Anatomy & Physiology

By: Renee Jessee Anthony E.Lopez, RN, HAAD-RN, LPT, MAN for GOD’s glory

Associate Professor, CdD-SOHS

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings

 Functions of Skin
Function of Integumentary System

A. Regulation of Body Temperature

B. Protection from Dehydration and Infection

C. Respond to Temperature, Pressure, Pain

D. Excretion of Water, Salts, Urea (nitrogenous waste)

E. Synthesis Vitamin D (essential for Ca + P absorption)

F. First Defensive Barrier of Immune Response

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 Overview of Structure
Structure of Integumentary System

A. Epidermis (epithilial tissue)

1. stratum corneum (superficial)
2. stratum lucidum
3. stratum granulosum
4. stratum spinosom
5. stratum basale (deep)

B. Dermis (connective tissue)

1. papillary layer (region)
2. reticular layer (region)

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 Skin (Integument)

Figure 5.1
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 Epidermis
Structure of Epidermis (epithilial tissue)
 
A. Different Cells of Epidermis
 
1. keratinocyte - produce protein "keratin" (structure)
2. Merkel’s cells - serve as touch receptors
2. melanocyte - produce "melanin" (pigment)
3. nonpigmented granular dendrocytes
a. Langerhan's cells - assist in immunity
b. Granstein cells - assist in immunity

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 Stratum Corneum
 
1. stratified sqamous epithilium
2. 25-30 rows of dead keratinized cells
3. keratinization occurs as cells rise from below
4. protects against light, heat, bacteria, chemicals
5. most superficial layer of epidermis

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 Layers of the Epidermis

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 Statum Lucidum

1. present only in thick areas (palms, feet)

2. contain clear substance called eleidin
3. eleidin eventually changes into keratin at surface

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 Stratum Granulosum
 
1. cells from lower layers begin to die here
2. contain granules with keratohyalin
3. keratohyalin is precursor to eleidin and keratin

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 Stratum Spinosum
 
1. 8-10 rows of polyhedral shaped cells
2. contain spine-like projections ("spinosum")

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Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
 Statum Basale (Stratum Germinativum) (germination)
 
1. deepest layer of the epidermis
2. single layer of cuboidal-columnar shaped cells
3. origin of all cells of epidermis through mitosis
4. origin of cells for sweat-oil glands and hair

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Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
 Structure of Dermis

Structure of the Dermis (connective tissue)

A. Overall Features

1. thick in some areas, thinner in others

2. contains blood supply, nerves, glands, hair follicle

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 B. Papillary Layer (Region)

1. loose connective tissue - much "elastin"

2. dermal papillae cause ridges in the epidermis above
3. Meissner's corpuscles - sense organ for touch
4. small capillaries supply O2 + nutrients

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 C. Reticular Layer (Region)
 
1. dense, irregular connective tissue "collagen"
2. collagen fibers interlace in net-like fashion
3. contains: adipose, hair follicle, nerves, glands
4. subcutaneous layer attaches skin to tissue below
a. Paccinian corpuscles - sense pressure change

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Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
 Hypodermis

 Subcutaneous layer deep to the skin

 Composed of adipose and areolar connective tissue

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 Skin Color

A. Melanin - pigment made in melanocytes

 
1. in basale and spinosum layers of epidermis
2. melanoblasts -> melanocytes in stratum basale
3. darkness due to melanin quantity (not cell #)
4. albinism - inability to produce melanin
5. vitligo - patchy loss of melanocytes
6. freckles - patchy concentration of melanocytes
7. UV light causes: tyrosine --> melanin production

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 B. Carotene
 
1. in stratum corneum and fatty areas of dermis
2. melanin + carotene = yellowish color

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 C. Other Colors
 
1. pink (Caucasian) - lack of pigment, capillaries
2. blue (cyanosis) - lack of oxygen in blood
3. yellow (jaundice) - liver disorder, protein release

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 Glands

A. Sebaceous Glands (oil glands)

 
1. found all over the body
2. generally connected to hair follicles
3. simple branched acinar glands
4. sebum - mixture fat, protein, cholesterol, salt
5. prevent dessication, keep skin soft, anti-bacterial
a. infected gland - acne, blackheads

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 B. Sudoriferous Glands (sweat glands)
 
1. Apocrine Sweat Glands
a. simple branched tubular glands
b. only in axilla (arm pit), pubic + areole areas
c. in dermis, duct opens into a hair follicle
 
2. Eccrine Sweat Glands
a. simple coiled tubular glands
b. all over the body
c. subcutaneous, opens onto epidermal surface

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 3. Perspiration (sweat)
a. mixture of water, salt, urea, ammonia, acids
b. eliminates waste and heat

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 C. Ceruminous Glands
 
1. simple coiled tubular glands
2. in the external auditory meatus (canal)
3. cerumen - wax-like substance, prevents entry

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 Hair

A. Shaft - projects above surface of epidermis

 
1. medulla - polyhedral cells with eleidin
2. cortex - elongated cells with/out pigment
3. cuticle - outermost layer, like shingles on roof

