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MODULE 2
Integumentary and Skeletal Systems

INTEGUMENTARY SYSTEM

Skin
- cutaneous membrane
- covers the entire surface of the body

Blood Supply of the Skin

- arteries in the superficial fascia just beneath the dermis
- branches: inward to supply the adipose tissue; outward to supply the
dermis of the overlying skin including the remaining portions of the hair
follicles, sweat glands and sebaceous glands

Nerve Supply
- nerve that carry impulses from the skin to the central nervous system
keep the brain (afferent nerves) informed of the
a. environmental temperature
b. objects touching the skin
c. threat in the surroundings that could harm the body
- efferent nerves carry impulses from the CNS to the skin

Functions of the Skin

1. protection from:
a. mechanical damage
b. chemical damage
c. bacterial damage
d. UV radiation
e. thermal damage
f. dessication

2. aids in body heat loss or heat retention

3. aids in excretion of urea and uric acid
4. synthesizes vitamin D

Appendages of the Skin

A. cutaneous glands
1. sebaceous glands
- pear-shaped, widely distributed in the skin except on the palms and soles
- may grow and then pour their secretory product called sebum; into the
neck of the follicle
- may grow in areas in which no hair follicles are present, such as in the
eyelids, where the Meibomian glands are found
- sebum oils the hair and serves as a sort of cold cream on the surface of
the skin

2. sweat glands
- each consists of a:
a. secretory portion – located in the superficial fascia, immediately
beneath the dermis
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b. excretory duct – that spirals through the dermis and epidermis to

open through a pore on the surface of the skin
- numerous in the axillae, forehead, palms and sole
- reflex emergency mechanism in the regulation of body temperature by the
evaporation of water from its surface when it is necessary for the body to
lose heat

3. ceruminous glands
- modified sweat glands and the combined secretion of the sebaceous and
ceruminous glands is called cerumen which lubricate the surface of the
canal and the drum membrane

B. Hair Follicles
- begin to develop early in the third month of intrauterine life as outgrowths
of the epidermis into the dermis and later into the superficial fascia
- 5th to 6th month of intrauterine development the body is covered with
delicate hairs called lanugo which shed before birth, except those in the
eyebrows, eyelids and scalp
- at birth, sheds and replaced
- at puberty, coarse hairs will develop in characteristic areas in male and
female
- shaft is pigmented and projects beyond the surface of the skin
- root is covered by the follicle
- if hair is straight, follicle is unbent, shaft is cylindrical
- if hair is curly, follicle is bent, shaft is flattened
- straight or curly depending on the difference of curvature of the follicle
and form of hair

C. Nails
- epidermis begin to invade the dermis
- nail bed > underlying the nail, consists of the deeper layer of the
epidermis and dermis

Layers of the Skin

A. epidermis
- composed of :
a. basale
- innermost; contains epidermal cell
- receive adequate nourishment via diffusion of nutrients from
the dermis
- constantly undergoing cell division and millions of new cells
are produced daily
- also known as germinativum
b. spinosum
c. granulosum
d. lucidum
e. corneum
- avascular
- cells are made up of keratinocytes producing keratin
- melanin is a pigment , yellow to brown to black; produced by
melanocytes; sunlight stimulates the melanocytes to produce melanin
- melanin protects the skin by:
➢ stratum basale cells
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➢ phagocytosis of the pigment

➢ accumulation of the pigment
➢ melanin forms a protective pigment “umbrella” over the superficial
or “sunny” side of their nuclei that shields their genetic material
(DNA) from the damaging effects of the UV radiation in sunlight
B. Dermis
- strong, stretchy envelope that helps to hold the body together
- composed:
a. papillary layer
- has dermal papillae or fingerlike projections which provide
nutrients to the epidermis and pain receptors (Meissner’s
Corpuscles)
b. reticulum layer
- have blood vessels, sweat and oil glands and pressure
(Pacinian Corpuscles)
- many phagocytes found
- collagen fibers responsible for the toughness of the dermis
which attract and bind water and help to hydrate the skin
- elastic fibers gives the skin its elasticity when young
- aging decreases collagen and elastic fibers; decrease
subcutaneous tissue fat
- supplied with blood vessels that maintain body temperature
homeostasis

SKELETAL SYSTEM

Functions of the Bone

1. contributes to the shape of the body
2. supports and provides protection for softer tissues
3. provides surfaces for the attachment of muscles, tendons, ligaments
4. protective areas for delicate organs
5. levers by means of which movement of the body are performed
6. production of blood cells

