Skin physiology

Lecturer:Dr Herman Mulijadi MS, SpKP

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Learning Objective
Topic : Skin as an organ of protection
Duration : 50 minutes
Lesson Objectives : Students should be able to
1.Identify the structure of the epidermis as a physical permeable
barrier.
2.Know the functions of the epidermal and dermal layers in skin
protection.
3. Melanin and ultraviolet radiation
4.Know the neurologic pathway of skin sensation.
5.Understand the pathophysiology and clinical aspects of itch
6.Recognize the pathologic skin barriers in dermatoses
7.Treatment implications and approaches: restoring the skin’s
protective function
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• The skin as Organs • Functions

– Protection
• Skin • Abrasion
• Hair • Infection
• Nails • UV light
• Dehydration (water lost)
• Glands
– Thermal Regulation
• Insulation (fat keeps you warm)
• Cooling (sweating cools you
down)
– Sensory Reception
– Vitamin D Production
– Communication (raised eyebrows)

NOTE
Vitamin D is made in the dermis of the skin, after exposure to sunlight. It’s function
is to allow calcium to be absorbed from the foods you eat so your blood calcium
levels are normal.
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The Skin and the Hypodermis
Skin – our largest organ
–Accounts for 7% of body weight…it weighs twice as much as your brain!
–Divided into three distinct layers
•Epidermis (‘epi” means above something)
•Dermis
•Hypodermis (“hypo” means deep to something)
Merkel (tactile) disc
Nociceptor (type I cutaneous
mechanoreceptor) Remember,
(pain receptor)
the term
Meissner corpuscle “SKIN” refers
Epidermis
(corpuscle of touch) to all three
layers:
Ruffini corpuscle epidermis,
(type II cutaneous dermis, and
Dermis mechanoreceptor hypodermis.
Hair root plexus

Subcutaneous Pacinian
layer (lamellated)
corpuscle
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•Keratinocytes (90%)- waterproofs & protects skin, nails, hair, stratum corneum
•Melanocytes (8%)- produce melanin
•Merkel Cells- slow mechanoreceptors
•Langerhans’ Cells- immunological defense

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 Layers of the Epidermis
The epidermis contains four major layers (thin skin) or
five major layers (thick skin)
• Stratum corneum (most superficial layer of epidermis)
• Stratum lucidum (only in thick skin)
• Stratum granulosum
• Stratum spinosum
• Stratum basale (the deepest layer of epidermis)
7 Epidermis
1. Stratum corneum:
 composed of many sublayers ( multi layer tissue ) of flat, dead
keratinocytes ( flattened, anucleate) called corneocytes or squames
 Embedded in an intercellular lipid matrix
 The primary barrier against pathogen entry
 Regulation of water loss from body
 Withstand physical force --> Protects skin against abrasion
 continuously shed and replaced by cells from deeper strata;
 constant friction can stimulate formation of a callus.

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Surrounded by multiple planar lamellae sheets, enriched in ceramides,
cholesterol, and free fatty acids (FFA)((brick & Mortar model)
Ceramides:
 important lipid component for the lamellar arrangement of the stratum
corneum.
 composed of polyunsaturated fatty acids (the omega-6 linoleic acid
contained in sunflower oil) and sphingosines..
 highly hydrophobic lipids inhibits the outward movement of water .
 SC desomosomes structures composed primarily of glycoproteins,
 The desomosomes joining corneocytes called corneodesmosine,
 SC desmosomes are sometimes referred to as corneodesmosomes

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 9 Epidermis
2. Stratum lucidum is present only in thick skin (the skin of the fingertips, palms, and
soles) Composed of a few rows of flat, dead keratinocytes.This THIN layer provides
protection from UV radiation.
3. Stratum granulosum, Consists of keratinocytes and tonofilaments
- Tonofilaments contain
• Keratohyaline granules – help form keratin
• Lamellated granules – contain a waterproofing glycolipid
4. Stratum spinosum, (spiny layer) 8-10 layers of keratinocytes.
"Spiny" appearance caused by artifacts of histological preparation Contains thick
bundles of intermediate filaments (tonofilaments) Contains star-shaped Langerhans cells

