Chapter 5

1. Chapter 5 The Integumentary System Lecture Outline

2. INTRODUCTION • The skin and its accessory structures make up the integumentary system. • The integumentary system functions to guard the body’s physical and biochemical integrity, maintain a constant body temperature, and provide sensory information about the surrounding environment. Principles of Human Anatomy and Physiology, 11e

3. Chapter 5The Integumentary System • Skin and its accessory structures • structure • function • growth and repair • development • aging • disorders Principles of Human Anatomy and Physiology, 11e

4. General Anatomy • A large organ composed of all 4 tissue types • 22 square feet • 1-2 mm thick • Weight 10 lbs. Principles of Human Anatomy and Physiology, 11e

5. STRUCTURE OF THE SKIN (Figure 5.1) • The superficial portion of the skin is the epidermis and is composed of epithelial tissue. • The deeper layer of the skin is the dermis and is primarily composed of connective tissue. • Deep to the dermis is the subcutaneous layer or hypodermis. (not a part of the skin) • It consists of areolar and adipose tissue. • fat storage, an area for blood vessel passage, and an area of pressure-sensing nerve endings. Principles of Human Anatomy and Physiology, 11e

6. Overview of Epidermis • Stratified squamous epithelium • avascular (contains no blood vessels) • 4 types of cells • 5 distinct strata (layers) of cells Principles of Human Anatomy and Physiology, 11e

7. Four Principle Cells of the Epidermis – Figure 5.2 • keratinocytes (Figure 5.2a) • produce the protein keratin, which helps protect the skin and underlying tissue from heat, microbes, and chemicals, and lamellar granules, which release a waterproof sealant • melanocytes (Figure 5.2b) • produce the pigment melanin which contributes to skin color and absorbs damaging ultraviolet (UV) light • Langerhans cells (Figure 5.2c) • derived from bone marrow • participate in immune response • Merkel cells (Figure 5.2d) • contact a sensory structure called a tactile (Merkel) disc and function in the sensation of touch Principles of Human Anatomy and Physiology, 11e

8. Layers of the Epidermis • There are four or five layers of the epidermis, depending upon the degree of friction and mechanical pressure applied to the skin. • From deepest to most superficial the layers of the epidermis are (Figures 5.3 a and b). • stratum basale (stratum germinativum) • stratum spinosum • stratum granulosum • stratum lucidum (only in palms and soles) • stratum corneum Principles of Human Anatomy and Physiology, 11e

9. Layers (Strata) of the Epidermis • Stratum corneum • Stratum lucidum • Stratum granulosum • Stratum spinosum • Stratum basale Principles of Human Anatomy and Physiology, 11e

10. Principles of Human Anatomy and Physiology, 11e

11. Keratinization and Growth of the Epidermis • Stem cells divide to produce keratinocytes • As keratinocytes are pushed up towards the surface, they fill with keratin • Keratinization is replacement of cell contents with the protein keratin; occurs as cells move to the skin surface over 2-4 weeks. • Epidermal growth factor (EGF) and other hormone-like proteins play a role in epidermal growth. Principles of Human Anatomy and Physiology, 11e

12. Dermis (Figure 5.1) • Connective tissue layer composed of collagen & elastic fibers, fibroblasts, macrophages & fat cells • Contains hair follicles, glands, nerves & blood vessels • Two major regions of dermis • papillary region • reticular region Principles of Human Anatomy and Physiology, 11e

13. Dermis - Papillary Region • Top 20% of dermis • areolar connective tissue containing fine elastic fibers, corpuscles of touch (Meissner’s corpuscles), adipose cells, hair follicles, sebaceous glands, sudoriferous glands • The collagen and elastic fibers provide strength, extensibility (ability to stretch), and elasticity (ability to return to original shape after stretching) to skin. • Finger like projections are called dermal papillae • anchors epidermis to dermis • contains capillaries that feed epidermis • contains Meissner’s corpuscles (touch) & free nerve endings for sensations of heat, cold, pain, tickle, and itch Principles of Human Anatomy and Physiology, 11e

14. Dermis - Reticular Region • Dense irregular connective tissue • Contains interlacing collagen and elastic fibers • Packed with oil glands, sweat gland ducts, fat & hair follicles • Provides strength, extensibility & elasticity to skin • stretch marks are dermal tears from extreme stretching • Epidermal ridges form in fetus as epidermis conforms to dermal papillae • fingerprints are left by sweat glands open on ridges • increase grip of hand Principles of Human Anatomy and Physiology, 11e

15. Dermis -- Structure • Epidermal ridges increase friction for better grasping ability and provide the basis for fingerprints and footprints. The ridges typically reflect contours of the underlying dermis. Principles of Human Anatomy and Physiology, 11e

