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5 The Integumentary System
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Epidermis, Dermis, and Hypodermis
© 2013 Pearson Education, Inc.
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Hair shaft Dermal papillae
Figure 5.1 Skin structure. Hair shaft Dermal papillae Epidermis Subpapillary plexus Papillary layer Sweat pore Appendages of skin Dermis Reticular layer Eccrine sweat gland Arrector pili muscle Sebaceous gland Hair follicle Hair root Hypodermis (subcutaneous tissue; not part of skin) Cutaneous plexus Nervous structures Sensory nerve fiber with free nerve endings Adipose tissue Lamellar corpuscle Hair follicle receptor (root hair plexus) © 2013 Pearson Education, Inc.
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Figure 5.2a The main structural features of the skin epidermis.
Stratum corneum 20–30 layers of dead cells Flat membranous sacs filled with keratin No nucleus present Glycolipids in extracellular space (slows water loss) Stratum granulosum Approximately five layers of flattened cells Cytoplasm full of granules; keratinization site Stratum spinosum Several layers of keratinocytes Contain thick bundles of intermediate filaments (pre-keratin) Stratum basale One row of mitotic stem cells; Some cells become part of superficial layers Occasional melanocytes and dendritic cells Dermis © 2013 Pearson Education, Inc.
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Epidermis Keratinized stratified squamous epithelium
Four or five distinct layers Stratum basale Stratum spinosum Stratum granulosum Stratum lucidum (only in thick skin) Stratum corneum © 2013 Pearson Education, Inc.
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What are some ways to remember this information?
Activity 1 What are some ways to remember this information? Stratum corneum Stratum lucidum Stratum granulosum Stratum spinosum Stratum basale Stratum Association Term Corneum Crown Lucidium Lucid Granulosum Gradual Spinosum Spine Basale Base © 2013 Pearson Education, Inc.
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Four Cell Types of Stratum Basale
Function Keratinocyte Produce keratin Melanocyte Produce melanin Dendritic cell Antigen-presenting macrophage; immunity Merkel cell Light touch receptor © 2013 Pearson Education, Inc.
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Figure 5.2b The main structural features of the skin epidermis.
Keratinocytes Stratum corneum Stratum granulosum Stratum spinosum Dendritic cell Stratum basale Sensory nerve ending Dermis Melanin granule Tactile (Merkel) cell Desmosomes Melanocyte © 2013 Pearson Education, Inc.
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Flexure lines Dermal folds at/near joints
Figure 5.4b Dermal modifications result in characteristic skin markings. Flexure lines Dermal folds at/near joints Dermis tightly secured to deeper structures Skin cannot slide easily for joint movement – causes deep creases Visible on hands, wrists, fingers, soles, toes Cleavage lines in the reticular dermis © 2013 Pearson Education, Inc.
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Three pigments contribute to skin color
Melanin Carotene Hemoglobin What colors are associated with each pigment? Browns Yellow-oranges Reds Which is the only one made in the skin? © 2013 Pearson Education, Inc.
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Skin Color in Diagnosis
Cyanosis Erythema Pallor Jaundice Bronzing Bruises © 2013 Pearson Education, Inc.
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Skin Color in Diagnosis
Cyanosis blue Erythema redness Pallor blanching Jaundice yellow cast Bronzing brown Bruises purple What are some causes for each of these? © 2013 Pearson Education, Inc.
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Skin Color in Diagnosis
Term Color Cause Cyanosis Blue Low oxygenation of hemoglobin Erythema Red Fever, hypertension, inflammation Pallor Pale Anemia, low BP, fear, anger Jaundice Yellow Liver disorder Bronzing Brown Inadequate steroid hormones Bruises Bruisy Clotted blood beneath skin © 2013 Pearson Education, Inc.
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Derivatives of the skin
Appendages of the Skin Derivatives of the skin Hairs and hair follicles Nails Cutaneous glands Sudoriferous glands "sweat" Eccrine glands “empty into duct to skin” Apocrine glands “modified hair follicle” Mammary glands Ceruminous glands Sebaceous glands "oils" © 2013 Pearson Education, Inc.
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Figure 5.5c Skin appendages: Structure of a hair and hair follicle.
Hair shaft Arrector pili Sebaceous gland Follicle wall Hair root • Peripheral connective tissue (fibrous) sheath Hair bulb • Glassy membrane • Epithelial root sheath • External root sheath • Internal root sheath Hair root • Cuticle • Cortex • Medulla Hair matrix Hair papilla Melanocyte Subcutaneous adipose tissue Diagram of a longitudinal view of the expanded hair bulb of the follicle, which encloses the matrix © 2013 Pearson Education, Inc.
