Fakulteti i Mjekesise

Dega Mjekesi e pergjithshme - Viti I

Lecture 12. Integumentary System

The integumentary system consists of the largest organ in the body, the skin. This
extraordinary organ system protects the internal structures of the body from damage,
prevents dehydration, stores fat and produces vitamins and hormones. It also helps to
maintain homeostasis within the body by assisting in the regulation of body temperature and
water balance. The integumentary system is the body's first line of defence against bacteria,
viruses and other microbes. It also helps to provide protection from harmful ultraviolet
radiation. The skin is a sensory organ in that it has receptors for detecting heat and cold,
touch, pressure and pain. Components of the skin include hair, nails, sweat glands, oil
glands, blood vessels, lymph vessels, nerves and muscles. Concerning integumentary
system anatomy, the skin is composed of a layer of epithelial tissue (epidermis) that is
supported by a layer of connective tissue (dermis) and an underlying subcutaneous layer.

 The layers of the skin

The skin has two major layers: the epidermis and the dermis, which are made of different
tissues and have very different functions. Below these layers lies the hypodermis or
subcutaneous adipose layer, which is not usually classified as a layer of skin.
 The outermost epidermis consists of stratified squamous keratinizing epithelium with an
underlying basement membrane. It contains no blood vessels, and is nourished by
diffusion from the dermis. The main type of cells which make up the epidermis are
keratinocytes and melanocytes cells. Cells are formed through mitosis at the innermost
layers. They move up the strata changing shape and composition as they differentiate,
inducing expression of new types of keratin genes. This process is
called keratinization and takes place within about 30 days. This layer of skin is
responsible for keeping water in the body and keeping other harmful chemicals and
pathogens out. Blood capillaries are found beneath the dermis, and are linked to an
arteriole and a venule. Arterial shunt vessels may bypass the network in ears, the nose
and fingertips.
 The dermis lies below the epidermis and contains a number of structures including blood
vessels, nerves, hair follicles, smooth muscle, glands and lymphatic tissue. It consists of
loose connective tissue - collagen, elastin and reticular fibers are present. The main cell
types are fibroblasts, adipocytes (fat storage) and macrophages. Sebaceous glands are
exocrine glands which produce, a mixture of lipids and waxy substances: lubrication,
water-proofing, softening and antibactericidal actions are among the many functions of
sebum. Sweat glands open up via a duct onto the skin by a pore. The dermis is made of
an irregular type of fibrous connective tissue consisting of collagen and elastin fibers. It
can be split into the papillary and reticular layers. The papillary layer is outermost and
extends into the epidermis to supply it with vessels. It is composed of loosely arranged
fibers. Papillary ridges make up the lines of the hands giving us fingerprints. The
reticular layer is more dense and is continuous with the hypodermis. It contains the bulk
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Fakulteti i Mjekesise
Dega Mjekesi e pergjithshme - Viti I
Lenda: English Language
L. 12. Integumentary System

of the structures (such as sweat glands). The reticular layer is composed of irregularly
arranged fibers and resists stretching.
The hypodermis is not part of the skin, and lies below the dermis. Its purpose is to attach the
skin to underlying bone and muscle as well as supplying it with blood vessels and nerves. It
consists of loose connective tissue and elastin. The main cell types are fibroblasts,
macrophages and adipocytes (the hypodermis contains 95% of body fat).

 The integumentary system and its relation to other systems

Our body is a complicated system that consists of many subsystems that help to keep it
functioning properly. These subsystems serve a variety of purposes and require needed
materials to function properly, as well as means of communicating information to other
parts of the body. Thus, the skin and other parts of the integumentary system work with
other systems in our body to maintain and support the conditions that your cells, tissues, and
organs need to function properly.
The skin is one of the first defense mechanisms in our immune system. Tiny glands in the
skin secrete oils that enhance the barrier function of the skin. Immune cells live in the skin
and provide the first line of defense against infections.
By helping to synthesize and absorb vitamin D, the integumentary system works
with the digestive system to encourage the uptake of calcium from our diet. This substance
enters the bloodstream though the capillary networks in the skin. Healthy functioning of our
skin also is related to the digestive system because the digestion and assimilation of dietary
fats and oils are essential for the body to be able to make the protective oils for the skin and
hair.
The integumentary system also works closely with the circulatory system and the surface
capillaries through the body. Because certain substances can enter the bloodstream through
the capillary networks in the skin, patches can be used to deliver medications in this manner
for conditions ranging from heart problems to smoking cessation (nicotine patches).
The skin also is important in helping to regulate our body temperature. If we are too hot or
too cold, our brain sends nerve impulses to the skin, which has three ways to either increase
or decrease heat loss from the body's surface: hairs on the skin trap more warmth if they are
standing up, and less if they are lying flat; glands under the skin secrete sweat onto the
surface of the skin in order to increase heat loss by evaporation if the body is too hot;
capillaries near the surface can open when our body needs to cool off and close when we
need to conserve heat.
The skin plays a vital role in our body as regards the sense of touch. The nervous
system depends on neurons embedded in your skin to sense the outside world. It processes
input from our senses, including touch, and initiates actions based on those inputs. For
example, when you stub your toe, nerve cells in the foot send signals up the leg, through the
spinal cord, and up into the brain. The nerve cell connections in the brain sense these signals
as pain.

