INTEGUMENTARY SYSTEM

FAPC 111

FUNCTIONS :
Keeps water and other precious molecules in the body
Keeps water out (so no one will be porous)
Protects the body from external agents
insulates and cushions deeper organs
protects the body from mechanical (cuts and bumps),
chemical(acids) and thermal (heat and cold) damages,
UV rad and bacteria
Regulates heat loss from the body surface
Acts as mini Excretory system since it extracts UREA,
SALT WATER through SWEAT
Produces several proteins important to immunity
Storage of vitamin D precursor
Contains cutaneous receptor that serve as sensors for
touch, pressure, temperature, and pain
LAYERS OF THE SKIN :
EPIDERMIS DERMIS
Superficial protective layer of the skin Deeper and thicker than epidermis
Composed of STRATIFIED SQUAMOUS A strong and stretchy envelope that helps
KERATINIZED EPITHELIUM that varies in to hold the body together
thickness Blood vessels within the dermis nourish
All but the deepest layers of epidermis are the living portion of the epidermis
composed of dead cells With numerous COLLAGENOUS, ELASTIC,
composed of 4-5 layers, depending on its AND RETICULAR FIBERS that gives support
location with in the body to the skin
palms and soles have 5 layers because Highly vascular and glandular
these areas are exposed to most friction Contains many nerve endings and hair
follicles

EPIDERMIS
DERMIS
 LAYERS OF THE EPIDERMIS:
Deep to Superficial

STRATUM BASALE
Composed of single layer of contact with dermis
4 types of cells in the Stratum Basale:
1. KERATINOCYTES 2. MELANOCYTES
produces Keratin which Synthesizes the pigment
toughens and waterproofs skin melanin providing a protective
melanocytes barrier to UV rad in sunlight

4. LANERHANS CELLS
3. TACTILE CELLS (MERKEL CELLS)
Aid in tactile (touch) reception non-pigmented granular
dendrocytes
protective macrophagic cells
that ingest bacteria and other
foreign debris

STRATUM SPINOSUM STRATUM GRANULOSUM

Contains several STRATIFIED
LAYER OF CELLS
Spiny appearance due to
changed shaped of keratinocytes
with LIMITED mitosis
GRANULAR LAYER
Consists of only 3-4 flattened rows of cells
Cells here appear granular due to the
presence of keratohyaline granules

STRATUM SPINOSUM + STRATUM

BASALE = STRATUM GERMATIVUM

STRATUM LUCIDUM STRATUM CORNEUM

CLEAR LAYER
Nuclei, organelles and cell
membranes are no longer visible
so this layer appear clear
Exist only in the lips and the
thickened skin soles and palms
contains a translucent substance
called ELEIDIN
Composed of 25-30 layers of flattened,
scale like anucleated cells, which are
continuously shed as flake like residues of
cells
this layer is cornified and is the real
protective layer of the skin
cornification is brought on by keratinization
and the hardening, flattening process that
takes places as the cells die and are pushed
to the surface
Friction at the surface of skin stimulates
additional mitotic activity of stratum
basale, resulting in the formation of a
CALLUS for additional protection
 COLORATION OF THE SKIN:
Caused by expression of a combination of 3 pigments
MELANIN
CAROTENE
HEMOGLOBIN
VITILIGO
White skin patches
caused by lack of melanocytes
MELANIN
Brown-black pigment produced by
the melanocytes of stratum basale
Guard skin against damaging effect
of ultraviolet rays of sunlight
gradual exposure to sunlight
promotes increased production of
melanin; hence tanning of the skin
In albino, there is normal number of
melanocytes but lacks enzymes
TYROSINASE, that converts the
amino acid Thyrosine to melanin
SURFACE PATTERNS
CONGENITAL PATTERNS :
Positive fingerprints and friction
ridges
Present on palms and soles
formed by the pull of elastic fibers
within the dermis
function to prevent slipopage when
grasping objects
FRECKLES
Aggregated patch of melanin
CAROTENE
A yellowish pigment found in
epidermal cells and fatty parts of
dermis
Abundant in skin of Asians
Together with melanin, accounts for
the yellowish-tan color in Asians
HEMOGLOBIN
Not a pigment of the skin, rather it is
the oxygen-binding pigment found in
RBC
Oxygenated blood flowing Through
the dermis gives its pinking tones
ACQUIRED LINES :
Deep flexion creases
- found on the palms
Shallow Flexion Lines
- seen on knuckles and surface of
other joints
Furrows in the Forehead and Face (Wrinkles)
Acquired from continual contraction
of facial muscles, such as from
smiling or squinting in bright light or
against the wind; facial lines become
more strongly delineated as person
ages

