● The epidermis is

THE INTEGUMENTARY stratified squamous

SYSTEM epithelium.
● The epidermis
FUNCTIONS OF THE resists abrasion o
the skin’s surface
INTEGUMENTARY SYSTEM
and reduces water
loss through skin.
1. PROTECTION
● The epidermis is a
vascular.
● The skin provides protection against
● The epidermis rests on the dermis, a layer of
abrasion and ultraviolet light. It also
connective tissue.
prevents microorganisms from entering the
● The epidermis is composed of several types
body and reduces water loss, thus preventing
of cells. Most cells of the epidermis are
dehydration.
called keratinocyte. This makes the cells
more durable.
2. SENSATION ● Other cells of the
epidermis include
● The integumentary system has sensory melanocytes, which
receptors that can detect heat, cold, touch, contribute to skin
pressure, and pain. color; Langerhans
cells, which are
3. VITAMIN D PRODUCTION part of the immune
system, and
● When exposed to ultraviolet light the skin Merkel cells, we
produces a molecule that can be transformed specialized
into vitamin D, an important regulator of epidermal cells
calcium homeostasis. associated with the
nerve endings
4. TEMPERATURE REGULATION responsible for detecting light touch and
superficial pressure.
● The amount of blood flow beneath the skin's
surface and the activity of the sweat gland in LAYERS OF EPIDERMIS
the skin both help regulate body
temperature. 1. STRATUM BASALE
2. STRATUM SPINOSUM
5. EXCRETION 3. STRATUM GRANULOSUM
4. STRATUM LUCIDUM
● Small amounts of waste products are lost 5. STRATUM CORNEUM
through the skin and gland secretions.
STRATUM BASALE
SKIN
● The deepest portion of the epidermis is a
The skin is made up of two major tissue layers, the single layer of cuboidal or columnar cells.
epidermis, and the dermis. ● Keratinocytes stem cells of the stratum
basale undergo mitotic divisions
approximately every 19 days.
● One daughter cell remains a stem cell in the
stratum basale and divides again, but the
other daughter cell is pushed towards the
surface and becomes keratinized.
● It takes approximately 40-56 days for the
cell to reach the epidermal surface and
EPIDERMIS slough off.

● The epidermis is the superficial layer of the STRATUM SPINOSUM

skin.
● Stratum spinosum consisting of 8-10layers the axillae, and the
of many-sided cells. genitalia.
● As the cells in this stratum are pushed to the ● Other areas of the body
surface, they flatten; desmosomes break such as the lips, palms
apart, and then you desmosomes form. of the hands, and soles
● cells attached by the desmosomes appear of the feet, contain less
spiny. melanin.

STRATUM GRANULOSUM MELANIN

● The stratum granulosum consist of 2 to 5 PRODUCTION
layers of somewhat flattened, diamond- ● Melanin production is determined by genetic
shaped. factors, exposure or light, and hormones.
● In the most superficial layers of the stratum ● Genetic factors are primarily responsible for
granulosum, the nucleus and other the variations in skin color among different
organelles degenerate, and the cell dies. races and among people of the same race.
● Since all races have about the same number
STRATUM LUCIDUM
● The stratum lucidum appears as a thin, clear
zone above the stratum granulosum; it
consists of several layers of the dead cell
with indistinct boundaries.
● The stratum lucidum is present in only a
few areas of the body

STRATUM of melanocytes, racial variations in skin

CORNEUM color are determined by the amount and
types of melanin produced by the
melanocytes, as well as by
● This stratum is
the size, number, and
composed of 25
distribution of the
or more layers
melanosomes.
of dead,
● Many genes are
overlapping
responsible for skin color,
squamous cells joined by desmosomes.
a single mutation can
Eventually, the desmosomes break apart,
prevent the manufacture of
and the cells are shed from the surface of the
melanin.
skin.
● Albinism is usually a recessive genetic trait
● Excessive shedding of the stratum corneum
that results from an inability to produce
of the scalp results in dandruff.
tyrosinase. The result is deficiency or
● The stratum corneum consists of cornified
absence of pigment in the skin, the hair, and
cells, which are dead cells, with a hard
the irises of the eyes.
protein envelope, filled with protein keratin.
● During pregnancy, certain hormones, such
● The type of keratin found in the skin is soft
as estrogen and melanocyte-stimulating
keratin. Another type of keratin, hard
hormone, cause the mother’s body to
keratin, is found in nails and the external
increased melanin production, which causes
parts of the hair.
the darkening of the areolae and genitalia of
the nipples.
● The cheekbones, forehead, and the chest
SKIN COLOR also may darken, resulting in the “mask of
● Melanin is a group of pigments primarily pregnancy,” and a dark line of pigmentation
responsible for skin, hair, and eye color. may appear on the midline of the abdomen.
● Melanin also provides protection against ERYTHEMA
ultraviolet light from the sun.
● Erythema is redness of the skin or mucous
● Large amounts of melanin are found in
membranes, caused by hyperemia in
certain regions of the skin, such as freckles,
superficial capillaries.
moles, the nipples, the areolae of the breasts,
● An inflammatory ● It’s an elastic system that contains and
response supports blood vessels, lymphatic vessels,
stimulated by nerves, and the epidermal appendages
infection, .
sunburn, allergic
reactions insect
TWO LAYERS OF DERMIS
● The dermis itself has two layers: Papillary
bites, or other
dermis and reticular dermis.
causes can produce erythema, as can
● The papillary dermis has fingerlike
exposure to the cold and blushing of
projections, papillae, that connect the
flushing when angry or hot.
dermis, to the epidermis.
● It contains characteristic ridges that on the
PALLOR fingers are known as fingerprints. These
● Pale or pallor is an unusual lightness of skin
color compared with normal complexion.
● A decrease in blood flow, as occurs in
shock, can make the skin appear pale.

