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Chapter 4

Skin and Body Membranes

Body Membranes
▪ Functions of body membranes
o Cover body surfaces
o Line body cavities
o Form protective sheets around organs
▪ Classified according to tissue types

Body Membranes
▪ Epithelial membranes
o Cutaneous membranes
o Mucous membranes
o Serous membranes
▪ Connective tissue membranes
o Synovial membranes

Epithelial Membranes
▪ Epithelial membranes are simple organs
▪ Also called covering and lining membranes
▪ These membranes contain:
o Epithelial tissue layer
o Connective tissue layer

Epithelial Membranes
▪ Cutaneous membrane = skin
o Dry membrane
o Outermost protective boundary
o Construction
▪ Epidermis is composed of keratinized stratified squamous epithelium
▪ Dermis is mostly dense (fibrous) connective tissue

Epithelial Membranes
▪ Mucous membranes (mucosae)
o Moist membranes
o Line all body cavities that open to the exterior body surface
o Adapted for absorption or secretion
o Construction
▪ Epithelium type depends on site
▪ Loose connective tissue (lamina propria)

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Epithelial Membranes
▪ Serous membranes (serosae)
o Line open body cavities that are closed to the exterior of the body
o Occur in pairs, separated by serous fluid, with a visceral and parietal layer
o Construction
▪ Simple squamous epithelium
▪ Areolar connective tissue

Epithelial Membranes
▪ Specific serous membranes
o Peritoneum
▪ Abdominal cavity
o Pleura
▪ Around the lungs
o Pericardium
▪ Around the heart

Connective Tissue Membranes


▪ Synovial membranes
o Loose areolar connective tissue only (no epithelial tissue)
o Line fibrous capsules surrounding joints
▪ Line bursae
▪ Line tendon sheaths
o Secrete a lubricating fluid to cushion organs moving against each other during
muscle activity

Integumentary System
▪ Integumentary system consists of the:
o Skin (cutaneous membrane)
o Skin appendages
▪ Sweat glands
▪ Oil glands
▪ Hair
▪ Nails

Functions of the Integumentary System


▪ Insulates and cushion deeper body organs
▪ Protects the entire body from:
o Mechanical damage (bumps and cuts)
o Chemical damage (acids and bases)
o Thermal damage (heat or cold)
o Ultraviolet (UV) radiation (sunlight)
o Microbes (bacteria)
o Desiccation (drying out)

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Functions of the Integumentary System
▪ Aids in loss or retention of body heat as controlled by the nervous system
▪ Aids in excretion of urea and uric acid
▪ Synthesizes vitamin D

Structure of the Skin


▪ Two kinds of tissue compose the skin
o Epidermis
o Dermis
▪ Hypodermis (subcutaneous layer)
o Anchors the skin to underlying organs
o Not technically part of the integumentary system
o Composed mostly of adipose tissue
o Serves as a shock absorber and insulates deeper tissues

Structure of the Skin


▪ Epidermis—outer layer
o Capable of being hard and tough
o Stratified squamous epithelium
o Keratinocytes (the most common cell) produce a fibrous protein called keratin
o Avascular
o Composed of five layers (strata)

Structure of the Skin


▪ Summary of layers of the epidermis from deepest to most superficial
o Stratum basale
o Stratum spinosum
o Stratum granulosum
o Stratum lucidum (thick, hairless skin only)
o Stratum corneum

Structure of the Skin


▪ Stratum basale (stratum germinativum)
o Deepest layer of epidermis
o Lies next to dermis
o Wavy borderline with the dermis anchors the two together
o Cells undergoing mitosis
o Daughter cells are pushed upward to become the more superficial layers
▪ Stratum spinosum
o Cells become increasingly flatter and more keratinized

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Structure of the Skin
▪ Stratum granulosum
▪ Stratum lucidum
o Formed from dead cells of the deeper strata
o Occurs only in thick, hairless skin of the palms of hands and soles of feet
▪ Stratum corneum
o Outermost layer of epidermis
o Shingle-like dead cells are filled with keratin (protective protein prevents water
loss from skin)

Structure of the Skin


▪ Melanin
o Melanin is a pigment produced by melanocytes
o Melanocytes are mostly in the stratum basale of the epidermis
o Color is yellow to brown to black
o Melanin accumulates in membrane-bound granules called melanosomes
o Amount of melanin produced depends upon genetics and exposure to sunlight

Structure of the Skin


▪ Epidermal dendritic cells
o Alert and activate immune cells to a threat (bacterial or viral invasion)
▪ Merkel cells
o Associated with sensory nerve endings
o Serve as touch receptors called Merkel discs

