Lorrine Bandillo M.

I Anatomy and Physiology

Integumentary System - Not all mucosae secrete mucus
Ex. Urinary Tract
Includes body membranes, skin, hair and hair - Mucosae that secretes mucus
follicles, nail and cutaneous glands (sweat and Ex. Digestive Tract = protective
sebaceous/oil glands). lubricating mucus.
Protect the body, regulates body temperature,
excrete wastes via sweat, helps in vit. D Serous Membrane (SEROSA)
production.
- Simple squamous epithelium resting on a thin
Skin - also known as the cutaneous membrane. layer of areolar connective tissue.
Covers the surface of the body, largest organ of - line body cavities that are closed to the exterior
the body in weight. (except dorsal body cavity and joint cavities)
- occurs in pairs.
Body Membranes - parietal layers line the ventral body.
- visceral layer= covers the outside layer of the
- Cover surfaces, line body cavities and form organs.
protective (often lubricate) sheets around organs.
 serosa layers relationship is like pushing
- has two major groups (epithelial and connective
your fist into a limp balloon only partially
tissue) that are classified according to their tissue
filled with air.
makeup.
Visceral Serosa: part of the balloon that clings to
your fist.
TWO MAJOR GROUPS OF BODY
Parietal Serosa: the outer part of the balloon
MEMBRANES
Epithelial Membrane:
- Cutaneous membrane
- Mucous membrane
- Serous membrane
Connective Tissue Membrane
- Synovial Membrane
Epithelial Membrane Serous Fluid: a clear fluid in scanty amount that
separates the serous layers.
Covering and lining of the membranes. Combined - a lubricant that allows the organs to slide
with underlying layer of connective tissue. easily across the cavity walls without
friction.
Cutaneous Membrane- exposed to air and is a dry Ex. When the heart pumps blood and the
membrane. lungs are expanding.
Has 2 layers:
1. Superficial epidermis; Stratified squamous
epithelium.
2. Underlying dermis; Dense (fibrous) connective
tissue. Peritoneum: Abdominal cavity serosa lining
Pleurae: Lungs (Thoracic Cavity) serosa lining
Mucous Membranes Pericardia/Pericardium: Heart (Thoracic Cavity)
- moist/wet membrane almost continously bathed serosa lining.
in secretions.
- composed of epithelium (type varies with the Connective Tissue Membranes
site) resting on lamina propia (loose connective SYNOVIAL MEMBRANES
tissue membrane)
- lines all body cavities that open to the exterior  loose areolar connective tissue with no
o Respiratory, digestive, urinary and epithelial cells.
reproductive tracts.  lines the fibrous capsules surrounding the
- Mucosa: location of the epithelium and not their joints.
cellular makeup.  provide smooth surface and secrete
lubricating fluid.
MUCOSAE o Bursae: lines small sacs of connective
tissue.
Stratified Squamous Epithelium (Mouth and o Tendon sheaths: tube-like.
Esophagus)  cushion organs moving against each other
Simple Columnar Epithelium (digestive tract) - for during muscle activity.
absorption or secretion
Lorrine Bandillo M. I Anatomy and Physiology
Ex. Movement of tendon across a bone’s - anchors the skin to the underlying
surface. organs
- site of nutrient storage.
Functions of the Integumentary System - a shock absorber and insulates
tissue.
 insulate and cushions the deeper body organs. - responsible for woman’s curves.
 Protects the body from mechanical damage
(bumps and cuts), chemical damages (acids Epidermis
and bases), thermal damage (heat and cold),
UV radiation and microbes. Composition: Keratinocytes (keratin cells)
 Stratum corneum (uppermost layer of the - produces keratin a fibrous protein
skin) is hardened to prevent water loss from that makes the epidermis tough
the body surface. through keratinization.
 Capillary network and sweat glands - connected to the epidermis by
(controlled by the nervous system) plays an desmosomes
important role in thermoregulation from the Properties:
body surface.  Avascular- no blood supply on its own and
 acts as a mini-excretory system just depends on diffusion.
 helps in synthesizing vitamin D  Strata- have a five layer.
 Bacteria protection because of the acid mantle  Apical Surface- a free surface
an acidic secretion that the skin produces.  Basement Membrane -
PSVET
MAIN STRUCTURAL FEATURES OF THE
1. Protection EPIDERMIS
 Prevents microorganisms from entering
 Keratinocytes – connected by many
the body.
desmosomes and form most of the epidermis.
 reducing water loss
 Melanocytes- make the pigment melanin
 protection from sunlight
- spider-shaped cells
2. Sensation
 sensory receptors for pain, touch, hot, - found in stratum basale
cold, pressure o Melanin: pigment that ranges from
yellow to brown to black (freckles
3. Vitamin D production and moles)
 skin exposed to UV light produces  Epidermal dendritic cells- protective immune
cholecalciferol (modified in the liver the in cells.
kidneys to produce active vitamin D) - star-shaped cells
4. Excretion - important “sentries”, alert and activate
 excretes sweat and sebum immune cells from viral invasion.
5. Temperature Regulation.  Merkel Cells- associated with a nerve ending
 helps in maintain body temperature. - act as touch receptors. (merkel disc)
- found in epidermal-dermal junction.
Structure of the Skin
Five Strata of the Epidermis
Skin is composed of two kinds of tissue:
 Epidermis: stratified squamous epithelium  Stratum Basale- deepest layer of the epidermis
