Human Anatomy, Fifth Edition, Martini/Timmons/Tallitsch

The Integumentary System

I. Introduction

● The integumentary system or integument is composed of skin, hair, nails, sweat,

oil, and mammary glands.

● Skin tells clinicians about the overall health of the body and can be used to detect
some internal problems.

II. Integumentary Structure and Function

● Integument covers the entire surface of the body, including the eyes and eardrum.

● All four tissue types are found in the integument.

1. An epithelium covers the surface.

2. Connective tissue provides underlying stability.

a. Blood vessels are abundant within the CT.

3. Smooth muscle is found in the walls of blood vessels in the integument, and
attached to hairs.

4. Neural tissue controls the blood vessels as well as provides sensation.

● Function of the integument includes:

1. Physical protection
2. Regulation of body temperature
3. Excretion (secretion)
4. Nutrition (synthesis)
5. Sensation
6. Immune defense

● The integument has two major parts:

1. Skin, or the cutaneous membrane has it own two subdivisions.

a. Epidermis is the stratified squamous epithelium of the skin.

b. Dermis is the underlying loose CT.

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o Deep to the dermis is the subcutaneous layer (superficial fascia or
hypodermis), which is not part of the skin but will be discussed in this
chapter because of the vast interconnections it has with the dermis.

2. Accessory structures include hair, nails, and many multicellular exocrine

glands.

III. The Epidermis

● The epidermis is a stratified squamous epithelium that contains four cell types.

1. Keratinocytes are the most abundant cells in the epidermis. They produce
keratin and keratohyalin for waterproofing the skin..

a. At least four different cell layers can be found on most areas of the body.

2. Melanocytes are pigment cells found deep in the epidermis.

3. Merkel cells are sensory cells.

4. Langerhans cells are wandering dendritic (having tentacles) macrophages.

● Thick and Thin Skin

● The references to thick and thin skin are made relative to the thickness of the
epidermis and not the entire thickness of the skin.

● Most of the body is covered with thin skin, having four distinct layers.

● Thick skin contains the stratum lucidum and may have 30 layers of keratinized
cells.

1. Folds in the stratum germinativum that extend into the dermis form epidermal
ridges.

a. In thick skin, on the palms and sole, the ridges and papillae are very
pronounced and can be seen and felt on the surface.

o These fingerprints increase the surface area of the skin covering the
digits and therefore help with gripping objects.

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o Ridges and papillae are genetically determined and are different in
everyone, and therefore can be used to identify individuals.

2. Skin Color is produced by a combination of two factors.

a. Dermal blood supply

o Decreased blood flow can cause one to become pale.

o Cyanosis, a bluing coloration, is the result of long term decreased

blood flow causing hypoxia in the area.

o Increased blood flow will cause a pink “blush”.

b. Epidermal pigment content

o Carotene is a yellow-orange pigment found in some vegetables that

may become trapped in the epidermis.

o Melanin is the dark pigment produced by the melanocytes.

 Vesicles called melanosomes are transferred from melanocytes to

keratinocytes.

a. If large melanosomes are transferred in the granulosum layer

the individual tends to have darker skin.

b. If smaller melanosomes are transferred in the spinosum layer

the individual will have lighter skin.

c. Ultraviolet radiation triggers melanin production and can lead

to tanning.

d. Melanin normally surrounds the nuclei of cells to protect them

from the UV radiation.

 Therefore UV radiation triggers more melanin production.

IV. The Dermis

● The dermis is deep to the epidermis and is a mixture of areolar CT and dense
irregular CT.

● Dermal Organization

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1. The superficial papillary layer contains areolar connective tissue.

a. Abundant blood vessels are found in the region.

b. Neural tissue is also found here.

2. The deeper reticular layer consists of dense irregular CT.

a. Blood vessels, glands, muscles, hair follicles and nerves are all found in
this layer.

3. Collagen fibers in the reticular layer extend into the papillary layer and deeper
into the subcutaneous layer to bind everything together.

a. The boundaries between layers are very indistinct.

4. Wrinkles, Stretch Marks, and Lines of Cleavage

a. Elastic fibers in the dermis afford a great deal of stretching.

b. Excessive stretching can permanently break the elastic fibers resulting in

wrinkles and stretch marks.

Lines of cleavage are made by patterns of parallel elastic and collagen fibers in the
dermis.

o Cutting across a line of cleavage results in the elastic fibers pulling the
incision open, resulting in scarring.

o Cutting parallel to the lines of cleavage is favorable to fast healing

with minimal scarring.

● Other Dermal Components

1. The Blood Supply to the Skin

a. Cutaneous plexus is the network of blood vessels at the border of the

reticular layer and the subcutaneous layer.

b. Papillary plexus is the highly branch network of blood vessels just deep to
the epidermis.

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c. Circulation to both plexi are important due to their role in
thermoregulation and overall blood flow.

