ANATOMY AND PHYSIOLOGY
1st TERM / SY 2024-2025
CSJR -BSP III
LECTURE#4 : INTEGUMENTARY SYSTEM
Ma. Cristina C. Danac-Delfin, MBA, MD, DPBA, FPSA
[email protected] +63-0920-907-7135
LEARNING OBJECTIVES
+Describe the integumentary system and
the role it plays in homeostasis
+Describe the layers of the skin and the
functions of each layer
+Describe the accessory structures of the
skin and the functions of each
LEARNING OBJECTIVES
+Describe the changes that occur in the
integumentary system during the aging process
+Discuss several common diseases, disorders, and
injuries that affect the integumentary system
+Explain treatments for some common diseases,
disorders, and injuries of the integumentary
system
SKIN
➢ body’s largest organ
➢17 – 20 square feet of surface
➢15% of body’s weight
➢Self-repairing and durable
➢First line of defense against the harmful
effects of the outside world
➢Helps retain moisture
➢Regulates body temperature
SKIN
➢Hosts the sense receptors
➢for touch,
➢pain, and heat
➢Excretes excess salts and small
➢amounts of waste
➢Stores blood to be moved quickly to
other parts of the body when needed
SKIN
➢Every square inch of
➢skin contains 15 feet of
➢blood vessels, 4 yards of nerves, 650
sweat glands, 100 oil glands, 1,500
sensory receptors and over 3M cells
with an average lifespan of 26 days
that are constantly being replaced
SKIN
➢ with hair, nails and glands
➢INTEGUMENTARY SYSTEM
➢Latin verb integer – “to cover”
➢Greek and Latin roots –
➢“dermato” and ”cutis” -- “skin”
➢Two primary parts:
➢Epidermis - Greek root epi – “upon” or
“above”
➢Dermis
SKIN
➢ HYPODERMIS
➢Underlying the epidermis and dermis
➢Superficial fascia
➢Subcutaneous tissue
➢Acts as a foundation but is not part of
the skin
SKIN
➢Composed of areolar
➢(porous) and adipose (fat) tissue
➢It anchors the skin through fivers that extend
from the dermis
➢Hypodermis attaches loosely to tissues and
organs so that muscles can move freely
SKIN
➢ HYPODERMIS
➢Around elbow and knee joints, hypodermis contains
➢fluid-filled sacs called bursae
➢Fat in the hypodermis buffers deeper tissues and
➢acts as an insulation, preventing heat loss from within
➢the body’s core
➢Home to pressure-sensitive nerve endings called
➢lamellated or Pacinian corpuscles that respond to a
➢deeper poke in the skin
The skin is composed of two main layers: the epidermis,
made of closely packed epithelial cells and the dermis,
made of dense irregular connective tissue that housed
blood vessels, hair follicles, sweat glands, and other
structures. Beneath the dermis lies the hypodermis, which
is composed mainly of loose connective and fatty tissues.
Figure 5.4 Epidermis The epidermis is epithelium composed of multiple
layers of cells. The basal layer consists of cuboidal cells, whereas the outer
layers are squamous, keratinized cells, so the whole epithelium is often
described as being keratinized stratified squamous epithelium. LM × 40.
