- They participate in immune

LESSON 5. INTEGUMENTARY SYSTEM responses mounted against

microbes that invade the skin, and
- Composed of the skin, hair, oil and sweat glands, are easily damaged by UV light.
nails, and sensory receptors. - Their role in immune response is to
- It helps maintain constant body temperature, help other cells of the immune
protects the body, and provides sensory information system recognize an invading
about the surrounding environment. microbe and destroy it.
d. Tactile epithelial cells
DERMATOLOGY - Also called Merkel cells
- The least numerous of epidermal
- ‘Dermato’ – skin, ‘logy’ – study of cells
- Medical specialty that deals with the structure, - Located at the deepest layer of the
function, and disorders of the integumentary system. epidermis, where they contact the
flattened process of a sensory
STRUCTURE OF THE SKIN neuron, a structure called a tactile
disc or Merkel disc. Tactile
- The skin, also known as the cutaneous membrane, epithelial cells and their associated
covers the external surface of the body and is the tactile discs detect touch
largest organ of the body in weight. sensations.
- Covers an area of 2 square meters (22 square feet),
weighs 4.5-5 kgs (10-11 pounds) LAYERS OF THE SKIN
- Thickness from 0.05mm on eyelids to 4.0mm on
heels. 1-2mm over most of the body. In most regions, epidermis has four strata or layers, this is
- Has two parts: called the thin skin – stratum basale, stratum spinosum,
1. EPIDERMIS stratum granulosum, and thin stratum corneum. Where
- The superficial, thinner portion, which is exposure friction is the greatest, such as fingertips, palms,
composed of epithelial tissue. soles, the epidermis has five layers, this is called the thick
- Is avascular, meaning it does not contain blood skin – stratum basale, stratum spinosum, stratum
vessels granulosum, stratum lucidum, and thick stratum corneum.
- Has four principal types of cells:
a. Stratum Basale
a. Keratinocytes
- Deepest later of epidermis, composed of
- ‘keratino’ – hornlike, ‘cytes’ – cells
single row of cuboidal or columnar
- About 90% of epidermal cells are
keratinocytes
keratinocytes
- Also called stratum germinativum to
- Are arranged in four or five layers
indicate its role in forming new cells
and produce the protein keratin, a
- Some cells in this layer are stem cells that
tough, fibrous protein that helps
undergo cell division to continually
protect the skin and underlying
produce keratinocytes
tissues from abrasions, heat,
- The nuclei of keratinocytes in stratum
microbes, and chemicals.
basale are large, and their cytoplasm
- Produce lamellar granules, which
contains many ribosomes, a small Golgi
release a water-repellent sealant
complex, a few mitochondria, and some
that decreases water entry and loss
rough endoplasmic reticulum.
and inhibits entry to foreign
- The cytoskeleton within keratinocytes of
material.
the stratum basale includes scattered
b. Melanocytes
intermediate filaments called keratin
- ‘melano’ – black, ‘cytes’ – cells
intermediate filaments (tonofilaments).
- Composes of 8% of epidermal cells
- Melanocytes and tactile epithelial cells
- Develops from ectoderm of
with their associated tactile discs are
developing embryo and produces
scattered among the keratinocytes of
the pigment melanin.
basal layer.
- Melanin is a yellow-red or brown-
b. Stratum Spinosum
black pigment that contributes to
- Superficial to the stratum basale
skin color and absorbs damaging
- ‘spinos’ – thornlike
UV light.
- Consists of numerous keratinocytes
- Melanin granules cluster to form a
arranged in 8-10 layers.
protective veil over the nucleus, on
- The keratinocytes in the stratum
the side toward the skin surface.
spinosum, which are produced by the
They shield the nuclear DNA from
stem cells in the basal layer, have the
damage by UV light.
same organelles as cells of the stratum
c. Intraepidermal macrophages
basale, and some retain their ability to
- Also called Langerhans cells
divide.
- Arise from red bone marrow and
migrate to epidermis
 - Produces courser bundles of keratin in the 2. DERMIS
intermediate filaments, has rounded and - The second, deeper, thicker layer, which
larger cells consists of connective tissue.
- Intraepidermal macrophages and - Is vascular, meaning it has blood vessels
projection of melanocytes are also present - Composed of dense irregular connective
in the stratum spinosum tissue containing collagen and elastic fibers.
c. Stratum Granulosum - Has great tensile strength for resisting pulling
- Found in the middle of epidermis or stretching forces.
- ‘granulos” – little grains - Also has the ability to stretch and recoil easily.
- Consists of 3-5 layers of flattened - Much thicker than epidermis and varies from
keratinocytes that are undergoing region to region in the body, thickest on the
apoptosis palms and soles.
- A distinctive feature of cells in this layer is - Few cells present in dermis include
the presence of darkly staining granules of predominantly fibroblasts, with some
a protein called keratohyalin, which macrophages, and a few adipocytes near its
assembles keratin intermediate filaments boundary with the subcutaneous layer
into keratin. - Embedded in the dermal layer are:
- Also present in the keratinocytes are a. Blood vessels
membrane-enclosed lamellar granules, b. Nerves
which fuse with the plasma membrane c. Glands
and release a lipid-rich secretion. This d. Hair follicles
