Академический Документы
Профессиональный Документы
Культура Документы
• Hair papilla, a nipplelike bit of dermal tissue, protrudes into the hair bulb
– Contains a knot of capillaries that supplies nutrients to the growing hair
and signals it to grow
• The wall of a hair follicle is composed of:
– Outer connective tissue root sheath, derived from the dermis,
– A thickened basement membrane called a glassy membrane,
– An inner epithelial root sheath, derived mainly from an invagination of the
epidermis
HAIR FOLLICLE
SKIN
Structure of a Hair Follicle
• Hair matrix: actively dividing
area of the hair bulb that
produces the hair
• Associated with each hair
follicle is a bundle of smooth
muscle cells called an arrector
pili muscle
– Most hair follicles approach
the skin surface at a slight
angle
– Arrector muscles are attached
in such a way that their
contraction pulls the hair
follicle into an upright
position and dimples the
skin surface to produce
goose bumps
SKIN
Types and Growth of Hair
• Hairs come in various sizes and shapes, but
can be classified as:
– Vellus: vell=wool, fleece
• Pale, fine body hair variety of children and adult females
– Terminal:
• Darker
• Coarser, longer hair of eyebrows and scalp
• Axillary and pubic
• Face and chest of males
• Hair growth and density are influenced by
many factors, such as nutrition and
hormones
Types and Growth of Hair
• The rate of hair growth varies from one body region to another and
with sex and age
– Averages 2.5 mm per week
• Life span of hairs varies and appears to be under control of a slew of
proteins
• Each follicle has a growth cycle where it is active and inactive for a
period of time
– Inactive, hair matrix cells die and the follicle base and hair bulb shrivel
– Follicle then enters a resting stage for a period of time
– After the resting phase, the matrix proliferates again and forms a new
hair to replace the old one that has fallen out or will be pushed out by
the new hair
– Only a small percentage of the hair follicles are shed at any one
time, we lose an average of 90 scalp hairs daily
– Follicles of the eyebrow hairs remain active for only 3-4 months, which
explains why your eyebrows are never as long as the hairs on your
head
HOMEOSTATIC IMBALANCE
• In women, small amounts of androgens
are normally produced by both the
ovaries and the adrenal glands
– Excessive hairiness (hirsutism: hirsut=hairy)
– Signs of masculinization
• Large amounts of androgens can be
secreted by ovarian tumors resulting in:
• Beard and hairy chest
– Tumors can be surgically removed
Hair Thinning and Baldness
• A follicle has only a limited number of cycles
in it
– Ideal conditions, hair grows faster from the teen years
to the 40s; then its growth slows
• The fact that hairs are not replaced as fast as they are shed
leads to hair thinning and some degree of baldness
(alopecia), in both sexes
– Begins at the anterior hairline and progresses posteriorly
– Coarse terminal hairs are replaced by vellus hairs, and the hair
becomes increasingly wispy
• Male pattern baldness, which is a type of true,
or frank, balding, is a genetically determined,
sex-influenced condition
FUNCTIONS
OF THE
INTEGUMENTARY SYSTEM
• Protection
– 1.Chemical barriers include skin
secretions and melanin:
• Although the skin’s surface teems with bacteria,
the low pH of skin secretions (acid mantle)
retards their multiplication
– Many bacteria are killed by bactericidal substances in
sebum
• Natural antibiotic (human defensin) kills bacteria
• Chemical pigment (melanin) prevents UV damage
FUNCTIONS
OF THE
INTEGUMENTARY SYSTEM
• 2.Physical or mechanical barriers are provided by the
continuity of the skin, and the hardness of the keratinized
cells
– Waterproofing glycolipids block diffusion of water and water
soluble substances between cells (preventing both loss and
entry)
• Lipid soluble substances DO penetrate:
– Oxygen, carbon dioxide
– Fat-soluble vitamins (A, D, E, K)
– Steriods
– Oleoresins (plants: poison ivy and oak)
– Organic solvents (acetone, dry cleaning fluids, paint thinner)
» Causes kidney shut down and brain damage
– Salts of heavy metals (lead, mercury, nickel)
» Results in anemia and neurological defects
– Drug agents (penetration enhancers) that help ferry other drugs into the
body
FUNCTIONS
OF THE
INTEGUMENTARY SYSTEM
• 3.Biological barriers include:
– Langerhans’ cells of the epidermis
• Active elements of the immune system
• Respond to antigens
– Macrophages of the dermis
• Dispose of viruses and bacteria that have managed to
penetrate the epidermis
– DNA itself
• Absorb UV radiation and transfer it to the atomic nuclei,
which heat up and vibrate vigorously
– Heat dissipates to surrounding water molecules
instantaneously, the DNA converts potentially destructive
radiation into harmless heat
Body Temperature Regulation
• The skin plays an important role in body
temperature regulation by:
– Using the sweat glands of the skin to cool the
body:
• Evaporation of sweat from the skin surface dissipates body
heat and efficiently cools the body, thus preventing
overheating
– Constriction of dermal capillaries to prevent heat
loss:
• When the external environment is cold, dermal blood vessels
constrict causing the warm blood to bypass the skin
temporarily and allows the skin temperature to drop to that of
the external environment
– Passive heat loss from the body is slowed, thus conserving
body heat
Cutaneous Sensation
• Made possible by the placement of cutaneous sensory
receptors, which are part of the nervous system, in
the layers of the skin
• Cutaneous receptors are classified as exteroceptors
because they respond to stimuli arising outside the
body:
– Example:
• Meissner’s corpuscles (in dermal papillae) and Merkel dics allow
us to become aware of a caress or the feel of our clothing against
our skin
• Pacinian receptors (in deepest dermis and hypodermis) alert us to
bumps or contacts involving deep pressure
• Hair follicle receptors sense wind blowing through our hair and a
playful tug on a pigtail
• Bare nerve endings that meander throughout the skin sense
painful stimuli ( irritating chemical, extreme heat or cold, etc.)
