1. THE INTEGUMENTARY SYSTEM
Skin and its Derivatives

2. Medical Terminology Combining Forms
Cutane/o, derm/o, dermat/o skin
Hidr/o sweat
Kerat/o horny tissue, hard
Onych/o, ungu/o nail
Seb/o sebum (oil)
Trich/o hair
Know anatomic locations and meanings! Diagrams!

3. Combining forms commonly used with integumentary system terms
Aut/o self
Bi/o life
Coni/o dust
Heter/o other
Myc/o fungus
Necr/o death (cells, body)
Pachy/o thick

4. (combining forms continued)
Rhytid/o wrinkles
Staphyl/o grapelike clusters
Strept/o twisted chain
Xer/o dry

5. Integumentary system prefixes
epi - on, upon, over
intra - within
para - beside, beyond around
per - through
sub - under, below

6. Integumentary system suffixes
-a noun suffix, no meaning
-coccus (pl. cocci) berry-shaped (bacterium)
-ectomy excision or surgical removal
-ia diseased or abnormal state, condition of
-itis inflammation
-malacia softening

7. Integumentary system suffixes (cont.)
-opsy view of, viewing
-phagia eating or swallowing
-plasty surgical repair
-rrhea flow, excessive discharge
-tome instrument used to cut

8. Remember… Four basic types of tissue *Epithelium – epidermis
*Connective tissue - dermis
*Muscle tissue
*Nervous tissue

9. TYPES OF MEMBRANES Epithelial + Connective Tissue (CT)
Serous
Cutaneous
Mucous
Connective Tissue (CT)
Synovial

10. Serous Membranes Line body cavities that have no openings to outside.
Secrete watery fluid.
Simple squamous epith + loose CT

11. Serous membranes Types Parietal—line walls of body cavities
Visceral—cover organs found in body
cavities
Examples
Pleura—parietal and visceral layers line
walls of thoracic cavity and cover the lungs
(Disease) Pleurisy—inflammation of the serous membranes that line the chest cavity and cover the lungs

12. Serous membranes Peritoneum—parietal and visceral layers
line walls of abdominal cavity and cover the organs in that cavity
(Disease) Peritonitis—inflammation of the serous membranes in the abdominal cavity that
line the walls and cover the abdominal
organs

13. Mucous Membranes Line cavities that lead to outside.
Secrete mucus for protection.
Epithelium + Loose CT

14. Serous, Mucous Membranes

15. Cutaneous Membrane – THE SKIN!!!
Stratified squamous epithelium + CT + muscle + nervous tissue
(Composing about 16% of your body weight!!!! More info later!)

16. Synovial Membrane Lines joint cavities at articulations.
Loose CT + elastic fibers + adipose tissue

17. Functions of Skin Protects from injuries
Acts as barrier and regulates what enters/leaves body.
Regulates body temperature.
Synthesizes, stores vitamins.
Sensory functions

18. EPIDERMIS Stratum corneum Stratum granulosum Stratum spinosum
Stratum lucidum**
Stratum granulosum
Stratum spinosum
Stratum basale (germinativum)
**Thick skin only (Where would this be???)

19. Epithelium: layers (on left) and cell types (on right)

20. Stratum Basale
Lowest epidermal layer, single row of DIVIDING cells attached to dermis
Good nutrient supply
Cuboidal, columnar in shape
youngest cells; move to upper epidermis in 27 days.
contains pigment cells called melanocytes, which produce the brown pigment melanin

21. Melanocyte

22. Melanocyte Produces melanin for protection from UV radiation.
Responsible for skin color.
Melanoma.

23. Melanoma
                                                    

24. Stratum Basale

25. Stratum Spinosum Living cells Dividing (lots of MITOSIS)
8-10 cells thick
Polygonal in appearance

26. Stratum Spinosum

27. Stratum Granulosum Poor nutrient supply.
Layers of flattened keratinocytes producing keratin (hair and nails made of it also).
3-5 cells thick.
No cell division.
Keratin accumulates.

28. Stratum Lucidum Found only in very thick skin. Translucent.
Highly keratinized.
Dead cells

29. Stratum Corneum 25-30 “dead” cells thick.
Cells are filled with keratin and hardened.
Sloughed off.
Outer most layer of epidermis.

