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INTRODUCTION
1. SKIN
2. SUPERFICIAL FASCIA
3. DEEP FASCIA
SKIN AND FASCIA
Skin coloration
• Skin is the best indicator of general health
• Three skin pigments
Melanin
carotene
Hemoglobin
Functions of skin
• Protection
Cushions and insulates and is waterproof
Protects from trauma, chemicals, heat, cold, bacteria
Screens UV
• Synthesis and storage of vitamin D
• Capable of absorption (drugs) and excretion (sweat)
• Regulates body temperature
• Prevents insensible water loss
• Sensory perception (nerve endings)
• Ability to regenerate
SKIN
Origin
EPIDERMIS
Layers of epidermis
Stratum Basale
• Lowest epidermal layer,
near dermis
• Good nutrient supply
• Reproduces by mitosis
• Cuboidal, columnar in
shape
• Moves to upper epidermis
in 27 days
Stratum Spinosum
• Living cells
• Dividing
• 8-10 cells thick
• Polygonal in appearance
Cont…
Stratus Granulosum,
• Poor nutrient supply.
• Flatten layer of cells.
• 3-5 cells thick.
• No cell division.
• Keratin accumulates
Stratus Lucidum
• Found only in very thick
skin.
• Translucent.
• Highly keratinized.
• Dead cells
Stratum Corneum
• 25-30 cells thick.
• Cells are filled with keratin and hardened.
• Sloughed off
• Outer most layer of epidermis
• Keratinocytes
CELL TYPES IN EPIDERMIS
Keratinocytes – produce keratin (tough
fibrous protein)
Melanocytes - Neural crest origin
Merkel cells – Neural crest origin,
associated with sensory nerve endings
and specialized in the perception of light
touch.
Langerhans cells – Bone marrow origin,
located in basal, spinous and granular
layers, act as antigen-presenting cells.
LAYERS OF DERMIS: Papillary layer
• Composed of loose areolar
connective tissue.
• Fingerlike projections called
papillae, that extend toward
the epidermis.
• The papillae provide the
dermis with a "bumpy"
surface that interdigitates
with the epidermis,
strengthening the connection
between the two layers of
skin.
Reticular layers
• The reticular region lies deep in the
papillary region and is usually much
thicker contains the skin appendages
• It is composed of dense irregular
connective tissue
• Fibers: are collagen, elastic and
reticular, give the dermis its
properties of strength, extensibility,
and elasticity.
• Cells: fibroblasts, macrophages, mast
cells, WBCs
THIN HAIRY SKIN THICK NONHAIRY/GLABROUS SKIN
Surface tension lines/ skin creases
• Form a network of
linear furrows which
divided the surface into
polygonal or lozenge
shaped areas . These
lines to some extent
correspond to
variations in the
pattern of fibers in the
dermis.
Tension lines/Cleavage
lines/Langer lines
• These are tension lines of skin, due
to the patterns of arrangement of
collagen fibers in the dermis.
• These lines were first described by
Langer in 1861 on cadaver.
• Tend to spiral longitudinal in the
limbs and run transversely in the
neck and trunk.
• At the elbow , knee, wrist and ankles
are parallel to the transverse creases
that appear when the limbs are
flexed.
Skin incisions
• Skin incisions that are given parallel to the
tension lines usually heal well with minimal
scarring because of minimum disruption of
collagen fibers.
Stretch marks in skin
• Damage to the collagen fibers in dermis due
to over stretching as in pregnancy or
abdominal enlargement.
Wrinkle lines
• Caused by contraction of
underlying muscles, present
perpendicular to their axis of
shortening.
• On face, they are known as
lines of facial expression,
aging makes them
permanent due to loss of
skin elasticity.
Flexure lines or joint lines
• Major markings found in the
vicinity of synovial joints where
the skin is attached strongly to
underlying deep fascia.
• Prominent on the flexor
surfaces of palms, soles and
digits.
• Skin lines don't necessarily
coincide with the underlying
joint line.
