metsyS yratnemugetnI

TOPIC 4 THE INTEGUMENTARY SYSTEM

The organs of the integumentary system include the skin

and its accessory structures including hair, nails, and glands,
as well as blood vessels, muscles and nerves.
Dermatology is the medical specialty for the diagnosis and
treatment of disorders of the integumentary system.
FUNCTIONS of THE INTEGUMENT
Cushions and insulates deeper organs
Protects body from abrasion, trauma, chemicals, pathogens,
temperature extremes and UV rays
Excretion and secretion
Contains sensory receptors associated with nerve endings
Synthesis and storage of nutrients (vitamin D3)
Two major types of skin:
Thin (hairy) skin covers all body regions except the palms,
palmar surfaces of digits, and soles
Thick (hairless) skin covers the palms, palmar surfaces of
digits, and soles
TOPIC 4 THE INTEGUMENTARY SYSTEM

Structure of the Skin

The skin (cutaneous membrane) covers the body and is the
largest organ of the body by surface area and weight.
Its area is about 2 square meters (22 square feet) and weighs
4.5 to 5kg about 16% of body weight and is 0.5 – 4 mm thick
The average thickness is 1 – 2 mm

two major layers:

Outer, thinner layer called the epidermis, consists of
epithelial tissue
Inner, thicker layer called the dermis
Beneath the dermis is a subcutaneous layer(hypodermis) which
attaches the skin to the underlying tissues and organs.

The Epidermis
Stratified squamous epithelium
The epidermis is composed of keratinized stratified
squamous epithelium.
Has Several distinct cell layers:
1. Thick skin—five layers on palms and soles
2. Thin skin—four layers on rest of body (does not contain stratum
lucidum)
 TOPIC 4 THE INTEGUMENTARY SYSTEM
Four Major Types of Cells: Epidermis
Keratinocytes - Arise from deepest layer of epidermis to stratum The epidermis contains four major layers (thin skin) or five major layers
spinosum. (thick skin):
Produce keratin (tough fibrous protein) and antibodies and enzymes
Keratinocytes are dead at skin's surface Stratum basale (deepest layer) or stratum germinativum, where
continuous cell division occurs which produces all the other layers
Melanocytes Stratum spinosum, 8-10 layers of keratinocytes
Found in basal layer. Stratum granulosum, which includes keratohyalin and lamellar
Manufacture and secrete pigment melanin that protects the skin granules
Stratum lucidum is present only in thick skin (the skin of the
Langerhans cells fingertips, palms, and soles)
Dendritic (langerhans) cells Stratum corneum - composed of many sublayers of flat, dead
Arise from red bone marrow keratinocytes called corneocytes or squames that are continuously
Can be found in the Stratum spinosum shed and replaced by cells from deeper strata.
In immune responses, part of immune system macrophage-like
Keratinization, the accumulation of more and more protective
Merkel cells keratin, occurs as cells move from the deepest layer to the surface
Tactile cells or Receptor cells associated with nerve fibers layer
Function in the sensation of touch along with the adjacent tactile Dandruff - an excess of keratinized cells shed from the scalp
discs Dermis
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Dermis Sensation
Second major layer of the skin Control of blood flow and secretion
Provides mechanical strength, flexibility, and protection for indicate the predominant direction of underlying collagen fibers
underlying tissues. Epidermal ridges reflect contours of the underlying dermal papillae
Highly vascular and contains a variety of sensory receptors that and form the basis for fingerprints (and footprints); their function is
provide information about the external environment to increase firmness of grip by increasing friction.
Two layers Dermatoglyphics - the study of the pattern of epidermal ridges.
Papillary layer – includes dermal papillae
- Underlies epidermis Hypodermis
- Named for dermal papillae Subcutaneous Layer -
- Aerolar connective tissue Composed of loose connective tissue - areolar and adipose
- it supports, nourishes epidermis and provides sensory nerves, Stabilizes skin position, loosely attached to dermis, loosely attached
lymphatics, and capillaries to muscle.
Reticular layer - deeper layer and consists of 80% of thickness of Contains many fat cells, Provides thermal insulation, Cushions
dermis underlying organs.
Tough, dense, fibrous layer Safely receives hypodermic needles
Dense irregular connective tissue
Collagen fibers - limit stretch
Elastic fibers - provide flexibility
Blends into papillary layer(above) and into subcutaneous layer(below)
Flexure lines - creases on palms
Epidermal accessory organs
Cells of connective tissues proper
Communication with other organ systems
- Cardiovascular, Lymphatic, Nervous
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Structural Basis of Skin Color
Variations in skin color arise from variations in the amounts of three
pigments:
- Melanin
-Carotene
Hemoglobin

A benign localized overgrowth of melanocytes is a nevus or mole.