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10 Epidermis
5. Stratum basale (deepest layer) or stratum germinativum,
Deepest layer of epidermis
• Attached to underlying dermis
• Cells actively divide . where continuous cell division occurs which
produces all the other layers
• Stratum basale contains
 Merkel cells – associated with sensory nerve ending
 Melanocytes – secrete the pigment melanin

Keratinization, the accumulation of

more and more protective keratin,
occurs as cells move from the
deepest layer to the surface layer
Dandruff - an excess of keratinized
cells shed from the scalp

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 Melanocytes
Melanocytes produce melanin by the oxidation
of the amino acid tyrosine, followed by
/ tyrosinase
polymerization. L Dehydroxy
Phenylalanin
/tyrosinase
In the skin,
melanogenesis
occurs after
exposure to UV tyrosinase-related
radiation, protein 2

tyrosinase-related
protein 1

5,6-dihydroxyindole-2- 5,6-dihydroxyindole
There are three basic types of carboxylic acid (DHICA) (DHI)
melanin: eumelanin, pheomelanin, polymers.

and neuromelanin.
The most common is eumelanin,
 Melanocytes

 Melanin has numerous properties which are beneficial to protect

epidermis and dermis fom the ultraviolet radiation.
 Granule melanin migrate and transfer to Keratinocytes then
accumulated above the keratinocyte nucleus in the germinativum and
spinosum of epidermis cel
 The accumulated granule melanin above the keratinocyte nucleus will
block the ultraviolet radiation
 The pigment is able to dissipate or scatter over 99.9% of absorbed UV
radiation
 Ultraviolet
Ultraviolet (A and B) radiation :
 Radiant energy of wavelength 280 nm – 400 nm.
 More energetic than visible light,
 Capability to cause certain chemical reactions including several within human skin
 Essential for the production of vitamin D, but have the potential lead to skin cancer
The UV index scale use in US:

2 or lower means low danger from the sun's UV rays for the average person.
3–5 means moderate risk of harm from unprotected sun exposure.
6–7 means high risk of harm from unprotected sun exposure. Apply a sunscreen with
a SPF of at least 15. Wear a wide-brim hat and sunglasses to protect the eyes.
8–10 means very high risk of harm from unprotected sun exposure. Minimize sun exposure during
midday hours, from 10 AM to 4 PM. Protect skin by liberally applying a sunscreen with an SPF of at least
15. Wear protective clothing and sunglasses to protect the eyes.
11 or higher means extreme risk of harm from unprotected sun exposure. Try to avoid sun exposure
during midday hours, from 10 AM to 4 PM. Apply sunscreen with an SPF of at least 15 liberally every
two hours.
 Ultraviolet

 UVA has the ability to penetrate through the epidermis, dermis and enter
the hypodermis.
 UVB penetrates completely through the epidermis and slightly into the
dermis.
 UV exposure may damage skin cells, leading to DNA defects in which
adjacent thymine bases become covalently linked, creating thymine dimers.
 Thymine dimers have the potential to cause buckling in the strand and
create misreading during DNA replication.

 The ultraviolet radiation have

potential to the DNA nucelus mutation
process and lead to skin cancer

One common type the damage that UV radiation can have

on a skin cell DNA strand, causing a thymine dimer.
 15 Epidermal function
The epidermis generates protective and defensive functions mediated by its
unique differentiation end product, the stratum corneum (SC).
 Most critical is the permeability barrier, , which retards transcutaneous
evaporative water loss to maintain the homeostasis toward the prevention of uncontrolled loss
or entry of water.
 A mechanical barrier to the invasion of microorganisms and toxic chemical substances
into the body
 Antimicrobial peptides are delivered to the SC intercellular domains via secretion of
lamellar body content, Like the permeability barrier, the antimicrobial barrier is compromised
 Immunologic functions , Langerhans cells are dendritic immune cells that are the
antigen-presenting cell of the skin. They are important to the immune barrier of the
epidermis and also participate in contact allergy.

