Chapter 5

Integumentary
System

Shaft of a hair protruding through the skin

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Functions of the Integumentary System
• Consists of the skin, hair, glands, and nails
• Functions
1. Protection
– Against abrasion and UV light
– Prevents entry of microorganisms
– Prevents dehydration
2. Sensation
– Sensory receptors that can detect heat, cold, touch,
pressure, and pain
3. Temperature regulation by controlling
– Blood flow through the 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)
• Consists of three major regions
– Epidermis: outermost region (superficial)
• Resists abrasion
• Reduces water loss
– Dermis: middle region (bulk of skin)
• Responsible for most of the structural strength of the skin
• Leather is produced from the dermis of animals
– Subcutaneous tissue (hypodermis): deepest region
• Not really part of the skin
• Connects the skin to underlying muscle or bone
Fig. 5.1
 Epidermis
• Composed of keratinized stratified
squamous epithelium, consisting of four
distinct cell types and four or five layers
• Cell types include keratinocytes,
melanocytes, Merkel cells, and
Langerhans’ cells
• Outer portion of the skin is exposed to the
external environment and functions in
protection
 Cells of the Epidermis
• Keratinocytes
– Most abundant cell type
– Produce the fibrous protein keratin
– Gives skin its protective properties
• Melanocytes
– Produce the brown pigment melanin
– Found in the deepest layers of the epidermis
• Langerhans’ cells
– Epidermal macrophages
– Help activate the immune system
• Merkel cells
– Touch receptors in association with sensory nerve endings
 Layers of the Epidermis
• Stratum Basale (Basal Layer)
– Deepest epidermal layer firmly attached to the
dermis
• Structural strength is provided by desmosomes and
hemidesmosomes
– Consists of a single row of the youngest
keratinocytes
– Cells undergo mitotic divisions ~every 19 days
– 10-25% are melanocytes
 Layers of the Epidermis
• Stratum Spinosum
– Melanin granules and Langerhans’ cells are abundant in
this layer
• Melanin is taken up by the keratinocytes and accumulates on
the “sunny side” to protect the nucleus from UV damage
• Stratum Granulosum
– Drastic changes in keratinocyte appearance occurs
– Keratohyaline and lamellated bodies (waterproofing)
accumulate in the cells of this layer
– Above this layer the epithelial cells die because they are
too far from the dermis
 Layers of the Epidermis
• Stratum Lucidum
– Thin, transparent band superficial to the Stratum
Granulosum
– Consists of a few rows of flat, dead keratinocytes
– Present only in thick skin
• Stratum Corneum
– Outermost layer of keratinized cells
– Accounts for three quarters of the epidermal thickness
– 20-30 cell layers thick, all dead.
– Millions rub off everyday. Totally new every 25-45 days.
– Functions include:
• Waterproofing
• Protection from abrasion and penetration
• Rendering the body relatively insensitive to biological, chemical,
and physical assaults
Fig. 5.2b
 Thick and Thin Skin
• Thick skin has all five epithelial strata
• Thin skin contains fewer cell layers per
stratum
– Stratum lucidum is usually absent
– Hair is found only in thin skin
 Skin Color
• Melanocytes produce melanin inside
melanosomes and then transfer the melanin to
keratinocytes
– The size and distribution of melanosomes determine
skin color
– Melanin production is determined genetically but can
be influenced by UV light (tanning) and hormones
• Increased blood flow produces a red skin color
(Erythema), whereas a decreased flow causes
pale skin
– Decreased oxygen content in the blood results in a
bluish color called cyanosis
• Carotene, an ingested plant pigment, can cause
the skin to appear yellowish
Melanin Transfer to Epithelial Cells

Melanocytes make melanin, which is packaged into melanosomes and transferred to

many epithelial cells
 Dermis
• Second major skin region containing
strong, flexible connective tissue
• Cell types include fibroblasts, a few
adipose cells and macrophages
• Composed of two layers: papillary and
reticular
 Layers of the Dermis
• Papillary layer
– Areolar connective tissue with collagen and elastic
fibers
– Its superior surface contains peg-like projections
called dermal papillae
• Genetically determined
• Responsible for fingerprints and footprints (films of sweat)
– Contains blood vessels that supply the overlying
epidermis
• With nutrients
• Remove waste products
• Aid in regulating body temperature
 Layers of the Dermis
• Reticular layer
– Dense irregular connective tissue
– Accounts for approximately 80% of the
thickness of the skin
– Collagen fibers in this layer add strength and
resiliency to the skin
– Elastin fibers provide stretch-recoil properties
– Striae (stretch marks) are caused when skin
is overstretched, the dermis ruptures and
leaves visible lines
 Layers of the Dermis
• Reticular layer
– Elastin and collagen
fibers are oriented
more in one direction
than in others and
produce cleavage, or
tension, lines

