The Integumentary System

BY: Tefera B(MSc.)

The integumentary(inte-whole;-gument-body covering)
meaning the whole body covering

As a system it consists of the skin( integument) and its

appendages (hairs, nails, and skin glands)

Dermatology (dermato-skin;-logy-study of) is the

medical specialty that deals with the diagnosis and
treatment of integumentary system disorders
STRUCTURE OF THE SKIN
SKIN ( THE CUTANEOUS MEMBRANE)
Covers the external surface of the body
The largest organ of the body in both surface area and
weight
Covers an area of about 2 square meters and weighs
4.5–5 kg which is about 7 % of total body weight( adult
skin)
FUNCTION 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
EPIDERMIS
The superficial, thinner portion, which is composed of
epithelial tissue (keratinized stratified squamous)

It is the protective layer of the skin

It is avascular layer ( bleeding is not common) epithelium

LAYERS OF THE EPIDERMIS

Has 4 to 5 layers depending on where the epidermis is

located

1. Stratum basale (basal layer)

Consists of a single layer of cells in contact with the

dermis

This layer is referred to as the stratum germinativum

Four types of cells compose the stratum basale:
1. Keratinocytes ( composed 90% of the cells)
Produce keratin which is a tough fibrous protein that provides
protection

2. Melanocytes
Produce the pigment melanin that gives skin color and protects
against damage by ultraviolet radiation

3. Langerhans cells (intra epidermal macrophage cells)

Involved in immune responses
Arise from red bone marrow

4. Merkel cells
Function in the sensation of touch along with the adjacent tactile
discs
2. Stratum spinosum (spiny layer)

It contains several layers of cells

There is limited mitosis in the stratum spinosum

3. Stratum granulosum (granular layer)

It consists of only three or four flattened layers of cells

The cells contain granules that are filled with keratohyaline

a chemical precursor to keratin
4. Stratum lucidum (clear layer)

The nuclei, organelles, and cell membranes are no longer

visible in the cells of the stratum lucidum (histologically
this layer appears clear)

It exists only in the lips and in the thickened skin of the

soles and palms
5. Stratum corneum (hornlike layer)

Composed of 25 to 30 layers of flattened, scale like

cells

Thousands of these dead cells shed from the skin

surface each day, only to be replaced by new ones
from deeper layers

It is the layer that actually protects the skin

This surface layer is cornified

Variations in the Epidermis

The epidermis exhibits variations among different body

regions within a single individual, as well as differences
between individuals.
The epidermis varies in thickness, coloration, and skin
markings
Thick Skin Versus Thin Skin
Skin is classified as either thick or thin based upon the
number of strata in the epidermis
Thick skin
Found on the palms of the hands, the soles of the feet,
and corresponding surfaces of the fingers and toes.
All five epidermal strata occur in thick skin.
The epidermis of thick skin ranges between 0.4 mm
and 0.6 mm thick.
Thick skin contains sweat glands, but no Hair follicles
or sebaceous (oil) glands
Thin skin covers most of the body.
The epidermis lacks the stratum lucidum, so it has only
four layers.
Thin skin contains the following accessories: hair
follicles, sebaceous glands, and sweat glands.
The epidermis of thin skin ranges from 0.075 mm to
0.150 mm thick
2- DERMIS

The deeper, thicker, connective tissue portion

Composed of a strong dense irregular connective

tissue containing collagen and elastic fibers

Thickness varies from region to region in the body,

reaching its greatest thickness on the palms and
soles
Has great tensile strength (resistance to pulling or stretching
forces) and ability to stretch and recoil easily

Has fixed (fibroblasts) and wandering ( macrophages, mast

cells, eosinophils, neutrophils, and dermal interstitial
dendritic cells (immune surveillance cells))

Contain the blood vessels and nerves, along with glands and
hair follicles
Layers/Regions of the Dermis
1. Stratum Papillarosum (Papillary Layer)
Upper layer of the dermis
In contact with the epidermis above
Accounts for about one-fifth of the entire dermis
Has numerous papillae that extend from it’s upper
portion into epidermis
Dermal papillae house capillaries, corpuscles of touch,
and free nerve endings
2. Stratum Reticularosum (Reticular Layer)

The deeper and thicker layer of the dermis

Fibers within this layer are more dense and regularly

arranged to form a tough, flexible meshwork

This layer is quite distensible ( with in a limit)

Eg . Obese individual , Pregnant women
Innervation of the Skin

Dermis has extensive innervations (nerve supply)

Specialized integumentary effectors (smooth muscles or

glands) within the dermis respond to motor impulses
transmitted from the CNS to the skin by autonomic nerve
fibers

Several types of sensory receptors respond to various

tactile (touch), pressure, temperature, tickle, or pain stimuli
Some are free nerve endings, some form a

network around hair follicles, and some extend

into the papillae of the dermis

Certain areas of the body, such as the palms,

soles, lips, and external genitalia, have a greater

concentration of sensory receptors and are

therefore more sensitive to touch

Vascular Supply of the Skin
Blood vessels within the dermis supply nutrients to the

mitotically active stratum basale of the epidermis and

to the cellular structures of the dermis, such as glands

and hair follicles

Dermal blood vessels play an important role in

regulating body temperature and blood pressure

Autonomic vasoconstriction or vasodilation responses
can either shunt the blood away from the superficial
dermal arterioles or permit it to flow freely throughout
dermal vessels

