INTEGUMENTARY SYSTEM EPIDERMIS

• It consists of • The epidermis is stratified squamous epithelium.

o Skin • It is separated from the underlying dermis by a
o Accessory structures (hair, glands, nails) basement membrane.
• Other disorders affect different body parts but are • The epidermis is not as thick as the dermis and
reflected in the integumentary system, which contains no blood vessels.
provides useful signs for diagnosis • The living cells of the epidermis receive nutrients
• The integumentary system is useful in diagnosis and excrete waste products by the diffusion of
because it is observed easily and often reflects events substances between the epidermis and capillaries
occurring in other parts of the body of the dermis.
• Ex. Cyanosis is a blueish discoloration of the skin caused
• The epidermis is composed of several types of
by decreased blood oxygen content. Cyanosis is an
indication of impaired respiratory or circulatory cells:
function. While the yellowish discoloration in the skin, o Keratinocytes
known as jaundice can occur when the liver is damaged ▪ Most cells of the epidermis are known
by a disease like viral hepatitis. as keratinocytes.
• Ex. A reduced blood flow through the skin during heart ▪ It produces a protein mixture called
attack can cause a person to look pale whereas, keratin which makes the cells more
increased blood flow as a result of fever can cause a durable
flash appearance. Some diseases cause skin rashes ▪ Keratinocytes give the epidermis its
such as those characteristics of measles, chicken pox ability to resist abrasion and reduce
and allergic reactions. water loss
▪ The keratinocytes of epidermis are
SKIN constantly lost at its surface but are
also constantly replaced by other
• The skin is made up of two major tissue layers: cells moving from deeper layers
o Epidermis o Melanocytes
o Dermis ▪ Produce the pigment melanin which
contributes to skin colors
EPIDERMIS o Langerhans cells
▪ Is a part of immune system
o Merkel cells
▪ Specialized epidermal cells
associated with the nerve endings
responsible for detecting like touch
and superficial pressure

1. New keratinocytes are produced when keratinocyte stem

cells undergo mitosis in the deepest layer of the epidermis
Process of Keratinization

2. As new cells form, they push older cells to the surface,

• The epidermis is the superficial layer of the skin where they slough off
consisting of stratified squamous epithelial tissue.
• The multiple cell layers of the epidermis resist abrasion
of the skin surface and reduces water loss to the skin. 3. The outermost cells in this stratified arrangement protect
the cells underneath, and the deeper, replicating cells replace
cells lost from the surface
DERMIS
4. As they move from the deeper epidermal layers to the
surface, the keratinocytes change shape and chemical
composition

In keratinization, the cells eventually die to produce an outer layer

of dead hard cells that resist abrasion and forms a permeability
barrier

• A layer of connective tissue

• The structure of dermis is responsible for most strength
of the skin.
• The strength of dermis is seen in leather which is
produced from the hide of the animal removing the
dermis and preserving the dermis in a processing called
tanning

TABAO, KRIZELYN CHARM B. BSN1J 21

THE LAYERS OF CELLS IN THE EPIDERMIS ARE DIVIDED • In the most superficial layers of the stratum granulosum
INTO REGIONS OR STRATA: the nucleus and other organelles regenerate, and the
cells die unlike the other organelles in the nucleus
STRATUM BASALE • However, the keratin fibers and the keratohyalin
granules within the cytoplasm do not degenerate
• “stratum germinativum” • The cells of stratum granulosum accumulate dense
• The deepest portion of the epidermis mesophilic keratohyalin granules. This granules contain
• Consist of single layer of cuboidal or columnar cells lipids which along the desmosomal connections help to
• The epidermis is anchored to the basement membrane form a waterproof barrier that functions to prevent fluid
by hemidesmosomes loss from the body
• Desmosomes hold the keratinocytes together and the
STRATUM LUCIDUM
connections form by the hemidesmosomes and
desmosomes provide structural strength to the
epidermis • The stratum lucidum is a thin, clear zone above the
• Keratinocytes are strengthened internally by keratin stratum granulosum
fibers that insert to the desmosomes • It consist of several layers of dead cells with
• Keratinocyte stem cells of the stratum basale indistinct boundaries
undergo mitotic divisions approximately every 19 • Keratin fibers are present, but the keratohyalin,
days which was evident as granules in the stratum
• One daughter cell remains a stem cell in the granulosum, has dispersed around the keratin
stratum basale and divides again, but the other fibers, and the cells appear somewhat
daughter cell is pushed toward the surface and transparent
becomes keratinized • The stratum lucidum is present in only a few areas
• It takes approximately 40-56 days for the cells to of the body
reach the epidermal surface and slough off • Stratum lucidum is responsible for the capability of the
• Two primary functions: skin to stretch
o For proliferation • It also contains a protein that is responsible the
o For attachment of the epidermis to the dermis degeneration of skin cells

STRATUM SPINOSUM STRATUM CORNEUM

• Superficial to the stratum basale is the stratum • The last, and most superficial, stratum of the
spinosum epidermis is the stratum corneum
• Consisting of 8-10 layers of many-sided cells • This stratum is composed of 25 or more layers of
• As the cells in this stratum are pushed to the dead, overlapping squamous cells joined by
surface, they flatten; desmosomes break apart, desmosomes
and new desmosomes form. • Eventually the desmosomes break apart and the cells
are shed from the surface of the skin
• During preparation for microscopic observation,
• Excessive shedding of the stratus corneum of the scalp
the cells usually shrink from one another, except may result in dandruff
where they are attached by desmosomes, causing
• The stratum corneum consists of cornified cells,
the cells to appear spiny – hence the name stratus
which are dead cells, with a hard protein
spinosum
envelope, filled with the protein keratin
• Additional keratin fibers and lipid filled membrane bound
• Keratin is a mixture of keratin fibers and keratohyalin
organelles called laminar bodies form inside the
keratinocytes • The envelope and the keratin are responsible for
• The stratum spinosum is partly responsible for the skin’s the structural strength of the stratum corneum
strength and flexibility • The type of keratin found in the skin is soft keratin
• Another type of keratin which is the hard keratin is found
STRATUM GRANULOSUM in nails and external parts of hair
• Cells containing hard keratin are more durable than
• The stratum granulosum consists of 2-5 layers of cells with self keratin and they are not shed
somewhat flattened, diamond-shaped cells • Lipids are released from the laminar bodies surrounding
• The long axes of these cells are oriented parallel the skin cells and they are responsible for many of the
skins permeability characteristics
to the surface of the skin
• The stratum corneum is the skin’s outermost layer, and
• This stratum derives its name from the presence interface with the outside world is recognized as the
of protein granules of keratohyalin, which barrier that prevents unwanted materials from entering
accumulate in the cytoplasm of the cell and the excessive loss of water from exiting the body
• The laminar bodies form as the cells pass through the
stratum spinosum moved to the plasma membrane and
release their lipid contents into the extracellular space
• Inside the cell, is a protein envelope which forms
beneath the plasma membrane

TABAO, KRIZELYN CHARM B. BSN1J 22

THICK AND THIN SKIN • The cells of the dermis include:
o Fibroblasts
• The terms thin and thick which refer to the epidermis
o Adipocytes
only should not be used when total thickness is
o Macrophages
considered
• Collagen is main type of protein fiber of
THICK SKIN extracellular matrix, but elastic and reticular
fibers are also present
• Thick skin has all five epithelial strata, and the • The dermis also contains nerve endings, hair
stratum corneum has many layers of cells follicles, smooth muscles, glands, and lymphatic
• Thick skin is found in areas subject to pressure or vessels
friction, such as the palms of the hands, the soles • The nerve endings are varied in structure and
of the feet, and the fingertips function. They include free nerve endings for pain,
• Each of its strata contains fewer layers of cells done or itch, tickle, and temperature sensations:
found in thick skin
• The stratum granulosum frequently consist of one or two Hair follicle → For light touch
layers of cell and the stratum lucidum is generally absent Pacinian → For deep pressure
corpuscles
Meissner → For detecting simultaneous stimulation at
THIN SKIN corpuscles two points on the skin
Ruffini end organs → For sensing continuous touch or pressure
• Thin skin covers the rest of the body and is more
flexible than thick skin
• Hair is found only in thin skin • The dermis is composed of two tissue layer:
• The entire skin including the epidermis and dermis o Papillary layer
varies in thickness from 0.5 millimeters in the eyelids to ▪ Derives its name from projections
5 millimeters in the back and shoulders called the dermal papillae that extend
toward the epidermis
SKIN COLOR ▪ Loose connective tissue with thin
fibers that are somewhat loosely
• Melanin arranged
o The group of pigments primarily ▪ It also contains blood vessels that
responsible for skin, hair and eye color supply the overlying epidermis with
oxygen and nutrients, remove waste
o Melanin also provides protection against
products in it in regulating body
ultraviolet light from the sun temperature
o Produced by melanocytes irregularly ▪ The dermal papillae under the thick
shaped cells with many long processes skins of the palms of the hands and
that extend between the keratinocytes of soles of the feet lie in parallel carving
the stratum basale and the stratum bridges that shape the overlying
spinosum epidermis into fingerprints and
footprints
o Melanocytes produce and package
melanin into vesicles called melanosomes o Reticular layer
▪ Composed of dense irregular
which move into cell processes of the
connective tissue which is the main
melanocytes layer of the dermis
o Keratinocytes phagocytized the tips of the ▪ It is continuous with the
melanocyte cell processes there by acquiring subcutaneous tissue and forms a mat
melanosomes although all keratinocytes can of irregularly arranged fibers that are
contain melanin, the only cells that produce are resistant to stretching in many
the melanocytes directions
o Large amount of melanin are found in certain
regions of the skin such as freckles, moles, SUBCUTANEOUS TISSUE
nipples, areola of the breast, the axilla and the
genitalia • The subcutaneous tissue attaches the skin to
o Other areas of the body such as the lips, palms underlying bone and muscle and supplies the skin
of the hand, soles of the feet, contain less with blood vessels and nerves
melanin
• The subcutaneous tissue consist of loose
o Melanin production is determined by
connective tissue with collagen and elastic fibers
genetic factors, exposure to light, and
• The main types of cells within the subcutaneous tissue
hormones
includes: fibroblasts, adipocytes, and macrophage
DERMIS • The subcutaneous tissue, which is not part of the
skin is sometimes called the hypodermis
• The dermis is connective tissue • The amount of adipose tissue in the subcutaneous
• The dermis contains blood vessels that allow for tissue varies with age, sex, and diet
nutrient and waste exchange to the cells of the
dermis and the living cells of the epidermis