secretion is deposited in the spaces - Dermis is essential to the survival of the
between cells of the stratum granulosum, epidermis, and these adjacent layers form
stratum lucidum, and stratum corneum. many important structural and functional
This lipid-rich secretion acts as a water- relations.
repellant sealant, retarding loss and entry - Can be divided into two regions according to
to water and entry of foreign materials. tissue structure:
- The stratum granulosum marks the A. Papillary region (thin, superficial)
transition between the deeper, - Makes up about 1/5 of thickness of the total
metabolically active strata and the dead layer
cells of the more superficial strata. - Contains thin collagen and fine elastic fibers
d. Stratum Lucidum - Surface area is greatly increased by dermal
- Only present in the thick skin of areas papillae (‘papillae’ – nipples), small, nipple-
such as fingertips, palms, and soles shaped structure that project into the
- ‘lucid’ – clear undersurface of the epidermis
- Consists of 4-6 layers of flattened, clear - All dermal papillae contain capillary loops
keratinocytes that contain large amounts (blood vessels).
of keratin and thickened plasma - Some also contain tactile receptors called
membranes. corpuscles of touch or Meissner corpuscles,
- Provides additional level of toughness of nerve endings that are sensitive to touch.
thick skin - Other dermal papillae also contain free nerve
e. Stratum Corneum endings, dendrites that lack any apparent
- ‘corne’ – horn/horny structural specialization. They initiate signals
- Consists on average of 25-30 layers of that give rise to sensations of warmth,
flattened dead keratinocytes, but can coolness, pain, tickling, and itching.
range in thickness from a few cells in thin B. Reticular region (thick, deeper)
to 50 or more cell layers in thick skin. - ‘reticul’ – netlike
- The cells are extremely thin, flat, plasma - About 4/5 of thickness
membrane-enclosed packages of keratin - Attached to the subcutaneous later, contains
that no longer contain a nucleus or any bundles of think collagen fibers, scattered
internal organelles. fibroblasts, various wandering cells
- Final product of differentiation process of (macrophages).
the keratinocytes. - Some adipose cells are also present in the
- The cells within each layer overlap one deepest part of the layer, along with some
another like the scales on the skin of a coarse elastic fibers
snake. - Collagen fibers are arranged in a netlike
- Its multiple layers of dead cells help the manner and have a more regular arrangement
stratum corneum to protect deeper layers than those in the papillary region.
from injury and microbial invasion. - The more regular orientation of the large
- Constant exposure of skin to friction collagen fibers helps the skin resist stretching.
stimulates increased cell production and - Blood vessels, nerves, hair follicles,
keratin production that results in the sebaceous glands, and sudiferous glands
formation of a callus, an abnormal occupy space between fibers
thickening of the stratus corneum.
 - Combination of collagen and elastic fibers Melanin that accumulates in patches are called freckles,
provide skin with strength, extensibility (ability typically reddish or brown and tend to be visible in summer
to stretch), and elasticity (ability to return to than the winter.
original shape after stretching).
- Extensibility of skin can be seen around joints, Age (liver) spots also develop as person ages. These are
in pregnancy, and obesity. flat blemishes that look like freckles and range in color
- Epidermal ridges are series of ridges and from light brown to black. They build up over time due to
grooves that appear as straight lines or as exposure to sunlight. They do not fade away and are
pattern of loops and whorls. Surfaces of palms, common in adults over 40.
fingers, soles, and toes have it. These form
during the third month of fetal development. A round, flat, or raised area that represents a benign
- Fingerprints or footprints form because the localized overgrowth of melanocytes and usually develops
ducts of sweat glands open on the tops of in childhood or adolescence is called a nevus or mole.
epidermal ridges as sweat pores.
Melanocytes synthesize melanin from the amino acid
- Dermatoglyphics is the study of pattern of
tyrosine in the presence of an enzyme called tyrosinase.
epidermal ridges.
Synthesis occurs in an organelle called melanosome.
3. SUBCUTANEOUS LAYER
Exposure to UV light increases enzymatic activity within
- Deep to the dermis, but not part of the skin
melanosomes and thus increases melanin production.
- Also called hypodermis
- Consists of areolar and adipose tissues Hemoglobin – red color, the oxygen-carrying pigment in
- Fibers that extend from the dermis anchor the red blood cells
skin to the subcutaneous layer, which in turn
attached to underlying fascia (connective Carotene – a yellow-orange pigment that gives egg yolks
tissue around muscles and bones). and carrots their color. This is a pre cursor of vitamin A,
- Serves as storage depot for fat and contains which is used to synthesize pigments needed for vision. It
large blood vessels that supply then skin. is stored in stratum corneum and fatty areas of dermis and
- This region also contains nerve endings called hypodermis in response to excessive dietary intake.
lamellated corpuscles or pacinian
corpuscles that are sensitive to pressure. TATTOOING AND BODY PIERCING

