UNIT 2 - CHAPTER 6: INTEGUMENTARY SYSTEM LEARNING OUTCOMES: 6.1 Introduction 1.

Describe what constitutes an organ, and name the large organ of the integumentary system. Discuss the functions of skin.

2. 6.2

Skin and Its Tissues 3. 4. Describe the structure of the layers of the skin. Summarize the factors that determine skin color.

6.3

Accessory Structures of the Skin 5. 6. Describe the accessory structures associated with the skin. Explain the functions of each accessory structure of the skin.

6.4

Regulation of Body Temperature 7. Explain how the skin helps regulate body temperature.

6.5

Healing of Wounds and Burns 8. 9. Describe wound healing. Distinguish among the types of burns, including a description of healing with each type.

6.6

Life-Span Changes 10. Summarize life-span changes in the integumentary system.

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UNIT 2 - CHAPTER 6: INTEGUMENTARY SYSTEM 6.1. INTRODUCTION The integumentary system is the first body system studied. A body system is composed of organs that work together to perform the function(s) of that system, and an organ is composed of two or more tissues working together toward a common goal. The integumentary system consists of a major organ, skin, and many accessory structures, which include hair follicles, sebaceous glands, sweat glands, and nails. The organs of the integumentary system are composed of many different tissues that perform common functions. Identify the tissues in Fig 6.1, page 180 and Fig 6.2, page 181; these tissues will be described in detail on the next few pages. The functions that these tissues collectively perform are many, including the following: A. Protection as a physical barrier from water loss, injury, from chemicals and microorganisms, a chemical barrier with pH of 5-6 preventing microorganism growth, and a biological barrier with Langerhans cells, macrophages and mast cells. Excretion of urea and uric acid, although minimal; most is through kidneys. Regulation of body temperature: Review negative-feedback mechanisms from Ch. 1 and see Figure 6.12, page 191. Cutaneous Sensation: 1. Light touch detection by tactile corpuscles. 2. Pressure detection by lamellated corpuscles. Vitamin D Synthesis is activated by ultraviolet rays in sunlight. Vitamin D is required for bone homeostasis and more. Blood Reservoir as the dermis houses about 10% of the body's blood vessels, but only requires 1-2% of the bodys blood. Immunity with Langerhans cells (macrophages) and interaction with T-helper cells in immune responses

B. C. D.

E. F. G.

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SKIN AND ITS TISSUES (Cutaneous Membrane) A. General Structure: See Fig 6.2a, page 181. 1. Two distinct regions or layers compose the skin: a. Epidermis = outermost layer o keratinized stratified squamous epithelium b. Dermis = inner layer o keratinized epithelium (hair follicles) o glandular epithelium (sweat, sebaceous glands) o dense irregular CT (collagen) o smooth muscle tissue (arrector pili muscles) o nervous tissue (tactile and lamellated corpuscles) o blood vessels 2. Subcutaneous (hypodermis) layer = adipose tissue o distinct layer beneath skin 6-2

UNIT 2 - CHAPTER 6: INTEGUMENTARY SYSTEM 6.2 SKIN AND ITS TISSUES B. Epidermis: 1. Structure = keratinized stratified squamous epithelium. See Fig 6.3, and Table 6.1, page 182. a. Four distinct layers determined by the extent of keratinization in the epithelial cells: 1. Stratum corneum = outermost layer. o composed of dead epithelial cells filled with the protein keratin *** Stratum lucidum = translucent layer cells separating s. corneum from s. granulosum. o extra layer only in thick skin of soles and palms 2. Stratum granulosum is composed of 3-5 layers of flattened granular cells (filled with keratin granules). 3. Stratum spinosum is composed of many layers of spiky cells with large nuclei. 4. Stratum basale = innermost layer. o directly above basement membrane o composed of a single row mitosing cuboidal epithelial cells and o composed of melanocytes a. specialized cells that produce the pigment melanin. b. See Fig 6.3b, page 182, which illustrates the pigmentation in melanocytes. * Together the s. spinosum and s. basale make up the stratum germinativum. 2. Main Function = Protection (keratin): a. prevents moisture loss (waterproof) b. prevents injury by penetration c. prevents microorganisms/chemicals entry 3. Pigment = Melanin: See Fig 6.4, page 183. a. determines skin color b. is produced by melanocytes in stratum basale (germinativum) i. Genetic Factors a. People of different races have essentially the same # of melanocytes, but the amount of melanin produced varies (determined by DNA); ii. Environmental Factors affect melanin production, by affecting gene expression a. UV rays b. chemicals c. drugs (antihistamines & antibiotics)

