Lect 5   intergumentary
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Lect 5 intergumentary






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Lect 5   intergumentary Lect 5 intergumentary Presentation Transcript

  • Chapter 5 The Integumentary System Lecture Outline
    • The skin and its accessory structures make up the integumentary system.
    • The integumentary system functions to guard the body’s physical and biochemical integrity, maintain a constant body temperature, and provide sensory information about the surrounding environment.
    • Skin and its accessory structures
      • structure
      • function
      • growth and repair
      • development
      • aging
  • STRUCTURE OF THE SKIN (Figure 5.1)
    • The superficial portion of the skin is the epidermis and is composed of epithelial tissue.
    • The deeper layer of the skin is the dermis and is primarily composed of connective tissue.
    • Deep to the dermis is the subcutaneous layer or hypodermis. ( not a part of the skin)
      • It consists of areolar and adipose tissue.
      • fat storage, an area for blood vessel passage, and an area of pressure-sensing nerve endings.
  • Overview of Epidermis
    • Stratified squamous epithelium
    • avascular (contains no blood vessels)
  • Four Principle Cells of the Epidermis – Figure 5.2
    • keratinocytes
      • produce the protein keratin, which helps protect the skin and underlying tissue from heat, microbes, and chemicals, and lamellar granules, which release a waterproof sealant
    • melanocytes
      • produce the pigment melanin which contributes to skin color and absorbs damaging ultraviolet (UV) light
    • Langerhans cells
      • derived from bone marrow
      • participate in immune response
    • Merkel cells
      • contact a sensory structure called a tactile (Merkel) disc and function in the sensation of touch
  • Layers (Strata) of the Epidermis
    • Stratum corneum
    • Stratum lucidum
    • Stratum granulosum
    • Stratum spinosum
    • Stratum basale
  • Stratum Basale ( stratum germinativum)
    • Stratum corneum
      • Barrier to light, heat, water, chemicals & bacteria
      • Lamellar granules in this layer make it water-repellent.
    • Stratum lucidum
      • Contains precursor of keratin
    • Stratum granulosum
      • transition between the deeper, metabolically active strata and the dead cells of the more superficial strata
    • Stratum spinosum
      • provides strength and flexibility to the skin
    • Stratum basale
      • Deepest single layer of epidermis
  • Dermis (Figure 5.1)
    • Connective tissue layer composed of collagen & elastic fibers, fibroblasts, macrophages & fat cells
    • Contains hair follicles, glands, nerves & blood vessels
    • Two major regions of dermis
      • papillary region
      • reticular region
  • Dermis - Papillary Region
    • Top 20% of dermis
    • areolar connective tissue containing fine elastic fibers, corpuscles of touch (Meissner’s corpuscles), adipose cells, hair follicles, sebaceous glands, sudoriferous glands
      • The collagen and elastic fibers provide strength, extensibility (ability to stretch), and elasticity (ability to return to original shape after stretching) to skin.
    • Finger like projections are called dermal papillae
      • anchors epidermis to dermis
      • contains capillaries that feed epidermis
      • contains Meissner’s corpuscles (touch) & free nerve endings for sensations of heat, cold, pain, tickle, and itch
  • Dermis - Reticular Region
    • Dense irregular connective tissue
    • Contains interlacing collagen and elastic fibers
    • Packed with oil glands, sweat gland ducts, fat & hair follicles
    • Provides strength, extensibility & elasticity to skin
      • stretch marks are dermal tears from extreme stretching
    • Epidermal ridges form in fetus as epidermis conforms to dermal papillae
      • fingerprints are left by sweat glands open on ridges
      • increase grip of hand
  • Dermis -- Structure
    • Epidermal ridges increase friction for better grasping ability and provide the basis for fingerprints and footprints. The ridges typically reflect contours of the underlying dermis.
    • Lines of cleavage in the skin indicate the predominant direction of the underlying collagen fibers. Knowledge of these lines is especially important to plastic surgeons.
  • Basis of Skin Color
    • The color of skin and mucous membranes can provide clues for diagnosing certain problems, such as
      • Jaundice
        • yellowish color to skin and whites of eyes
        • buildup of yellow bilirubin in blood from liver disease
      • Cyanosis
        • bluish color to nail beds and skin
        • hemoglobin depleted of oxygen looks purple-blue
      • Erythema
        • redness of skin due to enlargement of capillaries in dermis
        • during inflammation, infection, allergy or burns
  • Skin Color Pigments
    • Melanin produced in epidermis by melanocytes
      • melanocytes convert tyrosine to melanin
        • UV in sunlight increases melanin production
    • The wide variety of colors in skin is due to three pigments - melanin, carotene, and hemoglobin (in blood in capillaries) - in the dermis.
    • Carotene in dermis
      • yellow-orange pigment (precursor of vitamin A)
      • found in stratum corneum & dermis
    • Hemoglobin
      • red, oxygen-carrying pigment in blood cells
      • if other pigments are not present, epidermis is translucent so pinkness will be evident
  • Accessory Structures of Skin
    • develop from the embryonic epidermis
    • Cells sink inward during development to form:
      • hair
      • oil glands
      • sweat glands
      • nails
  • Structure of Hair
    • Shaft -- visible
    • Root -- below the surface
    • Follicle surrounds root
    • Functions of Hair
      • P revents heat loss
      • Decreases sunburn
      • Eyelashes help protect eyes
      • Touch receptors (hair root plexus) senses light touch
  • Glands of the Skin
    • Specialized exocrine glands found in dermis
    • Sebaceous (oil) glands
    • Sudiferous (sweat) glands
    • Ceruminous (wax) glands
    • Mammary (milk) glands
  • Sudoriferous (sweat) glands
    • Eccrine sweat glands have an extensive distribution most areas of skin
      • secretory portion is in dermis with duct to surface
      • ducts terminate at pores at the surface of the epidermis.
