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Chapter 5 Integumentary System • Skin • Epidermis • Dermis • Hypodermis • Associated skin structures • Skin Cancer • Burns
Epidermal Layers • Stratum Basale (Germinativum) • Stratum Spinosum • Stratum Granulosum • Stratum Lucidum (only in “thick” skin) • Stratum Corneum
Layers of the Epidermis: Stratum Basale (Basal Layer) • Deepest epidermal layer firmly attached to the dermis • Consists of a single row of the youngest keratinocytes • Cells undergo rapid division, hence its alternate name, stratum germinativum
Layers of the Epidermis: Stratum Spinosum (Prickly Layer) • Cells contain a weblike system of intermediate filaments attached to desmosomes • Melanin granules and Langerhans’ cells are abundant in this layer
Layers of the Epidermis: Stratum Granulosum (Granular Layer) • Thin; three to five cell layers in which drastic changes in keratinocyte appearance occurs • Keratohyaline and lamellated granules accumulate in the cells of this layer
Layers of the Epidermis: Stratum Lucidum (Clear Layer) • Thin, transparent band superficial to the stratum granulosum • Consists of a few rows of flat, dead keratinocytes • Present only in thick skin
Layers of the Epidermis: Stratum Corneum (Horny Layer) • Outermost layer of keratinized cells • Accounts for three quarters of the epidermal thickness • Functions include: • Waterproofing • Protection from abrasion and penetration • Rendering the body relatively insensitive to biological, chemical, and physical assaults
Layers of the Epidermis Figure 5.2b
Dermis • Two Layers • Papillary Layer (20%) • Dermal ridges • Reticular Layer (80%) • Cleavage Lines of Tension
Layers of the Dermis: Papillary Layer • Papillary layer • Areolar connective tissue with collagen and elastic fibers • Its superior surface contains peglike projections called dermal papillae • Dermal papillae contain capillary loops, Meissner’s corpuscles, and free nerve endings
Layers of the Dermis: Reticular Layer • Reticular layer • Accounts for approximately 80% of the thickness of the skin • Collagen fibers in this layer add strength and resiliency to the skin • Elastin fibers provide stretch-recoil properties
Hypodermis • Subcutaneous layer deep to the skin • Composed of adipose and areolar connective tissue
Appendages of the Skin • Epidermal derivatives • Glands • Sweat • Sebaceous (oil) • Nails • Hair • Hair follicles
Sweat Glands • Different types prevent overheating of the body; secrete cerumen and milk • Eccrine sweat glands – found in palms, soles of the feet, and forehead • Apocrine sweat glands – found in axillary and anogenital areas • Ceruminous glands – modified apocrine glands in external ear canal that secrete cerumen • Mammary glands – specialized sweat glands that secrete milk
Sebaceous Glands • Simple alveolar glands found all over the body • Soften skin when stimulated by hormones • Secrete an oily secretion called sebum
Hair • Filamentous strands of dead keratinized cells produced by hair follicles • Contains hard keratin which is tougher and more durable than soft keratin of the skin • Made up of the shaft projecting from the skin, and the root embedded in the skin • Consists of a core called the medulla, a cortex, and an outermost cuticle • Pigmented by melanocytes at the base of the hair
Hair Function and Distribution • Functions of hair include: • Helping to maintain warmth • Alerting the body to presence of insects on the skin • Guarding the scalp against physical trauma, heat loss, and sunlight
Hair Function and Distribution • Hair is distributed over the entire skin surface except: • Palms, soles, and lips • Nipples and portions of the external genitalia
Hair Follicle • Root sheath extending from the epidermal surface into the dermis • Deep end is expanded forming a hair bulb • A knot of sensory nerve endings (a root hair plexus) wraps around each hair bulb • Bending a hair stimulates these endings, hence our hairs act as sensitive touch receptors
Hair Follicle Figure 5.5a
Hair Follicle Figure 5.5c
Types of Hair • Terminal – coarse, long hair of eyebrows, axillary, and pubic regions • Evident more at puberty • Vellus – pale, fine body hair found in children and the adult female • Often seen in anorexics • Hirsutism is condition associated with “hairiness” of females with adrenal or ovarian tumors • Hair growth ~2.5mm/wk (varies w/ age, sex, and body region) • Growth Phase (months to years) – Regressive/Resting Phase (1-3 months), then matrix reactivated and the old hair sheds (head 6-10+ yrs.) (eyebrow 3-4 mos.)
Hair Loss/Thinning (alopecia) • Male Pattern Baldness – DHT and genes • High fever • Surgery • Emotional trauma • Pregnancy/Lactation • Excess Vit A • Antidepressants • Anticoagulants • Chemotherapy • Anabolic steroids
Structure of a Nail • Scalelike modification of the epidermis on the distal, dorsal surface of fingers and toes Figure 5.6
Skin Functions • Protection – • Chemical – melanin, acid mantle, human defensin, cathelicidins • Physical – keratinization, glycolipids • Biological –Langerhans cell, dermal macrophages, DNA & heat • Regulate Body Temp • Sensation • Metabolic Function • Blood Reservoir • Excretion
Skin Cancers • Basal Cell Carcinoma • Most common – least malignant • Squamous Cell Carcinoma • Ulcerative – can be malignant • Melanoma • Fewest cases - most malignant • ABCD(E)
Burns • Rule of “9’s” • First Degree – erythema – 2-3 days healing • Second Degree – blisters – 3-4 wks healing • Third Degree • loss includes dermis • not painful • grafts
3rd Degree Burn Prognosis • Fluid loss with protein and electrolytes • CV shock, renal shutdown • Nutrient needs • Protein for repair, glucose to provide energy • Infection • 24h, then mass sepsis
Critical Criteria • 2nd and 3rd Degree Burns • >25% of body with 2o • >10% of body with 3o • 3o of face, hands or feet.