INTEGUMENTARY SYSTEM (SKIN)
considered an organ or an organ system
body’s largest organ
‡organ of greatest surface area:15-20 sq ft. (1.5-2 m2)
General Functions:
1. protection
mechanical
chemical
bacterial
UV
desiccation
2. temperature homeostasis
>temp ‡ sweat glands, flushing
<temp ‡ arrector pili, pale
3. excretion
affects fluid & electrolyte balance
sweat glands release: water, salts, ammonia
oil glands release: lipids, acids
4. sensation
touch (light touch, wind, etc)
pressure
heat
cold
pain
5. synthesis
vitamin D precursor passes through capillaries in skin and light converts
it to vitamin D
6. nonverbal communication
eg. humans and other primates have much more expressive faces than
other animals
Layers of Skin:
1. Epidermis
stratified squamous epithelium
upper layers dead, filled with keratin (waxy protein)
lower layers living cells
replaced every 35-45 days
Subdivided into 5 identifiable layers:
A. stratum basale
lowermost layer of epidermis
single cell layer thick
only cells that get adequate nutrition and oxygen by diffusion from
tissues below
actively dividing cells
bordered below by basement membrane
B. stratum spinosum
several layers thick
less mitosis
flattened, irregular, spinelike projections
[basale + spinosum = stratum germinativum ‡ growing layers]
C. stratum granulosum
very thin; 2-3 cell layers thick
as cells move up from s. basale they die & get flatter and thinner
keratinization begins here
D. stratum lucidum
thin translucent band
only found in thick areas of epidermis: soles of feet and palms of
hand
E. stratum corneum
thickest of all layers; 3/4th ‘s the thickness of epidermis
20-30 cell layers thick
dead cells completely filled with keratin
water resistant
main protection against biological and chemical assault
takes keratinocytes 30-40 days from their formation in s basale
until they flake off of the s corneum
Cells of epidermis:
1. stem cells ‡ undifferentiated cells found only in deepest layer
2. keratinocytes ‡ most cells in epidermis synthesize keratin
3. melanocytes ‡ also in deepest layer synthesize pigment
melanin
4. Merkel cells ‡ touch receptors, attached to nerve cell
5. dentritic cells(Langerhans cells) ‡ found in s spinosum and s
granulosum are macrophages that stand guard against toxins, microbes
and other pathogens that penetrate the skin‡ if detected they alert
immune system
2. Dermis (=hide)
strong, flexible, connective tissue
gives skin its strength and resilience
gel-like matrix
contains collagen, elastic and reticular fibers
rich in nerves, receptors, blood vessels, lymph vessels
hair follicles and sweat glands extend into it
Two layers:
a. papillary layer
mainly areolar connective tissue
lots of blood vessels
dermal papillae
capillary loops
sensory cells
produce finger prints
b. reticular layer
mainly dense (irregular connective tissue)
lots of collagen fibers
lines of cleavage between collagen bundles
‡ tension lines
longitudinal in limbs
circular around trunk
incisions parallel to lines heal quicker
dermal tearing = stretch marks (silvery)
3.Subcutaneous Layer
= hypodermis or superficial fascia
below skin
mainly adipose tissue (ie subcutaneous fat)
insulation
infants and elderly have less of this than adults and are therefore more
sensitive to cold
Skin Color - due to combination of three different pigments:
Melanin
yellow, orange, brown or black pigments
racial shades due mainly to kinds and amount of melanin pigments
mainly in stratum basale
also, amount varies with exposure to sun=suntan
Carotene pigment from eating carrot & squash, gives the skin slightly
orange tint
esp in stratum corneum and subcutaneous layers
Hemoglobin
in blood of skin capillaries
Skin Color & Texture in Diagnosis
cyanosis = bluish cast ‡poor oxygenation
erythema = redness ‡ emotional, hypertension, inflammation
pallor = paleness ‡ emotion, anemia, low blood pressure
jaundice = yellowing ‡ liver disorder, >bile pigments in blood
bronzing = Addison’s disease, adrenal cortex
bruising (hematoma)= escaped blood has clotted, hematomas ‡ deficiency
in Vit C or hemophilia
leathery skin = overexposure, clumping of elastin fibers, depressed immune
system, can alter DNA to cause skin cancer
Photosensitivity = to antibiotics & antihistamines
Skin Markings -skin is marked by many lines, creases and ridges
friction ridges: ‡ markings on fingertips characteristic of primates, allow us
to manipulate objects more easily
flexion lines: on flexor surfaces of digits, palms, wirsts, elbows etc, skin is
tightly bound to deep fascia at these points
freckles: flat melanized patches, vary with heredity or exposure to sun
moles: elevated patch of melanized skin, of the with hair, mostly harmless,
beauty marks
Derivitives of skin - during embryonic development 1000’s of small groups of
epidermal cells from stratum basale push down into dermis to form hair follicles
and glands
1. Hair
covers entire body except palms, soles, lips, nipples, parts of external
genitals
hormones account for the development of “hairy” regions: eg. head,
axillary and pubic areas
humans are born with as many follicles as they will ever have
hairs are among the fastest growing tissues in the body
formation similar to epidermis
heavily keratinized
consists of:
shaft: visible part
root:
follicle: sheath surrounding root
papillae: vascularized, growing part of hair
Arrector Pili muscles attached to follicle causes hair to stand on end
(cold, fright)
oil glands: ≥2/follicle
hair receptor: entwines each follicle, responds to hair movements
hair color depends on kinds (yellow, rust, brown, and black) and the
amount of melanin cortex of shaft contains
hair texture related to differences in cross-sectional shape (eg. straight
hair is round, wavy hair is oval, tightly curly hair is relatively flat)
2. Nails
