Chapter 4 (Skin&membranes)

Holy Name University - College of Health Sciences
Department of Radiologic Technology

ANAPHY
First Semester A.Y 2023 - 2024
Chapter 4: Skin and Body Membranes • It lines all body cavities that open to
the exterior (e.g., hollow organs of
▪ Body membranes; respiratory, digestive, urinary and
o cover surfaces respiratory tracts)
o form protective lubricating sheets • Most mucosae contain either
around organs stratified squamous epithelium or
▪ have 2 major groups; simple columnar epithelium
o Epithelial membranes • They are moist membranes that are
(cutaneous, mucous and serous) almost continuously bathed in
o Connective membranes secretions
(synovial membranes) • The epithelium of mucosae is often
▪ Cutaneous membranes generally called adapted for absorption or secretion.
the skin or integumentary system • The mucosae of the respiratory and
digestive tracts secrete large
Classification of Body Membranes
amounts of protective, lubricating
There are 2 Categories of Body mucus; that of the urinary tract does
Membranes; not
a. Epithelial Membranes Serous Membranes

b. Connective Membranes
• Composed of layer of simple
EPITHELIAL MEMBRANES squamous epithelium resting on thin
layer of areolar connective tissue
• Also called covering and lining • It line body cavities that are closed
membranes to the exterior (except for dorsal
• Include; body cavity and joint cavities)
o cutaneous (skin) • They occur in pairs
o the mucous membranes and • They have 2 layers:
o the serous membranes o Parietal layer
Cutaneous Membrane o Visceral layer
• Parietal layer
o is composed of 2 layers; o Lines specific portion of the wall of
o Superficial epidermis the ventral body cavity
o Underlying epidermis • Visceral layer
• Epidermis is composed of stratified o It folds and covers the outside of the
squamous epithelium organs in that cavity
• Dermis is mostly dense (fibrous)
connective tissue
• Cutaneous membranes is exposed
to air and is a dry membrane
Mucous Membrane
• Is composed of epithelium that is

resting on a loose connective tissue
membrane called lamina propria
ANAPHY
• Serous layers are separated by
scanty amount of thin, clear fluid
called serous fluid that is secreted
by both membranes
• The lubricating serous fluid allows
the organs to slide easily across the
cavity walls and one another without
friction as they carry out their routine
functions
• Lubricating serous fluid is extremely
important in pumping heart and
expanding lungs
• Specific names of serous
membranes depend on their
locations
• Peritoneum- serosa lining the
abdominal cavity and covering its • Synovial membranes provide
organs smooth surface and secrete
lubricating fluid
• Pleurae- serous membrane
surrounding the lungs • They also line small sacs of
connective tissue called bursae and
• Pericardia- membranes surrounding
tubelike tendon sheaths
the heart
• They cushion organs moving against
each other during muscle activity
THE INTEGUMENTARY SYSTEM
SKIN
• Essential for it keeps water and

