Integumentary system

Compiled by Dr. Girmay (Assistant

professor)
 The Integumentary System
• Outer covering of the body
• consists of
– The skin and
– Its appendages(derivatives):
• Nails, hairs, arrector muscles of hairs (arrector
pili muscles).
• Cutaneous gland
– sudoriferous, sebaceous, mammary and
ceruminous glands
 Structure of the skin
• The skin is the largest organ in the body and has a
surface area of about 1.5–2 m2 in adults
• In certain areas, it contains accessory structures:
glands, hair and nails
• There are two main layers:
– the epidermis
– the dermis
• Between the skin and underlying structures is
a subcutaneous layer composed of areolar
tissue and adipose (fat) tissue called hypodermis
function of Integumentary System

• Protection
– Waterproof
– From chemicals, heat, cold, bacteria
– Ultraviolet (UV)
• Synthesis and storage of vitamin D.
• Regulates body heat
• Prevents dehydration
• Excretion
• Sensory reception (nerve endings)
• Communication- Reflects emotions through facial
expressions, gland secretions
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The skin
• The skin consists of two layers
– The epidermis is a superficial epithelial
tissue
– The dermis is a deeper layer composed of
dense, irregularly arranged connective
tissue
 1. The epidermis: consists of four layers of
The layers of skin keratinocytes (or five layers in thick skin)
2. The dermis: Two layers
 Integumentary System
The epidermis
– Stratified keratinized squamous epithelium

– Superficial layer that provides protection

– Has no blood vessels or lymphatics

– It is nourished by the underlying vascularized dermis.

– On the palms of the hands and the soles of the feet, it is

extremely thick

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 Layers of the EpidermisIntroduction
From deep to superficial layer

1. Stratum basale: deepest layer, single row of cells that divide and grow
(columnar keratinocytes)
2. Stratum spinosum: rows of polyhedral cells
3. Stratum granulosum: flat keratinized cells (keratinocytes) producing
keratin
4. Stratum lucidum: found only on palms and soles (thick skin)
5. Stratum corneum: many layers of flat, dead, keratinized, non-nucleated
cells
 Continuously shed and replaced (desquamation)
 The epidermis, like most epithelial tissues, regenerates.
 Exhibit high mitotic activity.
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 The epidermis
• It is the superficial layer of the skin
• Primarily of ectodermal origin, it is classified as
stratified squamous keratinized epithelium
The cellular composition
of epidermis:
•Keratinocytes: the most
predominant types of cells
and responsible for keratin
production
•Melanocytes: produce
melanin pigment
•Langerhans cells: are
antigen presenting cells
•Merkel cells: are tactile
epithelial cells
 Integumentary System
The epidermis
Cells of epidermis
• Keratinocyte-
– produce and accumulates
keratin
Epidermis
– Most abundant
• Melanocyte- produces
the pigment melanin
Dermis
– 8% of cells
• Langerhans’ cells
– Arising from bone marrow
that migrate to
epidermis
– Antigen presenting cells
• Merkel Cells
– Located at stratum basale
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 The dermis
• The dermis is tough and elastic.
• It is formed from connective tissue and the matrix
contains collagen fibres interlaced with elastic fibres.
• Rupture of elastic fibers occurs when the skin is
overstretched, resulting in permanent striae, or
stretch marks, that may be found in pregnancy
and obesity.
• Collagen fibres bind water and give the skin its
tensile strength, but as this ability declines with
age, wrinkles develop.
• Fibroblasts, macrophages and mast cells are the
main cells found in the dermis.
 Dermis cont…
• The structures in the
dermis are:
– blood and lymph
vessels
– sensory nerve
endings
– sweat glands and
their ducts
– hairs, arrector pili
muscles and
sebaceous glands.
Dermis cont…
• Blood and lymph vessels.
– Arterioles form a fine network with capillary
branches supplying sweat glands, sebaceous
glands, hair follicles and the dermis.
– Lymph vessels form a network throughout the
dermis
Integumentary System
Sensory Receptors
• Free nerve endings
– Pain and temprature
• Merkel cells
– light touch
• Root hair plexuses
– entwine hair follicles
(light touch)
• Encapsulated
Meissner’s corpuscles
– light touch in hairless
skin
• Ruffini’s corpusucles
– Deep pressure and
stretch
• Pacinian corpuscles
– deep pressure, vibration,
14
 The dermis
• It is the layer of
the skin
underlying the
epidermis.
• It is of
mesodermal
origin
• is com­posed of
dense, irregular
connective tissue
that contains
many type I
collagen fibers
and networks of
thick elastic
fibers
 Integumentary System
Dermis
• Supplied with afferent nerve endings that are sensitive to
touch, irritation (pain), and temperature.
• Thinner on the anterior than on the posterior body
surface.
• Two layers
– Papillary – areolar connective tissue; includes dermal papillae
• Ridges can form finger prints
– Reticular – “reticulum” (network) of collagen and reticular
fibers
• no distinct boundary exists between these layers