scale-like modification of the epidermis
fingernails and toenails are clear,hard derivatives of stratum corneum
very thin, dead, scaly cells, densely packed together
corresponds to hoof or claw of animals
most mammals have claws, flat nails are a primate characteristic
‡ more fleshy and sensitive fingertips
‡ still can be used for digging and picking apart food, etc
features:
nail matrix: growth zone beneath proximal skin, nail bed composed
of stratum basale
nail plate: visible portion of nail
fingernails grow ~1 mm/wk; toenails more slowly
[adding gelatin to diet has no effect on growth or hardness of nails]
appearance of nails has diagnostic value:
eg. spoonlike, flat, concave ‡ may indicate iron deficiency
eg. clubbed or swollen fingertips ‡ long term hypoxemia from
eg congenital heart defects and emphysema
3. Skin Glands
Oil glands (Sebaceous Glands, holocrine)
2 or more per follicle
keeps hair soft and pliable
esp on face and scalp
not on palms, soles or dorsal side of feet
reduces heat loss lipids are poor heat conductors
helps prevent water evaporation
become active at puberty ‡ acne
secrete sebum = breakdown products of dead cells
Sweat Glands (sudoriferous)(eccrine glands)
3 Million total on skin
3000 sweat glands/inch2
most numerous on palms, soles, forehead, armpits
essentially a tiny coiled tube that opens to skin surface
helps maintain temperature and fluid/electrolyte balance
‡ heat ‡ sweat ‡ evaporative cooling
Scent Glands (apocrine glands)
modified sweat glands ‡ scent, pheromones
much less common
confined to axillary and genital area
their ducts empty into hair follicles
secretions contain fatty acids and proteins in addition to “sweat”
respond especially to stress and sexual stimulation
Mammary Glands
modified sweat glands
produce milk
Ceruminous Glands
modified sweat glands
in external ear canal
secrete waxy pigmented cerumin
protection ‡ traps dust and particles
Skin Imbalances & Aging
the skin can develop >1000 different ailments
the most common skin disorders result from allergies or infections
less common are burns and skin cancers
A. Allergies
1. Contact Dermatitis
allergic response (eg. poison ivy, metals, etc)
B. Infections
1. viral
eg. cold sores
herpes simplex
especially around lips and oral mucosa
2. Fungal (eg. athletes foot)
3. Bacterial
eg. boils and carbuncles
inflammation of hair follicle and sebaceous glands
esp on dorsal side of neck
eg. impetigo
Streptococcus infection
C. Genetic Diseases
1. Psoriasis
chronic, noninfectious skin disease
skin becomes dry and scaly,
often with pustules
many varieties
cycle of skin cell production increases by 3-4x’s normal
stratum corneum gets thick as dead cells accumulate
seems to be a genetic component
often triggered by trauma, infection , hormonal changes or stress
2. Hypertrichosis (human werewolves)
patients show dense hair growth on faces and upper bodies
due to malfunction of gene on x chromosome
‡ a gene silenced during evolution has been
reactivated
D. Burns
too much sunlight or heat
categorized by degree of penetration of skin layer
extend of burn damage estimated by “rule of 9’s”
head, arms ~9% of skin surface
front and back of torso, each leg ~18% of skin surface
groin ~1% of skin surface
I. 1 st degree burns
skin is inflamed, red
surface layer of skin is shed
II. 2 nd degree burns
deeper injury
blisters form as fluid builds up beneath outer layers of epidermis
III. 3 rd degree burns
full thickness of skin is destroyed
sometimes even subcutaneous tissues
results in ulcerating wounds
typically results in catastrophic loss of fluids: dehydration, electrolyte
imbalances
also highly susceptible to infections
slow recovery (from cells of hair follicles if they survive; otherwise must
heal from margins of wound)
may require: autografts, cadaver skin, pig skin
prognosis may depend on extent of damage
E. Skin Cancer
caused by excessive or chronic exposure to UV, xrays or radiation
most forms progress slowly and are easily treated
a few are deadly
1. Basal Cell Carcinoma
least malignant
most common
stratum basale cant form keratin
lose boundary layer between epidermis and dermis
results in tissue erosion and ulceration
99% of these cancers are fully cured
2. Squamous Cell Carcinoma
cancer of the cells in stratum spinosum
usually induced by sun
cells grow rapidly and grow into the lymphatic tissues
3. Malignant Melanoma
cancer of pigment cells = melanocytes
rare ~1% of skin cancers
deadly, poor chance of cure once it develops
often begins with moles
F. Aging Skin - effects often become noticeable by late 40’s
Hair - thinner and grayer as melanocytes die and mitosis slows
Oil glands
sebaceous glands atrophy
skin and hair become drier
Skin Layers
mitosis declines, collagen is lost from dermis skin becomes thinner and
translucent
looser and sagging as elastic fibers are lost and dermal papillae smooth
out
fewer blood vessels and those remaining are more fragile more
bruising, slower healing and rosacea‡ tiny dilated, blod vessels esp in
nose and cheeks
age spots – accumulation of pigment cells
loss of immune cells and fibroblasts makes skin more susceptible to
recurring infections
thermoregulation is less efficient due to loss of blood vessels and glands
‡ more vulnerable to hypothermia and heatstroke
photoaging = an acceleration of skin aging due to overexposure to sun (UV)
accounts for 90% of the changes that people find medically
troubling or cosmetically disagreeable
G. Autoimmune Disease
eg. alopecia areata
causes hair to fall out in small round patches
~2% of population (4.7M in US) have some form of it
hair loss is usually short term and limited to a few patches
in rare cases causes permanent loss of all body hair
Clinical Terms:
Necrosis – cellular or tissue death, gangrene
Biopsy – tissue analysis