Metabolic Functions
• When sunlight bombards the skin, modified cholesterol molecules
circulating through dermal blood vessels are converted to a
vitamin D precursor, and transported via the blood to other body
areas to play various roles in calcium metabolism
– Example: calcium cannot be absorbed from the digestive tract without
vitamin D
• Makes chemical conversions that supplement those of the
liver:
– Examples: keratinocyte enzymes can:
• 1. Disarm many cancer-causing chemicals that penetrate the epidermis
• 2. Convert some harmless chemicals into carcinogens
• 3. Activate some steroid hormones:
– Transform cortisone applied to the skin into hydrocortisone, a potent anti-
inflammatory drug
• Make several biologically important proteins, including
collagenase, an enzyme that aids the natural turnover of collagen
(deters wrinkles)
Blood Reservoir
• Dermal vascular supply is extensive:
– The skin may act as a blood reservoir by
holding up to 5% of the body’s blood supply,
which may be diverted to other areas of the
body should the need arise
• When other body organs, such as vigorously
working muscles, need a greater blood supply, the
nervous system constricts the dermal blood
vessels shunting more blood into the general
circulation, making it available to the muscles and
other body organs
Excretion
• Limited amounts of nitrogenous
containing wastes (ammonia, urea, and
uric acid) are eliminated from the body in
sweat, although most nitrogenous wastes
are excreted in urine
• Profuse sweating is an important
avenue for water and salt (sodium
chloride) loss
Skin Cancer
• Most tumors that arise in the skin are benign and do
not spread (metastasize) to other body areas
– Example:
• A wart: a neoplasm (abnormal growth of tissue that serves no
purpose but grows at the expense of healthy tissue) caused by a
virus
• Some tumors are malignant, or cancerous, and
invade other body areas
• A crucial risk factor for the nonmelanoma skin
cancers is overexposure to the UV radiation in
sunlight, which appears to disable a tumor suppressor
gene
– However, frequent irritation of the skin by infections, chemicals,
or physical trauma seems to be a predisposing factor
Skin Cancer
• Sunburned skin accelerates its production of
Fas, a protein that causes genetically damaged
skin cells to commit suicide, thus decreasing the
risk of mutations that will cause sun-linked skin
cancer
– It is the death of these gene-damaged cells that
causes the skin to peel after a sunburn
– NEW lotions are being produced that will fix damaged
DNA before the involved cells can develop into cancer
cells
• These lotions contain tiny oily vesicles (liposomes) filled
with enzymes that initiate repair of the DNA mutations
most commonly caused by sunlight
Skin Cancer
• (a):Basal cell carcinoma is the
least malignant and the most
common skin cancer
• Stratum basale cells proliferate,
invading the dermis and
hypodermis
• Cancer lesions occur most often
on sun-exposed areas of the
face and appear as shiny, dome-
shaped nodules that later develop
a central ulcer with a pearly,
beaded edge
• Relatively slow growing
• Metastasis seldom occurs
before it is noticed
• Full cure by surgical excision is
the rule in 99% of cases
SKIN CANCER
Skin Cancer
• (b):Squamous cell
carcinoma tends to grow
rapidly and metastasize if
not removed
• Arises from the
keratinocytes of the stratum
spinosum
• Lesion appears as a scaly
reddened papule (small,
rounded elevation) that arises
most often on the head (scalp,
ears, and lower lip), and hands
• If it is caught early and
removed surgically or by
radiation therapy, chance of
complete cure is good
SKIN CANCER
Skin Cancer
• (c):Melanoma is the most
dangerous of the skin cancers
because it is highly metastatic and
resistant to chemotherapy
• Cancer of the melanocytes
• Begin wherever there is pigment:
– Most appear spontaneously
– About 1/3 develop from preexisting
moles
– Usually appears as a spreading brown
to black patch that metastasizes rapidly
to surrounding lymph and blood
vessels
• Key to surviving is early detection
– Chance of survival is poor if the lesion
is over 4mm thick