Albinism is an inherited inability to produce melanin.
Vitiligo is a condition in which there is a partial or complete loss of
melanocytes from patches of skin.
Sources of Skin Color
Melanocytes - Make melanin from tyrosine
- Melanin provides UV protection
- Gives reddish-brown to brown-black color
Carotene - Contributes orange-yellow color
Provided from diet (carrots and tomatoes)
Hemoglobin - blood pigment
- Caucasian skin contains little melanin
- Allows crimson color of blood to show through
-Pinkish to Redish
Accessory Structures of the Skin
Include hair, skin glands, and nails
Hairs (pili) have a number of important functions:
protection, reduction of heat loss, sensing light touch
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Hair Types and Growth of Hair

Filamentous strands of dead keratinized cells produced by hair Vellus hairs
follicles -Body hairs of women and children
Contains hard keratin which is tougher and more durable than soft Terminal hairs
keratin of the skin -Hair of scalp, Axillary and pubic area (at puberty)
Chief parts of a hair Hair thinning and baldness
Root – imbedded in the skin -Due to aging (Male pattern baldness)
Shaft – projects above skin's surface
Hair Color and Texture
Functions of hair include: Brunette - Eumelanin pigment colors brown and black hair.
Helping to maintain Warmth, Alerting the body, Guarding the scalp Blonde - Blond hair contain pheomelanin pigment, but little
against physical trauma, heat loss, and sunlight. eumelanin.
Hair is distributed over the entire skin surface except: Palms, Red - Red hair contains little eumelanin but lots of pheomelanin.
soles, and lips White hair - air in medulla and lack of pigment in cortex.
Nipples and portions of the external genitalia Gray hair is a mixture of white and pigmented hairs.
There are different types of hairs including lanugo, vellus hairs and
terminal hairs.
Hair color is determined by the amount and type of melanin
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Skin Glands Sweat (Sudoriferous) Glands

Sebaceous glands secrete an oily substance called sebum which Two types:
prevents dehydration of hair and skin, and inhibits growth of certain 1. Eccrine (Merocrine)
bacteria -Most abundant sweat gland also known as “True sweat”
Sudoriferous (sweat) glands-- 2 types: - 99% water with some salts
- Eccrine sweat glands - Contains traces of metabolic wastes ~ 2% urea
- Apocrine sweat glands - Role in thermoregulation
- Widely present in skin (up to500/cm2)
Sebaceous Glands (oil glands) 2. Apocrine
Occur over entire body - Except palms and soles - Odorous secretion (Absent before puberty)
Simple alveolar glands - Present in axillary, areolar, anal and genital areas
- Holocrine secretion – entire cell breaks up to form secretion Modified sweat glands located in the ear canal
- Secretes an oily substance called sebum Along with nearby sebaceous glands, they are involved in producing a
- Most are associated with a hair follicle waxy secretion called cerumen (earwax) which provides a sticky barrier
Functions of sebum that prevents entry of foreign bodies into the ear canal.
- Softens and lubricates hair and skin
- Skin waterproofing
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Nails Aging of the Skin

Nails are composed of hard, keratinized epidermal cells located Major Age-Related Changes
over the dorsal surfaces of the ends of fingers and toes - Injury and infection increase
Each nail consists of: - Immune cells decrease
- free edge - Sun protection diminishes
- transparent nail body (plate) with a whitish lunula at its base -Skin becomes dry, scaly
- nail root embedded in a fold of skin - Hair thins, grays
Skin Injury and Repair - Sagging, wrinkles occur
Four Stages in Skin Healing - Heat loss decreases
Inflammation
- Repair slows
- Blood flow increases and Phagocytes attracted
Scab formation
Effects of UV Radiation
Cell division and migration
Beneficial effect - activates synthesis of vitamin D3
Scar formation
Harmful effects -
- Sun burn
- Wrinkles, premature aging
- Malignant melanoma
- Basal cell carcinoma
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Skin Cancer
Skin cancer – induced by the ultraviolet rays of the sun
most often on the head and neck
most common in fair-skinned people and the elderly
one of the most common cancers
one of the easiest to treat
has one of the highest survival rates if detected and treated early
three types of skin cancer named for the epidermal cells in which
they originate
Basal cell carcinoma, Squamous cell carcinoma, and Malignant
melanoma

