Integumentary
System
Dr. Ammarah
Naseer
Tissues of the body
The tissue: is a group of cells
which perform a specific function
There are four basic
tissues: [Link]
[Link] tissue
[Link] tissue
[Link] tissue
Structure of the skin
Structure of the skin
Epidermis Dermis
Keratinized stratified Connective tissue
squamous epithelium containing (bood. v.
lymph v., sensory nerve
devoid of blood endings, smooth m, hair
vessels follicles, sweat and
sebaceous glands)
Wear & tear occurs In its deep part the
in superficial cells collagen bundles are
arranged in parallel
rows
Skin
• Layers of skin
• Epidermis
• Five type of layers
• Dermis
• Two type of layers
• Dermal papilla – conical
projections of papillary layer of
dermis into epidermis
Epidermis
Thickness:
The epidermis is generally thin except in :
• The palms of the hand.
• The soles of the feet.
Why?
To protect these parts and withstand friction,
wear and tear that occurs in these regions.
Dermi
s
• Corium
• Vascular layer of skin
• Made up of connective tissue
• Two layers:
– Superficial – papillary layer
• Thin
• 20%
• Contains loosely arrange collagen
fibers
• Reticular layer:
– Thick
– 80%
– Composed of thick collagen bundles
running parallel to skin
Functions of the Skin
• 1-Protection
• abrasion, invasion, water loss, UV
protection
• 2-Vitamin D synthesis
• epidermal keratinocytes when exposed to
UV light
• helps maintain health of skeleton by
increasing absorption of Ca2+
• 3-Sensation
• receptors for heat, cold, touch,
pressure, vibration and pain
• 4- Thermoregulation
• thermo receptors and sweat glands
• hypothalamus controls cutaneous
arteries and sweat glands to retain or
dissipate heat
• 5- Psychological and social functions
• appearance and social acceptance
• facial expression and
nonverbal communication
Langer’s lines
•The collagen fibers, arranged in parallel
rows, called:
Lines of cleavage (langer’s lines):
Tension lines
•The direction of the rows of collagen fibers
in the dermis:
It runs
•Longitudinally in the limbs.
•Circumferentially in the neck and the trunk.
Lines of cleavage
These lines are important
to determine the direction
for an incision (cut) during
a surgery to avoid obvious
scars.
•A surgical incision along or between these lines
causes the minimum disruption of collagen so that the
wound heals with a small scar.
•Conversely, an incision made across the rows of
collagen makes a disruption resulting in the massive
production of fresh collagen and the formation of a
broad scar.
Flexors Lines
Skin creases
Folded skin over the
joints.
Skin is thin and is
firmly adherent to
underlying structures.
Papillary
ridges
• Finger prints due to ridges & grooves
present on finger tip, palms, toes & sole of
the foot
• Appears in intrauterine life – 3rd & 4th month
• Peculiar to individual, used to identify
person
• Underlying structure of dermis forms a
patten on epidermis
Skin Color
Due to Melanin, a pigment in the epidermis and
Carotene, a pigment in dermis as well as the blood in the
capillaries of the dermis.
Melanin is synthesized in cells called Melanocytes
(found in basal layer).
Number of Melanocytes is essentially the same in
all races.
The differences in skin color is due to the amount of
pigment the melanocytes produce.
When skin is exposed to ultraviolet radiation, enzymatic
activity is increased and both the amount and darkness of
melanin increase and the skin darkens as a protective
measure
The appendages of the skin
• Nails
• Hairs
• Sebaceous glands
• Sweat glands
Nails
A nail is a flat horny plate on
the dorsal surface of tips of
the fingers and toes
• Nail bed is very vascular causing
pink color of the nail
• The germinative zone lies beneath
the root& is responsible for growth
of nail
Nail
s
• Nails
– Scale-like modifications of the epidermis
• Heavily keratinized
– Stratum basale extends beneath the nail
bed
• Responsible for growth
– Lack of pigment makes them colorless
Nail
• Nail structures
– Free edge Anatomy
– Body is the visible attached portion
– Root of nail embedded in skin
– Cuticle is the proximal nail fold that projects onto the nail
body
• Nail Plate: visible part
• Nail root: hidden part lying in groove
• Nail folds: skin fold bounding nail grooves
• Nail bed: beneath nail bed is stratified
squamous epithelium called nail bed
• Nail matrix: beneath proximal portion of nail
fold is epithelium from which nail grows (0.5
mm/week)
• Hyponychium: thickened epidermis under
free edge of nail
Hai
• Hair
r
– Keratinous filaments derived from invagination
of germinative layer of epidermis into dermis
– Produced by hair follicle which are made of
hard keratinized epithelial cells
– Melanocytes provide pigment for hair color
Structure of Hair
Follicle
Hairs
Cover whole surface of
the body except some
areas as lips, palms, soles,
reproductive organs.
