Body Membranes:

-function: cover surfaces, line body cavities, and form protective (and
often lubricating) sheets around organs
-have 2 major categories of membrane according to tissue makeup
1. Epithelial Membranes
• -also called covering and lining membranes
• - they all do contain an epithelial layer and
is always combined with an underlying layer
of connective tissue
1a. Cutaneous (ku-ta9ne-us)
Membrane
-aka the Skin
- composed of two layers:
-the superficial epidermis:
composed of stratified squamous
epithelium
-the underlying dermis: mostly
dense (fibrous) connective tissue
-Unlike other epithelial
membranes, the cutaneous
membrane is exposed to air and
is a dry membrane
 1bMucous Membrane
- composed of epithelium resting
on a loose connective tissue
membrane called a lamina propria
-lines all body cavities that open
to the exterior ie. the hollow
organs of the respiratory,
digestive, urinary, and
reproductive tracts
-most mucosae contain either
stratified squamous epithelium (as
in the mouth and esophagus) or
simple columnar epithelium (as in
the rest of the digestive tract)
*** lamina propria functions:
• supports the epithelium
• binds epithelium it to the underlying structures
• allows some flexibility of the membrane
• protection for underlying structures
• holds blood vessels in place and is the vascular source for the
overlying epithelium***
-moist membranes that are almost continuously bathed in secretions or,
in the case of the urinary mucosae, urine.
- the epithelium of mucosae is often adapted for absorption or secretion.
 2. Serous Membrane
-aka Serosae
-composed of a layer of simple squamous epithelium resting on a thin layer
of areolar connective tissue
-line body cavities that are closed to the exterior (in contrast to mucous
membranes which line open body cavities)
- have two layers:
Parietal Layer: The layer attached to and lining the cavity wall
Visceral Layer: the layer that covers and adheres to the organs within the
cavity
-The mesothelium(simple squamous epithelium) of a serous membrane
secretes serous fluid, a watery lubricant that allows organs to glide easily over
one another or to slide against the walls of cavities.
The serosa lining the abdominal cavity and covering its organs is the
peritoneum In the thorax, serous membranes isolate the lungs and heart
from one another. The membranes surrounding the lungs are the pleurae
those around the heart are the pericardia
 Synovial Membranes
• - syn- together, referring here
to a place where bones come
together; -ova- egg, because
of their resemblance to the
slimy egg white of an
uncooked egg
• -line the cavities of freely
movable joints, structures
that do not open to the
exterior
• lack an epithelium and are therefore not epithelial membranes
• composed of a discontinuous layer of cells called synoviocytes and a layer of
connective tissue (areolar and adipose)
• -Synoviocytes secrete some of the components of synovial fluid
• -Synovial fluid: lubricates and nourishes the cartilage covering the bones at movable
joints and contains macrophages that remove microbes and debris from the joint
cavity
THE
HUMAN
INTEGUMENA
RY
SYSTEM
INTEGUMENTARY SYSTEM
• The integumentary system is composed of the skin,
hair, oil and sweat glands, nails, and sensory receptors
(According to Tortora)
• The skin and its appendages (sweat and oil glands,
hair, and nails) are collectively called the
integumentary system; simply means “covering,”
performs a variety of functions; most, but not all, of
which are protective (According to Marieb)
 FUNCTIONS OF THE
INTEGUMENTARY SYSTEM
• Protects deeper tissues
from
• Mechanical damage
(bumps)
• Chemical damage (acids and
bases)
• Ultraviolet Radiation
(damaging effects of
sunlight or tanning beds)
• Microbe Damage
• Thermal (heat or
cold damage)
• Dessication (drying
out)
•Aids in body heat loss or heat or
retention (controlled by the nervous
system)
•Aids in excretion of urea and uric acid
•Synthesis of Vitamin D
According to Tortora
 COMPONENTS OF THE
INTEGUMENTARY SYSTEM
•SKIN
•APPENDAGES
• Sweat and Oil Glands
• Nails
• Hair
SKIN
• also known as the cutaneous
membrane
• covers the external surface of the
body and is the largest organ of the
body in weight
• In adults: covers an area of about 2
square meters (22 square feet) and
weighs 4.5–5 kg (10–11 lb), about 7%
of total body weight.
