Anatomy & Physiology - Lecture

STUDENT ACTIVITY SHEET BS NURSING / FIRST YEAR

Session # 4

LESSON TITLE: INTEGUMENTARY SYSTEM

LEARNING OUTCOMES:
Upon completion of this lesson, you can:

1. Define the integumentary system and its structures; 19. Describe the nail structures and its nail growth
2. Describe the major functions of integumentary system; process;
3. Identify the major tissue layers of skin; 20. Recognize how the integumentary system can
4. Describe the structure and function of epidermis; be used as a diagnostic aid;
5. Describe the different epidermal strata; 21. Define the burn injury and its classification on
6. Enumerate the common conditions associated with stratum the basis of the amount of skin damage
corneum; produced;
7. Illustrate the process of keratinization; 22. Describe the two burn treatments;
8. Discuss the structure and function of dermis; 23. Enumerate the different skin diseases and
9. Describe the layers of dermis and dermal papillae; disorders;
10. List the factors that determine the skin color; 24. Describe the skin cancer and its types; and,
11. Define the melanocytes and melanosomes; 25. List the changes the integumentary system
12. Describe melanin with its determinants and areas with more undergoes with age.
& less melanin production;
13. Discuss the process on how melanin transfers to epithelial Materials:
cells;
14. Describe the structure & function of subcutaneous tissue; Book, pen and notebook
15. Describe the structure and functions of a hair and its
components; Reference:
16. Identify the cycle of hair production; VanPutte, C., Regan, J., & Russo, A. (2019).
17. List down important facts regarding the hair; Seeley’s essentials of anatomy & physiology
18. Name the glands of the skin with its structure, types of (10th ed.). New York, NY: McGraw-Hill Education.
secretion, and function;

LESSON REVIEW/PREVIEW
Let us have a review from the previous chapter before moving forward. Identify if the characteristic posted
is under MUCOUS, SEROUS, or SYNOVIAL. Write the answers in CAPITAL LETTERS. Superimpositions
and erasures are not tolerated. Do this without looking at your notes and check it right after. Enjoy!
SEROUS
1. Hold organs in place. ________________
SYNOVIAL
2. Produce synovial fluid. ________________
MUCOUS
3. Line cavities in the interior of the body. ________________
MUCOUS
4. For protection of oral cavity. ________________
MUCOUS
5. Contains goblet cells. ________________

MAIN LESSON
You must read & study the concepts and refer to figures/tables in Chapter 5 of the book.

Integumentary System – consists of the skin and its accessory structures (hair, nails, and glands); one
of the more familiar systems of the body because it covers the outside of the body and is easily observed
Integument – this means covering.

Major Functions of Integumentary System:

1. Protection: These are the protective functions of the integumentary system:
1. The intact skin plays an important role in reducing water loss and acts as a barrier from the
microorganisms and foreign substances entering the body.

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 2. The stratified squamous epithelium of the skin protects underlying structures against abrasion.
3. Melanin absorbs UV light and protects underlying structures from its damaging effects.
4. Hair on the head acts as a heat insulator. Eyebrows keep sweat out of the eyes. Eyelashes protect
the eyes from foreign objects. Hair in the nose and ears prevents the entry of dust and other
materials.
5. The nails protect the ends of the fingers and toes from damage and can be used in defense.
2. Sensation
The skin contains sensory receptors for pain, heat, cold, and pressure. Sensory receptors around the hair
follicle can detect the movement of a hair.

3. Vitamin D Production
UV light causes skin to produce a precursor molecule of vitamin D (7-Dehydrocholesterol)
▼
Precursor is carried by blood to be modified in the liver (Vitamin D3)
▼
Carried by blood to the kidney for further modification
▼
Formation of active Vitamin D

Facts about Vitamin D:

1. Exposure to enough UV light can produce all the vitamin D needed by humans. However, people
need to ingest vitamin D as well.
2. Adequate levels of vitamin D are necessary because active vitamin D stimulates the small intestine
to absorb calcium and phosphate. (essentials for bone growth and muscle function)
3. Fatty fish (and fish oils) and vitamin D-fortified milk are the best sources of vitamin D.

