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Integumentary System
Dr.Zahoor Alam
Integumentry system
 Latin word Integumentum, A covering (skin)
 Help in differential diagnosis

 Functions
1. Protection
2. Containment of body structure
3. Heat regulation
4. Sensation
5. Synthesis and storage
Skin
 Largest organ of body

 3 layers
 Epidermis ……superficial cellular layer
 Dermis ….Deep connective tissue layer
 Hypodermis… fatty layer
Layers of skin
 Three layers
1. Epidermis (outer most)
2. Dermis (middle)
3. Hypodermis
Epidermis
 Outer most, Tough superficial layer, protective
 Keratenized Epithelium
 Regenerative and deep pigmented layer
 No blood vessels and Lymphatic
 Nourished by underlying Dermis
 Nerve endings … sensitive to touch, irritation and
temperature
Dermis
 Collagen fiber (skin toghness and strength)
 Elastic fiber Elasticity
 Tension line (longitudinal in limbs–)
 Hair follicles
 Smooth arrector muscle
 Sebaceous glands
 Arteries, veins, nerves
 Nails, mammary glands,
Hypodermis/ subcutaneous tissue
 Between dermis and underlying fascia
 Subcutaneous tissue/superficial fascia
 Loose connective tissue and stored fat
 Distribution different at different site and gender
 Waist, thigh,
 Subcutaneous tissue ,, thermal regulation, insulator
 Protect from compression
 Sweat glands thermoregulation
Skin ligaments
 Numerous small fibrous bands, extend through
subcutaneous tissue
 Attach deep surface of dermis to underlying deep
fascia
 Short and abundant ligament skin firmly attach to
underlying fascia
 Longer and sparse --- skin more mobile
Skin color signs in physical
diagnosis
 Cyanotic appearance…. Bluish color
1. Person stopped breathing/defective circulation
2. Blood is not carrying enough oxygen
3. Lips, eyelid, nails.
 Erythema skin injury, exposure to excess heat,
infection, inflammation, allergic reaction.
 Jaundice – yellow appearance to skin and eyes
 Light skin…. Color easily change
Stretch marks in skin
 Skin can stretch and grow
1. Abdominal enlargement , weight gain, pregnancy,
also in certain diseases (cushing, hypercortisolism)
2. Too much stretch can damage collagen fibers
3. Stretch mark appear--- wrinkled stretch---- first
purple--- red– white
4. Abdomen, buttocks, thigh, breast
5. Reduce (not disappear) after pregnancy, weight loss
Skin injuries and wounds
 Laceration….. Accidental cuts or skin tears
 Superficial or deep
 Burns … caused by,, therma; trauma, ultra violet/
ionizing radiation,chemical agents
 Classification of burns
Burn assessment
 Rule of nine

 Degree of burn
1. 1st degree surface damage, still intact
2. 2nd degree through epidermis into dermis, blisters
3. 3rd degree epidermis and dermis damaged
full thickness
 First-Degree Burn – (formerly superficial)
 The surface of the skin is damaged, but the epidermis
is still intact, and therefore able to perform its
functions (control temperature and protect from
infection or injury)
 Symbolized by sunburn are dry, warm, painful, and
hypersensitive
 They heal without treatment

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Second-Degree Burn – (formerly partial thickness)
 Damage through the epidermis and into the dermis
 Also known as partial-thickness burn
 Indicates a loss of skin function
 Superficial: red, painful, and potentially blistered
(classical sign)
 Deep: dry, white, and hyposensitive burns

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Third-Degree Burn – (formerly full thickness)
 Destruction of both the epidermis and dermis
 Trouble with fluid loss, heat loss, and infection (same
as with second-degree burn)
 Anesthetic, white, avascular, dry, and leathery
appearing

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Burn-Rule of Nines

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