INTEGUMENTARY

SYSTEM
Prepared by: Catherine Denise M. Palabyab, RMT, MD
Medical Laboratory Science Department
INTEGUMENTARY SYSTEM

● Also known as the skin or cutaneous layer

● Composed of skin, hair, nails, sweat and

sebaceous glands, sensory receptors
 SKIN FUNCTIONS

A. Sensation (largest sensory organ in the body)

B. Protection
1. Prevents dehydration
2. Prevents infection
3. Physical barrier to injury
4. Protects against ultraviolet light injury (Melanin)
 SKIN FUNCTIONS

C. Thermoregulation
1. Insulation (hair and adipose tissue)
2. Heat dissipation
a. Sweat evaporation
b. Increased blood flow

D. Metabolic
1. Energy storage of Triglycerides in adipose tissue
2. Vitamin D synthesis
INTEGUMENTARY SYSTEM
● Largest organ in the body
● 16% body weight
● 1.5-2 ㎡ in area
INTEGUMENTARY SYSTEM
MAIN LAYERS
EPIDERMIS
-superficial epithelium
-Ectodermal origin

DERMIS
-underlying connective tissue with blood supply
-Mesodermal origin
-Dense irregular CT

SUBCUTANEOUS LAYER
-loose connective tissue layer usually containing
pads of adipocytes
INTEGUMENTARY SYSTEM
MAIN LAYERS
 Composition of the lipid membrane
● MOST IMPT LIPID BARRIERS:
ceramides, cholesterol and free
fatty acids.

● Quantitative and qualitative

changes in the composition of
these lipids can lead to a SKIN
BARRIER DYSFUNCTION

8
SKIN BARRIER DYSFUNCTION- ECZEMA/ ATOPIC
DERMATITIS

9
Composition of the lipid membrane
CERAMIDES
● Protective layer that limits water
loss, locks in moisture

● Work together with other lipids

(cholesterol and FFA) → create a
barrier that mimics
“brick-and-mortar” wall.
○ Skin cells→ bricks
○ Ceraminds→ mortar

● Ceramide deficiency→ dry flaky

itchy skin → Eczema

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Composition of the lipid membrane
Ceramide deficiency→ dry flaky itchy skin → Eczema

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12
Protective acid mantle of skin
Slightly acidic composed of SEBUM, SWEAT AND DEAD SKIN
CELLS

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14
The skin‘s immune system
● They also play a role in immunosurveillance against viral
infections.

● Langerhans cells interact with neighboring keratinocytes, which

secrete a number of immunoregulatory cytokines, and
epidermotropic T-cells forming the skin immune system:

● SALT (skin associated lymphoid tissue).

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VIRAL SKIN INFECTIONS

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 STRUCTURE OF SKIN

❑ Epidermis

❑ Dermis

❑ Hypodermis/
Subcutaneous layer
Skin Anatomy

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EPIDERMIS
EPITHELIAL LINING
● ______________________

● Avascular → nutrients and oxygen diffuse from the

capillaries in the dermis

● 90% of epidermal cells are composed of keratinocytes

that produce keratin

● Keratin: tough fibrous protein that protects skin

EPIDERMIS
CELLS OF THE EPIDERMIS
● Keratinocytes- most abundant ; produces
keratin
● Melanocytes - pigment producing cells
● Langerhans cells - Antigen presenting cells
● Merkel cells - Tactile epithelial cells
LAYERS OF THE EPIDERMIS
STRATUM GERMINATIVUM
● Provides the germinal cells necessary for the regeneration of the layers of the epidermis.
● Separated from the dermis by a thin layer of basement membrane.

● After a mitotic division a newly formed cell will undergo a progressive maturation called
keratinization as its migrates to the surface.
STRATUM SPINOSUM
● The cells that divide in the stratum germinativum soon begin to
accumulate many desmosomes on their outer surface which

● Desmosomes→ provide the characteristic prickles of the stratum

spinosum (SS), which is often called the prickle-cell layer.
STRATUM SPINOSUM
DESMOSOMES
● role in adhesion

● “Cellular glue”

● Important in tissues that experience stress

and stretching (skin, heart)

● Desmosomes→ provide the characteristic

prickles of the stratum spinosum (SS),
which is often called the prickle-cell layer.
STRATUM GRANULOSUM
● The progressive maturation of a keratinocyte
● characterized by the accumulation of keratin, called keratinization.
● The cells of the stratum granulosum (SGR) accumulate dense basophilic
keratohyalin granules
● These granules contain lipids, which along with the desmosomal
connections, help to form a waterproof barrier that functions to prevent
fluid loss from the body.
STRATUM LUCIDUM
● The stratum lucidum is normally only well seen in thick epidermis and represents a
transition from the stratum granulosum to the stratum corneum.
● No nucleus in this layer
STRATUM CORNEUM
● outermost layer of the epidermis
● Consists of dead cells (corneocytes) that lack nuclei and organelles.
● Desquamation→ the process of cell shedding from the surface of the stratum corneum,
balances proliferating keratinocytes that form in the stratum basale.
 Types of skin

