Cheat sheet Integumentary System:

● Protection against injury and infection - The skin protects the body and internal organs from injury and infection.
● Regulates body temperature - When body temperature rises and is hotter than the external environment the
blood vessels in the dermal area dilate and sweat glands are stimulated into activity.
● Sensory perception - simply implies the use of the senses in our possession to gain a better understanding of the
world around us.
● Regulates water loss - controls the amount of water reabsorbed from the collecting ducts and tubules in the
kidney.
● Metabolic/chemical functions - adipose tissues within integumentary system are involved in production of vitamin
D and triglycerides
● Epidermis: The outermost layer which provides, Integumentary Glands and the effects of aging on the skin. The
epidermis does not have its own blood supply (vasculature) it relies solely on the Dermis below for nourishment. There
are 4 layers within the epidermis (5 in thick skin)
○ Stratum corneum: Most superficial layer which is exposed to the outside environment. Composed of
keratinocytes which are cells that produce and store protein. Keratinocytes in this layer are highly keratinized which is
dead cells filled with keratin (protein) filaments forming a tough strong barrier. Keratinization is also called cornification
which is where this layer gets its name. There are 15-30 layers of dry dead cells in this layer which provides barrier to
block entry of microbes or dehydration of underlying tissues.
○ Stratum lucidum: This layer is only found in thick skin (palms, hands, and soles of feet) Smooth translucent
layer. Composed of keratinocytes that are dead, flattened, and packed with eleiden (clear protein rich in lipids that
provides barrier to water)
○ Stratum granulosum (Grainy): This layer is 3-5 cell layers thick made up of keratinocytes that were pushed up
from the layer below (stratum spinosum) become known as granular cells in this layer. These cells become flattened, cell
membranes thicken and they generate large amounts of keratin that is fibrous called keratohyalin. The keratohyalin
accumulates as granules in the cell. These granules give this layer a dark grainy appearance when viewing tissue slides
in microscope. The organelles within the keratinocyte begin to disintegrates as the cell dies.
○ Stratum spinosum: This layer is “spiny” in appearance due to a structure called desmosomes. Desmosomes
interlock with each other and help strengthen the bond between the cells. SS contains 8-10 layers of keratinocytes
formed as a result of cell division in the stratum basale. Keratinocytes begin synthesis of keratin and release glycolipid
that helps prevent water loss and helps make the skin relatively waterproof.
■ Langerhans cell: These cells are interspersed among the keratinocytes of the SS. They are a cleanup crew for
the SS that engulf bacteria, foreign particles, and damaged cells that are found in this layer.
○ Stratum basale: Deepest layer of the epidermis (above the dermis). This layer is mostly made up of basal
cells. Basal cells develop into keratinocytes. All keratinocytes originate from the stratum basale. As basal cells mature
and turn into keratinocytes they are pushed toward the surface into the next layer of epidermis, the stratum spinosum.
■ Other cells found in stratum basale
● Merkel cell: receptors that stimulate sensory nerves that brain recognizes at touch. Merkel cells are especially
abundant on hands and feet
● Melanocyte: Cell that produces the pigment melanin (gives skin color)
● Dermis: The middle layer contains, tough connective tissue, hair follicles, and sweat glands. The dermis
consists of 2 layers
○ Papillary layer: thin outer layer (about 20% of the dermis) contains loose connective tissue and contains many
capillaries (tiny blood vessels). It extends up into the epidermis in small projections called dermal papillae. Contains 2
sensory receptors
● Meissner's corpuscles: touch receptor
● Nerve endings: sensitive to temperature
○ Reticular layer: a thick layer of dense irregular connective tissue contain collagen and elastin that give skin its
strength and extensibility. It also contains fibroblasts, macrophage and fat cells
● Hypodermis: The bottom most layer of integumentary system contains mostly adipose tissue. The arteries that
supply nutrients to the skin are in the hypodermis (some also in deeper parts of dermis).
 a. Skin Color
i.Your skin color is determined by the presence of certain pigments in your skin:
1. Melanin: Yellow to reddish-brown pigment responsible for dark skin colors.
a. Produced by melanocytes, which send the pigment to keratinocytes which consume the melanin pigments.
b. Melanocytes produce more melanin when stimulated by sunlight which protects you from excess UV light.
2. Carotene: Yellow/orange pigment most obvious in your palms and soles of your feet.
3. Hemoglobin: A pigment/oxygen carrier in your blood that gives your skin a reddish tint when there is a lot of
blood flow.
4. The pigments in your skin change to adapt to more or less sunlight in your environment
b. Skin Texture
i.The skin is covered by dead cells that flake off constantly.
ii.Uneven, bumpy skin is caused by buildup of these dead cells.
iii.When your ducts are blocked, you get a whitehead.
iv.If your skin oxidizes and dries up, you get a blackhead.
v.If a blocked duct gets infected, you get a pimple.
c. Hair
i.Strands of dead keratin produced by hair follicles.
ii.Contains harder keratin than the skin.
iii.Root in skin contains the growing cells that push your hair outwards.
iv.Has a core (medulla), cortex (middle), and a cuticle (outer layer).
v.Maintains warmth, alerts body of insect presence, and guards scalp against physical trauma and sunlight.
vi.Types of Hair:
1. Vellus: Pale, fine body hair.
2. Terminal: Coarse, long hair of eyebrows, scalp, and axillary regions.
vii.Alopecia: Hair thinning in both genders.
viii.True baldness is genetically determined and only occurs in males.
d. Nails
i.Modification of the epidermis on the distal, dorsal surface of fingers and toes (top ends).
ii.Protect the ends of your fingers.
e. Aging, changes to skin as it ages