KERATINIZATION AND GROWTH OF EPIDERMIS Tattooing is a permanent coloration of the skin which is a
foreign pigment deposited with a needle into the dermis.
Newly formed cells in stratum basale are slowly pushed to
the surface. As cell move from one epidermal layer to the Believed to be a practice that originated in ancient Egypt
next, they accumulate more and more keratin. This is between 4000 and 2000 B.C. They are created by injecting
called keratinization. ink with a needle that punctures the epidermis, moves
between 50 and 3000 times per minute and deposits the
The epidermal cells of the stratum basale are closest to ink in the dermis. They fade overtime due to exposure of
these blood vessels and receive most of the nutrients and sunlight, improper healing, picking scabs and flushing
oxygen. These cells are the most active metabolically and away ink particles by lymphatic system. Can be removed
continuously undergo cell division to produce new by lasers, which used concentrated beams of light.
keratinocytes.
Body piercing, the insertion of jewellery through an
The mechanisms that regulate this remarkable growth are artificial opening.
not well understood, but hormonelike proteins such as
epidermal growth factor (EGF) play a role. Also an ancient practice employed by Egyptian pharaohs
and Roman soldiers, and a common tradition among many
An excessive amount of keratinized cells shed from the Americans.
skin of the scalp is called dandruff.
ACCESSORY STRUCTURES OF THE SKIN
THE STRUCTURAL BASIS OF SKIN COLOR
1. HAIR
Melanin, hemoglobin, and carotene are three pigments - Also called pili
that impart a wide variety of colors to skin. Amount of - Present on most skin surfaces except the
melanin causes the skin’s color to vary from pale yellow to palms, palmar surfaces of the fingers, the
reddish-brown to black. There are two forms of melanin: soles, and plantar surfaces of the feet.
- Most heavily distributed across scalp,
a. Pheomelanin (yellow to red) eyebrows, axillae, and around external
b. Eumelanin (brown to black) – most apparent in genitalia.
the hair - Hair on head protects scalp from injury and sun
rays, also decreases heat loss from scalp.
Number of melanocytes is same in all people, differences
- Eyebrows and eyelashes protect eyes from
in skin color vary due to amount of pigment the
foreign particles, similar to the way hair in
melanocytes produce and transfer to keratinocytes.
nostrils and in the external ear canal defend
those structure.
 - Touch receptors (hair root plexuses) hair follicle. Bulb also contains a germinal layer of cells
associated with hair follicles are activated called the hair matrix. Hair matrix arise from stratum
whenever a hair is moved. Also functions in basale. They are responsible for the growth of existing
sensing light touch. hairs, and produce new hairs when old hairs are shed.

ANATOMY OF A HAIR Sebaceous glands and a bundle of smooth muscle cells

are also associated with hairs.

The smooth muscle is the arrector pili (arrect – to raise).

It extends from the superficial dermis of the skin to the
dermal root sheath around the side of the hair follicle.

Hair emerges at less than 90 degree angle to the surface

of the skin. Under physiological or emotional stress, such
as cold or fright, autonomic nerve endings stimulate
arrector pili muscles to contract, which pulls hair shafts
perpendicular to skin surface. This action is called “goose
bumps” or “goose flesh”.

