THE INTEGUMENTARY

SYSTEM
GROUP 5
INTRODUCTION
● The organ of the integumentary system include the
skin and its accessory structures including hair, nails,
and glands, as well as blood vessels, muscle and
nerves.
● Dermatology is the medical specialty for the diagnosis
and treatment of disorders of the integumentary
system.
PLAYS VITAL ROLE IN:
● Protection
● Regulation
● Immune function
● Synthesis of vitamin d
● Detection of stimuli
STRUCTURE OF THE SKIN
● The skin (cutaneous membrane) covers the body and is the
largest organ of the body by surface area and weight
● Its area is about 2 square meters ( 22 square feet) and
weigh 4.5 - 5kg (10-11 lb), about 7% of the body weight
● It is 0.5 -4 mm thick, thinnest on eyelid, thickest on the
heels: the average thickness is 1 - 2 mm.
STRUCTURE OF THE SKIN
● It consist of two major layer: epidermis and dermis
● Epidermis - outer and thinner layer
● Dermis - consist of epithelial tissue thicker layer
● Beneath the dermis is a subcutaneous layer (also
called hypodermis) which attaches the skin to the
underlying tissues and organs.
EPIDERMIS
● Covers, protects and waterproofs.
● Contains 4 main layers
❏ Stratum corneum: keratinized layer. Prevents loss or entry of water; protect
against pathogens and chemicals
❏ Stratum lucidum: found only on palms of hands and sole of feet; protect
against UV sun rays to prevent sunburn
❏ Stratum granulosum: is a layer of epidermis that involves in providing
waterproofing function
❏ Stratum germinativum: the innermost layer of epidermis, is only layer that
undergoes cell division & contains melanin & keratin - forming cells
The epidermis has a number of important characteristic

● The epidermis is composed of keratinized

stratified squamous epithelium
● It contains 4 major types of cells:
❏ Keratinocytes: ( 90% of the cells ) produce
keratin which is the tough fibrous protein that
provides protection
❏ Melanocytes: which produce the pigment
melanin that protect against damage by
ultraviolet radiation
❏ Langerhans cells: involved in immune
responses, arise from red bone marrow
❏ Merkel cells: which function in the sensation of
touch along with the adjacent tactile discs.
● The epidermis, hair, nail, dental enamel are composed
of keratin
● Its replaced every 3 - 4 weeks
● Skin color depends on:
1. The amount of melanin & carotene “yellow pigment”
contained in the skin
2. The volume of blood containing hemoglobin
3. The oxygen - binding pigment that circulates in the
dermis
DERMIS
● The dermis has several important characteristics:
● Is composed of two connective tissue containing collagen and
elastic fibers
● Contains 2 layers
❏ The outer papillary region consists of areolar connective tissue
containing thin collagen and elastic fibers, dermal papillae (
including capillary loops) corpuscles of touch and free nerve
endings
● Sweat glands ( sudoriferous) : most numerous on palms of
hands and soles of feet.
● Two types are eccrine and apocrine glands.
● Eccrine glands : respond to external temperature and
psychological stress
● Found over most of body but most numerous on palms of
hands and soles of feet; secrete sweat, which helps regulate
body temperature and, to a lesser degree, excretes waste
such as urea.
APOCRINE OR ODORIFEROUS GLANDS
● Found in axillary and genitial area.
● Respond to stress; secrete pheromones, a substance with a
barely perceptible odor; when apocrine secretion react with
bacteria, body odor result
● Ceruminous glands are type of apocrine gland found in the
external ear canal.
● They secrete cerumen, which prevent drying of the eardrum and
traps foreign substances.
● Sebaceous glands: produce sebum, which
lubricates and protects skin and hair
● Cholesterol: converts to vitamin D when
exposed to UV lights
● Arterioles: dilate when hot increase heat
lost and constrict when cold to converse
heat
Hypodermis or subcutaneous
● Connective tissue: connect skin to muscle;
contains WBC
● Adipose tissue: contains stored energy,
SYMPTOMS ANALYSIS
● Itching arises from free nerve
endings (unmyelinated), which
are especially abundant in the
flexor aspects of the wrist and
ankles. It occurs as a result of
a spinal reflex and external
stimuli, such as heat, dryness,
inflammation, and
vasodilation.
SYMPTOMS ANALYSIS
Pruritus
● Severe Itching
● It may be localized or
generalized and caused by a
dermatologic problem or
underlying systemic problem.
SYMPTOMS ANALYSIS
Rashes
● Like itching, may be localized
or generalized acute or
chronic, and caused by an
obvious dermatologic
problem or an underlying
systemic problem.
SKIN COLOR ASSESSMENT