1. Skin becomes rougher.

2. Skin develops lesions such as benign tumors.
3. Skin becomes slack. The loss of the elastic tissue (elastin and collagen) in the skin with age causes the skin to
hang loosely.
4. Skin becomes more transparent as we age. This is caused by thinning of the epidermis (surface layer of the
skin).
5. Skin becomes more fragile as we age. This is caused by a flattening of the area where the epidermis and dermis
(layer of skin under the epidermis) come together.
6. Skin becomes more easily bruised. This is due to thinner blood vessel walls as we age.
ii. Subcutaneous (Below the Skin) Changes is:
1. Loss of fat below the skin in the cheeks, temples, chin, nose and eye area may result in loosening skin, sunken
eyes and a "skeletal" appearance.
2. Bone loss, mostly around the mouth and chin, may become evident after age 60 and cause puckering of the skin
around the mouth.
3. Cartilage loss in the nose causes drooping of the nasal tip and accentuation of the bony structures in the nose.

Burns - too much sunlight or heat

a. 1st degree - Skin is inflamed or red - surface layer of skin is shed
b. 2nd degree - deeper injury - blisters form as fluids build up under epidermis outer layers
c. 3rd degree - full thickness of skin:p is destroyed - sometimes subcutaneous tissues are wounded
d. 4th degree - involves injury to deeper tissue, such as muscle or bone
Allergens/Allergies - skin becomes irritated after direct contact with a substance, irritant and allergies
Irritant dermatitis - caused by contact with acids, alkaline materials such as soaps, usually looks like a burn
Skin Imbalances - The skin can develop >1000 different ailments. the most common skin disorders result from allergies
or infections less common are burns and skin cancers.
Skin lesions – any measurable variation from normal structure of the skin
● Elevated lesions – cast a shadow outside the edges as warts, plaque, blister
● Flat lesions – do not cast a shadow as a scab, elevated lesion with pus, hive
● Depressed lesions – cast a shadow within their edges as lacerations, ulcers, fissures
Infections
● Viral - eg. cold sores, herpes simplex, especially around the lips and oral mucosa. A viral infection is a
proliferation (growth) of a harmful virus inside the body. Viruses cannot reproduce without the assistance of a host.
Viruses infect a host by introducing their genetic material into the cells and hijacking the cell's internal machinery to make
more virus particles.
● Warts – New or foreign growth caused by papillomavirus (HPV)
● Fungal - eg. athletes foot, Tinea. Fungal infections occur when an invading fungus takes over an area of the
body and is too much for the immune system to handle.
● Bacterial- eg. boils and carbuncles inflammation of hair follicle and sebaceous glands especially on face or
dorsal side of neck, impetigo Streptococcus infection. A bacterial infection is a growth of a harmful strain of bacteria on or
inside the body. Bacteria can infect any area of the body.
Examples of Infections
Boils (also called Furuncle)- A painful, pus-filled bump under the skin caused by infected, inflamed hair follicles. Boils
start as red, tender lumps. These fill with pus, grow, then rupture and drain. A carbuncle is a cluster of boils. Boils are a
bacterial infection caused by a bacteria called Staphylococcus (staph).
