INTEGUMENTARY

Sweat glands: found on body surface, prevent overheating, secrete scent.

Tactile corpuscle: sensitivity to textural changes.

Bulbous corpuscle: detect deep skin tension.
Hassall's corpuscles: found in the thymus gland.
Lamellar corpuscle: sensitive to vibration, not constant pressure.
Ruffini corpuscle: sense skin stretch, movement, finger position.

Notes on Skin Histology

Overview of Skin:

● Largest organ, visible daily

● Functions: Protection (trauma, infection, UV), temp regulation, waterproofing, Vitamin D synthesis, sensory interaction
● Types: Thick and thin skin

Layers of Skin:

1. Epidermis (outermost)
○ Keratinized stratified squamous epithelium
○ 5 layers (thick skin - hairless), 4 layers (thin skin-hairy )
○ Avascular (no blood supply)
○ Receives nutrients by diffusion
○ 5 Layers (superficial to deep):
■ Stratum corneum (dead, keratinized cells, waterproof)
■ Stratum lucidum (clear layer, only in thick skin)
■ Stratum granulosum (granules, keratin synthesis)
■ Stratum spinosum (prickle cell layer, keratinocytes linked)
■ Stratum basale (stem cells, keratinocytes, melanocytes, Merkel cells)

BASEMENT MEMBRANE - separate the epidermis and dermis

2. Dermis (middle layer)

○ Connective tissue (fibroblasts)
○ 2 Layers:
■ Stratum papillare (20%, papillae, Meissner’s corpuscles, capillaries)
■ Stratum reticulare (80%, collagen, elastic fibers, glands, nerve endings)
3. Hypodermis (deepest, subcutaneous tissue)
○ Adipose tissue (fat storage, insulation)

Skin Cells:

● Keratinocytes: Main cell in epidermis

● Melanocytes: Pigment cells
● Langerhans cells: Immune response
● Merkel cells: Sensory receptors

Mnemonic for Layers: British And Spanish Grannies Love Cornflakes

Epidermis Cells:

1. Keratinocytes:
○ Most abundant cell type (90% of epidermis cells).
○ Found throughout the epidermis, including the stratum spinosum, granulosum, and corneum.
○ Granular cells: Keratinocytes in the stratum granulosum with keratohyalin granules in their cytoplasm.
○ Corneocytes: Dead keratinocytes in the stratum corneum, with no nucleus or organelles. They eventually shed
through desquamation.
2. Basal Cells:
○ Found only in the stratum basale.
○ Columnar stem cells that divide and differentiate into keratinocytes.
○ Essential for skin regeneration.
3. Melanocytes: freckles, naevi moles, lentigines
○ Located in the stratum basale but extend through the stratum spinosum.
○ Responsible for producing melanin, the pigment protecting cells from UV radiation.
○ Dendrites deliver melanin to surrounding keratinocytes and basal cells.
4. Langerhans Cells:
○ Immune cells found mainly in the stratum spinosum.
○ Act as antigen-presenting cells, helping the immune system respond to pathogens.

Dermis Cells:

1. Fibroblasts:
○ The most abundant cell type in the dermis.
○ Produce the connective tissue fibers that provide structural support to the skin.
2. Adipocytes:
○ Fat cells that provide padding, insulation, and energy storage.
3. Macrophages:
○ Immune cells that help protect against infections by engulfing pathogens and presenting antigens to other
immune cells.

Hypodermis Cells:

● The hypodermis contains the same cell types as the dermis—fibroblasts, adipocytes, and macrophages—but
adipocytes are the most abundant in this layer, reflecting its role in fat storage.

This overview covers the main cell types in the skin layers. Each plays a role in protecting the body, maintaining structure, and
allowing the skin to perform various functions such as defense, regeneration, and insulation.\

Accessory Structures:

● Glands (sebaceous, sweat)

● Hair and nail roots
● Nerve endings (Meissner’s, Pacinian corpuscles)

Accessory Structures of the Skin:

● Venules: Small veins; carry blood from capillaries, found in the hypodermis.
● Arterioles: Small arteries; carry blood to capillaries, also in hypodermis.
● Lymphatic vessels: Carry lymph, return fluid to bloodstream, found in dermis.