Bone Development
- ossification >>>>>three layers of tissue

middle layer is involved in bone formation

the middle layer consists of a fibrous membrane, composed of fine bundles of

collagenous fibers that have been produced by fibroblast

in the center of a membranous area, the forerunner of a cranial bone that is to be

formed, the versatile fibroblasts differentiate into bone=forming cells known as
osteoblast
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produce intercellular substances and calcification begins

center of ossification

osteoblastic activity takes place all around the sides and the free ends of the first
bone that appears and then the bone forms in radiating spicules from the center of
ossification

the osteoblast that become trapped in the calcified matrix retire from active
synthetic duty and become osteocytes

bone continues to be formed at all surfaces of the spicules until the entire membrane
has been transformed into bone

Classification of Bones
1. spongy
- small needlelike pieces of bone and lots of open space
2. compact
- dense, looks smooth and homogenous

Descriptive Terms
A. Projections
1. condyle
- rounded projection for articulation with another bone
- lower end of the femur where it articulates with the tibia

2. crest
- ridge
- flaring upper border of the hip bone or ilium

3. head
- expanded end beyond a constricted portion called a neck
- head of the femur at the end of the neck of the bone

4. process
- marked prominence
- olecranon process of the vertebrae

5. spine
- sharp projection
- spine of the vertebrae
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6. trochanter
- very large process
- used to identify two large projections neat the upper end of
the femur

7. tubercle
- small rounded projection
- deltoid tubercle of the humerus

8. tuberosity
- large, roughened projection
- ischium of the hip bone, these bear the weight of the body in
the sitting position

B. Depressions
1. foramen
- hole in a bone
- large foramen or foramen magnum in the occipital bone
through which the spinal cord passes

2. fossa
- shallow or hollow depression on a bone
- mandibular fossa of the temporal bone; supraspinous fossa of
the scapula

3. groove
- long,shallow depression on a bone

4. sinus
- air cavity in a bone
- maxillary sinuses

5. meatus
- tube-shaped opening in a bone
- external auditory meatus or canal which leads to the
tympanic membrane

Divisions of the Skeletal System

I. Axial
- total of 80 bones

A. skull 29 bones cranial 8

face 14
small bones 6
hyoid 1
Bone of the Skull
- formed by two sets of bones
- cranium encloses and protects the brain
- facial bones hold the eyes in an anterior position and allow the facial
muscles to show our feelings through smiles or frowns
- joined by sutures
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- fontanelles > incomplete intramembranous ossification of the cranial

bones
anterior closes at 18 months
posterior closes at 1 month

1. cranium
a. frontal
- forehead, bony projections of the skull at the sagittal suture
and form the coronal suture where they meet the frontal bone

b. parietal
- superior and lateral walls of the cranium
- meet in the midline of the skull at the sagittal suture and
form the coronal suture where they meet the frontal bone

c. temporal
- lies inferior to the parietal bone
- join them at the squamous sutures
aa. external auditory meatus
- canal that leads to the eardrum

bb. styloid process

- sharp, neddlelike projection
- inferior to the external auditory meatus
- attachment point of may neck muscles

cc. zygomatic process

- thin bridge of bone that joins with the
cheekbone anteriorly

dd. mastoid process

- rough projection posterior and inferior to the
external auditory meatus
- full of air cavities

ee. jugular foramen

- junction of the occipital and temporal bones
- allows passage of the large jugular vein which
drain the brain

ff. carotid canal

- anterior to the jugular forearm
- allows passage of internal carotid artery
- supplies blood to most of the brain

d. occipital
- most posterior bone of the cranium
- forms the floor and back wall of the skull
aa. foramen magnum
- base, large hole
- surrounds the lower part of the brain and
allows the spinal cord to connect with the brain
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bb. occipital condyles

- rest on the first vertebra of the spinal column

e. sphenoid bone
- butterfly-shaped sphenoid bone
- spans the width of the skull and forms part of the floor of the
cranial cavity

aa. sella turcica

- small depression in the midline of the sphenoid
- holds the pituitary gland in place

bb. foramen ovale

- large oval opening in line with the posterior
end of the sella turcica
- allows fibers of cranial nerve V to pass to the
chewing muscles of the lower jaw

cc. sphenoid sinuses

- central part of the sphenoid bone
- air cavities

f. ethmoid bone
- very irregularly-shaped
- lies anterior to the sphenoid
- forms the roof of the nasal cavity and part of the medial walls
of the orbits

aa. crista galli

- projects superior to the ethmoid
- cock’s comb”

bb. cribriform plates

- small holes that allow nerve fibers carrying
impulses from the olfactory receptors