Consist of 2 parts:
Shaft: free end
Root: embeded part
Hairs
Root is surrounded by hair follicle
Hair follicles: invaginations of the
epidermis into the dermis, the
hair grows out of these follicles
(hair shaft).
Hair bulb: the expanded extremity
of the follicle, concaved at the
end (located deep in the
dermis).
Hair papilla: a vascular connective
tissue that occupies the
concavity of the bulb.
Arrector Pilli muscle
•A band of smooth muscle
connects the undersurface of the
follicle to the superficial part of
the dermis.
•It is innervated by sympathetic
nerve fibers.
• It is involuntary.
Arrector Pilli muscle
Functions:
•Its contraction causes the
hair to move into a more
vertical position.
•It compresses the
sebaceous gland and
causes it to extrude sebum.
Hair
Structures
• Associated hair structures
– Hair follicle
• Dermal and epidermal
sheath surround hair root
– Arrector pili muscle
• Smooth muscle
• Pulls hairs upright when cold
or frightened
– Sebaceous gland
Sebaceous glands
Function
It secrets sebum to oil
(lubricate) hair and
skin.
Sebum
An oily material that
keeps the flexibility of
the hair and oils the
epidermis around the
mouth of the follicle.
Sebaceous cyst
It occurs because of the
obstruction (blocking) of the
sebaceous duct.
Sweat glands
•long tubular glands with deep
coiled part.
•All over the body except red
margins of lips, nail beds, glans
penis and clitoris.
•The most deeply penetrated
structure.
• Consist of coiled tubes and straight duct
• Secretory portion is embeded in dermis
• Excretory portion open on surface – sweat
pores
• Two types:
– Eccrine glands:
– Found all over the skin especially sole, axilla,
forehead
– Under psychological & thermal control
– Helps in regulation of body temprature
– Also secrete salts
• Appocrine glands:
– Large glands
– Produce thick secretions
– Have characteristic odour – bacterial activity
– Composed of coiled secretory portion &
excretory portion which secretes into hair
follicle
– Appears on surface with sebum as both opens
into hair follicle
– Present in axilla, anogenital region
– Active at puberty
– Merocrine in nature
• Modified Sweat glands:
• Ceruminous glands: external acoustic
meatus
• Glands of Mol: in margins of eye lids
• Mammary glands: production of millk
Skin infections
Pathogenic organisms can
enter to the tissue through :
• Nail Folds
• Hair Follicles
• Sebaceous Glands
Staphylococcus:
A type of bacteria that causes
skin infections.
Skin infections
•Paronychia, infection between the nail and nail
fold
•Boil, Infection of the hair follicle and sebaceous
glands
•Carbuncle, infection in the superficial fascia
affecting single or group of hair follicles
CARBUNCLE
Par/onych/ia :
par- : through
onych- :nail
-ia :abnormal
condition
Severity of
Burns
• First-degree burns
– Only epidermis is damaged
– Skin is red and swollen
• Second-degree burns
– Epidermis and upper dermis are
damaged
– Skin is red with blisters
• Third-degree burns (worst)
– Destroys entire skin layer
– Burn is gray-white or black
Severity of
Burns
Rule of
Nines
• Way to determine the extent of burns
• Body is divided into 11 areas for
quick estimation
• Each area represents about 9% of total
body surface area
RulReuleooff
N
Niniene
Skin burns
Superficial Deep
Heals rapidly from the edges, Heals slowly from the edges.
cells of HF and glands.
Usually needs skin grafting.
Heals quickly.
Doesn’t need a skin graft.
Clinical notes
Graft is transferring tissue from one site to another.
Skin graft is needed when the skin is damaged ( usually by deep
burning )
Clinical notes
Skin Graft
Split thickness grafting Full thickness grafting
Transferring epidermis only Transferring both
epidermis and dermis.
Fascia
Collection of connective tissue
Superficial fascia Deep fascia
Superficial fascia
Deep Fascia
Superficial fascia
Superficial fascia:
• Loose, mixture of adipose and loose areolar tissues.
• It unites the skin to the underlying structures.
• It is dense in some places as scalp, palm of hand and sole of foot
and contains collagen bundles
• It is thin in the eyelids, auricle, scrotum, penis and clitoris
(devoid of adipose tissue).
Functions:
• Facilitates movement of skin over underlying structures.
• Passage for cutaneous vessels, nerves…
• Protects the body against heat loss.
Superficial fascia
Deep fascia
It is more dense than superficial
fascia
Collagenous bundles are more
compact and more regularly
arranged
Examples of deep fascia
A. Intermuscular
septa
lie between muscles
dividing the limb
into compartments
Examples of deep fascia
B. Investing fascia
• Covers the surfaces of muscles
• In the neck: it forms well-defined layers,
bounds fascial spaces so limits spread of
infection or determine the path of infection
• In the abdomen: it is thin
• In the limbs: forms a definite sheath around the
muscles
Examples of deep fascia
C. Retinacula
Localized thickening of deep fascia around joints, hold the tendons
in place, prevent bowstringing of tendons
