responsible for most of the skin’s structural
Integumentary strength.
System
Functions of the System
❖ Protection- the skin serves as the
primary defense against offending
microorganisms. It provides a barrier
against ultraviolet light and helps
maintain fluid inside the body, thus
preventing dehydration.
❖ Sensation- receptors in the skin
makes it possible for human organism
to perceive pain, pressure as well as Epidermal Cell Types
other sensation like temperature ❖ Keratinocytes- produce protein
changes. keratin and lamellar granules.
❖ Vitamin D Production- the body ❖ Langerhans- participate in immune
needs Vitamin D to help synthesize response against microbes that invade
calcium absorption, made possible by the skin and are easily damaged by UV
the skin’s sufficient exposure to early light.
sunlight.
❖ Melanocytes- produce melanin
❖ Temperature Regulation- the pigment; very susceptible to UV
amount of blood flow beneath the damage.
skin’s surface and the activity of sweat
glands in the skin both help regulate Melanin gives color to the skin,
body temperature. eyes, and hair.
❖ Excretion- small amounts of waste ❖ Merkel cells- contact the flattened
products are lost through the skin and process of a sensory neuron called
in gland secretions. tactile/Merkel disc; detect touch
sensations.
The Skin
A multilayered organ that consists
of two main parts: Epidermis and
Dermis
Epidermis- made from keratinized
stratified squamous epithelium, is the
superficial, thinner portion of the skin that
prevents water loss and resists abrasion.
Dermis- the deeper, thicker and dense
connective tissue portion. The dermis is
hair follicles, smooth muscles, glands, and
Epidermal Layers lymphatic vessels extend into the dermis.
❖ Stratum basale/germinatum- the
deepest layer that consists of either Cleavage lines- collagen fibers runs
columnar or cuboidal cells aligned in through different directions making the skin
single row. Some cells in this layer are to have tension lines.
stem cells undergoing cell division to
continually produce keratinocytes.
Stretch marks- if the skin is
overstretched, it produces a damage in the
❖ Stratum spinosum- 8 to 10 layers of
dermis and become stretch marks.
many-sided keratinocytes that are
close together.
Dermal papillae- uppermost portion
of the dermis; has a lot of blood vessels
❖ Stratum granulosum- cells in this
that keeps an avenue for providing
layer is the presence of the protein
nutrients, thermoregulation and
keratin and membrane-enclosed
elimination of wastes.
lamellar granules.
Reticular region- deeper part of the
❖ Stratum lucidum- this layer is found
dermis; contains bundles of collagen and
only in the areas of the body (thick skin)
some coarse elastic fibers interspersed with
where exposure to friction is greatest.
adipose cells, hair follicles, nerves, oil
glands, and sweat glands.
❖ Stratum corneum- 5 to 30 layers of
flattened dead cells from the deeper
Skin and Body Membranes: Dermis,
strata. The interior of the cells contains
Reticular Layer
mostly keratin that aids in its natural
strength. Its multiple layers of dead
squamous cells filled with keratin help Langer’s Cleavage Lines- separation
to protect deeper layers from injury of bundles of collagen fibers form lines of
and microbial invasion. cleavage in the skin.
Why do surgeons make incision
along these lines?
-For faster healing
-For less scarring
Dermis
It is composed of densed collagenous
connective tissue containing fibroblasts,
adiphocytes, and macrophages. Nerves,
BLEPHAROPLASTY
Collagen is naturally produced by the
body, as we age our supply of collagen
deflates.
Chicken feet is rich in collagen.
Injections
Intradermal injection – skin test
Subcutaneous injection – insulin
injection
Intramuscular injection - vaccines
STRETCH MARKS
Low level of collagen results to
stretch marks
Rapid change from being skinny to
fat stretches the skin, because of low
collagen, it will produce stretch marks.
INTRADERMAL INJECTION
INTRAMUSCULAR INJECTION
❖ Paleness and redness- paleness and
redness like blushing can be credited
to the amount of blood flowing
through the skin.
❖ Cyanosis- were due to a drop of
oxygen saturation in the blood,
producing a bluish discoloration of the
skin.
Skin Color
❖ Melanin- melanin plays responsible
for its pale yellow to reddish brown to
black shade; made in melanocytes.
❖ Carotene- produces a yellowish hue
brought about by increase intake of
carotene-rich foods such as squash
and carrots.
❖ Albinism- an inherited trait that
❖ Hemoglobin- white people have causes individuals to not produce
melanin.
epidermis that appears translucent,
and skin color ranges from pink to red,
depending on the oxygen content of
the blood.
-Eyes don’t look in the same direction
ALBINISM -Reduced vision
-Congenital disorder caused by lack -Issues with optic nerves
of skin pigments -Sensitivity to bright light
-Caused by mutation in the TRP-1 -Underdevelopment of part
gene leading to deficiency of an enzyme
(Tyrosinase) required in melanin
production.
NYSTAGMUS
-Associated with a number of vision
defects, such as photophobia,
nystagmus, amblyopia.
