Skin anatomy and physiology

Skin anatomy and physiology

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Diagnoses

Anatomy of the coronary circulation
Anatomy clinical correlates: Heart
Coronary artery disease: Pathology review
Anticoagulants: Direct factor inhibitors
Anticoagulants: Heparin
Antiplatelet medications
Thrombolytics
Renal failure: Pathology review
ACE inhibitors, ARBs and direct renin inhibitors
Anatomy of the lungs and tracheobronchial tree
Anatomy clinical correlates: Pleura and lungs
Alveolar surface tension and surfactant
Breathing cycle and regulation
Gas exchange in the lungs, blood and tissues
Pulmonary shunts
Regulation of pulmonary blood flow
Respiratory system anatomy and physiology
Ventilation
Ventilation-perfusion ratios and V/Q mismatch
Zones of pulmonary blood flow
Obstructive lung diseases: Pathology review
Anatomy of the abdominal viscera: Liver, biliary ducts and gallbladder
Anatomy clinical correlates: Other abdominal organs
Bile secretion and enterohepatic circulation
Liver anatomy and physiology
Cirrhosis: Pathology review
Anatomy of the heart
Anatomy of the coronary circulation
Anatomy of the inferior mediastinum
Anatomy of the superior mediastinum
Anatomy clinical correlates: Heart
Anatomy clinical correlates: Mediastinum
Cardiac afterload
Cardiac contractility
Cardiac cycle
Cardiac preload
Cardiac work
Cardiovascular system anatomy and physiology
Changes in pressure-volume loops
Frank-Starling relationship
Measuring cardiac output (Fick principle)
Microcirculation and Starling forces
Pressure-volume loops
Stroke volume, ejection fraction, and cardiac output
Heart failure: Pathology review
Anatomy of the coronary circulation
Anatomy clinical correlates: Heart
Cardiovascular system anatomy and physiology
Atherosclerosis and arteriosclerosis: Pathology review
Coronary artery disease: Pathology review
Anatomy of the cerebral cortex
Anatomy of the limbic system
Anatomy clinical correlates: Cerebral hemispheres
Dementia: Pathology review
Mood disorders: Pathology review
Selective serotonin reuptake inhibitors
Serotonin and norepinephrine reuptake inhibitors
Tricyclic antidepressants
Monoamine oxidase inhibitors
Atypical antidepressants
Pancreas histology
Diabetes mellitus: Pathology review
Dyslipidemias: Pathology review
Lipid-lowering medications: Fibrates
Lipid-lowering medications: Statins
Miscellaneous lipid-lowering medications
Enteric nervous system
Esophageal motility
Gastrointestinal system anatomy and physiology
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Hypertension: Pathology review
ACE inhibitors, ARBs and direct renin inhibitors
Adrenergic antagonists: Beta blockers
Calcium channel blockers
Thiazide and thiazide-like diuretics
Anatomy of the thyroid and parathyroid glands
Thyroid and parathyroid gland histology
Endocrine system anatomy and physiology
Thyroid hormones
Hyperthyroidism: Pathology review
Anatomy of the thyroid and parathyroid glands
Thyroid and parathyroid gland histology
Endocrine system anatomy and physiology
Thyroid hormones
Hypothyroidism: Pathology review
Introduction to the skeletal system
Bone remodeling and repair
Bone disorders: Pathology review
Anatomy of the abdominal viscera: Pancreas and spleen
Anatomy clinical correlates: Other abdominal organs
Pancreas histology
Pancreatic secretion
Pancreatitis: Pathology review
Anatomy of the diaphragm
Anatomy of the larynx and trachea
Anatomy of the lungs and tracheobronchial tree
Anatomy of the nose and paranasal sinuses
Anatomy of the pleura
Bones and joints of the thoracic wall
Muscles of the thoracic wall
Vessels and nerves of the thoracic wall
Anatomy clinical correlates: Pleura and lungs
Anatomy clinical correlates: Thoracic wall
Alveolar surface tension and surfactant
Anatomic and physiologic dead space
Breathing cycle and regulation
Gas exchange in the lungs, blood and tissues
Lung volumes and capacities
Pulmonary shunts
Regulation of pulmonary blood flow
Respiratory system anatomy and physiology
Ventilation
Ventilation-perfusion ratios and V/Q mismatch
Zones of pulmonary blood flow
Pneumonia: Pathology review
Drug misuse, intoxication and withdrawal: Alcohol: Pathology review
Drug misuse, intoxication and withdrawal: Hallucinogens: Pathology review
Drug misuse, intoxication and withdrawal: Other depressants: Pathology review
Drug misuse, intoxication and withdrawal: Stimulants: Pathology review
Atypical antidepressants
Nasal, oral and pharyngeal diseases: Pathology review
Anatomy of the abdominal viscera: Kidneys, ureters and suprarenal glands
Anatomy of the female urogenital triangle
Anatomy of the male urogenital triangle
Anatomy of the perineum
Anatomy of the urinary organs of the pelvis
Anatomy clinical correlates: Female pelvis and perineum
Anatomy clinical correlates: Male pelvis and perineum
Renal system anatomy and physiology
Urinary tract infections: Pathology review
Anatomy of the lungs and tracheobronchial tree
Fascia, vessels and nerves of the upper limb
Vessels and nerves of the forearm
Vessels and nerves of the gluteal region and posterior thigh
Anatomy clinical correlates: Pleura and lungs
Clot retraction and fibrinolysis
Coagulation (secondary hemostasis)
Platelet plug formation (primary hemostasis)
Deep vein thrombosis and pulmonary embolism: Pathology review
Anticoagulants: Direct factor inhibitors
Anticoagulants: Heparin
Anticoagulants: Warfarin

