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
 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
evaporates and lowers • Skin glands remove small
body temperature amounts of waste products
but are not primarily
important in excretion
 Skin
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
 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
 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
 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
 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
 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
 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
Kwashiorkor
- Severe protein deficiency
- The hair color is faded, and appears
reddish or bleached and the texture is
coarse and dry.
Alopecia
- Hair loss
 SKIN
Pallor
– is the result of inadequate circulating blood
or hemoglobin and subsequent reduction in
tissue oxygenation.
Cyanosis
- (bluish tinge)
- Most evident in the nail beds, lips, and
buccal mucosa.
Jaundice
- (yellowish tinge)
- May first be evident in the sclera of the
eyes and then in the mucous membranes
and the skin.
Erythema
- Skin redness associated with a variety of rashes
and other conditions.
Edema
- The presence of excess interstitial fluid.
- Appears swollen, shiny, taut, and tends to
blanch the skin color or, if accompanied by
inflammation, may redden the skin.
- Generalized edema is most often an indication
of imapired venous circulation and in some
cases reflects cardiac dysfunction or venous
abnormalities.
 ABNORMAL FINDINGS ( bleeding, ecchymosis
and vascularity)

spiderangioma Cherry angioma

petechiae
 NAILS
Functions to provide protection
to the distal surface of the digits
and can be used for self
protection.
 NAILS
• Horn – like envelop covering the tips of the
fingers and toes
• Parts includes
- Matrix
- Nail plate
- Nail root
- Nailbed
- lunula
 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
Fingernails
Toe nails
Nail Abnormalities
Nail Abnormalities
 NAIL ABNORMALITIES
Koilonychia
- Spoon shape, in which the nail
curves upward from the nail
bed.
- Maybe seen in clients with iron
deficiency anemia.
 NAIL ABNORMALITIES
Paronychia
- An inflammation of the tissues surrounding
a nail.
- The tissues appear inflamed and swollen
and tenderness is usually present.
 NAIL ABNORMALITIES
Onychomycosis (nail fungus)
- Symptoms include brittleness,
discoloration, thickening, distortion of nail
shape, crumbling of the nail and loosening
(detaching) of the nail.
 NAIL ABNORMALITIES
Clubbing
- A condition in which the angle between the
nail and the nail bed is 180 degrees or
greater.
- May be caused by a long-term lack of
oxygen.
 NAIL ABNORMALITIES
Blanch test
- To test the capillary refill, that is peripheral
circulation.
- Normal nail bed capillaries blanch when
pressed, but quickly turn pink on their
usual color when pressure is released.
 Burns
• First-degree: only the epidermis is damaged
– Symptoms include localized redness, swelling, and
pain
• Second-degree: epidermis and upper regions of
dermis are damaged
– Symptoms mimic first degree burns, but blisters also
appear
• 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)
Page
115
 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