• It ranges in thickness from
0.5 mm (0.02 in.) on the
eyelids to 4.0 mm (0.16 in.)
on the heels.
• Over most of the body it is
1–2 mm (0.04–0.08 in.)
thick.
LAYERS OF THE SKIN
• Epidermis
• The outer layer
• made up of
stratified
squamous
epithelium that
is capable of
becoming hard
and tough
• Dermis
• The underlying
layer
• made up mostly
of dense
connective tissue
*** blister- the separation
of the dermis and
epidermis allowing
interstitial fluid to
accumulate in the cavity
between the layers***
• subcutaneous tissue, or hypodermis
• Deep to the dermis
• essentially is adipose (fat) tissue
• not considered part of the skin, but
does anchor the skin to underlying
organs and provides a site for nutrient
storage
• serves as a shock absorber and
insulator
• This region (and sometimes the
dermis) also contains nerve endings
called lamellated corpuscles or
pacinian corpuscles (pa-SIN-e¯-an) that
are sensitive to pressure
EPIDERMIS

• composed of keratinized
stratified squamous
epithelium
• contains four principal types
of cells
• Keratinocytes
• Melanocytes
• intraepidermal macrophages
• tactile epithelial
Principal cell types in the Epidermis
• KERATINOCYTES:
• About 90% of epidermal cells
• keratino- hornlike; -cytes cells
• arranged in four or five layers and produce
the protein keratin
• a tough, fibrous protein that helps protect the
skin and underlying tissues from abrasions, heat,
microbes, and chemicals.
• Keratinocytes also produce lamellar granules
• release a water-repellent sealant that decreases
water entry and loss and inhibits the entry of
foreign materials.
KERATINIZATION AND GROWTH OF
EPIDERMIS
KERATINIZATION
• Newly formed cells in the deeper layers are slowly pushed to the surface.
As the cells move from one epidermal layer to the next, they accumulate
more and more keratin. Then they undergo apoptosis. Eventually the
keratinized cells slough off and are replaced by underlying cells that in
turn become keratinized.
• takes about four to six weeks
• The mechanisms that regulate this remarkable growth are not well
understood, but hormone like proteins such as epidermal growth factor
(EGF) play a role. An excessive amount of keratinized cells shed from the
skin of the scalp is called dandruff.
Principal cell types in the Epidermis
• MELANOCYTES
• 8% of the epidermal cells
• melano- black
• develop from the ectoderm of a developing embryo
and produce the pigment melanin
• Their long, slender projections extend between the
keratinocytes and transfer melanin granules to them
• Melanin -a yellow-red or brown-black pigment that
contributes to skin color and absorbs damaging
ultraviolet (UV) light
 Principal cell types in the Epidermis
• INTRAEPIDERMAL MACROPHAGES or Langerhans cells
• arise from red bone marrow and migrate to the epidermis
where they constitute a small fraction of the epidermal cells.
• participate in immune responses mounted against microbes
that invade the skin, and are easily damaged by UV light
• Help other cells of the immune system recognize an invading
microbe and destroy it
Principal cell types in the Epidermis
• TACTILE EPITHELIAL CELLS, or Merkel cells
• the least numerous of the epidermal cells
• located in the deepest layer of the epidermis
• they contact the flattened process of a sensory neuron (nerve cell), a
structure called a tactile disc or Merkel disc
• Tactile epithelial cells and their associated tactile discs detect touch
sensations
LAYERS OF THE EPIDERMIS
• distinct layers of
keratinocytes in various
stages of development
form the epidermis
• In most regions of the
body the epidermis has
four strata or layers—
and may either be
called thin skin or thick
skin
LAYERS OF THE EPIDERMIS
STRATUM BASALE
• The deepest layer of the epidermis
• composed of a single row of cuboidal or columnar keratinocytes
• Lies closest to the dermis and is connected to it along a wavy border that
resembles corrugated cardboard
• contains the most adequately nourished of the epidermal cells because
nutrients diffusing from the dermis reach them first.
