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Integumentary System

DEVELOPMENT OF SKIN:

Epidermis & its appendages, pilo sebaceous unit, nail & sweat glands: Surface ectoderm
Melanocyte Et Merkel cells: Neural crest
Langerhan’s cells: Bone marrow
Dermis in limbs & trunks: Somatopleuric mesenchyme
Dermis in face, Head Et neck: Neural crest
Skin and facia of great toe drains into Vertical group of superficial inguinal lymph nodes
It has been calculated that a human adult has about 10¹² bacteria on the skin
Density of bacterial population at most sites is between 100-1000 per square cm.

LAYERS OF SKIN:

Skin is the largest organ in the body.
Total surface area: 1.7m2.
The layers of the skin are

Epidermis

Dermis

Subcutaneous fat/ hypodermis

EPIDERMIS

0.4 -1.6 mm in thickness
Layers of epidermis:

Stratum corneum (Horny cell layer)	Outermost layer Made of flat, anucleated cells No cell organelles Dead layer of epidermis Underdeveloped in preterm infants for 2-3 weeks The stratum corneum of the palms and soles is about 0.5 mm thick and much thicker than that on the trunk and limbs. Stratum corneum is permeable in preterm infants and becomes similar to the adult and full term infant after 2-3 weeks, postnatal maturation.
Stratum lucidum	Transparent layer Seen only in palm & sole
Stratum granulosum	Made of intracellular basophilic kerato hyaline granules Forms a water impermeable layer Contains abundant Odland bodies. Layer absent in nail bed & matrix
Stratum spinosum or Prickle cells layer Malphigian layer	Provides mechanical strength to the skin Langerhan cells present.
Stratum basale or Stratum germinatum	Single layer of columnar/ cuboidal cells Contains mitotically active keratinocytes & melanocytes Melanoblast cells appear in basal layer of epidermis during 3rd month of intrauterine life

Cells in the epidermis:

keratinoytes
melanocytes
Merkel cells
Langerhans’ cells
Langerhans cells – antigen-presenting cells, derived from bone-marrow and found in the prickle cell layer.
- Langerhans cells are found scattered evenly throughout the epidermis.
Merkel cells are normally located in the basal layer
- slow adapting mechanoreceptors found in prickle cell layer.
Keratinization: conversion of keratinocyte into keratin (4 weeks)
- Keratin filaments are hallmark of keratinocyte
- Adamson’s fringe: beginning of Keratinization
- Keratin expressed in basal layer: K5, K14

Development:

1 epidermal melanocyte unit: 36 keratinocytes
Skin doubling time: 4 weeks
Epidermal turn over time: 1 month
Accelerated cell turnover: psoriasis and ichthyosiform erythroderma 2 to 4 days
Nail first develops at: 3 months of intra uterine life
Finger nail growth: 0.1mm/day
Scalp hair growth: 0.35 mm/day
Number of hair normally lost pev day:50-100
Factors stimulating skin development (Epidermopoiesis): EGF, TGF-a, IL-II & fibroblast growth factor.
Factors inhibiting skin development: Chalones, TGF-B, a and y interferons, TNF
Grenz zone: narrow clear zone B/W epidermis & dermis.
Racial variations in pigmentation are due to differences in melanocyte morphology and activity rather than to differences in frequency or distribution
Function of the epidermis layer of the skin provides a waterproof barrier and creates our skin tone.

DERMIS:

Flexible and strong connective tissue
Elastic, reticular and collagen fibers
Cells: fibroblasts, macrophages (WBC), mast cells (histamine).
Nerves, blood and lymphatic vessels Oil and sweat glands originate

Two layers:

Papillary layer:
Loose connective tissue with nipple like surface projection called dermal papilla.
Capillaries
Contain pain receptors
Contain touch receptors (Meissner’s corpuscles)
Dermal ridges- epidermal ridges- pattern called fingerprints

Reticular layer:

Dense irregular c.t.
Collagen fibers offer strength
Holds water
Dermal tearing causes stretch marks.
Striae

Hair (pili)

Main function is protection
Hair root nerve plexus for touch
Normal hair loss in adult 70-100 hairs/day

Nerve endings:

Exteroceptors (stimulus outside of body)
Pacinian (lamellated) corpuscles: deep pressure and stretch
Meissner’s (tactile) corpuscles: light touch, vibration and discriminative touch.
Hair root plexus
Free (naked) nerve endings: nociceptors (pain) and thermoreceptors ( hot – deep and cold- surface)
Ruffini’s corpuscles: deep pressure
Haascheiben cells in epidermis are responsible for Touch

HYPODERMIS:

Called subcutaneous, Sub- or superficial fascia
Anchors skin to underlying structures
Contains adipose tissue and blood vessels
Common site for injection

Exam Important

The portion of the skin that serves as a barrier to water loss is the Epidermis
Melanoblast cells appear in basal layer of epidermis during 3rd month of intrauterine life
Lymphatics are found in Dermis of skin
Stratum corneum is underdeveloped in the VLBW infants in the initial 7 days
Normal turnover time of epidermis (skin doubling time) is 4 weeks
Function of the epidermis layer of the skin provides a waterproof barrier and creates our skin tone.
Haascheiben cells in epidermis are responsible for Touch
Dead layer of epidermis is Stratum corneum
Skin and facia of great toe drains into Vertical group of superficial inguinal lymph nodes
It has been calculated that a human adult has about 10¹² bacteria on the skin
Density of bacterial population at most sites is between 100-1000 per square cm.

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Integumentary System