 Protection of the skin from ultraviolet light via the pigment system, Melanocytes
are the pigment-producing cells producing pigment granules called melanosomes containing
melanin a dark pigment that provides skin color.
 Skin barrier and pH. The acidic pH of the horny layer is called the ‘acid mantle’ of the
stratum corneum, and is important for both cutaneous antimicrobial defence and the formation
of a barrier against permeability. Normal pH on the surface of adult skin is in the range of 5.4 to
5.9, due to the components of the stratum corneum, sebum and sweat secretion.

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The Dermis
The dermis has several important characteristics:
Composed of connective tissue containing collagen and elastic fibers
The structure provides strength, extensibility (the ability to be stretched),
and elasticity (the ability to return to its original form).
 It is in the dermis where we find capillaries and many nerve endings.
(Major blood vessels are found in the hypodermis.)

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The Dermis
The dermis Contains two layers
 The thin outer papillary region consists of :
- Areolar connective tissue containing thin
collagen and elastic fibers,
- Dermal papillae (including capillary loops), papillary
dermis
- Corpuscles of touch and free nerve
endings
reticular
 The deeper thick reticular region dermis
consists of
- Dense irregular connective tissue
containing collagen and elastic fibers
adipose cells,
- Hair follicles, nerves,
- Sebaceous (oil) glands, and
sudoriferous (sweat) glands
Striae or stretch marks can appear if the skin is stretched
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Dermis
• Somatic receptor in dermis is Divided into
two groups
– Free or Unencapsulated nerve endings
– Encapsulated nerve endings - consist of
one or more neural end fibers enclosed in
connective tissue
• Pacinian Corpuscle: nerve
receptors in the dermis for
vibration and pressure
• Meissner's Corpuscle: nerve
receptors in the dermis for light
touch
• Ruffini’s corpuscles Located
in the dermis and respond to
pressure Monitor continuous
pressure on the skin – adapt
slowly

Merkel discs – lie in the

epidermis, slowly adapting
receptors for light touch
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• Subcutaneous (subQ) layer (also called hypodermis) is not part of the skin but,
• among its functions, it attaches the skin to the underlying tissues and organs;
• this layer (and sometimes the dermis) contains lamellated (pacinian) corpuscles
which detect external pressure applied to the skin.

This layer contains adipose

tissue and serves to attach
the dermis to its underlying
tissues.

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Sweat Glands
• Eccrine (merocrine) glands- sweat, The watery fluid they secrete contains
chloride, lactic acid, fatty acids, urea, glycoproteins and mucopolysaccharides.
• Apocrine glands- axillary & anogenital areas. the ducts of which empty out
into the hair follicles.
• Ceruminous glands- ears canal
• Mammary glands- female reproductive glands

Sweat
glands
Ceruminous
glands

Cooling (sweating cools you down)

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Hair shaft Hair

Sebaceous gland

Hair root

Hair bulb in follicle

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Nail

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Somatic Senses
• General somatic – include touch, pain,
vibration, pressure, temperature
• Proprioceptive – detect stretch in
tendons and muscle provide information
on body position, orientation and
movement of body in space
Stimulus type
• Mechanoreceptors- deformed by force
– Touch, pressure (BP), vibration, stretch, itch
• Thermoreceptors- changes in temperature
• Photoreceptors- light energy
• Chemoreceptors- chemicals in solution
– Smell, taste, blood chemistry
• Nociceptors- pain

All receptors can interpret pain if overstimulated!