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Fakulteti i Mjekesise
Dega Mjekesi e pergjithshme - Viti I
Lenda: English Language
L. 12. Integumentary System

As well as interacting with the body systems as explained above, the integumentary system
also contributes to numerous physiological processes, especially those involved in the
regulation of the body’s internal environment so as to maintain a stable condition. An
example is provided by the way that the skin helps in temperature regulation by changes in
the pattern of blood supply to the skin and by sweating, as mentioned above.

 Appendages of the Skin

 Hair - A characteristic feature of the human skin is the apparent lack of hair on
most of the body surface. This is actually not quite true. Most of the skin is haired
although the hair in most areas is short, fine and only lightly pigmented. Truly
hairless are only the palms of hands and soles of feet, the distal phalanges and sides
of fingers and toes and parts of the external genitalia. In those parts of the skin
which we perceive as "hairy" we find terminal hairs. The free part of each hair is
called the shaft. The root of each hair is anchored in the hair follicle, which extends
down into the dermis and, usually, a short distance into the hypodermis. The
deepest end of the hair follicle forms an enlargement, the bulb. Hair growth is
discontinuous. Hairs are lost and replaced by new ones. The hair follicle goes
through different stages that reflect the discontinuous hair growth. Anagen is the
phase of growth. The resting stage is called telogen. The length of the anagen is
variable in different regions of the body - lasting only a few months for hair of the
eyebrows and eyelashes but 2 to 5 years for hair of the scalp. Hair growth is
controlled by a number of hormonal and hereditary factors and their interactions.
 Sebaceous Glands - Sebaceous glands empty their secretory product into the upper
parts of the hair follicles. They are therefore found in parts of the skin where hair is
present. Sebaceous glands are also found in some of the areas where no hair is
present, for example, lips, oral surfaces of the cheeks and external genitalia. The
secretory portion consists of alveoli. Basal cells in the outermost layer of the
alveolus are flattened. Basal cells are mitotically active. Some of the new cells will
replenish the pool of basal cells, while the remaining cells are displaced towards the
centre of the alveolus as more cells are generated by the basal cells. The secretory
cells will gradullay accumulate lipids and grow in size. Finally their nuclei
disintegrate, and the cells rupture. The lipid secretion of the sebaceous glands has
no softening effect on the skin, and it has only very limited antibacterial and
antifungoid activity. Its importance in humans is unclear. Clinically the sebaceous
glands are important in that they are liable to infections

 Sweat Glands - Two types of sweat glands are present in humans. They are
distinguished by their secretory mechanism into merocrine sweat glands and apocrine
sweat glands. In addition, they differ in their detailed histological appearance and in
the composition of the sweat they secrete. Merocrine sweat glands are the only glands
of the skin with a clearly defined biological function. They are of critical importance
for the regulation of body temperature. The skin contains 3,000,000 sweat glands
which are found all over the body.

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Fakulteti i Mjekesise
Dega Mjekesi e pergjithshme - Viti I
Lenda: English Language
L. 12. Integumentary System

Apocrine sweat glands occur in, for example, the axilla. They are stimulated by
sexual hormones and are not fully developed or functional before puberty. Apocrine
sweat is a milky and odourless secretion. The odour is a result of bacterial
decomposition and is, at least in mammals other than humans, of importance for
sexual attraction.

 Skin cancer
Skin cancer is the growth of abnormal skin cells capable of invading and destroying other
cells. Skin cancer is the single most common type of cancer in humans. The cause of most
skin cancers or carcinomas is unknown, but overexposure to ultraviolet radiation in sunlight
is a risk factor.
 Basal cell carcinoma is the most common form of skin cancer, accounting for about
75 percent of cases. It is also the least malignant or cancerous (tending to grow and
spread throughout the body). In this form of skin cancer, basal cells in the epidermis
are altered so they no longer produce keratin. They also spread, invading the dermis
and subcutaneous layer. Shiny, dome-shaped lesions develop most often on sun
exposed areas of the face. The next most common areas affected are the ears, the
backs of the hands, the shoulders, and the arms.
 Squamous cell carcinoma affects the cells of the second deepest layer of the
epidermis. Like basal cell carcinoma, this type of skin cancer also involves skin
exposed to the sun: face, ears, hands, and arms. The cancer presents itself as a small,
scaling, raised bump on the skin with a crusting center. It grows rapidly and spreads
to adjacent lymph nodes if not removed. If the lesion is caught early and removed
surgically or through radiation, the patient has a good chance of recovering
completely.
 Malignant melanoma accounts for about 5 percent of all skin cancers, but it is the
most serious type. It is a cancer of the melanocytes, cells in the lower epidermis that
produce melanin. In their early stages, melanomas resemble moles. Soon, they appear
as an expanding brown to black patch. In addition to invading surrounding tissues,
the cancer spreads aggressively to other parts of the body, especially the lungs and
liver. Overexposure to the Sun may be a cause of melanomas, but the greatest risk
factor seems to be genetic.