Athlete’s Foot- Athlete's foot (tinea pedis) is a fungal infection that usually begins between the toes. It commonly occurs
in people whose feet have become very sweaty while confined within tightfitting shoes. Signs and symptoms of athlete's
foot include a scaly rash that usually causes itching, stinging and burning.
Impetigo- a common and highly contagious skin infection that mainly affects infants and children. Impetigo usually
appears as red sores on the face, especially around a child's nose and mouth, and on hands and feet. The sores burst
and develop honey-colored crusts. Impetigo is a bacterial infection caused by Staphylococcus (staph) and Streptococcus
(strep) bacteria.
Contact Dermatitis
Contact dermatitis is a condition in which the skin becomes red, sore, or inflamed after direct contact with a substance.
There are two kinds of contact dermatitis: irritant or allergies.
Irritant dermatitis is the most common type. It's caused by contact with acids, alkaline materials such as soaps and
detergents, fabric softeners, solvents, or other chemicals. The reaction usually looks like a burn.
Other irritants may include:
● Cement Hair dyes
● Long-term exposure to wet diapers
● Pesticides or weed killers
● Rubber gloves
● Shampoos
Allergic contact dermatitis is caused by exposure to a substance or material to which you have become extra sensitive
or allergic.
Common allergens include:
● Adhesives, including those used for false eyelashes or toupees
● Antibiotics such as neomycin rubbed on the surface of the skin
● Balsam of Peru (used in many personal products and cosmetics, as well as in many foods and drinks)
● Fabrics and clothing
● Fragrances in perfumes, cosmetics, soaps, and moisturizers
● Nail polish, hair dyes, and permanent wave solutions
● Nickel or other metals (found in jewelry, watch straps, metal zips, bra hooks, buttons, pocket-knives, lipstick
holders, and powder compacts)
● Poison ivy, poison oak, poison sumac, and other plants
● Rubber or latex gloves or shoes
Treatment:
● Washing with lots of water to remove any traces of the irritant that may remain on the skin
● Avoid further exposure to known irritants or allergens
● Anti-itch (antipruritic) or drying lotions may be recommended to reduce other symptoms
● Corticosteroid skin creams or ointments may reduce inflammation
● Corticosteroid pills or a corticosteroid shot from the doctor may be needed in severe cases

Skin Cancer
Basal Cell Carcinoma
● least hostile/fatal
● most common -78% of all skin cancers
● stratum basale can’t form keratin
● lose boundary layer between epidermis and dermis
● results in tissue erosion and ulceration
● 99% of these cancers are fully cured
Ulceration- The formation of a break on the skin or on the surface of an organ. An ulcer forms when the surface cells die
and are cast off. Ulcers may be associated with cancer and other diseases.
Squamous Cell Carcinoma -20% of all skin cancers
● cancer of the cells in stratum spinosum
● arise from squamous cells of the epidermis
● usually induced by sun cells grow rapidly and grow into the lymphatic tissues
● hardened small red growth
● spreads rapidly if not removed
● good chance of recovery if detected and treated early
Malignant Melanoma
● cancer of pigment cells = melanocytes
● rare ~1% of skin cancers
● deadly, poor chance of cure once it develops
● often begins with moles
● spreads rapidly
● early detection and treatment is the key to survival