other precious molecules in the body
• It keeps excess water out
• Skin is pliable yet tough
• It allow to take constant punishment
from external agents
• The skin and its appendages (sweat
and oil glands, hair, and nails) are
CONENCTIVE TISSUE MEMBRANES collectively called the
integumentary system.
• Synovial membranes
o Composed of loose areolar Functions of the Integumentary
connective tissue System
o Contain no epithelial cells at all
▪ Integument simply means “covering”
o Line the fibrous capsules
▪ Not all its functions are protective
surrounding joints
▪ It insulates and cushions deeper body
organs
ANAPHY
▪ Protects entire body from mechanical Subcutaneous/ hypodermis
(bumps and cuts), chemical damage • the adipose (fat) tissue.
(such as from acids and bases), thermal • Not considered part of the skin
damage (heat and cold) and microbes • Anchor the skin to underlying organs
▪ Uppermost layer of skin is hardened to • provides site for nutrient storage
help prevent water loss from the body • Serves as shock absorber and
surface insulates deeper tissues from
▪ Skin’s capillary network regulates heat extreme temperature changes occur
loss from the body surface outside the body
▪ Skin acts as a mini-excretory system; • Also responsible for the curves that
urea, salts and water are lost when are more part of woman’s anatomy
sweating than man
▪ Skin is a chemical plant; manufactures EPIDERMIS
several proteins important to immunity • Most of its cells are keratinocytes
and synthesize vitamin D that produce keratin
▪ Skin also produces acidic secretion
• Keratin- fibrous protein that makes
called acid mantle that protect against
the epidermis a tough protective
bacterial invasion
layer in a keratinization process
• Keratinocytes are connected by
desmosomes throughout epidermis
• Epidermis is AVASCULAR (means
no blood supply of its own)
• Epidermis is composed of 5 layers:
o Stratum basale (found only in
thick skin)
o Spinosum
o Granulosum
o Lucidum
o Corneum
Stratum basale
o Deepest cell layer of the epidermis
o Lies closest to the dermis
o Connected to it along a wavy border
that resembles corrugated
STRUCTURES OF SKIN cardboard
o Its basal layer contains most
▪ Skin is composed of 2 kinds of adequately nourished of epidermal
tissue: Epidermis and Dermis cells because nutrients diffuse it
▪ Epidermis- outer layer made up of reaches them first
stratified squamous epithelium and o Stem cells in this layer are
is capable of becoming hard and constantly dividing and millions of
tough new cells are produced daily
▪ Dermis- underlying layer made up of o Its alternate name; stratum
mostly dense connective tissue germinativum (germinating layer)
ANAPHY
o With the new cells produced some Epiderma dendritic cells
become epidermal cells and others o Scattered in the epidermis
maintain population of stem cells by o Important “sentries” that alert and
continuing to divide activate immune system cells to
o As epidermal cells goes to stratum bacterial or viral invasion
granulosum and stratum o Merkel cells: associated with
spinosum layers, they flatter and sensory nerve endings and serve as
keratinized tough receptors called Merkel discs
o Dead cells forms into clear stratum Homeostatic Imbalance
lucidum which occurs only where o Excessive exposure to UV light
skin is hairless and extra thick damages the skin that leaves
(palms of hands and soles of the leathery appearance
feet) o Overexposure to the sun alter the
Stratum corneum DNA of skin cells that leads to skin
• Outermost layer cancer
• 20-30 cell layers thick o Melanin that is abundant to dark skin
• Account for about 3 quarters of the people assist them to have natural
epidermal thickness sunscreen or sun protection
• Shingle-like dead cell remnants DERMIS
completely filled with keratin • Dermis is your “hide”
• Referred to as cornified or horny • A strong stretchy envelope that
cells helps to bind the body together
• Abundance of tough keratin in this • Connective tissue making up the
layer allows to provide to durable dermis consists of 2 major regions;
“overcoat” for the body o Papillary
• Protects deeper cells from hostile o Reticular areas
external environment and from water Papillary Layer
loss o Superficial dermal region
• Helps the body resist biological, o It is uneven and has peglike
chemical and physical assaults projections from its superior surface
• This layer rubs and flakes off slowly called dermal papillae
and steadily like a dandruff o Most dermal papillae contain
▪ Average person sheds about 18 capillary loops that furnish nutrients
kg (40lb) of these flakes to the epidermis
▪ We have a totally “new” o Papillae on hands and soles of the
epidermis every 25 to 45 days feet are arranged in whorled ridges
Melanin on the epidermal surfaces that
o A pigment that ranges in color from increase friction and enhance the
yellow to brown to black gripping ability of fingers and feet
o Is produced by special spider- o Those ridges have sweat pries and
shaped cells called melanocytes leave fingerprints
o Found chiefly in the stratum basale
o Freckles and mole are seen where
melanin is concentrated in one spot
o
ANAPHY
Reticular layer SKIN COLOR
o Deepest skin layer • There are 3 pigments that contribute to
o Contains dense irregular connective skin color;
tissue o Melanin
o Contains blood vessels, sweat and o Carotene
oil glands and deep pressure o Hemoglobin
receptors called lamellar
corpuscles Melanin
o Cutaneous sensory receptors that o Skin exposure to sunlight stimulates
includes touch, pressure, melanocytes to produce more
temperature and pain receptors melanin pigment (e.g., tanning)
provide a great deal of information o People who produce lot of melanin
from external environments have brown-toned skin while people
o Detecting stimuli (phagocytes) also with less melanin are light-skinned
found here that prevent microbes
from getting through the epidermis Carotene
and penetrates deeper into the body o Deposited in the stratum corneum
• Collagen and elastic fibers are found in and subcutaneous tissue
dermis o It is an orange yellow pigment
