THE ORGAN SYSTEMS: INTEGUMENTARY SYSTEM

INTERGUMENTARY SYSTEM
• Also known as the thermal system ➢ Consist of two layers:
• Largest system in the human body
• Consists of structures that form the body’s outer
covering

FUNCTIONS
a. Protection. Serving as the covering of the body, it
protects the deeper tissues from the following:
i. Mechanical damage- external forces acting or
reacting upon our skin (e.g. friction)
ii. Chemical damage- such as accidentally pouring
chemical in your skin
iii. Bacterial damage- skin is susceptible to bacteria
that’s why we have body odor. Our skin is naturally
covered in oils so when we sweat, our skin
releases glucose ( a sugar). When glucose exists
on our skin, the bacteria will be attracted to the A. EPIDERMIS
glucose and cling to our skin, thus, causing the ➢ is the superficial layer of the skin, consisting of
bad odor. stratified squamous epithelial tissue.
➢ Its multiple cell layers resists abrasion on the
iv. Thermal damage- intense heat or cold skin’s surface and reduces water loss through
v. Ultraviolet radiation- exists naturally especially that the skin.
it is given off by the Sun, specifically the ff: UVA, ➢ Most cells of the epidermis are keratinocytes,
UVB, and UVC ( UVA and UVB are the ones that which produce keratin, the fibrous protein that
causes sunburn) makes the epidermis a tough protective layer in
vi. Desiccation- state of extreme dryness or process a process called keratinization. These
of drying keratinocytes are connected by desmosomes
b. Sensation. The integumentary system has throughout the epidermis.
sensory receptors that can detect heat, cold, ➢ Is avascular (this explains why a man can
touch, pressure, and pain. shave daily and not bleed even though he cuts
c. Temperature/ heat regulation. The skin plays a off many cell layers each time he shaves)
major role in regulating body temperature through
the modulation of blood flow through the skin and LAYERS OF EPIDERMIS
the activity of sweat glands.
d. Vitamin D production. When exposed to
ultraviolet light, the skin produces a molecule that
can be transformed into vitamin D, an important
regulator of calcium homeostasis.
e. Excretion. Small amounts of waste products are
excreted through skin and glands. Specifically, the
skin aids in excretion of urea and uric acid.

MAJOR COMPONENTS
I. SKIN (CUTANEOUS MEMBRANE)
PARTS OF THE SKIN

1. Stratum Basale
• Cells undergoing mitosis (daughter cells destined
to become epidermal cells are pushed upward,
away from the source of nutrition, to become part
of the epidermal layers closer to the skin surface.
As they move away from the dermis and become
part of the more superficial layers, the stratum
spino- sum and then the stratum granulosum, they
become flatter and increasingly keratinized).
THE ORGAN SYSTEMS: INTEGUMENTARY SYSTEM
• Lies next to dermis o Associated with sensory nerve endings and
• contains the most adequately nourished of the serve as touch receptors called Merkel discs
epidermal cells because nutrients diffusing from
the dermis reach them first. Stem cells in this layer
are constantly dividing
• Aka stratum germinativum

2. Stratum Spinosum
• Aid in flexibility, and enables the epidermis to
better withstand the effects of friction and
abrasion

3. Stratum Granulosum
• Help to form a waterproof barrier that functions
to prevent fluid loss from the body.

4. Stratum Lucidum
• Occurs only in the thick skin
• Aka the callus/ kubal
• It occurs only where the skin is hairless and
extra thick, that is, on the palms of the hands
and soles of the feet.