TABAO, KRIZELYN CHARM B. BSN1J 23

 • Approximately half the body’s stored lipids are in o Cortex
the subcutaneous tissue, where they function in ▪ Surrounds the medulla and forms
insulation and padding and as a source of energy bulk of the hair and the cells of the
• The subcutaneous tissue can be used to estimate total cortex contain hard keratin
body fat like pinching the skin at selected locations and o Cuticle
measuring the thickness of the skinfold in underlying ▪ The cortex is covered by the cuticle
subcutaneous tissue ▪ A single layer of cells also containing
• The thicker the fold, the greater the amount of total body hard keratin
fat and amount of adipose tissue in the subcutaneous ▪ The edge of the cuticle cells overlap
tissue varies with age, sex, and diet. like shingles on the roof
• Hair follicle
ACCESSORY SKIN STRUCTURES o Tube-like invagination of the epidermis that
extends to the dermis
HAIR o A hair develops and grows within each hair
follicle and it consist of dermal root sheath and
• Hair structure and coloration change as a person epithelial root sheath
ages • Dermal root sheath
• By the 5th or 6th month of fetal development delicate o Portion of the dermis that surrounds the
unpigmented hair called lanugo is formed epithelial root sheath
• The loose hairs which are short, fine and usually • Epithelial root sheath
unpigmented replace the lanugo on the rest of the body o Divided into external and internal parts
• At puberty, terminal hair, especially in the pubic o At the opening of the follicle, the external
and axillary regions, replaces much of the vellus epithelial root sheath has all the strata found in
hair thin skin
• The hair of the chest, legs, and arms is o While, the internal epithelial root sheath has
rays edges that mesh closely with the rays
approximately 90% terminal hair in males and
edges of the hair cuticle and hold the hair in
approximately 35% in females place
• In males, terminal hairs replace the vellus hairs of o When a hair is pulled out, the internal epithelial
the face to form the beard root sheath usually comes out as well and is
• The beard, pubic and axillary hair are signs of plainly visible as a whitish tissue around the
sexual maturity root of the hair
• Pubic and axillary hair may function as wicks for • Internal root sheath
dispersing odors produced by secretions from • Hair bulb
specialized glands in the pubic and axillary o Is an expanded knob at the base of the hair root
regions • Matrix
• It also has been suggested that pubic hairs o Inside the hair bulb, is a mass of
undifferentiated epithelial cells
protects against abrasion during sexual o The matrix produces the hair and the internal
intercourse and axillary hair reduces friction epithelial root sheath
when the arms move o The dermis of the skin projects into the hair
bulb as a hair papilla, within the hair papilla are
blood vessels that provide nourishment to cells
of the matrix

HAIR COLOR

• Melanocytes within the hair bulb matrix produce

melanin and pass it to the keratinocytes in the hair
cortex and medulla
• Hair color is controlled by several genes, and dark
HAIR STRUCTURE hair color is not necessarily dominant over light

• A hair is divided into the shaft, which protrudes

above the surface of the skin, and the root, located
below the surface
• The base of the root is expanded to form the hair
bulb
• Most of the root and the shaft are composed of
columns of dead, keratinized epithelial cells
arranged in three concentric layers HAIR GROWTH
o Medulla
▪ Central axis of the hair and consist of • Hair is produced in cycles that involve a growth
2 or 3 layers of cells containing soft stage and a resting stage
keratin

TABAO, KRIZELYN CHARM B. BSN1J 24

• During the growth stage, a hair increases in length
and die
• The hair grows longer as cells are added at the
base of the hair root
• Eventually, hair growth stops; the hair follicle
shortens and holds the hair in place
• A resting period follows, after which a new cycle
begins and a new hair replaces the old hair, which
falls out of the hair follicle
• The length of each stage depends on the hair
• Eyelashes grow for approximately for 30 days and rests
for 105 days
• Whereas scalp hairs grow for 3 years and rest for 1 to 2
years
• Loss of approximately 100 scalp hairs per day is normal
• Most common kind of permanent hair loss is patterned
baldness MUSCLES
• Hair follicles shrink and revert to producing vellus hair
which is very short, transparent and for practical • Arrector pili
purpose invisible o Associated with each hair follicle are
• The average rate of hair growth is approximately 0.3
smooth muscle cells
millimeters per day, although hair grows at different
rates even the same approximate location o The arrector pili extend from the dermal
• For the stages of hair growth: root sheath of the hair follicle to the
o 1st stage – anagen phase papillary layer of the dermis
▪ Active growth phase of hair follicles • Normally, the hair follicle and the hair inside it are at an
▪ During which the root of the hair is obliged angle at the surface of the skin
dividing rapidly adding to the hair • When the arrector pili muscles contract, however, they
shaft pull the follicle into a more perpendicular position
▪ During this phase, the hair grows causing the hair to stand on end
within 1 cm every 28 days • Movement of the hair follicles produces rays areas
o 2nd stage – catagen phase called the goosebumps
▪ Short transition stage that occurs at
the end of the anagen phase GLANDS
▪ Singles the end of the active growth
of hair
▪ This phase lasts for 2 to 3 weeks
▪ All the hair converts into a club hair
o 3rd stage – telogen
▪ Resting phase of the hair follicle
▪ When the body is subjected to
extreme stress, as much as 70% of
the hair can prematurely enter the
telogen phase and begin to fall,
causing unnoticeable loss of hair, this
condition is called telogen effluvium
▪ The club hair is the final product of a
hair follicle in the telogen phase
▪ Fully keratinized hair also is dead,
SEBACEOUS GLANDS
and 50 to 100 club hairs are shed
daily from a normal scalp • Located in the dermis
• Simple or compound alveolar glands that produce
sebum an oily, white substance rich in lipids
• Sebaceous glands are classified as holocrine
glands
• Most sebaceous glands are connected by a duct
to the upper part of the hair follicles, from which
the sebum oils the hair and the skin surface
• The secretion of sebum into the hair and surrounding
skin prevents drying and protects against some bacteria
• Sebaceous glands located in the lips, the eyelids
(meibomian glands), and the genitalia are not
associated with hairs but open directly onto the
skin surface