Basal cell carcinoma

- Least malignant and most common
Squamous cell carcinoma
- Arises from keratinocytes of stratum spinosum
Melanoma
- A cancer of melanocytes
- The most dangerous type of skin cancer
Skeleta
lS
ystem
TOPIC 5 THE SKELETAL SYSTEM
Introduction
Human skeleton initially cartilages and fibrous membranes
Hyaline cartilage is the most abundant cartilage
By age 25 the skeleton is completely hardened
206 bones make up the adult skeleton (20% of body mass)
80 bones of the axial skeleton and 126 bones of the appendicular skeleton

Functions of Bone
Support, Movement & Protection • Gives shape to head, etc.
- Supports body’s weight
- Protects lungs, etc.
- Bones and muscles interact • When limbs or body parts move
- Blood Cell Formation
Inorganic Salt Storage
- Calcium
- Phosphate
- Magnesium • Sodium
- Potassium

Blood Cell Formation

-Also known as hematopoiesis
- Occurs in the red bone marrow
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Classification of Bone on the Basis of Shape

Bone Classification:
- Long Bones
- Short Bones
- Sesamoid (round) Bones
- Flat Bones
- Irregular Bones • Wormian (sutural) Bones

Gross Anatomy of Long Bone

- Diaphysis (Shaft) - Composed of compact bone
- Epiphysis (Ends of the bone) - Composed mostly of spongy bone

Structures of Long Bone

- Periosteum (Outside covering of the diaphysis) - Fibrous connective tissue membrane
- Sharpey’s fibers (Secure periosteum to underlying bone)
- Arteries (Supply bone cells with nutrients0
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Articular cartilage
- Covers the external surface of the epiphyses
- Made of hyaline cartilage
- Decreases friction at joint surfaces

Medullary cavity
-Cavity of the shaft
-Contains yellow marrow (mostly fat) in adults
-Contains red marrow (for blood cell formation) in infants

Bone Markings
Surface features of bones
Sites of attachments for muscles, tendons, and ligaments
Passages for nerves and blood vessels
Categories of bone markings
Projections and processes – grow out from the bone surface
Depressions or cavities – indentations
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Microscopic Anatomy of Bone

Osteon (Haversian System) - unit of bone
Central (Haversian) canal
- Opening in the center of an osteon
Perforating (Volkman’s) canal
- Canal perpendicular to the central canal
- Both Canals carry blood vessels and nerves
Lacunae
- Cavities containing bone cells (osteocytes)
- Arranged in concentric rings
Lamellae
- Rings around the central canal
- Sites of lacunae
Canaliculi
- Tiny canals
- Radiate from the central canal to lacunae
-Form a transport system
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Microscopic Structure
Bone cells (osteocytes)
Osteocytes transport nutrients and wastes
The extracellular matrix of bone is largely collagen and inorganic salts
-Collagen gives bone resilience
-Inorganic salts make bone hard

Compact Bone
Osteon (Haversian System)
Central canal
Perforating canal (Volkmann’s canal)
Osteocytes
Lamellae
Lacunae
Bone matrix
Canaliculi

Spongy Bone
Spongy Bone (Cancellous Bone)
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Types of Bone Cells
• Osteocytes (Mature bone cells)
• Osteoblasts (Bone-forming cells)
• Osteoclasts (Bone-destroying cells)
- Break down bone matrix for remodeling and release of calcium
- Bone remodeling is a process by both osteoblasts and osteoclasts

Bone Development and Growth

- Parts of the skeletal system begin to develop during the first few weeks of prenatal development
- Bones replace existing connective tissue in one of two ways:
As intramembranous bones and endochondral bones