5. Stratum Corneum A. DERMIS

• is 20 to 30 cell layers thick ➢ A layer of dense connective tissue where the
• The shingle-like dead cell remnants, completely epidermis lies
filled with keratin, are referred to as cornified, or ➢ Responsible for most of the strength of the skin
horny, cells. ➢ It is a strong, stretchy envelope that helps to
• The abundance of the tough keratin protein in bind the body together.
the stratum corneum allows that layer to
provide a durable “overcoat” for the body, which TWO MAJOR REGIONS
protects deeper cells from the hostile external 1. Papillary layer
environment and from water loss, and helps the ▪ Composed of areolar connective tissue
body resist biological, chemical, and physical ▪ Is the superficial dermal region.
assaults. ▪ It is uneven and has peg-like projections from its
• The stratum corneum rubs and flakes off slowly superior surface, called dermal papillae, which
and steadily as the dandruff and replaced by indent the epidermis above.
cells produced by the division of the deeper ▪ Many of the dermal papillae contain capillary
stratum basale cells. We have a totally “new” loops, which furnish nutrients to the epidermis.
epidermis every 25 to 45 days. Others house pain receptors (free nerve
endings) and touch receptors.
➢ MELANIN ▪ On the palms of the hands and soles of the feet,
o Pigment produced by Melanocytes (spider- the papillae are arranged in definite patterns that
shaped cells) which are chiefly found in the form looped and whorled ridges on the
Stratum Basale epidermal surface that increase friction and
o It ranges in color from yellow to brown to black enhance the gripping ability of the fingers and
o Amount of melanin produced depends upon feet.
genetics and exposure to sunlight. ▪ Papillary patterns are genetically determined.
o Freckles and moles are seen where melanin is The ridges of the finger- tips are well provided
concentrated in one spot. with sweat pores and leave unique, identifying
films of sweat called fingerprints.
➢ EPIDERMAL DENDRITIC CELLS
o Scattered in the epidermis which are important 2. Reticular Layer
“sentries” that alert and activate immune system ▪ is the deepest skin layer.
cells to a threat such as bacterial or viral ▪ It contains dense irregular connective tissue, as
invasion. well as blood vessels, sweat and oil glands, and
deep pressure receptors called lamellar
➢ MERKEL CELLS corpuscles.
o Seen at the epidermal-dermal junctions
THE ORGAN SYSTEMS: INTEGUMENTARY SYSTEM

ALSO FOUND IN THE SKIN ARE THE FF: I. SUBCUTANEOUS TISSUE

➢ Also known as the superficial fascia or
➢ Cutaneous sensory receptors hypodermis.
▪ tiny sensors, which include touch, pressure, ➢ is not part of the skin or the integumentary
temperature, and pain receptors system, but it does connect the skin to
▪ provide information about our external underlying muscle or bone.
environment; alert us to sources of heat or ➢ is a layer of loose connective tissue layer
cold, or the tickle of a bug exploring our skin. located immediately under the dermis consisting
of adipose tissue or fat; anchors skin to
➢ Phagocytes underlying organs.
▪ found throughout the dermis
▪ act to prevent microbes that have managed to NORMAL SKIN COLOR DETERMINANTS
get through the epidermis from penetrating
any deeper into the body. ▪ MELANIN (in dermis)
- yellow, brown, or black pigments
➢ Collagen and elastic fibers - exposure to sunlight stimulates melanocytes to
▪ are found throughout the dermis. produce more melanin pigment, resulting in
▪ Collagen fibers are responsible for the tanning of the skin.
toughness of the dermis; they also attract and - As the melanocytes produce melanin, it
bind water and thus help to keep the skin accumulates in their cytoplasm in membrane-
hydrated. bound granules called melanosomes. These
▪ Elastic fibers give the skin its elasticity when we granules then move to
are young. As we age, the number of collagen the ends of the melanocytes’ spidery arms,
and elastic fibers decreases, and the where they are taken up by nearby
subcutaneous tissue loses fat. As a result, the keratinocytes.
skin loses its elasticity and begins to sag and - Inside the keratinocytes, the melanin forms a
wrinkle. pigment umbrella over the superficial, or
“sunny,” side of their nuclei and shields their
genetic material (DNA) from the damaging
➢ Blood vessels
effects of UV radiation in sunlight
▪ maintains body temperature homeostasis.
- People who produce a lot of melanin have
▪ When body temperature is high, the capillaries
brown-toned skin, whereas people with less
of the dermis become engorged, or swollen, with
melanin are light skinned.
heated blood, and the skin becomes reddened
and warm. This allows body heat to radiate from
the skin surface. ▪ CAROTENE (in stratum corneum and
▪ If the environment is cool and body heat must be subcutaneous tissue)
conserved, blood bypasses the dermis - orange-yellow pigment from some vegetables
capillaries temporarily, allowing internal body (such as carrots and other orange, deep yellow,
temperature to remain high. or leafy green vegetables)
- Ingesting large amount of carotene-rich foods=
skin takes on yellow-orange cast
THE ORGAN SYSTEMS: INTEGUMENTARY SYSTEM

▪ HEMOGLOBIN (in dermal blood vessels)

• red coloring from blood cells in dermis capillaries • Acne- occurs when sebaceous gland ducts are
• oxygen content determines the extent of red blocked by sebum, acne appears on the skin
coloring surface. It is an active infection of the sebaceous
glands. If the accumulated material oxidizes and
Emotions also influence skin color, and many alterations dries, it darkens, forming a blackhead. If the
in skin color signal certain disease states: material does not dry or darken, a whitehead
form.
Redness or Erythema • Seborrhea (“fast-flowing sebum”), known as
- may indicate embarrassment (blushing), fever, “cradle cap” in infants, is caused by overactivity of
hypertension, inflammation, or allergy. the sebaceous glands. It begins on the scalp as
Pallor or Blanching (pale skin) pink, raised lesions that gradually form a yellow-to-
- Due to being under emotional stress (fear, anger, brown crust that sloughs off oily scales and
and others) dandruff.
- may also signify anemia, low blood pressure, or
impaired blood flow into the area. ii. Sweat Glands
Jaundice or a yellow cast (abnormal yellow skin tone) ▪ Aka sudoriferous
- usually signifies a liver disorder in which excess bile ▪ Widely distributed in skin
pigments accumulate in the blood, circulate ▪ Two types:
throughout the body, and become deposited in body
tissues. ➢ Eccrine glands
Bruises (black-and- blue marks) - Far more numerous
- reveal sites where blood has escaped from the - Open via duct to pore on skin surface (sweat
circulation and has clotted in the tissue spaces. pore)
Such clotted blood masses are called hematomas. - Produce sweat
- An unusual tendency to bruise may signify a
deficiency of vitamin C in the diet or hemophilia COMPOSITION OF SWEAT
(bleeder’s disease). • Mostly water
• Some metabolic wastes
APPENDAGES OF THE SKIN • Fatty acids and proteins (apocrine only)
• Accessory organs of your skin
FUNCTION OF SWEAT
I. CUTANEOUS GLANDS • Helps dissipate excess heat
- are all exocrine glands that release their • Excretes waste products
secretions to the skin surface via ducts. • Acidic nature (pH from 4 to 6) inhibits
- Falls into two groups: bacteria growth (Odor is from associated
i. Sebaceous (Oil) Glands bacteria)
▪ Found all over the skin except on the palms of
the hands and soles of the feet.
➢ Apocrine glands
▪ Ducts usually empty into a hair follicle but some
- Confined to the axillary (armpit) and genital
open directly to skin surface
areas of the body.
▪ Their product is SEBUM
- Ducts empty into hair follicles
- a mixture of oily substances and fragmented
- Their secretion contains fatty acids and proteins,
cells.
as well as all the substances present in eccrine
- A lubricant that keeps the skin soft and moist
sweat
and prevents the hair from becoming brittle
- may have a milky or yellowish color; odorless,
- contains chemicals that kill bacteria
but when bacteria that live on the skin use its
- become very active when androgens are
proteins and fats as a source of nutrients for
produced in an increase amount during puberty/
their growth, it can take on a musky, sometimes
adolescence.
unpleasant odor.
- begin to function during puberty under the
influence of androgens.
- play a minimal role in thermoregulation;
activated by nerve fibers during pain and stress
and during sexual arousal.