Fig. 5.5
 Subcutaneous Tissue
• Deep to the skin
• Composed of adipose and areolar
connective tissue
• Not really part of the skin
• Mostly adipose tissue
• Stores fat and connects the skin to the
underlying structures (mainly muscles)
• Shock absorber and insulator
• Increases greatly as you gain weight
 Accessory Skin Structures
• Hair
• Glands
• Nails
 Hair
• Lanugo (fetal hair) is replaced near the time of birth by
terminal hairs (scalp, eyelids, and eyebrows) and vellus
hairs
• At puberty, vellus hairs can be replaced with terminal hairs
• Hairs are columns of dead, keratinized epithelial cells
– Each hair consist of
• A shaft above the skin
• A root below the skin
• A hair bulb the site of hair formation
• Hairs have a growth stage and a resting stage
• Contraction of the arrector pili, which are smooth muscles,
causes hair to “stand on end” and produces “goose flesh”
Fig. 5.6
 Sebaceous Glands
• Simple or compound alveolar glands found
all over the body except on the palms and
soles
• Soften skin when stimulated by hormones
• Secrete an oily secretion called sebum
• Acne is an active inflammation of the
sebaceous glands.
 Sweat Glands
• Different types prevent overheating of
the body
• Secrete cerumen and milk
• Up to 3 million/person
– Merocrine sweat glands produce
sweat, which cools the body: most
numerous in the palms and soles of
the feet
– Apocrine sweat glands: Found in
axillary and genital areas. Ducts
empty into hair follicles. Produce an
organic secretion that can be broken
down by bacteria to cause body odor
– Ceruminous glands: modified
merocrine glands in external ear
canal that secrete cerumen (ear wax)
– Mammary glands: specialized sweat
glands that secrete milk
 Nails
• The nail is Stratum
Corneum containing hard
keratin
• The nail root is covered by
skin
• The nail body is the visible
part of the nail
• Nearly all of the nail is
formed by the nail matrix,
but the nail bed contributes
• The lunula is the part of the
nail matrix visible through
the nail body
 Integumentary System Functions
• Protection • Sensation
– Skin – Skin contains sensory
• Protects against abrasion and receptors for
UV light • heat
• Prevents the entry of • cold
microorganisms • touch
• Helps regulate body • pressure
temperature
• pain
• Prevents water loss
– Hair
• Protects against abrasion and
UV light
• Acts as a heat insulator
– Nails protect the ends of
the digits
 Integumentary System Functions
• Temperature • Vitamin D Production
Regulation • UV light stimulates the
production of a precursor
– Skin molecule in the skin that is
• Controls heat loss from the modified by the liver and
body by dilation and kidneys into vitamin D
constriction of blood • Vitamin D increases calcium
vessels uptake in the intestines
– Sweat glands
• Excretion
• Produce sweat, which
• Skin glands remove small
evaporates and lowers
body temperature amounts of waste products
but are not important in
excretion
 Temperature Regulation
• normal body temperature is 37︒C
• regulation of body temperature is
important because the rate of chemical
reactions within the body can be increased
or decreased by changes in body
temperature
• in order to maintan homeostasis, body
must rid of excess heat
 Heat Exchange in the Skin

Blood transfers heat from deeper tissues to the surface of the skin, where the heat is
lost. Alteration of blood vessel diameter, and therefore blood flow, allows for
regulation of heat loss at the skin.
2. Jaundice=yellowish skin color=liver
damaged by a disease like hepatitis
3. Rashes and Lesions= symptoms of
problems elsewhere in the body
4. Condition of skin, hair and nails=affected
by nutritional status
Burns= injury to a tissue caused by
heat, cold, friction, chemicals, electricity, or
radiation

•Can be classified according to their depth

– Partial-thickness burns
– Full-thickness burns
Partial-thickness burns=part of the
stratum basale remains viable, and
regeneration ocurs, divided into two:
1. First-degree: only the epidermis is
damaged
– Symptoms include localized redness,
swelling, and pain
2. Second-degree: epidermis and upper
regions of dermis are damaged
– Symptoms mimic first degree burns, but
blisters also appear
 Full-thickness burns

• Third-degree: entire thickness of the skin is

damaged
– Burned area appears gray-white, cherry red, or
black; there is no initial edema or pain (since
nerve endings are destroyed)
 Rule of Nines
• Estimates the severity
of burns
• Divides body into
areas that are ~ 9%,
or multiples of 9%, of
the total body area
• Younger patients are
different
• Burns considered
critical if:
– Over 25% of the body
has second-degree
burns
– Over 10% of the body
has third-degree burns
– There are third-degree
burns on face, hands,
or feet
Page 115
 Basal Cell Carcinoma
• Least malignant and most common skin cancer
• Stratum Basale cells proliferate and invade the dermis
and hypodermis
• Slow growing and do not often metastasize
• Can be cured by surgical excision in 99% of the cases
 Squamous Cell Carcinoma
• Arises from keratinocytes of Stratum Spinosum
• Arise most often on scalp, ears, and lower lip
• Grows rapidly and metastasizes if not removed
• Prognosis is good if treated by radiation therapy or
removed surgically
 Melanoma
• Cancer of melanocytes is the most dangerous type of
skin cancer because it is:
– Likely to metastasize
– Resistant to chemotherapy
 Melanoma
• Melanomas have the following characteristics
(ABCD rule)
– A: Asymmetry; the two sides of the pigmented area do
not match
– B: Border is irregular and exhibits indentations
– C: Color (pigmented area) is black, brown, tan, and
sometimes red or blue
– D: Diameter is larger than 6 mm (size of a pencil eraser)
• Treated by wide surgical excision accompanied by
immunotherapy
• Chance of survival is poor if the lesion is over 4 mm
thick
 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,
and the number of melanocytes decreases
• Age spots= increase of melanocytes in some
areas
Page 119