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Essentials of Human Anatomy

Skin and Body Membranes

Chapter 4
Dr Fadel Naim
Ass. Prof. Faculty of Medicine
IUG

Body Membranes
Thin tissue layers that cover surfaces, line cavities,
and divide spaces or organs
Epithelial membranes are most common type
Cutaneous membrane (skin)
Primary organ of integumentary system
One of the most important organs
Composes approximately 16% of body weight

Serous membrane (serosa)

Parietal membranesline closed body cavities


Visceral membranescover visceral organs
Pleurasurrounds a lung and lines the thoracic cavity
Peritoneumcovers the abdominal viscera and lines the
abdominal cavity
Slide 2

Body Membranes
Mucous membrane (mucosa)

Lines and protects organs that open to the exterior of the body
Found lining ducts and passageways of respiratory, digestive, other
tracts
Lamina propriafibrous connective tissue underlying mucous
epithelium
Mucus is made up mostly of water and mucinsproteoglycans that
form a double-layer protection against environmental microbes

Connective tissue membranes

Do not contain epithelial components


Synovial membranesline the spaces between bone in joints
Have smooth and slick membranes that secrete synovial fluid
Help reduce friction between opposing surfaces in a moveable joint
Synovial membranes also line bursae
Slide 3

Ventral Body Cavity Membranes


Parietal serosa lines internal body walls
Visceral serosa covers the internal organs
Serous fluid separates the serosae

Serous Membranes

Anatomy of Skin

Skin (integument) is bodys largest organ


Approximately 1.6 to 1.9 m2 in average-sized adult
Integumentary system describes the skin
and its appendagesthe hair, nails, and
skin glands
Thin and thick skin
Thin skincovers most of body surface
(1 to 3 mm thick)
Thick skinsoles and palms
(4 to 5 mm thick)

Slide 6

Functions of Skin
Function of Integumentary System
A. Regulation of Body Temperature
B. Protection from Dehydration and Infection
C. Respond to Temperature, Pressure, Pain
D. Excretion of Water, Salts, Urea (nitrogenous waste)
E. Synthesis Vitamin D (essential for Ca + P absorption)
F. First Defensive Barrier of Immune Response

Functions of the Skin


Protection
Physical barrier to microorganisms
Barrier to chemical hazards
Reduces potential for mechanical trauma
Prevents dehydration
Protects (via melanin) excess UV exposure

Slide 8

Functions of the Skin


Sensation
Skin acts as a sophisticated sense organ
Somatic sensory receptors detect stimuli that
permit us to detect pressure, touch,
temperature, pain, and other general
sensations

Slide 9

Functions of the Skin


Flexibility
Skin is supple and elastic, thus permitting
change in body contours without injury

Excretion
Water
Urea/ammonia/uric acid

Slide 10

Functions of the Skin


Hormone (Vitamin D) production
Exposure of skin to UV light converts
7-dehydrocholesterol to cholecalciferol
a precursor to vitamin D
Blood transports precursor to liver and
kidneys, where vitamin D is produced
Process and end result fulfill the necessary
steps required for vitamin D to be classified as
a hormone
Slide 11

Functions of the Skin


Immunity
Phagocytic cells destroy bacteria
Langerhans cells trigger helpful immune
reaction working with helper T cells

Slide 12

Functions of the Skin


Heat loss
approximately 80% of heat loss occurs through the
skin; remaining 20% occurs through the mucosa of
the respiratory, digestive, and urinary tracts

Slide 13

Layers of Skin
Epidermis
Dermis
Subcutaneous layer
beneath dermis
not part of skin

Epidermis
Lacks blood vessels
Keratinized
Thickest on palms and soles (0.8-1.4mm)
Melanocytes provide melanin
Rests on basement membrane
Stratified squamous

Epidermis

Layers of Epidermis
stratum corneum
stratum lucidum
stratum granulosum
stratum spinosum
stratum basale