(Micrograph provided by the Regents of University of Michigan Medical
School © 2012)
MEMORY TIP:
Sequence of layers
in the epidermis
from dermis to
outward:
Base - basale
Spine – spinosum
Grain – granulosum
Lucy – lucidum
Corny – corneum
Be - basale
Super - spinosum
Greedy-
granulosum
Less - lucidum
Caring - corneum
Stratum corneum – “horny layer”
- water-repellent protein called = keratin
- cornified
Stratum lucidum – “clear”
- thick skin on the palms of the hands and
soles of the feet
- contains eleidin – a protein that becomes
keratin as the cells migrate into the stratum
corneum and it consists of cells that have lost
their nuclei and cytoplasm
Stratum granulosum – 3 – 5 layers of flattened cells
containing keratohyalin – substance that marks
the beginning of keratin formation
Stratum spinosum – “spinous layer”
- has 10 layers containing prickle cells
- Langerhans cells – prevalent in the upper
portions of this layer and sometimes the lower
part of the stratum granulosum
Stratum basale – stratum germinativum
- germinal layer
- rests on the papillary (rough or bumpy) surface of the
dermis
- melanocytes – cells that synthesize a pale yellow to
black pigment called melanin that contributes to skin
color and provides protection against UV radiation (the
kind of radiation found in sunlight)
- secrete melanin directly into the keratinocytes =
cytocrine secretion
-keratinocytes – primary epithelial cell of the skin
-Merkel’s cells – involved in sense of touch
Figure 5.6 Cells
of the Epidermis
The cells in the
different layers of
the epidermis
originate from
basal cells located
in the stratum
basale, yet the
cells of each layer
are distinctively
different. EM ×
2700. (Micrograph
provided by the
Regents of
University of
Michigan Medical
School © 2012)
Figure 5.8 Skin Pigmentation The relative coloration of the skin depends of the amount
of melanin produced by melanocytes in the stratum basale and taken up by
keratinocytes.
Figure 5.3 Thin Skin
versus Thick Skin
These slides show
cross-sections of the
epidermis and dermis of
(a) thin and (b) thick
skin. Note the significant
difference in the
thickness of the epithelial
layer of the thick skin.
From top, LM × 40, LM ×
40. (Micrographs
provided by the Regents
of University of Michigan
Medical School © 2012)
EPIDERMIS
+CAROTENE – yellowish pigment
found in the stratum corneum and fatty
layers beneath the skin
+- produces yellowish hue associated
with Asian ancestry or increased carrot
consumption
EPIDERMIS
+HEMOGLOBIN – red pigment of the
blood cells that causes the pink to red
color of Caucasian skin
+Caucasian skin contains relatively less
melanin so hemoglobin can be seen
more easily through the epidermis
EPIDERMIS
+FRECKLES – melanin pools in small patches
+ALBINOS – have no melanin thus sensitive to UV
radiation
+VITILIGO - the melanocytes in certain areas lose
their ability to produce melanin, possibly due to an
autoimmune reaction. This leads to a loss of color in
patches
+Neither albinism nor vitiligo directly affects the
lifespan of an individual.
EPIDERMIS
+RIDGES and GROOVES – form on the outer surface of the
epidermis to increase the friction needed to grasp objects or
move across slick surfaces
+FINGERPRINTS, PALM PRINTS AND FOOTPRINTS – ridges
form patterns of loops and whorls; imprints on smooth
surfaces because of the oily secretions of the sweat glands
on the skin’s surface
+FLEXION LINES – patterns around joints
+FLEXION CREASES – deeper and more permanent lines
DERMIS: IT’S MORE THAN SKIN DEEP
+DERMIS OR CORIUM – thicker, fibrous
structure beneath the epidermis
+Two layers:
+1. Papillary Layer – outer, soft, contains
elastic and reticular (net-like) fibers that
project into the epidermis to bring blood
and nerve endings closer.
DERMIS: IT’S MORE THAN SKIN DEEP
+Papillae (finger-like projections) containing
loops of capillaries increase the surface area of
the dermis and anchor the epidermis.