Flexure lines
Papillary/epidermal/friction ridges
• A friction ridge is a raised portion of the
epidermis on the fingers and toes, the
palm of the hand or the sole of the
foot.
• Are caused by the underlying interface
between the dermal papillae of the
dermis and the interpapillary (rete)
pegs of the epidermis.
• along the summit of each ridge the
apertures of sweat ducts open at
regular intervals.
Dermis determines the developmental
pattern of epidermis
FINGER PRINT
• A fingerprint is an impression left
by the friction ridges of a human
finger
• This is genetically determined,
unique to the individual, stable
through out life & serves as a mean
of personal identification.
• The analysis of ridge patterns by
studying finger and foot prints is
known as dermatoglyphics.
The dermis is the receptive site for the pigment
of tattoos
Cutaneous blood supply
• The dermis contains horizontally
arranged superficial and deep
plexuses, which are interconnected
via communicating vessels oriented
perpendicular to the skin surface.
Lymphatics
• Blind-ended lymphatic capillaries arise within
the interstitial spaces of the dermal papillae.
These unvalved, superficial dermal vessels drain
into valved deep dermal and subdermal
plexuses.
Skin Innervation
• Free nerve endings in the basal layer of the epidermis
detect pain
• Merkel cells of the epidermis detect light touch.
• Meissner’s corpuscles also detect light touch. These are
found in the dermal papillae and are most concentrated in
the fingertips.
• Pacininian corpuscles are found deep within the dermis or
even in the subcutaneous tissue. These structures detect
pressure.
Hypodermis/ superficial fascia
• Fibrous mesh filled with fat, connects the dermis to
underlying layer of deep fascia
• Fat is absent in eyelids, pinna of ear, scrotum
• Muscle fibers are present in the subcutaneous
tissue of scalp, face and scrotum
DEEP FASCIA
• Dense inelastic sheet or
membrane, separates
superficial fascia from
underlying structures.
• It either invests or bind
structures.
• Named according to the
area of body it covers.
MODIFICATIONS:
Intermuscular septum
Retinacula

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Skin and fascial medicos notes.com

  • 1. INTRODUCTION 1. SKIN 2. SUPERFICIAL FASCIA 3. DEEP FASCIA SKIN AND FASCIA
  • 2. Skin coloration • Skin is the best indicator of general health • Three skin pigments Melanin carotene Hemoglobin
  • 3. Functions of skin • Protection Cushions and insulates and is waterproof Protects from trauma, chemicals, heat, cold, bacteria Screens UV • Synthesis and storage of vitamin D • Capable of absorption (drugs) and excretion (sweat) • Regulates body temperature • Prevents insensible water loss • Sensory perception (nerve endings) • Ability to regenerate
  • 6. Layers of epidermis Stratum Basale • Lowest epidermal layer, near dermis • Good nutrient supply • Reproduces by mitosis • Cuboidal, columnar in shape • Moves to upper epidermis in 27 days Stratum Spinosum • Living cells • Dividing • 8-10 cells thick • Polygonal in appearance
  • 7. Cont… Stratus Granulosum, • Poor nutrient supply. • Flatten layer of cells. • 3-5 cells thick. • No cell division. • Keratin accumulates Stratus Lucidum • Found only in very thick skin. • Translucent. • Highly keratinized. • Dead cells
  • 8. Stratum Corneum • 25-30 cells thick. • Cells are filled with keratin and hardened. • Sloughed off • Outer most layer of epidermis • Keratinocytes
  • 9. CELL TYPES IN EPIDERMIS Keratinocytes – produce keratin (tough fibrous protein) Melanocytes - Neural crest origin Merkel cells – Neural crest origin, associated with sensory nerve endings and specialized in the perception of light touch. Langerhans cells – Bone marrow origin, located in basal, spinous and granular layers, act as antigen-presenting cells.
  • 10.