Intramembranous & Endochondral Bones

Intramembranous Bones
- These bones originate within sheetlike layers of connective tissues and are the broad, flat bones
- Skull bones (except mandible) are known as intramembranous bones
Endochondral Bones
- Bones begin as hyaline cartilage
- Form models for future bones
- These are most bones of the skeleton known as endochondral bones
TOPIC 5 THE SKELETAL SYSTEM
Types of Bone Cells
Osteocytes (Mature bone cells)
Osteoblasts (Bone-forming cells)
Osteoclasts (Bone-destroying cells)
- Break down bone matrix for remodeling and release of calcium
- Bone remodeling is a process by both osteoblasts and osteoclasts

Bone Development and Growth

Parts of the skeletal system begin to develop during the first few weeks of prenatal development
Bones replace existing connective tissue in one of two ways:
As intramembranous bones and endochondral bones

Intramembranous & Endochondral Bones

Intramembranous Bones
- These bones originate within sheetlike layers of connective tissues
- They are the broad, flat bones
- Skull bones (except mandible) are known as intramembranous bones
Endochondral Bones
- Bones begin as hyaline cartilage
- Form models for future bones
- These are most bones of the skeleton are known as endochondral bones
TOPIC 5 THE SKELETAL SYSTEM

Homeostasis of Bone Tissue

Bone Resorption – action of osteoclasts and parathyroid hormone a.k.a. parathormone aka PTH
Bone Deposition – action of osteoblasts and calcitonin
- Occurs by direction of the thyroid and parathyroid glands

Factors Affecting Bone Development, Growth and Repair

Deficiency of VitaminA – retards bone development
Deficiency of VitaminC – results in fragile bones
Deficiency of VitaminD – rickets, osteomalacia
Insufficient Growth Hormone – dwarfism
Excessive Growth Hormone – gigantism, acromegaly
Insufficient Thyroid Hormone– delays bone growth
Sex Hormones – promote bone formation; stimulate ossification of epiphyseal plates
Physical Stress – stimulates bone growth
TOPIC 5 THE SKELETAL SYSTEM
Skeletal Organization
The actual number of bones in the human skeleton varies from person to person
Typically there are about 206 bones
For convenience the skeleton is divided into the:
1. Axial skeleton - Skull, Spine, Rib cage
2. Appendicular skeleton - Upper & Lower limbs, Shoulder & Pelvic girdle

Cranium
Frontal Bone
Forehead
Roof of nasal cavity
Roofs of orbits
Frontal sinuses
Supraorbital foramen
Coronal suture
TOPIC 5 THE SKELETAL SYSTEM
Cranium
Frontal Bone (1)
• Forehead
• Roof of nasal cavity
Roofs of orbits
• Frontal sinuses
• Supraorbital foramen
• Coronal suture

Parietal Bones (2)

Side walls of cranium
Roof of cranium
Sagittal suture

Occipital Bone (1)

Back of skull
Base of cranium
Foramen magnum
Occipital condyles
Lambdoidal suture
 TOPIC 5 THE SKELETAL SYSTEM
Temporal Bones (2)
Side & Walls floors of cranium
Floors and sides of orbits
Squamous suture
External acoustic meatus
Mandibular fossa
Mastoid, Styloid, Zygomatic process

Sphenoid Bone (1)

Base of cranium, Sides of skull
Floors and sides of orbits
Sella turcica
Sphenoid sinuses

Ethmoid Bone (1)

Roof and walls of nasal cavity
Floor of cranium
Wall of orbits
Cribriform plates, Perpendicular plate
Superior and middle nasal conchae
Ethmoid sinuses
Crista galli
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Facial Skeleton
Maxillary Bones (2)
Upper jaw
Anterior roof of mouth
Floors of orbits
Sides and Floor of nasal cavity
Alveolar processes
Maxillary sinuses
Palatine process

Palatine Bones (2)

‘L’ shaped bones located behind the maxillae
Posterior section of hard palate
Floor of nasal cavity
Lateral walls of nasal cavity

Zygomatic Bones (2)

Prominences of cheeks
Lateral walls of orbits
Floors of orbits
Temporal process
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Lacrimal Bones (2)
Medial walls of orbits
Groove from orbit to nasal cavity
Nasal Bones
Bridge of nose

Vomer Bone (1)

