The Integumentary System

Skin – Largest organ and seeks the most treatment and is the most vulnerable

Functions of skin:
a. Resistance to trauma and infection
i. Keratin
ii. Dermcidin and defensins
iii. Acid mantle
b. Other Barrier Functions
i. Water
ii. UV radiation
iii. Harmful synthesis
c. Vitamin D synthesis (calcium absorption)
i. Skin carries out first step
ii. Liver and kidney complete the process
d. Sensation
i. Receptors for temp, touch, pain
e. Thermoregulation
i. Thermoreceptors
ii. Perspiration
f. Nonverbal communication
i. Facial expressions

Five Epidermal Cells

1. Stem Cells
i. Can turn into any cell
ii. At the basal layer, produce all other types of cells

2. Keratinocytes
i. Great majority of epidermal cells
ii. Synthesize keratin
iii. Found throughout
3. Melanocytes
i. Synthesize pigment melanin that shields DNA from UV radiation
ii. Occur only in the stratum basal but have branches processes that
spread among keratinocytes and distribute melanin
iii. Shield DNA, Nature’s sunscreen
4. Tacticle Cells
i. Touch receptor cells associated with dermal nerve fibers
ii. In basal layer of epidermis
 5. Dendritic Cells
i. Responsible for the initiation of adaptive immune responses

Thick Skin – Palms and soles

Has sweat glands but no hair follicles or sebaceous (oil) glands

Thin Skin – everywhere else

Has hair follicles, sebaceous glands

Skin Color
UV light exposure stimulates melanin and darkness in skin
Hemoglobin also influences skin color
Pigment in red blood cells
Ads reddish to pinkish hue
Carotene can also influence skin color

Colors of diagnostic value

o Cyanosis – blueness due to oxygen deficiency
o Erythema – redness due to increased blood flow to skin
o Pallor – paleness due to decreased blood flow to skin
o Albinism – white skin due to genetic lack of melanin
o Jaundice – yellowing due to bilirubin in blood
 Can be caused by compromised liver function
o Hematoma - bruising
 Clotted blood under skin

Hair and Nails

Need to know anatomy of hair and nails

Hair will have phases (need to know phases of hair growth)

Hair- Pilus (plural is pili)

Three types of hair
Lanugo
Fine, downy, unpigmented hair that appears on the fetus in the last 3 months of
development

Vellus
Fine, pale hair that replaces lanugo by time of birth
2/3 of the hair in women
1/10 of the hair in men
All of hair of children except eyebrows, eyelashes, and scalp hair
 Terminal
Longer, coarser and more pigmented
Eyebrows, eyelashes, and hair of the scalp

Structure
Bulb
Root
Dermal Papilla
Hair Matrix
Basal layer, hair growth center
Hair receptors
Sensory nerve fibers entwining follicles
Smooth muscle attaching follicle to dermis
Piloerector muscle (arrector pilli)

Hair texture and color

Texture – related to cross sectional shape of hair
Straight = round
Wavy = oval
Curly = flat

Color – due to pigment granules in the cells of cortex

3 Stages of Hair Cycle

Anagen – growth stage
90% of scalp follicles at a given time
Stem cells multiply
Root sheath cells above papilla form hair cells of hair matrix
Hair cells make keratin and die as they are pushed upwards

Catagen – degeneration stage

Mitosis in hair matrix ceases and sheath cells below bulge die
Base of hair keratinizes into a hard club – club hair
Easily pulled out by brushing

Telogen – resting stage

When papilla reaches the bulge

Hair Growth and Loss

We lose about 50 – 100 hairs a day
Club hairs may fall out during catagen or telogen or be pushed out during anagen phase
Nails
Fingernails and toenails
Dead cells that are filled with keratin

Nail Plate
Hard part of the nail
Free edge – white part
Nail body – visible attached part
Root – Below the cuticle
Eponychium – cuticle
Nail Matrix
Where mitosis happens
Growth zone of thickened stratum basal at proximal end of the nail
Fingernails grow 1mm per week in fingernails
Toenails grow more slowly

Nail fold – surrounding skin rising above nail

Nail groove – separates nail fold from nail plate

Nail bed – skin underlying the nail plate

Cutaneous Glands
Apocrine Gland – sweat glands; secrete milky fat substance; this makes you smell
because the bacteria that lives on you eat that substance (usually a sign of sexual
maturity); associated with hair; (ex. groin, anal region, men beard)

Eccrine (Merocrine) Gland – sweat glands; all about cooling/perspiration; not associated
with hair follicles

Sebaceous Gland – bunch of cells that die and disintegrate and become an oily
substance on skin, prevents your skin from drying/cracking; found near follicles

Ceruminous glands –
what produces earwax, yellow waxy secretion combined with sebum and dead
epithelial cells
Kills bacteria, waterproofs the canal, makes guard hairs of ear sticky to help
block foreign particles from entering auditory canal
Keeps eardrum pliable
Coiled, simple tubular glands in external ear canal
 Modified apocrine glands

Myoepithelial cells – found in both apocrine and eccrine glands

Sweat – 99% water, ph range 4 to 6

Skin Cancer
Most skin cancer is caused by exposure to UV rays of the sun
Most often on the head, neck and hands
Most common in fair skinned people and the ederly

Basal cell carcinoma (basal layer)

Most common & least dangerous
Forms from cells in stratum basale

Squamos cell carcinoma – stratum spinosum, can metastasize and may become
lethal

Malignant melanoma (melanocytes)

Not common but most deadly
Can be successfully removed if caught early
Highest in men, redheads and people severely sunburned as children
How to catch:
A- (Asymetrical) Right and left halves are not the same,
B- (Border) Border is uneven,
C- (Color) Color is dark/purply,
D- (Diameter) Diameter bigger than a pencil eraser,
E- (evolution) Gotten bigger over time

Shingles – unilateral rash (only on one side); reactivation of chicken pox virus; cant give
someone shingles but can transmit chickenpox to someone who hasn’t had it before (not on
test)

Burns
Classified according to depth of tissue involvement

First Degree
o Only involves epidermis
o Redness, slight edema, and pain
o Heals within days
o Ex. - Sunburn
Second Degree (partial thickness burn)
Involves the dermis
Get blisters

Third Degree
Most severe
Goes through all dermis layers
Often require skin grafts

Both UVA rays and UVB rays are thought to initiate skin cancer

What to know:
5 types of cells
5 layers (what is special about each layer)
Functions of the skin
Draw and label each part of the skin
What is in the dermis (papillary layer and reticular layer) (know the glands, hairs, etc)
Connective tissue layers ^^^
Take picture of strata and cell types of the epidermis and learn how to label it
Hypodermis
Differences in skin color and hair color (types of skin color)
Know anatomy of hair and nails
Know hair cycle
Know the 3 cutaneous glands, mammary glands
Know skin cancers
Know about burns (1st, 2nd, 3rd degree)