Chapter 7 The Integumentary System

Epidermis and dermis Hypodermis Thick and thin skin Skin color Functions of the skin Hair and nails Cutaneous glands

Overview of the Skin

Largest organ of the body (15% of body weight) Two layers
epidermis
stratified squamous epithelium contains 5 layers

dermis
connective tissue layer

Rests on subcutaneous layer or hypodermis Normal thickness of 1-2 mm, up to 6 mm

thicker skin (palms & soles) has thicker stratum corneum, no hair follicles or sebaceous glands

Cell Types & Layers of the Epidermis

5 Layers of the Epidermis

5 4 3 Superficial

Deep

Stratum Basale
Single layer of cuboidal or low columnar cells sitting on basement membrane Cell types in this layer
keratinocytes
undergo mitosis to replace epidermis most of cells of epidermis

melanocytes synthesize melanin

distribute melanin from cell processes melanin picked up by keratinocytes & used to shade their nuclei from UV radiation

Merkel cells are touch receptors associated with nerve fibers to form Merkel disc

Stratum Spinosum
Several layers of keratinocytes thick
appear spiny due to shrinkage during histological preparation

Contains dendritic (Langerhans) cells

macrophages from bone marrow that migrate to the epidermis 800 cells/millimeter2 help protect body against pathogens by presenting them to the immune system

Stratum Granulosum
3 to 5 layers of flat keratinocytes Contain keratinohyalin granules
intermediate filaments convert granules to keratin

Produce lipid-filled vesicles that release a glycolipid by exocytosis to waterproof the skin
forms a barrier between surface cells and deeper layers of the epidermis cuts off surface strata from nutrient supply

Stratum Lucidum
Thin translucent zone seen only in thick skin Keratinocytes are packed with eleidin, a precursor to keratin
does not stain well

Cells have no nucleus or organelles

Stratum Corneum
Up to 30 layers of dead, scaly, keratinized cells
surface cells flake off (exfoliate)

The Dermis
Thickness = 0.6mm to 3mm Composition
collagen, elastic & reticular fibers, fibroblasts & accessory structures such as hair follicles and glands

Dermal papillae are upward extensions of the dermis into the epidermis forming the ridges of the fingerprints Layers
papillary layer is areolar tissue & dermal papillae of upper 1/5 of the dermis reticular layer is deeper part of dermis

Layers of the Dermis

Papillary layer

Reticular layer

The Hypodermis
Known as subcutaneous tissue or superficial fascia Has more adipose than dermis Functions
energy reservoir thermal insulation

Hypodermic injections
Hypodermis

into subcutaneous tissue since highly vascular

Subcutaneous Fat Distribution

Skin Colors (Pigmentation)

Hemoglobin is red pigment of red blood cells

visible through dermal collagen fibers

Carotene is yellow pigment of vegetables & egg yolks

concentrates in stratum corneum & subcutaneous fat

Melanin pigment produced by melanocytes

pigment synthesis stimulated by UV radiation from sunlight produces yellow, brown, black and reddish hues

Abnormal Skin Colors

Cyanosis is blueness resulting from deficiency of oxygen in the circulating blood (cold weather) Erythema is redness due to dilated cutaneous vessels (anger, sunburn, embarrassment) Jaundice is yellowing of skin & sclera due to excess of bilirubin in blood (liver disease) Bronzing is golden-brown color of Addison disease (deficiency of glucocorticoid hormone) Pallor is pale color from lack of blood flow Albinism is a genetic lack of melanin Hematoma is a bruise (visible clotted blood)

Skin Markings
Hemangiomas (birthmarks)
discolored skin caused by benign tumors of dermal blood capillaries (strawberry birthmarks disappear in childhood -- port wine birthmarks last for life)

Freckles & moles = aggregations of melanocytes

freckles are flat; moles are elevated

Friction ridges leave oily fingerprints on touched surfaces

unique pattern formed during fetal development

Flexion creases form after birth by repeated closing of the hand Flexion lines form in wrist & elbow areas

Functions of the Skin

Barrier = tough, dry, acid mantle, water barrier, UV barrier Vitamin D synthesis
UV light coverts 7-dehydrocholesterol (cholesterol derivative) in dermal vessels to vitamin D3

Cutaneous absorption
1-2 % oxygen absorption by diffusion through skin amino acids & steroids diffusing through skin attract mosquitoes fat-soluble vitamins (A, D, E & K) easily absorbed

Sensory functions
receptors for heat, cold, touch, pressure, vibration & pain

Thermoregulation
cutaneous vasodilation & constriction and sweating

Psychological and social functions

appearance & social acceptance facial expression and nonverbal communication

Characteristics of Human Hair

Stratum corneum of the skin is composed of pliable soft keratin Hair and nails are composed of hard keratin
toughened by disulfide bridges between molecules

Hair found almost everywhere on the body

differences between sexes or individuals is really difference in texture and color of hair

3 different body hair types

lanugo -- fine, unpigmented fetal hair vellus -- fine, unpigmented hair of children & women terminal hair -- coarse, long, pigmented hair of scalp

Structure of Hair and Follicle

Hair is filament of keratinized cells
shaft is visible above skin; root is below within follicle in cross section: medulla, cortex and cuticle layers

Follicle is oblique tube within the skin

bulb is swelling in base where hair originates vascular tissue (papilla) in bulb provides nutrients cells lining the follicle interlock with scales of cuticle to resist pulling on the hair

Texture and cross-sectional shape of hair

straight hair is round, wavy is oval and kinky is flat

Hair color is due to melanin pigment

Blond is due to a scanty amount of melanin pigment.