Inferior portion of nasal septum

Inferior Nasal Conchae

Extend from lateral walls of nasal cavity

Mandible Bone
Lower jaw
Body
Ramus
Mandibular condyle
Coronoid & Alveolar process
Mandibular & Mental foramen
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Paranasal Sinuses
Hollow portions of bones surrounding the nasal cavity
Functions of paranasal sinuses
Lighten the skull
Give resonance and amplification to voice

Hyoid Bone
The only bone that does not articulate with another bone
Serves as a moveable base for the tongue

Fetal Skull
The fetal skull is large compared to the infants total body length
Fontanelles – fibrous membranes connecting the cranial bones
Allow the brain to grow
Convert to bone within 24 months after birth
Fontanels – fibrous membranes
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Auditory Ossicles in the Middle Ear
The incoming sound waves make the eardrum vibrate, and the vibrations travel to three tiny bones in
the middle ear called the malleus, incus, and stapes—the Latin names for hammer, anvil, and stirrup.

Vertebral Column
The vertebral column, or spinal column, consists of many vertebrae separated by cartilaginous
intervertebral discs.
Cervical vertebrae (7)
Thoracic vertebrae (12)
Lumbar vertebrae (5)
Sacral (4-5 fused segments)
Sacrum is fused bone
Coccygeal (3-4 fused segments)
Coccyx is fused bone

Vertebral Column
Cervical, Thoracic, Lumbar, Sacral curvatures
Rib facets
Vertebral prominens
Intervertebral discs (IVD)
Intervertebral foramina (IVF)
 TOPIC 5 THE SKELETAL SYSTEM
Typical Vertebrae
Includes the following parts:
Vertebral body (A)
Pedicles (B)
Lamina (C)
Spinous process (D)
Transverse processes (E)
Vertebral foramen (F)
Facets (G)

Cervical Vertebrae
Atlas – 1st; supports head
Axis – 2nd; dens pivots to turn head
Transverse foramina
Bifid spinous processes
Vertebral prominens – useful landmark

Thoracic Vertebrae
Long spinous processes
Processes point inferiorly
Rib facets
 TOPIC 5 THE SKELETAL SYSTEM
Lumbar Vertebrae
Large bodies
Thick, short (almost square) spinous processes

Sacrum & Coccyx

4-5 fused segments
Median sacral crest
Posterior sacral foramina
Posterior wall of pelvic cavity
Sacral promontory aka base
Area toward coccyx is the apex
Coccyx aka tailbone
3-4 fused segments
 TOPIC 5 THE SKELETAL SYSTEM
Ribs
Humans have 12 pairs of ribs:
True ribs (7)
False ribs (5), of which:
Floating (2)

Rib Structure
Shaft
Head – posterior end; articulates with vertebrae (a)
Tubercle – articulates with vertebrae
Costal cartilage – hyaline cartilage

Sternum
Three (3) parts of the sternum:
Manubrium, Body, Xiphoid process
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Pectoral Girdle
Also known as the shoulder girdle
Clavicles (collarbone) - 2
Scapulae (shoulder blade) – 2
Supports upper limbs
True shoulder joint is simply the articulation of the humerus and scapula

Clavicles
Collarbone
Articulate with manubrium
Articulate with scapulae (acromion process)
First bone to begin ossification in the fetus
Last to complete ossification

Scapulae
Scapular Spine
Acromion process
Supraspinous fossa
Infraspinous fossa
Coracoid process (crow’s beak)
Glenoid fossa or cavity
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Upper Limb
Humerus - 2
Radius - 2
Ulna
Carpals - 16
Metacarpals - 10
Phalanges - 28

Humerus
- Head
- Greater & Lesser tubercle
- Anatomical & Surgical neck
- Deltoid tuberosity
- Capitulum (lateral)
- Trochlea (medial)
- Coronoid, Radial, Olecranon fossa
 TOPIC 5 THE SKELETAL SYSTEM
Radius
Lateral forearm bone
Head – rotates against the humerus and ulna
Radial tuberosity– biceps brachii attaches
Styloid process – lateral side of the distal end of the