• Collagen fibers plentiful in carrots and other orange
o Responsible for toughness of the deep yellow or leafy green
dermis vegetables
o Attract and bind water and keep skin o People who eat large amounts of
hydrated carotene-rich foods have skin with
• Elastic fibers yellow orange cast on it
o Give skin elasticity
• Dermis is abundantly supplied with Hemoglobin
blood vessels that maintain body o Pigment in red blood cells
temperature homeostasis o Light-skinned people, the crimson
• Capillaries tend to swell with heated color of oxygen-rich hemoglobin
blood to redden the skin and maintain flushes through the transparent cell
warm layers and gives the skin a rosy glow
• Dermis has rich nerve supply that send • Emotions also influence skin color
messages to the central nervous system • Many alteration in skin color signal
for interpretation certain disease states;
Decubitus ulcers (bedsores) occur in o Redness or erythema
bedridden patients who are not turned o Reddened skin indicate
regularly or who are dragged or pulled embarrassment (blushing), fever,
across the bed repeatedly. hypertension, inflammation or allergy
o Pallor or blanching
o Under certain type of emotional
stress some people become pale
ANAPHY
o Pale skin may also signify anemia, o Sebaceous glands become very
low blood pressure, or impaired active when androgens (male
blood flow into the area sex hormones) are produced in
o Jaundice or yellow cast increased amounts during
o Abnormal yellow skin tone adolescence
o Usually signifies liver disorder o When sebaceous gland ducts are
o Bruise blocked by sebum, acne appears
o Black and blue marks reveal sites on the skin surface
where blood has escaped from o If the accumulated material
circulation and has clotted in the oxidizes and dries, it darkens,
tissue spaces forming a blackhead.
o Hematomas- clotted blood masses o If the material does not dry or
o Unusual bruises may signal darken, a whitehead forms
deficiency in vitamin C in the diet or o Seborrhea (fast-flowing sebum”),
hemophilia (bleeder’s disease) known as “cradle cap” in infants,
is caused by overactivity of the
APPENDIGES OF THE SKIN
sebaceous glands.
• Skin appendages include cutaneous Sweat Glands
glands, hair and hair follicles and
nails - Also called sudoriferous
• Plays unique role in homeostasis - They are more 2.5 million per person
- Have 2 types;
Cutaneous Glands o Eccrine
o All are exocrine glands o Apocrine
o Releases secretion to skin surface Eccrine glands
via ducts
o Fall into two groups: sebaceous - More numerous and are found all
glands and sweat glands over the body
o These glands formed by cells of - Produce sweat (contains water, salt,
stratum basale vitamin C, traces of metabolic
wastes, and lactic acid)
Sebaceous glands - Sweat is acidic (ph4-6) that inhibits
o Also known as oil glands the growth of certain bacteria in our
o Found all over the skin except on skin
palms and soles of feet - Sweat reaches the skin surface via a
o Sebum is their byproduct duct that opens externally as a
o Sebum funnel-shaped sweat pore
o is a mixture of oily substances - Eccrine sweat glands are body’s
and fragmented cells heat-regulating equipment
o A lubricant that keeps the skin - Eccrine secrete sweat when the
soft and moist and prevents the external temperature or body
hair becoming brittle temperature is too high
o Contains chemical that kill - On a hot day, it is possible to lose
bacteria that prevent bacterial up to 7 liters of body water in this
infection way
ANAPHY
Apocrine glands • Cuticle- the most heavily keratinized
region. Provides strength and keep
- Confined to armpit and genital areas
inner hair layers tightly compacted
of the body
• The cuticle is also subject to
- Larger than eccrine glands and their
abrasion, and they wear away at the
ducts empty into hair follicles
tip allowing inner hair regions to frizz
- Their secretion contains fatty acids
out “split ends”
and proteins, as well as all the
• Hair pigment is made by
substances present in eccrine sweat
melanocytes in the hair bulb
- May have milky or yellowish color
- Secretion is odorless but can take a • Varying amounts of different types of
musky unpleasant odor when melanin (yellow, rust, brown, and
bacteria invades it black) combine to produce all
- Apocrine glands begin to function varieties of hair color
during puberty under influence of • Hairs are short and stiff in the
androgens eyebrows, long and flexible on the
- Have minimal role in head and nearly invisible
thermoregulation everywhere else
- activated by nerve fibers during pain • Oval hair shaft: hair is smooth silky
and stress and during sexual arousal and wavy
• Flat ribbonlike shaft: hair is curly or
HAIR AND HAIR FOLLICLES kinky
HAIR • Perfectly round shaft: hair is straight
and to be coarse
• a flexible epithelial structure
• part of hair enclosed in the hair
follicle is the root
• part projecting from the surface of
the scalp or skin is called the shaft
• hair forms by division of the well-
nourished stratum basale epithelial
cells in the matrix (growth zone) of
the hair bulb at the deep end of the
follicle
• Each hair is made up of central core
or the medulla
• Medulla consists of large cells and
air spaces surrounded by a bulky
cortex layer composed of flattened
cells
• Cortex- formed by single layer of
cells that overlap one another. Their
arrangement helps to keep hair
apart and keeps them from matting
ANAPHY
Hair Follicles • Nail bed- stratum basale of the
epidermis
• Are compound structures
• Nail matrix- thickened proximal
• The inner epithelial root sheath is
area. Responsible for nail growth
composed of epithelial tissue and
• Nails like hairs are mostly nonliving
forms the hair
materials
• The outer fibrous sheath is actually
• Nails are transparent and nearly
dermal connective tissue
odorless but look pink because of
• Outer fibrous sheath supplies blood
rich blood supply in underlying
vessels to the epidermal portion
dermis
• Its nipplelike follicle provides blood
• Lunule- white crescent at the edge
supply to the matrix in hair bulb
of the nail
(deepest part of follicle)
• Arrector pili- small bands of smooth