-No treatment, managed through
lifestyle adjustments
Symptoms of Albinism
-Freckles
-Moles with no color
-Sunburn and inability to tan
AMBLYOPIA
Two Types of Albinism
❖ Oculocutaneous Albinism- most
common type of Albinism
CHLOASMA OF PREGNANCY
❖ Ocular Albinism- rare type of
Albinism
BIRTHMARKS
-Uncontrolled back and forth eye
movement (Nystagmus)
-Not enough pigment in the eye
❖ Vitiligo- the skin has portions that has
❖ Freckles- occurs due to melanin complete or partial absence of
accumulation in patches melanocytes, irregular white spots are
evident.
Causes of Freckles can be: -long-term condition
-due to too much sun exposure -result of lack of melanin leading to
-overproduction of melanin the development of white patches
-deficiency in vitamin D12 resulting -area with white patches has no
to hyperpigmentation melanin
❖ Nevus- mole or nevus presents as a
round pigmentation brought about by
overgrowth of melanocytes
The cortex is covered by the cuticle, a single
Subcutaneous tissue layer of overlapping cells that holds the hair
Deepest layer of the skin, it is in the hair follicle
made up of mostly fat and connective
tissue The hair follicle surrounds the root and is
composed of epidermal cells
➢ deep to the dermis, but not part of the
skin Hair root plexuses are nerve endings that
➢ consists of areolar connective tissue surround each hair follicle
and adipose tissues
➢ serves as a storage depot for fat and Arrector pili is the muscle that contracts
contains large blood vessels that under stress, which pulls the hair shafts
supply the skin perpendicular to the skin surface
➢ measured to calculate for an
individual’s risks for lifestyle diseases Types of Hair
such as diabetes
Terminal hair is the type of natural
Accessory Skin Structures hair to which most people refer in their
❖ Hair everyday lives. It is the type of hair that
grows on your head, in your pubic regions
❖ Glands
and on almost all parts of your body.
❖ Nails
Vellus hair, frequently referred to as
“peach fuzz,” is the short, fine, colorless
Hair hair found all over the body. During puberty,
➢ hair protects the skin and other vellus hair can turn into intermediate or
structures of the body terminal hair.
➢ produced in the hair bulb, which rests
on the hair papilla Lanugo is the special downy hair that
➢ during the growth stage, it is formed completely covers the human baby inside
by epithelial cells within the hair bulb the womb.
➢ these cells divide and undergo
keratinization
➢ the hair root and shaft consist of
columns of dead keratinized epithelial
cells
➢ during the resting stage, growth stops
and the hair is held in the hair follicle
➢ when the next growth stage begins, a
new hair is formed and the old hair
falls out
Shaft is the superficial portion that projects
above the surface of the skin
Root is the portion below the surface that
penetrates into the dermis and sometimes
into the subcutaneous layer
Has a hard cortex, which surrounds a softer
center, the medulla
ALOPECIA AREATA
An autoimmune disorder;
happens when the immune system
attacks the hair follicles, which causes
hair loss.
Symptoms: Brittle finger and toe
nails
Medication: Corticosteroids and
Anti-inflammatory drugs; Intralesional
corticosteriod injections by
dermatologists
ANDROGENETIC ALOPECIA
Most common form of hair loss; HIRSUTISM
M-SHAPED pattern of baldness. Happens is when a woman has
thick and dark hair on the face, neck,
Primary cause is DHT or the and legs; imbalance in hormone
dihydrotestosterone hormone, which (androgen levels are high)
attacks the hair follicles, causing hair
loss that doesn’t grow back. Hirsutism is linked to PCOS
(Polycystic Ovary Syndrome)
Medication: Topical Minoxidil
(for scalp) and Oral Finasteride Symptoms of PCOS: Irregular
period, development of acne, excess
hair in the body
PCOS is caused by imbalance of
sex hormones called androgen; high
levels of androgen
PEDICULOSIS ❖ Apocrine Glands- limited to the
axillary and pubic regions and
-Lice Infestation
produces a thicker sweat often
released during emotional stress. They
respond to stress and sexual
stimulation.
-Common on the axillary area,
groin area, around the nipples of
the mammary.
-“scent glands”
PEDICULOSIS TREATMENT
SECRETION OF GLANDS
Glands
❖ Sebaceous glands- lies in the dermis
and open into hair follicles or directly
onto the skin. It secretes sebum as an
oily substance that contains lipids and
cellular debris. They help to soften the
skin, prevents water loss and lubricates
skin and hair.
