ANATOMY AND PHYSIOLOGY (MC 1)

11 MAJOR ORGAN SYSTEMS OF THE HUMAN BODY • contains 5 layers of the skin: stratum corneum,
stratum lucidum, stratum granulosum, stratum
1. INTEGUMENTARY SYSTEM
spinosum, stratum basale (germinativum)
• largest organ of the body that forms a
physical barrier between the external
THIN SKIN
environment and the internal environment
• 1-2 mm on most of the body and 0.5 mm in
that serves to protect and maintain
eyelids
• consists of the skin, hair, nails, the
• also called as vellus [hairy] skin
subcutaneous tissue below the skin, and
• covers all parts of the body except hand palms
some assorted glands
and feet soles
• thin epidermis and lacks stratum lucidum
FUNCTIONS OF THE INTEGUMENTARY SYSTEM
• lacks dermal papillae
PROTECTION – skin protects deeper tissues from • has more sebaceous glands
mechanical damage (bumps), chemical damage • fewer sweat glands, sensory receptors than
(acids and bases), ultraviolet radiation (damaging thick skin
effects of sunlight), bacterial damage, thermal • contains 4 layers of the skin but stratum
damage (heat or cold), and desiccation (drying out) lucidum is absent while stratum corneum is
much thinner
TEMPERATURE REGULATION – skin aids in body
heat loss or heat retention as controlled by the
nervous system

ELIMINATION – skin aids in the secretion of urea

and uric acid through perspiration produced by the
sweat glands

SYNTHESIZE – synthesizes vitamin D through

modified cholesterol molecules in the skin by
sunlight

SENSATION – has sensory receptors that can

distinguish heat, cold, touch, pressure, and pain

ANATOMY OF THE INTEGUMENTARY SYSTEM

STRUCTURE OF THE SKIN

The skin is composed of two kinds of tissue: the

outer epidermis and the underlying dermis being
separated by basement membrane.

A. EPIDERMIS
✓ superficial layer of the skin
✓ contains no blood vessels or avascular
✓ thicker in areas of significant wear and tear
(hand palms and feet soles)
✓ keratinized stratified squamous epithelium
✓ deepest layer (stratum basale) contains
cells that divide
✓ cells undergo keratinization (keratinization
– cells become filled with keratin protein
which makes them more rigid and durable)
as they mature and are pushed toward
TYPES OF SKIN surface