muscle cells that connect each side
of the hair follicle to the dermal
tissue
Homeostatic Imbalances of Skin
NAILS
▪ The skin can develop more than
• Scalelike modification of epidermis
1,000 different ailments
• Correspond to the hoof or claw of
▪ The most common are infections
other animals
with pathogens like bacteria, viruses
• Has a free edge, a body (visible and fungi
attached portion) and a root ▪ Allergies- are caused by abnormally
(embedded in the skin) strong immune responses, are also
• Nail folds- borders of the nail that commonly seen in the skin
overlapped by folds of skin
• Cuticle- thick proximal nail fold
ANAPHY
INFECTONS AND ALLERGIES ▪ Psoriasis
- Characterized by reddened
▪ Athlete’s foot
epidermal lesions covered with dry,
- An itchy, red, peeling condition of the
silvery scales that itch, burn, crack
skin between toes
sometimes bleed
- Resulting from an infection called
- A chronic condition believed to be an
Tinea pedis
autoimmune disorder that attacks its
▪ Boils (furuncles) and carbuncles
own immune system and leads to
o Boils
rapid overproduction of skin cells
- caused by inflammation of hair
- Attacks are often triggered by
follicles and surrounding tissues
trauma, infection, hormonal
- Commonly on dorsal neck
changes, or stress.
o Carbuncles are clusters of boils
often caused by Staphylococcus BURNS
aureus
▪ Cold sores (fever blisters) • A tissue damage and cell death
- Small fluid-filles blisters that itch and • Caused by heat, electrically, UV
sting radiation (sunburn), or certain chemicals
- Caused by human herpesvirus 1 (such as acids)
infection • When skin is burned and its cells are
- Localizes in cutaneous nerve where destroyed, two life-threatening
it remains dormant until activated by problems:
emotional upset, fever or UV o Without an intact boundary (skin),
- occur around the lips and in the oral the body loses its precious supply of
mucosa of the mouth and nose fluids containing proteins and
▪ Contact dermatitis electrolytes as these seep from the
- Itching, redness, and swelling of the burned surfaces.
skin, progressing to blistering o Dehydration and electrolyte
- Caused by exposure of chemical imbalance follow and can lead to a
(poison ivy) that provoke allergic shutdown of the kidneys and
responses in sensitive circulatory shock (inadequate
▪ Impetigo circulation of blood caused by low
- Pink, fluid-filled, raised lesions blood volume)
(commonly around the mouth and o Lost fluids should be replaced, and
nose) its volume can be estimated by
- Develop a yellow crust and determining how much of the body
eventually rupture of surface is burned using rule of
- Highly contagious staphylococcus or nines
streptococcus infections o Rule of nines
- Common in elementary school-aged - A method that divides the body into
children 11 areas
- Each accounting for 9% of the total
body surface area plus an additional
area in the genitals that represent
1% body surface area
ANAPHY
- Infection in burnt patients threatens Fourth Degree Burns
them more and leads to death
- Full-thickness burns
- Even when burned skin is sterile for
- They extend into deeper tissues like
24 hours, pathogens have already
bone, muscles, or tendons
invaded destroyed areas and
- Appear dry and leathery
patient’s immune system becomes
- require surgery and grafting
depressed within 1-2 days after
- in severe cases, amputations are
severe burn injury
done
CLASSIFICATION OF BURNS
Burns could be critical if:
o First-degree burn
o Second-degree (superficial partial- • over 30% of the body has 2nd degree
thickness burns) burn
o Third-degree (full-thickness burns) • over 10% of the body has 3rd degree
o Fourth degree (full-thickness burns burn
with deep-tissue involvement) • there are 3rd or 4th degree burns of the
face, hands, feet or genitals
First Degree Burns • burns affect airways
- Only superficial epidermis is • circumferential area (around body or
damaged limb)
- Area becomes read and swollen o Facial burns might burn respiratory
- Not serious and generally heal in 2-3 passageways that can swell and cause
days suffocation
- Example: Sunburn without o Joint injuries that leaves scar tissue can
blistering severely joint mobility
o Circumferential burns restrict movement