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How can we remember the layers of a hair follicle?
Activity 2 How can we remember the layers of a hair follicle? Hair papilla Hair matrix Medulla Cortex Int. Epi. Root Sheath Ex. Epi. Root Sheath Glassy membrane CT Root Sheath 5 4 6 3 7 2 8 1 © 2013 Pearson Education, Inc.
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Lunule Lateral nail fold Free edge of nail Body of nail Eponychium
Figure 5.6 Skin appendages: Structure of a nail. Lunule Lateral nail fold Free edge of nail Body of nail Eponychium (cuticle) Root of nail Proximal nail fold Nail matrix Hyponychium Nail bed Phalanx © 2013 Pearson Education, Inc.
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Comparing Eccrine and Sebaceous Glands
© 2013 Pearson Education, Inc.
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Figure 5.7b Photomicrograph of a sectioned eccrine gland (140x).
Sebaceous gland Sweat pore Eccrine gland Duct Dermal connective tissue Secretory cells Photomicrograph of a sectioned eccrine gland (140x) © 2013 Pearson Education, Inc.
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Figure 5.7a Photomicrograph of a sectioned sebaceous gland (90x).
Sweat pore Dermal connective tissue Hair in hair follicle Sebaceous gland duct Eccrine gland Secretory cells Photomicrograph of a sectioned sebaceous gland (90x) © 2013 Pearson Education, Inc.
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Importance of the Integumentary System
© 2013 Pearson Education, Inc.
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Functions of the Integumentary System
Protection Body temperature regulation Cutaneous sensation Metabolic functions Blood reservoir Excretion What are examples of each function? © 2013 Pearson Education, Inc.
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Skin Disorders © 2013 Pearson Education, Inc.
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Malignancy Commonness Basal cell carcinoma Squamous cell carcinoma
Figure 5.8 Photographs of skin cancers. Malignancy Basal cell carcinoma Squamous cell carcinoma Melanoma Commonness © 2013 Pearson Education, Inc.
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Melanoma Cancer of melanocytes Most dangerous
Highly metastatic and resistant to chemotherapy Treated by wide surgical excision accompanied by immunotherapy © 2013 Pearson Education, Inc.
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ABCDE Rule Key to survival is early detection – ABCD rule Letter Term
Explanation A Asymmetry Two sides of pigmented area do not match B Border Irregular boarder, indentations C Color Contains several (black, brown, tan, red, or blue) D Diameter Larger than 6mm (pencil eraser) E Evolving Continues to get larger or obtains any of the other properties over time. © 2013 Pearson Education, Inc.
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Classifications of Burns
© 2013 Pearson Education, Inc.
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Burns What is a burn? What happens when the tissue burns?
Tissue damage caused by Heat, Electricity, Radiation, Chemicals What happens when the tissue burns? Denatures proteins Kills cells Why are they bad? Dehydration and electrolyte imbalance Leads to renal shutdown and circulatory shock No barrier: can’t protect from infection © 2013 Pearson Education, Inc.
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Burns evaluation: Rule of nines Used to estimate volume of fluid loss
Figure 5.9 Estimating the extent and severity of burns using the rule of nines. Totals 41/2% Anterior and posterior head and neck, 9% Burns evaluation: Rule of nines Used to estimate volume of fluid loss Anterior and posterior upper limbs, 18% 41/2% Anterior trunk 18% 41/2% Anterior and posterior trunk, 36% Area Ant. + Post. Total Head/Neck 9 Trunk 36 Upper Limbs 9 x 2 18 Lower Limbs 18 x 2 Perineum 1 100 9% 9% (Perineum, 1%) Anterior and posterior lower limbs, 36% 100% © 2013 Pearson Education, Inc.
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Classifying Burns Degree Area 1st Some or most of epidermis 2nd
Epidermis + some dermis 3rd Full dermis + subcutaneous 4th Underlying tissues © 2013 Pearson Education, Inc.
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Figure 5.10 Partial thickness and full thickness burns.
1st-degree burn 3rd-degree burn 2nd-degree burn Skin bearing partial thickness burn (1st- and 2nd-degree burns) Skin bearing full thickness burn (3rd-degree burn) © 2013 Pearson Education, Inc.
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