2. Facial Bones
- 14 bones 12 paired
vomer and mandible single

a. maxillae
- fuse to form the upper jaw
aa. palatine processes
-extension of the maxillae
- form the anterior part of the hard palate
of the mouth

bb. paranasal sinuses

- drain into the nasal passages

b. palatine bones
- posterior to the palatine processes of the maxillae
- form the posterior part of the hard palate
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- cleft palate > failure of the palatine bones and

processes to fuse

c. zygomatic bones
- cheekbones

d. lacrimal bones
- fingernail-size bones forming part of the medial walls
of each orbit

e. nasal bones
- bridge of the noses

f. vomer bone
- nasal septum

g. inferior conchae
- thin, curved bones projecting from the lateral walls of
the nasal cavity

h. mandible
- lower jaw
- longest and strongest bone of the face
- only movable joint in the face

3. hyoid bone
- the only bone of the body that does not articulate directly
with any other bone
- suspended in the midneck region about 2 cms above the
larynx
- movable base for the tongue and attachment point for neck
muscles that raise and lower the larynx when we swallow and
speak

B. Vertebral Column
- backbone
- 26 bones – 24 vertebrae, sacrum, coccyx

1. cervical 7
atlas – has no body; the superior surfaces of its transverse
processes contain large depressions that receive the
occipital condyles of the skull
- this joint allows you to nod “yes”

axis – acts as a pivot for the rotation of the atlas (and skull)
above
2. thoracic 12
3. lumbar 5
4. sacral 5 fused into 1
5. coccyx 1
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Features of a Vertebrae
1. body or centrum
- disklike, weight-bearing part of the vertebra facing anteriorly
in the vertebral column

2. vertebral arch
- arch formed from the joining of all posterior extensions; the
laminae and pedicles from the vertebral body

3. vertebral foramen
- canal through which the spinal cord passes

4. transverse processes
- two lateral projections from the vertebral arch

5. spinous process
- single projection arising from the vertebral arch

6. superior and inferior articular processes

- paired projections lateral to the vertebral foramen allowing a
vertebra to form joints with adjacent vertebra

C. Bones of the Thorax

1. ribs
- 12 pairs
- true ribs are the first 7 ribs
- false ribs are the remaining 5 pairs; 8th, 9th,10th pairs have
cartilages which attach to the cartilage superiorly
- last two pairs are unattached anteriorly known as free or
floating ribs

2. intercostals spaces
- spaces between the ribs
- filled with muscles

3. sternum
- breast bone
- lies anteriorly in the middle of the thorax
- 15 cms long made up of manubrium, body and xyphoid
process
- covered with muscles and skin
- protects and supports the heart and other mediastinal
structures and the lungs
- support the bones of the shoulder girdle
- erythrocytes of red blood cells can be formed in the red bone
marrow of the ribs and the sternum

II. Appendicular

A. Pelvic Girdle
- hip bone or os coxae
- old name is inominate bone
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- broadest bone of the body

- large, heavy, attached securely to the axial skeleton
- sockets > receive the thigh bone
- where the total weight of the body rests
- protects the reproductive organs, urinary bladder and part of the
large intestine

Parts of the Pelvic Girdle

1. ilium
- largest of the 3 bones of the pelvic girdle
- forms the superior, broad expanded portion or prominence
- connects posteriorly to the sacrum at the sacroiliac joint
- when you put your hands on your hips
- iliac crest > the upper edge of the alae or winglike projection of the
alae
- important landmark in injections

2. ischium
- lowest and strongest portion
- ischial tuberosity > roughened areas that receives body weight
when you are sitting
- ischial spine > superior to the tuberosity; important for pregnant
women because it narrows the outlet of the pelvis through which the
baby must pass

3. pubis
- the body unites with its fellow in the midline in front to form a joint
known as symphysis pubis; most anterior

4. pelvis
- lowest portion of the ventral cavity
- bounded by the pelvic girdle; made up of hip bones: sacrum and
coccyx; and strong ligaments
- provides large surfaces for the attachments of the muscle of the
lower extremities

5. acetabulum
- receives the head of the femur

Functions of the Pelvic Girdle:

1. protects the urinary bladder, organs of reproduction, distal end of the large
intestine
2. firm base by means of which the trunk can rest upon the thigh

Important Differences in the Pelvis Between the Two Sexes

1. In women, the pelvis is adapted for pregnancy and parturition (delivery or birth
of children)
2. The pelvic bones in women are lighter and thinner.
3. The coccyx is more movable.
4. The female ilia flare more laterally.
5. Sacrum is shorter and less curved.
6. Ischial spines are shorter and farther apart.
7. More rounded pubic arch because of a greater angle
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Two Regions of the Bony Pelvis

