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Skin and Fascia
 Describe layers of skin.
 Enlist the functions of skin.
 Define appendages of skin.
 Define Fascia.
 Differentiate between Superficial and Deep
Fascia.
 Applied Anatomy
 The tissue: is a group of cells which
perform a specific function
 There are four basic tissues:
1.Epithelium
2.Connective tissue
3.Muscular tissue
4.Nervous tissue
Normal skin is a very complex organ
 The skin is one of the largest organs of the
body: 76oo sq cm
 1-Protection
 continuous and covers the body as well as
protects the deep tissues
 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- Excretion
 through the secretion of sweat.
 6- Psychological and social functions
 appearance and social acceptance
 facial expression and nonverbal
communication
 Keratinized stratified squamous
epithelium devoid of blood vessels
 Connective tissue
containing (bl. v.
lymph v., sensory
nerve endings,
smooth m, hair
follicles, sweat and
sebaceous glands)
 In its deep part the
collagen bundles
are arranged in
parallel rows
• Keratinocytes (90%)- waterproofs & protects skin,
nails, hair, stratum corneum
• Melanocytes (8%)- produce melanin
• Merkel Cells- slow mechanoreceptors
• Langerhans’ Cells- immunological defense
• Stratum Corneum
• Stratum Lucidum
• Stratum Granulosum
• Stratum Spinosum
• Stratum Basale-
(Germinativum)
Thickness is increased:
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.
Dermis
papillary dermis
reticular dermis
a. Cellular
Fibroblasts (synthesize collagen, elastin, and reticulin),
histiocytes, endothelial cells, perivascular macrophages and
dendritic cells, mast cells, smooth muscle, and cells of peripheral
nerves
b. Fibrous
Collagen & reticulin - provide tensile strength
Elastic fibers- provide for restoration of shape after a deformation
c. Ground substance
glycosaminoglycans: hyaluronic acid, chondroitin sulfate, and
dermatan sulfate.
This layer contains adipose tissue and serves to attach the dermis to its underlying tissues.
Hypodermis
• The collagen fibers, arranged in parallel rows,
called:
Lines of cleavage (langer’s 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.
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.
Folded skin over the
joints.
Skin is thin and is
firmly adherent to
underlying structures.
Some variations in human skin color
Sub-Saharan African, Indian, Southern European, Northwest European
 Due to Melanin, a pigment in the
epidermis and Carotene,
 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.
• Cyanotic
• Jaundice
• Erythema
• Pallor
• Pigmentation levels usually increase with
age.
- exception: premature graying
• Normal pigmentation may be altered by
genetic defects or by acquired diseases.
-Hyperpigmentation- age spots
-Hypopigmentation- vitiligo,
albinism
External agents can also alter skin color.
• lightening agents
• carotene
• dyes
• Some internal compounds--such as the byproducts
of hemoglobin metabolism--may color the skin.
Pathogenic organisms can
enter to the tissue through :
• Nail Folds
• Hair Follicles
• Sebaceous Glands
Staphylococcus:
A type of bacteria that causes
skin infections.
Malignant melanoma
• 2% of all cancers
Risks:
1. Skin type
2. Sun exposure
3. Family history
4. Age
5. Immunological status
• A= asymmetry
• B= border
• C= color
• D= diameter
Normal mole Melanoma
• Nails
• Hairs
• Sebaceous glands
• Sweat glands
A nail is a flat horny plate on
the dorsal surface of tips of
the fingers and toes
It has:
Root: proximal edge (part
embedded in skin)
body: exposed part & has a
free distal edge
Nail fold: folds of skin
surround and overlap the
nail
• Nail bed is very vascular causing
pink color of the nail
• The germinative zone lies beneath
the root& is responsible for growth
of nail
Cover whole surface of
the body except some
areas as lips, palms, soles,
some genital areas
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.
• 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.
Functions:
•Its contraction causes the
hair to move into a more
vertical position.
• It compresses the
sebaceous gland and
causes it to extrude sebum.
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.
It occurs because of the
obstruction (blocking) of the
sebaceous duct.
• 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.
Deep
Superficial
Heals slowly from the edges.
Usually needs skin grafting.
Heals rapidly from the edges,.
Heals quickly.
Doesn’t need a skin graft.
Graft is transferring tissue from one site to another.
Skin graft is needed when the skin is damaged ( usually by deep
burning )
Full thickness grafting
Split thickness grafting
Transferring epidermis only Transferring both
epidermis and dermis.
Skin Graft
Collection of connective tissue
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 (devoid of adipose
tissue).
Functions:
• Facilitates movement of skin over underlying structures.
• Passage for cutaneous vessels, nerves.
• Protects the body against heat loss.
It is more dense than superficial fascia
Collagenous bundles are more compact and
more regularly arranged
It is usually present in the form of membranes
A. Intermuscular septa
lie between muscles dividing
the limb into compartments
Examples of deep 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
Examples of deep fascia
C. Retinacula
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skin_&_fascia.ppt

  • 2.  Describe layers of skin.  Enlist the functions of skin.  Define appendages of skin.  Define Fascia.  Differentiate between Superficial and Deep Fascia.  Applied Anatomy
  • 3.  The tissue: is a group of cells which perform a specific function  There are four basic tissues: 1.Epithelium 2.Connective tissue 3.Muscular tissue 4.Nervous tissue
  • 4.