– Therapy is wide surgical excision
accompanied by immunotherapy
SKIN CANCER
Skin Cancer
• American Cancer Society suggests you regularly examine your
skin for new moles or pigmented spots and apply the ABCDE
rule for recognizing melanoma:
– A. Asymmetry:
• The two sides of the pigmented spot or mole do not match
– B. Border irregularity:
• The borders of the lesion exhibit indentations
– C. Color:
• The pigmented spot contains several colors (blacks, browns,
tans, and sometimes blues and reds)
– D. Diameter:
• The spot is larger than 6 mm in diameter (the size of a pencil
eraser)
– E. Elevation:
• Elevation above the skin
Burns
• A burn is tissue damage inflicted by intense
heat, electricity, radiation, or certain
chemicals, all of which denature cell proteins
and cause cell death to infected areas
• The most immediate threat to a burn patient
is dehydration and electrolyte imbalance due
to fluid loss
– Leads to renal shutdown and circulatory shock
(inadequate blood circulation due to reduced blood
volume)
– To save the patient, the lost fluids must be replaced
immediately
Burns
• The volume of fluid lost
can be estimated by
computing the
percentage of body
surface burned (extent of
the burns) using the rule
of nines (ONLY
APPROXIMATE)
– This method divides the
body into 11 areas, each
accounting for 9% of
total body area, plus an
additional area
surrounding the genitals
accounting for 1% of
body surface
BURNS
Burns
• Burn patients also need thousands of extra food
calories daily to replace lost proteins and allow
tissue repair:
– No one can eat this much, so burn patients are given
supplementary nutrients through gastric tubes and intravenous
(IV) lines
• After the first 24 hours has passed, the threat to a
burn patient becomes infection to the wound site:
– Burned skin is sterile for the first 24 hours
– Thereafter, bacteria, fungi, and other pathogens easily invade
areas where the skin barrier is destroyed, and they multiply
rapidly in the nutrient-rich environment of dead tissues
– Adding to this problem is the fact that the immune system
becomes deficient one to two days after severe burn injury
Burns
• Burns are classified according to their severity
– First-degree burns involve damage only to the epidermis
• Tend to heal in two to three days without special attention
• Sunburn is usually a first-degree burn
– Second-degree burns injure the epidermis and the upper region
of the dermis
• Blisters appear
• Skin regeneration occurs with little or no scarring within three to four
weeks if care is taken to prevent infection
– Third-degree burns involve the entire thickness of the skin
• Burned area appears gray-white, cherry red, or blackened, and
initially there is little or no edema (excessive tissue fluid-swelling)
• Since the nerve endings in the area have been destroyed, the
burned area is not painful
• Skin grafting is usually necessary
• Excessive scar tissue usually forms
Burns
• Burns are considered critical if any of the
following conditions exists:
– 1. Over 25% of the body has second-degree burns
– 2. Over 10% of the body has third degree burns
– 3. There are third-degree burns of the face, hands, or
feet
• Facial burns introduce the possibility of burned
respiratory passageways, which can swell and
cause suffocation
• Burns at joints are also troublesome because
scar tissue formation can severely limit joint
mobility
BURNS
ROSACEA
WINESTAIN
TATTO
DEVELOPMENTAL ASPECTS
OF THE
INTEGUMENTARY SYSTEM
• The epidermis develops from the embryonic ectoderm, and the
dermis and the hypodermis develop from the mesoderm
• By the end of the fourth month of development the skin is fairly well
formed
• During infancy and childhood, the skin thickens and more
subcutaneous fat is deposited
• During adolescence, the skin and hair become oilier as sebaceous
glands are activated
• The skin reaches its optimal appearance when we reach our 20s
and 30s; after that time the skin starts to show the effects of
cumulative environmental exposures
• As old age approaches, the rate of epidermal cell replacement slows
and the skin thins, becoming more prone to bruising and other types
of injuries