16. Accessory Structures of Skin • hair • oil glands • sweat glands • nails Principles of Human Anatomy and Physiology, 11e

17. HAIR • Hairs, or pili, are present on most skin surfaces except the palms, palmar surfaces of the digits, soles, and plantar surfaces of the digits. • Hair consists of • a shaft above the surface (Figure 5.4a) • a root that penetrates the dermis and subcutaneous layer (Figure 5.4c,d) • the cuticle (Figure 5.4b), and • a hair follicle (Figure 5.4c,d). • New hairs develop from cell division of the matrix in the bulb. Principles of Human Anatomy and Physiology, 11e

18. Structure of Hair • Shaft -- visible • medulla, cortex & cuticle • CS round in straight hair • CS oval in wavy hair • Root -- below the surface • Follicle surrounds root • external root sheath • internal root sheath • base of follicle is bulb • blood vessels • germinal cell layer Principles of Human Anatomy and Physiology, 11e

19. Structure of Hair • Shaft -- visible • medulla, cortex & cuticle • CS round in straight hair • CS oval in wavy hair • Root -- below the surface • Follicle surrounds root • external root sheath • internal root sheath • base of follicle is bulb • blood vessels • germinal cell layer Principles of Human Anatomy and Physiology, 11e

20. Structure of Hair • Shaft -- visible • medulla, cortex & cuticle • CS round in straight hair • CS oval in wavy hair • Root -- below the surface • Follicle surrounds root • external root sheath • internal root sheath • base of follicle is bulb • blood vessels • germinal cell layer Principles of Human Anatomy and Physiology, 11e

21. Hair Related Structures • Arrector pili • smooth muscle in dermis contracts with cold or fear. • forms goosebumps as hair is pulled vertically • Hair root plexus • detect hair movement • sebaceous (oil) glands Principles of Human Anatomy and Physiology, 11e

22. Types of hair • Lanugo is a fine, nonpigmented hair that covers the fetus. • Vellus hair is a short, fine hair that replaces lanugo • Course pigmented hair appears in response to androgens • Hair that appears in response to androgens and hair of the head, eyelashes and eyebrows is known as terminal hair. Principles of Human Anatomy and Physiology, 11e

23. Functions ofHair • Prevents heat loss • Decreases sunburn • Eyelashes help protect eyes • Touch receptors (hair root plexus) senses light touch Principles of Human Anatomy and Physiology, 11e

24. Glands of the Skin • Specialized exocrine glands found in dermis • Sebaceous (oil) glands • Sudiferous (sweat) glands • Ceruminous (wax) glands • Mammary (milk) glands Principles of Human Anatomy and Physiology, 11e

25. Sebaceous (oil) glands • Sebaceous (oil) glands are usually connected to hair follicles; they are absent in the palms and soles (Figure 5.1 ). • Secretory portion of gland is located in the dermis • produce sebum • contains cholesterol, proteins, fats & salts • moistens hairs • waterproofs and softens the skin • inhibits growth of bacteria & fungi (ringworm) Principles of Human Anatomy and Physiology, 11e

26. Sudoriferous (sweat) glands Eccrine sweat glands have an extensive distribution most areas of skin • secretory portion is in dermis with duct to surface • ducts terminate at pores at the surface of the epidermis. • regulate body temperature through evaporation (perspiration) • help eliminate wastes such as urea. Apocrine sweat glands are limited in distribution to the skin of the axilla, pubis, and areolae; their duct open into hair follicles. • secretory portion in dermis • duct that opens onto hair follicle • secretions are more viscous • Table 5.3 compares eccrine and apocrine sweat glands. Principles of Human Anatomy and Physiology, 11e

27. Ceruminous Glands • Ceruminous glands are modified sudoriferous glands that produce a waxy substance called cerumen. • found in the external auditory meatus • contains secretions of oil and wax glands • barrier for entrance of foreign bodies Principles of Human Anatomy and Physiology, 11e

28. Structure of Nails (Figure 5.5) • Tightly packed keratinized cells • Nail body • visible portion pink due to underlying capillaries • free edge appears white • Nail root • buried under skin layers • lunula is white due to thickened stratum basale • Eponychium (cuticle) • stratum corneum layer Principles of Human Anatomy and Physiology, 11e

29. Nail Growth • Nail matrix is below nail root -- produces growth • Cells transformed into tightly packed keratinized cells • 1 mm per week Principles of Human Anatomy and Physiology, 11e