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 25 Location of stimulus
• Exteroceptors:
- sensitive to stimuli arising outside the body(Located at or near body
surfaces)
- Touch, pressure, pain, special senses
• Interoceptors (visceroceptors):
- Respond to stimuli from inside the body (viscera/BV’s/ receive stimuli
from internal viscera)
- Chemical changes, stretching of tissues, temperature
- We are typically unaware of these receptors except for pain, discomfort,
hunger, & thirst
• Proprioceptors: Receptive Field
- Respond to internal stimuli (monitor degree of stretch)
- Location is only in skeletal muscle, tendons, joints, ligaments, & CT
coverings of bones & muscles

• Area is monitored by a single receptor cell

• The larger the receptive field, the more
difficult it is to localize a stimulus
Figure 15–2 25
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Type A and Type C Fibers

• Type A Fibers - Carry sensations of fast pain, or

prickling pain, such as that caused by an injection or a
deep cut
– Sensations reach the CNS quickly and often trigger
somatic reflexes
– Relayed to the primary sensory cortex and receive
conscious attention
• Type C Fibers - Carry sensations of slow pain, or
burning and aching pain
– You become aware of the pain but only have a
general idea of the area affected

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27 Somatic Receptors

• Divided into two groups

– Free or Unencapsulated nerve endings
– Encapsulated nerve endings - consist of one or more neural
end fibers enclosed in connective tissue

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28 Free Nerve Endings
• Abundant in epithelia and underlying connective tissue
- The simplest of our sensory receptors ;Branching tips of dendrites
- Not protected by accessory structures ; Can be stimulated by many different stimuli
• Nociceptors - respond to pain
• Thermoreceptors - respond to temperature
• Two specialized types of free nerve endings
– Merkel discs – lie in the epidermis, slowly adapting receptors for light touch
– Hair follicle receptors – Rapidly adapting receptors that wrap around hair follicles

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29 Encapsulated Nerve Endings
–Meissner’s corpuscles
•Spiraling nerve ending surrounded by Schwann cells
•Occur in the dermal papillae of hairless areas of the skin
•Rapidly adapting receptors for discriminative touch
–Pacinian corpuscles
•Single nerve ending surrounded by layers of flattened Schwann cells
•Occur in the hypodermis
•Sensitive to deep pressure – rapidly adapting receptors
–Ruffini’s corpuscles
•Located in the dermis and respond to pressure
•Monitor continuous pressure on the skin – adapt slowly

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 30 Encapsulated Nerve Endings - Proprioceptors
• Monitor stretch in locomotory organs
•Three types of proprioceptors
–Muscle spindles – monitors the changing length of a muscle, imbedded in the perimysium
between muscle fascicles
–Golgi tendon organs – located near the muscle-tendon junction, monitor tension within
tendons
–Joint kinesthetic receptors - sensory nerve endings within the joint capsules, sense pressure
and position

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An Overview of Neural Integration

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 32 Processing at the circuit level
• First order neurons (cell bodies in DRG or cranial nuclei)
– Conduct impulses from receptors/proprioceptors to the cord or brain stem to synapse w/
2nd order neurons (Sensory neurons that deliver sensory information to the CNS), enters
spinal cord from periphery
• Second order neurons (cell bodies in dorsal horn of cord or medullary nuclei)
– Transmit impulses to the thalamus or cerebellum where they synapse (First order neurons
synapse on these in the brain or spinal cord); crosses over (decussates), ascends in spinal
cord to thalamus
• Third order neurons (none found in the cerebellum)
– Located in the thalamus & conduct impulses to the somatosensory cortex of the cerebrum
(Second order neurons synapse on these); projects to somatosensory cortex
• Only 1% of incoming sensory impulses actually reach the cerebrum

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Central Pathways

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Pathways in the CNS sensory pathways

1.The posterior column pathway
2.The anterolateral (Spinothalamic) 3 Major Somatic Sensory
pathway Pathways
3.The spinocerebellar pathway