• Stem cells in this layer are constantly dividing, and millions of new cells
are produced daily; hence its alternate name, stratum germinativum
“germinating layer” or to sprout
LAYERS OF THE EPIDERMIS
STRATUM SPINOSUM
• mainly consists of numerous keratinocytes arranged in 8–10 layers.
• The keratinocytes in the stratum spinosum, which are produced by
the stem cells basal layer, have the same organelles as cells of the
stratum basale, and some retain their ability to divide
LAYERS OF THE EPIDERMIS
 DERMIS
• The second, deeper part of the skin
• composed of dense irregular connective
tissue containing collagen and elastic
fibers
• has great tensile strength (resists pulling
or stretching forces)
• has the ability to stretch and recoil easily
• much thicker than the epidermis, and this
thickness varies from region to region in
the body, reaching its greatest thickness
on the palms and soles.
Tattooing
permanent coloration of the
skin in which a foreign
pigment is deposited with a
needle into the dermis
They are created by injecting
ink with a needle that
punctures the epidermis,
moves between 50 and 3000
times per minute, and
deposits the ink in the dermis.
•CRITICAL THINKING: Why do the tattoo
ink not easily fade?
Body piercing
the insertion of jewelry through an
artificial opening
Total healing can take up to a year
Potential complications: infections,
allergic reactions, and anatomical
damage (such as nerve damage or
cartilage deformation
***In addition, body piercing jewelry
may interfere with certain medical
procedures such as masks used for
resuscitation, airway management
procedures, urinary catheterization,
radiographs, and delivery of a baby.
STRUCTURAL
BASIS OF SKIN
COLOR

• Three pigments
contribute to skin
color:
• Melanin
• Carotene
• hemoglobin
The amount and
kind (yellow,
reddish brown, or
black) of melanin in
the epidermis.
Skin exposure to sunlight
stimulates melanocytes to
produce more melanin
pigment, resulting in
tanning of the skin
People who produce a lot
of melanin have brown-
toned skin, whereas
people with less melanin
are light skinned.
• Carotene is an orange-yellow
pigment plentiful in carrots
and other orange, deep
yellow, or leafy green
vegetables
• The amount of carotene
deposited in the stratum
corneum and subcutaneous
tissue
• In people who eat large
amounts of carotene-rich
foods, the skin tends to take
on a yellow-orange cast.
• The amount of oxygen-
rich hemoglobin
(pigment in red blood
cells) in the dermal
blood vessels
• In light-skinned people,
the crimson color of
oxygen-rich hemoglobin
in the dermal blood
supply flushes through
the transparent cell
layers above and gives
the skin a rosy glow.
 SKIN COLOR ALTERATIONS
• Emotions also influence skin
color, and many alterations in
skin color signal certain disease
• Redness, or erythema
• may indicate embarrassment
(blushing), fever, hypertension,
inflammation, or allergy. • Pallor, or
blanching
• Under certain types of emotional
stress (fear, anger, and others),
some people become pale.
• Pale skin may also signify anemia,
low blood pressure, or impaired
blood flow into the area
• Jaundice or a yellow cast
• An abnormal yellow skin tone usually signifies a liver disorder in which excess
bile pigments accumulate in the blood, circulate throughout the body, and
become deposited in body tissues
Bruises
• The black-and-blue marks of bruising reveal
sites where blood has escaped from the
circulation and has clotted in the tissue spaces.
Such clotted blood masses are called
hematomas
• An unusual tendency to bruise may signify a
deficiency of vitamin C in the diet or
hemophilia (bleeder’s disease).
TYPES OF
SKIN
• Although similar in structure,
there are quite a few local
variations related to thickness of
the epidermis, strength,
flexibility, degree of
keratinization, distribution and
type of hair, density and types of
glands, pigmentation, vascularity
(blood supply), and innervation
(nerve supply).
