2nd SEMESTER - YEAR 1
NCM 101: HEALTH ASSESSMENT
LECTURE NOTES | MR. PORNIA
INTEGUMENTARY SYSTEM
 Pertaining to or composed of skin
 Largest organ of the body and together with its
accessory organs (hair, glands and nails)
 The average human body is covered with about
2 square meters (22 square feet &
 weigh about 6 pounds (2.7 kilograms)
 skin, hair, glands, nails
PHYSIOLOGY OF THE SKIN
PROTECTION OF THE BODY
 The skin is a barrier to microorganism, water
and excessive sunlight
 Against abrasion and UV light
 Prevents entry of microorganisms
 Prevents dehydration
REGULATION OF BODY FLUIDS AND
TEMPERATURE
A. Fluid loss
TEMPERATURE REGULATION
 the skin plays a crucial role in regulating body
temperature.
CUTANEOUS ABSORPTION
 absorption through the skin is limited because
some gases such as oxygen and carbon
 dioxide may pass through the skin and enter the
blood but harmful chemicals such as
 pesticides can easily enter the body through the
skin.
SYNTHESIS
 the integumentary system synthesizes melanin
and keratin, which remain in the skin.
 synthesize vitamin D in the presence of UV light
SENSORY RECEPTORS
 highly specialized sensory receptors that
respond to heat, cold, pressure, touch,vibration
and pain
 located through out the dermis and it is called
cutaneous receptors as a general
 the thinner the skin, the greater the sensitivity
KERATIN
 Is a protein found on the deepest layer of the
epidermis which are dead cells
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 It toughens and waterproofs the skin, is formed
in a process called keratinization
CORNIFICATION
 Is the flattening and drying of the outer
stratum corneum of the epidermis
 important protective adaptation of the skin.
COLORATION OF THE SKIN
NORMAL SKIN COLOR IS OF THREE PIGMENTS:
A. MELANIN
 -Is a brown-black pigment formed in cells called
melanocytes
 Melanocytes is found throughout the stratum
basale and stratum spinosum
B. CAROTENE
 is a yellowish pigment found in the epidermal
cells fatty parts of the dermis
 It is abundant in skin of people of Asian descent.
 Together with melanin, carotene accounts for
there yellow tan skin.
C. HEMOGLOBIN
 Is not a pigment of the skin, but rather the
oxygen-binding
 Pigment found in red blood cells.
 Oxygenated blood flowing through the dermis
gives the skin a pinkish tone.
The color of a person’s skin may be indicative of
certain conditions or disease.
CYANOSIS
 is a bluish hue of the skin symptomatic of
certain cardiovascular or respiratory disease
JAUNDICE
 the skin becomes yellowish because of excess
bile pigment in the blood.
 *Jaundice is usually caused by liver
abnormalities
SKIN ACCESSORIES
A. HAIR
 -is found everywhere in the body, but only the
scalp, face, pubic hair and underarms are densely
haired.
 Its primary function is protection against
sunlight, airborne particles and mechanical injury.
 INTEGUMENTARY SYSTEM
 secondary function: is to distinguished
individuals and to serve as a sexual attractant.
HUMANS HAVE THREE DISTINCT KINDS OF HAIR.
1. LANUGO
- is a fine, silky fetal hair that appears during the
last trimester of development. It is usually seen
only on premature babies.
2. ANGORA
- it grows continuously. It is found on the scalp
and on the faces of mature males.
3. DEFINITIVE
- it grows to a certain length and then stops. It is
the most common type of hair
- Eyelashes, eyebrows, and pubic and axillary hair
are examples.
B. NAILS
 The nails of the ends of the fingers and toes are
formed from the compress outer layer (stratum
corneum) of the epidermis.
 Both fingernails and toe nails protect the digits,
and fingernails also aid in grasping and picking up
small objects.
 Nail should appear pinkish, showing the rich
vascular capillaries beneath the nails.
 A yellowish hue may indicate glandular
dysfunctions or nutritional deficiencies.
 A bluish tint may indicate low blood oxygen
levels
 the tympanic membrane from drying out.
SKIN
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
EPIDERMIS
• Composed of keratinized stratified squamous
epithelium, consisting of four distinct cell types and
four or five layers
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 spoon nails (a concave nail body) may be the
results of iron -deficiency anemia.
C. GLANDS
THE GLANDS OF THE SKIN ARE OF THREE BASIC
TYPES:
A. SEBACEOUS GLAND OR OIL GLAND
 branched glands attached to a follicle.
 It secrets a lipid mixture called sebum onto the
shaft of the hair to the surface of the skin thus it
lubricates and waterproofs the skin and prevents
the hair from becoming brittle.
B. SUDORIFEROUS GLANDS OR SWEAT GLANDS
 it excretes perspiration, sweat onto the surface
of the skin.
 Perspiration is composed of water, salts, and
uric acids.
Sweat glands have two types:
1. ECCRINE SWEAT GLANDS
are widely distributed all over the body especially
on the forehead, back, palm, and soles.
2. APOCRINE SWEAT GLANDS
are found in the axillary and pubic regions and
secrets into hair follicles.
MAMMARY GLANDS - found within the breasts. It
secrets milk during lactation.
C. CERUMINOUS GLAND
 are found only in the external auditory canal,
where they secrets cerumin, or earwax.
 Cerumin is an insect repellent and also keeps
• 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 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
 INTEGUMENTARY SYSTEM
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 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
• 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
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– Elastin fibers provide stretch-recoil properties
– Striae (stretch marks) are caused when skin is
overstretched, the dermis ruptures and leaves
visible 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
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
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