Sensations that originate in different areas of the body can be

distinguished because sensory neurons from each body region synapse
in a specific brain region
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35 Posterior Column Pathway
• Fasciculus gracilis
• Fasciculus cuneatus
• Carries sensations of highly localized
(“fine”) touch, pressure, vibration, and
proprioception
• Ability to determine stimulus Precisely
where on the body a specific stimulus
originated depends on the projection of
information from the thalamus to the
primary sensory cortex
• Carries fine touch, vibration and onscious
proprioception signals
• 1st neuron enters spinal cord through dorsal
root; ascends to medulla (brain stem)
• 2nd neuron crosses over in medulla; ascends to
thalamus
• 3rd neuron projects to somatosensory cortex

Figure 15–5a 35
 36 Dorsal/Posterior column damage
dorsal
column Left
pathway spinal cord
• Sensory ataxia
injury • Patient staggers;
cannot perceive
position or
movement of legs
• Visual clues help
movement

dorsal
cloumn
pathway
Loss of sense of:
•touch
•proprioception
•vibration in left leg
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37 The Anterolateral (Spinothalamicus ) Pathway
• Provides sensations of “crude” touch,
pressure, pain, and temperature
• Ascend within the anterior or lateral
spinothalamic tracts:
– The anterior spinothalamic tracts
carry crude touch and pressure
sensations
MESENCEPHALON
– The lateral spinothalamic tracts
carry pain and temperature
sensations

MEDULA OBLONGATA
SPINAL CHORD

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Spinothalamic pathway
• Carries pain, temperature, touch and
pressure signals
• 1st neuron enters spinal cord through dorsal
root; first-order neurons from one side of
body synapse with dendrites and cell bodies
of second-order neurons in posterior gray
horn on same side of body.
• 2nd neuron crosses over in spinal cord;
ascends to thalamus; neurons decussate,
enter spinothalamic tract on opposite side,
and extend to thalamus.
• 3rd neuron projects from thalamus to
somatosensory cortex; neurons transmit
nerve impulses from thalamus to primary
somatosensory cortex on side opposite the
site of stimulation.
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Spinothalamic damage
Left
spinothalamic pathway spinal cord injury

spinothalamic
pathway

Loss of sense of:

•Touch
•Pain
•Warmth/cold
in right leg 39
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Strong Visceral Pain as Referred pain

• An individual can feel pain in uninjured part of body when pain actually
originates at another location
• Sensations arriving at segment of spinal cord can stimulate
interneurons that are part of anterolateral pathway
• Activity in interneurons leads to stimulation of primary sensory cortex,
so an individual feels pain in specific part of body surface:

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The Spinocerebellar Pathway
• Cerebellum receives proprioceptive information about
position of skeletal muscles, tendons, and joints
• Carries unconscious proprioception signals
• Receptors in muscles & joints
• 1st neuron: enters spinal cord through dorsal root
• 2nd neuron: ascends to cerebellum
• No 3rd neuron to cortex, hence unconscious

Figure 15–7 41
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Spinocerebellar tract damage

• Cerebellar ataxia
• Clumsy movements
• Incoordination of the limbs (intention tremor)
• Wide-based, reeling gait (ataxia)
• Alcoholic intoxication produces similar effects!

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Somatosensory cortex

Located in the postcentral gyrus

of the human cerebral cortex.

Spatial orientation of signals.

1) Each side of the cortex receives sensory information
exclusively from the opposite side of the body (the
exception: the same side of the face).
2) The lips, face and thumb are represented by
large areas in the somatic cortex, whereas the trunk
and lower part of the body, relatively small area.

3) The head in the most lateral

portion, and the lower body is
presented medially
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Skin / wound Healing
• natural restorative response to tissue injury.
• Healing is the interaction of a complex cascade of cellular events that
generates resurfacing, reconstitution, and restoration of the tensile
strength of injured skin
• Individual skin cells do not have a high metabolic rate, and construction of
scar tissue is more difficult than making normal skin. You get a scar only if
the dermis is excessively damaged.
• Remember that the epidermis does not have blood supply and the
fibroblasts are only present in the dermis.
• Still, the skin is capable of repair, even after serious damage because
stem cells persist in both the epidermis and the dermis.