Thick skin Thin skin

● 4 layers
● 5 layers
● less Prominent
● Prominent st. corneum
stratum corneum
● Well developed st.
● Less developed
granulosum
stratum
● Palms of the hands and
granulosum
soles of the feet
● Dominant and
● Thinner dermis
lines most of the
● No hair and sebaceous
body surface
glands
● Thicker dermis
● (+)hair and
sebaceous glands
TYPES OF EPIDERMAL CELLS
 KERATINOCYTES
● They are responsible for keratin formation
● Formed of many layers that continuously shed and
regenerate every 2-4 weeks
● They are arranged In many layers
Melanocytes:
● Found in between cells of the basal layer

● Branched cells with central nuclei by EM contains

organelles for protein synthesizes (rER, Golgi,
mitochondria & melanosomes).
● They form melanin by tyrosinase from tyrosine amino
acid by converting it to dioxyphenyl alanine DOPA.
Langerhans cells
● Langerhans cells are dendritic cells
(antigen-presenting immune cells) of the skin.
● Found in upper layers of st.spinosum
● Have branched shape and central nuclei
● Represent 3-8% of epid. Cells
Merkel cells
● Found in basal cell layer
● They are modified epidermal cells
● Sensory nerve fibers form the terminal disk under Merkels cells
● Function as touch and pressure receptors
 RECAP
● Stratum basale provides for epidermal cell renewal.
● Cells of stratum spinosum characteristically exhibit spinous process.
● Cells of stratum granulosum contain conspicuous keratohyalin granules.
● Stratum corneum consists of anucleate squamous cells largely filled with keratin
filaments
DERMIS
● Supports the epidermis and binds it in the subcutaneous tissue
● Supply the avascular epidermis with nutrients

● The dermis is typically subdivided into two zones

○ Papillary dermis - Loose areolar CT
○ Reticular layer. - Dense irregular CT

● The dermis contains mostly fibroblasts

○ responsible for secreting collagen, elastin and
ground substance→ give support and
elasticity of the skin.
PAPILLARY DERMIS
● The papillary dermis (PD) contains vascular networks that have two important
functions:
○ to support the avascular epidermis with vital nutrients
○ to provide a network for thermoregulation

● TYPE OF CONNECTIVE TISSUE? ___________________________

Papillary Dermis
Papillary Dermis
Meissner's Corpuscles also called
mechanoreceptor: responsible for light
touch

○ Detect motion across skin and light

touch
○ Tactile discrimination
○ Detects fine details

Braille reading
Why do we have fingerprints

Due to the ridges and furrows that develop

in the DERMAL PAPILLAE
Reticular dermis
● The reticular layer of the dermis (RD) consists of mainly dense irregular connective tissue

● The reticular layer of the dermis is important in giving the skin it overall strength and elasticity,
as well as housing other important epithelial derived structures such as glands and hair follicles.
Components of the Dermis
● The dermis is composed of three major types of cell
○ Fibroblasts
○ Mast cells
○ Adipocytes.
Components of the Dermis
● MAST CELL
contains many granules rich in histamine
and heparin. Although best known for their
role in allergy and anaphylaxis, mast cells play
an important protective role as well, being
intimately involved in wound healing and
defense against pathogens.
Fibroblast
Fibroblast is a type of cell that synthesizes the extracellular matrix and collagen and plays a critical role
in wound healing.

Fibroblasts have a branched cytoplasm surrounding an elliptical, speckled nucleus having two or
more nucleoli. Active fibroblasts can be recognized by their abundant rough endoplasmic reticulum.
Inactive fibroblasts, which are also called fibrocytes , are smaller and spindle shaped. They have a
reduced rough endoplasmic reticulum.
x
Components of the Dermis

● The dermis is also composed of matrix components such as

○ Collagen (which provides strength)
○ Elastin (which provides elasticity)
○ Extrafibrillar matrix- an extracellular gel-like substance primarily composed
of glycosaminoglycans (most notably hyaluronan), proteoglycans,
and glycoproteins)
 Sensory Structures of Dermis
● Deep touch/pressure: Pacinian corpuscles
● Light touch/pressure: Meissner's corpuscles
● Warm temperature: Free nerve endings
● Cold temperature: Free nerve endings
x

