibroblasts, a few adipose cells and macrophages
• Composed of two layers: papillary and reticular

Layers of the Dermis

• Papillary layer
 Areolar connective tissue with collagen and elasticfibers
 Its superior surface contains peg-like projections called dermal papillae
 Genetically determined
 Responsible for fingerprints and footprints (films of sweat)

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 • Contains blood vessels that supply the overlying epidermis
○ With nutrients
○ Remove waste products
○ Aid in regulating body temperature

Reticular layer
• Dense irregular connective tissue
• Accounts for approximately 80% of the thickness of the skin
• Collagen fibers in this layer add strength and resiliency to the skin
• Elastin fibers provide stretch-recoil properties
• Striae (stretch marks) are caused when skin is overstretched, the dermis ruptures and leaves visible lines
• Elastin and collagen fibers are oriented more in one direction than in others and produce cleavage, or
tension, lines

Subcutaneous Tissue
• Deep to the skin
• Composed of adipose and areolar connective tissue
• Not really part of the skin
• Mostly adipose tissue
• Stores fat and connects the skin to the underlying structures (mainly muscles)
• Shock absorber and insulator
• Increases greatly as you gain weight

Accessory Skin Structures Sebaceous Glands

• Hair • Simple or compound alveolar glands found all over the body except
• Glands on the palms and soles
• Nails • Soften skin when stimulated by hormones
• Secrete an oily secretion called sebum
• Acne is an active inflammation of the sebaceous glands.
Hair
• Lanugo (fetal hair) is replaced near the time of birth by terminal hairs (scalp, eyelids, and eyebrows) and
vellus hairs
• At puberty, vellus hairs can be replaced with terminal hairs
• Hairs are columns of dead, keratinized epithelial cells
 Each hair consist of
 A shaft above the skin
 A root below the skin
 A hair bulb the site of hair formation
• Hairs have a growth stage and a resting stage
• Contraction of the arrector pili, which are smooth muscles, causes hair to “stand on end” and produces
“goose flesh”

Sweat Glands
• Different types prevent overheating of the body
• Secrete cerumen and milk
• Up to 3 million/person
 Merocrine sweat glands produce sweat, which cools the body: most numerous in the palms and soles
of the feet
 Apocrine sweat glands: Found in axillary and genital areas. Ducts empty into hair follicles. Produce an
organic secretion that can be broken down by bacteria to cause body odor
 Ceruminous glands: modified merocrine glands in external ear canal that secrete cerumen (ear wax)
 Mammary glands: specialized sweat glands that secrete milk

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Nails
• The nail is Stratum Corneum containing hard keratin
• The nail root is covered by
skin
• The nail body is the visible part of the nail
• Nearly all of the nail is formed by the nail matrix, but the nail bed contributes
• The lunula is the part of the nail matrix visible through the nail body

Integumentary System Functions

• Protection
• Temperature Regulation
 Skin
 Skin
 Protects against abrasion and UV light
 Controls heat loss from the body by
 Prevents the entry of microorganisms
dilation and constriction of blood
 Helps regulate body temperature
vessels
 Prevents water loss
 Sweat glands
 Hair
 Produce sweat, which evaporates and
 Protects against abrasion and UV light lowers body temperature
 Acts as a heat insulator • Vitamin D Production
 Nails protect the ends of the digits  UV light stimulates the production of a
• Sensation precursor molecule in the skin that is
 Skin contains sensory receptors for modified by the liver and kidneys into vitamin
 heat D
 cold  Vitamin D increases calcium uptake in the
 touch intestines
 pressure
 Pain
• Excretion
 Skin glands remove small amounts of waste products but are not important in excretion

Temperature Regulation
• normal body temperature is 37︒C
• regulation of body temperature is important because the rate of chemical reactions within the body can be
increased or decreased by changes in body temperature
• in order to maintian homeostasis, body must rid of excess heat

Integumentary System as a Diagnostic Aid

• useful in diagnosis=reflects events occuring in the other parts of the body
• Examples are:
1. Cyanosis= bluish color to the skin caused by decreased of blood O 2 content=indication of impaired
circulatory or respiratory function.
2. Jaundice=yellowish skin color=liver damaged by a disease like hepatitis
3. Rashes and Lesions= symptoms of problems elsewhere in the body
4. Condition of skin, hair and nails=affected by nutritional status

Burns= injury to a tissue caused by heat, cold, friction, chemicals, electricity, or radiation
• Can be classified according to their depth
 Partial-thickness burns
 Full-thickness burns

Partial-thickness burns=part of the stratum basale remains viable, and regeneration occurs, divided into two:

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1. First-degree: only the epidermis is damaged
 Symptoms include localized redness, swelling, and pain
2. Second-degree: epidermis and upper regions of dermis are damaged
 Symptoms mimic first degree burns, but blisters also appear

Full-thickness burns
• Third-degree: entire thickness of the skin is damaged
– Burned area appears gray-white, cherry red, or black; there is no initial edema or pain (since nerve endings are
destroyed)

Rule of Nines
• Estimates the severity of burns
• Divides body into areas that are ~ 9%, or multiples of 9%, of the total body area
• Younger patients are different
• Burns considered critical if:
 Over 25% of the body has second-degree burns
 Over 10% of the body has third-degree burns
Skin Cancer
 There are third-degree burns on face, hands, or feet
• most common type of cancer
• development is associated with
exposure to ultraviolet (UV) light
from the sun
• develop on the face, neck, or
hands
• fair-skinned people & ages 50
up=prone to skin cancer
• 3 main types of skin cancer

Basal Cell Carcinoma

• Least malignant and most
common skin cancer
• Stratum Basale cells proliferate
and invade the dermis and
hypodermis
• Slow growing and do not often
metastasize
• Can be cured by surgical excision
in 99% of the cases

Squamous Cell Carcinoma

• Arises from keratinocytes of Stratum Spinosum
• Arise most often on scalp, ears, and lower lip
• Grows rapidly and metastasizes if not removed
• Prognosis is good if treated by radiation therapy or removed surgically

Melanoma
• Cancer of melanocytes is the most dangerous type of skin cancer because it is:
 Likely to metastasize
 Resistant to chemotherapy

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 • Melanomas have the following characteristics (ABCD rule)
 A: Asymmetry; the two sides of the pigmented area do not match
 B: Border is irregular and exhibits indentations
 C: Color (pigmented area) is black, brown, tan, and sometimes red or blue
 D: Diameter is larger than 6 mm (size of a pencil eraser)
• Treated by wide surgical excision accompanied by immunotherapy
• Chance of survival is poor if the lesion is over 4 mm thick

Effects of Aging on the Integumentary System

• Epidermal replacement of cells slows and skin becomes thinner
• Decreased elasticity and loss of subcutaneous tissue leads to wrinkles
• Subcutaneous fat layer diminishes, leading to intolerance of cold
• Skin becomes dry and itchy
• Sweat and sebaceous glands are less active, and the number of melanocytes decreases
• Age spots= increase of melanocytes in some areas

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