+Meissner’s corpuscles – nerve endings that
are sensitive to soft touch; it’s the dermal
papillae that form the epidermal ridges
referred to as fingerprints
DERMIS: IT’S MORE THAN SKIN DEEP
+2. Reticular Layer – “rete” – net – inner, thicker,
made up of dense, irregular connective tissue
containing interlacing bundles of collagenous and
elastic fibers that form the strong, resistant layer
used to make leather and suede from animal
hides; gives skin its strength, extensibility and
elasticity
DERMIS: IT’S MORE THAN SKIN DEEP
+SEBACEOUS GLANDS (oil
glands), sweat glands, fat cells and
larger blood vessels – within the
reticular layer
Figure 5.7 Layers of the
Dermis This stained slide
shows the two components of
the dermis—the papillary layer
and the reticular layer. Both are
made of connective tissue with
fibers of collagen extending
from one to the other, making
the border between the two
somewhat indistinct. The
dermal papillae extending into
the epidermis belong to the
papillary layer, whereas the
dense collagen fiber bundles
below belong to the reticular
layer. LM × 10. (credit:
modification of work by
“kilbad”/Wikimedia Commons)
DERMIS: IT’S MORE THAN SKIN DEEP
+FIBROBLASTS – from which connective tissue develops
+MACROPHAGES – which engulf waste and foreign
microorganisms
+ADIPOSE TISSUE
+THICKEST – palms of the hands and soles of feet
+THINNEST – eyelids, penis, scrotum
+THICKER – back (posterior) than on the stomach
(anterior); on the sides (lateral) than toward the middle of
the body (medial)
TOUCHING A NERVE IN THE INTEGUMENTARY SYSTEM
+FOUR KINDS OF TOUCH RECEPTORS
+1. Free nerve endings
+Afferent nerve endings called dendrites
(branched extensions) of sensory neurons
that act primarily as pain receptors
+Some sense temperature, touch and
muscles (including the sensation of
“stretch”)
+Found all over the body
TOUCHING A NERVE IN THE INTEGUMENTARY SYSTEM
+FOUR KINDS OF TOUCH RECEPTORS
+1. Free nerve endings
+Prevalent in epithelial and connective tissue
+Small-diameter fibers
+Swelling at the end that responds to touch and
sometimes to heat, cold or pain
+Some disc-shaped structures called Merkel discs that
function as light-touch receptors within the deep
layers of the epidermis
TOUCHING A NERVE IN THE INTEGUMENTARY
SYSTEM
+FOUR KINDS OF TOUCH RECEPTORS
+2. Meissner’s corpuscles – light-touch mechanoreceptors
lie within the dermal papillae
+Small, egg-shaped capsules of connective tissue surrounding
a spiraled end of a dendrite
+Most abundant in sensitive skin areas such as the lips and
fingertips, these corpuscles and free nerve endings can sense
a quick touch but not a sustained one
+Skin is able to ignore the touch sensation of your own
clothing
Figure 5.15 Light Micrograph of a Meissner Corpuscle In this micrograph of a skin cross-section, you
can see a Meissner corpuscle (arrow), a type of touch receptor located in a dermal papilla adjacent to the
basement membrane and stratum basale of the overlying epidermis. LM × 100. (credit:
“Wbensmith”/Wikimedia Commons)
TOUCHING A NERVE IN THE INTEGUMENTARY SYSTEM
+FOUR KINDS OF TOUCH RECEPTORS
+3. Pacinian corpuscles – deep-pressure
mechanoreceptors are dendrites surrounded by
concentric layers of connective tissue
+Found deep within the dermis
+Respond to deep or firm pressure and vibrations
+Each is over 2 millimeters long and therefore visible to
the naked eye
TOUCHING A NERVE IN THE INTEGUMENTARY SYSTEM
+FOUR KINDS OF TOUCH RECEPTORS
+4. Hair nerve endings –
mechanoreceptors that respond to
change in position of a hair;
+Consist of bare dendrites
TOUCHING A NERVE IN THE INTEGUMENTARY SYSTEM
+Two primary temperature receptors (heat or cold)
+1. End-bulbs of Krause – Krause’s
corpuscles
+- cold receptors usually activate below
68 degrees F or 20 degrees C
+Consist of bulbous capsule
surrounding the dendrite
TOUCHING A NERVE IN THE INTEGUMENTARY SYSTEM
+Two primary temperature receptors (heat or cold)
+1. End-bulbs of Krause – Krause’s
corpuscles
+Commonly found throughout the body
in the dermis as well as in the lips, the
tongue and the conjunctiva of the eyes
TOUCHING A NERVE IN THE INTEGUMENTARY SYSTEM
+Two primary temperature receptors (heat or cold)
+2. Brushes of Ruffini – Ruffini cylinders or
Ruffini’s corpuscles
+Warmth receptors respond to temperatures between 77
degrees and 113 degrees F or 25 degrees to 45 degrees C
+Found primarily in the dermis and subcutaneous tissue
+Dendrite endings enclosed in a flattened capsule
+Fewer than Krause’s end-bulbs and lie in deeper tissue,
body is less sensitive to heat than to cold
TOUCHING A NERVE IN THE INTEGUMENTARY SYSTEM
+PROPRIOCEPTORS – neuromuscular spindles
that transmit information to the spinal cord and
brain about the lengths and tensions of muscles
+Information helps provide awareness of the
body’s position and the relative position of body
parts
+Spindles also assist with muscle coordination
and muscle action efficiency
ACCESSORIZING WITH HAIR, NAILS AND GLANDS
+HAIR
+Covers the entire human body except for the
lips, eyelids, palms of the hands, soles of the feet,
nipples and portions of external reproductive
organs.