4. Temperature Regulation
Body temperature normally is maintained at about 37°C (98.6°F). The rate of chemical reactions
(metabolism) is altered by the changes in temperature.
▪ Too heat body: Blood vessels constrict to reduce blood flow to skin and heat is retained.
▪ To cool the body: Blood vessels in dermis dilate and heat is transferred from deep in tissues to
skin and sweat is produced.

Types of Heat Loss:

1. Radiation – heat is lost through infrared energy.
2. Convection – through air movement.
3. Conduction – through direct contact with an object.

5. Excretion
Skin glands can remove large amounts of sweat, but only a small amount of waste products (urea, uric
acid, and ammonia). They do not play a significant role in the excretion of waste products.

Skin – made up of two major tissue layers: epidermis and dermis.

✔ This is used to determine the body fat.
✔ Skin weighs approximately 9 lbs.
✔ Skin is usually referred to as “thin skin”. “Thick skin” is found only on the palms of the hands and
soles of feet.

Epidermis – the most superficial layer of the skin; made up of stratified squamous epithelium.
Function: prevents water loss and resists abrasions.

Strata – distinct layers of epidermis.

Five Epidermal Strata:

1. Stratum Basale / Stratum Germinativum – deepest layer; consists of cuboidal or columnar cells that
undergo mitotic divisions about every 19 days. This stratum is a single layer of cells and firmly
attached to dermis.
2. Stratum Spinosum –spiny in appearance due to the protruding cell processing that join the cells;
composed of 8 to 10 layers of keratinocytes (cells that manufacture & store the protein keratin)

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 3. Stratum Granulosum – has grainy appearance due to further changes to the keratinocytes as they
are pushed from the spinosum; generate large amounts of keratin, which is fibrous
4. Stratum Lucidum – a smooth, seemingly translucent layer that is found only on thick skin of palms,
soles, & digits
5. Stratum Corneum - outermost layer of epidermis; 20 to 30 layers of dead squamous cells filled with
keratin & accounts for 75% of epidermal thickness; joined by desmosomes. This layer is also
coated and surrounded by lipid, which acts as waterproofing material.

Common Conditions associated with Stratum Corneum:

▪ Dandruff – excessive sloughing of corneum from the surface of the scalp.
▪ Callus – hard skin; forms when the skin has been exposed to frequent friction resulting in increased
layers of corneum and thickened area.
▪ Corn – occurs when the corneum thickens to form a cone-shaped structure over a bony prominence.

Keratinization – a process in which new cells (with keratin) is pushing old cells to the surface. It takes 40
to 56 days for the new cells to reach the surface.
New cells form and push older cells to the surface
▼
Cells slough, or flake off
▼
Epithelial cells eventually die
▼
Formation of outer layer of dead, rigid cells (resist abrasion and acts as permeability barrier)

Dermis – the 2nd major skin region; composed of dense collagenous connective tissue containing
fibroblasts, adipocytes, macrophages, nerves, hair follicles, smooth muscles, glands, and lymphatic
vessels.

Structure: made up of collagen and elastic fibers; collagen fibers are oriented in many different directions
Function: supplies nutrients & removes waste products to the overlying epidermis; helps regulate body
temperature

Cleavage Lines / Tension Lines – these are areas where skin is most resistant to stretching; caused by
orientation of collagen fibers; vital in scarring.

Stretch Marks – visible lines through the epidermis that result from overstretched skin, for any reason,
damaging the dermis; usually common when a person increases in size quite rapidly.

Layers of Dermis:
1. Papillary Layer - thin connective tissue layer that contains blood vessels.
▪ Dermal Papillae
✔ projections that extend up into epidermis
✔ blood flow through these vessels supplies the overlying epidermis
✔ arranged in parallel, curving ridges that shape into fingerprints,
footprints, & palm lines; these ridges increase friction and improve
the grip of hands & feet
✔ the pattern is genetically determined
2. Reticular Layer - deepest layer of dermis; accounts for 80% of dermis.

Factors affecting Skin Color:

▪ Pigments in skin ▪ Thickness of stratum corneum
▪ Blood circulating through the skin ▪ Genetics

Melanocytes – irregularly shaped cells with many long processes that extend between the epithelial cells
of the deep part of epidermis; responsible for production of melanin.
▪ Melanocytes of darker skinned people produce more and darker melanin than fairer skinned
people.
▪ All races have the same number of melanocytes.
Melanosomes – these are melanin-containing vesicles which move into the cell processes of melanocytes.

