6.

0 Discuss the Integumentary (Skin, hair, nails, exocrines) system

6.1 Anatomy and physiology of the Integumentary system

6.1.1 Draw, label and describe the structures of the skin

6.2 6.1 Functions of the skin Functions of the skin under the following
headings:
• Protection
• Sensation
• Heat regulation
• Control of evaporation
• Aesthetics and communication
• Storage and synthesis
• Excretion
• Absorption
• Water resistance

6.3 Pigmentation of the skin Pigmentation of the skin

6.4 Skin care and hygiene Skin care and hygiene

6.5 Disease conditions of the skin Disease conditions of the skin

SECTION A
FUNCTIONS OF THE INTEGUMENTARY SYSTEM
FUNCTIONS OF SKIN
„ PROTECTIVE FUNCTION
„ SENSORY FUNCTION
„ STORAGE FUNCTION
„ SYNTHETIC FUNCTION
„ REGULATION OF BODY TEMPERATURE
„ REGULATION OF WATER AND ELECTROLYTE BALANCE
„ EXCRETORY FUNCTION
„ ABSORPTIVE FUNCTION
„ SECRETORY FUNCTION

Protection. The skin protects deeper tissues from mechanical damage (bumps),
chemical damage (acids and bases), ultraviolet radiation (damaging effects of
sunlight), bacterial damage, thermal damage (heat or cold), and desiccation (drying
out).

Temperature regulation. The skin aids in body heat loss or heat retention as
controlled by the nervous system.

Elimination. The skin aids in the secretion of urea and uric acid through
perspiration produced by the sweat glands.

Synthesizer. Synthesizes vitamin D through modified cholesterol molecules in the

skin by sunlight.

Sensation. The integumentary system has sensory receptors that can distinguish
heat, cold, touch, pressure, and pain.

ANATOMY OF THE INTEGUMENTARY SYSTEM

The skin and its derivatives (sweat and oil glands, hair and nails) serve a number of
functions, mostly protective; together, these organs are called the integumentary
system.

Structure of the Skin

The skin is composed of two kinds of tissue: the outer epidermis and the
underlying dermis.
Epidermis

The outer epidermis is composed of stratified squamous epithelium that is capable

of keratinizing or becoming hard and tough.

Composition. The epidermis is composed of up to five layers or strata; from the

inside out these are the: stratum basale, spinosum, granulosum, lucidum, and
corneum.

Epithelial tissue. Like all other epithelial tissues, the epidermis is avascular; that is,
it has no blood supply of its own.

Keratinocytes. Most cells of the epidermis are keratinocytes (keratin cells), which
produce keratin, the fibrous protein that makes the epidermis a tough protective
layer.

Stratum basale. The deepest layer of the epidermis, the stratum basale, lies closest
to the dermis and is connected to it along a wavy borderline that resembles
corrugated cardboard; this basal layer contains epidermal cells that receive the
most adequate nourishment via diffusion of nutrients from the dermis.

Stratum spinosum. As the epidermal layers move away from the dermis and
become part of the more superficial layers, the stratum spinosum.

Stratum granulosum. Upon reaching the stratum granulosum, the layers become
flatter and increasingly full of keratin.

Stratum lucidum. Finally, they die, forming the clear stratum lucidum; this latter
epidermal layer is not present in all skin regions, it occurs only where the skin is
hairless and extra thick, that is, on the palms of the hands and soles of the feet.

Stratum corneum. The outermost layer, the stratum corneum, is 20 to 30 cells

layers thick but it accounts for about three-quarters of epidermal thickness; it rubs
and flakes off slowly and steadily as the dandruff familiar to everyone; then, this
layer is replaced by cells produced by the division of the deeper stratum basale
cells.
Keratin. Keratin is an exceptionally tough protein; its abundance in the stratum
corneum allows that layer to provide a durable “overcoat” for the body, which
protects deeper cells from the hostile external environment.