TABAO, KRIZELYN CHARM B. BSN1J 25

SWEAT GLANDS o Cerumen and hairs in the ear canals protect
the tympanic membrane by preventing the
• There are two types of sweat glands: rude and small insects from moving too deeply
o Eccrine glands in the ear canal
▪ “Merocrine sweat glands” • Mammary glands
▪ They are simple, coiled, tubular o Modified apocrine sweat glands located in the
breast which produces milk
glands that open directly onto the
surface of the skin through sweat NAILS
pores
▪ Distributed over the majority of the
areas of the body but are most
numerous in the palms of the hands
and soles of the feet
▪ Not found in the margin of the lips, the
labia minora, tips of the penis and the
clitoris
▪ Can be divided into two parts
• A deep coiled portion which
is located mostly on the
dermis
o The coiled part of
the gland
produces an
• Nail
isotonic fluid that
o Thin plate consisting of layers of dead stratum
is mostly water but
also contains corneum cells that contain a very hard type of
keratin.
some salts and
o located on the distal ends of the digits of the
small amounts of
fingers and toes and consists of the proximal
ammonia, urea,
uric acid and nail root and the distal nail body.
o Nail grows on an average rate of .5 to 1.2
lactic acid
millimeter per day and fingernails grow more
• The duct which passes to rapidly than toenails
the skin surface
o Unlike hair, they grow continuously throughout
o Sweat can also be life and do not have a resting phase.
released in palms,
soles and axilla as
• Nail root
a result of o is covered by skin and the nail body is the
emotional stress visible portion of the nail
o Apocrine sweat glands • Nail fold
▪ Simple, coiled, tubular glands o covers the lateral and proximal edges of this
nail
that usually open into hair
• Nail groove
follicles superficial to the
o Holds the nail edges in place.
opening of the sebaceous glands
• Eponychium
▪ Found in the axilla and genitalia and
o or the cuticle is the stratum corneum of the nail
around the anus
fold grows onto the nail body of the cuticle
▪ Do not help regulate temperature in
• Hyponychium
humans
o Hyponychium beneath the free edge of the nail
▪ Apocrine sweat glands become
body is a thickened region region of the
active at puberty as a result of stratum corneum
sex hormones o The nail root extends distally from the nail
▪ Their secretions contain organic matrix and the nail matrix and bed are
substances which are essentially composed of epithelial tissue with a stratum
odorless when first released but are basale that gives rise to the cells that form the
quickly metabolized by bacteria to nail
cause what is commonly known as • Nail bed
body odor o visible through the clear nail and appears pink
because of blood vessels in the dermis
OTHER GLANDS
• Lunula
o mall part of the nail matrix which is seen
• Ceruminous glands
through the nail body as a whitish Crescent
o Are modified eccrine sweat glands located in
shape area at the base of the nail.
the ear canal or the external auditory canal
o Seen best on the thumb appears white because
o Cerumen or earwax is composed of the
the blood vessels do not show through the
combined secretions of the ceruminous glands
thicker nail matrix.
and sebaceous glands