• Two major types of skin:
thin (hairy) skin and
thick (hairless) skin
• The greatest contributor
to epidermal thickness is
the increased number of
layers in the stratum
corneum. This arises in
response to the greater
mechanical stress in
regions of thick skin
APPANDAGES OF THE SKIN
are formed by the epidermis but resides in the dermis

CUTANEOUS GLANDS
The cutaneous glands are all exocrine glands that release their
secretions to the skin surface via ducts. They fall into two groups:
• 1. Sebaceous glands
• 2. Sweat glands
SEBACEOUS GLANDS
• The sebaceous glands, or
oil glands, are found all
over the skin, except on
the palms of the hands
and the soles of the feet
• Their ducts usually
empty into a hair follicle,
but some open directly
onto the skin surface
The product of the sebaceous glands,
sebum
a mixture of oily substances and
fragmented cells
lubricant that keeps the skin soft
and moist and prevents the hair
from becoming brittle
also contains chemicals that kill
bacteria, so it is important in
preventing bacterial infection of
the skin
SWEAT GLANDS
Sweat glands, also called
sudoriferous glands, are widely
distributed in the skin.
more than 2.5 million per person
There are two types of sweat
glands
eccrine
apocrine
Eccrine glands
• far more numerous and are
found all over the body
• They produce sweat, a clear
secretion that is primarily
water plus some salts (sodium
chloride), vitamin C, traces of
metabolic wastes (ammonia,
urea, uric acid), and lactic acid
(a chemical that accumulates
during vigorous muscle
activity).
• Sweat is acidic (pH from 4 to 6)
• reaches the skin surface via a
duct that opens externally as a
funnel-shaped sweat pore
• highly efficient part of the
body’s heat-regulating
equipment
APOCRINE GLANDS
• Apocrine glands are
largely confined to the
axillary (armpit) and
genital areas of the body
• usually larger than
eccrine glands, and their
ducts empty into hair
follicles.
• Their secretion contains fatty
acids and proteins, as well as all
the substances present in
eccrine sweat; consequently, it
may have a milky or yellowish
color
• secretion is odorless, but when
bacteria that live on the skin
use its proteins and fats as a
source of nutrients for their
growth, it can take on a musky,
sometimes unpleasant odor
HAIR AND HAIR FOLLICLES
• found all over the body surface except on
the palms of the hands, soles of the feet,
nipples, and lips.
• among the fastest growing tissues in the
body
• FUNCTION: few minor protective functions,
such as guarding the head against bumps,
shielding the eyes (via eyelashes), and
helping to keep foreign particles out of the
respiratory tract (via nose hairs)
HAIRS
a flexible epithelial structure
root - part of the hair enclosed in the hair follicle
shaft -the part projecting from the surface of the scalp or skin
Hair formation: A 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. As the daughter cells are pushed farther away
from the growing region, they become keratinized and die.
medulla – central core; consists of large
cells and air spaces, surrounded by a
bulky cortex layer composed of several
layers of flattened cells
The cortex - enclosed by an outermost
cuticle formed by a single layer of cells
that overlap one another like shingles
on a roof(helps to keep the hairs apart
and keeps them from matting)
cuticle - most heavily keratinized region
-provides strength and helps keep
the inner hair layers tightly compacted
• Hair pigment - made by melanocytes in the hair bulb, and varying
amounts of different types of melanin (yellow, rust, brown, and black)
Hairs come in a variety of sizes and shapes
• ***They are short and stiff in the
eyebrows, long and flexible on
the head, and usually nearly
invisible almost everywhere else.
When the hair shaft is oval, hair is
smooth, silky, and wavy. When
the shaft is flat and ribbonlike,
the hair is curly or kinky. If it is
perfectly round, the hair is
straight and tends to be
coarse***
NAIL
• a scalelike
modification of the
epidermis that
corresponds to the
hoof or claw of other
animals.
• Parts: free edge, a body (visible
attached portion), and a root
(embedded in the skin
• Nail folds- the overlapping folds of skin
that borders of the nail
• Cuticle-The edge of the thick proximal
nail fold
• Nail bed- extension of the stratum
basale of the epidermis
• Nail Matrix- thickened proximal
area of the nail bed that is
responsible for nail growth
• Lanule- is the region over the
thickened nail matrix that appears
as a white crescent
***As noted earlier, when the
supply of oxygen in the blood is
low, the nail beds take on a
cyanotic (blue) cast
SKIN WOUND HEALING
• Epidermal wound healing
occurs following wounds
that affect only the
epidermis; deep wound
healing occurs following
wounds that penetrate the
dermis.