+Human body hair sparser and much lighter in
color than that sported by most other mammals
ACCESSORIZING WITH HAIR, NAILS AND GLANDS
+HAIR
+Body hair for humans is largely a secondary sex
characteristic
+thick head of hair protects the scalp from
exposure to the sun’s harmful rays and limits heat
loss
+Eyelashes block sunlight and deflect debris from
the eyes
ACCESSORIZING WITH HAIR, NAILS AND GLANDS
+HAIR
+Hair in the nose and ears prevents airborne
particles and insects from entering
+Touch receptors connected to hair follicles
respond to lightest brush
+Average adult has about 5M hairs, with about
100,000 of those growing from the scalp
ACCESSORIZING WITH HAIR, NAILS AND GLANDS
+HAIR
+Normal hair loss from an adult scalp is
about 70 to 100 hairs each day, although
baldness can result from genetic factors,
hormonal imbalances, scalp injuries,
disease, dietary deficiencies, radiation or
chemotherapy
Figure 5.11 Hair Hair follicles originate in the epidermis and have many
different parts.
HAIR
+THREE CONCENTRIC LAYERS OF KERATINIZED CELLS:
+1. Medulla – central core; consists of large cells
containing eleidin that are separated by air spaces;
+In fine hair, medulla may be small or entirely absent
+2. Cortex – surrounding the medulla forms the major
part of the hair shaft with several layers of flattened
cells;
+Has elongated pigment-bearing cells in dark hair and air
pockets in white hair
HAIR
+THREE CONCENTRIC LAYERS OF KERATINIZED CELLS:
+3. Cuticle – outermost; single layer of overlapping
cells with the free and pointing upward;
+The cuticle strengthens and compacts the inner
layers
+Abrasion tends to wear away the end of the shaft,
exposing the medulla and cortex in a pattern known
as split ends
NAILING THE FINGERS AND TOES
+NAILS – vestigial claws
+Three parts:
+1. Root bed – at the nail base
+2. Body – attached to the fingertip
+3. Free Edge – that grows beyond the end of the
finger or toe
+- heavily cornified tissue from modified strata
corneum and lucidum
+Nail bed – under the nail; formed by the strata
basale and spinosum
NAILING THE FINGERS AND TOES
+Eponychium or cuticle – formed by a narrow fold of the
stratum corneum that turned back
+Lunula – “little moon” – at the base of the nail, partially
tucked under the cuticle, whitish area formed by
thickened strata
+Nail matrix – beneath the lunula; a region of thickened
strata where mitosis pushes previously formed cornified
cells forward, making the nail grow
NAILING THE FINGERS AND TOES
+Hyponychium – under the free edge
of the nail; thickened stratum corneum
+Pinkish in color – hemoglobin in the
underlying capillaries, which are
visible through the translucent cells of
the nail
NAILING THE FINGERS AND TOES
+Fingernails grow about 1 mm each week
+Toenails grow even more slowly
+Nails function as an aid to grasping; as a
tool for manipulating small objects; and
as protection against trauma to the ends
of the fingers and toes
Figure 5.13 Nails The nail is an accessory
structure of the integumentary system.