TABAO, KRIZELYN CHARM B. BSN1J 26

PHYSIOLOGY OF THE INTEGUMENTARY SYSTEM • When blood vessels in the dermis constrict less
warm blood flows. From deeper structures to the
FUNCTIONS OF THE INTEGUMENTARY SYSTEM skin and heat loss decreases.
• If the body temperature begins to drop below
1. Protection normal, heat can be conserved by a decrease in the
• The integumentary system is the body's fortress, diameter of thermal blood vessels.
defending it from harm. • Contraction of the erector pili muscles causes hair
• The skin protects underlying structures from to stand on end, but this does not significantly
mechanical damage. reduce heat loss in humans because so little hair
• The dermis provide structural strength, preventing covers the body. However, the hair on the head is
tearing of the skin. an effective insulator.
• In the stratified epithelium of the dermis, epidermis 4. Vitamin D Production
protects against abrasion as the outer cells of the • vitamin D functions as a hormone involved in the
stratum corneum slough off, they are replaced by regulation of calcium homeostasis.
the cells from the stratum. • Its primary role is to stimulate the Arctic of calcium
• Calluses develop in areas subject to heavy friction and phosphate from the intestines.
or pressure. • Adequate levels of these minerals are necessary for
• The skin also prevents microorganisms and other normal bone metabolism, and calcium is required
foreign substances from entering the body. for normal nerve and muscle function.
• Secretions from the skin glands produce an • Vitamin D synthesis begins in skin exposed to the
environment unsuitable for some microorganisms. ultraviolet light, and people can produce all the
• The skin also contains components of the immune vitamin D they require by this process. If enough UV
system that act against microorganisms. light is available, vitamin D can also be ingested and
• Melanin absorbs UV light and protects underlying absorbed in the small intestine.
structures from its damaging effect. • Natural sources of vitamin D are liver. Egg yolks and
• Hair provides protection in several ways. dairy products, so when exposed to ultraviolet light,
• The hair on the head acts as a heat insulator and the precursor molecule is converted into
protects against UV light and abrasion. Cholecalciferol.
• The eyebrows keep sweat out of the eyes and the • Cholecalciferol is released into the blood and
eyelashes protect the eyes from foreign objects and modified first by the liver and later by the kidneys to
hair in the nose and ears prevents dust and other form active vitamin D3 which is your calcitriol.
materials from entering 5. Excretion
• While the axillary and pubic hair are a sign of sexual • Excretion is the removal of waste products from the
maturity and protect against abrasion. body in addition to water and salt, sweat contains
• The nail protect the ends of the fingers and toes amount of waste products including urea, uric acid
from damage and can be used in the fence. and ammonia.
• The intact skin plays an important role in reducing • However, even when the large amount of sweat or
water loss because its lipids act as a barrier to the lost. The quantity of waste products eliminated in
diffusion of water. Some lipid soluble substances the sweat is insignificant because the urinary
readily pass through the epidermis and lipid soluble system excretes most of the body's waste products
medications can be administered by applying them
to the skin. After which the medication slowly BURN
diffuses through the skin in the blood.
2. Sensation • Is injury to a tissue caused by heat, cold, friction,
• Receptors in the skin can detect pain, heat, cold chemicals, electricity, or radiation
and pressure. • Burns are classified according to the extent of
• For example, the epidermis and dermal papillae are surface area involved and the depth of the burn
well supplied with touch receptors, the dermis and • So, in calculating or assessing the body surface area
deeper tissues contain pain, heat, cold touch and that has been burned to a patient, we use the rule of
pressure receptors. nines.
• Hair follicles are well innervated and sensory
receptors. Surrounding the base of the hair follicles RULE OF NINES
can detect hair movement.
3. Temperature regulation • The rule of nines is a standardized method used to
• Body temperature is affected by blood flow through quickly assess how much body surface area (BSA)
the skin. has been burned on a patient
• When the blood vessels in the dermis dilate, more • This rule is only applied to partial thickness (2nd
warm blood flows from deeper structures to the degree) and full thickness (3rd degree) burns
skin and heat loss increases.
• For an adult, the surface area that is burned can be
• Body temperature tends to increase as a result of
conveniently estimated by the rule of nines, which
exercise fever or a rise in environmental temperate.
divides the body in two areas that are approximately 9%
• In order to maintain homeostasis, this excess heat or multiples of 9% of the body surface area.
must be lost. The body accomplishes this by
• For younger patients, surface area relationships are
producing sweat. The sweat spreads over the
different. For example, in an infant, the head and neck
surface of the skin as it evaporates, the body loses
are 21% of the body surface area, whereas in an adult
heat.
they are 9% for burn victims younger than age 15