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Melanin – the group of pigments primarily responsible for skin, hair, and eye color.
▪ Pigments of most molecules are brown to black, some are yellowish or reddish.
▪ Racial variations in skin color are determined by the amount, kind, & distribution of melanin.
▪ Function: Provides protection against ultraviolet light from sunlight.
Determinants of Melanin Production:
1. Genetic factors: responsible for the amounts of melanin produced in different races.
▪ Albinism – a recessive genetic trait that causes a deficiency or an absence of melanin
(have fair skin, white hair, and unpigmented irises in eyes)
2. Exposure to UV light: stimulates melanocytes to increase melanin production to help protect the
skin resulting in a suntan.
▪ UV light causes elastic fibers to clump and become leathery.
▪ UV light can alter DNA in cells causing them to mutate (skin cancer).
▪ A sunburn is the skin reacting to UV exposure.
3. Hormones: certain hormones, such as estrogen & melanocyte-stimulating hormone (MSH),
increase the melanin production during pregnancy.
Areas with More Melanin Areas with Less Melanin
✔ Freckles
✔ Lips
✔ Moles
✔ Palms of hands
✔ Darkened areas in genitalia
✔ Soles of feet
✔ Areola & nipples

Melanin Transfer to Epithelial Cells: (See Process figure 5.4, page 97)

You must read & study the concepts and refer to figures/tables in Chapter 5 of the book.

Subcutaneous Tissue / Hypodermis

► attaches the skin to underlying bone and muscle; below the dermis
► supplies the area with blood vessels and nerves
► not part of the skin; made up of loose connective tissue, including adipose tissue; contains about
½ of the body’s stored lipids
► the amount and location of adipose tissue vary with age, sex, and diet.
► Functions: 1. Serves as padding and insulator
2. Responsible for some of the differences in appearance between men and
women
3. Used to estimate total body fat (the thicker the fold, the greater the amount of
total body fat)
► acceptable body fat varies from 21%-30% for females and from 13%-25% for males

Accessory Skin Structures: these include the hair, glands, and nails.

Hair – is found everywhere on the skin, except on the palms, the soles, lips, nipples, parts of genitalia,
and the distal segments of fingers and toes.

Hair Components:
▪ Hair Shaft – flexible strands of keratinized cells; protrudes above the surface of the skin.
▪ Hair Root – protrudes below the surface.
▪ Hair Bulb – base of hair root; where the hair is produced.
▪ Hair Follicle – an invagination of the epidermis that extends deep into the dermis; a group of
cells that surround the root and bulb and responsible for giving different shapes to the hair.
▪ Hair Cortex – a hard covering of hair that is surrounded by the cuticle, a single layer of
overlapping cells that holds the hair in the hair follicle.
▪ Hair Medulla – the softer center that is surrounded by the cortex.
▪ Hair Papilla – an extension of the dermis that protrudes into the hair bulb; the blood vessels
within supply the hair bulb with the nourishment needed to produce hair.
▪ Arrector Pili – made up of smooth muscle that surrounds each hair follicle; its contraction causes
the hair to become more perpendicular to the skin’s surface called “goose bumps”.

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Cycle of Hair Production:
Old hair falls out; formation of new hair
▼
Hair is formed by epithelial cells within the hair bulb (Growth Stage)
▼
These cells divide and undergo keratinization
▼
Hair grows longer as cells are added to the base of the hair within the hair bulb
▼
Hair root & shaft consist of columns of dead keratinized epithelial cells
▼
Growth stops & hair is held in the hair follicle until it falls out (Resting Stage)

Facts about the Hair:

✔ Testosterone and good nutrition promote hair growth
✔ Scalp hair grows for 3 years and rests for 1 year
✔ Eyelashes grow for 30 days and rest for 105 days
✔ Normally, we lose about 90 scalp hairs per day.
✔ Hair color is determined by varying amounts and types of melanin. Grey hair is the loss or fading
of melanin.
✔ Male pattern baldness is from the loss of the hair follicle

Glands: there are two major glands of the skin, the sebaceous and sweat glands.