  • 5. Normal skin is a very complex organ  The skin is one of the largest organs of the body: 76oo sq cm
  • 6.  1-Protection  continuous and covers the body as well as protects the deep tissues  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+
  • 7.  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
  • 8. 5- Excretion  through the secretion of sweat.  6- Psychological and social functions  appearance and social acceptance  facial expression and nonverbal communication
  • 9.
  • 10.
  • 11.  Keratinized stratified squamous epithelium devoid of blood vessels  Connective tissue containing (bl. v. lymph v., sensory nerve endings, smooth m, hair follicles, sweat and sebaceous glands)  In its deep part the collagen bundles are arranged in parallel rows
  • 12.
  • 13. • Keratinocytes (90%)- waterproofs & protects skin, nails, hair, stratum corneum • Melanocytes (8%)- produce melanin • Merkel Cells- slow mechanoreceptors • Langerhans’ Cells- immunological defense
  • 14. • Stratum Corneum • Stratum Lucidum • Stratum Granulosum • Stratum Spinosum • Stratum Basale- (Germinativum)
  • 15.
  • 16. Thickness is increased: 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.
  • 19. a. Cellular Fibroblasts (synthesize collagen, elastin, and reticulin), histiocytes, endothelial cells, perivascular macrophages and dendritic cells, mast cells, smooth muscle, and cells of peripheral nerves b. Fibrous Collagen & reticulin - provide tensile strength Elastic fibers- provide for restoration of shape after a deformation c. Ground substance glycosaminoglycans: hyaluronic acid, chondroitin sulfate, and dermatan sulfate.
  • 20. This layer contains adipose tissue and serves to attach the dermis to its underlying tissues. Hypodermis
  • 21. • The collagen fibers, arranged in parallel rows, called: Lines of cleavage (langer’s 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.
  • 22. These lines are important to determine the direction for an incision (cut) during a surgery to avoid obvious scars.
  • 23. • 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.
  • 24. Folded skin over the joints. Skin is thin and is firmly adherent to underlying structures.
  • 25. Some variations in human skin color Sub-Saharan African, Indian, Southern European, Northwest European
  • 26.  Due to Melanin, a pigment in the epidermis and Carotene,  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.
  • 27. • Cyanotic • Jaundice • Erythema • Pallor
  • 28. • Pigmentation levels usually increase with age. - exception: premature graying • Normal pigmentation may be altered by genetic defects or by acquired diseases. -Hyperpigmentation- age spots -Hypopigmentation- vitiligo, albinism
  • 29. External agents can also alter skin color. • lightening agents • carotene • dyes • Some internal compounds--such as the byproducts of hemoglobin metabolism--may color the skin.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.
  • 35.
  • 36. Pathogenic organisms can enter to the tissue through : • Nail Folds • Hair Follicles • Sebaceous Glands Staphylococcus: A type of bacteria that causes skin infections.
  • 37.
  • 38. Malignant melanoma • 2% of all cancers Risks: 1. Skin type 2. Sun exposure 3. Family history 4. Age 5. Immunological status • A= asymmetry • B= border • C= color • D= diameter Normal mole Melanoma
  • 39.
  • 40. • Nails • Hairs • Sebaceous glands • Sweat glands
  • 41. A nail is a flat horny plate on the dorsal surface of tips of the fingers and toes It has: Root: proximal edge (part embedded in skin) body: exposed part & has a free distal edge Nail fold: folds of skin surround and overlap the nail • Nail bed is very vascular causing pink color of the nail • The germinative zone lies beneath the root& is responsible for growth of nail
  • 42. Cover whole surface of the body except some areas as lips, palms, soles, some genital areas
  • 43. 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.
  • 44. • 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.
  • 45. Functions: •Its contraction causes the hair to move into a more vertical position. • It compresses the sebaceous gland and causes it to extrude sebum.
  • 46. 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.
  • 47. It occurs because of the obstruction (blocking) of the sebaceous duct.
  • 48. • 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.
  • 49. Deep Superficial Heals slowly from the edges. Usually needs skin grafting. Heals rapidly from the edges,. Heals quickly. Doesn’t need a skin graft.
  • 50.
  • 51. Graft is transferring tissue from one site to another. Skin graft is needed when the skin is damaged ( usually by deep burning )
  • 52. Full thickness grafting Split thickness grafting Transferring epidermis only Transferring both epidermis and dermis. Skin Graft
  • 53.
  • 54. Collection of connective tissue Deep fascia Superficial fascia
  • 55.
  • 56.
  • 57. 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 (devoid of adipose tissue). Functions: • Facilitates movement of skin over underlying structures. • Passage for cutaneous vessels, nerves. • Protects the body against heat loss.
  • 58.
  • 59. It is more dense than superficial fascia Collagenous bundles are more compact and more regularly arranged It is usually present in the form of membranes
  • 60. A. Intermuscular septa lie between muscles dividing the limb into compartments Examples of deep fascia
  • 61. • 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
  • 62.
  • 63. Examples of deep fascia C. Retinacula