Chapter 05

Integumentary System
The integumentary system includes the skin and accessory structures such as hair, glands, and nails.
5.1 Functions of the Integumentary System
Structures that are part of the integument.
• Skin.
• Hair.
• Nails.
• Glands.
Functions:
• Protection – protects against U V light, microorganisms, water loss.
• Sensation – sensory receptors for heat, cold, touch, pressure, pain.
• Temperature regulation – modulation of blood flow through the skin and activity of
sweat glands.
• Vitamin D production from a molecule made in the skin when exposed to U V light.
• Excretion – small amounts of waste products eliminated.
5.2 Skin
Epidermis: Superficial layer of stratified squamous epithelial tissue.
• Protection and reduces water loss.
Dermis: Deep layer of connective tissue.
• Structural strength.
Subcutaneous tissue.
• Not part of skin.
• Loose connective tissue that connects skin to underlying structures.
Epidermis
• Avascular; nourished by diffusion from capillaries of the papillary layer of the dermis.
• Composed of epithelial cells arranged into layers or strata.
• Separated from dermis by basement membrane.
Epidermal Cells
Cell types.
• Keratinocytes: most cells. Produce keratin for strength.
• Melanocytes: contribute to skin color. Melanin produced by these cells then transferred
to keratinocytes. Same number of melanocytes in all people.
• Langerhans cells: part of the immune system.
• Merkel cells: detect light touch and superficial pressure.
Keratinization: as cells move outward through the layers they fill with keratin, die, and serve as a layer
that resists abrasion and forms permeability layer.
Epidermal Strata
Stratum basale (germinativum).
• Deepest portion of epidermis and single layer of cuboidal or columnar cells.
• High mitotic activity; keratinocyte stem cells undergo mitosis about every 19 days; one
daughter cell remains in the stratum basale to divide again, while the other daughter
cell is pushed to the surface and becomes keratinized.
• Desmosomes hold the keratinocytes together and provide structural strength.
• It takes 40 to 56 days to move from the stratum basale to the surface and be sloughed
off.
Stratum spinosum.
• Eight to ten layers of many-sided cells that flatten as they are pushed upward.
 • Contain new desmosomes, lipid-filled lamellar bodies, and additional keratin fibers.
Epidermal Strata 2
Stratum granulosum.
• Two to five layers of flattened, diamond-shaped cells.
• Contains protein granules of keratohyalin that accumulate in the cytoplasm.
• Lamellar bodies move to the plasma membrane and release their lipid contents into the
extracellular space.
• In superficial layers, nucleus and other organelles degenerate and cell dies; the keratin
fibers and keratohyalin granules do not degenerate.
Stratum lucidum.
• Thin, clear zone of dead keratinocytes with indistinct boundaries.
• Found only in palms and soles.
Stratum corneum.
• Most superficial and consists of 25 or more layers of dead, overlapping squamous cells
joined by desmosomes called cornified cells.
• Cell remnants have a soft protein envelop of keratin, a mixture of keratin fibers and
keratohyalin.
Thick skin (designation refers only to the epidermis)
• Has all 5 epithelial strata.
• Found in areas subject to pressure or friction.
• Palms of hands, fingertips, soles of feet.
• Fingerprints and footprints. Papillae of underlying dermis in parallel rows.
Thin skin.
• Composed of 4 strata (no stratum lucidum).
• More flexible than thick skin.
• Covers rest of body.
• Hair grows here.
Callus: Increase in number of layers in stratum corneum. When this occurs over a bony prominence, a
corn forms.
Skin Color
Determined by 3 factors: pigments in the skin, blood circulating through the skin, thickness of stratum
corneum.
Pigments.
• Melanin: provides for protection against U V light. Group of chemicals derived from
amino acid tyrosine. Colored brown to black, may be yellowish or reddish.
• Melanocytes. processes extend between keratinocytes; deposit melanosomes.
• Albinism: deficiency or absence of pigment; production determined by genetics,
hormones, exposure to light.
• Carotene: yellow pigment from vegetables; accumulates in stratum corneum, in adipose
cells of dermis, and in subcutaneous tissue.
Melanin Transfer to Keratinocytes
1. Melanocytes produce and package melanin into vesicles called melanosomes.
2. These melanosomes move into cell processes of the melanocytes.
3. Keratinocytes phagocytize the tops of the melanocyte cell processes, thereby acquiring
melanosomes.
Skin Color 2
Racial variations in skin color due to:
• Types of melanin produced
 • Amount of melanin produced
• Size of melanosomes
• Number of melanosomes
• Distribution of melanosomes
Skin Color 3
Blood circulating through the skin imparts reddish hue and increases during blushing, anger,
inflammation.
• Cyanosis: blue color caused by decrease in blood oxygen content.
• Erythema: red color caused by increased blood flow.
Thickness of stratum corneum impacts color.
• Thicker areas can be yellowish.
Pigments and other substances in the dermis or subcutaneous tissue may impart a bluish color to the
skin; the deeper, the bluer.