II. HAIR
- Found all over the body except on palms, soles
of the feet, nipple and lips.
THE ORGAN SYSTEMS: INTEGUMENTARY SYSTEM
- Produced by the hair bulb (deepest part of the ASSOCIATED HAIR STRUCTURES
hair follicle) 1. Hair follicle
- Consists of hard keratinized epithelial cells • are actually compound structures:
- Melanocytes in the hair bulb provide pigment for 1. inner epithelial root sheath: epithelial tissue
hair color which varies from the amount of and forms the hair
melanin (yellow, rust, brown, black)
2. outer fibrous sheath: dermal connective
tissue (this dermal region supplies blood
PROTECTIVE FUNCTION OF HAIR vessels to the epidermal portion and
➢ guarding the head against bumps reinforces it. Its nipplelike hair papilla
➢ shielding the eyes (via eyelashes) provides the blood supply to the matrix in the
➢ helping to keep foreign particles out of the hair bulb (the deepest part of the follicle).
respiratory tract (via nose hairs) • The sheaths surrounds the hair root
2. Arrector Pilli
• Small bands of smooth muscle cells that
connects each side of the hair follicle to the
dermal tissue.
• When these muscles contract (as when we are
cold or frightened), the hair is pulled upright,
dimpling the skin surface with “goose bumps.”
3. Sebaceous gland
4. Sweat gland

HAIR ANATOMY
a. Medulla
- The central core
- Consisting of large
cells and air
spaces
b. Cortex
- Surrounds the
medulla
- Composed of
several layers of
flattened cells.
c. Cuticle
- Formed by single
layer of cells that
overlap one
another. This arrangement of the cuticle cells ➢ These structures are susceptible to skin
helps to keep the hairs apart and keeps them diseases like Folliculitis (inflammation of
from matting. the follicles) or Hair Follicle tumor.
- Most heavily keratinized region; provides III. NAILS
strength and helps keep inner hair layers tightly • Scale-like modifications of the epidermis which are
compacted. heavily keratinized
- Most subjected to abrasion, allowing the keratin • Each nail has a free edge, a body and a root.
fibrils in the inner hair regions to frizz out, a • Borders of the nail are overlapped by folds of skin
phenomenon called “split ends.” called nail folds
- Hairs come in variety of sizes and shape: • Stratum Basale extends beneath the nail as nail
o Hair shaft is oval= smooth, silky and wavy bed
o Hair shaft is flat and ribbon-like= curly or • Thickened proximal area is called nail matrix which
kinky is responsible for growth ( as the matric produces
o Hair shaft is perfectly round= straight and nail cells, they become heavily keratinized and die,
tends to be coarse thus, are nonliving material)
• Looks pink because of rich blood supply in the
dermis.
THE ORGAN SYSTEMS: INTEGUMENTARY SYSTEM
• Thickened nail matrix that appears as a white c. Cold Sores (fever blisters)
crescent is called the lunule. • caused by virus
• Lack of pigment makes them colorless • small fluid-filled blisters that itch and sting,
• When the supply oxygen in the blood is low, the caused by human herpesvirus 1 infection.
nail bed take on a cyanotic (blue) cast. • The virus localizes in a cutaneous nerve, where
it remains dormant until activated by emotional
NAIL STRUCTURE upset, fever, or UV radiation.
• Free edge • Cold sores usually occur around the lips and in
• Body the oral mucosa of the mouth and nose.
• Root of nail • If human herpesvirus 2 infection, same but
• Eponychium- proximal nail fold that projects onto commonly occurs in genitalia and passed on
the nail body sexual contact

d. Contact Dermatitis
• exposures cause allergic reaction
• Itching, redness, and swelling of the skin,
progressing to blistering.
• caused by exposure of the skin to chemicals
(such as those in poison ivy) that provoke
allergic responses in sensitive individuals.