1. Sebaceous Glands – are simple, branched acinar glands; most are connected by a duct to the hair
follicle.
– secrete sebum, released by holocrine secretion, an oily substance rich in lipids
that lubricates hair and skin to prevent drying.
2. Sweat Glands have two types:
a. Eccrine Sweat Glands – release sweat by merocrine secretion that is made mostly of water
with a few salts; located in almost every part of the skin but most numerous in palms and
soles; open into the sweat pores
b. Apocrine Sweat Glands – produce a thick secretion rich in organic substances by merocrine
secretion, though some glands demonstrate holocrine secretion; located only in armpits and
genitalia; open into the hair follicles and become active during puberty, causing body odor.

Nail – a thin plate with layers of dead stratum corneum cells with a very hard type of keratin.

Nail Structure:
▪ Nail Body – the visible part of the nail.
▪ Nail Root – the covered part by the skin.
▪ Cuticle / Eponychium – a stratum corneum that extends onto the nail body.
▪ Nail Matrix – made up of epithelial cells with a stratum basale that gives rises to most of the nail;
continuation of nail roots and is thicker than nail bed.
▪ Nail Bed – located distally to the nail matrix & attaches to nail; made up of epithelial cells with a
stratum basale
▪ Lunula – a small part of the nail matrix that can be seen through the nail body as a whitish,
crescent-shaped area at the base of the nail.

Process of Nail Growth: Production of epithelial cells within the nail matrix causes the nail to grow. Unlike
hair, the nail grows continuously and does not have a resting stage.

Integumentary System as a Diagnostic Aid:

▪ Sandpaper texture (skin) – associated with vitamin A deficiency in which the skin produces
excess keratin.
▪ Spoon-Shaped (nails) – associated with iron-deficiency anemia in which the nails lose their
normal contour and become flat or concave.

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Variations in Skin Color:
▪ Redness / Blushing – caused by increased blood flowing through the skin.
o Associated with fever, hypertension, inflammation, and allergies
o Scarlet Fever – bacterial infection that causes reddish rash on the skin.
▪ Pallor / Paleness – caused by decreased blood flow.
o Associated with anemia, low blood pressure, shock
▪ Cyanosis – a bluish color of skin caused by a decrease in the blood oxygen content.
o Associated with impaired circulation or respiratory functions.
▪ Jaundice – a yellowish discoloration of the skin.
o Associated with liver disorder, too much consumption of carotene
o Carotene – a yellow pigment found in plants (squash & carrots); normally used as a source
of vitamin A and accumulates in lipids of stratum corneum & in the adipocytes of dermis
and subcutaneous.
▪ Bronzing – a darkened skin pigmentation usually caused by stimulant effect of excess
adrenocorticotropic hormone (ACTH) on the melanocytes.
o Associated with Addison’s disease
▪ Bruising – a blue to purple discoloration caused by broken blood vessels.
o Associated with trauma, blood disorders

Burn – is an injury to a tissue caused by heat, cold, friction, chemicals, electricity, or radiation.

Classification of Burns:
1. Partial-Thickness Burn – the part of the stratum basale remains viable, and regeneration of the
epidermis occurs from within the burn area, as well as from the edges of the burn.
a. First-Degree Burn
✔ this involves only the epidermis
✔ presence of redness, slight swelling, pain.
✔ heals within 2 to 3 days or about a week with no scarring.
✔ usually caused by sunburn or brief exposure to very hot or very cold
objects.

b. Second-Degree Burn
✔ damages both the epidermis and dermis.
✔ symptoms may include redness, pain, swelling, and blisters.
✔ if minimal dermal damage, heals about 2 weeks with no scarring.
✔ if burn goes deep into the dermis, the wound appears red, tan, or white
and heals for several months with some scarring.
2. Full-Thickness Burn / Third-Degree Burn
✔ the epidermis & dermis are completely destroyed.
✔ usually painless as the sensory receptors have been destroyed.
✔ the burned areas appear white, tan, brown, black, or deep cherry red
✔ recovery occurs from the edges of the burn wound.
✔ skin graft may be necessary.