Structure of the Skin


▪ Dermis
o Connective tissue
o Underlies the epidermis

Structure of the Skin


▪ Two layers of the dermis
o Papillary layer (upper dermal region) contain projections called dermal papillae
▪ Indent the epidermis above
▪ Many projections contain capillary loops, and others house pain and
touch receptors
▪ On palm and sole surfaces, papillae increase friction and gripping ability
▪ Fingerprints are identifying films of sweat

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Structure of the Skin
▪ Two layers of the dermis (continued)
o Reticular layer (deepest skin layer)
▪ Blood vessels
▪ Sweat and oil glands
▪ Deep pressure receptors (lamellar corpuscles)

Structure of the Skin


▪ Other dermal features
o Cutaneous sensory receptors
o Phagocytes
o Collagen and elastic fibers
o Blood vessels

Skin Color
▪ Three pigments contribute to skin color
1. Melanin
▪ Yellow, reddish brown, or black pigments
2. Carotene
▪ Orange-yellow pigment from some vegetables
3. Hemoglobin
▪ Red coloring from blood cells in dermal capillaries
▪ Oxygen content determines the extent of red coloring

Skin Color
▪ Redness (erythema)—due to embarrassment, inflammation, hypertension, fever, or
allergy
▪ Pallor (blanching)—due to emotional stress (such as fear), anemia, low blood
pressure, impaired blood flow to an area
▪ Jaundice (yellow cast)—indicates a liver disorder
▪ Bruises (black and blue marks)—hematomas

Appendages of the Skin


▪ Cutaneous glands are all exocrine glands
o Sebaceous glands
o Sweat glands
▪ Hair
▪ Hair follicles
▪ Nails

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Appendages of the Skin
▪ Sebaceous (oil) glands
o Located all over the skin except for palms and soles
o Produce sebum (oil)
▪ Makes skin soft and moist
▪ Prevents hair from becoming brittle
▪ Kills bacteria
o Most have ducts that empty into hair follicles; others open directly onto skin
surface
o Glands are activated at puberty

Appendages of the Skin


▪ Sweat (sudoriferous) glands
o Produce sweat
o Widely distributed in skin
▪ Two types of sudoriferous glands
1. Eccrine glands
2. Apocrine glands

Appendages of the Skin


▪ Eccrine glands
o Open via duct to sweat pores on the skin’s surface
o Produce acidic sweat
▪ Water, salts, vitamin C, traces of metabolic waste
o Function in body temperature regulation

Appendages of the Skin


▪ Apocrine glands
o Ducts empty into hair follicles in the armpit and genitals
o Begin to function at puberty
o Release sweat that also contains fatty acids and proteins (milky or yellowish
color)
o Play a minimal role in body temperature regulation

Appendages of the Skin


▪ Hair
o Produced by hair follicle
o Root is enclosed in the follicle
o Shaft projects from the surface of the scalp or skin
o Consists of hard keratinized epithelial cells
o Melanocytes provide pigment for hair color
o Hair grows in the matrix of the hair bulb in stratum basale

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Appendages of the Skin
▪ Hair anatomy
o Central medulla
o Cortex surrounds medulla
o Cuticle on outside of cortex
▪ Most heavily keratinized region of the hair

Appendages of the Skin


▪ Associated hair structures
o Hair follicle
▪ Composed of an epithelial root sheath and fibrous sheath
▪ Dermal region provides a blood supply to the hair bulb (deepest part of
the follicle)
▪ Arrector pili muscle connects to the hair follicle to pull hairs upright when
we are cold or frightened

Appendages of the Skin


▪ Nails
o Heavily keratinized, scalelike modifications of the epidermis
o Stratum basale extends beneath the nail bed, which is responsible for growth
o Lack of pigment makes nails colorless

Appendages of the Skin


▪ Parts of a nail
o Free edge
o Body is the visible attached portion
o Nail folds are skin folds that overlap the edges of the nail; the cuticle is the
proximal edge
o Root of nail is embedded in skin
o Growth of the nail occurs from nail matrix

Homeostatic Imbalances of Skin


▪ Infections and allergies
o Athlete’s foot
▪ Caused by fungal infection (Tinea pedis)
▪ Itchy, red peeling skin between the toes
o Boils (furuncles) and carbuncles
▪ Caused by inflammation of hair follicles
▪ Carbuncles are clusters of boils caused by bacteria
o Cold sores (fever blisters)
▪ Caused by human herpesvirus 1
▪ Blisters itch and sting