THICK SKIN
• up to 6 mm thick on hand palms and feet soles
• also called as glabrous (hairless) skin
• covers hand palms and feet soles
• thick epidermis and a distinct stratum lucidum
• epidermal ridges are present due to well-
developed, numerous dermal papillae
• lacks sebaceous glands, has more sweat
glands
• sense receptors are more densely packed
ANATOMY AND PHYSIOLOGY (MC 1)
4 TYPES OF EPIDERMAL CELLS
KERATINOCYTES
• major epidermal cell type
• 90% of epidermal cells are keratinized
• contains keratin (fibrous protein)
• protects and waterproofs the skin
MELANOCYTES
• 8% of the epidermal cells
• melanin-producing cells; contributes to skin
color; absorbs UV light
• scattered between cells of stratum basale
• contain melanosomes, an organelle which
melanin pigment is synthesized
MERKEL CELLS
• least numerous of the epidermal cells
• found in the deepest layer of the epidermis
• associated with sensory nerve endings
LANGERHANS CELLS
• arise from red bone marrow and migrate to the
epidermis constitute small portion of
epidermal cells
• participate in immune responses
• easily damaged by UV light
SKIN APPEARANCES
o epidermis appears translucent when there is
little melanin or carotene
o WHITE SKIN appears pink to red depending on
amount and oxygen content of blood moving
in the capillaries of the dermis
o ALBINISM is an inherited trait where a person
can’t produce melanin; have melanocytes but
are unable to make tyrosinase (the enzyme
which initiates melanin production); melanin is
missing in their hair, eyes, and skin.
SKIN COLOR
o all people have about the same concentration
of melanocytes
o we differ in the amount and distribution of
melanin
o environmental (sun exposure) and
physiological factors, as well as GENES,
influence skin color
SKIN PIGMENTS
o three pigments that are responsible for skin
color: melanin, carotene, hemoglobin
MELANIN
• located mostly in epidermis
• number of melanocytes are about the same in
all races
• difference in skin color is due to the amount of
pigment that melanocytes produce and
disperse to keratinocytes
• freckles are caused by the accumulation of
melanin in patches
• liver spots are also caused by the
accumulation of melanin
• melanocytes synthesize melanin from an
amino acid called tyrosine along with an
• enzyme called tyrosinase. all this occurs in the
melanosome which is an
• organelle in the melanocyte
• two types of melanin: eumelanin is brownish
black and pheomelanin is reddish yellow
• fair-skinned people have more pheomelanin
and dark-skinned people have more eumelanin
CAROTENE
• carot = carrot
• yellow-orange pigment
• precursor for Vitamin A which is used to make
pigments needed for vision
• found in stratum corneum and fatty areas of
dermis and hypodermis layer
HEMOGLOBIN
• oxygen-carrying pigment in red blood cells
LAYERS OF EPIDERMIS
(in order, from deep to superficial)
STRATUM BASALE (STRATUM GERMINATIVUM)
• deepest layer of the epidermis
• where new cells are formed
• single row of cuboidal or columnar
keratinocytes
STRATUM SPINOSUM
• between the stratum basale layer and the
stratum granulosum layer
• 8-10 layers of keratinocytes
• provides skin strength and flexibility
• some cells retain their ability for cell division
STRATUM GRANULOSUM
• between the stratum spinosum layer and the
stratum lucidum layer
• layers of flattened keratinocytes producing
keratin
• 3-5 layers of flattened keratinocytes
undergoing apoptosis
• organelles begin to disintegrate becomes
nonliving cells; contains lamellar granules
ANATOMY AND PHYSIOLOGY (MC 1)
STRATUM LUCIDUM
• between the stratum granulosum and stratum
corneum
• present only in thick skin (ex.: palms and soles)
• 3-5 layers of clear, flat, dead keratinocytes
• dense packed intermediate filaments
• thick plasma membranes
STRATUM CORNEUM
• top layer of the epidermis
• 25-30 layers of dead flat keratinocytes
• shed continuously and replaced by cells from
the deeper strata
• serves as a water, microbe, injury barrier
B. DERMIS
✓ middle layer of the skin
✓ dermal blood vessels supply nutrients to
all skin cells; also help regulate body
temperature
✓ comprised of elastic connective tissue;
allows for skin to stretch
✓ contains blood vessels (vascular) and
nerves (innervated)
✓ location of accessory structures (sweat
glands, oil glands, and hair)
✓ site for palm prints and footprints
✓ receptive site for pigments of tattoos and
striae or stretch marks