Blushing is the result of involuntary vasodilation of

dermal blood vessels
HYPODERMIS /SUBCUTANEOUS TISSUE/
SUPERFICIAL FASCIA

Layer below the dermis

Deep to the dermis, but not part of the skin

Binds the dermis to underlying organs

Consists of the areolar and adipose tissues

Various factors affect amount of adipose tissue in the

hypodermis (the region of the body , sex, age, and

nutritional state of the individual)

Eg. Females have about an 8% thicker hypodermis

than males
Function

Store lipids, insulate and cushion the body, and regulate

temperature

Allowing the skin to move freely over these deeper

structures

Forms tough fat pads, which absorb shock and protect

underlying muscle and bone
EPIDERMAL DERIVATIVES
They are also called appendages/ accessory structures
of the skin
Include: hair, integumentary /skin glands, and nails
1. HAIR (PILI)
Have a number of important functions:
Protection
Reduction of heat loss
Sensing light touch
Hair is composed of dead, keratinized epidermal cells

Hair consists of:

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
B. Root - below epidermis, penetrates into the dermis
C. Hair Follicle - at the base a single hair

1. External root sheath - Basale and spinosum extension

-originates from the dermis

1. Internal root sheath - internal hair cell layers

-originates from the epidermis

1. Bulb - base of hair cell

2. Papilla - in the bulb, provides nourishment for hair

3. Matrix - origin of new hair cells

Hair Follicle
Hair Follicle
D. Arrector pili :

The smooth muscle extends from the superficial dermis of the skin to
the connective tissue sheath around the hair follicle

The arrector pili muscles are usually stimulated in response to an

emotional state, such as fear or rage, or exposure to cold temperatures.
Upon stimulation, the arrector pili muscles contract, pulling on the
follicles and elevating the hairs.

E. Hair root plexuses - nerve bundle responds to touch

NOTE: The hair bulb contains living epithelial cells, whereas the root and
shaft consist of dead epithelial cells.
In a healthy person, hair grows at the rate of approximately
1 mm every 3 days

The life span of a hair varies from 3 to 4 months for an

eyelash to 3 to 4 years for a scalp hair

Each hair lost is replaced by a new hair that grows from

the base of the follicle and pushes the old hair out
Skin Color
Normal skin color results from a combination of
hemoglobin, melanin, And carotene

Hemoglobin is an oxygen-binding protein present within

red blood cells.

Hemoglobin exhibits a Bright red color upon binding to

oxygen, giving blood Vessels in the dermis a bright reddish
tint that is most easily seen in the skin of lightly pigmented
individuals.
• Melanin is a pigment produced and stored in
melanocytes
• The amount of melanin in the skin is determined by both
heredity and light exposure.
• All people have about the same number of melanocytes.
• However, melanocyte activity and the color of the
melanin produced by these cells varies among
individuals and ethnicities, resulting in different skin
color tones.
• Darker-skinned individuals have melanocytes that
produce relatively more and darker melanin than do
lighter-skinned individuals.
Carotene
Carotene is a yellow-orange pigment that is acquired in
the body by eating various yellow-orange vegetables, such
as carrots and corn.
Normally, carotene accumulates inside keratinocytes of
the stratum corneum and within the subcutaneous layer.
In the body carotene is converted into vitamin A, which
has an important function in normal vision.

. melanin + carotene = yellowish color

. Other Colors

1. Pink (Caucasian) - lack of pigment, capillaries

2. Blue (cyanosis) - lack of oxygen in blood
3. Yellow (jaundice) - liver disorder, protein release
Reading assignment

• Nails
Glands
A. Sebaceous Glands (oil glands)
Generally connected to hair follicles
The secreting portions of the glands lie in the dermis
and open into the hair follicles or directly onto a skin
surface.
There are no sebaceous glands in the palms and soles.
Sebaceous glands secrete an oily substance called
sebum
oSebum
Keeps hair from drying out
Prevents ex-cessive evaporation of water from the skin
Keeps the skin soft, and inhibits the growth of certain
bacteria.
Sebaceous gland activity increases during adolescence
B. Sudoriferous Glands (sweat glands)
1. Apocrine Sweat Glands
A. Simple branched tubular glands
B. Only in axilla (arm pit), pubic + areole areas
C. The secretory portion of these located mostly in
the subcutaneous layer
D. Do not begin to function until puberty.
2. Eccrine Sweat Glands
A. Simple coiled tubular glands
B. All over the body
C. The secretory portion is located mostly in the deep
dermis (sometimes in the upper subcutaneous
layer)
D. start to function soon after birth
Main function: to help regulate body temperature
through evaporation
3. Perspiration (sweat)
a. Mixture of water, salt, urea, ammonia, acids
b. Eliminates waste and heat
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
Skin Cancer
The three major types of skin cancer are:
• Basal cell carcinoma
• Squamous cell carcinoma
• Melanoma
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
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
Basal and squamous cell carcinomas are together
known as nonmelanoma skin cancer
Melanoma
Cancer of melanocytes is the most dangerous type of
skin cancer because it is:
• Highly metastatic
• Resistant to chemotherapy
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)
Melanoma

• Treated by wide surgical excision accompanied by

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