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 Epidermal
appendages
• Skin and its appendages
– Hair
– nails
– Glands:
• sweat glands (both
eccrine and apocrine),
• sebaceous glands,
 Epidermal Appendages
• Hairs
– form in hair follicles, in which keratinocytes
comprising the matrix of the deep hair bulb
proliferate rapidly and undergo
keratinization to form the medulla, cortex,
and cuticle of a hair root.
– A large dermal hair papilla penetrates the
base of the hair bulb, and its vasculature
supplies nutrients and O 2 for
proliferating and differentiating cells.
– The growing hair root is surrounded by
internal and external root sheaths
continuous with the epidermis, a glassy
membrane formed in part by the basal
lamina, and a connective tissue sheath.
 Skin appendages cont…
• Nails are formed in a manner similar to hairs: keratinocytes proliferate in the
matrix of the nail root and differentiate with the formation of hard keratin as a
growing nail plate with edges covered by skin folds.
• Sebaceous glands produce sebum by terminal differentiation of sebocytes, the
classic example of holocrine secretion, secreting this oily substance onto hair in
the follicles or pilosebaceous units.
• Eccrine sweat glands in the dermis produce sweat that is mostly water onto
the skin surface, where its evaporation provides an important mechanism for
cooling the body.
• Apocrine sweat glands are restricted to skin of the axillae and perineum,
have much wider lumens than eccrine glands, develop after puberty, and
secrete protein-rich sweat onto the hair of hair follicles.
 Glands in the skin
Sweat glands
1.eccrine sweat glands
– There are 3 to 4 million eccrine sweat glands
– are simple coiled tubular glands consisting of a
secretory unit and a single duct
– are present in skin throughout most of the body but
not in the lips and certain regions of the external
genitalia
– function in controlling body temperature, conserving
electrolytes, and excreting urea and lactic acid.
 Introduction
Integumentary System
Subcutaneous tissue
• AKA- Hypodermis or superficial
fascia
• Composed of
– Adipose (fat) and loose connective
tissue
– Sweat glands
– Superficial blood vessels & nerves
Subcutaneous tissue
• Different patterns of (Superficial fascia)
Functions
accumulation (male/female) •Storage in adipose tissue
•Cushions and insulates underlying
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 Introduction
Integumentary System
Skin color
• 3 pigments contribute to skin color
– Melanin- protein pigment
• Range in color from yellow to reddish-brown to black
• Everyone has same number of melanocytes
• Increased melanin production can caused by sunlight.
– Carotene-yellow to orange pigment found in carrots.
• Commonly found in the palms or soles.
– Hemoglobin- Red blood gives a pinkish hue to fair skin
• If oxygen level in blood is low, skin will be pale (bluish). This
08/10/23 Condition is called cyanosis. 26
 Introduction
Integumentary System
Skin contains many
specialized structures
In Deep layer of the
dermis
– Hair follicles, with
associated smooth
arrector muscles and
sebaceous glands.
– Sweat glands
• Skin structures or
derivatives
Nails (fingernails,
toenails)
Mammary glands, and
Enamel of teeth
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 Introduction
Integumentary System
Skin ligaments (L. retinacula cutis)
• Attach the subcutaneous tissue and the deep surface of the
dermis to the deep fascia
• Length and density of these ligaments determines the
mobility of the skin.
– When short and abundant, the skin is firmly attached, E.g.,
palms and soles
– When longer and sparse, the skin is more mobile, E.g., on
dorsum of the hand.

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 Introduction Fascias
• Connective tissues that constitutes the
wrapping, packing, and insulating materials of
the deep structures of the body.

• Underlying the subcutaneous tissue

(superficial fascia) almost everywhere is the
deep fascia

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 Fascias Introduction
Deep fascia
• Is a dense, organized connective tissue layer, devoid of
fat.
• Covers most of the body deep to the skin and
subcutaneous tissue.
• Invest (cover) deeper structures, such as individual
muscles and neurovascular bundles, as investing fascia.
• Its thickness varies widely. For example, in the face,
distinct layers of deep fascia are absent.

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 Introduction
Fascias
Deep fascia
• In the limbs, groups of muscles with similar
functions sharing the same nerve supply are located
in fascial compartments.

• Fascial compartments are separated by thick sheets

of deep fascia, called intermuscular septa.

• It gives attachment (origin) to the underlying

muscles.

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Fascial compartments, Intermuscular septa and muscle
compartments of Thigh
 Introduction
Fascias
Deep fascia
• Limits the outward expansion of the bellies of
contracting skeletal muscles.
• Together with contracting muscles, and venous valves work as
a musculovenous pump to return blood to the heart.
– Especially in the lower limbs where blood must move
against the pull of gravity.

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 Introduction
Fascias
Deep fascia
• Near certain joints it becomes
markedly thickened, forming a
retinaculum to hold tendons in
place where they cross the joint
during flexion and extension.
– Preventing joint from taking a
shortcut, or bow stringing, across
the angle created
– E.g., wrist and ankle
Fig. Flexer retinaculum at
wrist joint

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 Fascias Introduction

Subserous fascia
• With varying amounts of fatty tissue, lies between the
internal surfaces of the musculoskeletal walls and the
serous membranes lining the body cavities.
• These are the endothoracic, endoabdominal, and
endopelvic fascias.
• The latter two may be referred to collectively as
extraperitoneal fascia.

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 Burns
• These may be caused by many types of trauma including:
heat, cold, electricity, ionising radiation and corrosive
chemicals, including strong acids or alkalis (bases). Local
damage occurs disrupting the structure and functions of the
skin.
• Burns are classified according to their depth:
– first degree: when only the epidermis is involved, the surface is
moist and there are signs of inflammation including redness,
swelling and pain. There are no blisters and tissue damage is
minimal.
– second degree: when the epidermis and upper dermis are
affected. In addition to the signs and symptoms above, blistering is
usually present.
– third degree(deep or full thickness): when the epidermis and
dermis are destroyed. These burns are usually relatively painless as
the sensory nerve endings in the dermis are destroyed. After a few
days the destroyed tissue coagulates and forms an eschar, or thick
scab, which sloughs off after 2 to 3 weeks.
• In circumferential burns, which encircle any area of
the body, complications may arise from constriction
of the part by eschar, e.g. respiratory impairment
may follow circumferential burns of the chest, or the
circulation to the distal part of an affected limb may
be seriously impaired.
• The extent of burns in adults is roughly
estimated using the ‘rule of nines’
• In adults, hypovolaemic shock usually
develops when 15% of the surface area is
affected
• Fatality is likely in adults with third degree
burns if the surface area affected is added to
the patient’s age and the total is greater than
80
Figure 14.13 The ‘rule of nines’ for estimating
the extent of
burns in adults.
 Complications of burns
• Although burns affect the skin, when
extensive, their systemic consequences can
also be life-threatening or fatal.
– Dehydration and hypovolaemia:These may
occur in extensive burns when there is excessive
leakage of water and plasma proteins from the
damaged skin surface.
– Shock:This may accompany severe hypovolaemia.
– Hypothermia: This develops when excessive heat
is lost in leakage from burns.
Complication cont…
• Infection: This occurs easily when
subcutaneous tissue is exposed to the
environment and may result in septicaemia.
• Renal failure: This occurs when the kidney
tubules cannot deal with the large amount of
waste from haemolysed erythrocytes and
damaged tissue.
• Contractures: These may develop later as
fibrous scar tissue contracts distorting joints, e.g.
the hands, restricting their range of motion.
 Exercise
• Write the layers of epidermis from deep to
superficial
• List the cells of epidermis and their
corresponding function
• Write the pigments that contribute to skin
color
• List the Sensory receptor cells of skin with
their corresponding function
• Write structures found in the dermal layer