CYANOSIS
● Cyanosis is a bluish discoloration of the skin
and mucous membrane due to the decrease ridges also help the fingers and toes in
in blood oxygen gripping surfaces.
content. ● The reticular dermis covers a layer of
● Decrease blood subcutaneous tissue. Its made of collagen
oxygen content fibers and provides strength, structure, and
produces elasticity to the skin.
cyanosis. ● The elastic and collagen fibers are oriented
more in some directions than in others and
CAROTENE produce cleavage lines, or tension lines in
● Carotene is a the skin.
yellow pigment found in plants, such as
carrots and corn.
● Humans normally ingest carotene and use it STRECH MARK
as a source of vitamin A. ● If the skin is overstreched, the dermis may
● Carotene is lipid-soluble and when large rupture and leave lines that are visible
amounts of carotene are consumed, the through the epidremis.
excess accumulates in the stratum corneum ● These lines of scar tissue called streched
and adipocytes of the dermis and marks can develop on the abdomen and
subcutaneous tissue, breasts of woman during pregnancy or on
causing the skin to the skin of athletes who have quickly
develop a yellowish tint. increased muscle size by intense weight
● The yellowish tint training.
slowly disappears once
carotene intake is
reduced. SUBCUTANEOUS
TISSUE
DERMIS ● The skin rests on the
subcutaneous tissue.
● The dermis s the
● The subcutaneous
skin’s second layer.
tissue, which is not part of the skin, is
● The dermis is a
sometimes called hypodermis.
connective tissue,
● The subcutaneous tissue
most of the dermis is
is a layer of fat. It
made up of
contains larger blood
extracellular
vessels and nerves, as
material called
well as adispose cells
matrix. The matrix contains collagen and
which are filled with fat.
elastic fibers.
This subcutaneous fat
layer lies on the muscles and bones.
● Functions of subcutaneous tissue include
insulation, shock absorption, and storage of
ARRECTOR PILI MUSCLE
● Each hair follicle is attached to smooth
muscle cells arrector pili muscle, which can
contract and cause the hair to become
perpendicular to the skin's surface causing
the hair to “stand on the end.”
● Movement of the hair follicles produces
raised areas called “goose bumps.”

HAIR BULB
energy reserves. ● The hair bulb is an expanded knob at the
base of the hair root.
HAIR ● inside the hair, bulb is a mass of
undifferentiated epithelial cells, the matrix,
● A hair is divided into the shaft, which
which produces the hair and the internal
protrudes above the surface of the skin, and
epithelial root sheath.
the root, located below the surface.
● the dermis of the skin projects into the hair
● the base of the root is expanded to form the
bulb as a hair papilla; it contains blood
hair bulb.
vessels that provide nourishment to the cells
● Most of the route and the shaft are
of the matrix.
composed of columns of dead, keratinized
epithelium cells arranged in three concentric
layers: the medulla, the cortex and the HAIR GROWTH
cuticle. ● Hair is produced in cycles that involve a
growth stage and arresting stage.
● During the growth stage, hair is formed by
matrix cells that become keratinized, and
die.
● The hair grows longer as cells are added at
the base of the hair root. Eventually, hair
growth stops; the follicle shortens and holds
the hair in place.

