Chapter 5

Integumentary
System

Shaft of a hair protruding through the skin

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
Fig. 5.1
Tab. 5.1
 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
• Keratinocytes
– Most abundant cell type
– Produce the fibrous protein keratin
– Gives skin its protective properties
• Melanocytes
– Produce the brown pigment melanin
– Found in the deepest layers of the epidermis
• Langerhans’ cells
– Epidermal macrophages
– Help activate the immune system
• Merkel cells
– Touch receptors in association with sensory nerve endings
 Layers of the Epidermis
• Stratum Basale (Basal Layer)
– 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
 Layers of the Epidermis
• 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
• 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
 Layers of the Epidermis
• 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
Fig. 5.2b
Fig. 5.3
 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
Fig. 5.4
 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 elastic
fibers
– Its superior surface contains peg-like projections
called dermal papillae
• Genetically determined
• Responsible for fingerprints and footprints (films of sweat)
– Contains blood vessels that supply the overlying
epidermis
• With nutrients
• Remove waste products
• Aid in regulating body temperature
 Layers of the Dermis
• 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
 Layers of the Dermis
• Reticular layer
– Elastin and collagen
fibers are oriented
more in one direction
than in others and
produce cleavage, or
tension, lines

Fig. 5.5
 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
 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”
Fig. 5.6
 Sebaceous Glands
• Simple or compound alveolar glands found
all over the body except on the palms and
soles
• Soften skin when stimulated by hormones
• Secrete an oily secretion called sebum
• Acne is an active inflammation of the
sebaceous glands.
 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
Fig. 5.7
 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
Fig. 5.8
 Integumentary System Functions
• Protection • Sensation
– Skin – Skin contains sensory
• Protects against abrasion and receptors for
UV light • heat
• Prevents the entry of • cold
microorganisms • touch
• Helps regulate body • pressure
temperature
• pain
• Prevents water loss
– Hair
• Protects against abrasion and
UV light
• Acts as a heat insulator
– Nails protect the ends of
the digits
 Integumentary System Functions
• Temperature
Regulation
– Skin
• Controls heat loss from the
body by dilation and
constriction of blood
vessels
– Sweat glands
• Produce sweat, which
evaporates and lowers
body temperature
• Vitamin D Production
• UV light stimulates the
production of a precursor
molecule in the skin that is
modified by the liver and
kidneys into vitamin D
• Vitamin D increases calcium
uptake in the intestines
• Excretion
• Skin glands remove small
amounts of waste products
but are not important in
excretion
Fig. 5.9
 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
 Melanoma
• 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
 Burns
• First-degree: only the epidermis is damaged
– Symptoms include localized redness, swelling, and
pain
• Second-degree: epidermis and upper regions of
dermis are damaged
– Symptoms mimic first degree burns, but blisters also
appear
• 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
– There are third-degree
burns on face, hands,
or feet
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115
 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
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