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 B. Root - below epidermis, penetrates into the dermis
 
C. Hair Follicle - at the base a a single hair
 
1. external root sheath - basale and spinosum extension
2. internal root sheath - internal hair cell layers
3. bulb - base of hair cell
4. papilla - in the bulb, provides nourishment for hair
5. matrix - origin of new hair cells

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 Hair Follicle

Figure 5.6c
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 Hair Follicle

Figure 5.6a
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 D. arrector pili - smooth muscle, cause hair to rise
 
E. hair root plexuses - nerve bundle responds to touch

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 Types of Hair

 Vellus – pale, fine body hair found in children and

the adult female
 Terminal – coarse, long hair of eyebrows, scalp,
axillary, and pubic regions

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THE NAIL AND ITS
STRUCTURE
NAIL STRUCTURE/ANATOMY
The nail consist of three parts: the nail body or
plate, nail root, and free edge.
The nail body or plate, is the visible portion of
the nail that rests upon, and is attached to the nail
bed. The nail body extends from the root to the
free edge.
The nail root is at the base of the nail and is
embedded underneath the skin. It is attached to
an actively growing tissue known as the matrix.
The free edge is the end portion of the nail plate
that extends from the tip of the finger or toe.
The nail bed is the living portion of the skin upon
which the nail body rests. It is pinkish in color and
The bed epithelium helps guide the nail plate along the nail bed as it
grows.

The MATRIX is the part of the nail bed that extends beneath the nail
root and contains nerves, lymph, and blood vessels to nourish the nail.
The lunula or half-moon, is located at the base
of the nail. The light whitish color of the lunula is
caused by the reflection of light where the matrix
and the connective tissue of the nail bed join.

FREE EDGE
NAIL BODY
OR PLATE
NAIL BED

LUNULA
NAIL ROOT
MATRIX
STRUCTURES SURROUNDING THE NAIL:
CUTICLE: The cuticle is the dead, colorless tissue attached to
the natural nail plate.

EPONYCHIUM: The eponychium

Is the living skin at the base of the
 Hair Thinning and Baldness

 Alopecia – hair thinning in both sexes

 True, or frank, baldness

 Genetically determined and sex-influenced
condition
 Male pattern baldness – caused by follicular
response to DHT

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 Skin Cancer

 Most skin tumors are benign and do not metastasize

 A crucial risk factor for non-melanoma skin cancers

is the disabling of the p53 gene
 Newly developed skin lotions can fix damaged DNA

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 Skin Cancer

The three major types of skin cancer are:

 Basal cell carcinoma

 Squamous cell carcinoma

 Melanoma

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 Basal Cell Carcinoma

 Least malignant and most common skin cancer

 Stratum basale cells proliferate and invade the

dermis and hypodermis
 Slow growing and do not often metastasize

 Can be cured by surgical excision in 99% of the

cases

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 Squamous Cell Carcinoma

 Arises from keratinocytes of stratum spinosum

 Arise most often on scalp, ears, and lower lip

 Grows rapidly and metastasizes if not removed

 Prognosis is good if treated by radiation therapy or

removed surgically

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 Melanoma

Cancer of melanocytes is the most dangerous type of

skin cancer because it is:
 Highly metastatic

 Resistant to chemotherapy

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 Melanoma

Melanomas have these characteristics (ABCD rule)

 A: Asymmetry; the two sides of the pigmented
area do not match
 B: Border is irregular and exhibits indentations

 C: Color (pigmented area) is black, brown, tan,

and sometimes red or blue
 D: Diameter is larger than 6 mm (size of a pencil
eraser)

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 Melanoma

 Treated by wide surgical excision accompanied by

immunotherapy
 Chance of survival is poor if the lesion is over 4 mm
thick

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 Burns

First-degree – only the epidermis is damaged

 Symptoms include localized redness, swelling, and pain
Second-degree – epidermis and upper regions of dermis are
damaged
 Symptoms mimic first degree burns, but blisters also appear

Third-degree – entire thickness of the skin is damaged

 Burned area appears gray-white, cherry red, or black; there is
no initial edema or pain (since nerve endings are destroyed)

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 Rule of Nines

Estimates the severity of burns

 Burns considered critical if:
 Over 25% of the body has second-degree burns

 Over 10% of the body has third-degree burns

 There are third-degree burns on face, hands, or feet

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 Rule of Nines

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 Developmental Aspects of the Integument:
Adolescent to Adult

 Skin and hair become oilier and acne may appear

 Skin shows the effects of cumulative environmental

assaults around age 30
 Scaling and dermatitis become more common

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 Developmental Aspects of the Integument:
Old Age

 Epidermal replacement of cells slows and skin becomes

thinner
 Skin becomes dry and itchy

 Subcutaneous fat layer diminishes, leading to intolerance of

cold
 Decreased elasticity and loss of subcutaneous tissue leads to
wrinkles
 Decreased numbers of melanocytes and Langerhans’ cells
increase the risk of skin cancer

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings