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Integumentary System Dr. Michael P. Gillespie Integumentary System  The skin (cutaneous membrane) covers the external surface of the body.  It is the largest organ of the body in terms of both surface area and weight. Functions of the Integumentary System  Thermoregulation  Reservoir for blood  Protection from external environment  Cutaneous sensations  Excretion and absorption  Vitamin D synthesis Structure of the Skin  Two main parts   Epidermis – epithelial tissue Dermis – connective tissue  Subcutaneous layer (hypodermis) – not part of the skin – areolar and adipose tissue  Contains nerve endings called lamellated (Pacinian) corpuscles Epidermis  Keratinized squamous epithelium  4 types of cells  5 basic layers of the epidermis Cell Types in Epidermis  Keratinocytes (90%)   Keratino = hornlike; cytes = cells Keratin –protects from heat, microbes, and chemicals  Melanocytes (8%)   Melano = black Produce pigment melanin – absorbs UV light  Langerhans cells   Arise from red bone marrow – migrate to epidermis Immune response  Merkel cells  Tactile (Merkel) disc Layers of Epidermis  Stratum Basale  Stratum Spinosum  Stratum Granulosum  Stratum Lucidum  Stratum Corneum Stratum Basale  Deepest layer  Single row of columnar or cuboidal keratinocytes  Keratin protects the deep layers from injury  Stem cells  Also known as the stratum germinativum (germ = sprout) Stratum Spinosum  Spinos = thornlike  8 – 10 layers of many sided keratinocytes close together  Provides strength and flexibility to the skin Stratum Granulosum  Middle of the epidermis  Granulos – little grains  3-5 layers of flattened keratinocytes  Undergoing apoptosis (cell death)  Lamellar Granules – release a lipid-rich secretion Stratum Lucidum  Lucid = clear  Present only in the thick skin of the fingertips, palms, and soles  3-5 layers of flattened clear, dead keratinocytes Stratum Corneum      Corne = horn or horny 25 – 30 layers of flattened dead keratinocytes Shed and replaced by cells from deeper strata Mostly keratin Between the cells are lipids from lamellar granules – creates water repellent barrier  Protects deep layers from injury  Friction creates a callus – abnormal thickening Growth of Epidermis  Newly formed cells are pushed to the surface  Accumulate more keratin (keratinization)  Undergo apoptosis  Keratinized cells slough off  4 weeks Psoriasis  Common skin disorder  Keratinocytes divide more quickly than normal and shed prematurely (7-10 days)  Immature keratinocytes make abnormal keratin  Forms flaky, silvery scales  Knees, elbows, and scalp (dandruff)  Tx. Topical ointments, UV phototherapy (decreases cell division) Dermis  Deeper layer  Mainly connective tissue  Collagen and elastic tissue  Fibroblasts, macrophages, and adipocytes Dermis Continued…  Papillary region – dermal papillae (papillae = nipples) – indent the epidermis – capillary loops  Corpuscles of touch (Meissner corpuscles)  Free nerve endings – warmth, coolness, pain, tickling, and itching Dermis continued…  Reticular region (reticul = netlike) – deeper part of dermis  Dense irregular CT  Adipose cells, hair follicles, nerves, sebaceous (oil) glands, sudoriferous (sweat) glands  Striae – streaks – stretch marks  Epidermal ridges – grip / friction – palms, fingers, soles, toes Types of Skin  Thin skin – covers all surfaces of the body except for the palms, palmar surfaces of the digits, and soles.  