Camarines Sur Polytechnic Colleges - HOW ACCOMPLISHED: Has an unbroken

College of Health Sciences

SY 2022-2023
surface and “acid mantle” (skin secretions are
acidic and thus inhibit microbes, such as

Chapter 4 bacteria). Phagocytes ingest foreign substances

and pathogens, preventing them from
INTEGUMENTARY SYSTEM:
A Review Material penetrating into deeper body tissues.
 Ultraviolet (UV) radiation (damaging effects
OUTLINE of sunlight or tanning beds)
4.1 The Integumentary System
4.2 Functions of the Integumentary System - HOW ACCOMPLISHED: Melanin produced by
4.3 Structure of the Skin melanocytes offers protection from UV damage.
4.4 Skin Color
 Thermal (heat or cold) damage
4.5 Appendages of the Skin
4.6 Homeostatic Imbalances of Skin - HOW ACCOMPLISHED: Contains
4.7 Summary heat/cold/pain receptors.
 Desiccation (drying out)
Chapter 4: Integumentary System
- HOW ACCOMPLISHED: Contains a water-
4.1 THE INTEGUMENTARY SYSTEM resistant glycolipid and keratin.

INTEGUMENTARY SYSTEM 2. SENSATION

 The integumentary system is the external
covering of the body, or the skin, including hair
and fingernails.
 It waterproofs the body and cushions and
protects the deeper tissues from injury.
 It consists of the skin and accessory structures,
such as hair, glands, and nails.
4.2 FUNCTIONS OF THE
INTEGUMENTARY SYSTEM
The integumentary system has sensory receptors that can
detect heat, cold, touch, pressure, and pain.
3. VITAMIN D PRODUCTION
When exposed to ultraviolet light, the skin produces a
molecule that can be transformed into vitamin D, an
important regulator of calcium homeostasis.
4. TEMPERATURE REGULATION
The amount of blood flow beneath the skin’s surface and
the activity of sweat glands in the skin both help regulate

The integumentary system, performs a variety of functions; most,
but not all, of which are protective.
1. PROTECTION
It protects deeper tissues from
 Mechanical damage (bumps)
- HOW ACCOMPLISHED: Physical barrier
contains keratin which toughens cells; fat cells
to cushion blows; and both pressure and pain
receptors, which alert the nervous system to
possible damage.
body temperature. The skin also aids in body heat loss or
heat retention which is controlled by the nervous system.
How accomplished:
- HEAT LOSS: By activating sweat glands and by
allowing blood to flush into skin capillary beds
so that heat can radiate from the skin surface.
- HEAT RETENTION: By not allowing blood to
flush into skin capillary beds.
5. EXCRETION
Small amounts of waste products are lost through the

 Chemical damage (acids and bases) skin and in gland secretions. The skin also aids in the

- HOW ACCOMPLISHED: Has relatively excretion of urea and uric acid that is contained in

impermeable keratinized cells; contains pain perspiration produced by sweat glands.

receptors, which alert the nervous system to

possible damage. 4.3 STRUCTURE OF THE SKIN
 Microbe damage
The skin is composed of two kinds of tissue. The outer epidermis
and the underlying dermis.
 2. Stratum Spinosum
- Cells contain thick bundles of intermediate
filaments made of pre-keratin.
- Cells on the stratum spinosum take on a
flattened appearance and accumulate lipid-filled
vesicles called lamellar bodies.

3. Stratum Granulosum
- Cells of the stratum granulosum are flat and
diamond-shaped. Organelles deteriorating;
cytoplasm is full of granules.
4. Stratum Lucidum
- It is a thin, clear zone between the stratum
granulosum and stratum corneum.
- It is present in certain areas of the body. It
occurs only where the skin is hairless and extra
EPIDERMIS thick, that is, on the palms of the hands and soles
 Most cells of the epidermis are keratinocytes, of the feet.
which produce keratin, the fibrous protein that - The cells of this stratum no longer have nuclei or
makes the epidermis a tough protective layer in organelles, and as a result, the cells stain more
a process called keratinization. lightly.
 Like all other epithelial tissues, the epidermis is
avascular, that is, it has no blood supply of its
5. Stratum Corneum
own. - The most superficial stratum of the epidermis.