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 45 3 classic phases:
• Inflammatory phase : A clot forms and cells of inflammation debride injured
tissue
• Proliferative phase : Occur Epithelialization, fibroplasia, and angiogenesis ;
additionally, granulation tissue forms and the wound begins to contract.
• Maturation phase : Collagen forms tight cross-links to other collagen and
with protein molecules, increasing the tensile strength of the scar during

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• Blood vessels • Granulation tissue • Scar area has

dilate forms contracted
• WBC & clotting • Capillary beds invade • Epithelium
agents released clot regeneration begins
• Scab forms • Clean up begins

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 47 Recognize the pathologic skin barriers in dermatoses

Vulnerable skin. Vulnerable skin may be malfunctioning in one or more

of the aspects protection of defensive function,
 by giving way to mechanical stress and tearing,
 by not being able to balance biological homeostasis
 or by defective immunological functions.

Vulnerable skin can also be caused by one or more of

the following factors.:
a. Skin thickness. Skin thickness varies according to age, gender,
anatomical site and even diurnal phases, owing to changes in dermal
hydration caused by postural changes.
b. Ageing . Skin ageing is accelerated by exposure to ultraviolet
light. Old skin loses elasticity, its epidermal hydration is less well
restored and turnover of cells and tissues may be slower. The skin of
old people may thus become extremely thin and vulnerable
c. Ultraviolet radiation damage. The skin has two barriers to
UV radiation: a melanin barrier in the epidermis, and a protein-lipid
barrier concentrated in the stratum corneum

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d. Genetic diseases. Genetic defects in lipid metabolism or in the protein components

of the stratum corneum are also accompanied by skin barrier defects, such as in ichthyosis
and related cornification disorders.
e Atopic dry skin has an impaired barrier function due to abnormalities in enzymes and
lipids in the stratum corneum resulting in increased transepidermal water loss, lower water-
binding capacity and vulnerability to Staphylococcus aureus colonisation
f. Deposition of abnormal substances. With advancing age and especially in
patients suffering from long-standing diabetes, end-products of advanced glycoxidation and
lipoxidation of structural molecules accumulate in the extracellular matrix of the skin (and
other tissues)
g. Inflammation. Inflammation of the skin is characterised by the migration of
neutrophils, macrophages and lymphocytes, followed by a proliferation of endothelial cells
and fibroblasts.

Atopic dermatitis
Impaired skin barrier in a has affected skin Eczematous
patient with ichthyosis barrier function skin
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h. Irritants. Accumulation of debris, sebum, remnants of topical formulations and of dressing

materials will also induce inflammation .Sweating and retention of water in wet and/or occluded
areas or skin folds is the main cause of maceration and the development of intertriginous erosive
skin lesions
i. Colonisation and infection. Normal human skin resists penetration by micro-organisms
that routinely colonise its surface. Moist lesions where the epidermal barrier is disrupted by a
dermatological disease
j. Mechanical injury . After mechanical injury, keratinocytes release interleukin-1 (IL-1),
which activates them and signal-alerts the surrounding tissues

Irritant dermatitis possibly
caused by dressings used
to treat a leg ulcer
Irritant dermatitis
probably caused by
repeated cleansing with
an irritant
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Itch sensation

 Itching and pruritus are often used synonymously and a frequent problem
 Very sensitive, rapidly adapting mechanoreceptive free nerve endings or
unspecialised nerve endings at dermal-epidermal junction.
 Exclusively in superficial layers of the skin,
 Characterised by peculiar, tingling or uneasy irritation
 Characteristic sensory feature of numerous dermatologic and non-
dermatologic disorders.
 Transmitted by very small type C, (unmyelinated fiber ),
 The purpose to call attention to activate the scratch reflex
 Relieved by scratching or if the scratch is strong enough to elicit pain.