2 LAYERS OF DERMIS
RETICULAR LAYER
• deeper portion of the dermis
• consist of dense irregular connective tissue
containing collagen/elastic fibers
• provides skin with strength and elasticity
• contains hair follicles, nerves, sebaceous and
sudoriferous glands
PAPILLARY LAYER
• superficial portion of the dermis
• consist of areolar connective tissue containing
elastic fiber
• surface area is increased due to projections
called dermal papillae which contains
capillaries or tactile receptors
• epidermal ridges conform to the dermal
papillae
DERMAL PAPILLAE
✓ extensions of dermis into epidermal layer
✓ form fingerprints
C. SUBCUTANEOUS LAYER / HYPODERMIS
✓ “hypodermis” (Greek) = below the skin
✓ “subcutaneous” (Latin) = below the skin
✓ also called “superficial fascia”
o “fascia” (Latin) = band; in anatomy:
sheet of connective tissue
✓ not part of the skin – lies below the dermis
✓ connects skin to surface muscles
✓ consists of loose connective tissue and fat
(adipose) tissue
✓ derived from epidermis but extend into
dermis
✓ include hair and hair follicles, sebaceous
(oil) glands, sweat (sudoriferous) glands,
nails
FUNCTION OF HYPODERMIS
o lies beneath the dermis; consists of loose
connective and adipose tissues
o adipose tissue helps conserve body heat
o subcutaneous layer contains blood vessels that
supply the skin and adipose tissue
o fatty tissue which stores fat and anchors skin
(areolar tissue and adipose cells)
HYPODERMIS ACCUMULATION
MALES – subcutaneous fat accumulates primarily
in the neck, arms, and lower back, above the
buttocks, and in the abdominal region (the paunch)
FEMALES - evenly distributed; have
proportionately more body fat; subcutaneous and
layers are generally thicker; tend to have softer
skin than do men; subcutaneous fat is especially
prone to accumulate in the breasts, buttocks, hips,
and thighs
BABIES AND YOUNG CHILDREN – have extensive
deposits of “baby fat” in the hypodermis; provides
ANATOMY AND PHYSIOLOGY (MC 1)
additional insulation against heat loss; important
because the smaller a warm-blooded animal is the
faster it tends to lose body heat across its skin
surface; children grow larger and become less
vulnerable to heat loss, these fat layers become
thinner
ACCESSORY STRUCTURES OF THE SKIN
1. SEBACEOUS (OIL) GLANDS
✓ associated with hair follicles
✓ oily secretion (sebum); lubricates skin and
coats hair; prevents drying; believed that
bacterial lipases break down; triglycerides
of sebum into irritative fatty acids that
cause acne
✓ ducts open into hair follicles
✓ meibomian glands
o modified sebaceous glands; lubricate
eyes
✓ helps keep skin and hair soft and
waterproof (holocrine secretions)
✓ found everywhere except palms and soles
2. SUDORIFEROUS (SWEAT) GLANDS
✓ cool the body via evaporation
✓ each sweat gland is a coiled tube
✓ sweat is mostly water (plus some salts
and waste products)
✓ entire skin surface except nipples and part
of external genitalia
✓ prevent overheating
TWO MAIN TYPES OF SWEAT GLANDS
ECCRINE SWEAT GLANDS
o secretes cooling sweat o secretes directly onto
the skin
o began to function soon after birth o sweat is
composed of 98% water and two percent
dissolved salts and nitrogenous wastes, such
as urea and uric acid
o helps regulate body temperature/aids in waste
removal
APOCRINE SWEAT GLANDS
o stimulated during emotional stress/excitement
o secretes into hair follicle
o begins to function at puberty
o slightly more viscous than eccrine secretions
o composed of the same components as eccrine
sweat plus o lipids and proteins
o referred to as “cold sweat”
MODIFIED APOCRINE SWEAT GLANDS
CERUMINOUS GLANDS – ear canal; produce
cerumen or ear wax
CILIARY GLANDS - eyelids
MAMMARY GLANDS – produce milk (breasts)
3. HAIR
✓ composed mainly of “hard keratin” (as
opposed to “soft keratin” in the epidermal
cells)
✓ almost every part of body is covered with
hair except palms of hands, soles of feet,
sides of fingers and toes, lips, and parts of
genitals
ANATOMY OF HAIR FOLLICLE
SHAFT: portion of hair that projects from skin
surface; straight hair has a round shaft while curly
hair has oval shaft
ROOT: portion of hair deep to the shaft penetrating
the dermis
FOLLICLE: sheath of epithelial and connective
tissue that surrounds the hair
3 CONCENTRIC LAYERS
MEDULLA: contains pigment granules and air
spaces
CORTEX: middle layer; in dark hair contains
pigment; in gray or white hair contains air bubbles