Langer lines
Lines of tension in the skin produced
by the orientation of collagen and
elastic fibers in nonrandom pattern
of arrangement
surgical incision should be made
parallel to Langer lines to promote
better wound healing

LAYERS OF DERMIS:

PAPILLARY LAYER RETICULAR LAYER

In contact with the epidermis Deepest skin layer
Accounts for about 1/5 of the entire Contains BLOOD VESSELS, SWEAT
dermis AND OIL GLANDS, AND DEEP
With numerous projections called PRESSURE RECEPTORS (Pacinian
DERMAL PAPILLAE, that extend from Corpuscles)
the upper portion of the dermis into Many Phagocytes are found here;
the epidermis they engulf bacteria that have
DERMAL PAPILLAE contain capillary managed to get through the
loops, which furnish nutrients to the epidermis
epidermis
some papillae house pain receptors
(free nerve endings) and touch
receptor (Meissner's corpuscles)
Dermal papillae form the base for
the friction ridges on the fingers and
toes

Epidermal Ridges
 CUTANEOUS GLANDS
All exocrine glands
release secretions to skin surface via ducts

SEBACEOUS (OIL) GLANDS

Found all over the skin, except on palms and
soles
Ducts usually empty into a hair follicle but
some open directly onto skin surface
secretion is called sebum, a mixture of oily
substance and fragmented cells that keeps
skin soft and moist and prevents hair from
becoming brittle
if the drainage pathway for sebaceous gland
becomes blocked for some reason, the glands
become infected, resulting in acne
Sebum also contains chemicals that kills
bacteria
Become very active when sex hormones are
produced in increased amounts during
adolescence, thus skin is oilier during this
period of life

SWEAT GLANDS
Also called SUDORIFEROUS GLANDS
Widely distributed in the skin; numerous in palms, sole, axillary, and
pubic regions
Secretion evaporates and cools the body

TWO TYPES OF SWEAT GLANDS

MEROCRINE (ECCRINE) APOCRINE
More numerous and found all over Much larger, localized gland found in
body especially in forehead, back, axillary and pubic regions where they
palms and soles secrete into hair follicles
Secretion reaches skin surface via a Not functional until puberty
duct that opens directly on surface Secretion is thick and rich in organic
of skin through sweat pores substance which is odorless when
Secretion is mostly water with few released but quickly broken down by
salts bacteria into substances responsible
for body odor.
If the drainage pathway becomes blocked for some reason, the glands may
become infected, resulting in ACNE formation
CERUMINOUS GLANDS
Modified Sudoriferous glands
Secrete CERUMEN (ear wax)
Empties into the ear canal

MAMMARY GLANDS
Specialized sweat glands
found within the breast tissue
undergoes cell hypertrophy (size
increase) and cell hyperplasia
(increase in number) under pituitary
influence in pregnancy
Secrete milk during lactation

HAIR
Characteristic of all mammals, but its distribution, function, density and
texture varies across mammalian species
Humans are relatively hairless, with only the scalp, face, pubis and axilla
being densely haired
Men with more obvious hair because of the male hormone
Certain regions of the body are hairless, like the palms, soles, lips,
nipples, penis, labia minora
Lifespan 3-4 months for eyelash, 3-4 years in scalp hair
Primary function: Protection