- hard and tough and lies closest to the dermis.
- most superficial layer - most nourished epidermal cells.
 Keratinization: cells change shape and - also known as “stratum germinativum”
chemical composition; cells become filled with  Stratum Spinosum – between the stratum
protein keratin. basale and stratum granulosum; keratinocytes
 Dermis: dense (fibrous) connective tissue appear spiny
- tear resistant  Stratum Granulosum- between the stratum
o Blister: interstitial fluid that accumulates spinosum and stratum lucidum; granules
in the cavity between the layers when a  Stratum Lucidum- not present in all skin
burn and friction separate the connected regions.
epidermis and dermis. - occurs where skin is hairless and thick
 Subcutaneous Tissue: hypodermis or adipose (palms and soles)
fat. - secretes a water-repellent glycolipid.
- not part of the skin
Lorrine Bandillo M. I Anatomy and Physiology
 Stratum Corneum- outermost layer of the  Collagen Fibers- toughness of the dermis;
epidermis keep the skin hydrated (attract and bin water)
- ¾ of the epidermal thickness  Elastic Fibers- elasticity to the skin (young)
- composed of dead cell remnants filled with  Collagen and Elastic fibers have an inverse
keratin (cornified or horny cells) relationship to our age.
- a durable overcoat for the body  Supplied with blood vessel that maintains
body temp. homeostasis.
EFFECTS OF OVER EXPOSURE TO UV  High Body Temp: capillaries
LIGHT engorged/swollen skin reddened and warm
 Low Body Temp: blood bypasses the dermis
1. Damage the skin (leathery appearance) capillaries temporarily to keep body
2. Depresses the immune system temperature high.
3. Alteration of DNA skin cells that leads to skin Homeostatic Imbalance
cancer. Decubitus Ulcers- Bed sores
- type of skin ulcers
Dark Colored People seldom gets skin cancer due - result of the weight of the body puts pressure on
to high concentration of melanin. Melanin the skin especially on bony projections that
protects from UV light the higher concentration restricts blood supply.
the higher the protection. Prevention: Turning the bedridden patients
regularly.
Dermis
SKIN COLOR
 strong stretchy envelope that binds the body
together.  there are three pigments that contributes to
 composed of dense (fibrous) connective tissue skin color: melanin, carotene, hemoglobin.
that has two major regions.
 “Hide”  Melanin- yellow to brown to black
pigment
TWO MAJOR REGIONS OF THE DERMIS - produced by spider-shaped
cells called melanocytes.
 Papillary Layer
- natural colors
- areolar and dense irregular tissue
o Melanosomes: area in the cytoplasm in
- superficial dermal region
- uneven and has a Dermal Papillae membrane bound organelles where
o Dermal Papillae: indent the epidermis melanin accumulate.
- Light skinned= low melanin
above
- Brown to black skin= high melanin
- contain capillary loops that delivers
nutrients to the epidermis
Factors of Melanin Production
- house pain receptors and touch
a. Genetic Factors
receptors.
b. Exposure to UV light
 Papillary patterns- whorled ridges in the
c. Hormones
epidermal surface of hands and soles.
- increases friction and gripping ability  Carotene- orange-yellow pigment
(fingers and toes)
- in stratum corneum and
- genetically determined
subcutaneous tissue.
- Fingerprints - when people eat carotene-rich
foods, skin takes on a “yellow-
 Reticular Layer orange cast”
- deepest skin layer
- dense connective tissue, blood vessel and  Hemoglobin- pigment in red blood cells;
cutaneous glands (oil and sweat), and oxygen-riched blood
lamellar corpuscle (deep pressure - Light-skinned People= flush
receptors) and rosy glow.
o Cutaneous sensory receptors: part of the
nervous system located at the skin. SKIN COLOR ON EMOTION AND DISEASE
- provide information about external
environment (touch, pressure,  Redness/Erythema- reddened skin;
temperature pain receptors) embarrassment, fever, hypertension,
- detecting stimuli for phagocytes to prevent inflammation or allergy.
microbes invasion.
Lorrine Bandillo M. I Anatomy and Physiology
 Pallor/Blanching- pale skin; due to - reaches the skin through ducts called
emotional stress, anemia, low bp, impaired sweat pores
blood flow. o Sweat pores: a funnel shape
ducts that extend to the surface
 Jaundice- yellow cast; liver disorder where bile of the skin.
pigments accumulate in the blood. - important part of body’s heat-
 Bruises- black-and-blue marks; blood escaped regulating equipment.
circulation and clotted in tissue paces; - supplied with nerve endings that
hemophilia or vitamin C deficiency. stimuli them to secrete sweat when
temperature is high.
SKIN APPENDAGES
 Apocrine glands
Cutaneous Glands: Sebaceous and Sweat
- confined to the armpit (axillary) and
Gland
genital areas.
 Hair and hair follicles
- larger than eccrine glands but lesser in
 Nails
number
 arises from the epidermis and plays a unique
- empty their ducts through hair follicles.
role in homeostasis.
- their secretion contains fatty acids,
CUTANEOUS GLANDS proteins and substances present in sweat.
- secretions are odorless and milky or
 all exocrine glands yellowish in color but when bacteria react
o Exocrine glands: release secretion via ducts. with it produces a foul smell.
 formed in the Stratum basale pushed through - began to function during puberty due to
the dermis. androgens influence.