Various mediators of itch are histamine, peptide products of proteases,

tachykinin, opioid peptides & naxonolone, prostaglandins and related
eicosanoids, platelet activating factor, and cytokines

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Types of itch
a. Localized itch: Persists briefly after the stimulus is removed, and is
spontaneous. It is also called as “spontaneous itch” and is conducted
by myelinated, rapidly conducting delta ‘A’ fibres.

b. Diffuse itch: Involves surrounding areas, and is not spontaneous but

responds with intense itching to a light touch or minor stimulus. Also
called as “itchy skin”, this unpleasant, pathologic itch is conducted by
unmyelinated slowly conducting C fibres (pain fibres).
Itch has recently been reclassified as:
a. Pruritoceptive (cutaneous, e.g., scabies),
b. Neuropathic (due to lesions of afferent pathways of the nervous system,
e.g., peripheral neuritis, brain tumours),
c. Neurogenic (due to centrally acting mediators which do not damage the
central nervous system, e.g., opioid peptides of cholestasis),
d. Psychogenic.
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Pathophysiology of Itching

 Itch-transmitting fibres
a. enter the dorsal horn of the grey matter of the spinal cord,
b. synapse there with secondary neurones which cross over
to the contralateral spinothalamic tract
c. ascend to the thalamus.

 From there, tertiary neurons relay

the itch sensation to the level of conscious perception
in the cerebral cortex

 the involvement of anterior cingulated cortex

(Broadmann area 24) in the recognition of itch sensation
at the conscious level. whereas the premotor cortical
areas participate in intention to scratch.

 Itching is perceived in the skin, but actually originates

in the central nervous system due to dysfunctional
processing of sensory information in the central pathways.

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 53 Barrier Repair Treatments

A range of barrier repair treatments focusing on skin hydration and

restoration of skin lipids are well established in the care of human Atopic Dermatitis

Options include:
Moisturizers: contain variable combinations of naturally occurring skin lipids and
sterols as well as artificial or natural oils, humectants, emollients, and lubricants.

There are a number of major components to moisturisers:

Humectants: keep water in by attracting water from deep within the skin towards the
surface e.g. carboxylic acid, lactic acid, urea, sodium lactate - non-oily; may cause
irritation and prevent water loss via transpiration e.g. propylene glycol, glycerol,
sorbolene
Emollients: fill spaces between skin cells with oil; include a variety of oils (almond,
corn, coconut, olive, peanut, safflower, sesame); animal fats (lanolin), and hydrocarbons
(mineral oil, paraffin oil, petrolatum)
Emulsifiers: help distribute oils in a water solution (e.g. acetyl alcohol, laureth-5,
lecithin, steric acid, stearyl alcohol)

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54 Summary Neural Integration
55 Summary

Fasciculus Fasciculus
Cuneatus Gracilis

Posterior Lateral Anterior

Anterior
Tract Tract Tract
Tract

Spinocerebellar Posterior Column Anteriolatheral

Pathway Pathways Pathways

Sensory pathways

General Sensory Receptors

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56 Summary
The Posterior Column Pathway and the Spinothalamic Tracts

The area of sensory cortex devoted to a body region is relative

to the number of sensory receptors.
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57
Thanks for your attention

Any Question?

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 Reference

Lauralee Sherwood: Human Physiology;. Department of Physiology and

Pharmacology School of Medicine West Virginia University. rooks/Cole
10 Davis Drive Belm
Arthur C. Guyton, M.D., John E. Hall, Ph.D:Text Book of Medical Physiology;.
Department of Physiology and Biophysics University of Mississippi Medical
Center Jackson, Mississippi, 11th ed. Philadelphia, Saunders.
Vander et al's : Human Physiology: The Mechanisms of Body Function,
9th ed , the McGraw-Hill Publishing
W.F.: Ganong MD: Review of Medical Physiology, 12th ed , Lange
Medical Publications
Gerard J. Tortora.,Bryan Derrickson: Principles of Anatomy and
Physiology. 12th ed, John Wiley & Sons, Inc.
Other sources,