CUTICLE: outer layer; heavily keratinized cells that
lie like shingles
BASE OF THE HAIR FOLLICLE
BULB – houses papilla that contains the blood
vessels that nourishes the growing hair follicle
MATRIX – responsible for hair growth and
produces new hair
ARRECTOR PILI SMOOTH MUSCLE – extends from
the dermis to the side of hair follicle; hair grows at
an angle to the surface of the skin; contracts and
pulls hair straight causing goose bumps
HAIR ROOT PLEXUS - dendrites of neurons which
are sensitive to touch
THREE PHASES IN LIFE CYCLE OF EACH HAIR
ANAGEN (GROWTH PHASE) – the period of active
growth (0.04 cm per day); can vary from 2 to 6
years
CATAGEN (TRANSITIONAL PHASE) – the period of
involution (degeneration) when the lower part of
the follicle below the arrector pili muscle
atrophies
TELOGEN (RESTING PHASE) – the resting period
between the end of follicular atrophy and the
shedding of the hair
ANATOMY AND PHYSIOLOGY (MC 1)
FUNCTIONS OF THE HAIR
• hair on the head protects scalp from injury and
sunlight
• eyelashes and eyebrows protect eyes
• nostril and ear hairs protect from foreign
particles
• help in sensing light touch due to the touch
receptors associated with the hair root
plexuses
HAIR COLOR
o Hair color is due to amount and type of melanin
in the keratinized cells.
o Melanocytes in the matrix of the bulb
synthesizes melanin.
o Melanin passes into the cortex and medulla of
the hair.
o Dark hair contains true melanin
o Blond and red hair have variants of
melanin in which there is iron/sulfur
o Gray hair results from a decline in
tyrosinase (enzyme which initiates
melanin production)
o White hair results from the accumulation
of air bubbles in the medullary shaft
4. NAIL
• made of tightly packed, hard, keratinized
epidermal cells
• protective covers on ends of fingers and
toes
• consist of nail body, nail plate, free edge,
nail root, lunula, hyponychium, and
eponychium or cuticle, nail matrix
ANATOMY OF THE NAIL
NAIL BODY: portion of the nail that is visible
NAIL PLATE: comprised of stratum basale and
stratum spinosum
NAIL MATRIX: area where fingernails and toenails
start to grow
NAIL ROOT: portion buried in a fold of skin
FREE / DISTAL EDGE: part that extends past the
distal end of the digit
LUNULA: means little moon; crescent shaped area
of the nail
HYPONYCHIUM: secures the nail to the fingertip;
thickened stratum corneum
EPONYCHIUM (CUTICLE): narrow band of epidermis
FUNCTIONS OF THE NAIL
▪ grasping objects, manipulating objects,
protects ends of digits from trauma, scratching
CONDITIONS AND DISORDERS HAPPENED IN
INTEGUMENTARY SYSTEM
SKIN DISCOLORATION (as diagnostic clues for
medical conditions)
CYANOSIS – cyan means blue; bluish color to the
skin caused by decreased blood O2 content
JAUNDICE – jaund means yellow; yellowish skin
color caused by liver damage (viral hepatitis);
buildup of bilirubin (yellow pigment) in the blood
ALBINISM – lack of melanin production due to
genetic mutation
ERYTHEMA - ery means red; engorgement of
capillaries in the dermis indicating skin injury,
infection, heat exposure, inflammation, allergies,
emotional state, hypertension
PALLOR - paleness, emotional state, anemia, low
blood pressure
BRONZING - Addison’s disease, adrenal cortex
BRUISING (HEMATOMA)- escaped blood has
clotted hematomas, deficiency in Vitamin C or
hemophilia
LEATHERY SKIN - overexposure clumping of
elastin fibers depressed immune system; can alter
DNA to cause skin cancer
PHOTOSENSITIVITY - to antibiotics &
antihistamines
MOST COMMON SKIN DISEASES
CONTACT DERMATITIS – inflammation of the skin;
due to irritants such as oil of poison oak or poison
ivy, detergents, acids, etc.
2 KINDS OF CONTACT DERMATITIS
IRRITANT DERMATITIS – most common type;
caused by contact with acids, alkaline materials
such as soaps and detergents, fabric softeners,
solvents, or other chemicals
ALLERGIC CONTACT DERMATITIS – caused by
exposure to a substance or material to which can
have become extra sensitive or allergic
PSORIASIS
▪ chronic, non-infectious skin disease; seems to
be a genetic component
▪ faster than normal renewal of cells resulting in
accumulation of cells in the stratum corneum
▪ skin becomes dry and scaly, often with
pustules and many varieties
▪ produces red (erythematous), flat areas
(plaques) covered with silvery scales
▪ often triggered by trauma, infection, hormonal
changes or stress
▪ unknown etiology or cause
ANATOMY AND PHYSIOLOGY (MC 1)