Normal
● Varies from light to deep brown, from ruddy pink to
light pink • Deviations from normal
SYMPTOMS ANALYSIS
Pallor

● Decrease in color of the skin

caused by lack of oxygen in the
body. Best observed around
fingernails, lips, palpebral
conjunctiva, and oral mucosa;
likewise, on the palms of hands
and soles of feet
SYMPTOMS ANALYSIS
Cyanosis

● Bluish discoloration of the skin

due to lack of oxygen or poor
tissue perfusion
● ▪ best observed on the lips and
nail beds
2 TYPES OF CYANOSIS

1. Central
- Cause by diseases of heart and lungs. Bluish
discoloration of tongue and linings of the mouth.
2. Peripheral
- Results from decreased peripheral circulation. Seen at
the arms and legs.
SYMPTOMS ANALYSIS
Jaundice

● Also known as icterus; a

yellowish appearance of the skin,
sclera, mucous membranes, and
excretions related to
hepatobiliary disorders or
hemolytic diseases.
SYMPTOMS ANALYSIS
Erythema

● Redness of the skin due to

congestion of the capillaries
SKIN COLOR UNIFORMITY
Normal
- Generally uniform except in areas exposed to sun. And in areas of lighter
pigmentation in dark skinned.
Deviations from normal
● Hyperpigmentation (BIRTHMARKS)
- Abnormal destruction of the melanin.
● Hypopigmentation (VITILIGO )
- Destruction of melanocytes in the area.
● ALBINISM
- Complete or partial lack of melanin.
BIRTHMARK VITILIGO ALBINISM
SKIN ODOR

➢ Unusual body odor

➢ Odors from excessive sweating
➢ Odor from night sweat
➢ Urine odor
➢ Mousy odor
Inspect, palpate and describe skin lesions
● According to location, distribution, color, configuration, size, shape, type or
structure
● Types
❏ Primary skin lesions
- Initial alteration in the skin
- abscess, ulcer, tumor, and open wound
❏ Secondary skin lesions
- Arises from a change in a primary lesion
- crusts, keloids, scars
● The ABCDE of Lesions
Useful for assessment of skin cancers
ABCDE stands for asymmetry, border, color, diameter and evolving. These are the
characteristics of skin damage that doctors look for when diagnosing and classifying
melanomas.

● Asymmetry – Melanoma is often asymmetrical, which means the shape isn’t uniform.
Non-cancerous moles are typically uniform and symmetrical in shape.
● Border – Melanoma often has borders that aren’t well defined or are irregular in shape,
whereas non-cancerous moles usually have smooth, well-defined borders.
● Color – Melanoma lesions are often more than one color or shade. Moles that are benign
are typically one color.
● Diameter – Melanoma growths are normally larger than 6mm in diameter, which is
about the diameter of a standard pencil.
● Evolution – Melanoma will often change characteristics, such as size, shape or color.
Unlike most benign moles, melanoma tends to change over time. If you have a mole or
skin growth, watch it for signs of changes. If you notice any of the ABCDEs of melanoma,
make an appointment right away to be evaluated by a dermatologist.
Primary Skin Lesions
Macule and Patch

- Small, flat, non palpable skin color

change (skin color may be brown,
white, tan, purple, red). Macules are
less than 1cm with a circumscribed
border. Whereas patches are greater
than 1 cm, and may have an irregular
border
Primary Skin Lesions
Cherry Angioma

- The collection of small blood vessels

- Cherry angiomas are small, red bumps
on your skin that are harmless to your
overall health. Angiomas commonly
appear after age 30 and can be removed
if you don’t like how they look.
Primary Skin Lesions
Cherry Angioma

- The collection of small blood vessels

- Cherry angiomas are small, red bumps
on your skin that are harmless to your
overall health. Angiomas commonly
appear after age 30 and can be removed
if you don’t like how they look.
Primary Skin Lesions
Lentigines