PARTS OF HAIR

SHAFT ROOT HAIR BULB MATRIX

the visible but enclosed in the growth zone;

dead portion of follicle contains
hair projecting MELANOCYTES
above surface of that give color to
the skin the hair
 3 LAYERS OF HAIR IN CROSS SECTION
MEDULLA

Inner part

CORTEX
Thick middle part

CUTICLE

Covers cortex and forms

toughened outer portion

LANUGO VELUS DEFINITIVE HAIR

Fine, Silky fetal Short, Fine Hairs Grows up to a
(immature hair) grows all over the certain length only,
can be found in new body except the most dominant
born babies palms and soles type of hair
Eyelashes,
eyebrow, pubic
and axillary hair '

NAIL

NAIL BODY HYPONYCHIUM NAIL MATRIX

Visible attached Beneath free Growth area of
edge edge the proximal
portion of nail
bed
LUNULA FREE EDGE NAIL ROOT
White crescent Distal exposed Covered by skin
shape portion

EPONYCHIUM
(cuticle) covers
the nail root
 SKIN HOMEOSTATIC IMBALANCES

Infections
Athletes Foot- Caused by fungal infection
Boils and Carbuncles - Caused by bacterial infection
Cold Sores- caused by virus

ATHLETE'S FOOT
Tinea Pedis
Itchy, red peeling condition of the
skin between the toes due to fungal
infection

BOILS AND CARBUNCLES

Inflammation of hair follicles and
sebaceous glands, found on the
dorsal neck
typically caused by bacterial
infection
Staphylococcues aureus

COLD SORES
Fever Blisters
Small-fluid filled blisters that itch and
sting, caused by herpes simplex
infection
The virus localizes in a cutaneous
nerves, where it remains dormant
until activated by emotional upset,
fever, or UVR
Commonly occurs around the lips
and in the oral mucosa of the mouth

CONTACT DERMATITIS IMPETIGO

Itching, redness, and swelling of the Pink water-filled, raised lesions that
skin, progressing to blisters develop a yellow crust and eventually
Caused by exposure of the skin to rupture
chemicals (poison ivy) that provoke caused by a highly contagious
allergic responses in sensitive staphylococcal infection
individuals Commonly affects elementary
school-aged children
Commonly occurs around the mouth
and nose
 PSORIAISIS
Chronic condition characterized by
reddened epidermal lesions covered
with dry, silvery scales
Triggering Factors:
1. Trauma
2. infection
3. hormonal changes
4. stress

BURNS RULES OF NINES

Tissue damage and cell death caused Way to determine the extent of
by heat, electricity, UV radiation, or burns
chemicals Body is divided into 11 areas for
Associated dangers: quick estimation
1. Dehydration each area represents about 9%
2. Electrolyte Imbalance
3. Circulatory Shock

ADULTS CHILDREN
HEAD - 9% HEAD - 18%
ARMS - 9% EACH ARMS - 9% EACH
LEGS - 18% EACH LEGS - 13.5% EACH
CHEST - 18% EACH CHEST - 18% EACH
BACK - 18% BACK - 18%
GROIN - 1% GROIN - 1%

FIRST DEGREE BURNS SECOND DEGREE BURNS
Partial Thickness burn
Epidermis is damaged
Generally heal in 2-3
days without any special
attention
The area becomes red
and swollen (sunburn)
SEVERITY OF BURNS
THIRD DEGREE BURNS
Partial thickness burn Full thickness burn
Involves the dermis and Destroys the entire
upper region of the dermis thickness of the skin
skin is red and painful and burned area appears
blisters appear blanched (gay white) or
Regeneration of the blackened
epithelium (healing) can still Painless because the nerve
occur because of sufficient endings in the area are
number of epithelial cells destroyed
still present regeneration (healing) is no
longer possible
Skin grafting must be done
to cover the underlying
exposed tissue
 CRITICAL BURNS COMPLICATIONS OF BURNS
1. Over 25% TBSA has 2nd degree 1. Circulator Shock
burns 2. Renal Failure
2. Over 10% TBSA has 3rd degree burn 3. Infection
3. 3rd degree burns of the face, hand 4. Depression of the immune system
or feet
Facial burns are dangerous because RENAL FAILURE
of the possibility of the burned Due to extravassation of fluids
respiratory passageways to swell containing proteins and electrolytes
and cause suffocation from the burned surface-
Joint burns are troublesome dehydration & electrolyte
because scar tissue formation can imbalance- Renal Failure
severely limit joint mobility

