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Chapter 5 Integumentary System Shaft of a hair protruding through the skin Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Integumentary System • skin, hair, glands, nails • Functions 1. Protection – Against abrasion and UV light – Prevents entry of microorganisms – Prevents dehydration 2. Sensation – Sensory receptors detect heat, cold, touch, pressure, pain 3. Temperature regulation by controlling – Blood flow through skin – Sweat gland activity 4. Vitamin D production 5. Excretion of small amounts of waste products Skin • SA – 1.2-2.2 m2 and weighs 4-5 kg (9-11 lbs)!! • 3 major regions – Epidermis: outermost region (superficial) • Resists abrasion • Reduces water loss – Dermis: middle region (bulk of skin) • Responsible for most structural strength of skin • Leather produced from dermis of animals…ewww. – Subcutaneous tissue (hypodermis): deepest region • Not really part of skin • Connects skin to underlying muscle or bone Fig. 5.1 Tab. 5.1 Epidermis • • • • keratinized stratified squamous epithelium 4 distinct cell types 4-5 layers Outer portion exposed to external environment – protection 4 Cell Types of Epidermis • Keratinocytes – Most abundant – Produce fibrous protein keratin – Gives skin its protective properties • Melanocytes – Produce brown pigment melanin – Found in deepest layers of epidermis • Langerhans’ cells – Epidermal macrophages – Help activate immune system • Merkel cells – Touch receptors in association with sensory nerve endings Layers of Epidermis • Stratum Basale (Basal Layer) – Deepest, firmly attached to dermis • Structural strength provided by desmosomes and hemidesmosomes – single row of youngest keratinocytes – Cells undergo mitotic divisions ~every 19 days – 10-25% are melanocytes Layers of the Epidermis • Stratum Spinosum – Melanin granules and Langerhans’ cells abundant • Melanin taken up by keratinocytes, accumulates on “sunny side” to protect nucleus from UV damage • Stratum Granulosum – Drastic changes in keratinocyte appearance – Keratohyaline and lamellated bodies (waterproofing) accumulate in cells – Above this layer epithelial cells die because too far from dermis Layers of the Epidermis • Stratum Lucidum – Thin, transparent band superficial to S. Granulosum – few rows of flat, dead keratinocytes – only in thick skin (soles, palms) • Stratum Corneum – – – – – Outermost layer of keratinized cells ¾ of epidermal thickness 20-30 cell layers thick, all dead Millions rub off everyday. Totally new every 25-45 days. Functions: • Waterproofing • Protection from abrasion and penetration • Rendering body relatively insensitive to biological, chemical, and physical assaults Fig. 5.2b Fig. 5.3 Thick and Thin Skin • all 5 epithelial strata – Stratum lucidum – No hair • Only 4 strata • fewer cell layers per stratum – lucidum usually absent – Hair found only in thin skin Skin Color • Melanocytes produce melanin inside melanosomes (vesicles, from golgi), then transfer melanin to keratinocytes – size and distribution of melanosomes determine skin color – genetic but influenced by UV (tanning) and hormones • Increased blood flow produces red skin color (Erythema) • decreased flow causes pale skin – Decreased oxygen content in blood bluish color (cyanosis) • Carotene, ingested plant pigment, can cause skin to appear yellowish Fig. 5.4 Dermis • 2nd major skin region • strong, flexible conn tissue • Cell types: fibroblasts, a few adipose cells, macrophages • 2 layers: – papillary – reticular Papillary layer of Dermis – Areolar conn tissue w/collagen & elastic fibers – superior surface- peg-like projections “dermal papillae” • Genetic • fingerprints & footprints – Contains blood vessels that supply overlying epidermis • With nutrients • Remove waste products • Aid in regulating body temperature Reticular layer of Dermis – Dense irregular conn tissue – ~80% of thickness of skin – Collagen fibers add strength and resiliency to skin – Elastin fibers provide stretch-recoil properties – Striae (stretch marks) caused when skin overstretched, dermis ruptures and leaves visible lines Reticular layer – Elastin and collagen fibers oriented more in one direction than in others – produce cleavage, or tension, lines Fig. 5.5 Subcutaneous Tissue • Deep to the skin • Adipose (primarily) and areolar connective tissue • Not really part of skin • Stores fat, connects skin to