Hair root plexus – formed by dendrites of neurons that

surrounds each hair follicle.

HAIR GROWTH

Each hair is composed of columns of dead, keratinized Hair follicles go through a growth cycle, which consists of:
epidermal cells bonded together by extracellular proteins.
a. Growth Stage
Shaft – the superficial portion of the hair which projects - Cells of hair matrix divide. As new cells from
above the surface of the skin. the hair matrix are added to the base of hair
root, existing cells of the hair root are pushed
Root – the portion of hair deep to the shaft that penetrates upward and the hair grows longer.
into the dermis, and sometimes into the subcutaneous - Lasts about 2-6 years
layer. b. Regression Stage
- When cells of hair matrix stop dividing, the hair
Both shaft and root consists of three concentric layers of follicle atrophies (shrinks), and the hair stops
cells: medulla, cortex, and cuticle growing.
- Lasts about 2-3 weeks
Inner medulla is composed of two or three rows of c. Resting Stage
irregularly shaped cells that contain large amount of - Lasts about 3 months
pigment granules in dark hair, small amounts in gray hair,
and lack of pigment granules and presence of air bubbles Following the resting stage, a new growth cycle begins.
in white hair. Old hair root is pushed out of hair follicle and new hair
begins to grow in place. About 85% of scalp hairs are in
Middle cortex forms the major part of the shaft and growth stage. Visible hair is dead, but until the hair is
consists of elongated cells. pushed out of its follicle by a new hair, portions of its root
within the scalp are alive.
The cuticle of the hair, the outermost layer, consists of a
single layer of thin, flat cells that are the most heavily Normal hair loss in adult scalp is about 70-100 hairs per
keratinized. day.
Hair follicles – surrounds the root of the hair, which is Alopecia – the partial or complete lack of hair, may result
made up of external root sheath and an internal root from genetic factors, aging, endocrine disorders,
sheath, together referred as epithelial root sheath. chemotherapy, or skin disease.
External root sheath is a downward continuation of the TYPES OF HAIRS
epidermis. The internal root sheath is produced by the
matrix and forms a cellular tubular sheath of epithelium Hair follicles develop at about 12 weeks after fertilization.
between external root sheath and hair.
Lanugo – Very fine, nonpigmented, downy hairs produced
The dense dermis surrounding the hair follicle is called by follicles, they cover the body of the fetus.
dermal root sheath.
Terminal hairs – Long, coarse, heavy pigmented hairs,
Bulb – Base of each hair follicle and its surrounding and produced by shedding of lanugo of eyebrows,
dermal root sheath is an onion-shaped structure. This eyelashes, and scalp.
structure houses a nipple-shaped indentation called the
papilla of the hair, which contains areolar connective Vellus hairs – Short, fine, pale hairs that are barely visible,
tissue and many blood vessels that nourish the growing produced by shedding lanugo in the rest of the body.
During adulthood, about 95% of the body hair on males is 1. Eccrine sweat glands
terminal hair and 5% is vellus hair; on females, about 35% - ‘eccrine’ – secreting outwardly
is terminal hair and 65% is vellus hair. - Simple, coiled tubular glands
that are much more common
HAIR COLOR than apocrine glands
- They are distributed throughout
Color of hair is primarily to the amount and type of melanin the forehead, palms, and soles
in its keratinized cells. Melanin is synthesized by - They are not present in margins
melanocytes scattered in the matrix of the bulb and passes of the lips, nail beds of fingers
into cells of the cortex and medulla of the hair. and toes, glans penis, glans
clitoris, labia minora, or
Dark-colored hairs contain mostly eumelanin; blond and
eardrums.
red hair contain variants of pheomelanin; hair becomes
- Secretory portion located
gray because of a progressive decline in melanin
mostly in deep dermis;
production. White hair results from the lack of melanin and
excretory duct projects through
the accumulation of air bubbles in shaft.
the dermis and epidermis and
Hair coloring is a process that adds or removes pigment. ends as a pore at the surface of
Temporary hair dyes coat the surface of a hair shaft and epidermis
usually wash out within 2 or 3 shampoos. Semipermanent - Sweat produced by eccrine
dyes penetrate hair shaft moderately and fade after 5-10 glands (about 600mL per day)
shampoos. While permanent hair dyes penetrate deeply consists primarily of water, with
and don’t wash out but eventually lost as the hair grows. small amounts of ions (Na and
Cl), urea, uric acid, ammonia,
2. SKIN GLANDS amino acids, glucose, and lactic
- Glands are epithelial cells that secrete a acid.
substance - Main function of eccrine gland is
- Several kinds of exocrine glands are to help regulate our body
associated with the skin: temperature through
A. Sebaceous Glands evaporation.
- ‘sebace’ – greasy - Homeostatic regulation of body
- Also called oil glands temperature is known as
- Simple, branched acinar (rounded) thermoregulation.
glands and are connected to hair - Eccrine glands help the body in
follicles achieving thermoregulation by
- The secreting portion of a thermoregulatory sweating.
sebaceous gland lies in the dermis - Sweat the evaporates from the
and usually opens into the neck of skin before it is perceived as
hair follicle. moisture is termed as
- Sebaceous glands directly open insensible perspiration
