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Chapter 6
      The Integumentary System

•   Epidermis and dermis
•   Hypodermis
•   Thick and thin skin
•   Skin color
•   Functions of the skin
•   Hair and nails
•   Cutaneous glands
Overview of the Skin
• Largest organ of the body (15% of body weight)
• Epidermis
  – stratified squamous epithelium
  – contains 5 layers
• Dermis
  – connective tissue layer
• Skin rests on subcutaneous layer or hypodermis
• Skin thickness variable, normally 1-2 mm
  – thicker when dermis is thicker, up to 6 mm
  – called thick skin if stratum corneum layer is increased
     • calluses on hands and feet, no hair follicles or oil glands
Cell Types & Layers of the Epidermis
5 Layers of the Epidermis


5                               Superficial

4
3



2



1                               Deep
Stratum Basale
• Single layer of cuboidal or low columnar cells
  sitting on basement membrane
• Cell types in this layer
  – keratinocytes
     • undergo mitosis to replace epidermis
     • most of cells of epidermis
  – melanocytes synthesize melanin
     • distribute melanin from cell processes
     • melanin picked up by keratinocytes &
       used to shade their nuclei from UV
       radiation
  – Merkel cells are touch receptors associated with
    nerve fibers to form Merkel disc
Stratum Spinosum
• Several layers of keratinocytes
  thick
  – appear spiny due to shrinkage
    during histological preparation
• Contains dendritic (Langerhans)
  cells
  – macrophages from bone marrow
    that migrate to the epidermis
  – 800 cells/millimeter2
  – help protect body against pathogens by “presenting”
    them to the immune system
Stratum Granulosum
• 3 to 5 layers of flat keratinocytes
• Contain keratinohyalin granules
   – combine with filaments of cytoskeleton
     to form keratin
• Produces lipid-filled vesicles that
  release a glycolipid by exocytosis
  to waterproof the skin
   – forms a barrier between surface cells
     and deeper layers of the epidermis
   – cuts off surface strata from nutrient supply
Stratum Lucidum

• Thin translucent zone seen only
  in thick skin
• Keratinocytes are packed with
  eleidin, a precursor to keratin
  – does not stain well
• Cells have no nucleus or
  organelles
Stratum Corneum

• Up to 30 layers of dead, scaly,
  keratinized cells
  – surface cells flake off (exfoliate)
The Dermis
• Thickness = 0.6mm to 3mm
• Composition
  – collagen, elastic & reticular fibers, fibroblasts &
    accessory structures such as hair follicles and glands
• Dermal papillae are upward extensions of the
  dermis into the epidermis forming the ridges of the
  fingerprints
• Layers
  – papillary layer is areolar tissue & dermal papillae of
    upper 1/5 of the dermis
  – reticular layer is deeper part of dermis
Layers of the Dermis

              • Papillary layer




              • Reticular layer
The Hypodermis
             • Known as subcutaneous
               tissue or superficial fascia
             • Has more adipose than
               dermis
             • Functions
               – energy reservoir
               – thermal insulation
             • Hypodermic injections
               – into subcutaneous tissue
Hypodermis
                 since highly vascular
Subcutaneous Fat Distribution
Skin Colors (Pigmentation)