Melanin. Melanin, a pigment that ranges in color from yellow to brown to black, is
produced by special spider-shaped cells called melanocytes, found chiefly in the
stratum basale.

Melanosomes. As the melanocytes produce melanin, it accumulates within them in

membrane-bound granules called melanosomes; these granules then move to the
ends of the spidery arms of the melanocytes, where they are taken up by nearby
keratinocytes.

DERMIS
The underlying dermis is mostly made up of dense connective tissue.

Major regions. The dense (fibrous) connective tissue making up the dermis
consists of two major regions- the papillary and reticular regions.

Papillary layer. The papillary layer is the upper dermal region; it is uneven and
has peg-like projections from its superior surface called dermal papillae, which
indent the epidermis above and contain capillary loops which furnish nutrients to
the epidermis; it also has papillary patterns that form looped and whorled ridges on
the epidermal surface that increase friction and enhance the gripping ability of the
fingers and feet.

Reticular layer. The reticular layer is the deepest skin layer; it contains blood
vessels, sweat and oil glands, and deep pressure receptors called Pacinian
corpuscles.

Collagen. Collagen fibers are responsible for the toughness of the dermis; they
also attract and bind water and thus help to keep the skin hydrated.

Elastic fibers. Elastic fibers give the skin its elasticity when we are young, and as
we age, the number of collagen and elastic fibers decreases and the subcutaneous
tissue loses fat.
Blood vessels. The dermis is abundantly supplied with blood vessels that play a
role in maintaining body temperature homeostasis; when body temperature is high,
the capillaries of the dermis become engorged, or swollen, with heated blood, and
the skin becomes reddened and warm; if the environment is cool, blood bypasses
the dermis capillaries temporarily, allowing internal body temperature to stay high.

Nerve supply. The dermis also has a rich nerve supply; many of the nerve endings
have specialized receptor end-organs that send messages to the central nervous
system for interpretation when they are stimulated by environmental factors.

APPENDAGES OF THE SKIN

The skin appendages include cutaneous glands, hair and hair follicle, and nails.

Cutaneous Glands

As these glands are formed by the cells of the stratum basale, they push into deeper
skin regions and ultimately reside almost entirely in the dermis.

Exocrine glands. The cutaneous glands are all exocrine glands that release their
secretions to the skin surface via ducts and they fall into two groups: sebaceous
glands and sweat glands.

Sebaceous (oil) glands. The sebaceous, or oil, glands are found all over the skin,
except on the palms of the hands and the soles of the feet; their ducts usually
empty into a hair follicle; the product of the sebaceous glands, sebum, is a mixture
of oily substances and fragmented cells, and it is a lubricant that keeps the skin soft
and moist and prevents the hair from becoming brittle.

Sweat glands. Sweat glands, also called sudoriferous glands, are widely
distributed in the skin, and there are two types: eccrine and apocrine.

Eccrine glands. The eccrine glands are far more numerous and are found all over
the body; they produce sweat, a clear secretion that is primarily water plus some
salts, vitamin C, a trace of metabolic wastes, and lactic acid; the eccrine glands are
also a part of the body’s heat-regulating equipment.

Apocrine glands. Apocrine glands are largely confined to the axillary and genital
areas of the body; they are usually larger than eccrine glands and their ducts empty
into hair follicles; their secretion contains fatty acids and proteins, as well as all
substances present in eccrine secretion; they begin to function during puberty
under the influence of androgens, and they also play a minimal role in
thermoregulation.

Hair and Hair Follicles

There are millions of hair scattered all over the body, but other than serving a few
minor protective functions, our body hair has lost much of its usefulness.

Hairs. A hair, produced by a hair follicle, is a flexible epithelial structure.

Root. The part of the hair enclosed in the follicle is the root.

Shaft. The part projecting from the surface of the scalp or skin is called the shaft.

Formation. The hair is formed by the division of well-nourished stratum basale

epithelial cells in the matrix (growth zone) of the hair bulb at the inferior end of the
follicle.