 The epidermis is composed of up to five layers - Cells are dead, flat membranous sacs filled with

or strata. keratin. Glycolipids in extracellular space make

skin water-resistant.
- It is 20-30 cell layers thick, but it accounts for
about three-quarters of the epidermal thickness.
FIVE STRATA OF EPIDERMIS
From the deepest
Definition to the most superficial stratum of the
of Terms
epidermis.
Keratinocytes (tan), connected by many desmosomes,
form most of the epidermis.
1. Stratum
 Basale
Melanocytes (gray) make the pigment melanin.
 Epidermal Dendritic Cells (blue) are star-shaped
- The deepest
epidermal cellscell layer
and are of theimmune
protective epidermis,
cells. which
 Occasional Merkel Cells (purple), each associated
lies closest to the dermis and is connected to it
with a nerve ending, act as touch receptors called
along
Merkela discs.
wavy border that resembles corrugated
 Dandruff is the excessive sloughing of stratum
cardboard.
corneum cells from the surface of the scalp.
- It Callus

containsis a thickened and hardened part of the skin or
the most adequately nourished of the
soft tissue, especially in an area that has been subjected
epidermal
to friction. cells.
 Melanin is a pigment that ranges in color from yellow
- Stem cellstoinblack
to brown thisand
layer are constantly
is produced by specialdividing,
spider-
shaped cells called melanocytes, found chiefly in
and millions of new cells are produced daily;
 the stratum basale. Freckles and moles are seen where
hence
melanin is its alternate name, stratum
 concentrated in one spot. The pigment which ranges in
germinativum
color from yellow to brown to black is produced by
special spider-shaped cells called melanocytes, found
- Some newly formed cells in this layer become
chiefly in the stratum basale. Freckles and moles are
part
seenofwhere
the more superficial
melanin layers.
is concentrated in one spot.
 2. Reticular Layer
 It is the deepest skin layer.
 It contains dense irregular connective tissue, as
DERMIS well as blood vessels, sweat and oil glands, and
 The dermis is your “hide.” deep pressure receptors called lamellar
 It is a strong, stretchy envelope that helps to corpuscles.
bind the body together.  Other cutaneous sensory receptors, which are
 The connective tissue making up the dermis actually part of the nervous system, are also
consists of two major regions–the papillary and located in the skin.
the reticular areas.  These tiny sensors, which include touch,
 Like the epidermis, the dermis varies in pressure, temperature, and pain receptors,
thickness. provide us with a great deal of information about
 Both collagen and elastic fibers are found our external environment.
throughout the dermis.
Both collagen and elastic fibers are found throughout the
dermis.
TWO MAJOR REGIONS OF THE
 COLLAGEN FIBERS
DERMIS
Which are composed of areolar and dense irregular connective - are responsible for the toughness of the dermis;
tissue, respectively. they also attract and bind water and thus help to
keep the skin hydrated.
- it is oriented in many different directions and
can resist stretching.
- it produces cleavage lines or tension lines in the
skin.
- if the skin is overstretched, the dermis can be
damaged, leaving lines that are visible through
the epidermis. These lines are called stretch
marks.

 ELASTIC FIBERS
- give the skin its elasticity when we are young.

REMEMBER:
1.As we age, the number of collagen and elastic fibers decreases,
Papillary Layer
and the subcutaneous tissue loses fat. As a result, the skin loses
 It isand
its elasticity thebegins
superficial
to sag anddermal
wrinkle.region. It is uneven