EPIDERMAL WOUND HEALING
• central portion of an epidermal
wound may extend to the dermis
BUT the edges of the wound usually
involve only slight damage to
superficial epidermal cells
• Common types: abrasions and minor
burns.
Injury ---> basal cells of the epidermis break contact with the basement
membrane ---> cells enlarge and migrate across the wound ---> cells
advance from opposite sides of the wound meet ---> contact inhibition
contact with other epidermal cells on all sides (stops totally) --->
epidermal growth factor stimulates basal stem cells to divide and
replace the ones that have moved into the wound ---> The relocated
basal epidermal cells divide to build new strata ---> thickening the new
epidermis
 DEEP WOUND HEALING
• Occurs when an injury extends to the dermis and subcutaneous
layer.
• more complex than in epidermal wound healing
• because scar tissue is formed, the healed tissue loses some of
its normal function
• occurs in four phases: an inflammatory phase, a migratory
phase, a proliferative phase, and a maturation phase.
INFLAMMATORY
PHASE
• blood clot forms in the
wound and loosely
unites the wound
edges
• Inflammation occurs
MIGRATORY PHASE
• clot becomes a scab
• epithelial cells migrate beneath the
scab to bridge the wound
• Fibroblasts migrate along fibrin
threads and begin synthesizing scar
tissue (collagen fibers and
glycoproteins)
• damaged blood vessels begin to
regrow.
• granulation tissue- the tissue filling
the wound
PROLIFERATIVE PHASE
• characterized by
extensive growth of
epithelial cells
beneath the scab
• deposition by
fibroblasts of collagen
fibers in random
patterns
• continued growth of
blood vessels
MATURATION PHASE
• the scab sloughs off once the
epidermis has been restored to
normal thickness
• Collagen fibers become more
organized
• fibroblasts decrease in number
• blood vessels are restored to
normal
HOMEOSTA
TIC
IMBALANC
ES
• Psoriasis
• common and chronic skin
disorder in which
keratinocytes divide and
move more quickly than
normal from the stratum
basale to the stratum
corneum and are shed
prematurely in as little as 7
to 10 days
• forms flaky, silvery scales at
the skin surface, most often
on the knees, elbows, and
scalp (dandruff)
• Stretch marks
• A form of internal scarring
• can result from the internal
damage to the dermis that occurs
when the skin is stretched too
much.
• When the skin is overstretched,
the lateral bonding between
adjacent collagen fibers is
disrupted and small dermal blood
vessels rupture
• CYANOTIC When blood is not
picking up an adequate
amount of oxygen from the
lungs, as in someone who has
stopped breathing, the
mucous membranes, nail beds,
and skin appear bluish
• JAUNDICE due to a buildup of
the yellow pigment bilirubin in
the skin. This condition gives a
yellowish appearance to the
skin and the whites of the
eyes, and usually indicates
liver disease
• ERYTHEMA redness of the skin;
caused by engorgement of
capillaries in the dermis with
blood due to skin injury, exposure
to heat, infection, inflammation,
or allergic reactions
• PALLOR paleness of the skin, may
occur in conditions such as shock
and anemia.
ALBINISM
• inherited inability of an
individual to produce
melanin.
• Albinos have melanocytes
that are unable to
synthesize tyrosinase.
• Melanin is missing from
their hair, eyes, and skinIn
another condition, called
VITILIGO
• the partial or complete loss
of melanocytes from patches
of skin produces irregular
white spots
• loss of melanocytes may be
related to an immune system
malfunction in which
antibodies attack the
melanocytes.
ACNE (black heads and white heads)
inflammation of sebaceous glands that
usually begins at puberty, when the
sebaceous glands are stimulated by
androgens
predominantly in sebaceous follicles
that have been colonized by bacteria,
some of which thrive in the lipid-rich
sebum
The infection may cause a cyst or sac
of connective tissue cells to form,
which can destroy and displace
epidermal cells “Cystic Acne”
DECUBITUS ULCER (and other Skin
Ulcers)
• Prolonged restriction of the normal
blood supply to the skin resulting in
cell death and
• occur in bedridden patients who are
not turned regularly or who are
dragged or pulled across the bed
repeatedly
• At first, the skin reddens when
pressure is released, but if the
situation is not corrected, the cells
begin to die, and small cracks or breaks
in the skin appear at compressed sites
• Seborrhea
• “fast-flowing sebum”
• Also known as “cradle cap”
in infants
• pink, raised lesions that
gradually form a yellow-to-
brown crust that sloughs
off oily scales and dandruff
• caused by overactivity of
the sebaceous glands
Athlete’s foot. An itchy, red, peeling
condition of the skin between the
toes, resulting from an infection
with the fungus Tinea pedis.
