Skin anatomy and physiology

Skin anatomy and physiology

Boards Physiology

Boards Physiology

Cardiovascular system anatomy and physiology
Lymphatic system anatomy and physiology
Coronary circulation
Blood pressure, blood flow, and resistance
Pressures in the cardiovascular system
Laminar flow and Reynolds number
Resistance to blood flow
Compliance of blood vessels
Control of blood flow circulation
Microcirculation and Starling forces
Measuring cardiac output (Fick principle)
Stroke volume, ejection fraction, and cardiac output
Cardiac contractility
Frank-Starling relationship
Cardiac preload
Cardiac afterload
Law of Laplace
Cardiac and vascular function curves
Altering cardiac and vascular function curves
Cardiac cycle
Cardiac work
Pressure-volume loops
Changes in pressure-volume loops
Physiological changes during exercise
Cardiovascular changes during hemorrhage
Cardiovascular changes during postural change
Normal heart sounds
Abnormal heart sounds
Action potentials in myocytes
Action potentials in pacemaker cells
Excitability and refractory periods
Cardiac excitation-contraction coupling
Cardiac conduction system
Cardiac conduction velocity
ECG basics
ECG normal sinus rhythm
ECG intervals
ECG QRS transition
ECG axis
ECG rate and rhythm
ECG cardiac infarction and ischemia
ECG cardiac hypertrophy and enlargement
Baroreceptors
Chemoreceptors
Renin-angiotensin-aldosterone system
Endocrine system anatomy and physiology
Hunger and satiety
Adrenocorticotropic hormone
Growth hormone and somatostatin
Oxytocin and prolactin
Antidiuretic hormone
Thyroid hormones
Insulin
Glucagon
Somatostatin
Synthesis of adrenocortical hormones
Cortisol
Testosterone
Estrogen and progesterone
Phosphate, calcium and magnesium homeostasis
Parathyroid hormone
Vitamin D
Calcitonin
Anatomy and physiology of the eye
Photoreception
Optic pathways and visual fields
Anatomy and physiology of the ear
Auditory transduction and pathways
Vestibular transduction
Vestibulo-ocular reflex and nystagmus
Olfactory transduction and pathways
Taste and the tongue
Gastrointestinal system anatomy and physiology
Anatomy and physiology of the teeth
Liver anatomy and physiology
Enteric nervous system
Esophageal motility
Gastric motility
Gastrointestinal hormones
Chewing and swallowing
Carbohydrates and sugars
Fats and lipids
Proteins
Vitamins and minerals
Intestinal fluid balance
Pancreatic secretion
Bile secretion and enterohepatic circulation
Prebiotics and probiotics
Blood components
Erythropoietin
Blood groups and transfusions
Platelet plug formation (primary hemostasis)
Coagulation (secondary hemostasis)
Role of Vitamin K in coagulation
Clot retraction and fibrinolysis
Introduction to the immune system
Cytokines
Innate immune system
Complement system
T-cell development
B-cell development
MHC class I and MHC class II molecules
T-cell activation
B-cell activation, differentiation, and contraction
Cell-mediated immunity of CD4 cells
Cell-mediated immunity of natural killer and CD8 cells
Antibody classes
Somatic hypermutation and affinity maturation
VDJ rearrangement
Contracting the immune response and peripheral tolerance
B- and T-cell memory
Anergy, exhaustion, and clonal deletion
Vaccinations
Type I hypersensitivity
Type II hypersensitivity
Type III hypersensitivity
Type IV hypersensitivity
Skin anatomy and physiology
Hair, skin and nails
Wound healing
Skeletal system anatomy and physiology
Bone remodeling and repair
Cartilage structure and growth
Fibrous, cartilage, and synovial joints
Muscular system anatomy and physiology
Brachial plexus
Neuromuscular junction and motor unit
Sliding filament model of muscle contraction
Slow twitch and fast twitch muscle fibers
Muscle contraction
Muscle spindles and golgi tendon organs
Nervous system anatomy and physiology
Neuron action potential
Cerebral circulation
Blood brain barrier
Cerebrospinal fluid
Cranial nerves
Ascending and descending spinal tracts
Motor cortex
Pyramidal and extrapyramidal tracts
Spinal cord reflexes
Sensory receptor function
Somatosensory receptors
Somatosensory pathways
Sympathetic nervous system
Adrenergic receptors
Parasympathetic nervous system
Cholinergic receptors
Body temperature regulation (thermoregulation)
Cerebellum
Basal ganglia: Direct and indirect pathway of movement
Memory
Sleep
Consciousness
Learning
Stress
Language
Emotion
Attention
Renal system anatomy and physiology
Hydration
Body fluid compartments
Movement of water between body compartments
Renal clearance
Glomerular filtration
TF/Px ratio and TF/Pinulin
Measuring renal plasma flow and renal blood flow
Regulation of renal blood flow
Tubular reabsorption and secretion
Tubular secretion of PAH
Tubular reabsorption of glucose
Urea recycling
Tubular reabsorption and secretion of weak acids and bases
Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule
Sodium homeostasis
Potassium homeostasis
Osmoregulation
Kidney countercurrent multiplication
Free water clearance
Physiologic pH and buffers
Buffering and Henderson-Hasselbalch equation
The role of the kidney in acid-base balance
Acid-base map and compensatory mechanisms
Respiratory acidosis
Metabolic acidosis
Plasma anion gap
Respiratory alkalosis
Metabolic alkalosis
Anatomy and physiology of the male reproductive system
Puberty and Tanner staging
Anatomy and physiology of the female reproductive system
Menstrual cycle
Menopause
Pregnancy
Stages of labor
Breastfeeding
Respiratory system anatomy and physiology
Reading a chest X-ray
Lung volumes and capacities
Anatomic and physiologic dead space
Alveolar surface tension and surfactant
Compliance of lungs and chest wall
Combined pressure-volume curves for the lung and chest wall
Ventilation
Zones of pulmonary blood flow
Regulation of pulmonary blood flow
Pulmonary shunts
Ventilation-perfusion ratios and V/Q mismatch
Breathing cycle
Airflow, pressure, and resistance
Ideal (general) gas law
Boyle's law
Dalton's law
Henry's law
Graham's law
Gas exchange in the lungs, blood and tissues
Diffusion-limited and perfusion-limited gas exchange
Alveolar gas equation
Oxygen binding capacity and oxygen content
Oxygen-hemoglobin dissociation curve
Carbon dioxide transport in blood
Breathing control
Pulmonary chemoreceptors and mechanoreceptors
Pulmonary changes at high altitude and altitude sickness
Pulmonary changes during exercise