HAIR LOSS
HAIR LAYERS ● A resting period
● The medulla is the central axis of the hair; it follows, after
consists of two or three layers of cells which a new
containing soft keratin. cycle begins
● The cortex forms the bulk of the hair; it and a new hair
consists of cells containing hard keratin. replaces the old
The cortex by the cuticle. hair, which falls
● Cuticle is a single layer of cells that contain out of the hair
hard keratin. the edges of the cuticle cells follicle.
overlap like shingles on a roof. ● the length of
each stage
HAIR FOLLICLE depends on the hair eyelashes grow for
approximately 30 day and rest for 105 days,
● The hair follicle is a tube like invagination
whereas scalp hair grows for 3 years and rest
of the epidermis that extends into the dermis
for 1-2 years.
from which hair develops.
● estimated 90% of the scalp hairs or in the
● A hair follicle consists of a dermal roof
growing stage, and lost of approximately
sheath and an epithelial root sheath.
100 scalp hairs per day is normal.
● The dermal root sheat is the portion of the
dermis that surrounds the epithelial root
sheath. PATTERN BALDNESS
● The epithelial root sheath is divided into ● The most common kind of permanent hair
external and internal parts. loss is “pattern baldness.” Hair follicles
shrink and revert to producing vellus hair,
which is very short, transparent, and for ● The glands open into hair follicles in the
practical purposes invisible. armpits and genatilia.
● Eventually, hair ● Apocrine sweat glands become active at
production in puberty because of the influence of sex
these smaller hormones.
follicles may ● The secretion generally is odorless, but
completely when released quickly breaks down by
cease. bacterial action giving body odor.
● Baldness is more
common and
more
NAILS
● The nail is a thin plate consisting of layers
pronounced in
Off dead stratum corneum cells that contain
certain men, it
a very hard type of keratin.
can also occur in women.
● The visible part of the nail is the nail body
● Genetic factors and the hormones
and the part of the nail covered by skin is the
testosteroneare involved in causing pattern
nail root.
baldness.
● The cuticle or eponychium, is stratum
corneum that exchange on to the nail body
GLANDS and the nail root extends distally from the
● The major glands of the skin are the nail matrix.
sebaceous glands and the sweat glands. ● The nail also attaches to the underlying nail
● Sebaceous glands are simple, branched bed which is located distal to the nail
acinar glands, with most being connected by matrix.
a duct to superficial part of a hair follicle. ● The nail matrix and bed or epithelial tissue
● Sebaceous glands produces sebum. with a stratum basale that gives rise to the
● The sebum is released by holocrine cells that form the nail.
secretion and lubricates the hair and the ● A small part of the nail matrix, the lunula,
surface of the skin, which prevents drying can be seen through the nail body as a
and protects against some bacteria. whitish, crescent-shaped area at the base of
the nail.
● Cell production within the nail matrix causes
the nail to grow continuously.

PHYSIOLOGY OF THE
INTEGUMENTARY SYSTEM

● PROTECTION
1. The

SWEAT GLANDS
● There ae two kinds of sweat glands: eccrine
and apocrine.
● Eccrine glands are simple, coiled, tubular
glands and release sweat by mecocrine
secretion. skin protects underlying structures
● Eccrine glands are located in almost every from mechanical damage.
part of the skin but most numerous in the 2. The skin prevents microorganisms
palms and soles. and other foreign substances from
● Eccrine sweat glands have ducts that open entering the body.
onto the surface of the skin through sweat 3. Melanin absorbs ultraviolet light
pores and are for thermal regulation. and protects underlying structures
● Apocrine sweat glands are simple, coiled, from its damaging effects.
tubular glands that produce a thick secretion 4. Hair provides protection in several
rich in organic substances. ways.
● The hair on the head acts
as a heat insulator and ● TEMPERATURE
protects against ultraviolet
light REGULATION
and 1. Blood vessels in the dermis dilate
and enable more blood to flow

within the skin, thus causing heat to

dissipate from the body.
2. Sweat also assist in loss of heat
abrasion. through evaporative cooling.
● The eyebrows keep sweat 3. Heat can be conserved by the
out of the eyes, the constriction of blood vessel, which
eyelashes protect the eyes reduces blood flow to the skin.
from foreign objects, and 4. With smaller amounts of warm
hair in the nose and ears blood flowing through the skin, the
prevents dust and other skin temperature decreases.
materials from entering.
● EXCRETION
● SENSATION 1. The integumentary system plays a
1. Receptors in the epidermis and minor role and excretion, the
dermis can detect pain, heat cold, removal of waste products from the
body.
2. In addition to water and salts, sweat
contains small amounts of waste
products, such as urea, uric acid,
and ammonia.

DIAGNOSTIC AID
● Cyanosis, bluish color to the skin caused by
and pressure. decreased blood O2
2. Hair does not have a nerve supply, content,Is an indication
sensory receptors around the hair of impaired circulatory
follicle can detect the movement of or respiratory function.
a hair.