Two groups HAIR AND HAIR FOLLICLES

 Sebaceous Glands (oil glands) Hair

- found all over the skin except palms and  column of dead keratinized cells
soles.  fastest growing tissue in the body.
- empty their ducts through hair follicles  a flexible epithelial structure.
but some on the skin directly. Few protective functions of Hair:
- produces sebum  head against bumps (scalp hair)
- becomes very active during adolescence  shielding the eyes(eyelashes)
due to the production of androgens.  keeps foreign particles away from
o Sebum: an oily substance and respiratory tract (nose hairs)
fragmented cells
- acts as lubricant for the skin (moist and
STRUCTURE OF THE HAIR
soft) and prevents hair from becoming
brittle.  Hair root- part of the hair enclosed in the
- contains chemical that kills bacteria. hair follicle; bellow the skin
 Hair Shaft- part projecting from the scalp;
 Sweat Gland (sudoriferous glands) above the skin.
- widely distributed in the skin (2.5m  Medulla- central core of the hair; consists
per person) of large cells and air spaces
 Cortex- bulky layer of flattened cells that
surrounds the medulla
 Cuticle- outermost layer that surrounds
TWO TYPES OF SWEAT GLANDS the cortex; single layer of cells that
overlaps one another; provides strength
 Eccrine
and keep the hair tightly compacted.
- numerous and found all over the
body
- produce sweat
o Sweat: clear secretion made of water,
vit. C, metabolic waste (urea,
ammonia), and lactic acids.
- acidic (ph of 4 to 6) and bacteria can  Hair Follicles- compound structure: inner
grow. epithelial sheath and outer fibrous sheath;
Lorrine Bandillo M. I Anatomy and Physiology
tube-like in folding surrounding the hair  Lead Poisoning- high levels of lead in the
root. hair
 Inner epithelial sheath: composed of
epithelial tissue and forms the hair. Homeostatic Imbalances of Skin
 Outer fibrous sheath: dermal connective
tissue has a hair papilla.  Most common skin disorders are infections
 Hair papilla: supplies blood to the hair (with pathogens) and allergies (abnormal
matrix. strong immune response).
 Hair bulb- deepest part of the hair follicle;  Less common are burns and skin cancers but
site of hair cell formation. are more severe and damaging.
 Arrector pili- muscle of the hair, connects
the hair follicle to the dermal tissue, INFECTIONS AND ALLERGIES SKIN
responsible for goosebumps. DISORDERS:

 Athletes Foot – itchy, red, peeling

HAIR GROWTH STAGES:
condition of the skin between the toes;
 Growth Stage- Formation of new hair; 2 to infection from tinea pedis (fungus)
6 years  Boils(furuncles)- inflammation of hair
 Regression Stage- Hair stops growing; 2 to follicles and tissues; found in dorsal neck
3 weeks  Carbuncles- clusters of boil caused by
 Resting Stage- new growth cycle begins; 3 staphylococcus aureus (bacterium)
months  Cold Sores- fever blisters; small fluid-filled
blister that itch and sting; cause by human
Nails herpesvirus 1 infection; occur around lips
and in the oral mucosa of mouth and nose.
Nail  Contact dermatitis- itching, redness and
 scale like modification of the epidermis. swelling that progress to blister; caused by
 dead stratum corneum cells exposure to chemicals (poison ivy) that
 contain a very hard type of keratin. provoke allergic response.
 colorless but appear pink due to the  Impetigo- pink, fluid-filled, raised lesions
underlying dermis that have rich blood (around mouth and nose) that develop
supply. crust and rupture; caused by
staphylococcus or streptococcus
Structure of the Nail infections; common in elementary
 Free edge children.
 Nail Body- visible attached portion  Psoriasis- reddened epidermal lesions
 Nail Root- Embedded on the skin covered with dry, silvery scales that itch,
 Nail Folds- borders of the nail overlapped burn, crack and bleed (sometimes);
by folds of the skin. chronic condition an autoimmune
 Cuticle- edge of the thick proximal nail disorder; triggered by trauma, infection,
fold. hormonal changes, stress.
 Nail bed- the stratum basale of the
epidermis extends beneath the nail. Burns and Skin Cancer
 Nail Matrix- responsible for nail growth;
when it produces nail cells they become Burn
keratinized and die.  tissue damage and cell death caused by
 Lunule- a white crescent shape in the nail. intense heat, electricity, UV radiation or
certain chemicals.
INTEGUMENTARY SYSTEM AS A TWO LIFE-THREATENING PROBLEMS
DIAGNOSTIC AIR WHEN BURNED

 Cyanosis- bluish color to the skin due to 1. Body loses supply of fluids.
low blood O2 content - the body lose its intact boundary
 Jaundice- yellowish skin color caused by - dehydration and electrolyte imbalance
liver that can further lead to kidney and
 Raches & lesions- symptoms of problems circulatory shock.
elsewhere - Cure: lost fluids must be supplied to the
 Vitamin A Deficiency- excess keratin; patient immediately and volume of fluid
sandpaper texture characteristic lost can be estimated indirectly by
 Iron Deficiency Anemia- nails become flat determining the range or extent of the
or concave burn using rule of nines.
Lorrine Bandillo M. I Anatomy and Physiology
- Rule of Nines: divides the body into 11 b) Joints injuries limits the joint mobility due
areas, each area accounting for 9 percent to scar tissues.
of the total body surface area, plus an c) Circumferential burns restrict movement
additional 1 percent for the genitals. base on location.