• Hemoglobin is red pigment of red blood cells
   – visible through dermal collagen fibers
• Carotene is yellow pigment of vegetables & egg yolks
   – concentrates in stratum corneum & subcutaneous fat
• Melanin pigment produced by melanocytes
   – pigment synthesis stimulated by UV radiation from sunlight
   – produces yellow, brown, black and reddish hues
Abnormal Skin Colors
• Cyanosis is blueness resulting from deficiency of
  oxygen in the circulating blood (cold weather)
• Erythema is redness due to dilated cutaneous
  vessels (anger, sunburn, embarrassment)
• Jaundice is yellowing of skin & sclera due to
  excess of bilirubin in blood (liver disease)
• Bronzing is golden-brown color of Addison
  disease (deficiency of glucocorticoid hormone)
• Pallor is pale color from lack of blood flow
• Albinism is a genetic lack of melanin
• Hematoma is a bruise (visible clotted blood)
Skin Markings
• Hemangiomas (birthmarks)
   – discolored skin caused by benign tumors of dermal blood
     capillaries (strawberry birthmarks disappear in childhood -- port
     wine birthmarks last for life)
• Freckles & moles = aggregations of melanocytes
   – freckles are flat; moles are elevated
• Friction ridges leave oily fingerprints on touched surfaces
   – unique pattern formed during fetal development
• Flexion creases form after birth by repeated closing of the
  hand
• Flexion lines form in wrist & elbow areas
Functions of the Skin
• Barrier = tough, dry, acid mantle, water barrier, UV
  barrier
• Vitamin D synthesis
   – begins in epidermal keratinocytes under influence of UV light
   – helps maintain health of skeleton
• Sensory functions
   – receptors for heat, cold, touch, pressure, vibration & pain
• Thermoregulation = thermoreceptors and sweat glands
   – hypothalamus constricts or dilates cutaneous arteries and
     sweat glands to retain or dissipate heat
• Psychological and social functions
   – appearance & social acceptance
   – facial expression and nonverbal communication
Characteristics of Human Hair
• Stratum corneum of the skin is composed of
  pliable soft keratin
• Hair and nails are composed of hard keratin
  – toughened by disulfide bridges between molecules
• Hair found almost everywhere on the body
  – differences between sexes or individuals is really
    difference in texture and color of hair
• 3 different body hair types
  – lanugo -- fine, unpigmented fetal hair
  – vellus -- fine, unpigmented hair of children & women
  – terminal hair -- coarse, long, pigmented hair of scalp
Structure of Hair and Follicle
• Hair is filament of keratinized cells
  – shaft is visible above skin; root is below within follicle;
  – in cross section: medulla, cortex and cuticle layers
• Follicle is oblique tube within the skin
  – bulb is swelling in base where hair originates
  – vascular tissue (papilla) in bulb provides nutrients
  – cells lining the follicle interlock with scales of cuticle to
    resist pulling on the hair
• Texture and cross-sectional shape of hair
  – straight hair is round, wavy is oval and kinky is flat
• Hair color is due to pigment in cells of cortex
Eumelanin pigment colors brown and black hair.
Blond hair contain sulfur-containing pheomelanin pigment.
Red hair contains eumelanin and pheomelanin pigments.
White hair is due to air in medulla & lack of pigment in
cortex. Gray hair is a mixture of white and pigmented hairs.
Structure of Hair Follicle
                 • Epithelial root sheath
                   is an extension of the
                   epidermis (lies next
                   to hair root)
                 • Connective tissue
                   root sheath is derived
                   from the dermis
                   (surrounds it)
                 • Hair receptors
                   entwine each follicle
                 • Piloerector muscle
                    – goose bumps
Structure of Hair Follicle
Hair Growth and Loss
• Hair cycle = 3 repeating cycles
  – anagen is growth stage (.3mm/day in young adult)
     • lasts 6-8 years in young adult, 90% of scalp follicles
  – catagen is shrinking follicle (lasts 2-3 weeks)
  – telogen is resting stage (lasts 1-3 months
• Hair growth during anagen follows specific steps:
  – stem cells in follicles>epithelial root sheath>hair matrix>hair
    cells that keratinize and die
• Thinning or baldness = alopecia
• Pattern baldness = genetic and hormonal
  – sex-influenced trait(dominant in males, recessive in females);
    expressed only with high testosterone levels
• Hirsutism = excessive hair growth
  – hormone imbalance (ovary or adrenal cortex problem)
Functions of Hair
• Body hair
  – too thin to provide warmth
  – alert us to parasites crawling on skin
• Scalp hair provides heat retention & sunburn
  cover
  – sex and individual recognition
• Beard, pubic & axillary hair indicate sexual
  maturity & help distribute sexual scents
• Guard hairs & eyelashes prevent foreign objects
  from getting into nostrils, ear canals or eyes
•
Nails
• Clear, hard derivative of stratum corneum
   – densely packed cells filled with hard keratin
• Flat nails allow for fleshy, sensitive fingertips
   – eponychium = cuticle
• Growth rate is 1 mm per week
   – new cells added by mitosis in the nail
     matrix
      • growth zone at proximal edge
        of nail
   – nail bed is skin on which
     nail plate rests
   – hyponychium is epithelium
     of nail bed
Cutaneous Glands


         • Sweat glands
           – merocrine
           – apocrine
         • Sebaceous glands
         • Ceruminous glands
         • Mammary glands
Sweat Glands
• Filtrate of plasma containing some waste products
   – 500 ml of insensible
     perspiration/day
   – sweating with visible wetness
     is diaphoresis
• Merocrine glands is simple
  tubular gland
   – millions of them (size of kidney)
   – cool the body
• Apocrine glands produce sweat
  containing fatty acids
   – found only near hair follicles & respond to stress & sex
   – bromhidrosis is body odor produced by bacterial action on
     fatty acids
Sebaceous Glands
• Oily secretion called sebum that contains broken-
  down cells
   – lanolin in skin creams is sheep sebum
• Flask-shaped gland with duct that opens into hair
  follicle
Ceruminous Glands