and has peg-like projections from its superior

surface, called dermal papillae.
 Many of the dermal papillae contain capillary
4.4 SKIN COLOR
loops, which furnish nutrients to the epidermis.
Three
 pigments contribute
Others house painto skin color: melanin,
receptors carotene,
(free nerve and
endings)
hemoglobin
and touch receptors.
 The dermal papillae in the palms of the hands, Three pigments that contribute to skin color:
soles of the feet, and the tips of the digits are
 The amount and kind (yellow, reddish brown, or
arranged in parallel, curving ridges that shape
black) of melanin in the epidermis. Skin
the overlying epidermis into patterns called
exposure to sunlight stimulates melanocytes to
friction ridges.
produce more melanin pigment, resulting in the
 tanning of the skin. As the melanocytes produce  Pallor, or blanching. Under certain types of
melanin pigment, it accumulates in their
cytoplasm in membrane-bound granules called
melanosomes. People who produce a lot of
melanin have brown-toned skin, whereas people
with less melanin are light-skinned.
 The amount of carotene deposited in the stratum
corneum and subcutaneous tissue. (Carotene is
an orange-yellow pigment plentiful in carrots
and other oranges, deep yellow, or leafy green
vegetables.) In people who eat large amounts of
carotene-rich foods, the skin tends to take on a emotional stress, some people become pale. Pale
yellow-orange cast. skin may also signify anemia, low blood
 The amount of oxygen-rich hemoglobin pressure, or impaired blood flow into the area.
(pigment in red blood cells) in the dermal blood  Jaundice, or a yellow cast. An abnormal yellow
vessels. In light-skinned people, the crimson skin tone usually signifies a liver disorder in
color of oxygen-rich hemoglobin in the dermal which excess bile pigments accumulate in the
blood supply flushes through the transparent cell blood, circulate throughout the body, and
layers above and gives the skin a rosy glow. become deposited in body tissues.
 Bruises. The black-and-blue marks of bruising
Process of Melanin Transfer from reveal sites where blood has escaped from the
Melanocytes to Epithelial Cells circulation and has clothed in the tissue spaces.

1. Within melanocytes, the Golgi apparatuses Such clotted blood masses are called

package melanin into vesicles called hematomas. An unusual tendency to bruise may

melanosomes. signify a deficiency of vitamin C in the diet or

2. Melanosomes move into the cell processes of the hemophilia (bleeder’s disease).

melanocytes. HOMEOSTATIC IMBALANCE

3. Epithelial cells phagocytize the tips of the
 When hemoglobin is poorly oxygenated, both
melanocyte cell processes, thereby acquiring
the blood and the skin of light-skinned people
melanosomes. Although all the epithelial cells of
appear blue, a condition called cyanosis.
the epidermis can contain melanin, only the
Cyanosis is common during heart failure and
melanocytes produce it.
severe breathing disorders.

Several Factors That Determine Skin Color:

1. Pigments in the skin;
2. Blood circulating through the skin; and
3. The thickness of the Stratum Corneum.

Emotion also influences skin color, and

many alterations in skin color signal certain
disease state:
 Redness, or erythema. Reddened skin may
indicate embarrassment (blushing), fever,
hypertension, inflammation, or allergy.
  Skin color variations are determined by the
amount, kind, and distribution of melanin.
Although many genes are possible for skin
color, a single mutation can prevent the
production of melanin. For example, albinism.
palms of the hand and the soles of the
feet.
- Their ducts usually empty into a hair
follicle, but some open directly onto the
skin surface.

4.5 APPENDAGES OF THE SKIN

This includes cutaneous glands, hair and hair follicles, and nails.
Each of these appendages arises from the epidermis and plays a
unique role in maintaining body homeostasis.

APPENDAGES OF THE SKIN

 The skin appendages are epidermal and dermal-
derived components of the skin that include
cutaneous glands, hair and
hair follicles, and nails.

GLANDS

CUTANEOUS GLANDS
 The cutaneous glands are all exocrine glands
that release their secretions to the skin via ducts.
 They fall into two groups: sebaceous glands and
sweat glands.
 As these glands are formed by the cells of the
stratum basale, they push into the deeper skin
regions and ultimately reside almost entirely in
the dermis.
1. SEBACEOUS GLANDS
 - Sweat glands, also called sudoriferous
glands, are widely distributed in the HAIR AND HAIR FOLLICLES
skin.
Hair is an important part of our body image. Millions of
- Their number is staggering—more than
2.5 million per person.
- There are two types of sweat glands,
eccrine and apocrine.

