INTEGUMENTARY

SYSTEM

Eric B. Panopio, M.D.

 The Integument
• The skin that covers your body.
• Skin is also known as the cutaneous membrane.
• Integumentary system consists of the skin and
its derivatives—nails, hair, sweat glands, and
sebaceous glands.
 The Integument
• Is the body’s largest organ.
• Its surface is covered by an epithelium that protects underlying
body layers.
• The connective tissues contain blood vessels that provide
nutrients and provide strength and resilience to the skin.
• Smooth muscle controls both blood vessel diameter and hair
position.
• Neural tissue supports and monitors sensory receptors in the
skin
 Integumentary System

 Skin (cutaneous membrane)

 Skin derivatives
 Sweat glands
 Oil glands
 Hairs
 Nails

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 Skin Functions

 Protects deeper tissues from:

 Mechanical damage
 Chemical damage
 Bacterial damage
 Thermal damage
 Ultraviolet radiation
 Desiccation
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 Skin Functions

 Aids in heat regulation

 Aids in excretion of urea and uric acid
 Synthesizes vitamin D

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 Skin Structure

 Epidermis – outer layer

 Stratified squamous epithelium
 Often keratinized (hardened by keratin)
 Dermis
 Dense irregular connective tissue

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 Skin Structure

Figure 4.4

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 Thick Skin
• Thick epidermis is found on the palms of the
hands, the soles of the feet, and corresponding
surfaces of the fingers and toes.
• All five epidermal strata occur in thick skin.
 Thin Skin
• Thin epidermis covers most of the body.
• Lacks the stratum lucidum
– Has only four specific layers.
– Contains the following accessories: hair follicles,
sebaceous glands, and sweat glands.
 Friction Ridges
• Found on the fingers, palms, soles, and toes.
• Formed from large folds and valleys of both dermal
and epidermal tissue.
• Help us grasp objects, and they
• Increase friction so that items do not slip easily from
our hands.
• Our feet do not slip on the floor when we walk.
 Friction Ridges
• Friction ridges can leave noticeable prints on
touched surfaces.
• Each individual has a unique pattern of friction
ridges.
• Fingerprints have become a valuable tool for law
enforcement in identifying individuals.
 Skin Structure

 Deep to dermis is the hypodermis

 Not “part” of the skin
 Termed “subcutaneous tissue”
 Anchors skin to underlying organs
 Composed mostly of adipose tissue

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 Skin Structure

Figure 4.4

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 Dermis
 Two layers
Papillary layer
 Projections called dermal papillae
 Pain receptors
 Capillary loops
Reticular layer
 Blood vessels
 Glands
 Nerve receptors

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 Skin Structure

Figure 4.4

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 Appendages of the Skin

 Sebaceous glands
 Produce oil
 Most with ducts that empty into hair follicles
 Glands are activated at puberty
 Sweat glands
 Widely distributed in skin

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 Skin Structure

Figure 4.4

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 Sweat and Its Function
 Composition
 Mostly water
 Some metabolic waste

Function
• Helps dissipate excess heat
• Excretes waste products
• Low pH inhibits bacterial growth

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 Hair Structures
 Hair follicle
 Dermal and epidermal
sheath surround hair root
 Arrector pilli
 Smooth muscle
 Sebaceous gland
 Sweat gland
Figure 4.7a

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 Hair
• Found almost everywhere on the body except
the palms of the hands, the sides and soles of
the feet, the lips, the sides of the fingers and
toes, and portions of the external genitalia.
• Most of the hairs on the human body are on the
general body surface rather than the head.
 3 Kinds of Hair
• During our lives, we produce three kinds of
hair:
– lanugo
– vellus
– terminal hair
 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 Color
• Result of the synthesis of melanin in the matrix
adjacent to the papillae.
• Variations in hair color reflect genetically determined
differences in the structure of the melanin.
• Environmental and hormonal factors
• Age
– Gray hair
 Hair Growth and Replacement
• Sometimes hair loss may be temporary as a
result of one or more of the following factors:
exposure to drugs, dietary factors, radiation,
high fever, or stress.
• Thinning of the hair, called alopecia can occur
in both sexes, usually as a result of aging.
 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.
 Skin Homeostatic Imbalances: FYI

 Infections
 Athletes foot
 Caused by fungal infection
 Boils and carbuncles
 Caused by bacterial infection
 Cold sores
 Caused by virus

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Inter-digital Ringworm or Tinea Pedis of the Toes of Foot.
 Vesicular Type:

Vesicular Rupture 
Erythema w/ Bleeding
 Vesicular Type

Scaling w/ Erythema
Furuncle
Carbuncle
 Skin Homeostatic Imbalances: FYI

 Infections and allergies

 Contact dermatitis
 Exposures cause allergic reaction
 Impetigo
 Caused by bacterial infection
 Psoriasis
 Cause is unknown
 Triggered by trauma, infection, stress
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Allergic Contact Dermatitis Allergic Contact Dermatitis
Poison Ivy Rash;
Bullous Impetigo of the Face & Extremities

• Impetigo is a superficial
Skin Infection caused
by either:
▶ Streptococci or;
▶ Staphylococci;

■Here, affecting the Face

& Upper Extremities but
also seen more frequently
on other parts of the
body of Children.
Impetigo on a Child’s Face

☀ It causes a Superficial
Skin Infection which
appears Red w/ Yellow
or Golden Crusts;

☀ It is seen frequently in
Children’s face, upper
trunk, arms, buttocks &
Lower Extremities;

☀ Note that the Nose is

also infected.
Impetigo, on a Child’s Face
• It causes a superficial
skin infection which
appears red with yellow
or golden crusts. It is
seen frequently in
children on the face,
upper trunk, and arms.
Note that the nose is also
infected.
Bullous Impetigo Ruptured Bullous Impetigo
• This patient presented
with psoriatic dermatitis
of the sacroiliac region of
the lower back, buttocks,
and perineum.

• Psoriasis is an erythematous
skin condition characterized
by irregular red patches
covered by a dry scaly
hyperkeratotic stratum
corneum, which usually
occur on the elbows and
knees, as well as scalp and
lower back, but can occur
anywhere on the body.
 Skin Homeostatic Imbalances: FYI

 Burns
 Tissue damage and cell death caused by
heat, electricity, UV radiation, or chemicals
 Associated dangers
 Dehydration
 Electrolyte imbalance
 Circulatory shock

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 Severity of Burns: FYI
 First-degree burns
 Only epidermis is damaged
 Skin is red and swollen
 Second degree burns
 Epidermis and upper dermis are damaged
 Skin is red with blisters
 Third-degree burns
 Destroys entire skin layer
 Burn is gray-white or black
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 Burns
• Major cause of accidental death, primarily as a result of
their effects on the skin.
• Usually caused by heat, radiation, harmful chemicals,
sunlight, or electrical shock.
• The immediate threat to life results primarily from fluid
loss, infection, and the effects of burned, dead tissue.
• Burns are classified according to the depth of tissue
involvement.
 Classification of Burns
• First- and second-degree burns are called partial-
thickness burns.
• Third-degree burns are called full-thickness
burns.
– first-degree burns involve only the epidermis and are
characterized by redness, pain, and slight edema
• an example is sunburn
 Classification of Burns
• Second-degree burns involve the epidermis and
part of the dermis.
• The skin appears red, tan, or white, and is
blistered and painful.
– An example is a scald.
 Classification of Burns
• Third-degree burns involve the epidermis, dermis, and
subcutaneous layer, which are often destroyed.
• Regeneration may occur from the edge only, due to the absence
of dermis.
• Skin grafting is required to prevent abnormal connective tissue
fibrosis and disfigurement.
• Dehydration is a major concern because the entire portion of
skin has been lost, and water cannot be retained.
• Must be aggressively treated for dehydration.
 Skin Cancer: FYI
 Cancer – abnormal cell mass
 Two types
 Benign
 Does not spread (encapsulated)
 Malignant
 Metastasized (moves) to other parts of
the body
 Skin cancer is the most common type of
cancer
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 Skin Cancer Types: FYI
 Basal cell carcinoma
 Least malignant
 Most common type

 Squamous cell carcinoma

 Metastasizes to lymph nodes
 Early removal allows a good chance of cure

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Basal Cell Carcinoma
Melanoma
 Skin Cancer Types: FYI

 Malignant melanoma
 Most deadly of skin cancers
 Cancer of melanocytes
 Metastasizes rapidly to lymph and blood
vessels
 Detection uses ABCD rule

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Melanoma at the Eyebrow
 ABCD Rule: FYI
 A = Asymmetry
 Two sides of pigmented mole do not match
 B = Border irregularity
 Borders of mole are not smooth
 C = Color
 Different colors in pigmented area
 D = Diameter
 Spot is larger than 6 mm in diameter
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 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.