Ulna
Medial forearm bone
Trochlear notch – semilunar notch
Olecranon process– extension of the ulna
Coronoid process– helps complete the “grip” of the ulna on the distal end of the humerus
Styloid process– medial side of distal end of ulna; articulates with bones of the wrist
TOPIC 5 THE SKELETAL SYSTEM
Wrist and Hand
Carpal Bones (16 total bones)
Scaphoid (boatlike)
Lunate (moonshape)
Triquetral (three-cornered)
Pisiform (pea-shaped)
Hamate (hook)
Capitate (os magnum)
Trapezoid (lesser multangular)
Trapezium (greater multangular)
Metacarpal Bones (10)
Phalangeal Bones (28)
Proximal phalanx
Middle phalanx
Distal phalanx

Pelvic Girdle
Coxal Bones (2)
Supports trunk of body
Protects viscera
Forms pelvic cavity
TOPIC 5 THE SKELETAL SYSTEM
Hip Bones
Acetabulum (vinegar cup)
There are three (3) bones:
1. Ilium (most superior)
Iliac crest, Iliac spines, Greater sciatic notch
2. Ischium (inferior & posterior)
Ischial spines
Lesser sciatic notch
Ischial tuberosity
3. Pubis (inferior & anterior)
Obturator foramen
Symphysis pubis
Pubic arch

Greater and Lesser Pelvis

Greater Pelvis
Lumbar vertebrae posteriorly
Iliac bones laterally
Abdominal wall anteriorly
Lesser Pelvis
Sacrum and coccyx posteriorly
Lower ilium, ischium, and pubic bones laterally and anteriorly
TOPIC 5 THE SKELETAL SYSTEM
Differences Between Male & Female Pelvis
Female pelvis
Iliac bones more flared
Broader hips
Pubic arch angle greater
More distance between ischial spines and ischial tuberosities
Sacral curvature shorter and flatter
Lighter bones

Lower Limb
Femur (2)
Patella (2)
Tibia (2)
•Fibula (2)
Tarsals (14)
Metatarsals (10)
Phalanges (28)
 TOPIC 5 THE SKELETAL SYSTEM
Femur (Longest/strongest bone of body)
Head
Fovea capitis
Neck
Greater trochanter (“runners”)
Lesser trochanter
Linea aspera - posterior
Condyles
Epicondyles – medial and lateral to the condyles; point of ligament attachment

Patella (kneecap)
Anterior surface of the knee joint
Flat sesamoid bone located in the quadriceps

Tibia (shin bone)

Major weight bearing bone of the leg
Medial to fibula
Condyles
Tibial tuberosity– anterior surface
Anterior crest
Makes the medial malleolus (a hammer or mallet)
TOPIC 5 THE SKELETAL SYSTEM
Fibula
Resembling a clasp or buckle
Lateral to tibia
Long, slender
Head
Makes the lateral malleolus
Non-weight bearing

Foot
Tarsal Bones (14)
Calcaneus (heel bone)
Talus (ankle bone)
Navicular (boat-shaped)
Cuboid
Lateral (3rd) cuneiform (*wedge-shaped)
Intermediate (2nd) cuneiform
Medial (1st) cuneiform
Metatarsal Bones (10)
Phalanges (28)
Proximal, Middle, Distal
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Joints
Articulations of bones
Functions of joints
Hold bones together
Allow for mobility
Ways joints are classified
Functionally
Structurally

Functional Classification of Joints

Synarthroses – immovable joints • Amphiarthroses – slightly moveable joints
Diarthroses – freely moveable joints

Structural Classification of Joints

Fibrous joints
Generally immovable
Cartilaginous joints
Immovable or slightly moveable
Synovial joints
Freely moveable
 TOPIC 5 THE SKELETAL SYSTEM

Fibrous Joints
Bones united by fibrous tissue – synarthrosis or largely immovable.

Cartilaginous Joints
Bones connected by cartilage
Examples: Pubic symphysis & Intervertebral joints

Synovial Joints
Articulating bones are separated by a joint cavity
Synovial fluid is found in the joint cavity

Features of Synovial Joints

Articular cartilage (hyaline cartilage) covers the ends of bones
Joint surfaces are enclosed by a fibrous articular capsule
Have a joint cavity filled with synovial fluid
Ligaments reinforce the joint
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Types of Synovial Joints based on Shape

Lifespan Changes
Decrease in height beginning at about age 30
Calcium levels fall
Bones become brittle
Osteoclasts outnumber osteoblasts
Spongy bone weakens before compact bone
Bone loss rapid in menopausal women • Hip fractures common
Vertebral compression fractures common
TENCHUUUU :))

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