1. PA 475 Clinical Anatomy Dr. Tony Serino
Integument
PA 475 Clinical Anatomy
Dr. Tony Serino

2. Skin: Topic Objectives
Be able to list the primary functions and layers of the skin
Apply the severity of a burn to the layer of skin affected and be able to apply the rule of “9’s”
Be able to list structures associated with the accessory structures of the skin

3. Integument System: Skin
Functions:
Protection
Germ and water proof barrier, abrasion resistant
Sensory
Organ in first contact with external environment
Homeostasis
Thermoregulation (excretory), Ca++ balance
Communication
Muscle attachment
Secretes phermones –for communicating

4. Layers of the Skin Epidermis Dermis Subcutaneous layer (Hypodermis)
Outermost layer, composed of keratinocytes
Dermis
Thickest layer, composed of many connective tissues and is the site for many glands and other epidermal derivatives
Subcutaneous layer (Hypodermis)
Attaches skin to underlying structures

5. Composed of 4-5 layers of keratinocytes which is formed into a stratified squamous epithelium
Main gene product is keratin, a water insoluble protein
Some cells from the dermis invade and reside in the epidermis’ deepest layers including Merkel cells, Langerhans cells, and melanocytes
Epidermis
(basale)

6. Melanocytes: produce melanin

7. Tattoo –voluntary injection of ink below epidermis
Acne Rosacea –permanent reddening of skin on face, especially. Maybe due to drug interactions, alcohol, spicy foods, TB, syphilis, or lupus
Wine Stain –birth mark due to overgrowth of blood vessels in skin
Other Pigmentations

8. Composed of a mixture of CT, including dense irregular, loose areolar, elastic, and adipose tissues
Divided into 2 regions:
Papillary layer: region of dermal papillae
Reticular layer: thickest layer of skin, provides strength, elasticity and space for glands, hair follicles, etc.
creates tension lines of skin
Dermis
Papillary Region
Reticular Region
Hypodermis

9. Dermal Papillae: arranged into regular patterns in palms and soles

10. Burns
Rule of “9’s”
1st
2nd
3rd

11. Skin Cancers
Squamous cell carcinoma
Basal cell carcinoma
Melanoma

12. Epidermal Derivatives
Structures which grow from the epidermis but reside mostly in the dermis
Nails, Hair, and glands of skin

13. Nail
Nail Fold
Nail Matrix
Nail Bed

14. Hair
Hair shaft
Sebaceous gland
Hair root
Hair papilla
Hair Bulb

16. Epidermal Glands
Sebaceous glands –secretes sebum (an oil) used to maintain skin and hair moisture
Ceruminous glands –secretes cerumen (ear wax), used to keep foreign objects out of ear
Sudoriferous (sweat) glands –secrete sweat (water with some salts), used in heat regulation and in phermone secretion: two types: Apocrine and Eccrine (Merocrine)
Mammary Glands –secrete milk

17. Sweat Glands

18. Breast

19. Milk Line

20. Breast Cancer and Mammograms
Normal
Tumor

21. Mammary gland