INTEGUMENT. Surface Anatomy Palpation Palpation Bony landmarks Bony landmarks Dermatomes Dermatomes...
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Transcript of INTEGUMENT. Surface Anatomy Palpation Palpation Bony landmarks Bony landmarks Dermatomes Dermatomes...
INTEGUMENTINTEGUMENT
Surface AnatomySurface Anatomy
PalpationPalpationBony landmarksBony landmarksDermatomesDermatomes
Neural assessmentNeural assessment
Integument HistologyIntegument Histology
Epidermis:Epidermis:Stratified squamous epitheliumStratified squamous epithelium
Resting on:Resting on:Basement membraneBasement membrane
Resting on:Resting on:Dermis:Dermis:
Dense irregular connective tissueDense irregular connective tissue
EpidermisEpidermis
The epidermis is a stratified squamous The epidermis is a stratified squamous epithelium.epithelium.
It is made up of many layers of cells.It is made up of many layers of cells.The stratum germinativum is the deepest The stratum germinativum is the deepest
layer:layer:Area of high mitotic activity.Area of high mitotic activity.
EpidermisEpidermis
The stratum corneum is the most The stratum corneum is the most superficial layer:superficial layer:
The cells in this layer are dead and The cells in this layer are dead and keratinized.keratinized.
Between the stratum germinativum and Between the stratum germinativum and the stratum corneum are several the stratum corneum are several transitional layers represented by cells transitional layers represented by cells from the stratum germinativum that are from the stratum germinativum that are transforming into dead, keratinized cells.transforming into dead, keratinized cells.
EpidermisEpidermis
The epidermis is innervated.The epidermis is innervated.The epidermis is avascular.The epidermis is avascular.
DermisDermis
The dermis is the deepest region of the The dermis is the deepest region of the integument.integument.
The dermis is classified as dense irregular The dermis is classified as dense irregular connective tissueconnective tissue
The dermis has an abundance of collagen The dermis has an abundance of collagen fibersfibers
There may also be some elastic fibers:There may also be some elastic fibers:Decrease with age.Decrease with age.
DermisDermis
The dermis is vascularized.The dermis is vascularized.Refer to Figure 1 in your course packet.Refer to Figure 1 in your course packet.
Thick Skin vs. Thin SkinThick Skin vs. Thin Skin
Classification into thin and thick skin Classification into thin and thick skin depends on the structure of the epidermis.depends on the structure of the epidermis.
Layers of epidermis are well-formed in Layers of epidermis are well-formed in thick skin.thick skin.
Layers of epidermis are not as well-formed Layers of epidermis are not as well-formed or thick in thin skin.or thick in thin skin.
Thick SkinThick Skin
Thick skin is found only on the palms of Thick skin is found only on the palms of the hands and the soles of the feet.the hands and the soles of the feet.
The epidermis of thick skin is 0.4 – 0.6 mm The epidermis of thick skin is 0.4 – 0.6 mm thickthick
Thick skin has no hair follicles.Thick skin has no hair follicles.
Thin SkinThin Skin
Thin skin is found over the rest of the Thin skin is found over the rest of the body.body.
The epidermis of thin skin is 0.075 – 0.150 The epidermis of thin skin is 0.075 – 0.150 mm thick.mm thick.
Total skin thickness is 0.5 – 3 mm thick.Total skin thickness is 0.5 – 3 mm thick.
Skin ThicknessSkin Thickness
Thickest skin found on back (= thin skin)Thickest skin found on back (= thin skin)Thinnest skin found on eyelids (= thin skin)Thinnest skin found on eyelids (= thin skin)Thicker on extensor surfaces than flexor Thicker on extensor surfaces than flexor
surfaces.surfaces.
Superficial Fascia: SynonymsSuperficial Fascia: Synonyms
Subcutaneous fasciaSubcutaneous fasciaSuperficial fasciaSuperficial fasciaHypodermisHypodermisSubQ SubQ
Superficial FasciaSuperficial Fascia
Consists of loose bundles of collagen and Consists of loose bundles of collagen and elastic fibers with variably sized elastic fibers with variably sized aggregations of lipocytes (fat cells)aggregations of lipocytes (fat cells)
May be loosely or tightly attachedMay be loosely or tightly attachedSupports cutaneous nerves and blood Supports cutaneous nerves and blood
vesselsvessels
Deep FasciaDeep Fascia
Synonyms:Synonyms:Membranous fasciaMembranous fascia
Investing fasciaInvesting fasciaUsually several thin layers of tough Usually several thin layers of tough
collagen materialcollagen materialTightly adherent to muscles, bones, Tightly adherent to muscles, bones,
tendons, etc.tendons, etc.