Hair Structures:

● Hair follicles: Found beneath the skin, contain trichocytes (stem cells for hair).
● Hair shaft: Visible part of the hair, made of keratin.
● Arrector pili muscles: Cause hair to stand, smooth muscles.

Glands:

● Sebaceous glands: Produce sebum (oily substance), protect skin/hair.

● Sweat glands:
○ Eccrine: Secrete salt solution, regulate body temperature, found in dermis. whole body, thermoregulation,
secrete dilute sodium chloride, maintain skin pH, located in dermis, not linked to hair follicles.palm and soles
○ Apocrine: Found in armpits, axillae, areolae, perineum, ear canals and eyelids , become active at puberty,
produce pheromones Responsible for: providing nutrients to skin, natural scents

Nerves and Nerve Endings:

● Merkel cells: Sense light touch, found in hairless (glabrous) skin.
● Meissner’s corpuscles: Sense light touch, found in dermal papillae.
● Ruffini’s corpuscles: Detects skin stretch and temperature, found in dermis.
● End bulbs of Krause: Detect cold, found all over the body.
● Pacinian corpuscles: Detect vibration, found deep in the dermis and hypodermis.

Clinical Condition: Melanoma: Skin cancer from melanocytes overgrowth, forms pigmented moles.

Thick vs Thin Skin

● Thick skin:
○ Hairless
○ Location: Soles, fingertips, palms
○ Layers: 5 (includes stratum lucidum)
○ Thick stratum corneum
○ Thick stratum spinosum
○ Thinner dermis
○ More nerve endings
○ Many eccrine glands (sweat glands)
○ No apocrine glands, hairs, sebaceous glands
○ Function: Abrasion resistance, high sensation
● Thin skin:
○ Hairy
○ Location: Rest of the body
○ Layers: 4 (no stratum lucidum)
○ Thin stratum corneum
○ Thin stratum spinosum
○ Thicker dermis
○ Smaller or no dermal papillae/epidermal ridges
○ Contains hairs, apocrine & sebaceous glands
○ Fewer eccrine glands, fewer nerve endings
○ Function: Temperature regulation, less sensation

Friction Ridges

● Definition: Unique patterns on fingertips.

● Function: Enhance grip and touch sensitivity.

Injections

1. Intradermal Injection:
○ Location: Just below the skin (dermis).
○ Uses: Allergy tests, TB tests.
2. Subcutaneous Injection:
○ Location: In the fatty tissue under the skin.
○ Uses: Insulin, vaccines.
3. Intramuscular Injection:
○ Location: In the muscle.
○ Uses: Antibiotics, pain relief.

Skin Conditions

1. Albinism:
○ Definition: Lack of melanin (pigment).
○ Appearance: Pale skin, light hair, light eyes.
2. Cyanosis:
○ Definition: Bluish discoloration of skin.
○ Cause: Lack of oxygen in blood.
3. Jaundice:
○ Definition: Yellow discoloration of skin and eyes.
○ Cause: Excess bilirubin due to liver issues.
4. Carotene:
○ Definition: Yellow pigment found in skin.
○ Source: Carrots, sweet potatoes.

Nails

● Nail Body: Visible part of the nail.

● Nail Root: Part under the skin, grows nails.
● Cuticle: Skin at the base of the nail.
● Nail Matrix: Area where nail growth starts.
● Nail Bed: Skin beneath the nail.
● Lunula: White crescent shape at the base of the nail.

Burns

1. Partial Thickness Burns:

○ First Degree Burn: Affects only the outer layer (epidermis). Symptoms: Redness, pain, no blisters.
○ Second Degree Burn: Affects epidermis and part of the dermis. Symptoms: Red, swollen, blisters.
2. Full Thickness Burns:
○ Third Degree Burn: Destroys all layers of skin. Symptoms: White or charred skin, no pain in burned areas.
○ Fourth Degree Burn: Extends into muscle and bone. Symptoms: Severe damage, often requires surgery.