onto the surface of lips, glans penis, - Sweat that is excreted in larger
labia minora, and tarsal glands of amounts and is seen as
eyelids moisture on the skin is called
- Absent in palms and soles, small in sensible perspiration.
areas of trunk and limbs, large in - Eccrine glands also release
skin of breast, face, neck, and sweat in response to an
superior chest. emotional stress such as fear or
- Sebaceous glands secrete an oily embarrassment. This is referred
substance called sebum, a mixture as emotional sweating or cold
of triglycerides, cholesterol, sweat.
proteins, and inorganic salts. - Begins to function after birth
- Sebum coats the surface of hairs 2. Apocrine sweat glands
and helps keep them from drying - ‘apo’ – separated from
and becoming brittle; prevents - Simple, coiled tubular glands
excessive evaporation of water from but have larger ducts and
skin, keeps skin soft and pliable, lumens than eccrine glands
inhibits growth of some bacteria. - Found mainly on axilla, groin,
B. Sudoriferous Glands areolae of breasts, bearded
- ‘sudor’ – sweat, ‘ferous’ – bearing regions of face
- There are 3-4 million sweat glands - Release excretions via
- Cells in this gland release sweat or exocytosis.
perspiration into hair follicles or onto - Located in lower dermis or
skin surface through pores upper subcutaneous layer, and
- Divided into two main types: the excretory duct opens into
hair follicles.
 - Apocrine sweat appears milky or eponychium or cuticle is a narrow band of
yellowish, contains same epidermis that extends from and adheres
components as eccrine sweat + to the margin of the nail wall.
lipids and proteins
- Sweat from apocrine is odorless The portion of epithelium proximal to the nail root is the
but when bacteria interacts with it, nail matrix.
the sweat metabolizes, causing
apocrine sweat to have musky Nails have a variety of function:
odor, often referred as body odor.
1. They protect distal end of the digits
- Begins to function after puberty.
2. They provide support and counterpressure to
- Also active in emotional sweating
the palmar surface of the fingers to enhance
- Secretes sweat during sexual
touch perception and manipulation
activities
3. They allow us to grasp and manipulate small
- Does not participate in
objects and they can be used to scratch and
thermoregulation
groom the body in various ways.
C. Ceruminous Glands
- ‘cer’ – wax
- Modified sweat glands in external
ear
- Produce a waxy lubricating
secretion
- Secretory portion is located in
subcutaneous layer, deep to
sebaceous glands. Excretory ducts
open directly to surface of external
auditory canal or ducts of
sebaceous glands. TYPES OF SKIN
- Combined secretion of ceruminous
and sebaceous glands is a The skin has two major types on the basis of certain
yellowish material called cerumen structural and functional properties:
or earwax.
- Cerumen, along with external Features Thin Skin Thick Skin
auditory canal, provides a sticky Distribution All parts of body Areas such as
barrier that impedes the entrance of except palms, palms, palmar
foreign bodies and insects; palmar surface surface of digits,
waterproofs canal and prevents of digits, soles soles
bacteria and fungi from entering Epidermal 0.10-0.15mm 0.6-4.5mm
cells thickness (0.004-0.006 in) (0.024-0.18in)
3. NAILS Epidermal Stratum Strata lucidum
strata lucidum present; thicker
- Plates of tightly packed, hard, dead, keratinized
essentially strata spinosum
epidermal cells that form a clear solid covering
lacking; thinner and corneum
over the dorsal surfaces of the distal portions of strata spinosum
the digits. and corneum
- Each nail consists of: Epidermal Lacking due to Present due to
a. Nail body (plate). Visible portion of the nail; ridges poorly well-developed
keratinized cells fill with a harder type of developed, and more
keratin and cells are not shed. Below the fewer, and less numerous
nail body is a region of epithelium, and a well-organized dermal papillae
deeper layer of dermis. It appears pink dermal papillae organized in
because of the blood flowing through the parallel rows
capillaries. Nail bed is the skin below the Hair follicles Present Absent
nail plate that extends from lunula to and arrector
hyponychium. pili muscles
b. Free edge. Part of the nail body that extend Sebaceous Present Absent
glands
past the distal end of the digit. Free edge is
Sudoriferous Fewer More numerous
white because there are no underlying
glands
capillaries. Beneath free edge is a
Sensory Sparser Denser
thickened region of stratum corneum called receptors
hyponychium (‘hypo’ – below; ‘onych’ –
nail), which secures the nail to the fingertip.
FUNCTIONS OF THE SKIN
c. Nail root. Portion of nail that is buried in a
fold of skin. The whitish, crescent-shaped
1. THERMOREGULATION
area of the proximal end of the nail body is
- Homeostatic regulation of the body
called the lunula (little moon). The
temperature.
 - Contributes by liberating sweat at its surface EPIDERMAL WOUND HEALING
and by adjusting the flow of blood in dermis
- In response to high environmental Even though the central portion of an epidermal wound
temperature or heat produced by exercise, may extend to the dermis, the edges of the wound usually
sweat production from eccrine glands involve only slight damage to superficial epidermal cells.
increases; evaporation of sweat from skin Common types of epidermal wounds include abrasions, in
surface helps lower body temperature which portions of skin has scraped away, and minor burns.
- Blood vessels in dermis become wider, which