SWEATING THE DETAILS
+SWEAT GLANDS – numerous in the palms and
soles with the forehead running a close third
+Two types of sweat or sudoriferous glands:
+1. Eccrine
+2. Apocrine
+Both coiled tubules embedded in the dermis or
subcutaneous layer composed of simple columnar
cells
+Each gland’s duct passes through the epidermis to
the skin’s surface where it opens as a sweat pore
SWEATING THE DETAILS
+ECCRINE GLANDS – distributed widely over
the body – an average adult has roughly 3M
of them
+Produce the watery, salty secretion known
as SWEAT
+Sympathetic division of the autonomic
nervous system controls when and how
much perspiration is secreted depending on
how hot the body becomes
SWEATING THE DETAILS
+Sweat helps cool the skin’s surface
by evaporating as fast as it forms
+About 99% of eccrine – type sweat
is water, but the remaining 1% is a
mixture of sodium chloride and
other salts, uric acid, amino acids,
ammonia sugar, lactic acid and
ascorbic acid
Figure 5.14 Eccrine Gland Eccrine glands are coiled glands in the
dermis that release sweat that is mostly water.
SWEATING THE DETAILS
+APOCRINE sweat glands – located
primarily in armpits (known as the
axillary region) and the groin area.
+Usually associated with hair
follicles, they produce a white,
cloudy secretion that contains
organic matter
SWEATING THE DETAILS
+APOCRINE sweat glands – sweat
contains the same basic components as
eccrine sweat
+Odorless when first secreted, bacteria
quickly begin to break down its additional
fatty acids and proteins – explains the
post-exercise underarm stench
+Sexual and other emotional stimuli can
cause contraction of cells around these
glands releasing sweat
GETTING AN EARFUL
+CERUMINOUS GLANDS – outer
part of the ear canal from modified
sudoriferous glands
+Secretes occasionally troublesome
yellowish substance known as
earwax
+cera =Latin for wax
GETTING AN EARFUL
+Lie within the subcutaneous
layer of the ear canal
+Have ducts that either open
directly into the ear canal or
empty into the ducts of nearby
sebaceous glands
GETTING AN EARFUL
+Cerumen – earwax - combined
secretion of these two glands
+With ear hairs, traps any foreign
particles before they reach the
eardrum
+As cerumen dries, it flakes and falls
from the ear, carrying particles out
of the ear canal
VITAMIN D SYNTHESIS
+EPIDERMAL LAYER – of human skin synthesizes
vitamin D when exposed to UV radiation
+In the presence of sunlight, a form of vitamin D3 –called
cholecalciferol is synthesized from a derivative of the
steroid cholesterol in the skin
+Liver converts cholecalciferol to calcidiol, which is then
converted to calcitriol – the active chemical form of the
vitamin – in the kidneys
+VIT D – essential for normal absorption of calcium and
phosphorus, which are required for healthy bones
VITAMIN D SYNTHESIS
+Absence of sun exposure can lead to lack of vitamin
D in the body leading to a condition called
RICKETS, a painful condition in children where the
bones are misshapen due to lack of calcium, causing
bow leggedness
+Elderly individuals who suffer from vitamin D
deficiency can develop a condition called
osteomalacia, a softening of the bones
+Vitamin D is added as a supplement to many foods,
including milk and orange juice, compensating for
the need for sun exposure
DISEASES, DISORDERS AND INJURIES
+SKIN CANCER
+Cancer – broad term that describes diseases caused by
abnormal cells in the body dividing uncontrollably
+Degradation of the ozone layer in the atmosphere and the
resulting increase in exposure to UV radiation has
contributed to rise in skin cancer
+Damaged DNA - lead to the formation of cancerous
lesions
+Accumulation of DNA mutations
+Tumors – uncontrolled cell proliferation
+Metastasis – production of cells that can mobilize and
establish tumors in other organs of the body
DISEASES, DISORDERS AND INJURIES
+SKIN CANCER
+Basal Cell CA – affects the mitotically active stem cells in
the stratum basale of the epidermis
+- most common in the US
Figure 5.18 Basal Cell
Carcinoma Basal cell
carcinoma can take
several different forms.
Similar to other forms of
skin cancer, it is readily
cured if caught early and
treated. (credit: John
Hendrix, MD)
DISEASES, DISORDERS AND INJURIES
+SQUAMOUS CELL CARCINOMA – affects the
keratinocytes of the stratum spinosum and presents
as lesions commonly found on the scalp, ears and
hands
+Figure 5.19 Squamous
Cell Carcinoma
Squamous cell carcinoma
presents here as a lesion
on an individual’s nose.