Burn Treatments:
▪ Split Skin Graft – a burn treatment procedure in which the epidermis and part of the dermis are
removed from another part of the body and placed over the burn area.
▪ Debridement – a procedure that involves removal of dead tissue from the burn area that helps
prevent infections by cleaning the wound.

Skin Diseases and Disorders: (Refer to Table 5.1 of the book for the description, page 104.)
1. Ringworm 7. Rubella (German Measles)
2. Eczema & Dermatitis 8. Chicken Pox
3. Psoriasis 9. Shingles
4. Impetigo 10. Cold Sores (Fever Blisters)
5. Decubitus Ulcers 11. Genital Herpes
6. Rubeola (Measles) 12. Acne (refer to Clinical Impact, page 102)

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Skin Cancer
✔ Most common type of cancer and mainly caused by UV light exposure from the sun.
✔ Common to develop in fair-skinned people or older than 50 years old.
✔ Prevented by limiting sun exposure and using sunscreens that should block UVA and UVB rays.
o UVA rays can cause tanning of the skin; associated with malignant melanomas.
o UVB rays can cause burning of the skin associated with basal cell & squamous cell
carcinomas.

Types of Skin Cancer:

1. Basal Cell Carcinoma – most frequent type that affects the cells in stratum basale and extends
into dermis to produce an open wound; readily treatable with surgery.
2. Squamous Cell Carcinoma – develops from cells immediately superficial to the stratum basale;
if untreated, can metastasize and lead to death.
3. Malignant Melanoma – a rare form that arises from melanocytes, usually in pre-existing mole;
appear as a large, flat, spreading lesion or as a deeply pigmented nodule; metastasis is common
and often fatal.

Effects of Aging:
▪ Blood flow to the skin is reduced. Skin becomes thinner, and elasticity is lost. It begins to sag and
wrinkle.
▪ Sweat and sebaceous glands are less active resulting in reduced ability for thermoregulation. The
number of melanocytes decreases, but some areas develop age spots.
▪ Gray or white hair is evident.

CHECK FOR UNDERSTANDING

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be
given to the correct answer and another one (1) point for the correct ratio. Superimpositions or erasures in
your answer/ratio is not allowed. You are given 20 minutes for this activity.

Write TRUE if the statement is correct and FALSE if it is not. Defend your answer by rationalizing
why or how.

1. Skin cells have the ability to regenerate and divide.

TRUE
ANSWER: ________
The ski n,speci all
ythe epi dermis,ismade up ofstratifi
ed squamousepi thel
ium.Epi
RATIO:______________________________________________________________________________ thel
ialti
ssues
have the abil
ityto regenerate and repl ace damage cel l
swi
th new cell
s,Stem cel
lscontinuousl
____________________________________________________________________________________ ydivi
de and
produce new cel l
sto repl ace the dead cel
__________________________ ls.

2. The water can simply move across the skin.

FALSE
ANSWER: ________
The ski
n,speci al
lythe epi
dermi s,ismade up strati
fi
ed squamousepi
thel
ium.Thi siskerati
RATIO:______________________________________________________________________________ ni
zed and
contai
nsa protein call
ed kerati
n.Thisformsa barrierthatpreventstoxi
cchemicalsfrom enteri
ng the bodyand
____________________________________________________________________________________
reduceswaterl oss.
__________________________

3. The skin is composed of epidermis, dermis, and hypodermis.

FALSE
ANSWER: ________
Skini smade up two maj orti
ssue layer:epi dermisand dermi s.The ski
n restson hypodermi
RATIO:______________________________________________________________________________ swhi
ch
____________________________________________________________________________________
isnota partofi tbuti
tdoesconnectthe ski n to underlyi
ng muscl e orbone.
__________________________

4. The dermis is thicker than epidermis.

TRUE
ANSWER: ________
On average,the dermi sis10 to 20 ti
mesthi
ckerthan the epi
dermi
s.
RATIO:______________________________________________________________________________
____________________________________________________________________________________
__________________________

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5. In the process of keratinization, the cells of epidermis and dermis change shape and chemical
composition.
FALSE
ANSWER: ________
The processofkerati ni
zation i nvolvesthe strata ofepi dermis,notdermi s.
RATIO:______________________________________________________________________________
____________________________________________________________________________________
________________________