TWO TYPES OF SWEAT GLANDS

1. Eccrine
- Sweat glands are simple coiled, tubular
glands that release sweat by microneme
secretion.
- Are far more numerous and are found all
over the body.
- They produce sweat, a clear secretion hairs, produced by hair follicles, are found all over the
that is primarily water plus some salts body surface except on the palms of the hands, soles of
(sodium chloride), vitamin C, traces of the feet, nipples, and lips. Humans are born with as
metabolic wastes (ammonia, urea, uric many hair follicles as they will ever have, and hairs are
acid), and lactic acid (a chemical that among the fastest-growing tissues in the body.
accumulates during vigorous muscle
HAIR
activity).
- They are supplied with nerve endings  It is a flexible epithelial structure. The part of

that cause them to secrete sweat when the hair enclosed in the hair follicle is called the

external temperature or body “root”, and the part projecting from the surface

temperature is too high. of the scalp or skin is called the “shaft”.

2. Apocrine  Hair serves a few minor protective functions,

- Are largely confined to the axillary such as guarding the head against bumps,

(armpit) and genital areas of the body. shielding the eyes (via eyelashes), and helping to

- They are usually larger than eccrine keep foreign particles out of the respiratory tract

glands, and their ducts empty into hair (via nose hairs).

follicles.  Hair may also help to attract sexual partners, as

- Their secretion contains fatty acids and evidenced by its place in our body image.

proteins, as well as all the substances Hormones account for the development of hairy

present in eccrine sweat; consequently, regions—the scalp and, in the adult, the pubic

it may have a milky or yellowish color. and axillary areas. Despite these functions,

The secretion is odorless, but when however, our body hair has lost much of its

bacteria that live on the skin use its usefulness.

proteins and fats as a source of nutrients Structure of Hair

for their growth, it can take on a musky, - Each hair arises from a hair follicle.
sometimes unpleasant odor. - The medulla is the softer center that is
- Apocrine glands begin to function surrounded by the hair.
during puberty under the influence of - The cortex is covered by a cuticle, a single layer
androgens. of overlapping cells that holds the hair in the
- They play a minimal role in hair follicle.
thermoregulation.
 - The hair papilla is an extension of the dermis Structure of a Nail
that protrudes into the hair bulb. - The borders of the nail are overlapped by folds
of skin called nail folds.
HAIR FOLLICLES
- The edge of the thick proximal nail fold is
 They are actually compound structures. The
commonly called cuticle or eponychium.
inner epithelial root sheath is composed of
- The stratum basale of the epidermis extends
epithelial tissue and forms the hair. The outer
beneath the nail as the nail bed.
fibrous sheath is actually dermal connective
- Its thickened proximal area, called the nail
tissue.
matrix, is responsible for nail growth.
 This dermal region supplies blood vessels to the
epidermal portion and reinforces it.
 Its nipple-like hair papilla provides the blood
4.6 HOMEOSTATIC IMBALANCE
OF SKIN
supply to the matrix in the hair bulb (the deepest
Loss of homeostasis in body cells and organs reveals itself on the
part of the follicle). skin in thousands of different ways.
 Associated with each hair follicle are smooth
muscle cells called the arrector pili. Contraction The skin can develop more than 1,000 different

of the arrector pili causes the hair to become ailments. The most common skin disorders are infections

more perpendicular to the skin’s surface, or to with pathogens such as bacteria, viruses, or fungi.

“stand on end,” and it produces a raised area of Allergies, which are caused by abnormally strong

skin called a “goose bump.” immune responses, are also commonly seen in the skin.
Less common, but far more damaging to body well-
being, are burns and skin cancers.