Composition. Each hair is made up of a central core called the medulla surrounded
by a bulky cortex layer.

Cuticle. The cortex is enclosed by an outermost cuticle formed by a single layer of

cells that overlap one another like shingles on the roof; this arrangement helps to
keep the hairs apart and keeps them from matting; the cuticle is the most heavily
keratinized region; it provides strength and helps keep the inner hair layers tightly
compacted.

Hair pigment. Hair pigment is made by melanocytes in the hair bulb, and varying
amounts of different types of melanin combine to produce all varieties of hair color
from pale blond to pitch black.

Hair follicles. Hair follicles are actually compound structures.

Epidermal sheath. The inner epidermal sheath is composed of epithelial tissue

and forms the hair.
Dermal sheath. The outer dermal sheath is actually dermal connective tissue; this
dermal region supplies blood vessels to the epidermal portion and reinforces it.

Papilla. Its nipple-like papilla provides the blood supply to the matrix in the hair
bulb.

Arrector pili. Small bands of smooth muscle cells -arrector pili- connect each side
of the hair follicle to the dermal tissue; when these muscles contract, the hair is
pulled upright, dimpling the skin surface with “goosebumps”.

NAILS
A nail is a scale-like modification of the epidermis that corresponds to the hoof or
claw of other animals.

Parts. Each nail has a free edge, a body (visible attached portion), and a root
(embedded in the skin).

Nail folds. The borders of the nail are overlapped by skin folds, called nail folds.

Cuticle. The thick proximal nail fold is commonly called the cuticle.

Nail bed. The stratum basale of the epidermis extends beneath the nail as the nail
bed.

Nail matrix. Its thickened proximal area, the nail matrix, is responsible for nail
growth.

Color. Nails are transparent and nearly colorless, but they look pink because of the
rich blood supply in the underlying dermis.

Lunula. The exception to the pinkish color of the nails is the region over the
thickened nail matrix that appears as a white crescent and is called the lunula.”
PHYSIOLOGY OF THE INTEGUMENTARY SYSTEM
The normal processes that occur in the integumentary system are:

Development of Skin Color

Pigments and even emotions contribute to skin color:

Melanin. The amount and kind (yellow, reddish brown, or black) of melanin in the
epidermis.

Carotene. The amount of carotene deposited in the stratum corneum and

subcutaneous tissue; carotene is an orange-yellow pigment abundant in carrots and
other orange, deep yellow, or leafy green vegetables; the skin tends to take on a
yellow-orange cast when the person eats large amounts of carotene-rich foods.

Hemoglobin. The amount of oxygen-rich hemoglobin in the dermal blood vessels.

Emotions. Emotions also influence skin color, and many alterations in skin color
signal certain disease states.

Redness or erythema. Reddened skin may indicate embarrassment, fever,

hypertension, inflammation, or allergy.

Pallor or blanching. Under certain types of emotional stress, some people become
pale; pale skin may also signify anemia, low blood pressure, or impaired blood
flow into the area.

Jaundice or a yellow cast. An abnormal yellow skin tone usually signifies a liver
disorder in which excess bile pigments are absorbed into the blood, circulated
throughout the body, and deposited in body tissues.

Bruises or black-and-blue marks. Black-and-blue marks reveal sites where blood

has escaped from circulation and have clotted in tissue spaces; such clotted blood
masses are called hematomas.
SECTION C
Moles

Moles are growths that form when skin cells bunch together with surrounding
tissue. Most are called “common moles” and cause no harm.

Many people have moles, and a person may have as many as about 40 moles
throughout their body.

Check moles regularly for any changes in their appearance, such as an increase in
size or change in color. Anyone who notices changes should let their doctor know
so that they can screen for skin cancer.

Eczema

Eczema usually develops early in childhood, but it can arise in adulthood. There
are several types, including atopic dermatitis and contact dermatitis.