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UNIT 2 - CHAPTER 6: INTEGUMENTARY SYSTEM 6.2 SKIN AND ITS TISSUES (Cutaneous Membrane) B. Epidermis: 3. Pigment = Melanin iii. Physiologic Factors may affect skin color (but not melanin production) a. Carotene may accumulate in s. corneum = orange. b. Hemoglobin (Hb) in dermal blood vessels = pink. c. Lack of Hb in dermal blood vessels = blue (cyanosis). d. Inability to breakdown Hb (liver problems) = yellow (jaundice; See box page 185). iv. Consequences of excess sun exposure Skin Cancer. See Clinical Application 6.1, page 184: Indoor Tanning and Skin Cancer. 4. Nourishment of epidermis is through diffusion of nutrients from blood vessels in underlying connective tissues. See box on page 182 re: pressure ulcers, which result when epidermal cells cannot receive nutrients and die. 5. Overproduction of epidermal cells may result in a condition called psoriasis. See box on page 183. Dermis: 1. inner layer of skin; binds epidermis to underlying tissues. Structure: See Fig 6.1, page 180 and Fig 6.2, page 181. a. Two layers: 1. upper papillary layer (20%) is below epidermis: o composed of loose areolar CT o surface forms dermal papillae (finger-like projections into the epidermis) that form fingerprints in thick skin o Tactile (Meissners) corpuscles = sensory receptors for fine touch. 2. lower reticular layer (80%) = dense irregular CT o bundles of collagen fibers o elastic fibers o reticular fibers which together give skin its strength and resiliency. o Lamellated (Pacinian) corpuscles = sensory receptors for pressure. b. The dermis houses epidermal derivatives or accessory structures (see below). Main Functions = nourishment of epidermis and strength of skin. See introduction on page 180, The Secret of Skins Strength and Flexibility. See box on page 186 re: tattoos and painful tattoo removal. 6-4

C.

2.

UNIT 2 - CHAPTER 6: INTEGUMENTARY SYSTEM 6.3 ACCESSORY STRUCTURES OF THE SKIN (Epidermal Derivatives) A. Nails: See Fig 6.6, page 186. 1. Epithelium undergoing keratinization (active mitosis in lunula). 2. Functions: a. manipulation b. protection of digit ends * See box on page 186 re: Nails appearance mirror health Hair Follicles: See Fig 6.7, page 187, and Figs 6.8 and 6.9, page 188. 1. Structure: a. root or base in deep dermis b. follicle throughout dermis c. hair shaft in epidermis and extending beyond the surface 2. Keratinization a. Cells are epithelium. b. Cells in root are actively dividing. c. Cells in follicle are maturing and accumulating keratin. d. Cells in epidermis are dead epithelial cells; filled with keratin and are exposed hair or hair shaft. 3. Pigment = Melanin; a. albinism = lack of melanin. See text and Fig 6.5, page 185. b. red hair = trichosiderin. See box on page 186 re: Neanderthals with reddish hair and pale skin. 4. Arrector Pili Muscle = a bundle of smooth muscle associated with every hair follicle. See Fig 6.7, page 187. a. causes hair to stand on end ("goose bumps") when frightened or cold. * Hair Loss. See Clinical Application 6.2, page 187. Skin Glands 1. Sebaceous Glands: See Fig 6.7, page 187 & Fig 6.9 and 6.10, page 188. a. holocrine gland (simple cuboidal epithelium) b. associated with every hair follicle c. Secretion (holocrine) = sebum (i.e. oil). fat and cellular material d. Sebum is secreted into hair follicle. e. Function: Sebum keeps skin and hair soft, pliable and virtually waterproof. f. Disorders: acne (hypersecretion of sebum; ducts clog & inflame); See Clinical Application 6.3, page 189. seborrhea (hyperproduction of sebum; oily scales)

B.

C.

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UNIT 2 - CHAPTER 6: INTEGUMENTARY SYSTEM 6.3 ACCESSORY STRUCTURES OF THE SKIN (Epidermal Derivatives) C. Skin Glands 2. Sweat Glands or Sudoriferous Glands Two types (based on glandular secretion): See Fig 6.10, page 188 and Fig 6.11, page 189. a. Eccrine (Merocrine) Glands: o Structure: 1. coil in deep dermis 2. duct in dermis 3. pore at surface o Characteristics: 1. respond to elevated temperature / exercise 2. no odor in secretion 3. function throughout life 4. not associated with hair follicles 5. Location: forehead neck back o Secretion (merocrine) = water plus 1. salts and 2. wastes (urea and uric acid) b. Apocrine glands: o Structure: ducts terminate into hair follicles o Characteristics: 1. respond to stress / emotions 2. odor in secretion 3. begin to function at puberty & continue through life 4. associated with hair follicles 5. Location: axillary region (armpits) inguinal region (groin) o Secretion (apocrine) = sweat above plus 1. oil and 2. cellular debris. o Modified Apocrine Glands 1. Ceruminous glands = external ear; secretion = earwax; 2. Mammary glands = breasts; milk.