      • regulate body temperature through evaporation (perspiration)
      • help eliminate wastes such as urea.
    • Apocrine sweat glands are limited in distribution to the skin of the axilla, pubis, and areolae; their duct open into hair follicles.
      • secretory portion in dermis
      • duct that opens onto hair follicle
      • secretions are more viscous
  • Ceruminous Glands
    • Ceruminous glands are modified sudoriferous glands that produce a waxy substance called cerumen.
      • found in the external auditory meatus
      • contains secretions of oil and wax glands
      • barrier for entrance of foreign bodies
    • An abnormal amount of cerumen in the external auditory meatus or canal can result in impaction and prevent sound waves from reaching the ear drum (Clinical Application).
  • Structure of Nails (Figure 5.5)
    • Tightly packed keratinized cells
    • Nail body
      • visible portion pink due to underlying capillaries
      • free edge appears white
    • Nail root
      • buried under skin layers
      • lunula is white due to thickened stratum basale
    • Eponychium (cuticle)
      • stratum corneum layer
  • Sebaceous (oil) glands
    • Sebaceous (oil) glands are usually connected to hair follicles; they are absent in the palms and soles
    • Secretory portion of gland is located in the dermis
      • produce sebum
        • contains cholesterol, proteins, fats & salts
        • moistens hairs
        • waterproofs and softens the skin
        • inhibits growth of bacteria & fungi (ringworm)
    • Acne
      • bacterial inflammation of glands
      • secretions are stimulated by hormones at puberty
    • Thin skin
      • covers all parts of the body except for the palms and palmar surfaces of the digits and toes.
      • lacks epidermal ridges
      • has a sparser distribution of sensory receptors than thick skin.
    • Thick skin (0.6 to 4.5 mm)
      • covers the palms, palmar surfaces of the digits, and soles
      • features a stratum lucidum and thick epidermal ridges
      • lacks hair follicles, arrector pili muscles, and sebaceous glands, and has more sweat glands than thin skin.
  • FUNCTIONS OF SKIN -- thermoregulation
    • Perspiration & its evaporation
      • lowers body temperature
      • flow of blood in the dermis is adjusted
    • Exercise
      • in moderate exercise, more blood brought to surface helps lower temperature
      • with extreme exercise, blood is shunted to muscles and body temperature rises
    • Shivering and constriction of surface vessels
      • raise internal body temperature as needed
    • blood reservoir
      • extensive network of blood vessels
    • protection - physical, chemical and biological barriers
      • tight cell junctions prevent bacterial invasion
      • lipids released retard evaporation
      • pigment protects somewhat against UV light
      • Langerhans cells alert immune system
    • cutaneous sensations
      • touch, pressure, vibration, tickle, heat, cold, and pain arise in the skin
    • Synthesis of Vitamin D
      • activation of a precursor molecule in the skin by UV light
      • enzymes in the liver and kidneys modify the activated molecule to produce calcitriol, the most active form of vitamin D.
      • necessary vitamin for absorption of calcium from food in the gastrointestinal tract
    • excretion
      • 400 mL of water/day, small amounts salt, CO2, ammonia and urea
  • Epidermal Wound Healing
    • Abrasion or minor burn
    • Basal cells migrate across the wound
    • Contact inhibition with other cells stops migration
    • Epidermal growth factor stimulates basal cells to divide and replace the ones that have moved into the wound
    • Full thickness of epidermis results from further cell division
  • Deep Wound Healing
    • When an injury extends to tissues deep to the epidermis, the repair process is more complex than epidermal healing, and scar formation results.
    • Healing occurs in 4 phases
      • inflammatory phase has clot unite wound edges and WBCs arrive from dilated and more permeable blood vessels
      • migratory phase begins the regrowth of epithelial cells and the formation of scar tissue by the fibroblasts
      • proliferative phase is a completion of tissue formation
      • maturation phase sees the scab fall off
    • Scar formation
      • hypertrophic scar remains within the boundaries of the original wound
      • keloid scar extends into previously normal tissue
        • collagen fibers are very dense and fewer blood vessels are present so the tissue is lighter in color
  • Deep Wound Healing
    • Phases of Deep Wound Healing
      • During the inflammatory phase , a blood clot unites the wound edges, epithelial cells migrate across the wound, vasodilatation and increased permeability of blood vessels deliver phagocytes, and fibroblasts form
      • During the migratory phase , epithelial cells beneath the scab bridge the wound, fibroblasts begin scar tissue, and damaged blood vessels begin to grow. During this phase, tissue filling the wound is called granulation tissue .
  • Phases of Deep Wound Healing
  • Deep Wound Healing
    • Phases of Deep Wound Healing
      • During the proliferative phase , the events of the migratory phase intensify.
      • During the maturation phase , the scab sloughs off, the epidermis is restored to normal thickness, collagen fibers become more organized, fibroblasts begin to disappear, and blood vessels are restored to normal
      • Scar tissue formation (fibrosis) can occur in deep wound healing.
  • Age Related Structural Changes
    • Collagen fibers decrease in number & stiffen
    • Elastic fibers become less elastic
    • Fibroblasts decrease in number
    • decrease in number of melanocytes (gray hair, blotching)
    • decrease in Langerhans cells (decreased immune responsiveness)
    • reduced number and less-efficient phagocytes
    • Most of the changes occur in the dermis
      • wrinkling, slower growth of hair and nails
      • dryness and cracking due to sebaceous gland atrophy
      • Walls of blood vessels in dermis thicken so decreased nutrient availability leads to thinner skin as subcutaneous fat is lost.