6. The new cells in the keratinization are produced by mitosis.

TRUE
ANSWER: ________
RATIO:______________________________________________________________________________
Allthe cell
si n the bodyundergo the cel ldi
vision i
n the processofmi
tosi
s,exceptthe sexcel
ls.The
gametesdivide through the processofmei osis.
____________________________________________________________________________________
__________________________

7. In keratinization, the cells become filled with the protein keratin, which make them more stretchable
and durable.
FALSE
ANSWER: ________
Kerati nisa type ofprotei n thatmakesthe cel lsmore rigid and durabl e.
RATIO:______________________________________________________________________________
____________________________________________________________________________________
__________________________

8. The new cells produced by mitosis occur in most superficial layers of epidermis.
FALSE
ANSWER: ________
The new cel l
sare produced in the deepestl ayerofthe ski n,whi ch consistsofcuboi
RATIO:______________________________________________________________________________ dalofcol
umnar
cel
ls.
____________________________________________________________________________________
__________________________

9. The dead epithelial cells are formed in the outer layer of epidermis to act as a barrier.
TRUE
ANSWER: ________
RATIO:______________________________________________________________________________
The mostsuperfi ci
all ayerofthe ski niscomposed ofdead strati fied squamousepi thel
ium wi
th kerati
n.
Thiskerati
n provi
desa structuralstrength and waterproofi ng ability.
____________________________________________________________________________________
__________________________

10. Skin is the largest organ of the body.

ANSWER: TRUE________
RATIO:______________________________________________________________________________
Anatomi cal l
y,the ski
nisthe l argestorgan ofthe body.In human organi
sms,an organ i
spri
mari
ly
____________________________________________________________________________________
composed ofdi fferentti
ssues;and thatqual i
fi
esthe skin.
__________________________

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RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION)
The instructor will now rationalize the answers. You can now ask questions and debate among yourselves.
Write the correct answer and correct/additional ratio in the space provided.
1. ANSWER: ________
RATIO:___________________________________________________________________________
_________________________________________________________________________________
________________________
2. ANSWER: ________
RATIO:___________________________________________________________________________
_________________________________________________________________________________
________________________
3. ANSWER: ________
RATIO:___________________________________________________________________________
_________________________________________________________________________________
________________________
4. ANSWER: ________
RATIO:___________________________________________________________________________
_________________________________________________________________________________
________________________
5. ANSWER: ________
RATIO:___________________________________________________________________________
_________________________________________________________________________________
________________________
6. ANSWER: ________
RATIO:___________________________________________________________________________
_________________________________________________________________________________
________________________
7. ANSWER: ________
RATIO:___________________________________________________________________________
_________________________________________________________________________________
________________________
8. ANSWER: ________
RATIO:___________________________________________________________________________
_________________________________________________________________________________
________________________
9. ANSWER: ________
RATIO:___________________________________________________________________________
_________________________________________________________________________________
________________________
10. ANSWER: ________
RATIO:___________________________________________________________________________
_________________________________________________________________________________
________________________

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LESSON WRAP-UP

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a
visual to help you track how much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

AL Activity: CAT: 3-2-1

This strategy provides a structure for you to record your own comprehension and summarize your learning.
Let us see your progress in this chapter!

Three things you learned:

1. _________________________________________________________________________________
Ilearned thatThe new cel l
sin the kerati
nizati
on are produced bymitosi
s.
________________________________________________________________________________
_________________________
2. _________________________________________________________________________________
Ilearned thatThe dead epithel
ialcellsare formed in the outerl
ayerofepidermi
sto actasa barri
________________________________________________________________________________ er.
_________________________
3. _________________________________________________________________________________
Lastly,Ilearned thatThe dermisisthickerthan epidermi s.
________________________________________________________________________________
_________________________

Two things that you’d like to learn more about:

Iwoul dl i
ke to l
earn aboutwhythatthe human skini
sturned tan when we go to the beach and swi
1. ________________________________________________________________________________ m
to the sea?
________________________________________________________________________________
__________________________
2. ________________________________________________________________________________
________________________________________________________________________________
__________________________

One question you still have:

Idon'thave anyquesti ons.
1. _________________________________________________________________________________
________________

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