2. The Nerve Supply to the Skin

a. Nerve fibers to the skin are involved in:

o Regulation of blood flow

o Regulation of glands

o Sensations
 Tactile discs form with the union of a Merkel cell and a sensory
nerve ending.
 Free dendrites are sensitive to pain and temperature.
 Other receptor of the skin will be noted in Chapter 18
a. Tactile corpuscles (light touch)
b. Root hair plexus (light touch)
c. Ruffini corpuscles (stretch)
d. Lamellated corpuscles (deep pressure and vibrations)

V. The Subcutaneous Layer.

● The subcutaneous layer (hypodermis or superficial fascia) is not technically part

of the skin.

● The subcutaneous layer is a mixture of areolar and adipose tissues.

● Adipose tissue distribution is highly individual, however common patterns are

seen in males and females.

1. Males – neck, upper arms, lower back, and buttocks.

2. Females – breasts, buttocks, hips and thighs.

3. Both – abdomen.

● Because no vital organs are in this region it is a great location for injection of
drugs through a hypodermic needle.

VI. Accessory Structures

● Hair Follicles and Hair

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a. Hair is a non-living keratinized structure that extends beyond the surface
of the skin in most areas of the body.

o 98% of the 5 million hairs on the body are not on the head.

b. Hair follicles are the organs that form the hairs.

1. Hair Production comes from growth from a hair follicle.

2. Functions of Hair

a. Protection of the scalp from UV light, blows to the head and

thermoregulation.

b. Trapping of particles in the nasal passageway and external auditory canals.

c. The root hair plexus provides sensation.

d. Arrector pili allow movement of hairs, as in “goose bumps”.

3. Types of Hair

a. The first hairs are produced before birth and are called lanugo.

o Most lanugo is shed before birth and is replaced by one of three types
of adult hairs, vellus, intermediate, or terminal.

b. Vellus hairs are the fine, colorless “peach fuzz” that covers most of the
body.

c. Intermediate hairs are thin, colored hairs common to the limbs and groin.

d. Terminal hairs are the coarse, deepest pigmented hairs found on the head
and face.

4. Hair color is determined by pigment production of the melanocytes in the

follicle.

a. Greater amounts of melanin result in darker hairs.

b. Red hair is the result of an altered melanin pigment.

c. Hormones and age play roles in hair color as well.

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● Glands in the Skin

1. Sebaceous glands are exocrine glands that discharge oily secretions into hair
follicles.

a. Lipids are the main component of the secretions that are released by the
holocrine mode of secretion.

b. Sebaceous follicles are large sebaceous glands that do not attach to a hair
follicle.

o Locations of sebaceous follicles include the:

 Face
 Back
 Chest
 Nipples
 Male sex organs

2. Sweat glands or sudoriferous glands are found throughout the surface of the
body.

a. Apocrine sweat glands are found in the axillae, around the nipples and in
the groin.

o Secretion is a viscous, cloudy, and potentially odorous secretion.

 Bacteria may act on the secretion changing its biochemical makeup,

causing an undesirable odor.

b. Merocrine sweat glands or eccrine sweat glands are far more numerous
than apocrine sweat glands.

o The highest density of these glands is on the palms and soles.

o Sweat or sensible perspiration is released by these glands.

 99% water
 1% electrolytes

o Sweat functions in:

 Thermoregulation – sweat cools the surface of the skin and reduces

body temperature.

 Excretion – water and electrolytes.

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 Protection – dilution of chemicals on skin and bacteriocidal.

3. Control of Glandular Secretions

a. The autonomic nervous system control glands.

o Sebaceous glands and apocrine glands have not precise control – just
on or off for all of them.

o Merocrine sweat glands have more precise control. Therefore

sometimes only a certain area may sweat.

4. Other Integumentary Glands

a. Mammary glands are milk-producing glands found in the breast that are
anatomically related to apocrine sweat gland.

b. Ceruminous glands are modified sweat gland in the external auditory canal.

o Secretions from these glands mix with those of nearby sebaceous

glands to form cerumen, or earwax.

● Nails are special keratinized structures of the epidermis that cover the dorsal
surfaces of the distal digits.

VII. Local Control of Integumentary Function

● The integument can respond independently of the endocrine system and nervous
system.

1. Mechanical stress can trigger stem cell divisions resulting in calluses.

2. Regeneration occurs after damage.

a. The inability to completely heal after severe damage may result in

acellular scar tissue.

VIII. Aging and the Integumentary System

● The epidermis thins as germinative cell activity declines.

● The number of Langerhans cells decreases, affecting the immune system.
● Vitamin D production declines, leading to calcium deficiency.

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● Melanocyte activity declines.
● Glandular activity declines, reducing the ability to cool oneself.
● Blood supply to the dermis decreases, further reducing cooling ability.
● Hair follicles stop functioning, or produce thinner hairs.
● The dermis thins and loses elastic fibers, resulting in wrinkles.
● Secondary sex characteristics of the integument fade.
● Skin repair slows.

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