30. Epidermis and dermis of (a) thick skin and (b) thin skin
(which one makes the difference?)

31. Anatomy A215: EPIDERMIS LAYERS Memory Matrix
Superficial or Deep Layer?
Characteristics
Are cells keratinized in this layer?
Seen in THIN skin too?
Stratum Basale
Stratum Spinosum
Stratum Granulosum
Stratum Lucidum
Stratum Corneum

32. Anatomy A215: EPIDERMIS LAYERS Memory Matrix
Superficial or Deep Layer?
Characteristics
Are cells keratinized in this layer?
Seen in THIN skin too?
Stratum Basale
Stratum Spinosum
Stratum Granulosum
Stratum Lucidum
Stratum Corneum
A lot of mitosis here
Single row of cells
Youngest cells
Melanocytes
Deepest NO
Living, dividing cells
8-10 cells thick NO
Poor nutrients, no cell
Division
Keratinocytes make keratin
YES
Only in thick skin
Highly keratinized,
dead cells NO
YES
25-30 dead cells thick
Cells filled with keratin,
sloughed off
Most
Superficial
YES

33. DERMIS A. Strong, flexible connective tissue: your “hide”
B. Cells: fibroblasts, macrophages, mast cells, WBCs
C. Fiber types: collagen, elastic, reticular
D. Rich supply of nerves and vessels
E. Critical role in temperature regulation (the vessels)
F. Two layers (see next slides)
1. Papillary – areolar connective tissue; includes dermal papillae
2. Reticular – “reticulum” (network) of collagen and reticular fibers

34. DERMIS
                                                                
Irregular Dense Connective Tissue
Collagenous fibers

35. *Dermal papillae
*Dermis layers * *

36. Dermis Dermis also contains nerve endings, muscle fibers,
hair follicles,
sweat and sebaceous
glands,
and many blood vessels

37. Dermis (continued) Birthmarks—malformation of dermal blood vessels
Strawberry hemangioma
Port-wine stain

38. Dermal-epidermal junction
*is specialized area between two primary skin layers
* Blisters—caused by breakdown of union between cells of primary layers of skin

39. Fingerprints, palmprints, footprints
A. Dermal papillae lie atop dermal ridges and elevate the overlying epidermis into epidermal ridges
B. Actually are “sweat films” because of sweat pores
C. Genetically determined
Flexion creases
Deep in the dermis, from continual
folding
The dermis is the receptive
site for the pigment of tattoos

40. Fibers B. Elastic fibers: stretch-recoil Striae: stretch marks
A. Collagen: strength and resilience
B. Elastic fibers: stretch-recoil
Striae: stretch marks
Numbers decrease with age contributing to wrinkles
C. Tension lines (or lines of cleavage)
The direction the bundles
of fibers are directed

41. Skin appendages Derived from epidermis but extend into dermis Include
Nails
Hair and hair follicles
Skin glands
Sensory receptors

43. Nails Hard keratin Corresponds to hooves and claws
Grows from nail matrix

44. Hair and hair follicles: complex Derived from epidermis and dermis Everywhere but palms, soles, nipples, parts of genitalia
*“arrector pili” is smooth muscle *
Hair bulb: epithelial cells surrounding papilla
Hair papilla
is connective tissue________________

45. Make up of hair – hard keratin Three concentric layers
Functions of hair
Warmth – less in man than other mammals
Sense light touch of the skin
Protection - scalp
Parts
Root imbedded in skin
Shaft projecting above skin surface
Make up of hair – hard keratin
Three concentric layers
Medulla (core)
Cortex (surrounds medulla)
Cuticle (single layers, overlapping)

46. Hair growth: averages 2 mm/week
Types of hair
Vellus: fine, short hairs
Intermediate hairs
Terminal: longer, courser hair
Hair growth: averages 2 mm/week
Active: growing
Resting phase then shed
Hair loss
Thinning – age related
Male pattern baldness
Hair color
Amount of melanin for black or brown; distinct form of melanin for red
White: decreased melanin and air bubbles in the medulla
Genetically determined, though influenced by hormones and environment

47. Alopecia hair loss

48. Hair Follicle

49. Hair Follicles

50. Skin Glands
Types
Sweat or sudoriferous
Sebaceous

51. Types of Sweat Glands (Sudoriferous Glands)
Merocrine glands: release fluid by exocytosis
Eccrine (respond to temperature)
Most common
Secretion is mostly water with solutes
Cools body down; heat regulation
Apocrine (respond to pain, emotions)
Develops scent as bacteria metabolize secretion
Stimulated when frightened, during pain, during emotional upset

52. Sweat glands
Entire skin surface except nipples and part of external genitalia
Prevent overheating
500 cc to 12 l/day! (is mostly water)
Humans most efficient (only mammals have)
Produced in response to stress as well as heat

53. Sweat Gland

54. Sweat Gland Exiting the Skin

55. Eccrine Gland

56. Sebaceous Gland Secrete oil or sebum for hair and skin
Levels and amounts of secretion regulated by sex hormones; increases during adolescence
Sebum in sebaceous gland ducts may darken to form a blackhead
Acne vulgaris inflammation of sebaceous gland ducts

57. Sebaceous Gland Exocrine gland Associated with follicle
Secretes oily substance
Holocrine gland

58. Sebaceous Gland

59. Sensory Structures of Dermis
Deep touch/pressure: Pacinian corpuscles
Light touch/pressure: Meisner’s corpuscles
Warm temperature: Free nerve endings
Cold temperature: Free nerve endings
Pain: Free nerve endings

