LECTURE 5: The skin is made up of two major tissue
THE INTEGUMENTARY SYSTEM
Integumentary System
 Skin
 Accessory gland (hair, glands, nails)
 Means covering.
 One of the more familiar systems of the
body to everyone because it covers the
outside of the body and is easily
observed.
The appearance of Integumentary System
can indicate physiological imbalances.
 Reduced blood flow through the skin
during a heart attach can cause a
person to look pale, whereas increased
blood flow as a result of fever can
caused a flushed appearance.
 Some diseases can cause skin rashes
(measles, chicken pox, allergic reaction)
Function of Integumentary System
PROTECTION
 Provides protection against abrasion
and UV light.
 Prevents microorganisms from entering
the body.
 Reduces water loss, thus preventing
dehydration.
SENSATION
 Has sensory receptors that can detect
heat, cold, touch, pressure, and pain.
VITAMIN D PRODUCTION
 Produces molecule that can be
transformed into vitamin D when exposed
to UV light, an important regulator of Ca
homeostasis.
TEMPERATURE REGULATION
 The amount of blood flow beneath the
skin’s surface and the activity of sweat
glands in the skin both help regulate body
temperature.
EXCRETION
 Small amount of waste products are lost
through the skin and in gland secretions.
layers:
EPIDERMIS
 most superficial layer of skin
 epithelial tissue
 prevents water loss and resists abrasion.
DERMIS – connective tissue
 average thickness of 10 – 20 times
thicker that epidermis
 responsible for most of the skin’s
structural strength
SUBCUNTANEOUS TISSUE (hypodermis) –
layer of connective tissue
 not part of the skin
 connect the skin to underlying muscle or
bone
Layers of the Skin
Epidermis
 Stratified squamous epithelium.
 In its deepest layers, new cells are
produced by mitosis.
 Outermost cells protect the cells lost from
the surface.
 During their movement, the cells change
shape and chemical composition.
 KERATINIZATION - reflects the fact that
the cells become filled with the protein
keratin, which makes them more rigid and
durable.
 Stratified Squamous Epithelium As
keratinization proceeds, epithelial cells
eventually die and form an outer layer of
dead, rigid cells that resists abrasion and
acts as a permeability barrier
 The epidermis prevents water loss and
resists abrasion.
 The epidermis, known as the cutaneous
membrane, is a keratinized stratified
squamous epithelium.
 The epidermis is composed of distinct
layers called strata.
 The stratum corneum, the most superficial
stratum of the epidermis, consists of dead
squamous cells filled with keratin.
 Keratin gives the stratum corneum its
structural strength.
 Cells of the deepest strata perform mitosis.
 As new cells form, they push older cells to
the surface, where they slough, or flake off.

DERMIS example:
DANDRUFF
Excessive sloughing of stratum corneum cells
from the surface of the scalp. Oil from the scalp
causes the skin cells to clump together and
appear as white flakes.
Causes:
 dry skin; sensitivity to hair products; and
skin conditions such as seborrheic
dermatitis or eczema
 The overgrowth of a yeast-like fungus
can also cause dandruff. This
overgrowth can be caused by stress,
hormones, too much oil on the scalp, or
problems with the immune system.
CALLUS
In skin subjected to friction, the number of
layers in the stratum corneum greatly
increases, producing a thickened area called a
callus.
CORN
Over a bony prominence, the stratum corneum
can thicken to form a cone-shaped structure
called a corn.
Dermis
 Composed of dense collagenous
connective tissue containing fibroblasts,
adipocytes, and macrophages.
 Nerves, hair follicles, smooth muscles,
glands, and lymphatic vessels extend into
the dermis.
 Collagen fibers, oriented in many
directions, and elastic fibers are
responsible for the structural strength of the
dermis and resistance to stretching.
 Some collagen fibers are oriented in more
directions than others, forming cleavage
lines.
 Cleavage lines, or tension lines, in the
skin, are more resistant to stretching.
 It is important for surgeons to be aware of
cleavage lines.
If the skin is overstretched for any reason, the
dermis can be damaged, leaving stretch
marks.
Stretch Marks - can develop when a person
increase in size quite rapidly.