Lacks a stratum lucidum  Thick skin – covers the palms, palmar surfaces of the fingers, and soles  Distinct stratum lucidum Accessory Structure of the Skin  Hair  Skin glands  Nails Hair  Hair or pili – present on most surfaces except the palms, palmar surfaces of fingers, soles, and plantar surfaces of feet  Shaft – superficial portion – projects from skin  Root – deeper portion – penetrates the dermis and sometimes into the subcutaneous layer  Arrector pili – muscle which pulls on hair shaft causing it to raise – emotional stress (cold or fright) Conditions  Hirsutism = excessive body hair due to excessive androgens – tumor of the adrenal glands, testes, or ovaries  Androgenic alopecia – male-pattern baldness Skin Glands  Sebaceous Glands (greasy) – oil glands - typically connected to hair follicles  Secrete sebum – coats hair and keeps it from becoming dry and brittle – keeps skin soft and pliable  Sudoriferous Glands – sweat glands   Eccrine – throughout skin Apocrine – skin of axilla, groin, areolae and bearded regions  Ceruminous Glands – cer = wax – external ear  Cerumen = earwax – creates sticky body to impede entrance of foreign substances Nails  Tightly packed, hard, keratinized epidermal cells  Nail body, free edge and nail root  Lunula  Hyponychium – beneath free edge  Eponychium (cuticle) adheres to the lateral margin of the nail wall. Epidermal Wound Healing  Cells enlarge and migrate across the wound  Contact inhibition – when migrating cells touch one another they stop due a this cellular response Deep Wound Healing  The injury extends to the dermis and subcutaneous layer  Inflammatory phase   Blood clot forms Inflammation eliminates wastes and microbes  Migratory phase  Damaged blood vessels begin to regrow  Proliferative phase   Extensive growth of epithelial cells Deposition of fibroblasts  Maturation phase Contributions of the Integumentary System  The Integumentary System contributes to the functioning of all other body systems.  Refer to the table on page 155. Skin Disorders  Skin Cancer  Burns  Pressure Ulcers Skin Cancer  Almost exclusively caused by excessive exposure to the sun.  Basal cell carcinomas  Squamous cell carcinomas  Malignant Melanomas Basal Cell Carcinoma Squamous Cell Carcinoma Detection of Malignant Melanoma  A Asymmetry  MM lack symmetry  B Border  MM have notched, indented, scalloped, or indistinct borders  C Color  MM have uneven coloration, may contain several colors  D Diameter  MM are typically greater than 6mm (0.25 in.)  E Elevation Normal Nevus & Malignant Melanoma Risk Factors for Malignant Melanoma  1. Skin type  Light skinned individuals who burn, but don’t tan  2. Skin exposure  Sunny areas, high altitude (UV light), outdoor occupation  3. Family Hx.  4. Age  5. Immunological status  Immunosuppressed individuals have a higher risk of skin cancer Burns  Tissue damage caused by     Excessive heat Electricity Radioactivity Corrosive chemicals  Destroy some of the skin’s contributions to homeostasis Grading of Burns  First-degree burn  Second-degree burn (partial thickness)  Third-degree burn (full thickness) Systemic Effects of Burns  1. Large loss of water, plasma, and plasma proteins (causes shock)  2. Bacterial infection  3. Reduced circulation of blood  4. Decreased production of urine  5. Diminished immune response Severity of Burns  Determined by the depth of the burn and the extent of the area involved.  According to the American Burn Association a major burn includes:    Third-degree burns over 10% Second-degree burns over 25% Third-degree burns over face, hands, feet, or perineum  When the burn area exceeds 70%, more than half of the victims die Determining the Extent of a Burn  Rule of nines – a quick method for estimating the surface area affected by burns  Lund-Browder method – a more accurate method for assessing the extent of burns Skin Color  Melanin – causes skin color from pale yellow to black   Melanocytes produce melanin Freckles and liver spots are accumulations of melanin  Carotene – yellow-orange pigment  Hemoglobin – imparts a red color  Albinism – inability to produce melanin - missing from the hair, eyes, and skin  Vitiligo – loss of melanocytes from patches of skin Skin Color Clues  Cyanotic – blue - hemoglobin is depleted of oxygen  Jaundice – yellow – buildup of the yellow pigment bilirubin in the blood – usually indicates liver disease  Erythema – red – engorgement of capillaries in the skin – skin injury, heat, infection, inflammation, allergies Carotonemia Cyanosis Jaundice Vitiligo Scabies