underlying structures (mainly muscles) • Shock absorber, insulator • Increases as you gain weight Hair • Lanugo (fetal hair) replaced near time of birth by terminal hairs (scalp, eyelids, eyebrows) and vellus hairs • At puberty, vellus hairs replaced with terminal hairs • Hairs are columns of dead, keratinized epithelial cells – Each hair consists of • shaft above skin • root below skin • hair bulb - site of hair formation • growth stage and resting stage • Contraction of arrector pili, smooth muscles, causes hair to “stand on end” “goose bumps” Fig. 5.6 Sebaceous Glands • Simple or compound alveolar glands – found all over body except palms & soles • Soften skin when stimulated by hormones • Secrete oily secretion called sebum • Acne: active inflammation of sebaceous glands Sweat Glands • Different types prevent overheating of body • Secrete cerumen and milk • Up to 3 million/person – Merocrine sweat glands produce sweat, cools body: most numerous in palms and soles – Apocrine sweat glands: axillary and genital areas. Ducts empty into hair follicles. Produce organic secretion, broken down by bacteria to cause body odor – Ceruminous glands: modified merocrine glands in external ear canal, secrete cerumen (ear wax) – Mammary glands: specialized sweat glands, secrete milk Fig. 5.7 Nails • nail is Stratum Corneum containing hard keratin • nail root covered by skin • nail body = visible part of nail • Nearly all nail formed by nail matrix, but nail bed contributes • lunula = part of nail matrix visible through nail body (white “crescent”) Fig. 5.8 5 Integumentary System Functions 1. Protection – Skin • Protects against abrasion, UV • Prevents entry of microorganisms • Helps regulate body temperature • Prevents water loss – Hair • Protects against abrasion, UV • heat insulator – Nails protect ends of digits 2. Sensation – sensory receptors for • • • • • heat cold touch pressure pain Integumentary System Functions 3.Temp Regulation – Skin • Controls heat loss from body (dilation and constriction of blood vessels) – Sweat glands • Produce sweat, evaporates, lowers body temperature 4. Vitamin D Production • UV stimulates production of a precursor molecule in skin that’s modified by liver and kidneys into vit D • Vit D increases calcium uptake in intestines 5. Excretion • Skin glands remove small amounts of waste products but not important in excretion Blood Vessel Dilation, Fig. 5.9 Cancer: Basal Cell Carcinoma • Least malignant and most common skin cancer • Stratum Basale cells proliferate and invade dermis and hypodermis • Slow growing, do not often metastasize • 99% Can be cured by surgical excision Squamous Cell Carcinoma • • • • Arises from keratinocytes of Stratum Spinosum Arise most often on scalp, ears, lower lip Grows rapidly, metastasizes if not removed Prognosis is good if treated by radiation therapy or removed surgically Melanoma • Cancer of • most dangerous type of skin cancer because it is: – Likely to metastasize – Resistant to chemotherapy Melanomas • ABCD rule – A: Asymmetry; the 2 sides of pigmented area do not match – B: Border irregular w/indentations – C: Color (pigmented area) is black, brown, tan, sometimes red or blue – D: Diameter larger than 6 mm (size of a pencil eraser) • Treated by wide surgical excision accompanied by immunotherapy • Chance of survival is poor if lesion is over 4 mm thick Burns • First-degree: only epidermis is damaged – localized redness, swelling, pain • Second-degree: epidermis and upper regions of dermis damaged – Symptoms mimic first degree burns – blisters also appear • Third-degree: entire thickness of skin is damaged – Burned area appears gray-white, cherry red, or black; – no initial edema or pain • nerve endings are destroyed Page 115 Rule of Nines • Estimates severity of burns • Divides body into areas ~ 9%, or multiples of 9%, of total body area • Younger patients are different • Burns considered critical if: – Over 25% of body has 2nd degree burns – Over 10% of body has 3rd degree burns – 3rd degree burns on face, hands, or feet Effects of Aging on the Integumentary System • Epidermal replacement of cells slows and skin becomes thinner • Decreased elasticity and loss of subcutaneous tissue leads to wrinkles • Subcutaneous fat layer diminishes, leading to intolerance of cold • Skin becomes dry and itchy • Sweat and sebaceous glands are less active • number of melanocytes decreases Page 119