• Found only in external ear canal
• Their secretion combines with sebum to produce
  earwax
  – waterproof keeps eardrum flexible
  – bitterness repel mites & other pests
Mammary Glands
• Breasts of both sexes rarely contain glands
  – secondary sexual characteristic of females
  – mammary glandular tissue found only during lactation
    and pregnancy
     • modified apocrine sweat gland
     • thicker secretion released by ducts open on the nipple
• Mammary ridges or milk lines
  – 2 rows of mammary glands in most mammals
  – primates kept only anteriormost glands
• Additional nipples (polythelia) may develop along
  milk line
Diseases of the Skin
• Most vulnerable organ to injury & disease
   – skin diseases common in old age
• Skin cancer
   – induced by UV rays of the sun
      • most common in fair-skinned and elderly
   – basal cell carcinoma
      • arises from stratum basale & invades dermis
      • treated by surgical removal & radiation
   – squamous cell carcinoma
      • arises from keratinocytes in the stratum spinosum
      • metastasis to the lymph nodes can be lethal
   – malignant melanoma (most deadly cancer)
      • arises from melanocytes of a preexisting mole
      • ABCD--asymmetry, border irregular, color
        mixed & diameter over 6 mm
Burns
• Causes of burns -- hot water, sunlight, radiation, electric
  shock or acids and bases
• Causes of deaths
   – fluid loss, infection, & effects of (eschar) dead tissue
• Degrees of burns
   – 1st-degree = only the epidermis (red, painful & edema)
   – 2nd-degree = epidermis & part of dermis (blistered)
      • epidermis regenerates from hair follicles & sweat glands
   – 3rd-degree = epidermis, dermis & more is destroyed
      • often requires grafts or fibrosis & disfigurement may occur
• Treatment -- fluid replacement & infection control
   – debridement and IV proteins, nutrients & fluids
Burns
UVA, UVB & Sunscreens

• UVA & UVB are called “tanning rays” and
  “burning rays”
  – both can burn as well as tan
• Both thought to initiate skin cancer
• As sale of sunscreens has risen so has skin
  cancer
  – those who use have higher incidence of basal cell
  – chemical in sunscreen damage DNA & generate
    harmful free radicals
     • PABA, zinc oxide & titanium dioxide
Skin Grafts & Artificial Skin
• Third-degree burns require skin grafts
• Graft options
  – autograft -- tissue from different region of patient
  – isograft -- skin graft tissue from identical twin
  – cultured keratinocyte patches
• Temporary graft options (immune system)
  –   homograft (allograft) -- graft from unrelated person
  –   heterograft (xenograft) -- tissue from another species
  –   amnion from an afterbirth
  –   artificial skin from silicone and collagen