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Homeostatic Imbalances of Skin
▪ Infections and allergies (continued)
o Contact dermatitis
▪ Caused by exposure to chemicals that provoke allergic responses
▪ Itching, redness, and swelling of the skin
o Impetigo
▪ Caused by bacterial infection
▪ Pink, fluid-filled raised lesions around mouth/nose
o Psoriasis
▪ Triggered by trauma, infection, hormonal changes, or stress
▪ Red, epidermal lesions covered with dry, silvery scales that itch, burn,
crack, or sometimes bleed

Homeostatic Imbalances of Skin


▪ Burns
o Tissue damage and cell death caused by heat, electricity, UV radiation, or
chemicals
o Associated dangers
▪ Protein denaturation and cell death
▪ Dehydration and electrolyte imbalance
▪ Circulatory shock
o Result in loss of body fluids and infection from the invasion of bacteria

Homeostatic Imbalances of Skin


▪ Extent of a burn is estimated using the rule of nines
o Body is divided into 11 areas for quick estimation
o Each area represents about 9 percent of total body surface area
▪ The area surrounding the genitals (the perineum) represents 1 percent
of body surface area

Homeostatic Imbalances of Skin


▪ First-degree burn (superficial burn)
o Only epidermis is damaged
o Skin is red and swollen
▪ Second-degree burn (partial-thickness burn)
o Epidermis and superficial part of dermis are damaged
o Skin is red, painful, and blistered
o Regrowth of the epithelium can occur

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Homeostatic Imbalances of Skin
▪ Third-degree burn (full-thickness burn)
o Destroys epidermis and dermis; burned area is painless
o Requires skin grafts, as regeneration is not possible
o Burned area is blanched (gray-white) or black
▪ Fourth-degree burn (full-thickness burn)
o Extends into deeper tissues (bone, muscle, tendons)
o Appears dry and leathery
o Requires surgery and grafting
o May require amputation

Homeostatic Imbalances of Skin


▪ Criteria for deeming burns critical (if any one is met):
o Over 30 percent of body has second-degree burns
o Over 10 percent of the body has third- or fourth-degree burns
o Third- or fourth-degree burns of the face, hands, or feet, or genitals
o Burns affect the airways
o Circumferential (around the body or limb) burns have occurred

Homeostatic Imbalances of Skin


▪ Skin cancer
o Most common form of cancer in humans
o Most important risk factor is overexposure to ultraviolet (UV) radiation in
sunlight and tanning beds
▪ Cancer can be classified two ways
1. Benign means the neoplasm (tumor) has not spread
2. Malignant means the neoplasm has invaded other body areas

Homeostatic Imbalances of Skin


▪ Most common types of skin cancer
o Basal cell carcinoma
o Squamous cell carcinoma
o Malignant melanoma

Homeostatic Imbalances of Skin


▪ Basal cell carcinoma
o Least malignant and most common type of skin cancer
o Arises from cells in stratum basale that are altered so that they can no longer
make keratin
o Lesions appear as shiny, dome-shaped nodules that develop a central ulcer

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Homeostatic Imbalances of Skin
▪ Squamous cell carcinoma
o Believed to be induced by UV exposure
o Arises from cells of stratum spinosum
o Lesions appear as scaly, reddened papules that gradually form shallow ulcers
o Early removal allows a good chance of cure
o Metastasizes to lymph nodes if not removed

Homeostatic Imbalances of Skin


▪ Malignant melanoma
o Most deadly of skin cancers, but accounts for only 5 percent of skin cancers
o Arises from melanocytes
o Metastasizes rapidly to lymph and blood vessels
o Detection uses ABCDE rule for recognizing melanoma

Homeostatic Imbalances of Skin


▪ Malignant melanoma (continued)
o A = Asymmetry
▪ Two sides of pigmented mole do not match
o B = Border irregularity
▪ Borders of mole are not smooth
o C = Color
▪ Different colors in pigmented area
o D = Diameter
▪ Spot is larger than 6 mm in diameter
o E = Evolution
▪ One or more of the ABCD characteristics is evolving

Developmental Aspects of Skin and Body Membranes


▪ Lanugo, a downy hair, covers the body by the fifth or sixth month of fetal development
but disappears by birth
▪ Vernix caseosa, an oily covering, is apparent at birth
▪ Milia, small white spots, are common at birth and disappear by the third week
▪ Acne may appear during adolescence

Developmental Aspects of Skin and Body Membranes


▪ In youth, skin is thick, resilient, and well hydrated
▪ With aging, skin loses elasticity and thins
▪ Skin cancer is a major threat to skin exposed to excessive sunlight
▪ Balding and/or graying occurs with aging; both are genetically determined; other
factors that may contribute include drugs and emotional stress

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