● VITAMIN D PRODUCTION
1. UV light causes the skin to produce
a precursor molecule of vitamin D.
2. The precursor molecule is carried
by the blood to the liver where it is
enzymatically converted.
3. The enzymatically converted
molecule is carried by the blood to
the kidneys where it is converted
again to the active form of vitamin
d.
4. Vitamin D stimulates the small
intestine to absorb calcium and
postpaid for many body functions.
● Jaundice, yellowish skin coloration can ● Healing takes about two weeks and
occur when the liver is damaged by a no scarring results.
disease, such as viral hepatitis or gallbladder
obstruction.

BURNS

● A burn is injury to a tissue caused by heat,

cold, friction, chemicals, electricity or
radiation. Burns are classified according to ● If second degree burn goes deep
their depth. into the dermis, the wound appears
red, tan, or white; can take several
months to heal and might scar.

CLASSIFICATION OF BURN
THIRD-DEGREE (FULL
1. FIRST-DEGREE
(SUPERFICIAL) BURNS
● First degree burns affect only the
outer layer of skin, the epidermis.
● The burn site is red, painful dry and
with no blisters.
● Mild sunburn is an example.
Long-term tissue damage is rare THICKNESS) BURNS
and often consists of an increase or ● Third degree burns destroy the
decrease in the skin color. epidermis and dermis.
● They may go into the innermost
2. SECOND-DEGREE layer of skin, the subcutaneous
tissue.
(PARTIAL THICKNESS)
BURNS ● The burnside may look white or
black and and charred.
● The region of third-degree burn is
usually painless.

3. FOURTH-DEGREE BURNS
● Fourth degree burns go through
● Second degree burns involves the both layers of the skin and
epidermis and part of the lower underlying tissue
layer of as well as deeper
skin, the tissue, possibly
dermis. involving muscle
● If dermal and bones. There
damage is is no feeling in
minimal, the area since the
symptoms nerve endings are
include destroyed.
redness,
pain, edema and blisters.
occupational exposure to the sun, or who
RULE OF NINE have experienced sunburne are at increased
●
risk.
The
● Most skin cancers developed on the parts of
the body that are frequently exposed to
extent of a burn injury is determined using sunlight, such as the face, neck, ears, and
the wallace rule of nines. Both the burned dorsum of the forearm and hand.
and unburned areas are calculated to ensure
accuracy. TYPES OF CANCER
1. BASAL CELL
PATHOPHYSIOLOGY OF
CARCINOMA
BURNS
● A burn injury usually results from energy
transfer from a heat source to the body.
● Adjacent intact vessels dilate, causing
redness and blanching with pressure.
● Platelets and leukocytes begin to adhere to
the vascular endothelium as an early event ● Cells in stratum basale affected.
in the inflammatory process. ● Basal cells carcinomas have a
● Increased capillary permeability produced varied appearance. some are open
wound edema. source that bleed, oozed, or crust
● An influx of leukocytes and monocytes for several weeks. others are
occurs at the injury site. reddish patches; shiny, pearly, or
● Eventually, new capillaries, immature translucent bumps.
● The prognosis for BCCis usually
good. tumors remain localized.
● Some require wide excision with
resultant disfigurement.
● The risk for death from BCC is
low.
●

fibroblast, and newly formed collagen fibrils

2. SQUAMOS CELL
appear within the wound. this supports the CARCINOMA
regenerating epithelium.

● Squamous cell carcinoma affects

cells in the stratum spinosum and
can appear as a wartlike growth;
BURNS SYSTEMIC EFFEC persistent, scaly red patch; an open

SKIN CANCER
● Most common cancer. sore; or an elevated growth with a
● the most successfully treated type of cancer central depression. These lesions
(Odom et al., 2000) may bleed.
● Most skin cancers result from damage ● Removal or destruction of the
caused by the ultraviolet radiation in tumor cures most cases.
sunlight. ● The prognosis for SCC depends on
● Some skin cancers are induced by chemicals the incidence of metastases.
x-rays depression of the immune system or
inflammation whereas others are inherited. 3. MELANOMA
● Fair-skinned more prone.
● Individuals who are older than 50, who have
engage in repeated recreational or
● Melanoma is the least common, but
deadly, type of skin cancer.
● Melanoma arise from
melanocytes,Most melanomas are
black or brown, but occasionally a
melanoma stops producing melanin
and appears skin colored pink, red,
or purple.
● About 40% of melanomas develop
in pre-existing moles.
● Treatment of melanoma when they
are confined to the epidermis is
almost always successful.
● If a melanoma invades the dermis
and mestastasizes to other parts of
the body, it is difficult to treat and

can be deadly.

AGING AND INTEGUMENT

● Blood flow decreases and skin becomes
thinner due to decreased amounts of
collagen.
● Decreased activity of sebaceous and sweat
glands make temperature regulation more
difficult.
● Loss of elastic fibers causes skin to sag and
wrinkle.