Cold sores (fever blisters). Small
fluid-filled blisters that itch and
sting, caused by human herpesvirus
1 infection. The virus localizes in a
cutaneous nerve, where it remains
dormant until activated by
emotional upset, fever, or UV
Boils are caused by
inflammation of hair
follicles and surrounding
tissues, commonly on the
dorsal neck
Carbuncles are clusters
of boils often caused by
the bacterium
Staphylococcus aureus.
CONTACT DERMATITIS
• Itching, redness, and
swelling of the skin,
progressing to
blistering
• caused by exposure of
the skin to chemicals
(such as those in poison
ivy) that provoke
allergic responses in
sensitive individuals
IMPETIGO
• Pink, fluid-filled, raised
lesions (commonly around
the mouth and nose) that
develop a yellow crust and
eventually rupture
• Caused by highly
contagious staphylococcus
or streptococcus infections
• impetigo is common in
elementary school–aged
children.
SKIN CANCER
• Neoplasm in the skin
• Basal cell carcinoma
• Squamous Cell Carcinoma
• Malignant Melanoma
• (A) Asymmetry. Any two sides of the pigmented spot or mole
do not match
• (B) Border irregularity. The borders of the lesion are not
smooth but exhibit indentations
• (C) Color. The pigmented spot contains areas of different
colors (black, brown, tan, and sometimes blue or red)
• (D) Diameter. The lesion is larger than 6 millimeters (mm) in
diameter (the size of a pencil eraser)
• (E) Evolution. One or more of these characteristics (ABCD) is
evolving, or changing.
BURN
• Tissue damage and cell death caused by intense heat, electricity, UV
radiation (sunburn), or certain chemicals (such as acids), which
denature proteins and cause cell death in the affected areas
• Thermal burn
• Scald burn
• Electrical burn
• Chemical Burn
•When the skin is burned and its cells are
destroyed, two life-threatening
problems result
• Dehydration and electrolyte
• Infection
Burns are classified according to their severity (depth):
 as first-degree (superficial)
second-degree (superficial partial-thickness burns)
thirddegree (full-thickness burns)
fourth-degree (full-thickness burns with deep-tissue involvement)
FIRST-DEGREE BURNS
• only the superficial epidermis is
damaged
• area becomes red and swollen
• Except for temporary discomfort,
first-degree burns are not usually
serious and generally heal in two
to three days

Sunburn without blistering is a first-

degree burn.
SECOND-DEGREE BURNS
• involve injury to the
epidermis and the superficial
part of the dermis.
• skin is red, painful, and
blistered
• regrowth (regeneration) of
the epithelium can occur
• no permanent scars result if
care is taken to prevent
infection
THIRD-DEGREE BURNS
• destroy both the epidermis and the dermis
and often extend into the subcutaneous
tissue, reflecting their categorization as full
thickness burns
• Blisters are usually present
• burned area appears blanched (gray-white) or
blackened
• burned area is not painful
• regeneration is not possible
• skin grafting must be done to cover the
underlying exposed tissues
FOURTH-DEGREE BURNS
• also full-thickness burns
• extend into deeper tissues such as
bone, muscle, or tendons
• dry and leathery
• require surgery and grafting to cover
exposed tissue
• In severe cases, amputation may be
required to save the patient’s life.
In general, burns are considered critical if any of the
following conditions exists:
• Over 30 percent of the body has second- degree burns.
• Over 10 percent of the body has third- or fourth-degree
burns.
• There are third- or fourth-degree burns of the face,
hands, feet, or genitals
• Burns affect the airway
• Circumferential (around the body or limb) burns have
occurred.