Dermis
Two layers of dermis, variable in thickness.
• Papillary. Superficial. Areolar with lots of elastic fibers, dermal papillae, capillary beds.
Friction ridges form fingerprints. Whorls of ridges. Touch receptors (Meissner, Pacinian,
and Ruffini), free nerve endings sensing pain.
• Reticular: Deep. Dense irregular C.T. of collagen and elastic fibers. Also contains some
adipose tissue, hair follicles, nerves, oil glands, ducts of sweat glands, heat sensors.
Cleavage Lines
Cleavage (tension) lines: elastic and collagen fibers oriented in some directions more than in others.
Important in surgery.
• If incision parallel to lines, there is less gapping, faster healing, less scar tissue.
If skin is overstretched, stretch marks occur.
Subcutaneous tissue
Deep to skin.
Also called hypodermis.
Consists of loose connective tissue with collagen and elastic fibers.
Types of cells.
• Fibroblasts.
• Adipose cells.
• Macrophages.
Contains about one-half of body’s adipose tissue.
Functions as.
• Energy source.
• Insulation.
• Padding.
Injections
Three types of injections:
• Intradermal – into the dermis; skin taut; needle at shallow angle
• Subcutaneous – into subcutaneous layer; pinch skin; short needle
• Intramuscular – long needle perpendicular to skin
Accessory Skin Structures: Hair
Found everywhere on human body except palms, soles, lips, nipples, parts of external genitalia, and
distal segments of fingers and toes.
Hair structure and coloration changes as a person ages.
 • Lanugo – delicate, unpigmented hair of the fetus
• Terminal hair – long, course, pigmented hair of the scalp, eyelids, eyebrows, and with puberty,
axilla, pubic, and face.
• Vellus hair – fine, short hair on the rest of the body.
Hair Structure

Shaft protrudes above skin surface.

Root located below surface; base of root is the hair bulb.
Has 3 concentric layers.
• Medulla: central axis.
• Cortex: forms bulk of hair.
• Cuticle: forms hair surface.
Hair bulb expanded base of root
• Internal matrix is source of hair.
• Dermis projects into bulb as hair papilla, serves as blood supply.
Hair Follicle
Dermal root sheath: part of dermis that surrounds the epithelial root sheath.
Epithelial root sheath with internal and external parts.
• Internal part contains stratum basale that may remain after injury and supply a
source of new epidermis.
• When hairs are pulled out, internal part comes out and is visible as white bulb.