30. TYPES OF SKIN • Thin skin • covers all parts of the body except for the palms and palmar surfaces of the digits and toes. • lacks epidermal ridges • has a sparser distribution of sensory receptors than thick skin. • Thick skin (0.6 to 4.5 mm) • covers the palms, palmar surfaces of the digits, and soles • features a stratum lucidum and thick epidermal ridges • lacks hair follicles, arrector pili muscles, and sebaceous glands, and has more sweat glands than thin skin. • Table 5.4 summarizes the fractures of thin and thick skin. Principles of Human Anatomy and Physiology, 11e

31. FUNCTIONS OF SKIN -- thermoregulation • Perspiration & its evaporation • lowers body temperature • flow of blood in the dermis is adjusted • Shivering and constriction of surface vessels • raise internal body temperature as needed Principles of Human Anatomy and Physiology, 11e

32. FUNCTIONS OF SKIN • blood reservoir • extensive network of blood vessels • protection - physical, chemical and biological barriers • tight cell junctions prevent bacterial invasion • lipids released retard evaporation • pigment protects somewhat against UV light • Langerhans cells alert immune system • cutaneous sensations • touch, pressure, vibration, tickle, heat, cold, and pain arise in the skin Principles of Human Anatomy and Physiology, 11e

33. FUNCTIONS OF SKIN • Synthesis of Vitamin D • activation of a precursor molecule in the skin by UV light • enzymes in the liver and kidneys modify the activated molecule to produce calcitriol, the most active form of vitamin D. • necessary vitamin for absorption of calcium from food in the gastrointestinal tract • excretion • 400 mL of water/day, small amounts salt, CO2, ammonia and urea Principles of Human Anatomy and Physiology, 11e

34. Transdermal Drug Administration • method of drug passage across the epidermis and into the blood vessels of the dermis • drug absorption is most rapid in areas where skin is thin (scrotum, face and scalp) • Examples: • nitroglycerin (prevention of chest pain from coronary artery disease) • scopolamine ( motion sickness) • estradiol (estrogen replacement therapy) • nicotine (stop smoking alternative) Principles of Human Anatomy and Physiology, 11e

35. Epidermal Wound Healing • Abrasion or minor burn • Basal cells migrate across the wound (Figure 5.6a) • Contact inhibition with other cells stops migration • Epidermal growth factor stimulates basal cells to divide and replace the ones that have moved into the wound (Figure 5.6b). • Full thickness of epidermis results from further cell division Principles of Human Anatomy and Physiology, 11e

36. Deep Wound Healing • Phases of Deep Wound Healing • During the inflammatory phase, a blood clot unites the wound edges, epithelial cells migrate across the wound, vasodilatation and increased permeability of blood vessels deliver phagocytes, and fibroblasts form (Figure 5.6c). • During the migratory phase, epithelial cells beneath the scab bridge the wound, fibroblasts begin scar tissue, and damaged blood vessels begin to grow. During this phase, tissue filling the wound is called granulation tissue. Principles of Human Anatomy and Physiology, 11e

37. Phases of Deep Wound Healing Principles of Human Anatomy and Physiology, 11e

38. Deep Wound Healing • Phases of Deep Wound Healing • During the proliferative phase, the events of the migratory phase intensify. • During the maturation phase, the scab sloughs off, the epidermis is restored to normal thickness, collagen fibers become more organized, fibroblasts begin to disappear, and blood vessels are restored to normal (Figure 5.6d). • Scar tissueformation (fibrosis) can occur in deep wound healing. Principles of Human Anatomy and Physiology, 11e

39. Age Related Structural Changes • Collagen fibers decrease in number & stiffen • Elastic fibers become less elastic • Fibroblasts decrease in number • decrease in number of melanocytes (gray hair, blotching) • decrease in Langerhans cells (decreased immune responsiveness) • reduced number and less-efficient phagocytes Principles of Human Anatomy and Physiology, 11e

40. Burns • Destruction of proteins of the skin • chemicals, electricity, heat • Problems that result • shock due to water, plasma and plasma protein loss • circulatory & kidney problems from loss of plasma • bacterial infection • Two methods for determining the extent of a burn are the rule of nines and the Lund-Bowder method (Figure 5.10). Principles of Human Anatomy and Physiology, 11e

41. Burns Principles of Human Anatomy and Physiology, 11e

42. Burns Principles of Human Anatomy and Physiology, 11e

43. Pressure Sores • Pressure ulcers, also known as decubitus ulcers • caused by a constant deficiency of blood to tissues overlying a bony projection that has been subjected to prolonged pressure • typically occur between bony projection and hard object such as a bed, cast, or splint • the deficiency of blood flow results in tissue ulceration. • Preventable with proper care Principles of Human Anatomy and Physiology, 11e