- small brown patches on the skin

typically on elderly people
- is the medical term for a skin
condition commonly known as liver
spots. These are flat spots on your
skin darker than your usual skin tone.
They’re not itchy, painful, or
dangerous.
Primary Skin Lesions
Petechiae

- tiny circular bleeding under the skin

- are pinpoint-sized spots of bleeding
under the skin or mucous membranes.
The purple, red or brown dots are not
raised or itchy, and they’re not a rash.
Primary Skin Lesions
Scarlet fever
- bright red rash that covers
most of the body, bacterial
illness that develops in
people with strep throat
Secondary Skin Lesions
Lichenification

- Thickening and scaling with

increased skin markings, ex.
Eczema
Secondary Skin Lesions
Crust

- Dried exudates, dried serum,

blood or pus on the surface of
the skin, Ex. Impetigo
Secondary Skin Lesions
Scar
- Skin mark left after healing of
wound or lesion that
represents replacement by
connective tissue of the injured
tissue
- Young scars are red or purple,
whereas mature scars are
white or glistening o
- Ex. Trauma scar
Secondary Skin Lesions
Keloid

- Hypertrophic scarring because

of excess collagen formation
- Raised and irregular
Secondary Skin Lesions
Excoriations

- Abrasion or other loss that

does not extend beyond the
superficial epidermis
- Loss of outer skin layers from
scratching or rubbing
- Ex. Scabies
Secondary Skin Lesions
Erosions

- Loss of superficial epidermis

that does not extend to the
dermis
- Ex. Dermatophyte
INTRODUCTION TO HAIR
● Composition: Hair is primarily made up of keratinized
cells, which are cells filled with keratin, a tough and
fibrous protein. These cells are produced in hair
follicles located in the dermis layer of the skin.
● Growth: Hair grows from the follicles that are supplied
with nutrients through blood vessels, ensuring the
growth and health of the hair.
FUNCTION OF HAIR

● Protection: Hair provides several protective functions:

● Scalp: Protects the scalp from UV radiation and
environmental damage.
● Facial Hair: Eyebrows and eyelashes help shield the
eyes from debris and sweat.
● Nasal Hair: Filters out dust and other particles from
the airways.
 TYPES OF HAIR

1. Vellus Hair
Description: Vellus hair is fine,
short, and lightly pigmented.
Often referred to as "peach fuzz."
Location: Covers most of the
body including the face, chest,
and arms. It is less visible due to
its fine texture and lighter color.
TYPE OF HAIR
2. Terminal Hair

Description: Terminal hair is thicker,

longer, and more pigmented compared
to vellus hair.

Location: Found on the scalp,

eyebrows, and eyelashes. It becomes
more prominent after puberty,
appearing on the legs, axillae (armpits),
and pubic area. It provides more
significant protection and insulation.
HAIR
● Hair is composed of dead keratinized epidermis cells

Hair consists of:

❏ Shaft - which mostly projects above the surface of the skin

❏ Root - which penetrates into the dermis
❏ Hair follicle - are responsible for your hair color, hair growth, hair texture, and
more.
Nails
● Made up of hard, keratinized cells and grow from
a nail root under the cuticle.
● Protect the distal portions of the digits enhance
precise movement of the digits aid in picking up
objects.
Nails
 Parts of Nails
Free edge
- overhangs the tip of the
finger or toe
- The portion of the nail that
extend past the end of the
matrix bed.
Parts of Nails
Lunula
- The withish
half-moon at the
base of the nail
 Parts of Nails
Nail plate
- The visible, hardened part
of the nail, composed
primarily of keratin.
Parts of Nails
Matrix
- The hidden parts of the
nail unit under the cuticle
Parts of Nails
Cuticle
- Overlapping epidermis
around the nail
Nail disorder
1. Onychatrophia
- Is an atrophy or wasting
away from nail palate
which causes it to lose its
luster become smaller and
sometimes shed entirely
Nail disorder
2. Leukonychia
- Cause by tiny bubbles of
air that are trapped in the
nails plate layers due to
trauma.
Nail disorder
3. Pterygium
- It is an overgrowth of
cuticle which thicks to the
surface of nail plate.
Nail disorder
4. Brittle nails
- A vertical splitting or
separation of the nail plate
layers at the distal (free)
edge of the nail plate.
Nail disorder
4. Bruised nails
- Condition in which a blood
clot form under the nail
plate, forming a dark
purplish spot
Thank You !!!