Hair Growth
Growth and resting stages are cyclic.
• Growth stage: cells added at base and hair elongates.
• Resting stage: follicle shortens and holds hair in place. Rest, then hair falls out
of follicle. New hair begins.
• The amount of time spent in each stage depends on the type or location of the
hair.
Hair Color and Muscles
Hair Color.
• Caused by varying amounts and types of melanin. Melanin can be black-brown and red. Color is
controlled by several genes.
Muscles.
• Arrector pili. Type of smooth muscle.
• Extends from the dermal root sheath of the follicle to the papillary layer of the dermis.
• Muscle contraction causes hair to “stand on end”.
• Skin pushed up by movement of hair follicle to produce “goose bumps”.
Accessory Skin Structures: Glands
Sebaceous Glands.
• Holocrine (death of secretory cells).
• Oily secretion called sebum.
• Prevents drying and inhibits some bacteria.
• Most empty into hair follicle.
• Exceptions: lips, meibomian glands of eyelids, genitalia.
Two types traditionally called apocrine and merocrine, but apocrine may secrete in a merocrine or
holocrine fashion
Eccrine (merocrine) glands.
 • Most common; numerous in palms and soles.
• Simple coiled tubular glands.
• Open directly onto surface of skin. Have own pores.
• Coiled part in dermis, duct exiting through epidermis.
• Produce isotonic fluid (sweat) containing mostly water and some wastes.
• Important role in body temperature regulation.
Apocrine glands.
• Active at puberty.
• Simple coiled tubular, usually open into hair follicles superficial to opening of sebaceous
gland.
• Secretion: organic compounds that are odorless but, when acted upon by bacteria, may
become odiferous.
• Found in axillae, genitalia (external labia, scrotum), around anus.
• Do not help regulate temperature.
Other Glands
Ceruminous glands: modified eccrine sweat glands in the external auditory canal.
• Earwax (cerumen). Composed of a combination of sebum and secretion from
ceruminous.
• Function- In combination with hairs, prevent dirt and insects from entry.
Mammary glands: modified apocrine sweat glands that produce milk.
Accessory Skin Structures: Nails
Structure – thin plate of layers of dead stratum corneum cells with hard keratin.
• Nail body: stratum corneum; visible portion.
• Eponychium or cuticle is corneum superficial to nail body, hyponychium is corneum
beneath the free edge.
• Matrix and nail bed: cells that give rise to the nail.
• Nail root: covered by skin; extends from nail matrix.
Nail Growth
• The nail matrix and bed are composed of epithelial tissue with a stratum basale that
gives rise to the cells that form the nail.
• Grow continuously unlike hair.
• Fingernails grow 0.5 to 1.2 mm/day; faster than toenails.
• Lunula – small part of nail matrix seen through the nail body as a whitish, crescent-
shaped area at the base of the nail.
5.5 Physiology of the Integumentary System
Protection.
• Against abrasion, sloughing off of bacteria as desquamation occurs.
• Against microorganisms and other foreign substances. Glandular secretions
bacteriostatic and skin contains cells of the immune system.
• Melanin against UV radiation.
• Hair on head is insulator and protection against light, and from abrasion. Eyebrows keep
sweat out of the eyes; eyelashes protect eyes from foreign objects. Hair in nose and ear
against dust, bugs, etc.
• Nails protect ends of digits, self defense.
• Acts as barrier to diffusion of water.
Physiology of the Integumentary System 1
Sensation: Pressure, temperature, pain, heat, cold, touch, movement of hairs.
Temperature Regulation: sweating and radiation.
 • Sweat causes evaporative cooling.
• Arterioles in dermis change diameter as temperature changes. More or less blood flows
through the dermis.

Physiology of the Integumentary System 2

Vitamin D Production.
• 7-dehydrocholesterol converts to cholecalciferol when exposed to U V radiation.
Cholecalciferol released to blood and modified in the liver and kidneys to form calcitriol
(active vitamin D).
• People in cold climates and those who cover the body can be deficient, but calcitriol can
be absorbed through intestinal wall.
• Sources: dairy, liver, egg yolks, supplements.
Production of Vitamin D
1. Vitamin D synthesis involves a precursor molecule, 7 dehydrocholesterol, which is stored in the
skin. When exposed to UV light, the precursor molecule is converted into cholecalciferol, which
is released into the blood.
2. Cholecalciferol is transported first to the liver where it is modified. The modified cholecalciferol
re-enters the blood and is transported to the kidneys.
3. At the kidneys, the substance is again modified to form active vitamin D3, also called calcitriol.
Calcitriol stimulates the uptake of calcium and phosphate at the small intestine.
Physiology of the Integumentary System 3
Excretion.
• Removal of waste products from the body.
• Sweat: water, salt, urea, ammonia, uric acid.
• Insignificant when compared with kidneys.
5.6 Burns
Partial-thickness.
• First-degree.
• Second-degree.
Full-thickness.
• Third-degree.
Fourth-degree affect deeper structures.
Skin Grafts.
• Split skin.
• Artificial skin.
• Cadavers or pigs.
Burns
Symptoms
• Tissue damage of skin and possible deeper tissue
• Edema
• Shock
• Microbial infection
Treatment
• Intravenous fluids
• High-protein, high-caloric diet
• Antimicrobials
• Debridement
• Skin grafts