CIRCULATORY SHOCK INFECTION

Due to extravassation of fluids Leading cause of death after burns
containing proteins and electrolytes burned skin is sterile for about 24
from the burned surface- hours
dehydration & electrolyte after 24 hours, bacteria and fungi
imbalance- decrease volume - easily invade areas where the skin
circulatory shock has been destroyed and multiply
rapidly in the nutrient rick
DEPRESSION OF IMMUNE SYSTEM environment of dead tissues
Occurs in severe burn cases

SKIN CANCER
Cancer - abnormal cell mass
Skin cancer - most common type of cancer
Two types:
1. Benign - does not spread (encapsulated)
2. Malignant - metastasized (moves) to other parts of the body

TYPES OF SKIN CANCER

SQUAMOUS CELL CARCINOMA
Arises from stratum
spinosum
Metastasizes to lymph
nodes
Early removal allows a
good chance of cure
Common sites:
1. scalp
2. ears
3. dorsum of the hands
4. lower lip
BASAL CELL CARCINOMA
Least malignant
most common type
arises from stratum basale
Appears as shiny dome-shaped nodules
that later developed a central ulcer with
pearly beaded edge
slow growing and metastasis seldom
occurs before it is noticed
grows rapidly and metastasizes to adjacent
lymph nodes if not removed
believed to be sun-induced
Good prognosticating factors;
1. early detection
2. early removal through surgery
3. early chemotherapy

MALIGNANT MELANOMA
Mostly deadly of skin cancers
cancer of melanocytes
metastasizes rapidly to lymph and blood
vessels
detection uses ABCD rule
Accounts for 5% of skin cancers
Occurs spontaneously in pigmented ares
but some develop from pigmented moles
usually appears as a spreading brown to
black patch that metastasize rapidly to
surrounding lymph and blood vessels
50% chances of survival with early
detection
ABCD RULE

A- ASYMMETRY B- BORDER IRREGULARITY

Two sides of Borders of mole are
pigmented mole do not smooth
not match

C- COLOR D- DIAMETER
Different colors in Spot is larger than
pigmented area 6mm in diameter
 DEVELOPMENTAL ASPECTS OF SKIN AND BOSY
MEMBRANES

LANUGO VERMIX CASEOSA

Down type of hair covering the Accumulations of small white
soon-to born infant during 5th- spots in the sebaceous glands on
6th months of fetal development the baby's nose and forehead
(shed by birth) normally disappear by the 3rd
week after birth
SKIN DEVELOPMENT
FETAL NEONATAL INFANCY
(+) lanugo Vermis caseosa and Thicker and moist, and
millia more deposition of
very thin and blood subcutaneous fats
vessels can easily be
seen through it
ADOLESCENCE ADOLESCENCE GETRIATRIC PERIOD
Skin and hair Skin reaches its 1. Reduction of
become oilier due optimal subcutaneous fats
to activation of appearance 2. dry skin
sebaceous glands, 3. thinning of the skin
causing acne 4. decrease skin elasticity
acne subsides in 5. baldness
early adulthood 6. (+) vellus hair

REDUCTION OF SUBCUTANEOUS FATS DRY SKIN

Causes cold Due to decrease oil
intolerance production and reduction
THINNING OF THE SKIN of collagen fibers
Increases the risk for causes itchiness and
bruising and other types of discomfort
DECREASE SKIN ELASTICITY
injuries
Along with the loss of
BALDNESS subcutaneous fat causes
eyebags and sagging of
Alopecia
jowls
occurs in 5th decade of life
due to reduced number of VELLUS HAIRS
degeneration of hair Very tin and colorless hairs
follicles on the bald area due to
male patter baldness = degeneration of the hair
obvious balding / hair loss follicles
with aging