Key Components and Functions

1. Components: The integumentary system consists of the epidermis, dermis, hypodermis, hair, nails, and glands.
2. Epidermis: The outermost layer, made of stratified squamous epithelium. It provides a barrier against the environment.
3. Dermis: The thicker layer beneath the epidermis, containing blood vessels, nerves, hair follicles, and sweat glands.
4. Hypodermis: The deepest layer, made of adipose tissue (fat) and providing insulation and cushioning.
5. Keratinization: The process by which cells in the epidermis produce keratin, a protein that hardens and toughens the
skin.
6. Structural strength: The dermis provides structural strength due to its connective tissue, collagen, and elastin.
7. Blood supply: The dermis contains blood vessels that supply oxygen and nutrients to the skin and remove waste
products.
8. Melanocytes: Cells that produce melanin, a pigment that determines skin color and protects against UV radiation.
9. Melanin production: Melanin production is influenced by genetic factors, sunlight exposure, and hormones.
10. Factors affecting skin color: Melanin production, blood flow, carotene (a pigment from plants), and collagen.
11. Hair follicles: Structures in the dermis that produce hair.
12. Hair growth: Hair growth occurs in cycles of growth, rest, and shedding.
13. Arrector pili muscles: Muscles attached to hair follicles that cause hair to stand on end when cold or frightened.
14. Sebaceous glands: Glands that produce sebum (oil) to moisturize the skin.
15. Sweat glands: Glands that produce sweat to cool the body and regulate temperature.
16. Sensory receptors: The skin contains receptors for touch, pain, temperature, and pressure.
17. Vitamin D synthesis: The skin converts cholesterol into vitamin D when exposed to sunlight.
18. Body temperature regulation: The integumentary system helps regulate body temperature through sweating, blood
flow, and hair erection.
19. Excretion: The skin excretes waste products through sweat and sebum.
20. Protection: The skin acts as a barrier against injury, infection, and UV radiation.
21. Diagnostic aid: The skin can be a valuable diagnostic aid for various medical conditions.
22. Burns: Burns are classified as first-, second-, or third-degree based on severity.
Situational Notes: Integumentary System (Function & Issues)
● Sweat glands:
○ Function: Prevent overheating, scent secretion.
○ Issue: Dysfunction leads to overheating, skin irritation, or unpleasant body odor.
● Tactile corpuscle:
○ Function: Detect texture changes.
○ Issue: Loss of sensitivity to textures and fine touch.
● Bulbous corpuscle:
○ Function: Detect deep skin tension.
○ Issue: Reduced ability to sense pressure or skin tension.
● Hassall’s corpuscles:
○ Function: Found in thymus, involved in immune function.
○ Issue: Impaired immune responses.
● Lamellar corpuscle:
○ Function: Sense vibration, not constant pressure.
○ Issue: Difficulty sensing quick vibrations or changes in pressure.
● Ruffini corpuscle:
○ Function: Detect skin stretch, movement, finger position.
○ Issue: Reduced coordination, loss of finger movement precision.
● Keratinocytes:
○ Function: Form protective barrier, waterproofing, keratin synthesis.
○ Issue: Skin dehydration, vulnerability to injury, infections.
● Melanocytes:
○ Function: Produce melanin, protect against UV.
○ Issue: UV damage, hyperpigmentation or hypopigmentation.
● Langerhans cells:
○ Function: Immune defense in the skin.
○ Issue: Weakened skin immunity, infection susceptibility.
● Merkel cells:
○ Function: Sensory detection (light touch).
○ Issue: Impaired sense of touch.
● Fibroblasts:
○ Function: Produce connective tissue (strength and elasticity).
○ Issue: Reduced skin elasticity, sagging, poor wound healing.
● Adipocytes (hypodermis):
○ Function: Fat storage, insulation, cushioning.
○ Issue: Loss of insulation, increased risk of injury, difficulty with temperature regulation.