Clinical conditions

Abdominal quadrants, regions and planes
Anatomy of the abdominal viscera: Blood supply of the foregut, midgut and hindgut
Anatomy of the abdominal viscera: Esophagus and stomach
Anatomy of the abdominal viscera: Innervation of the abdominal viscera
Anatomy of the abdominal viscera: Large intestine
Anatomy of the abdominal viscera: Liver, biliary ducts and gallbladder
Anatomy of the abdominal viscera: Pancreas and spleen
Anatomy of the abdominal viscera: Small intestine
Anatomy of the anterolateral abdominal wall
Anatomy of the diaphragm
Anatomy of the gastrointestinal organs of the pelvis and perineum
Anatomy of the inguinal region
Anatomy of the muscles and nerves of the posterior abdominal wall
Anatomy of the peritoneum and peritoneal cavity
Anatomy of the vessels of the posterior abdominal wall
Anatomy clinical correlates: Anterior and posterior abdominal wall
Anatomy clinical correlates: Inguinal region
Anatomy clinical correlates: Other abdominal organs
Anatomy clinical correlates: Peritoneum and diaphragm
Anatomy clinical correlates: Viscera of the gastrointestinal tract
Appendicitis: Pathology review
Diverticular disease: Pathology review
Gallbladder disorders: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Inflammatory bowel disease: Pathology review
Pancreatitis: Pathology review
Acid-base map and compensatory mechanisms
Buffering and Henderson-Hasselbalch equation
Physiologic pH and buffers
The role of the kidney in acid-base balance
Acid-base disturbances: Pathology review
Anatomy of the abdominal viscera: Kidneys, ureters and suprarenal glands
Kidney histology
Renal system anatomy and physiology
Renal failure: Pathology review
Anatomy of the basal ganglia
Anatomy of the blood supply to the brain
Anatomy of the brainstem
Anatomy of the cerebellum
Anatomy of the cerebral cortex
Anatomy of the cranial meninges and dural venous sinuses
Anatomy of the diencephalon
Anatomy of the limbic system
Anatomy of the ventricular system
Anatomy of the white matter tracts
Anatomy clinical correlates: Anterior blood supply to the brain
Anatomy clinical correlates: Cerebellum and brainstem
Anatomy clinical correlates: Cerebral hemispheres
Anatomy clinical correlates: Posterior blood supply to the brain
Nervous system anatomy and physiology
Amnesia, dissociative disorders and delirium: Pathology review
Central nervous system infections: Pathology review
Cerebral vascular disease: Pathology review
Dementia: Pathology review
Drug misuse, intoxication and withdrawal: Alcohol: Pathology review
Drug misuse, intoxication and withdrawal: Hallucinogens: Pathology review
Drug misuse, intoxication and withdrawal: Other depressants: Pathology review
Drug misuse, intoxication and withdrawal: Stimulants: Pathology review
Mood disorders: Pathology review
Schizophrenia spectrum disorders: Pathology review
Seizures: Pathology review
Traumatic brain injury: Pathology review
Anticonvulsants and anxiolytics: Benzodiazepines
Atypical antipsychotics
Typical antipsychotics
Blood histology
Blood components
Erythropoietin
Extrinsic hemolytic normocytic anemia: Pathology review
Intrinsic hemolytic normocytic anemia: Pathology review
Macrocytic anemia: Pathology review
Microcytic anemia: Pathology review
Non-hemolytic normocytic anemia: Pathology review
Introduction to the central and peripheral nervous systems
Introduction to the muscular system
Introduction to the skeletal system
Introduction to the somatic and autonomic nervous systems
Anatomy of the ascending spinal cord pathways
Anatomy of the descending spinal cord pathways
Anatomy of the muscles and nerves of the posterior abdominal wall
Anatomy of the vertebral canal
Anatomy of the vessels of the posterior abdominal wall
Bones of the vertebral column
Joints of the vertebral column
Muscles of the back
Vessels and nerves of the vertebral column
Anatomy clinical correlates: Anterior and posterior abdominal wall
Anatomy clinical correlates: Bones, joints and muscles of the back
Anatomy clinical correlates: Spinal cord pathways
Anatomy clinical correlates: Vertebral canal
Back pain: Pathology review
Positive and negative predictive value
Sensitivity and specificity
Test precision and accuracy
Type I and type II errors
Anatomy of the breast
Anatomy of the coronary circulation
Anatomy of the heart
Anatomy of the inferior mediastinum
Anatomy of the lungs and tracheobronchial tree
Anatomy of the pleura
Anatomy of the superior mediastinum
Bones and joints of the thoracic wall
Muscles of the thoracic wall