increases amount of heat loss from the body 1. Basal cells of epidermis surrounding wound
2. BLOOD RESERVOIR break contact with basement membrane.
- Dermis houses an extensive network of blood 2. The cells enlarge and migrate across the wound
vessels that carry 8-10% of the total blood flow as a sheet until advancing cells from opposite
in a resting adult. sides of the wound meet.
3. PROTECTION 3. When the epidermal cells encounter one
- Provides protection in various ways another, they stop migrating due to a cellular
- Keratin protects underlying tissues from response called contact inhibition. Migration
microbes, abrasion, heat, and chemicals, and of epidermal cells stops completely when each
tightly interlocked keratinocytes resist is in contact with other epidermal cells on all
invasions by microbes. sides
- The oily sebum from the sebaceous glands
keeps skin and hairs from drying out and As the basal epidermal cells migrate, a hormone called
contains bactericidal chemicals (substances epidermal growth factor stimulates basal stem cells to dive
that kill bacteria). and replace ones that have moved into the wound. The
- The acidic pH of perspiration retards the relocated epidermal cells divide to build new strata, thus
growth of some microbes. The pigment thickening the new epidermis.
melanin helps shield against the damaging
effects of ultraviolet light. DEEP WOUND HEALING
- Intraepidermal macrophages alert the immune
system to the presence of potentially harmful Occurs when an injury extends to the dermis and
microbial invaders by recognizing and subcutaneous layer.
processing them, and macrophages in the
dermis phagocytize bacteria and viruses that *Healing process is more complex because multiple tissue
manage to bypass the intraepidermal layers must be repaired; scar tissues are also formed,
macrophages of the epidermis. healed tissue loses some of its normal function
4. CUTANEOUS SENSATIONS
Has four phases:
- Sensations that arise in the skin, including
tactile sensations – touch, pressure, vibration, 1. Inflammatory phase
and tickling – as well as thermal sensations - A blood clot forms in the wound and loosely
such as warmth and coolness. unites the wound edges. This phase of deep
5. EXCRETION AND ABSORPTION wound healing involves inflammation, a
- Excretion is the elimination of substances from vascular and cellular response that helps
the body eliminate microbes, foreign material, and dying
- Absorption is the passage of materials from tissues in preparation for repair.
external environment into body cells 2. Migratory phase
6. SYNTHESIS OF VITAMIN D - The clot turns into a scab, and epithelial cells
- Requires activation of a precursor molecule in migrate beneath the scab to bridge the wound.
the skin by UV rays in sunlight. Enzymes in the Fibroblasts migrate along fibrin threads and
liver and kidneys then modify the activated begin synthesizing scar tissue (collagen fibers,
molecule, producing calcitriol, the most active glycoproteins) and damaged blood vessels
form of vitamin D. begin to regrow.
- Calcitriol is a hormone that aids in absorption - The tissue that fills the wound is called
of calcium foods in the gastrointestinal tract in granulation tissue.
the blood. 3. Proliferative phase
- Characterized by extensive growth of epithelial
MAINTAINING HOMEOSTASIS: SKIN WOUND cells beneath the sab, deposition by fibroblasts
HEALING of collagen fibers in random patterns, and
continued growth of blood vessels
Skin damage sets in motion a sequence of events that 4. Maturation phase
repairs the skin to its normal structure and function. Two - Scab sloughs off once epidermis has restored to
kinds of healing process can occur, depending on the normal thickness. Collagen fibers become more
depth of the injury. Epidermal wound healing occurs organized, fibroblasts decrease in number, and
following wounds that affect only the epidermis; deep blood vessels are restored to normal.
wound healing occurs following wounds that penetrate the
dermis.
SCAR TISSUE FORMATION Hair follicles are developed at about 12 weeks as
downgrowths of basal layer of epidermis into the dermis.
- Process of scar tissue formation is called fibrosis. These downgrowths are called hair buds. As hair buds
penetrate deeper to the dermis, their distal ends become
Sometimes, when there are too many scar tissue formed club-shaped and are called hair bulbs. Cells in the center
during deep wound healing, a raised scar, elevated scar of hair bulb develop into matrix, which forms hair. The
above normal epidermal surface, is formed. peripheral cells of hair bulb is called epithelial root sheath;
mesenchyme surrounding dermis develops into dermal
If scar remains within boundaries of original wound, it is
root sheath and arrector pili muscle.
called hypertrophic scar. If it extends beyond boundaries
into normal surrounding tissues, it is called keloid scar or By fifth month, hair follicles produce lanugo. It is first
cheloid scar. produced on the head and then on the parts of the body.
Scar tissues differ from normal skin by its: Most sebaceous gland develop as outgrowth from sides of
hair follicles at about four months and remain connected
1. More densely arranged collagen fibers
to the follicles.
2. Decreased elasticity
3. Fewer blood vessel Most sudoriferous gland are derived from downgrowths of
4. May or may not contain same number of hair, stratum basale of epidermis into dermis. Sweat glands
skin gland or sensory structure appear at about five months on the palms and soles and a
5. Scars are lighter in color little later in other regions.