● Pain: Free nerve endings

 Dermatitis
● An inflammation of the papillary layer
● Caused by
○ infection, radiation, mechanical
irritation, or chemicals (e.g., poison
ivy)
x

● Characterized by
○ itch or pain
Dermatitis

x
Dermatitis

x
Dermatitis

x
Dermatitis

x
Dermatitis

x
 Skin Structure: Hypodermis

Hypodermis
 Hypodermis (Subcutaneous)

Recognized by
adipose tissue.
 Skin Structure: Hypodermis
● The Hypodermis (Subcutaneous Layer)
○ Lies below the integument
○ Stabilizes the skin
○ Allows separate movement
○ Made of elastic areolar and adipose tissues
○ Connected to the reticular layer of integument by connective tissue fibers
x

● Deposits of Subcutaneous Fat

○ Distribution patterns determined by hormones
○ Reduced by cosmetic liposuction (lipoplasty)
Skin Structure: Hypodermis

x
SKIN COLORS

x
 FACTORS INFLUENCING SKIN COLOR
1. GENETIC INFORMATION
2. AMOUNT OF MELANIN PIGMENTS
3. DEGREE OF OXYGENATION
4. HORMONES (MSH)
5. EXPOSURE TO SUNLIGHT x
 FACTORS INFLUENCING SKIN COLOR
GENETIC INFORMATION

x
 FACTORS INFLUENCING SKIN COLOR
AMOUNT OF MELANIN PIGMENTS

x
 FACTORS INFLUENCING SKIN COLOR
DEGREE OF OXYGENATION

x
 FACTORS INFLUENCING SKIN COLOR
HORMONES

x
FACTORS INFLUENCING SKIN COLOR

x
 FACTORS INFLUENCING SKIN COLOR
EXPOSURE TO SUNLIGHT
ASSOC WITH SKIN AGING?
ASSOC WITH SUNBURN?

x
FACTORS INFLUENCING SKIN COLOR

x
x
x
WHITE SKIN

x
BROWN SKIN

x
 Skin Appendages
1-Hair Follicles and hair

2-Sweat Glands
Eccrine or merocrine sweat glands
Apocrine sweat glands

3-Sebaceous glands

4-Nails
x
 Sweat Glands
Eccrine sweat gland Apocrine sweat gland
▪ Merocrine secretion
▪ Empty into hair follicle
▪ Empty directly onto skin surface ▪ Location: armpits, groin, nipples
▪ Secrete substances via EXOCYTOSIS ▪ Release subtances by pinching off a portion of their cell
▪ Viscous, cloudy secretion → good nutrient source for
▪ Location: most all over body (esp. abundant on bacteria (odor !!)
palms & soles: ~ 500/cm2) x

▪ Secretion may contain Pheromones

▪ Clear, watery secretion (99% H2O; rest NaCl + ▪ Secretion begins at puberty and is stimulated during
some waste products emotional distress
Sweat Glands
Eccrine sweat gland Apocrine sweat gland

x
Types of Sweat Glands (Sudoriferous Glands)
● Merocrine glands: release fluid by exocytosis
● Eccrine
○ Most common
○ Secretion is mostly water with solutes
x

○ Cools body down

● Apocrine
○ Develops scent as bacteria metabolize secretion
○ Stimulated when frightened, during pain, during emotional upset
APOCRINE SWEAT GLAND
SKIN GLANDS
Sweat Gland

x
ECCRINE SWEAT GLAND
Mammary gland
Sebaceous glands
Sebum discharged mostly into hair follicles
(lubrication & bactericidal)

- HOLOCRINE GLANDS
x
Skin Appendages
WHAT TYPE OF GLAND?

A. APOCRINE
B. HOLOCRINE
C. MEROCRINE
D. ECCRINE
x
 (1)-Hair and hair Follicles
Hair -Produced by hair follicle which are made of hard keratinized epithelial cells

Melanocytes: produce pigment for hair color

Structure of Hair Follicle

x
 Hair Anatomy
Hair anatomy
Central medulla
Cortex surrounds medulla
Cuticle on outside of cortex Most heavily keratinized

x
Associated hair structures
● Hair follicle
○ Dermal and epidermal sheath surrounding hair root

● Arrector pili muscle

○ Smooth muscle
○ Pulls hairs upright when cold or frightened
x

● Sebaceous gland
 Structure of Hair
● The Hair Follicle
○ Hair follicles are the organs that form the hair

○ Located deep in dermis.

○ Produces nonliving hairs. x

○ Wrapped in a dense connective tissue sheath.