Structure of the Skin


Epidermis
Cell types
Keratinocytes constitute
over 90% of cells present;
principal structural element of
the outer skin
Melanocytes pigmentproducing cells (5% of the
total); contribute to skin color;
filter ultraviolet light
Langerhans cells dendritic
(branched) antigen-presenting
cells (APCs), they play a role
in immune response
Slide 17

Structure of the Skin


Epidermis
Cell layers
Stratum germinativum (growth layer)
describes the stratum spinosum and stratum
basale together
Stratum basale (base layer)single layer of
columnar cells; only these cells undergo mitosis, then
migrate through the other layers until they
are shed
Stratum spinosum (spiny layer)cells arranged in 8
to 10 layers with desmosomes that pull cells into spiny
shapes; cells rich in RNA

Slide 18

Structure of the Skin


Cell layers
Stratum granulosum (granular layer)cells
arranged in two to four layers and filled with
keratohyalin granules; contain high levels of
lysosomal enzymes
Stratum lucidum (clear layer)cells filled with
keratin precursor called eleidin; absent in thin skin
Stratum corneum (horny layer)most superficial
layer; dead cells filled with keratin (barrier area)

Slide 19

Structure of the Skin


Epidermal growth and repair
Turnover or regeneration time refers to time required for
epidermal cells to form in the stratum basale and migrate
to the skin surfaceabout 35 days
Shortened turnover time will increase the thickness of
the stratum corneum and result in callus formation
Normally 10% to 12% of all cells in stratum basale enter
mitosis daily
Each group of 8 to 10 basal cells in mitosis with their
vertical columns of migrating keratinocytes is called an
epidermal proliferating unit, or EPU

Slide 20

Structure of the Skin


Dermal-epidermal junction
A definite basement membrane,
specialized fibrous elements, and a
polysaccharide gel serve to glue the
epidermis to the dermis below
The junction serves as a partial barrier to
the passage of some cells and large
molecules

Slide 21

Structure of the Skin


Dermis
Sometimes called true skinmuch thicker
than the epidermis and lies beneath it
Gives strength to the skin
Serves as a reservoir area for storage of
water and electrolytes

Slide 22

Dermis
On average 1.0-2.0mm thick
Contains dermal papillae
Binds epidermis to underlying tissues
Irregular dense connective tissue
Muscle cells
Nerve cell processes
Specialized sensory receptors
Blood vessels
Hair follicles
Glands

Structure of the Skin


Dermis
Contains various structures:

Arrector pili muscles and hair follicles


Sensory receptors
Sweat and sebaceous glands
Blood vessels

Rich vascular supply plays a critical role in


temperature regulation

Slide 24

Structure of the Skin


Dermis
Layers of dermis:
Papillary layer composed of dermal papillae that
project into the epidermis; contains fine
collagenous and elastic fibers; contains the dermalepidermal junction; forms a unique pattern that
gives individual fingerprints
Reticular layer contains dense, interlacing white
collagenous fibers and elastic fibers to make the
skin tough yet stretchable; when processed from
animal skin, produces leather
Slide 25

Lines of Cleavage
Tension lines in the skin identify the predominant
orientation of collagen fiber bundles.
Clinically and surgically significant because cuts
can result in slow healing and increased
scarring.

Structure of the Skin


Dermis remains a scar
Dermal growth and repair
The dermis does not continually shed and regenerate itself
as does the epidermis
During wound healing, the fibroblasts begin forming an
unusually dense mass of new connective fibers; if not
replaced by normal tissue, this mass by the collagenous
fibers of the reticular layer of the dermis; also called Langers
lines

Slide 28

Subcutaneous Layer
hypodermis
loose connective tissue
adipose tissue
insulates
major blood vessels

Structure of the Skin


Hypodermis
Also called subcutaneous layer or superficial
fascia
Deep to the dermis, forming connection
between the skin and other structures
Not part of the skin

Slide 30

Slide 31

Skin Color
Genetic Factors
Physiological Factors
varying amounts of
dilation of dermal blood
melanin
vessels
varying size of melanin
constriction of dermal blood
granules
vessels
albinos lack melanin
accumulation of carotene
jaundice
Environmental Factors
sunlight
UV light from sunlamps
X rays
darkens melanin