Cutaneous DerivativesCutaneous Derivatives
Glands.Glands.Hairs.Hairs.Nails.Nails.
GlandsGlands
Glands are epithelial structuresGlands are epithelial structuresGlands are classified according to the Glands are classified according to the
presence or absence of a secretory duct:presence or absence of a secretory duct:
ExocrineExocrine
Endocrine Endocrine
Epidermal GlandsEpidermal Glands
Sudoriferous glandsSudoriferous glandsSebaceous glandsSebaceous glandsCeruminous glandsCeruminous glandsMammary glandsMammary glands
Sudoriferous GlandsSudoriferous Glands
Are long, simple, tubular glands.Are long, simple, tubular glands.
Their method of secretion is merocrine .Their method of secretion is merocrine .
Sebaceous GlandsSebaceous Glands
Are holocrine .Are holocrine .
Sebaceous glands are associated with Sebaceous glands are associated with hair follicles.hair follicles.
Ceruminous GlandsCeruminous Glands
Are located in the external auditory canal.Are located in the external auditory canal.
Secrete ear wax. Secrete ear wax.
Mammary GlandsMammary Glands
Are modified sweat glandsAre modified sweat glands
Method of secretion is apocrine Method of secretion is apocrine
HairsHairs
Hairs develop during 3Hairs develop during 3rdrd month of month of gestation.gestation.
The earliest fine embryonic hair = lanugo.The earliest fine embryonic hair = lanugo.
Lanugo is Shed before birth except around Lanugo is Shed before birth except around eyebrows, scalp, and eyelids.eyebrows, scalp, and eyelids.
HairsHairs
A new downy coat of hair appears a few A new downy coat of hair appears a few months after birth.months after birth.
This new coat is called vellus.This new coat is called vellus.Vellus is converted to terminal hair at Vellus is converted to terminal hair at
puberty:puberty:Vellus represents 95% of the hair Vellus represents 95% of the hair
coverage coverage in males.in males.Vellus represents 35% of the hair Vellus represents 35% of the hair
coverage coverage in females.in females.
Parts of a HairParts of a Hair
Shaft:Shaft:Made up of dead cornified epidermal cells.Made up of dead cornified epidermal cells.
Follicle:Follicle:Derived from both epidermis and dermis.Derived from both epidermis and dermis.
Dermal papilla with matrix.Dermal papilla with matrix.
Parts of a HairParts of a Hair
Arrector pili muscle.Arrector pili muscle.Sebaceous glands.Sebaceous glands.Hair bulb and connective tissue papilla.Hair bulb and connective tissue papilla.
Hair GrowthHair Growth
Anlagen Anlagen Active growth:Active growth:
Scalp hair = 2-3 yearsScalp hair = 2-3 years
Eyebrow hair = 3-4 monthsEyebrow hair = 3-4 months
Hair Function and LocationHair Function and Location
Hair follicles are innervated, and hairs Hair follicles are innervated, and hairs serve as sensory receptors.serve as sensory receptors.
Hairs are found everywhere except palms, Hairs are found everywhere except palms, soles, dorsal distal phalanges, anal and soles, dorsal distal phalanges, anal and urogenital aperturesurogenital apertures
NailsNails
Ungis:Ungis:
Modified stratum corneumModified stratum corneum
Flattened Flattened
Avascular and not innervatedAvascular and not innervated
Travels over a nail bed guided by lateral Travels over a nail bed guided by lateral nail nail groovesgrooves
Matrix:Matrix:Stratum germinativum produces ungisStratum germinativum produces ungis
Subungis Subungis
MelanocytesMelanocytes
Found in deep layers of epidermisFound in deep layers of epidermisDerived from nervous system componentsDerived from nervous system componentsForm:Form:
Melanosomes:Melanosomes: Passed off to keratinocytes (cells of Passed off to keratinocytes (cells of epidermis).epidermis).
Phagocytized by keratinocytes.Phagocytized by keratinocytes.
MelanocytesMelanocytes
All individuals produce same number of All individuals produce same number of melanosomes.melanosomes.
Skin color depends on number of Skin color depends on number of remaining melanosomes.remaining melanosomes.
Langer’s LinesLanger’s Lines
Represent tension lines created by Represent tension lines created by orientation of collagen fibers in the dermis orientation of collagen fibers in the dermis of the skin.of the skin.
Used by surgeons as guides for incisions:Used by surgeons as guides for incisions:Incisions normally made parallel to Incisions normally made parallel to
Langer’s Langer’s lineslines
DermatomesDermatomes
Specific region of skin innervated by a Specific region of skin innervated by a specific spinal cord level.specific spinal cord level.
Refer in syllabus to figure 3Refer in syllabus to figure 3