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Rola A Hanania

  • 1. Chapter 6 The Integumentary System • Epidermis and dermis • Hypodermis • Thick and thin skin • Skin color • Functions of the skin • Hair and nails • Cutaneous glands
  • 2. Overview of the Skin • Largest organ of the body (15% of body weight) • Epidermis – stratified squamous epithelium – contains 5 layers • Dermis – connective tissue layer • Skin rests on subcutaneous layer or hypodermis • Skin thickness variable, normally 1-2 mm – thicker when dermis is thicker, up to 6 mm – called thick skin if stratum corneum layer is increased • calluses on hands and feet, no hair follicles or oil glands
  • 3. Cell Types & Layers of the Epidermis
  • 4. 5 Layers of the Epidermis 5 Superficial 4 3 2 1 Deep
  • 5. Stratum Basale • Single layer of cuboidal or low columnar cells sitting on basement membrane • Cell types in this layer – keratinocytes • undergo mitosis to replace epidermis • most of cells of epidermis – melanocytes synthesize melanin • distribute melanin from cell processes • melanin picked up by keratinocytes & used to shade their nuclei from UV radiation – Merkel cells are touch receptors associated with nerve fibers to form Merkel disc
  • 6. Stratum Spinosum • Several layers of keratinocytes thick – appear spiny due to shrinkage during histological preparation • Contains dendritic (Langerhans) cells – macrophages from bone marrow that migrate to the epidermis – 800 cells/millimeter2 – help protect body against pathogens by “presenting” them to the immune system
  • 7. Stratum Granulosum • 3 to 5 layers of flat keratinocytes • Contain keratinohyalin granules – combine with filaments of cytoskeleton to form keratin • Produces lipid-filled vesicles that release a glycolipid by exocytosis to waterproof the skin – forms a barrier between surface cells and deeper layers of the epidermis – cuts off surface strata from nutrient supply
  • 8. Stratum Lucidum • Thin translucent zone seen only in thick skin • Keratinocytes are packed with eleidin, a precursor to keratin – does not stain well • Cells have no nucleus or organelles
  • 9. Stratum Corneum • Up to 30 layers of dead, scaly, keratinized cells – surface cells flake off (exfoliate)
  • 10. The Dermis • Thickness = 0.6mm to 3mm • Composition – collagen, elastic & reticular fibers, fibroblasts & accessory structures such as hair follicles and glands • Dermal papillae are upward extensions of the dermis into the epidermis forming the ridges of the fingerprints • Layers – papillary layer is areolar tissue & dermal papillae of upper 1/5 of the dermis – reticular layer is deeper part of dermis
  • 11. Layers of the Dermis • Papillary layer • Reticular layer
  • 12. The Hypodermis • Known as subcutaneous tissue or superficial fascia • Has more adipose than dermis • Functions – energy reservoir – thermal insulation • Hypodermic injections – into subcutaneous tissue Hypodermis since highly vascular
  • 14. Skin Colors (Pigmentation) • Hemoglobin is red pigment of red blood cells – visible through dermal collagen fibers • Carotene is yellow pigment of vegetables & egg yolks – concentrates in stratum corneum & subcutaneous fat • Melanin pigment produced by melanocytes – pigment synthesis stimulated by UV radiation from sunlight – produces yellow, brown, black and reddish hues
  • 15. Abnormal Skin Colors • Cyanosis is blueness resulting from deficiency of oxygen in the circulating blood (cold weather) • Erythema is redness due to dilated cutaneous vessels (anger, sunburn, embarrassment) • Jaundice is yellowing of skin & sclera due to excess of bilirubin in blood (liver disease) • Bronzing is golden-brown color of Addison disease (deficiency of glucocorticoid hormone) • Pallor is pale color from lack of blood flow • Albinism is a genetic lack of melanin • Hematoma is a bruise (visible clotted blood)
  • 16. Skin Markings • Hemangiomas (birthmarks) – discolored skin caused by benign tumors of dermal blood capillaries (strawberry birthmarks disappear in childhood -- port wine birthmarks last for life) • Freckles & moles = aggregations of melanocytes – freckles are flat; moles are elevated • Friction ridges leave oily fingerprints on touched surfaces – unique pattern formed during fetal development • Flexion creases form after birth by repeated closing of the hand • Flexion lines form in wrist & elbow areas
  • 17. Functions of the Skin • Barrier = tough, dry, acid mantle, water barrier, UV barrier • Vitamin D synthesis – begins in epidermal keratinocytes under influence of UV light – helps maintain health of skeleton • Sensory functions – receptors for heat, cold, touch, pressure, vibration & pain • Thermoregulation = thermoreceptors and sweat glands – hypothalamus constricts or dilates cutaneous arteries and sweat glands to retain or dissipate heat • Psychological and social functions – appearance & social acceptance – facial expression and nonverbal communication
  • 18. Characteristics of Human Hair • Stratum corneum of the skin is composed of pliable soft keratin • Hair and nails are composed of hard keratin – toughened by disulfide bridges between molecules • Hair found almost everywhere on the body – differences between sexes or individuals is really difference in texture and color of hair • 3 different body hair types – lanugo -- fine, unpigmented fetal hair – vellus -- fine, unpigmented hair of children & women – terminal hair -- coarse, long, pigmented hair of scalp
