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The Integumentary System

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Introduction
 Integumentary  Accessory organs:
system consists of ◼ Hair follicles
skin and its ◼ Nails
accessory organs ◼ Skin glands

Skin is the body’s outer covering and its

largest organ.

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Functions of the Integumentary

System
 Protection
◼ First line of defense against
 Bacteria
 Viruses

◼ Protects underlying
structures from
 Ultraviolet (UV) radiation
 Dehydration

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Functions of the Integumentary

System (cont.)
 Body temperature regulation
◼ If too hot
 Dermal blood vessels dilate
 Vessels carry more blood to
surface so heat can escape
◼ If too cold
 Dermal blood vessels constrict
 Prevents heat from escaping

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Functions of the Integumentary

System (cont.)
 Vitamin D production
◼ Needed for calcium absorption
 Sensation
◼ Sensory receptors
 Excretion
◼ Small amounts of waste products
are lost through perspiration

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Apply Your Knowledge

What are the functions of the integumentary system?

ANSWER: The functions of the integumentary system are

protection, regulation of body temperature, vitamin D
production, sensation, and excretion.

Super!

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Skin Structure: Epidermis

 Most superficial layer
 Two parts
◼ Stratum corneum
 Outermost layer
 Mostly dead cells form an impermeable layer
◼ Stratum basale (stratum germinativum)
 Deepest layer
 Cells constantly dividing and pushing older cells
outward
To Figure of Skin

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Skin Structure: Epidermis (cont.)

 Keratinocyte – most common
◼ Makes and accumulates keratin
 Durable protein that makes the epidermis waterproof
and resistant to pathogens
 Melanocyte
◼ Makes the pigment melanin
 Traps UV radiation and prevents damage to
underlying layers of the skin

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Skin Structure: Dermis

 Deeper of the two skin layers
 Contains all major tissue types, plus
◼ Sudoriferous (sweat) glands
◼ Sebaceous (oil) glands
◼ Hair follicles and arrector pili muscles
◼ Collagen, elastic, and nerve fibers
◼ Blood vessels
 Binds the epidermis to the
subcutaneous tissue To Figure of Skin

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Skin Structure: Subcutaneous Layer

 Hypodermis
 Composed of
◼ Adipose (fat) and loose connective tissue
◼ Blood vessels and nerves
 Functions
◼ Storage in adipose tissue
◼ Cushions and insulates underlying
structures To Figure of Skin

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Skin Color
 Determined by amount
of melanin in the
epidermis of skin

 The more melanin, the

darker the skin color
◼ Range is from yellowish
to brownish

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Skin Color (cont.)

 Oxygenated blood
◼ Amount of oxygen dissolved in the hemoglobin
of the red blood cells
 Hemoglobin – a pigment in the RBCs

◼ If blood is well-oxygenated, skin will be pink

◼ If oxygen level in blood is low, skin will be pale

or have a bluish color (cyanosis)

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Skin Lesions
 Any variation in the
skin
◼ As simple as a freckle

◼ As serious as a tumor

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Skin Lesions (cont.)

Lesion Name Description
Bulla A large blister or cluster of blisters
Cicatrix A scar, usually inside a wound or tissue

Crust Dried blood or pus on the skin

Ecchymosis A black-and-blue mark or bruise
Erosion A shallow area of skin worn away by
friction or pressure
Excoriation A scratch; may be covered with dried blood

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Skin Lesions (cont.)

Lesion Name Description
Fissure A crack in the skin’s surface
Keloid An overgrowth of scar tissue
Macule A flat skin discoloration, such as a freckle or
a flat mole
Nodule A large pimple or small node
Papule An elevated mass similar to but smaller than
a nodule
Petechiae Pinpoint skin hemorrhages that result from
bleeding disorders
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Skin Lesions (cont.)

Lesion Name Description
Plaque A small, flat, scaly area of skin
Purpura Purple-red bruises usually due to clotting
abnormalities
Scale Thin plaques of epithelial tissue on skin’s
surface
Pustule An elevated (infected) lesion containing pus

Tumor A swelling of abnormal tissue growth

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Skin Lesions (cont.)

Lesion Name Description
Ulcer A wound that results from tissue loss
Vesicle A blister

Wheal Another term for hive

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Accessory Organs (cont.)

 Hair follicles  Sebaceous glands
◼ Tube-like depressions ◼ Produce sebum to keep
in the dermis of skin hair soft
◼ Generate hairs ◼ Prevent bacteria from
◼ Alopecia (baldness) growing on skin
occurs when follicles
die  Nails
◼ Arrector pili muscles ◼ Protect the ends of
attached to follicles fingers and toes
cause goose bumps ◼ Hard keratin
Diagram

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Accessory Organs (cont.)

 Sudoriferous (sweat) glands
◼ Located in the dermis of skin
◼ Types
 Eccrine
◼ Produce watery type of sweat
◼ Activated by heat
 Apocrine
◼ Produce thicker type of sweat with more proteins
◼ Concentrated in armpit and groin areas
◼ Activated by nervousness or stress Diagram

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Accessory Organs

Sebaceous gland

Hair follicle

Sudoriferous gland

Return

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Skin Healing
 Injury → inflammation
◼ Redness due to dilation of nearby
blood vessels

◼ Swelling because vessels leak

fluid into spaces between cells

◼ Pain because excess fluid

activates pain receptors

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Skin Healing (cont.)