TABAO, KRIZELYN CHARM B. BSN1J 27

 specifically develop tool for calculating the extent of follicles and sweat glands, as well as from the
burns are designed for them. edges of the wound.
o If you have a superficial second degree burn
The percentage which you use for calculating using the rule of only part of the dermis is damage. You
nights. probably won't have scarring a deep partial
thickness burn is more severe, and it may leave
a scar and cause permanent change in the
color of the skin.
o Second degree burns involve the epidermis
and part of the dermal layer of the skin. The
burn site appears red, blistered and maybe
swollen and painful.
• Third degree burn
o the full thickness burns
o the epidermis and dermis are completely
destroyed and deeper tissue may be involved.
o Third degree burns are often surrounded by
first and second degree burns, and they are
usually painless because the sensory
receptors have been destroyed.
o Third degree burns appear white, tan, brown,
black or deep cherry red skin. Red can
DEPTH OF BURN regenerate only from the edges, and skin
grafts are often necessary.
First-Degree Burn Second-Degree Burn o Third degree burns destroy the epidermis and
dermis. And may also damage the underlying
bones, muscles and tendons. The burn site
appears white or charred, and there is no
sensation in the area since the nerve endings
are destroyed
• Fourth degree burn
Third-Degree Burn Fourth-Degree Burn o this is the deepest and most severe of burns,
and they are potentially life threatening.
o these burns destroy all layers of the skin as
well as your bones, muscles and tendons

The depth and percentage of the body surface area affected can
be combined with other criteria to classify the seriousness of a
burn. The following criteria define a major burn.

A third degree burn over 10% or more of the body surface area.

A second degree burn over 25% or more of the body surface area.
A second or third degree burn of the hands, feet, face, genitals
• First degree burns and the anal region.
o also known as superficial burns,
A moderate burn is a third degree burn over 2 to 10% of the body
o involve only the epidermis and may result in
surface area, or a second degree burn over 15 to 25% of the body
redness, pain and slight edema or swelling.
surface area.
o They can be caused by sunburn or brief
exposure to heart or cold objects and they heal A minor burn is a third degree burn over less than 2% or a second
in a week or so without scarring. degree burn over less than 15% of the body surface area.
o First degree burns affect only the epidermis or
outer layer of skin. To prevent these complications and speed healing, skin grafts are
o The burn site is red, painful, dry and with no performed in a split skin graft the epidermis and part of the dermis
blister are removed from another part of the body and replaced over the
• Second degree burns burn interstitial fluid from the burned area. Nourishes the graft
o partial thickness burns until it's dermis becomes vascularized. At the graft donation site,
o damaged epidermis and dermis. the part of the dermis is still present. The deep parts of the hair
o Minimal thermal damage causes redness, pain, follicles and sweat gland ducts remain in this dermis, where they
edema, and blisters. serve as a source of epithelial cells that form a new epidermis.
o Healing takes approximately 2 weeks and no This is the same process of the epidermis formation that occurs
scarring results. following superficial second degree burns when it is not possible
o If the burn goes deep into the dermis, the or practical to move the skin from one part of the body to a burn
wound appears red, tan, or white and may take site, artificial skin or grafts from human cadavers or pigs are used.
several months to heal and might.
o Scar in all second degree burns the epidermis
regenerates from the epithelial tissue in hair