Skin Color
Melanin
Basic determinant of skin color is quantity, type, and distribution of
melanin

Beta carotene
(group of yellowish pigments from food) can also contribute to skin
color

Hemoglobin
color changes also occur as a result of changes in blood flow
Redder skin color when blood flow to skin increases
Cyanosisbluish color caused by darkening of hemoglobin when
it loses oxygen and gains carbon dioxide (Figure 6-9)
Bruising can cause a rainbow of different colors to appear in the
skin

Other pigments
from cosmetics, tattoos, and bile pigments in jaundice
Slide 33

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

Slide 34

Skin glands

Sebaceous glands
Secrete sebumoily substance that keeps hair and skin
soft and pliant; prevents excessive water loss from the
skin
usually associated with hair follicles
Lipid components have antifungal activity
Simple, branched glands
Found in dermis except in palms and soles
Secretion increases in adolescence; may lead to
formation of pimples and blackheads
Slide 35

Sweat Glands
Widespread in skin
Originates in deeper dermis
Or hypodermis
Eccrine glands
Apocrine glands
Ceruminous glands
Mammary glands

Sweat glands
Eccrine glands
Most numerous sweat glands; quite small
Distributed over total body surface with
exception of a few small areas
Simple, coiled, tubular glands
Function throughout life
Secrete perspiration or sweat; eliminate
wastes; and help maintain a constant core
temperature
Slide 37

Sweat glands
Apocrine glands
Located deep in subcutaneous layer
Limited distributionaxilla, areola of breast,
and around anus
Large (often more than 5 mm in diameter)
Simple, branched, tubular glands
Begin to function at puberty
Secretion shows cyclic changes in female
with menstrual cycle
Slide 38

Sweat glands
Ceruminous glands

Modified apocrine sweat glands


Simple, coiled, tubular glands
Empty contents into external ear canal alone or with
sebaceous glands
Mixed secretions of sebaceous and ceruminous glands
called cerumen (wax)
Function of cerumen to protect area from dehydration;
excess secretion can cause blockage of ear canal and
loss of hearing
Slide 39

Hair
Distributionover entire body except
palms of hands and soles of feet and a
few other small areas
Fine and soft hair coat present before birth called
lanugo
Coarse pubic and axillary hair that develops at
puberty called terminal hair

Slide 40

Functions of Hair
Protection
Heat retention
Prevents the loss of conducted heat from the
scalp to the surrounding air
Facial expression
Sensory reception
Visual identification
Chemical signal dispersal

Hair Follicles
Epidermal cells
Tube-like depression
Extends into dermis
Hair root
Hair shaft
Hair papilla
Dead epidermal cells
Melanin
Arrector pili muscle

A. Shaft - projects above surface of


epidermis
1. medulla - polyhedral cells with eleidin
2. cortex - elongated cells with/out
pigment
3. cuticle - outermost layer, like shingles
on roof

B. Root - below epidermis, penetrates


into the dermis

C. Hair Follicle - at the base a a single


hair
1.
external root sheath - basale and
spinosum extension
2.
internal root sheath - internal hair
cell layers
3.
bulb - base of hair cell
4.
papilla - in the bulb, provides
nourishment for hair
5.
matrix - origin of new hair cells
D. arrector pili - smooth muscle, cause
hair to rise
nerve bundle responds to touch
E. hair root plexuses

Slide 44

Slide 45

Slide 46

Appearance of hair
Color
result of different amounts, distribution, types of melanin in
cortex of hair

Growth
hair growth and rest periods alternate; hair on head averages 5
inches of growth per year

Sebaceous glands
attach to and secrete sebum
(skin oil) into follicle

Male pattern baldness results from combination of genetic


tendency and male sex hormones

Slide 47

Hair Thinning and Baldness


Alopecia hair thinning in both sexes
True, or frank, baldness
Genetically determined and sex-influenced
condition