(credit: the National
Cancer Institute)
DISEASES, DISORDERS AND INJURIES
+MELANOMA – uncontrolled growth of
melanocytes, the pigment-producing
cells in the epidermis; develops from a
mole
+Most fatal of all skin cancers; highly
metastatic and difficult to detect before it
has spread to other organs
+treatment involves surgical excision and
immunotherapy
DISEASES, DISORDERS AND INJURIES
Figure 5.20
Melanoma
Melanomas
typically present
as large brown or
black patches with
uneven borders
and a raised
surface. (credit:
the National
Cancer Institute)
Figure 5.9 Moles Moles range from benign accumulations of melanocytes to
melanomas. These structures populate the landscape of our skin. (credit: the
National Cancer Institute)
ABCDE Mnemonic – Dx of Early-Stage Melanoma
+If you observe a mole on your body displaying these
signs, consult a doctor:
+Asymmetry – the two sides are not symmetrical
+Borders – the edges are irregular in shape
+Color – the color is varied shades of brown or black
+Diameter – it is larger than 6 mm (0.24 in.)
+Evolving – its shape has changed
+Additional signs for most serious form, nodular
melanoma:
+Elevated – it is raised on the skin surface
+Firm – it feels hard to the touch
+Growing – it is getting larger
SKIN DISORDERS
+ECZEMA – allergic reaction that manifests as
dry, itchy patches of skin that resemble rashes
+- accompanied by swelling of the skin, flaking
and in severe cases, bleeding
+Antibodies against dust mites in the blood but
the link between eczema and allergy to dust
mites has not been proven
+Symptoms usually managed with moisturizers,
corticosteroid creams and
immunosuppressants
1.Figure 5.21
Eczema
Eczema is a
common skin
disorder that
presents as a
red, flaky rash.
(credit:
“Jambula”/Wiki
media
Commons)
SKIN DISORDERS
+ACNE – typically occurs on areas of the
skin that are rich in sebaceous glands
+Can also occur in infants and continue into
adulthood
+HORMONES – androgens – stimulate the
release of sebum
+Overproduction and accumulation of sebum
along with keratin can block hair follicles
SKIN DISORDERS
+Plug initially white
+Sebum when oxidized by exposure to air,
turns black
+Results from infection by acne-causing
bacteria (Propionibacterium and
Staphylococcus) which lead to redness and
potential scarring due to the natural wound
healing process
Figure 5.22 Acne Acne is a result of over-productive
sebaceous glands, which leads to formation of blackheads and
inflammation of the skin.
INJURIES
+BURNS - skin damaged by intense heat, radiation,
electricity or chemicals
+- death of skin cells – massive loss of fluid
+Dehydration, electrolyte imbalance, renal and circulatory
failure – fatal
+Treated with intravenous fluids to offset dehydration, as
well as intravenous nutrients that enable the body to repair
tissues and replace lost proteins
+INFECTION – burned skin extremely susceptible to
bacteria and other pathogens due to the loss of protection
by intact layers of skin
INJURIES
+BURNS measured in terms of size of total surface area
affected = “rule of nines”
+First degree burn – superficial burn that affects only the
epidermis ex. Mild sunburn
+ Second degree burn – affects both the epidermis and a
portion of the dermis; swelling and blistering of skin
+Third degree burn – fully extends into the epidermis and
dermis; destroying the tissue and affecting the nerve
endings and sensory function
+Fourth degree burn – more severe; affecting underlying
muscle and bone
Figure 5.23
Calculating the Size
of a Burn The size of a
burn will guide
decisions made about
the need for
specialized treatment.
Specific parts of the
body are associated
with a percentage of
body area.
Interesting videos to watch….
+http://openstaxcollege.org/l/layers
+http://openstaxcollege.org/l/albino
+http://openstaxcollege.org
+http://openstaxcollege.org/
+http://openstaxcollege.org/l/follicle
+http://openstaxcollege.org/l/sweating
+http://openstaxcollege.org/l/tattoo
+http://www.Diplomaguide.com
+http://openstaxcollege.org/l/skingraft