TABAO, KRIZELYN CHARM B. BSN1J 28

EFFECTS OF AGING IN THE INTEGUMENTARY SYSTEM • Psoriasis
o is a chronic skin disease characterized by
• As the body ages, the skin is more easily damaged thicker than normal epidermal layer that
because the epidermis thins and the amount of sloughs off to produce large silvery scales.
collagen in the dermis decreases. Skin infections Bleeding may occur if the scales are scraped
are more likely, and skin repair occurs more away.
• Vitiligo
slowly
o is the development of patches of white skin
• A decrease in the number of elastic fibers in the dermis where melanocytes are destroyed, apparently
and a loss of adipose tissue from the subcutaneous by an autoimmune response.
tissue cause the skin to sag and wrinkle.
• Retin A is a vitamin A derivative that appears to be BACTERIAL INFECTIONS
effective in treating fine wrinkles on the face, such as
those caused by long term exposure to the sun, and it is Impetigo Erysipelas
not effective in treating deep lines. One ironic side effect
of Retin A use is increased sensitivity to the sun's UV
rays
• The number of functioning melanocytes generally
decreases; however, in some localized areas,
especially on the hands and face, melanocytes
increase in number, producing age spots
• Age spots are different from freckles, which are caused Decubitus Ulcer Acne
by an increase in the melanin production, not an
increase in the melanin site numbers
• White or gray hairs also appear because of a
decrease in or lack of melanin production. Skin
that is exposed to sunlight appears to age more
rapidly than nonexposed skin
• In skin exposed to sunlight, normal elastic fibers are
replaced by an interwoven mat take elastic like material • Impetigo
and the number of collagen fibers decrease and the o are small blisters containing pass easily to
ability of keratinocytes to divide is impaired rupture to form a thick yellowish grass.
o Usually affects children.
SKIN CONDITIONS • Erysipelas
o Are swollen touches in the skin caused by the
Birthmark Ringworm Eczema bacterium Streptococcus pyogenes.
• Decubitus ulcers
▪ also known as dead sores or
pressure sores,
o which develop in people who are bedridden or
confined to a wheelchair.
o Compression of tissue and reduce circulation
result in destruction of the skin and
subcutaneous tissue which later become
infected by bacteria forming ulcers.
Psoriasis Vitiligo • Acne
• this is a disorder of the sebaceous glands in hair follicles
that occur when Slough cells block the hair follicle,
resulting in the formation of a lesion or pimple, and the
lesion may become infected and may result in scarring
• acne appears to be the affected by hormones, sebum,
abnormal keratinization within hair follicles.

• birthmark
o congenital and present at birth
o And these are disorders of the dermal
capillaries
• Ringworms
o are fungal infection that produces patchy
scaling and inflammatory response in the skin.
o This is an inflammatory condition of the skin
caused by allergy infection, poor circulation or
exposure to chemical or environmental
factors.

TABAO, KRIZELYN CHARM B. BSN1J 29

VIRAL INFECTIONS

Rubeola Rubella Chicken Pox

Shingles Cold Sores Genital Herpes

• rubeola
o or measles.
o This is a skin lesions caused by a virus
contracted through the respiratory tract and
may develop into pneumonia or infect the brain
causing damage.
• rubella
o or German measles.
o Which also is a skin lesions, usually mild viral
disease, contracted through the respiratory
tract, may be dangerous if contracted during
pregnancy because the virus can cause the
placenta and damage the feet.
• chicken pox
o usually mild viral disease contracted through
the respiratory tract.
• Shingles
o painful skin lesion caused by the chicken pox
virus after childhood infection.
o This can recur when the dormant virus is
activated by trauma, stress or another illness.
• Cold sores
o or fever blisters
o caused by herpes simplex one virus,
transmitted by oral or respiratory routes, and
lesions occur.
• genital herpes.
o Are genital lesions caused by herpes simplex 2
virus transmitted by sexual contact

TABAO, KRIZELYN CHARM B. BSN1J 30