* *

See Table 6.2, page 190, Skin Glands. Note that the above structures under 6.3. ACCESSORY STRUCTURES OF THE SKIN are epithelial in nature and are actually specialized parts of the epidermis, even though their location is within the dermis. 6-6

UNIT 2 - CHAPTER 6: INTEGUMENTARY SYSTEM 6.4 REGULATION OF BODY TEMPERATURE normally near 98.6F/37C (set point) A. Heat Production and Loss 1. 2. Heat production is mostly a by-product of cellular metabolism. Heat loss is controlled by regulating dermal blood flow. a. Vasodilation increases dermal blood flow, which also increases heat loss. b. Vasoconstriction decreases dermal blood flow which decreases heat loss. Heat loss is by four methods a. Radiation o most heat loss by this mode o Infrared heat rays move from area of high heat (i.e. the blood) to areas of low heat (i.e. the environment). b. Conduction o less heat loss o Heat moves by physical contact. o (This is the reason your seat is warm when you stand up) c. Convection o heat loss to surrounding air o increases as air movement increases. This is why turning on a fan cools your body. d. Evaporation o heat loss varies o If heat increases our sweating increases, so we lose more heat by evaporation of the sweat on the surface of our skin. Low body temperatures require heat loss to be minimized a. The hypothalamus signals for sweating to decrease (decreasing heat loss by evaporation), and dermal vasoconstriction (decreasing heat loss by radiation). b. Usually this brings the body temperature back to normal. If the body temperature remains low after the above actions a. heat must be produced b. Shivering occurs and the tiny muscle contractions involved produce heat. c. See Figure 6.12 page 191.

3.

4.

5.

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UNIT 2 - CHAPTER 6: INTEGUMENTARY SYSTEM 6.4 REGULATION OF BODY TEMPERATURE B. Problems in Temperature Regulation 1. Hyperthermia elevated body temperature. a. Two common causes: o Humid air decreases evaporation. o air temperature exceeds body temperature; thus heat is gained, not lost o See Clinical Application 6.4 page 192, Elevated Body Temperature.

2.

Hypothermia low body temperature, a. b. c. very dangerous if core body temperature drops below 94F Limbs can withstand about 65F because they contain no vital organs. Its cause is intentional during some surgical procedures. See box on bottom of page 191.

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UNIT 2 - CHAPTER 6: INTEGUMENTARY SYSTEM 6.5 HEALING OF WOUNDS AND BURNS Inflammation process involving blood flow changes and chemical signaling leading to healing. A. Cuts 1. 2. Epidermal cuts are closed by increased cell division in the stratum basale. Deep cuts involve blood vessel damage resulting in: a. b. c. d. e. f. g. B. Burns 1. Superficial partial-thickness burns (1st degree) a. epidermis only b. reddening due to increased blood flow c. mild pain d. common in sunburn. See Chapter 3, page 117 and box on page 194. e. usually heals in a few days-2 weeks Deep partial-thickness burns (2nd degree) a. epidermis and some dermal damage b. reddening and blistering caused by blood vessel damage c. moderate pain d. common to physical contact with hot objects e. heals in 2-6 weeks, without scars unless infected Full-thickness burns (3rd degree) a. epidermis, entire dermis, and potentially subcutaneal damage b. dry, leathery tissue with red or black color c. severe pain d. caused by prolonged heat or chemical contact e. Healing rarely occurs due to lack of surviving skin cells. Skin replacements (grafts) are usually needed; usually extensive scarring o Autograft transplant from undamaged area of yourself. o Homograft temporary transplant from cadaver. Body Surface affected a. estimated by rule of nines b. important for determining treatment and prognosis c. See Figure 6.14 page 195. inflammation blood clotting (See Hemostasis Chapter 14) scab formation fibroblast infiltration and repair scab formation and then shedding Scar may or may not remain. See Figure 6.13 page 193.

2.

3.

4.

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UNIT 2 - CHAPTER 6: INTEGUMENTARY SYSTEM 6.6 LIFE-SPAN CHANGES A. Aging skin exhibits: 1. wrinkling a. Some individuals choose Botox injections to temporarily reduce wrinkles. See box on page 194. sagging age spots or liver spots a. See Fig 6.15, page 195.

2. 3.

B.

Efficient regulation of body temperature declines with age. 1. 2. The number of sweat glands changes. Capillary beds in the skin shrink.

C.

Synthesis of vitamin D declines as skin ages, which affects skeletal health.

INNERCONNECTIONS between Integumentary System and other organ systems, page 196. CHAPTER SUMMARY see pages 197-198. CHAPTER ASSESSMENTS see page 199. INTEGRATIVE ASSESSMENT/CRITICAL THINKING see page 200.

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