 Dermal papillae are projections toward the
epidermis found in the upper part of the
dermis.
 The dermal papillae contain many blood
vessels.
 The dermal papillae in the palms of the
hands, the soles of the feet, and the tips
of the digits are arranged in parallel,
curving ridges that shape the overlying
epidermis into fingerprints and footprints.
Type of Injection - An injection delivers
substances, such as medicines, to the body by
puncturing the skin. *
INTRADERMAL INJECTION – administered
by drawing the skin taut and inserting a small
needle at a shallow angle into the dermis.
 Example: tuberculin skin test
SUBCUTANEOUS INJECTION – achieved by
pinching the skin to form a “tent” and inserting
a short needle into the adipose tissue of
subcutaneous tissue.
 Example: insulin injection
INTRAMUSCULAR INJECTION –
accomplished by inserting a long needle at a
90-degree angle to the skin into a muscle deep
to the subcutaneous tissue.
 Example: vaccination and
antibiotic injection
Skin Color
MELANIN
 Group of pigments primarily responsible for
skin, hair, and eye color.
 Mostly brown to black pigments
 Some are yellowish or reddish.
 Provides protection against UV light.
 Produced by melanocyte.
 MELANOCYTE – are irregularly shaped
cells with many long processes that
extend between epithelial cells of the
deep part of the epidermis.
 Melanin transfer to epithelial cell
MELANIN PRODUCTION
 Determined by genetic factors, exposure to
sunlight, and hormones.
Genetic factors
 Responsible for the amounts of melanin
produced in different races.
 All races have about the same number of
melanocytes.
 Racial variations in skin color are
determined by amount, kind, and
distribution of melanin.
 A single mutation can prevent the
production of melanin. (Albinism)
ALBINISM – is a recessive genetic trait that
causes a deficiency or an absence of melanin.
Albinos have fair skin, white hair, and
unpigmented irises in the eyes.
Exposure to sunlight
 Exposure to UV stimulates melanocytes
to increase melanin production.
Hormones
 Estrogen and melanocyte-stimulating
hormone
 Cause an increase in melanin production
during pregnancy in the mother
 Darkening of nipples, pigmented circular
areas around the nipples, “the mask of
pregnancy”, dark line of pigmentation on
the middle of the abdomen
CAROTENE
 A yellow pigment found in plants such as
squash and carrots.
 Source of vitamin A for humans.
 Lipid-soluble
 When consumed, it accumulates in the
lipids of the stratum corneum and in the
adipocytes of the dermis and subcutaneous
tissue.
ACCESSORY SKIN STRUCTURES
The accessory skin structures are:
 Hair
 Glands
 Nails
Hair
 Found everywhere on the skin except on
the palms, the soles, the lips, the nipples,
parts of the genitalia, and the distal
segments of the fingers and toes.
 HAIR FOLLICLE – where hair arises, an
invagination of the epidermis that extends
deep into the dermis
 HAIR SHAFT – protrudes above the
surface of the skin
 HAIR ROOT – protrudes below the surface
 HAIR BULB – the expanded base of the
root, where hair is produced
 A hair has a hard cortex, which surrounds
a softer center, the medulla.
 The cortex is covered by the cuticle, a
single layer of overlapping cells that holds
the hair in the hair follicle.
 Hair is produced in the hair bulb, which
rests on the hair papilla.
 HAIR PAPILLA – an extension of the
dermis that protrudes into hair bulb.
 Blood vessels within the papilla supply the
hair bulb with the nourishments needed to
produce the hair.
growth stage, hair is formed by mitosis of
epithelial cells within the hair bulb; these cells
divide and undergo keratinization.
During the resting stage, growth stops and the
hair is held in the hair follicle.
PATTER BALDNESS IN MEN – permanent
loss of hair. These changes occur when male
sex hormones act on the hair follicles of men
who have genetic predisposition for pattern
baldness.
“Hair color is determined by varying amounts
and types of melanin. The production and
distribution of melanin by melanocytes occurs
in the hair bulb by the same method in the
skin.”