2. Infections Skin cancer

- can lead to death
- burned skin are sterile for 24hrs but after  malignant (cancerous) neoplasms (tumor)
that pathogens can invade the areas. that tend to invade body area.
- depressed immune system within 1 to 2  most common type of cancer in humans.
days after severe burn injury.  can be acquired through:
 overexposure to UV radiation and tanning
SEVERITY OF BURN CLASSIFICATION beds.
 Irritation of the skin by infection, chemicals or
I. First-degree (superficial) physical trauma.
 superficial epidermis is damages  limiting exposure to sun, using sunscreen;
 area becomes red and swollen. reduces development of skin cancer.
 temporary discomfort can be felt
 usually not serious a) Neoplasms (tumors) arise in our skin and
Ex. sunburn without blistering mostly they are benign and do not spread
(metastasize).
II. Second-degree (superficial partial- Ex. Warts.
thickness burns)
 injury to the epidermis and superficial Three most common type of skin cancer
part of the dermis
 skin is red, painful and blistered. Basal Cell Carcinoma
 regrowth (regeneration) of the epithelium  least malignant (least cancerous) and most
can occur. common.
 no permanent scars when treated right.  stratum basale cannot form keratin, no longer
honor the boundary of epidermis and dermis.
III. Third-degree (Full-thickness burns)  invades the dermis and hypodermis.
 destroy both the dermis and extend to the  occurs in sun-exposed areas of the face;
hypodermis (full-thickness) lesions appear shiny, dome-shaped nodules
 blisters are present and the burned area and have central ulcer.
appears blanched (gray-white)  slow-growing and metastasis seldom occurs.
 not painful because nerve endings are  can be completely or 99% cure if lesions are
destroyed removed surgically.
 regeneration is not possible
 skin grafting must be done to cover the Squamous Cell Carcinoma
exposed tissue.  arises from the cells of stratum spinosum.
IV. Fourth-degree (full-thickness burns w/  lesions are scaly, reddened papules (small
deep-tissue involvement) rounded swellings) that form shallow ulcers
 extends to the bone, muscle or tendons. with firm raised borders.
 burns appear dry and leathery.  appears most often on scalp, ears, back of
 require surgery and grafting to cover hands, and lower lip but can appear
exposed tissue. anywhere.
 amputation may be required in some  grows rapidly and metastasizes to lymph
cases. nodes if not removed.
 induced by UV exposure.
Conditions that consider burns critical:  can be completely cured if removed surgically
1. Over 30% of the body has 2nd degree burn. or radiation therapy.
2. Over 10% of the body has 3rd or 4th degree burn.
3. 3rd or 4th degree burn on face, feet, and genitals. Malignant Melanoma
4. Burns affect the airways.  cancer of melanocytes.
5. Burn are around the body or limb  5% of skin cancers but DEADLY.
(circumferential)  begin wherever there is pigment but most
appear spontaneously.
a) Facial burns are dangerous because of  arises from accumulated DNA damage in skin
possibility of burn in respiratory tracts. cell and usually appears as a spreading brown
to black patch.
Lorrine Bandillo M. I Anatomy and Physiology
 metastasizes rapidly on the lymph nodes and
blood vessels.
 50% chance of survival if detected early.
 requires wide surgical excision with
immunotherapy and radiation or
chemotherapy after surgical removal.

ABCDE rule for recognizing melanoma:

 Assymetry- two sides of the pigemented spot
or mole do not match.
 Border Irregularity- borders are not smooth
and have indentions
 Color- pigmented areas have different colors
 Diameter- larger than 6mm in diameter.
 Evolution- one or more of these characteristic
(ABCD) is evolving or changing.

Effects of Aging in the Skin

 Decrease in subcutaneous tissue; sensitive to
cold.
 Thinning of the skin; susceptible to bruising
and injuries.
 Eye bags and sagging of jowls (loss of
elasticity and subcutaneous fat)
 Epidermis thins
 Amount of collagen in the dermis decreases
 Skin infections are most likely
 Repair of skin occurs slower
 Decrease no. of elastic fibers in the dermis
and loss of fat (sagging of skin, wrinkles)
 Decrease of activity of sweat glands = reduced
ability to regulate body temp.
 Decrease sebaceous gland activity = ski
becomes drier
 Decrease no. of melanocytes
 Some areas, the no. of melanocytes increase =
age spots
 Increased melanin production = freckles; also,
gray/white hair
 Skin that is exposed to sunlight = shows signs
of aging more rapidly