Transcript

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The skin makes up around 16% of total body weight, making it the largest organ in the body - although it’s hard to imagine it as a single organ. The skin along with its accessory structures--like oil and sweat glands--makes up the integumentary system. The integumentary system protects the body from infections, helps regulate body temperature, and contains nerve receptors that detect pain, sensation, and pressure.

Now, the skin is divided into three layers--the epidermis, dermis, and hypodermis. The epidermis forms the thin outermost layer of skin. Underneath, is the thicker dermis layer that contains the nerves and blood vessels. And finally, there’s the hypodermis which is made of fat and connective tissue that anchors the skin to the underlying muscle.

The epidermis itself is made of multiple layers of developing keratinocytes - which are flat pancake-shaped cells that are named for the keratin protein that they’re filled with. Keratin is a fibrous protein that allows keratinocytes to protect themselves from getting destroyed when you rub your hands through the sand at the beach. Keratinocytes also make and secrete glycolipids, glyco meaning part sugar and lipid meaning part fat. Glycolipids help to prevent water from easily seeping into and out of the body. Keratinocytes start their life at the lowest layer of the epidermis called the stratum basale, or basal layer, which is made of a single layer of stem cells that continually divide and produce new keratinocytes. These new keratinocytes then migrate upwards to form the other layers of the epidermis. The stratum basale also contains another group of cells - melanocytes, which secrete a protein pigment, or coloring substance, called melanin. Melanin is actually a broad term that constitutes several types of melanin found in people of differing skin color. These subtypes of melanin range in color from black to reddish yellow and their relative quantity define a person’s skin color. When keratinocytes are exposed to the sun, they send a chemical signal to the melanocytes, which stimulates the melanocytes into making more melanin. The melanocytes move the melanin into small sacs called melanosomes, and these get taken up by newly formed keratinocytes. Melanin then acts as a natural sunscreen, because its protein structure disspitates, or scatters, UVB light--which if left unchecked can damage the DNA in the skin cells and lead to skin cancer. Darker types of melanin and greater quantities of of this kind of melanin are produced by individuals living close to the equator because they typically get more sun exposure. However, it’s a fine balance because UVB light helps us generate vitamin D, which is an important regulator of calcium absorption. Keratinocytes contain cholesterol precursor molecules that are activated by UVB into Vitamin D.

As keratinocytes in the stratum basale mature and lose the ability to divide, they migrate into the next layer, called the stratum spinosum which is about 8 to 10 cell layers thick. Keratinocytes in the stratum spinosum layer have tiny proteins on the membrane that look like tiny spines; these help the cells adhere to one another. The stratum spinosum layer also has dendritic cells lurking around - these are star-shaped immune cells, that are constantly patrolling - looking for invading microbes.

The next layer up is the stratum granulosum which is 3 to 5 cell layers thick. Keratinocytes in this layer begin the process of keratinization, which is the process where the keratinocytes flatten out and die, and in the process they create the epidermal skin barrier. To do this, keratinocytes in the stratum granulosum layer produce large amounts of keratin precursor proteins and glycolipid which remain within granules called keratohyalin granules and lamellar granules, respectively. Keratohyalin granules eventually start to aggregate and cross-link forming enormous bundles of keratin within the keratinocyte. Lamellar granules, on the other hand, get secreted and stick to the outer cell surface. It forms a sort of cement between the cells, making them more resistant to external forces and water loss. Over time, the intracellular organelles disintegrate so the cells flatten out and die.

Keratinization leads to development of the stratum lucidum layer which is 2 to 3 cell layers thick of translucent, dead keratinocytes that have secreted most of their lamellar granules. The stratum lucidum is only found in thick skin like on the palms and soles of the feet, because those are the areas that need extra protection. The stratum lucidum is absent in thin skin, which covers the rest of the body, and the other layers are thinner.

Key Takeaways

The skin or the integumentary system is the largest organ of the body that has many important functions in physiology. It protects the body from infections, helps in thermoregulation, and contains nerve receptors that detect pain, sensation, and pressure.

The integumentary system is divided into three major components including the epidermis, dermis, and hypodermis. The epidermis is the most superficial layer and it's responsible for protection from pathogens, and the environment, for vitamin D production, and for giving the skin its color. The dermis lies below the epidermis and controls temperature regulation and helps with sensation. The hypodermis lies below the dermis and provides a point of attachment for the skin to the deeper muscles.

The skin also contains several accessory structures, including hair, and nails. Hair provides protection and insulation, while nails provide support and protection for the tips of the fingers and toes.

Sources

  1. "Medical Physiology" Elsevier (2016)
  2. "Physiology" Elsevier (2017)
  3. "Human Anatomy & Physiology" Pearson (2018)
  4. "Principles of Anatomy and Physiology" Wiley (2014)
  5. "The skin: an indispensable barrier" Experimental Dermatology (2008)