With age, the amount of melanin in hair can
decrease, causing the hair color to become
faded, or the hair can contain no melanin and
be white. “
Glands
SEBACEOUS GLANDS
 Simple, branched acinar gland
 Most connected by a duct to the
superficial part of a hair follicle
 Produce sebum
 An oily, white substance rich in lipids
 Sebum is released by holocrine
secretion and lubricates the hair and the
surface of the skin, which prevents
drying and protects against bacteria
Acne - Inflammation of hair follicles and
sebaceous gland.

SWEAT GLANDS
1. Eccrine Sweat Glands
 Simple, coiled, tubular glands and release
sweat by merocrine secretion.
 Located in almost every part of the skin but
most numerous in the palms and soles.
 They produce a secretion that is mostly
water with a few salts.
 Have ducts that open onto the surface of
the skin through sweat pores and are for
thermal regulation.
 Sweat can also be released in the palms,
soles, armpits, and other places because of
emotional stress.
2. Apocrine Sweat Glands
 Simple, coiled, tubular glands that produce
a thick secretion rich in organic substances.
 The glands open into hair follicles in the
armpits and genitalia.
 Become active at puberty because of the
influence of sex hormones.
 The secretion generally is odorless, but
when released quickly breaks down by
bacterial action giving body odor.
Nails
The nail is a thin plate, consisting of layers of
dead stratum corneum cells that contain a very
hard type of keratin.
PHYSIOLOGY OF THE INTEGUMENTARY
SYSTEM
Protection
The integumentary system performs many
protective functions:
1. Reduction in body water loss.
2. Acts as a barrier that prevents
microorganisms and other foreign
substances from entering the body.
3. Protects underlying structures against
abrasion.
4. Melanin absorbs ultraviolet light and
protects underlying structures from its
damaging effects.
5. Hair protection: The hair on the head acts
as a heat insulator, eyebrows keep sweat
out of the eyes, eyelashes protect the eyes
from foreign objects, and hair in the nose
and ears prevents the entry of dust and
other materials.
6. The nails protect the ends of the fingers
and toes from damage and can be used in
defense.
Sensation
 Many sensory receptors are associated
with the skin.
 Receptors in the epidermis and dermis can
detect pain, heat, cold, and pressure.
 Although hair does not have a nerve supply,
sensory receptors around the hair
follicle can detect the movement of a
hair.
Vitamin D Production
1. UV light causes the skin to produce a
precursor molecule of vitamin D.
2. The precursor molecule is carried by the
blood to the liver where it is enzymatically
converted.
3. The enzymatically converted molecule is
carried by the blood to the kidneys where it
is converted again to the active form of
vitamin D.
4. Vitamin D stimulates the small intestine to
absorb calcium and phosphate for many
body functions.

Temperature Regulation
 Regulation of body temperature is
important because the rate of chemical
reactions within the body can be increased
or decreased by changes in body
temperature.
 Even slight changes in temperature can
make enzymes operate less efficiently
and disrupt the normal rates of chemical
changes in the body.
 Exercise, fever, and an increase in
environmental temperature tend to raise
body temperature.
 In order to maintain homeostasis, the
body must rid itself of excess heat.
 Blood vessels in the dermis dilate and
enable more blood to flow within the
skin, thus causing heat to dissipate from
the body.
 Sweat also assists in loss of heat through
evaporative cooling.
 If body temperature begins to drop below
normal, heat can be conserved by the
constriction of dermal blood vessels,
which reduces blood flow to the skin.
 Less heat is transferred from deeper
structures to the skin, and heat loss is
reduced.
 However, with smaller amounts of warm
blood flowing through the skin, the skin
temperature decreases.
 If the skin temperature drops below 15°C,
dermal blood vessels dilate.
Heat Exchange in the Skin
 Radiation
 Convection
 Conduction
 Evaporation
Excretion
 The integumentary system plays a minor
role in excretion, the removal of waste
products from the body.
 In addition to water and salts, sweat
contains small amounts of waste products,
such as urea, uric acid, and ammonia.
 Even though the body can lose large
amounts of sweat, the sweat glands do
not play a significant role in the
excretion of waste products.
INTEGUMENTARY SYSTEM AS A
DIAGNOSTIC AID
The integumentary system is useful in
diagnosis because it is observed easily and
often reflects events occurring in other
parts of the body.