VITILIGO – auto-immune pigmentation disorder HAIR DISEASES

where melanocytes in the epidermis are destroyed
DANDRUFF – causes white or yellow flakes on
ACNE – disorder of the sebaceous glands; your scalp and hair shaft. It’s also known as
produces blackheads, whiteheads, pimples seborrheic dermatitis

ATHLETE’S FOOT – fungal infection; usually affects HEAD LICE – tiny, crawling insects that live in a
skin of the toes and soles person’s head hair

PEDICULOSIS – lice infestation HIRSUTISM – excessive hair growth in people

assigned female at birth
SCABIES – mite infestation
NAIL DISORDERS AND DISEASES
WARTS (VERRUCA) – small tumors; raised area
caused by viruses of the human papillomavirus ONYCHOMYCOSIS – nail fungus in your fingernails
(HPV) family or toenails

SHINGLES – caused by herpes zoster virus (same ONYCHOLYSIS – nail separates from nail bed
virus as chicken pox); causes very painful rash;
LICHEN PLANUS – rash that appears as ridges or
accompanied by feeling very tired and run down
grooves on nail
HAIR DISORDERS PARONYCHIA – inflammation or infection of the
tissue directly surrounding your nail
HAIR LOSS – most common condition that affects
your hair; some types of hair loss are temporary,
SKIN BURNS AND SKIN CANCER
while others are permanent
BURNS - too much sunlight or heat; categorized by
PERSISTENT PATCHY ALOPECIA AREATA – patchy
degree of penetration of skin layer
hair loss continues but does not improve or
worsen over time, it’s characterized as persistent 4 CLASSIFICATIONS OF BURNS
patchy alopecia areata; caused by the same factors
that lead to alopecia areata FIRST-DEGREE (SUPERFICIAL) BURNS. First-
degree burns affect only the outer layer of skin,
ALOPECIA AREATA – patches of hair loss caused the epidermis. The burn site is red, painful, dry, and
by an auto-immune disease has no blisters. Long-term tissue damage is rare
and often consists of an increase or decrease in
ALOPECIA TOTALIS – entire scalp experiences hair
the skin color.
loss; appears to be related to an unusual immune
system response; researchers are still trying to SECOND-DEGREE (PARTIAL THICKNESS) BURNS.
discover the exact causes of alopecia totalis Second-degree burns involve the epidermis and
part of the lower layer of skin, the dermis. The
ALOPECIA UNIVERSALIS – a condition that
burn site looks red, blistered, and may be swollen
involves complete hair loss; includes the scalp and
and painful.
the rest of the body; like other autoimmune
diseases, it’s unclear why some people develop THIRD-DEGREE (FULL THICKNESS) BURNS. Third-
this condition and others don’t degree burns destroy the epidermis and dermis.
They may go into the innermost layer of skin, the
ANDROGENIC ALOPECIA – baldness in both
subcutaneous tissue. The burn site may look white
genders/sexes that’s based on genetics
or blackened and charred.
TRAUMATIC ALOPECIA – hair loss due to damage
FOURTH-DEGREE BURNS. Fourth-degree burns go
to scalp from hair styling, through rubbing scalp
through both layers of the skin and underlying
repeatedly against a surface or hat or by playing
tissue as well as deeper tissue, possibly involving
with and breaking hair
muscle and bone. There is no feeling in the area
ANAGEN EFFLUVIUM – loss of hair during its since the nerve endings are destroyed.
growth phase; this often occurs during medical
RULE OF NINE FOR ADULTS AND CHILDREN
treatments like chemotherapy.
RULE OF NINE’S – measures the percent of the
TELOGEN EFFLUVIUM (DIFFUSE ALOPECIA
body burned
AREATA) – loss of hair during its rest phase;
RULE OF NINE FOR ADULTS
typically shows up a few months after your body
goes through something stressful or from
hormonal changes

OPHIASIS ALOPECIA – a form of alopecia areata

that mostly affects the sides and back of the scalp;
an autoimmune disorder mainly affects young
people
ANATOMY AND PHYSIOLOGY (MC 1)

RULE OF NINE FOR CHILDREN

SKIN CANCER

BASAL CELL CARCINOMA

▪ least malignant
▪ most common of all skin cancers
▪ stratum basale can’t form keratin
▪ lose boundary layer between epidermis and
dermis
▪ results in tissue erosion and ulceration
▪ 99% of these cancers are fully cured

SQUAMOUS CELL CARCINOMA

▪ 20% of all skin cancers
▪ cancer of the cells in stratum spinosum
▪ arise from squamous cells of the epidermis
▪ usually induced by sun
▪ cells grow rapidly and grow into the lymphatic
tissues
▪ hardened small red growth
▪ spreads rapidly if not removed
▪ good chance of recovery if detected and
treated early

MALIGNANT MELANOMA
▪ cancer of pigment cells = melanocytes
▪ rare ~1% of skin cancers
▪ deadly, poor chance of cure once it develops
▪ often begins with moles
▪ spreads rapidly
▪ early detection and treatment is the key to
survival