DEVELOPMENT OF THE INTEGUMENTARY SYSTEM Nails are developed about 10 weeks. They consist of a
thick layer of epithelium called primary nail field. The nail
Epidermis is derived from the ectoderm, which covers the itself is keratinized epithelium and grows distally from its
surface of the embryo. base. It is not until the ninth month that the nails actually
reach the tips of digits.
At four weeks after fertilization, epidermis only has a single
layer of ectodermal cells. At seventh week, the single
layer, called basal layer, divides and forms a superficial
protected layer of flattened called periderm.

Vernix caseosa (‘vernix; - varnish; ‘caseosa’ – cheese), a

fatty substance form from development secretions from
sebaceous glands mixing with peridermal cells sloughed
off and hairs, covers and protects the skin of the fetus from
constant exposure to the amniotic fluid in which it is
bathed. The vernix caseosa also facilitates the birth of
fetus because of its slippery nature and protects skin from
being damaged by nails.

By 11 weeks, basal layer forms intermediate layer of

cells. Proliferation of basal cells forms all layers of
epidermis, which are all present at birth. Epidermal ridges
form along with the epidermal layers. By eleventh week,
cells from the ectoderm migrate into the dermis and
differentiate into melanoblasts.

These cells enter the epidermis and differentiate into

melanocytes. Later in the first trimester of pregnancy,
intraepidermal macrophages, which arise from red bone
marrow, invade the epidermis. Tactile epithelial cells
appear in the epidermis in the fourth to sixth months; their
origin is unknown.

The dermis arises from mesoderm located deep to the

surface ectoderm. The mesoderm gives rise to a loosely
organized embryonic connective tissue called
mesenchyme. By 11 weeks, the mesenchymal cells
differentiate into fibroblasts and begin to form collagen and
elastic fibers. As the epidermal ridges form, parts of the
superficial dermis project into the epidermis and develop
into dermal papillae, which contain capillary loops,
corpuscles of touch, and free nerve endings