  • 11. LAYERS OF DERMIS: Papillary layer • Composed of loose areolar connective tissue. • Fingerlike projections called papillae, that extend toward the epidermis. • The papillae provide the dermis with a "bumpy" surface that interdigitates with the epidermis, strengthening the connection between the two layers of skin.
  • 12. Reticular layers • The reticular region lies deep in the papillary region and is usually much thicker contains the skin appendages • It is composed of dense irregular connective tissue • Fibers: are collagen, elastic and reticular, give the dermis its properties of strength, extensibility, and elasticity. • Cells: fibroblasts, macrophages, mast cells, WBCs
  • 13. THIN HAIRY SKIN THICK NONHAIRY/GLABROUS SKIN
  • 14. Surface tension lines/ skin creases • Form a network of linear furrows which divided the surface into polygonal or lozenge shaped areas . These lines to some extent correspond to variations in the pattern of fibers in the dermis.
  • 15. Tension lines/Cleavage lines/Langer lines • These are tension lines of skin, due to the patterns of arrangement of collagen fibers in the dermis. • These lines were first described by Langer in 1861 on cadaver. • Tend to spiral longitudinal in the limbs and run transversely in the neck and trunk. • At the elbow , knee, wrist and ankles are parallel to the transverse creases that appear when the limbs are flexed.
  • 16. Skin incisions • Skin incisions that are given parallel to the tension lines usually heal well with minimal scarring because of minimum disruption of collagen fibers.
  • 17. Stretch marks in skin • Damage to the collagen fibers in dermis due to over stretching as in pregnancy or abdominal enlargement.
  • 18. Wrinkle lines • Caused by contraction of underlying muscles, present perpendicular to their axis of shortening. • On face, they are known as lines of facial expression, aging makes them permanent due to loss of skin elasticity.
  • 19. Flexure lines or joint lines • Major markings found in the vicinity of synovial joints where the skin is attached strongly to underlying deep fascia. • Prominent on the flexor surfaces of palms, soles and digits. • Skin lines don't necessarily coincide with the underlying joint line.
  • 21. Papillary/epidermal/friction ridges • A friction ridge is a raised portion of the epidermis on the fingers and toes, the palm of the hand or the sole of the foot. • Are caused by the underlying interface between the dermal papillae of the dermis and the interpapillary (rete) pegs of the epidermis. • along the summit of each ridge the apertures of sweat ducts open at regular intervals. Dermis determines the developmental pattern of epidermis
  • 22. FINGER PRINT • A fingerprint is an impression left by the friction ridges of a human finger • This is genetically determined, unique to the individual, stable through out life & serves as a mean of personal identification. • The analysis of ridge patterns by studying finger and foot prints is known as dermatoglyphics.
  • 23. The dermis is the receptive site for the pigment of tattoos
  • 24. Cutaneous blood supply • The dermis contains horizontally arranged superficial and deep plexuses, which are interconnected via communicating vessels oriented perpendicular to the skin surface.
  • 25.
  • 26. Lymphatics • Blind-ended lymphatic capillaries arise within the interstitial spaces of the dermal papillae. These unvalved, superficial dermal vessels drain into valved deep dermal and subdermal plexuses.
  • 27.
  • 28. Skin Innervation • Free nerve endings in the basal layer of the epidermis detect pain • Merkel cells of the epidermis detect light touch. • Meissner’s corpuscles also detect light touch. These are found in the dermal papillae and are most concentrated in the fingertips. • Pacininian corpuscles are found deep within the dermis or even in the subcutaneous tissue. These structures detect pressure.
  • 29.
  • 30.
  • 31. Hypodermis/ superficial fascia • Fibrous mesh filled with fat, connects the dermis to underlying layer of deep fascia • Fat is absent in eyelids, pinna of ear, scrotum • Muscle fibers are present in the subcutaneous tissue of scalp, face and scrotum
  • 32. DEEP FASCIA • Dense inelastic sheet or membrane, separates superficial fascia from underlying structures. • It either invests or bind structures. • Named according to the area of body it covers. MODIFICATIONS: Intermuscular septum Retinacula