 Inflammation promotes healing
◼Extra blood to area
◼ Extra nutrients for skin repair Injury occurs
◼ Defensive cells Blood clot
forms
Scab replaces
blood clot Clotted blood and
Collagen fibers other dried tissue
replace scab Bind the edges of wound;
major component of scars
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Skin and Aging

 Skin loses firmness due to
◼ Loss of elastic and collagen
fibers in dermis
◼ Loss and shifting of underlying
adipose tissues

 Skin color changes

◼ Dermis becomes thinner and more transparent
◼ Paler due to decrease in circulation

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Skin and Aging (cont.)

 Melanocytes decrease
◼ Those remaining gather → “age” spots
◼ Hair grays and becomes thinner
 Decreased tolerance to temperature changes
◼ Sudoriferous glands decrease in number
 Decreased perspiration, hard to adjust to high
temperatures
◼ Loss in adipose tissue and decreased circulation
 Increased sensitivity to cold

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Burns
 Second leading cause of accidental death in
the U.S.
 Rule of nines is used to determine severity
(degree) of burn
 Burn severity:
◼ First-degree
◼ Second-degree
◼ Third-degree
Rule of Nines

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Back

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Burns: Treatment
 Do not remove anything
sticking to the burn
 Do not apply butter, lotions,
or ointments
 Cool with large amounts of
water
 Cover with sterile sheet or
plastic bag

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Apply Your Knowledge

Using Figure 24-5, determine Click for Figure 24-5
burn severity for a patient who Rule of Nines

has burnt his anterior face and

both arms.
ANSWER: Head = 9%
Both arms, hands, and shoulders = 18% + 18%
9% + 18% + 18% = 45%

It all adds up to a
right answer!
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Skin Cancer
 Basal cell carcinoma – progresses slowly and
rarely spreads to other body parts

 Squamous cell carcinoma – more likely to

spread to surrounding tissues

 Malignant melanoma – more aggressive and

occurs anywhere
◼ Most arise from melanocytes

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Skin Cancer: Basal Cell Carcinoma

 Signs and symptoms
◼ New growth or sore that will not heal
◼ Waxy, smooth, red, pale, flat, or lumpy
◼ May or may not bleed

 Treatment:
◼ Curettage and electrodessication ◼ Cryosurgery
◼ Mohs’ surgery ◼ Laser therapy

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Skin Cancer: Squamous Cell Carcinoma

 Less common than basal cell carcinoma

 Found on face, lips, ears, and backs of hands

 Signs and symptoms and

treatments are the same
as for basal cell carcinoma

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Skin Cancer: Malignant Melanoma

 Signs and Symptoms  Treatment
◼ From melanocytes ◼ Surgery and biopsy
◼ Appear on trunk, head, ◼ Removal of lymph
neck of men nodes
◼ Appear on arms and ◼ Chemotherapy and
legs of women radiation therapy
◼ Itches or bleeds ◼ Immunotherapy

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Skin Cancer: Stages of Melanoma

Stage 0 Only found in epidermis
Stage I Spread to epidermis and dermis (1 to 2 mm
thick)
Stage II 2 to 4 mm thick plus ulceration
Stage III Spread to one or more lymph nodes
Stage IV Spread to other body organs or lymph nodes
far from original melanoma

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Skin Cancer: ABCD Rule

Asymmetry: The mole should not become
A asymmetrical
Border should not become irregular
B
Color should not change or become
C mixture of colors
Diameter should not grow larger than the
D diameter of a pencil eraser
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Cancer Warning Signs

C– Change in bowel or bladder habits
A– A sore that will not heal
U– Unusual bleeding or discharge
T– Thickening or lump
I – Indigestion or difficulty swallowing
O– Obvious change in wart or mole
N– Nagging cough or hoarseness
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Common Skin Disorders

 Alopecia  Dermatitis
◼ Results in hair loss ◼ Inflammation of skin
or a rash
 Cellulitis
 Eczema
◼ Inflammation of
connective tissue ◼ Chronic dermatitis
in skin
 Folliculitis
◼ Inflammation of hair
follicles

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Common Skin Disorders (cont.)

 Herpes simplex  Pediculosis
◼ Type 1 – cold sores ◼ Head lice
◼ Type 2 – genital ◼ Body lice
◼ Pubic lice
 Herpes zoster
◼ Shingles  Psoriasis
◼ Inherited autoimmune
 Impetigo disorder
◼ Oozing skin lesions that
eventually crust over

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Common Skin Disorders (cont.)

 Ringworm  Scabies
◼ Tinea corporis ◼ Contagious skin
◼ Tinea capitis condition caused by
◼ Tinea pedis mites

 Warts
 Rosacea
◼ Harmless growths
◼ Dilation of small facial caused by a virus
blood vessels

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In Summary:
 First line of defense for body
 Protects the body from
◼ Invading organisms
◼ Chemicals
◼ UV light
◼ Water loss
 Regulates body temperature
 Understanding this system can help you be more
effective in your role

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We may have different

religions, different
languages, different
colored skin, but we all
belong to one human
race.

~ Kofi Annan
© 2009 The McGraw-Hill Companies, Inc. All rights reserved