Some of the homeostatic imbalances of

NAILS the skin are:

NAILS
 A nail is a scale-like modification of the
epidermis that corresponds to the hoof or claw
of other animals.
 The nail is a thin plate, consisting of layers of
dead stratum corneum cells that contain a very
hard type of keratin.
 Each nail has a free edge, a body (visible
attached portion), and a root (embedded in the
skin).
 Nails are transparent and nearly colorless, but
they look pink because of the rich blood supply 1. Infections and Allergies
in the underlying dermis. Infections and allergies cause the following
 The exception to this is the region over the commonly occurring skin disorders:
thickened nail matrix that appears as a white  Athlete’s Foot
crescent and is called the lunule (lunul = - an itchy, red, peeling condition
crescent). of the skin between the toes,
 Cell production within the nail matrix causes the resulting from an infection with
nail to grow. Unlike hair, nails grow the fungus Tinea pedis.
continuously and do not have a resting stage.  Boils and Carbuncles
 - boils are caused by yellowish crust; usually affects
inflammation of hair follicles children.
and surrounding tissues,  Decubitus Ulcers
commonly on the dorsal neck. - Develop in people who are
- carbuncles are clusters of boils bedridden or confined to a
often caused by the bacterium wheelchair, compression of
Staphylococcus aureus. tissue and reduced circulation
result in destruction of the
 Ringworm subcutaneous tissue and skin,
- fungal infection that produces which later become infected by
patchy scaling and bacteria, forming ulcers.
inflammatory response in the VIRAL INFECTION:
skin.  Chicken Pox
 Eczema and Dermatitis - Skin lesions; usually mild viral
- Inflammatory conditions of the disease contracted through the
skin caused by allergy, respiratory tract.
infection, poor circulation, or  Shingles
exposure to chemical or - Painful skin lesions that can
environmental factors. recur when the dormant virus is
 Psoriasis activated by trauma, stress, or
- Chronic skin disease another illness; caused by the
characterized by a thicker than chicken pox virus after
normal epidermal layer (stratum childhood infection.
corneum) that sloughs to  Cold Sores
produce large, silvery scales; - Skin lesions; caused by herpes
bleeding may occur if the scales simplex I virus; transmitted by
are scraped away. oral or respiratory routes;
BACTERIAL INFECTION: lesions recur.
 Impetigo  Genital Herpes
- Small blisters containing pus; - Genital lesions; caused by
herpes simplex II virus;
transmitted by sexual contact.

2. Burns
There are few threats to life more serious than
burns. A burn is tissue damage and cell death
caused by intense heat, electricity, UV radiation
(sunburn), or certain chemicals (such as acids),
which denature proteins and cause cell death in
the affected areas.