○ Base is surrounded by sensory nerves (root hair plexus).

■ Control bacteria
 Structure of Hair
❑ Accessory Structures of Hair
❑ Arrector pili Exposed
shaft
of hair
❑ Involuntary smooth muscle
❑ Causes hair to stand up x

Sebaceous
❑ Produces “goose bumps” gland

❑ Sebaceous glands Arrector

pili
muscle
❑ Lubricate the hair
Connective
tissue sheath

Root hair
plexus
 Structure of Hair
● Regions of the Hair
○ Hair root
■ Lower part of the hair Hair shaft

■ Attached to the integument Sebaceous

Boundary gland
○ Hair shaft x

between Arrector
hair shaft pili muscle
■ Upper part of the hair and
hair root
■ Not attached to the integument
Hair root
Connective
tissue sheath
Hair bulb
Hair matrix
Hair papilla
 Structure of Hair

● Hair Shaft Structure

○ Medulla
■ Core, dead cells contain soft keratin and air to provide flexible
○ Cortex x

■ Middle layer, dead cells contain hard keratin to provide stiffness

○ Cuticle
■ Outermost, overlapping dead keratinized cells form shiny surface
 Hair Function
❑ Head:
❑ UV protection
❑ Cushion from trauma
❑ Insulation
❑ Nostrils, Ear canals, Eyelashes:
❑ Prevent entry of foreign material
❑ Body Hair: x

❑ sensory detection
❑ Root hair plexus:
❑ Sensory nerves at base of hair follicle that detect slight movement of hair
❑ Arrector pili muscle:
❑ Attached to every hair follicle
❑ Contract to stand hair perpendicular to skin surface
Nail
Nails
● Scale-like modifications of the epidermis
○ Heavily keratinized
● Stratum basale extends beneath the nail bed
○ Responsible for growth
● Lack of pigment makes them colorless

Nail structures
● Free edge
● Body is the visible attached portion
x

● Root of nail embedded in skin

● Cuticle is the proximal nail fold that projects onto the nail body

Nail Anatomy
 Structure & function of Nail
❑ Nails
❑ Protect fingers and toes Free edge of
Nail
❑ Made of dead cells packed with keratin Body of Nail
❑ Metabolic disorders can change nail
x

Laternal Nail
structure fold
❑ Nail Production Lunula
❑ Occurs in a deep epidermal fold near the Eponychium
bone called the nail root (cuticle)
 Structure & function of Nail
● Structure of a Nail
○ Nail body
■ The visible portion of the nail
■ Covers the nail bed
○ Lunula
x

■ The pale crescent at the base of the nail

○ Sides of nails
■ Lie in lateral nail grooves
■ Surrounded by lateral nail folds
Structure & function of Nail
Lateral
nail Nail
groove body
Lateral nail fold

Nail
bed
Phalanx
(bone of A cross-sectional
fingertip)
view
 Structure & function of Nail
Eponychium
Proximal nail fold Lunula Nail body
Nail root

Epidermis Dermis Phalanx Hyponychium

A longitudinal section
 Blood Supply of Nail
● Lateral digital arteries supply nail through superficial,proximal & distal arcades

● Vasculature of nail bed is unique in that it must supply a vascular structure b/w two hard surfaces

ie. nail plate & distal phalanx

x
 Blood Supply of Nail
● Large AV anastomoses with glomus bodies, play key role in peripheral circulation &
thermoregulation

● Glomus bodies called as Peripheral heart of masson

x
Blood Supply of Nail

Vasculature of nail
 Blood Supply of Nail

Capillary microscopy of the proximal nail fold

showing longitudinally oriented capillary loops
 Nerve Supply of Nail
✔ Nail unit is richly innervated by nerves which are
branches of median,ulnar & radial nerves
✔ Innervation of nail unit is through two laterally
positioned sensory nerves
x

✔ Digital nerves divides in to three branches just distal to

the interphalangeal joint to supply different
constituents of the nail unit
Nerve supply of nail through branches of
Median,Ulnar & Radial nerves
 Nail Growth
● Nail growth is continuous,it ceases at death( skin tightens &
dehydrates appear nails grow)

● Finger nail grows at rate of 0.1 mm/ day, 3mm/ month

● Toe nail grows at rate of 0.033 mm/ day,1mm/month

x
 Nail Growth
● It is proliferating cells of germinative matrix most contributes
to nail growth

● Thinning of nail plate usually sign of nail matrix disease

● Nail thickening sign of nail bed disease
x
 ● Nail Growth
● Complete replacement
○ finger nails- 6 months
○ toe nails-18 months
● Nails grow more in summer than other seasons
x