60. Hypodermis “Hypodermis” (Gk) = below the skin
“Subcutaneous” (Latin) = below the skin
Also called “superficial fascia”
“fascia” (Latin) =band; in anatomy: sheet of connective tissue
Fatty tissue which stores fat and anchors skin (areolar tissue and adipose cells)
Different patterns of accumulation
(male/female)

61. Hypodermis (Subcutaneous)
                                                                      
Atlas of Human Anatomy in Cross Section: Section 2. Neck, Shoulders, Upper Arm, and Upper Thorax (Lungs)
Key Figure 4a
Ronald A. Bergman, Ph.D., Adel K. Afifi, M.D., Jean J. Jew, M.D., and Paul C. Reimann, B.S. Peer Review Status: Externally Peer Reviewed
                                                            
Hypodermis (Subcutaneous)
Recognized by adipose tissue.

62. Functions of the Skin (Review)
Protection—first line of defense
Against infection by microbes
Against ultraviolet rays from sun
Against harmful chemicals
Against cuts and tears
Skin grafts

63. Functions of the Skin (Review)
Temperature regulation
Skin can release almost 3000 calories of
body heat per day
Mechanisms of temperature regulation
Regulation of sweat secretion
Regulation of flow of blood close to the
body surface

64. Functions of the Skin (Review)
Sense organ activity
Skin functions as an enormous sense
organ
Receptors serve as receivers for the body, keeping it informed of changes in its environment
—disorders of the skin (dermatoses)

65. Disorders of the integumentary system
Burns
Threat to life
Catastrophic loss of body fluids
Dehydration and fatal circulatory shock
Infection
Types
First degree – epidermis: redness (e.g. sunburn)
Second degree – epidermis and upper dermis: blister
Third degree - full thickness
Skin cancer
Lesions
Infections

66. Burns First-degree Second-degree Third-degree
(epidermis only; redness)
Second-degree
(epidermis and dermis,
with blistering)
Third-degree
(full thickness, destroying epidermis, dermis, often part of hypodermis)

67. Critical burns Estimate by “rule of 9’s”
Over 10% of the body has third-degree burns
25 % of the body has second-degree burns
Third-degree burns on face, hands, or feet

68. Burns Estimating body surface area using the “rule of nines” in adults
Body divided into 11 areas of 9% each
Additional 1% of body surface area around genitals

69. Tumors of the skin Benign, e.g. warts
Cancer – associated with UV exposure (also skin aging)
Three common types of cancer
Basal cell - cells of stratum basale, rarely spreads
Squamous cell – keratinocytes; the most
common type, characterized by hard,
raised tumors

70. Skin Cancer
Melanoma—malignancy in a nevus (mole); involves melanocytes; most dangerous; recognition:
A - Asymmetry
B - Border irregularity
C - Colors
D - Diameter larger than 6 mm

71. Skin Cancer
Sqaumous cell carcinoma
Basal cell carcinoma
Melanoma

72. Basal Cell Carcinoma

73. Untreated…..

74. Actinic Keratosis Caused by sun damage. Premalignant; can lead to
squamous cell carcinoma.

75. Skin Lesions Elevated lesions—cast a shadow outside their edges
Papule—small, firm raised lesion
Plaque—large raised lesion
Vesicle—blister
Pustule—pus-filled lesion
Crust—scab
Wheal (hive)—raised, firm lesion with a
light center

76. Skin Lesions Flat lesions—do not cast a shadow
Macule—flat, discolored region
Depressed lesions cast a shadow within their edges
Excoriation—missing epidermis, as in a scratch wound
Ulcer—craterlike lesion
Fissure—deep crack or break

77. Skin Infections Impetigo—highly contagious staphylococcal infection
Tinea—fungal infection (mycosis) of the
skin; several forms occur
Boils—furuncles; staphylococcal infection
in hair follicles
Scabies—parasitic infection

78. Vascular and Inflammatory Skin Disorders
Decubitus ulcers (bedsores) develop when pressure slows down blood flow to local
areas of the skin
Urticaria or hives—red lesions caused by
fluid loss from blood vessels
Scleroderma—disorder of vessels and connective tissue characterized by hardening
of the skin; two types: localized and systemic

79. Vascular and Inflammatory Skin Disorders
Psoriasis—chronic inflammatory
condition accompanied by scaly
plaques
Eczema—common inflammatory
condition characterized by papules, vesicles,
and crusts; not a disease
itself but a symptom of an underlying
condition

80. PSORIASIS

81. MAP SHOWING SKIN COLOR
DISTRIBUTION

82. EVOLUTION OF SKIN COLOR
Balance between
Need for protection against UV radiation which
Causes skin cancer
Destroys folate (vitamin B)
Need for UV to produce vitamin D for calcium absorption