e. Impetigo
• caused by bacterial infection
• Pink, fluid-filled, raised lesions (commonly
around the mouth and nose) that develop a
yellow crust and eventually rupture.
• Caused by highly contagious staphylococcus or
streptococcus infections
• common in elementary school–aged children.
- .
f. Psoriasis
• cause is unknown; triggered by trauma,
infection, stress
• Characterized by reddened epidermal lesions
covered with dry, silvery scales that itch, burn,
crack, and sometimes bleed.
• A chronic condition psoriasis s believed to be an
autoimmune disorder in which the immune
system attacks a person’s own tissues, leading
to the rapid overproduction of skin cells.
• Attacks are often triggered by trauma, infection,
hormonal changes, or stress. When severe,
psoriasis may be disfiguring.
SKIN HOMEOSTATIC IMBALANCES
II. BURNS
• Tissue damage and cell death caused by heat,
I. INFECTIONS AND ALLERGIES electricity, UV radiation (sunburn), or chemicals
a. Athletes Foot (such as acids),
• An itchy, red, peeling condition of the skin • Results to two life-threatening problem:
between the toes, resulting from an infection ➢ Dehydration
with the fungus Tinea pedis. ➢ Electrolyte Imbalance
• caused by fungal infection • Dehydration and electrolyte imbalance follow and
can lead to a shutdown of the kidneys and
b. Boils and carbuncles circulatory shock (inadequate circulation of blood
• caused by bacterial infection caused by low blood volume).
• Boils are caused by inflammation of hair follicles • To save, lost fluid must be replaced. Such could
and surrounding tissues, commonly on the be estimated by how much of the body surface is
dorsal neck. burned with the use of the RULE OF NINES.
• Carbuncles are clusters of boils often caused by
the bacterium Staphylococcus aureus.
THE ORGAN SYSTEMS: INTEGUMENTARY SYSTEM

DEPTH OF BURN LAYERS OF SKIN AFFECTED CLINICAL FEATURES

Epidermal Burn Epidermis only Skin is red and

painful, but not
blistered. This is
typical of
sunburn.

Superficial Partial The epidermis & The skin is pale

Thickness Burn upper layer of pink and painful
dermis. with blistering.
Capillary refill:
blanches &
rapidly returns.

Deep Partial The epidermis, upper The skin appears

Thickness Burn and deeper layers of dry or moist, blotchy
and cherry red, and
dermis. may be painful or
painless. There may
be blisters. Capillary
refill: blanches with
a sluggish return or
does not blanch.

Full Thickness The burn extends The skin is dry

Burn through all the layers and white,
of skin to brown, or black
subcutaneous in color, with no
tissues. blisters. It may
be described as
leathery or waxy.
It is painless.
Capillary refill:
does not blanch.

SEVERITY OF BURNS
RULE OF NINE a. FIRST-DEGREE BURNS
▪ Way to determine the extent of burns - Superficial burns
▪ Body is divided into 13 areas for quick estimation - only epidermis is damaged
- Each area represent about 9% - skin is red and swollen
b. SECOND-DEGREE BURNS
- Superficial partial-thickness burns
- Epidermis and upper dermis are damaged
- Skin is red with blisters
c. THIRD-DEGREE BURNS
- Full- thickness burns
- Destroys entire skin layer
d. FOURTH-DEGREE BURNS
- Full- thickness burns with deep-tissue
involvement
CRITICAL BURNS (life-threatening: 50-50)
- Over 25% of body has second degree burns
- Over 10 % of the body has third degree burns
- There are third degree burns of the face, hands,
or feet