Second Degree Burns and can interfere with normal breathing
- Injury to epidermis and superficial SKIN CANCER
part of the dermis
- Skin is red, painful and blistered • Some skin neoplasms are malignant
- Regrowth of epithelial cells can or cancerous and tend to invade
occur other body areas
- No permanent scar if taken to • Skin cancer is most common type of
prevent infection cancer in humans
• Most risk factor: overexposure to
Third Degree Burns UV radiation in sunlight and tanning
- Destroy both epidermis and dermis beds
- Often extend into subcutaneous • Frequent irritation of the skin by
tissue reflecting as full thickness infections, chemicals, or physical
burns trauma also seems to be a
- Blisters are usually present and predisposing factor
burned area appear blanched (gray, • 3 Common Types of Skin Cancer;
white) or blackened o Basal cell carcinoma
- Regeneration is not possible and o Squamous cell carcinoma
skin grafting must be done o Malignant melanoma
ANAPHY
Basal Cell Carcinoma C. Color- pigmented spot contains
areas of different colors (black,
- Least malignant and most common
brown, tan, blue and red)
skin cancer
D. Diameter- is larger than 6
- Cells of stratum basale can’t form
millimeters (mm) in diameter (the
keratin and boundary between
size of a pencil eraser)
epidermis and dermis is gone
E. Evolution- one or more of these
- Occur most often on sun-exposed
characteristics (ABCD) is
areas of face and often appear
evolving or changing
shiny, dome-shaped nodules
▪ Surgical excision along with
- Develop central ulcer with “pearly”
immunotherapy is the treatment for
beaded edge
malignant melanoma
Squamous Cell Carcinoma ▪ Large lesions may require radiation or
chemotherapy after surgical removal
- Arises from cells of stratum
spinosum DEVELOPMENTAL ASPECT OF SKIN
- Appear as scaly, reddened papules AND BODY MEMBRANES
(small, rounded swellings)
• Lanugo- a downy type of hair
- Gradually form shallow ulcers with
• Vernix caseosa- oily coating
firm raised borders
• This white, cheesy-looking substance,
- Appears often on the scalp, ears,
produced by the sebaceous glands,
back of the hands and lower lip
protects the baby’s skin while it is
- Grows rapidly and metastasizes to
floating in its water-filled sac inside the
adjacent lymph nodes
mother
- Believed to be induced by UV
exposure • As the baby grows, its skin becomes
thicker, and more subcutaneous fat is
Malignant Melanoma deposited.
• During adolescence, skin becomes oiler
- A cancer of melanocytes
and acne is already showing
- Accounts for 5% of skin cancers but
• Skin reaches optimal appearance in our
often deadly
20s and 30s
- Can begin wherever there is pigment
- Arises from accumulated DNA • Visible changes on skin begin to appear
damage in skin cell as it continually exposed to many
- Usually appears as a spreading factors
brown to black patch • In return, pimples, scales and dermatitis
- Chance for survival is 50% percent or skin inflammation become more
and early detection helps common
- Use ABCDE rule to recognize • As we get older, our skin decreases
melanoma subcutaneous tissue and becomes drier
A. Asymmetry- any two sides of and as result it becomes itchy and
the pigmen spot or mole do not bothersome
match • Thinning of skin result of aging process
B. Border irregularity- borders of
lesions are not smooth but
exhibit indentation
ANAPHY
• 3 best things to do on our skin:
a. Avoid smoking
b. Shield your skin from sun (use
sunblock)
c. Don’t go to tanning beds
• Hair loses its luster as we age and by 50
number of hair follicles has dropped by
1/3 and continues to decline
• Bald man is not really hairless, they just
have hair follicles that degenerate vellus
and hairs are colorless and very tiny
• Graying hair- amount of melanin
deposited in the hair decrease or
becomes entirely absent

Chapter 4 (Skin&membranes)

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Chapter 4 (Skin&membranes)

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Holy Name University - College of Health Sciences

Department of Radiologic Technology

a. Epithelial Membranes Serous Membranes

• Is composed of epithelium that is

• Essential for it keeps water and

• Arrector pili- small bands of smooth

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