Cyanosis
 A bluish color to the skin caused by
decreased blood O2 content, is an
indication of impaired circulatory or
respiratory function.
Jaundice
 A yellowish skin color, can occur when
the liver is damaged by a disease, such
as viral hepatitis.
Rashes and Lesions
 Rashes and lesions in the skin can be
symptoms of problems elsewhere in
the body.
Vitamin A Deficiency
 Skin produces excess keratin and
assumes a characteristic sandpaper
texture.
Iron Deficiency Anemia
 The nails lose their normal contour and
become flat or concave (spoon-shaped)
BURNS
 A burn is injury to a tissue caused by
heat, cold, friction, chemicals, electricity,
or radiation.
 Burns are classified according to their
depth.
 Partial-thickness burns are classified as
first-degree and second-degree.
 A full-thickness burn is a third-degree
burn.
Partial-thickness burns
Parts of stratum basale remains viable, and
regeneration of the epidermis occurs from
within the burn area, as well as from the edges
of the burn.
First-degree burns (superficial)
 Burn involves only the epidermis and is
red and painful.
 Slight edema, or swelling, may be present.
 They can be caused by sunburn or brief
exposure to very hot or very cold
objects, and they heal without scarring in
NOTE:
 about a week.
Limiting exposure to the sun and using sunscreens that block UV light can reduce the likelihood of
developing skin cancer.
 Gray or whiteburns
Second-degree hair also results from decrease in or lack of melanin production.
(partial-thickness)
 Burns damage both sunlight
 Skin that is exposed to shows signs
the epidermis
the
 If dermal damage is minimal, symptoms
include redness, pain, edema, and blisters.
 Healing takes about 2 weeks, and no
scaring results.
 If the burn goes deep into the dermis, the
wound appears red, tan, or white; can take
several months to heal and might scar.
Full-thickness burns
Third-degree burns
 Damage the complete epidermis and
dermis.
 The region of third-degree burn is usually
painless because sensory receptors in
the epidermis and dermis have been
destroyed.
 Third-degree burns appear white, tan,
brown, black, or deep cherry red.
Burn Healing
 In all second-degree burns, the epidermis,
including the stratum basale where the
stem cells are found, is damaged.
 The epidermis regenerates from
epithelial tissue in hair follicles and sweat
glands, as well as from the edges of the
wound.
 Deep partial-thickness and full-
thickness burns take a long time to heal,
and they form scar tissue with disfiguring
and debilitating wound contractures.
Treatments of Burns
 To prevent complications of deep partial-
thickness and full-thickness burns and to
speed healing, skin grafts are often
performed.
 Split skin graft – the epidermis and part
of the dermis are removed from another
part of the body and placed over the
burn
 When it is not possible or practical to move
skin from one part of the body to a burn
site, physicians sometimes use artificial
skin or grafts from human cadavers.
andof aging more rapidly than non-exposed skin.
SKIN CANCER
 Most common cancer
 Mainly caused by UV light exposure
 Develop on the face, neck, or hands
 Fair-skinned people more prone (have less
protection from the sun), 50 y/o above (had
long exposure to the sun)
Types of Skin Cancer
Basal cell carcinoma
 cells in stratum basale affected
 cancer removed by surgery
Squamous cell carcinoma
 cells above stratum basale affected
 can cause death
Malignant melanoma
 arises from melanocytes in a mole
 rare type
 can cause death
Limiting exposure to the sun and using
sunscreens that block UV light can reduce the
likelihood of developing skin cancer.
UVA vs. UVB
Ultraviolet light is classified into two types
based on their wavelengths:
 UVA – has longer wavelength than UVB,
exposure to UVA causes most tanning of
the skin but is associated with the
development of malignant melanoma.
(photoaging)
 UVB – shorter wavelength, exposure to
UVB causes most burning of the skin and
associated with the development of basal
cell and squamous cell carcinomas.
(sunburn)
EFFECTS OF AGING ON THE
INTEGUMENTARY SYSTEM
 Blood flow decreases and skin
becomes thinner due to decreased
amounts of collagen
 Decreased activity of sebaceous and
sweat glands make temperature
regulation more difficult
 Loss of elastic fibers cause skin to sag
and wrinkle