Nails
Consist of epidermal cells
converted to hard keratin
Nail bodyvisible part of
each nail
Rootpart of nail in groove
hidden by fold of skin, the
cuticle
Lunulamoon-shaped
white area nearest root
Slide 49

Nail bedlayer of epithelium under nail body


contains abundant blood vessels
Appears pink under translucent nails
Growthnails grow by mitosis of cells in stratum germinativum
beneath the lunula; average growth about 0.5 mm per week, or
slightly over 1 inch per year

Slide 50

Burns
Tissue damage from excessive heat, electricity, radioactivity,
or corrosive chemicals that destroys (denatures) proteins in
the exposed cells is called a burn.
Generally, the systemic effects of a burn are a greater threat
to life than are the local effects.
The seriousness of a burn is determined by

Its depth
Extent
Area involved
The persons age and general health.

When the burn area exceeds 70%, over half of the victims die
Slide 51

Burns
Destruction of proteins of the skin
chemicals, electricity, heat

Problems that result


shock due to water, plasma and plasma
protein loss
circulatory & kidney problems from loss of
plasma
bacterial infection

Slide 52

Types of Burns
First-degree
only epidermis (sunburn)

Slide 53

Types of Burns
Second-degree burn

destroys entire epidermis & part of dermis


fluid-filled blisters separate epidermis & dermis
epidermal derivatives are not damaged
heals without grafting in 3 to 4 weeks & may scar

Slide 54

Types of Burns
Third-degree or full-thickness
destroy epidermis, dermis & epidermal derivatives
damaged area is numb due to loss of sensory nerves

Slide 55

Rule of Nines

Cycle of Life: Skin


Children
Skin is smooth, unwrinkled, and characterized
by elasticity and flexibility
Few sweat glands
Rapid healing

Slide 57

Cycle of Life: Skin


Adults
Development and activation of sebaceous
and sweat glands
Increased sweat production
Body odor

Increased sebum production


Acne

Slide 58

Cycle of Life: Skin


Aging
Skin repair processes take longer due to
reduced number and activity of stem cells.
Skin forms wrinkles and becomes less resilient.
Skins immune responsiveness is diminished.
Skin becomes drier due to decreased
sebaceous gland activity.
Altered skin and hair pigmentation.

Cycle of Life: Skin


Aging
Sweat production diminishes.
Blood supply to the dermis is reduced
leading to impaired thermoregulation.
Hair thinning and loss.
Integumentary production of vitamin D3
diminishes.
Development of skin cancers.

SkinandAgingProcess

Skin Cancer
The most common type of cancer.
The greatest risk factor is exposure to UV
rays of the sun.
The highest incidence is in people who
have had severe sunburns, especially as
children.

Skin Cancer
Most skin tumors are benign and do not
metastasize
The three major types of skin cancer are:
Basal cell carcinoma
Squamous cell carcinoma
Melanoma

Basal Cell Carcinoma


Least malignant and most common skin cancer
Stratum basale cells proliferate and invade the
dermis and hypodermis
Slow growing and do not often metastasize
Can be cured by surgical excision in 99% of the
cases

Squamous Cell Carcinoma

Arises from keratinocytes of stratum spinosum


Arise most often on scalp, ears, and lower lip
Grows rapidly and metastasizes if not removed
Prognosis is good if treated by radiation
therapy or removed surgically

Melanoma
Cancer of melanocytes is the most dangerous type
of skin cancer because it is:
Highly metastatic
Resistant to chemotherapy

Melanoma
Melanomas have these characteristics (ABCD
rule)
A: Asymmetry; the two sides of the pigmented area
do not match
B: Border is irregular and exhibits indentations
C: Color (pigmented area) is black, brown, tan, and
sometimes red or blue
D: Diameter is larger than 6 mm (size of a pencil
eraser)

Melanoma
Treated by wide surgical excision
accompanied by immunotherapy
Chance of survival is poor if the lesion is
over 4 mm thick

THE END