❖ Sudoriferous Glands- also called
sweat glands; appears to be the most
numerous of the skin glands; has two
types: eccrine and apocrine
Nails
❖ Eccrine Glands- produces a
transparent, watery fluid called sweat Nails are plates of tightly packed, hard,
that contains small amount of dead, keratinized cells of the epidermis
potassium, ammonia, lactic acid, uric
acid and other wastes. Nails help us grasp and manipulate small
objects, provide protection to the ends of
➢ Occur over most parts in the body the fingers and toes, and allow us to scratch
and opens directly on the surface various parts of the body
of the skin
➢ Present throughout the body, Nail body is the externally visible portion of
most common on the soles of the the nails
feet Nail root is covered and extends to the nail
matrix
BEAU LINES
Cuticle, or eponychium, is stratum
Horizontal ridges or dents on
corneum that extends onto the nail body
finger and toe nails; may be a sign of
The lunula can be seen through the nail illness
body as a whitish, crescent- shaped area at
the base of the nail Associated conditions of beau
lines: Uncontrolled diabetes, uncontrolled
➢ Unlike hair, nails grow continuously increase of blood sugar level, measles,
and do not have a resting stage mumps, pneumonia (in some cases), scarlet
➢ Average growth of fingernails is about fever
1 mm (0.04 inch) per week
➢ The nail body is pink because the blood Doctors have to search for these
vessels of the underlying skin partially underlying causes in order to treat beau
show through lines
➢ The free edge is white because it
extends past the tip of the finger or toe
➢ The lunula is white because the nail is
too thick in this region
Most common ingredients of nail polish:
formaldehyde and toluene
MEE’S LINES
Discoloration in the nail plate
MUEHRCKE’S LINES
Hypopigmentation below the
nails and without ridges
Nephrotic Syndrome- A kidney disorder
that causes the body to pass too much
protein in the urine; visible sign causing
Muehrcke’s lines
CLUBBING OF FINGERS
Low blood oxygen level; heart
and lung problems
THE PHYSIOLOGY OF THE ❖ Protection- the skin protects the body
against invasion of pathogenic
INTEGUMENTARY microorganisms as well as extensive
water loss
SYSTEM
❖ Sensation- the skin has specialized ➢ The skin, with its squamous
nerve receptors sense pressure, pain, epithelium decreases chances of
changes in temperature, and things we having abrasions brought about
touch by friction and trauma
➢ Protection from harmful effects of
➢ These receptors include ultraviolet light were afforded by
mechanoreceptors, Meissner the presence of melanin in the
corpuscles, Pacinian corpuscles, skin
thermoreceptors, and pain ➢ Hair on the head acts as a heat
receptors called nociceptors insulator
➢ Sensory receptors around the hair ➢ Eyebrows keep sweat out of the
follicle can detect the movement eyes
of a hair ➢ Eyelashes protect the eyes from
foreign objects
❖ Temperature- because the skin’s ➢ Hair in the nose and ears prevents
surface area is so large, our body is the entry of dust and other
able to radiate to the outside air vast materials
amounts of heat that your body has ➢ Nails protect the ends of the
produced. fingers and toes from damage and
can be used in defense
➢ Eccrine glands produce sweat to
help eliminate heat via ❖ Vitamin D Production- a thirty-
evaporation minute exposure to sunlight in a two-
➢ The skin acts as a large reservoir day frequency in a week can provide
of blood the body with adequate Vitamin D
➢ When cold, arrector pili contract ➢ Vitamin D plays an important role
to raise the angle of body hairs in calcium homeostasis in the
and cause goose bumps body
➢ Skin forms a protective barrier for
the internal organs
➢ Vitamin D is converted to an FUNGAL INFECTION
active form by reactions in the
liver and kidney
➢ Active vitamin D stimulates the
small intestine to absorb calcium
and phosphate
❖ Absorption and Excretion- small
amounts of salt, ammonia and urea are VARICELLA (CHICKENPOX)
being excreted through the sweat
glands
➢ the integumentary system
contributes to absorption of
substances such as medication
like in the case of transdermal
patches and intradermal implants.
JAUNDICE SHINGLES
-yellow discoloration of the skin;
caused by liver problems (livercirosis),
hepatitis B
SHINGLES – DUE TO HERPES
ZOSTER/VARICELLA ZOSTER VIRUS
RINGWORM –NOT DUE TO WORMS
-common skin infection caused by
fungus; can be passed from skin-to-skin
contact
NEUROFIBROMATOSIS
-tumors are benign
HERPES SIMPLEX VIRUS
DECUBITUS ULCER BURNS
-Pressure sores/ulcer sores, bed
sores
RULE OF NINES FOR BURNS
ASSESSMENT
Prevention of decubitus ulcers
(bedsores)
➢ Check the patient’s body everyday
from head to toe
Early signs of pressure ulcers:
-Skin redness
-Warm areas
-Spongy or hard skin
-Breakdown of the top layers of skin
SKIN CANCER
➢ Patient’s position must be changed
every 1 to 2 hours to keep the pressure
off any one spot Three main types
➢ Sheets and clothing should be dry and
smooth, with no wrinkles ❖ Basal Cell Carcinoma– most
➢ DO NOT raise the head of the bed to common, begins with cells in stratum
more than a 30-degree angle. Sliding basale and extends into the dermis to
down may further harm the skin. produce an open ulcer
Squamous Cell Carcinoma– develops
from cells immediately superficial to the
stratum basale; nodular, keratinized tumor
Malignant Melanoma – rare form of skin
cancer that arises from melanocytes