Classification of Burns According to their

Severity (Depth):
easily rupture to form a thick,
 FIRST-DEGREE (superficial)
 - In here, only the superficial
epidermis is damaged. The area
becomes red and swollen. This
is not usually serious
generally heals in two to three
days.
 SECOND-DEGREE (superficial
partial-thickness burns)
- It involves injury to
epidermis and the superficial
part of the dermis. The skin is
red, painful, and blistered.
Regeneration of the epithelium
can occur. Ordinarily,
permanent scars result if care is
taken to prevent infection.
 THIRD-DEGREE (full-thickness
burns)
- destroy both the epidermis and
the dermis and often extend into
the subcutaneous tissue,
reflecting their categorization as
full-thickness burns. Blisters are
usually present, and the burned
area appears blanched (gray-
white) or blackened. In this
degree, regeneration is
possible, and skin grafting must
be done to cover the underlying
exposed tissue.
 FOURTH-DEGREE (full-thickness
burns with deep-tissue involvement)
- are also full-thickness burns, but
they extend into deeper tissues
such as bone, muscle,
tendons. These burns appear dry
and leathery, and they require
surgery and grafting to cover the
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
and 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
the 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,
no can interfere with normal breathing.
3. Skin Cancer
Numerous types of neoplasms (tumors) arise in
the skin. Most skin neoplasms are benign and do
not spread to other body areas. However, some
skin neoplasms are malignant or cancerous, and
they tend to invade other body areas.
Skin cancer is the single most common type of
cancer in humans. Furthermore, there are three
most common types of skin cancer: basal cell
carcinoma, squamous cell carcinoma, and
malignant melanoma.
not
THREE MAIN TYPES OF SKIN
CANCER:
1. Basal Cell Carcinoma
 It is the least malignant and most
common skin cancer that begins with
cells in the stratum basale and extends
or into the dermis to produce an open ulcer.
 It is relatively slow-growing and
fortunately, there is little danger that this
type of cancer will spread to other areas
of the body since metastasis seldom
occurs before the lesion is noticed.
 When the lesion is removed through
surgical removal or radiation therapy, 99
percent of cases are completely cured.
 2. Squamous Cell Carcinoma
 It arises from the cells of the stratum
spinosum. The lesions appear as scaly,
reddened papules (small, rounded
swellings) that gradually form shallow
ulcers with firm, raised borders.
 This variety of skin cancer appears most
(A) Asymmetry. Any two sides of the
often on the scalp, ears, back of the
pigmented spot or mole do not match.
hands, and lower lip, but can appear
(B) Border irregularity. The borders of the
anywhere on the skin. This epidermal
lesion are not smooth but exhibit indentations.
cancer is also believed to be induced by
(C) Color. The pigmented spot contains areas of
UV exposure.
different colors (black, brown, tan, and
 If it is caught early and removed sometimes blue or red).
surgically or by radiation therapy, the (D) Diameter. The lesion is larger than 6
chance of a complete cure is good. millimeters (mm) in diameter (the size of a
pencil eraser).
3. M (E) Evolution. One or more of these

a characteristics (ABCD) is evolving, or changing.

l
i INTEGUMENTARY SYSTEM SUMMARY

The integumentary system consists of the skin, hair, glands, and nails.
g 4.1 Functions of the Integumentary System
The integumentary system consists of the skin, hair, glands, and nails.
n The integumentary system protects us from the external environment.
Other functions include sensation, vitamin D production, temperature
regulation, and excretion of small amounts of waste products.
ant Melanoma 4.2 Skin
Epidermis
 It is a rare form of skin cancer that arises  The epidermis is stratified squamous epithelium divided into
strata. Strata from deep to superficial are stratum basale,
from melanocytes. stratum spinosum, stratum granulosum, stratum lucidum, and
stratum corneum. New cells are produced in the stratum
 It accounts for only about 5 percent of basale. The stratum corneum consists of many layers of dead
squamous cells containing keratin. The most superficial layers
skin cancers, but it is often deadly. are sloughed.
 Keratinization is the transformation of stratum basale cells into
 It can appear as a large, fat, spreading stratum corneum cells. Structural strength results from the
keratin inside the cells and from desmosomes, which hold the
lesion or as a deeply pigmented nodule. cells together. Lipids surrounding the stratum corneum cells
help prevent fluid loss.
 It arises from accumulated DNA Dermis
damage in a skin cell and usually  The dermis is dense connective tissue.
 Collagen and elastic fibers provide structural strength, and the
appears as a spreading brown-to-black blood vessels of the papillae supply the epidermis with
nutrients.
patch that metastasizes rapidly to
surrounding lymph and blood vessels.
 It only has 50 percent chance of
survival.
 The American Cancer Society suggests
Skin Color that people who sunbathe frequently or  Balding and/or graying occurs with aging. Both are
 Melanocytes produce melanin, which is responsible for genetically determined but can also be caused by other factors
different attend tanning
skin colors. parlors
Melanin examine
production their skin
is determined (drugs, emotional stress, and so on).
genetically but can be modified by exposure to ultraviolet
periodically for new moles or pigmented
light and by hormones.
 Carotene, a plant pigment ingested as a source of vitamin A,
spots and apply the ABCDE rule for
can cause the skin to appear yellowish.
 Increasedrecognizing melanoma:
blood flow produces a red skin color, whereas
decreased blood flow causes a pale skin color. Decreased
blood O2 results in the blue skin color of cyanosis.
 Scattering of light by collagen produces a bluish color.
4.3 Subcutaneous Tissue