Red hair is colored by an iron-containing pigment, trichosiderin.

White hair is due to air in medulla & lack of pigment in cortex. Gray hair is a mixture of white and pigmented hairs.

Structure of Hair Follicle

Epithelial root sheath is an extension of the epidermis (lies next to hair root) Connective tissue root sheath is derived from the dermis (surrounds it) Hair receptors entwine each follicle Arrector pili muscle
goose bumps

Growth of Hair
Mitosis in stratum basale of epithelial root sheath
as become keratinized are pushed upward

Grows 1 mm every 3 days for 2 to 4 years

dormant phase lasts 3 to 4 months as new hair begins to grow it pushes out old hair eyelashes and eyebrows only grow for 3 to 4 months

Alopecia and pattern baldness (patchy thinning)

baldness gene is dominant in males & expressed with male levels of testosterone
thinning on top & then sides of head in males with 1 baldness allele baldness in females if homozygous recessive with abnormal testosterone

Hirsutism -- abnormal hairiness in women or children

masculinizing ovarian tumors or adrenal cortex hypersecretion of testosterone

Functions of Hair
Body hair too thin to provide warmth Sensory functions
alert us to parasites crawling on skin

Scalp hair provides heat retention & sunburn cover Sex and individual recognition Beard, pubic & axillary hair indicate sexual maturity & help distribute sexual scents Guard hairs & eyelashes prevent foreign objects from getting into nostrils, ear canals or eyes Expression of emotions with eyebrows

Nails
Clear, hard derivative of stratum corneum
densely packed cells filled with hard keratin

Flat nails allow for fleshy, sensitive fingertips Growth rate is 1 mm per week
new cells added by mitosis in the nail matrix
growth zone at proximal edge of nail

nail plate is visible part of nail

Hyponychium is cuticle
scrub for operating room

Cutaneous Glands

Sweat glands
merocrine apocrine

Sebaceous glands Ceruminous glands Mammary glands

 Filtrate of plasma containing some waste products

500 ml of insensible perspiration/day sweating with visible wetness is diaphoresis

Sweat Glands

Merocrine glands is simple tubular gland

millions of them (size of kidney) cool the body

Apocrine glands produce sweat containing fatty acids

found only near hair follicles & respond to stress & sex bromhidrosis is body odor produced by bacterial action on fatty acids

Sebaceous Glands
Oily secretion called sebum that contains brokendown cells
lanolin in skin creams is sheep sebum

Flask-shaped gland with duct that opens into hair follicle

Ceruminous Glands
Found only in external ear canal Their secretion combines with sebum to produce earwax
waterproof keeps eardrum flexible bitterness repel mites & other pests

Breasts and Mammary Glands

Breasts of both sexes rarely contain glands

secondary sexual characteristic of females mammary glandular tissue found only during lactation and pregnancy
modified apocrine sweat gland thicker secretion released by ducts at nipple

Mammary ridges or milk lines

2 rows of mammary glands in most mammals most milk from anteriormost glandular tissue in row primates kept only anteriormost glands

Witches identified by additional nipples (polythelia)

Diseases of the Skin

Most vulnerable organ to injury & disease
skin diseases common in old age

Skin cancer
induced by UV rays of the sun
most common in fair-skinned and elderly

basal cell carcinoma

arises from cells of the stratum basale & invades dermis treated by surgical removal & radiation

squamous cell carcinoma

arises from keratinocytes in the stratum spinosum if neglected, metastasis to the lymph nodes can be lethal

malignant melanoma (most deadly cancer)

arises from melanocytes of a preexisting mole ABCD--asymmetry, border irregular, color mixed & diameter over 6 mm

Burns
Causes of burns -- hot water, sunlight, radiation, electric shock or acids and bases Causes of deaths
fluid loss, infection, & effects of (eschar) dead tissue

Degrees of burns
1st-degree = only the epidermis (red, painful & edema) 2nd-degree = epidermis & part of dermis (blistered)
epidermis regenerates from hair follicles & sweat glands

3rd-degree = epidermis, dermis & more is destroyed

often requires grafts or fibrosis & disfigurement may occur

Treatment -- fluid replacement & infection control

debridement and IV proteins, nutrients & fluids

UVA, UVB & Sunscreens

UVA & UVB are called tanning rays and burning rays
both can burn as well as tan

Both thought to initiate skin cancer As sale of sunscreens has risen so has skin cancer
those who use have higher incidence of basal cell chemical in sunscreen damage DNA & generate harmful free radicals
PABA, zinc oxide & titanium dioxide

Skin Grafts & Artificial Skin

Third-degree burns require skin grafts Graft options
autograft -- tissue from different region of patient isograft -- skin graft tissue from identical twin cultured keratinocyte patches

Temporary graft options (immune system)

homograft (allograft) -- graft from unrelated person heterograft (xenograft) -- tissue from another species amnion from an afterbirth artificial skin from silicone and collagen