Eczema may cause rashes on or around the face, scalp, elbows, neck, wrists, ankles,
or legs. The rashes are very itchy and may become bumpy, change color, or
thicken. In adults, the rashes may cover more of the body, leading to widespread
dry, itchy areas.

The symptoms may be less noticeable in people with darker skin, compared with
those who have lighter skin. However, in People of Color, eczema can cause
discoloration, making the affected areas lighter or darker. This may last, even after
the eczema symptoms are no longer present.

There is no known cure for eczema. It may resolve on its own, but medications that
relieve the symptoms are available.

Vitiligo

Vitiligo causes a loss of pigmentation. There are a few types, but vitiligo generally
causes white patches to appear on the skin, usually in areas exposed to sunlight.
People with vitiligo often lose their hair color early, as well.
Some people find that more areas of whiteness appear gradually, over many years.
Since this condition affects pigmentation, it is typically more noticeable in people
with dark or tanned skin.

There is currently no cure for vitiligo, but a range of treatments are available,
including light therapy and topical medicines. A person also has surgical options,
and some alternative therapies may help, though scientists need to look further into
their effectiveness.

Hives

Hives are itchy, raised welts. They may be pinkish or reddish in people with lighter
skin.

An allergic reaction is usually responsible, though stress, illness, and friction, such
as from tight clothes, can be the cause.

Hives typically form in clusters. They may go away in one part of the body and
reappear in another. Treatment usually involves antihistamines or corticosteroids.

Warts

The human papillomavirus, better known as HPV, causes warts, which are
contagious.

These bumps can appear on any part of the body, typically on the hands, feet, and
joints. They tend to be the color of a person’s skin or are darker.

Warts sometimes go away on their own, but a dermatologist may recommend

removing them, depending on their type and location.

Fungal nail infection

This involves an overgrowth of fungus near, under, and around the nails. Usually,
it affects the toenails.

The nails’ edges may crumble away, and their surfaces may have whitish-
yellowish scaling and flaking.
Different types of fungi can cause this infection, and the treatment may depend on
the type. Doctors can prescribe oral or topical medications. In some cases, they
may need to remove the affected nail.

Candidiasis

The overgrowth of the Candida albicans fungus causes this issue, and when it
affects the skin, it is called cutaneous Candidiasis or cutaneous Moniliasis.

The areas may be irritated and have lesions or small pustules. Candidiasis typically
develops in skin folds, such as the armpit or around the groin. Sometimes, it affects
the face.

People can usually prevent Candidiasis by boosting their skin hygiene and
avoiding the overuse of antibiotics. To treat it, doctors may prescribe antifungal
and corticosteroid creams.

Athlete’s foot

Athlete’s foot is a fungal infection. The fungus responsible thrives in warm, damp
conditions, such as inside sneakers.

Symptoms may include dry, itchy, peeling skin. There can also be blisters and
bleeding, and the skin between the toes or under the foot may be soggy, pale,
cracked, or scaly.

Doctors usually treat athlete’s foot with antifungal creams or sprays.

Skin cancer

Cancer involves cells growing uncontrollably, and it can happen anywhere. When
it begins in the skin, doctors call it skin cancer. Although skin cancer can be life
threatening, treatments can be effective if a doctor diagnoses the issue early.

These cancers tend to occur after prolonged exposure to the sun. Darker skin
produces more melanin, which gives the skin more protection from harmful sun
rays.
Still, research Trusted Source shows that skin cancer tends to be diagnosed later in
People of Color. This results in delayed medical care and a higher likelihood of
death.

There are several types of skin cancer, and some are more common than others.

Carbuncle

When Staphylococcus aureus bacteria make their way into the hair follicles and
cause an infection, it can result in a carbuncle. This is an irritated lump beneath the
skin that may be red and will have a white or yellow center. The pus within may
ooze out, or there may be a crust over the lump.

Carbuncles can fill with pus and swell quickly. Other symptoms include tiredness,
itchiness of the lump, and a fever.

Doctors usually treat carbuncles with antibiotics, drainage, and antibacterial

washes.