  • 19. Structure of Hair and Follicle • Hair is filament of keratinized cells – shaft is visible above skin; root is below within follicle; – in cross section: medulla, cortex and cuticle layers • Follicle is oblique tube within the skin – bulb is swelling in base where hair originates – vascular tissue (papilla) in bulb provides nutrients – cells lining the follicle interlock with scales of cuticle to resist pulling on the hair • Texture and cross-sectional shape of hair – straight hair is round, wavy is oval and kinky is flat • Hair color is due to pigment in cells of cortex
  • 20. Eumelanin pigment colors brown and black hair.
  • 21. Blond hair contain sulfur-containing pheomelanin pigment.
  • 22. Red hair contains eumelanin and pheomelanin pigments.
  • 23. White hair is due to air in medulla & lack of pigment in cortex. Gray hair is a mixture of white and pigmented hairs.
  • 24. Structure of Hair Follicle • Epithelial root sheath is an extension of the epidermis (lies next to hair root) • Connective tissue root sheath is derived from the dermis (surrounds it) • Hair receptors entwine each follicle • Piloerector muscle – goose bumps
  • 25. Structure of Hair Follicle
  • 26. Hair Growth and Loss • Hair cycle = 3 repeating cycles – anagen is growth stage (.3mm/day in young adult) • lasts 6-8 years in young adult, 90% of scalp follicles – catagen is shrinking follicle (lasts 2-3 weeks) – telogen is resting stage (lasts 1-3 months • Hair growth during anagen follows specific steps: – stem cells in follicles>epithelial root sheath>hair matrix>hair cells that keratinize and die • Thinning or baldness = alopecia • Pattern baldness = genetic and hormonal – sex-influenced trait(dominant in males, recessive in females); expressed only with high testosterone levels • Hirsutism = excessive hair growth – hormone imbalance (ovary or adrenal cortex problem)
  • 27. Functions of Hair • Body hair – too thin to provide warmth – alert us to parasites crawling on skin • Scalp hair provides heat retention & sunburn cover – sex and individual recognition • Beard, pubic & axillary hair indicate sexual maturity & help distribute sexual scents • Guard hairs & eyelashes prevent foreign objects from getting into nostrils, ear canals or eyes •
  • 28. Nails • Clear, hard derivative of stratum corneum – densely packed cells filled with hard keratin • Flat nails allow for fleshy, sensitive fingertips – eponychium = cuticle • Growth rate is 1 mm per week – new cells added by mitosis in the nail matrix • growth zone at proximal edge of nail – nail bed is skin on which nail plate rests – hyponychium is epithelium of nail bed
  • 29.
  • 30. Cutaneous Glands • Sweat glands – merocrine – apocrine • Sebaceous glands • Ceruminous glands • Mammary glands
  • 31. Sweat Glands • Filtrate of plasma containing some waste products – 500 ml of insensible perspiration/day – sweating with visible wetness is diaphoresis • Merocrine glands is simple tubular gland – millions of them (size of kidney) – cool the body • Apocrine glands produce sweat containing fatty acids – found only near hair follicles & respond to stress & sex – bromhidrosis is body odor produced by bacterial action on fatty acids
  • 32. Sebaceous Glands • Oily secretion called sebum that contains broken- down cells – lanolin in skin creams is sheep sebum • Flask-shaped gland with duct that opens into hair follicle
  • 33. Ceruminous Glands • Found only in external ear canal • Their secretion combines with sebum to produce earwax – waterproof keeps eardrum flexible – bitterness repel mites & other pests
  • 34. Mammary Glands • Breasts of both sexes rarely contain glands – secondary sexual characteristic of females – mammary glandular tissue found only during lactation and pregnancy • modified apocrine sweat gland • thicker secretion released by ducts open on the nipple • Mammary ridges or milk lines – 2 rows of mammary glands in most mammals – primates kept only anteriormost glands • Additional nipples (polythelia) may develop along milk line
  • 35. Diseases of the Skin • Most vulnerable organ to injury & disease – skin diseases common in old age • Skin cancer – induced by UV rays of the sun • most common in fair-skinned and elderly – basal cell carcinoma • arises from stratum basale & invades dermis • treated by surgical removal & radiation – squamous cell carcinoma • arises from keratinocytes in the stratum spinosum • metastasis to the lymph nodes can be lethal – malignant melanoma (most deadly cancer) • arises from melanocytes of a preexisting mole • ABCD--asymmetry, border irregular, color mixed & diameter over 6 mm
  • 36. Burns • Causes of burns -- hot water, sunlight, radiation, electric shock or acids and bases • Causes of deaths – fluid loss, infection, & effects of (eschar) dead tissue • Degrees of burns – 1st-degree = only the epidermis (red, painful & edema) – 2nd-degree = epidermis & part of dermis (blistered) • epidermis regenerates from hair follicles & sweat glands – 3rd-degree = epidermis, dermis & more is destroyed • often requires grafts or fibrosis & disfigurement may occur • Treatment -- fluid replacement & infection control – debridement and IV proteins, nutrients & fluids
  • 37. Burns
  • 38. UVA, UVB & Sunscreens • UVA & UVB are called “tanning rays” and “burning rays” – both can burn as well as tan • Both thought to initiate skin cancer • As sale of sunscreens has risen so has skin cancer – those who use have higher incidence of basal cell – chemical in sunscreen damage DNA & generate harmful free radicals • PABA, zinc oxide & titanium dioxide
  • 39. Skin Grafts & Artificial Skin • Third-degree burns require skin grafts • Graft options – autograft -- tissue from different region of patient – isograft -- skin graft tissue from identical twin – cultured keratinocyte patches • Temporary graft options (immune system) – homograft (allograft) -- graft from unrelated person – heterograft (xenograft) -- tissue from another species – amnion from an afterbirth – artificial skin from silicone and collagen