SKIN CANCER
• Numerous types of neoplasms (tumors) arise in
the skin.
• Cancer- abnormal cell mass
• Two types:
1. Benign- does not spread (encapsulated); an
example is warts which is caused by human
papillomaviruses
THE ORGAN SYSTEMS: INTEGUMENTARY SYSTEM
2. Malignant- metastasized (moved) to other ABCD RULE
parts of the body (bone cancer - lungs) A= ASYMMETRY
• Two sides of pigmented molds do not match
• Skin cancer is the most common type of cancer.
- The most important risk factor is overexposure B= BORDER IRREGULARITY
to UV radiation in sunlight and tanning beds. • Borders of mole are not smooth but exhibit
- Frequent irritation of the skin by infections, indentions
chemicals, or physical trauma also seems to be
a predisposing factor. C= COLOR
• Different colors in pigmented area (black, brown,
COMMON TYPES tan, and sometimes blue or red)
1. Basal Cell Carcinoma D= DIAMETER
- Least malignant and most common type
- Arises from Stratum Basale • Lesion is larger than 6 mm in diameter (size of a
pencil eraser)
- Cells of the Stratum Basale, altered so that they
cannot form keratin, no longer honor the
E= EVOLUTION
boundary between epidermis and dermis. They
proliferate, invading the dermis and • One or more of these characteristics (ABCD) is
evolving or changing.
subcutaneous tissue.
- The cancerous lesions occur most often on sun-
exposed areas of the face and often appear as
shiny, dome-shaped nodules that later develop a SENSORY CUTANEOUS RECEPTORS
central ulcer with a “pearly” beaded edge .
- relatively slow-growing, and metastasis seldom • FREE NEVER ENDINGS : Perception of pain,
occurs before the lesion is noticed. temperature, touch, pressure, tickle and itch
- When the lesion is removed surgically, 99% of sensations(discriminate shapes_
cases are completely cured.
• HAIR FOLLICLE ENDINS OR HAIR-END
ORGANS: Mechanical movement and touch.
2. Squamous Cell Carcinoma (pag agi sa wind)
- Arises from Stratum Spinosum
- The lesions appear as scaly, reddened papules
(small, rounded swellings) that gradually form • MERKEL’S DISC: Low-intensity touch, as well
shallow ulcers with firm, raised borders. as to the velocity of touch and respond to
- appears most often on the scalp, ears, back of constant indentation of the skin (pressure),
the hands, and lower lip, but can appear abundant in fingertips. (lady merkel)
anywhere on the skin.
- It grows rapidly and metastasizes to adjacent • RUFFINI ENDINGS: Touch and Pressure,
lymph nodes if not removed. Stretch, Join position Sense (init for heat, lihok
- also believed to be induced by UV exposure. ang shoulders)
- Early removal allows a good chance of cure
• KRAUSE’S END BULB: Touch and Pressure
(cold – santa krause)
3. Malignant Melanoma
- Most deadly of skin cancers
- Cancer of melanocytes • MEISSNER’S CORPUSCLES LOW-
- It accounts for only about 5 percent of skin THRESHOLD – rapidly adapting and in high
cancers, but it is often deadly. concentration in the fingertips, lips, and toes,
- can begin wherever there is pigment; most such areas that require high levels of
cancers appear spontaneously, but some discrimination (helps ruffinins)
develop from pigmented moles.
- It arises from accumulated DNA damage in a • PACINIAN CORPUSCLES – perception of
skin cell and usually appears as a spreading deep touch and vibration (vibration)
brown to black patch that metastasizes rapidly to
surrounding lymph and blood vessels. STAGES OF PRESSURE SORES
- The chance for survival is about 50 percent, and • Stage 1 -redness only (pain)
early detection helps. • Stage 2 – start form ang crater (pantay)
- The American Cancer Society suggests that • Stage 3 – injury both in epidermis and dermis
people who sunbathe frequently or attend layer
tanning parlors examine their skin periodically • Stage 4 – makita na ang subcutaneous tissue
for new moles or pigmented spots and apply the
ABCDE rule for recognizing melanoma.
THE ORGAN SYSTEMS: INTEGUMENTARY SYSTEM

- Bed-ridden and immobilized patients

- Spinal injury patients
- TA AND SI – part na dili nila ma feel, kay wala
na ang sensory nerves