1. False Pelvis
- superior to the true pelvis
- area medial to the flaring portions of the ilia

2. True Pelvis
- surrounded by bone and lies inferior to the flaring portions of the ilia and
the pelvic bone
- dimensions are important because they must be large enough to allow the
infant’s head to pass during childbirth
- dimensions of the cavity, particularly the outlet (the inferior opening of the
pelvis) and the inlet (the superior opening of the pelvis) are crucial because
they are measured by the obstetrician

Greater Sciatic Notch

- allows blood vessels and the large sciatic nerve to pass from the pelvis
posteriorly into the thigh
- injections away from this area

Bones of the Lower Extremities

Bones of the Thigh
1. femur
- bones of the thigh
- heaviest, longest, strongest bone in the body
- covered thickly with muscles so that you can feel it near its end
- common fracture site in old age is the neck of the femur

2. patella
- knee cap
- prominence in front of the knee when the leg is extended
- largest sesamoid bone in the body
- ligament attaches to the tibial tuberosity

Bones of the Leg

1. tibia
- shin bone
- medial and larger bone of the leg
a. tibial tuberosity
b. medial malleolus
- a process that form the inner bulge of the ankle
c. anterior crest
- anterior to the tibia, sharp-ridge; unprotected by muscles so early
felt beneath the skin
2. fibula
- long, slender bone on the lateral side of the leg
- no part is forming the knee joint; distal end is the late lateral malleolus
forming the outer part of the ankle

Bones of the Foot

1. tarsal – 7
2. metatarsal – 5
3. phalanges – 14
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Bones of the Upper Extremities

1. Shoulder Girdle
- pectoral girdle
a. clavicle
- collar bone; attaches to the manubrium of the sternum medially and
to the scapula laterally
b. scapula
- shoulder girdle
c. humerus
- arm, longest and largest bone of the upper extremities; shoulder to
elbow

2. forearm
a. ulna
- medial side of the forearm
b. radius
- lateral or thumb side

3. hand
a. carpal bones
proximal row (lateral to medial)
scaphoid
lunate
triquetral
pisiform

distal row
trapezium (greater multangular)
trapezoid (lesser multangular)
capitate
hamate

b. metacarpals
- bony structure of the palm
- long, cylindrical, rounded distal ends – knuckles

c. phalanges
- bones of the fingers
- thumb 2
- finger 3
proximal
middle
distal

PRACTICAL CONSIDERATIONS
Composition of Bone
- matrix is impregnated with calcium salts
- fresh bone is composed of water and solid materials both organic and
inorganic
- calcium phosphate is the chief inorganic constituent
- collagen is the chief organic constituent
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Healing of Fractures
- fragments of bones must be placed in the proper position known as
reduction of bone

damage to soft tissues

all the blood vessels that cross the line of fracture are torn

death of all tissues which are deprived of their blood supply

callus formation ( connecting link between the fragments of bone )

mitosis to form new trabeculae of bone

periosteal cells form a collar around each fragment

capillaries proliferate

2 collars of the 2 fragments meet and fuse

cartilage is replaced by bone

a new trabeculae is firmly cemented to the dead bone

dead bone is replaced by new living bone

Bone Transplants
- plastic surgery
- new bone becomes firmly cemented to the old
- new trabelulae from the bone of the host firmly unite with dead bone of
the transplant
- dead bone is reabsorbed and replaced with new bone produced by the
host
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Clinical Advances in Bone Repair

1. electrical stimulation of fracture site
- negative fileds > where bone tissues are deposited
- positive fields > where bone tissues are absorbed
- negative fields prevent parathyroid hormone from stimulating the
bone-forming osteoblast cells
- the fields induce production of growth chemicals that stimulate
bone-forming osteoblast cells

2. ultrasound
- daily exposure to low-power ultrasound waves reduces the healing
time of broken arm and skin bones by 25-35%
- this stimulates cartilage cells to make callus

3. free vascular fibular graft technique

4. bone substitutes
- fill the gaps of non-union defects

Infections of the Bone

1. osteomyelitis
- resulting inflammation of the bone
2. TB of the Bone
- vertebrae
- Pott’s Disease

Joint Disorders
1. age changes
- degenerative disease
- osteoporosis > vertebral collapse > fragile bone caused by:
a. decreased estrogen – helps maintain the health and
normal density of a woman’s skeleton
b. decreased protein and calcium
c. decreased vitamin D
d. smoking
e. insufficient weight-bearing exercise to stress the
bones
2. dislocation
- displacement of one of the bones

3. ankylosis
- fixation of a joint; rendering it immobile

4. arthritis
- inflammation of the tissues around joints

5. sprain
- wrenching of a joint
- result from tearing of the attachment
- tendons and ligaments have poor blood supply (heal slowly)

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