Vessels and nerves of the thoracic wall
Anatomy clinical correlates: Breast
Anatomy clinical correlates: Heart
Anatomy clinical correlates: Mediastinum
Anatomy clinical correlates: Pleura and lungs
Anatomy clinical correlates: Thoracic wall
Cardiovascular system anatomy and physiology
Respiratory system anatomy and physiology
Aortic dissections and aneurysms: Pathology review
Coronary artery disease: Pathology review
Deep vein thrombosis and pulmonary embolism: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review
Anatomy of the abdominal viscera: Esophagus and stomach
Anatomy of the abdominal viscera: Large intestine
Anatomy of the abdominal viscera: Small intestine
Anatomy of the gastrointestinal organs of the pelvis and perineum
Gastrointestinal system anatomy and physiology
Enteric nervous system
Colorectal polyps and cancer: Pathology review
Diverticular disease: Pathology review
Laxatives and cathartics
Anatomy of the diaphragm
Anatomy of the larynx and trachea
Anatomy of the lungs and tracheobronchial tree
Anatomy of the nose and paranasal sinuses
Anatomy of the pleura
Bones and joints of the thoracic wall
Muscles of the thoracic wall
Vessels and nerves of the thoracic wall
Anatomy clinical correlates: Pleura and lungs
Anatomy clinical correlates: Thoracic wall
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Lung cancer and mesothelioma: Pathology review
Nasal, oral and pharyngeal diseases: Pathology review
Obstructive lung diseases: Pathology review
Pneumonia: Pathology review
Restrictive lung diseases: Pathology review
Anatomy of the abdominal viscera: Large intestine
Anatomy of the abdominal viscera: Small intestine
Anatomy of the gastrointestinal organs of the pelvis and perineum
Bile secretion and enterohepatic circulation
Enteric nervous system
Gastrointestinal system anatomy and physiology
Inflammatory bowel disease: Pathology review
Malabsorption syndromes: Pathology review
Bacillus cereus (Food poisoning)
Campylobacter jejuni
Clostridium difficile (Pseudomembranous colitis)
Clostridium perfringens
Escherichia coli
Norovirus
Salmonella (non-typhoidal)
Shigella
Staphylococcus aureus
Vibrio cholerae (Cholera)
Yersinia enterocolitica
Anatomy of the heart
Anatomy of the lungs and tracheobronchial tree
Anatomy of the pleura
Anatomy clinical correlates: Heart
Anatomy clinical correlates: Mediastinum
Anatomy clinical correlates: Pleura and lungs
Anatomy clinical correlates: Thoracic wall
Alveolar surface tension and surfactant
Anatomic and physiologic dead space
Breathing cycle and regulation
Diffusion-limited and perfusion-limited gas exchange
Gas exchange in the lungs, blood and tissues
Pulmonary shunts
Regulation of pulmonary blood flow
Respiratory system anatomy and physiology
Ventilation
Ventilation-perfusion ratios and V/Q mismatch
Zones of pulmonary blood flow
Cardiac afterload
Cardiac contractility
Cardiac cycle
Cardiac preload
Cardiac work
Frank-Starling relationship
Measuring cardiac output (Fick principle)
Pressure-volume loops
Stroke volume, ejection fraction, and cardiac output
Acid-base map and compensatory mechanisms
Buffering and Henderson-Hasselbalch equation
Physiologic pH and buffers
The role of the kidney in acid-base balance
Apnea, hypoventilation and pulmonary hypertension: Pathology review
Deep vein thrombosis and pulmonary embolism: Pathology review
Heart failure: Pathology review
Lung cancer and mesothelioma: Pathology review
Obstructive lung diseases: Pathology review
Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review
Pneumonia: Pathology review
Restrictive lung diseases: Pathology review
Tuberculosis: Pathology review
Introduction to the cardiovascular system
Introduction to the lymphatic system
Microcirculation and Starling forces
Cirrhosis: Pathology review
Deep vein thrombosis and pulmonary embolism: Pathology review
Heart failure: Pathology review
Hypothyroidism: Pathology review
Nephrotic syndromes: Pathology review
Renal failure: Pathology review
Antidiuretic hormone
Phosphate, calcium and magnesium homeostasis
Potassium homeostasis
Renin-angiotensin-aldosterone system
Sodium homeostasis
Diabetes insipidus and SIADH: Pathology review
Electrolyte disturbances: Pathology review
Parathyroid disorders and calcium imbalance: Pathology review
Anxiety disorders, phobias and stress-related disorders: Pathology Review
Apnea, hypoventilation and pulmonary hypertension: Pathology review
Mood disorders: Pathology review
Psychological sleep disorders: Pathology review
Adrenergic antagonists: Beta blockers
Anticonvulsants and anxiolytics: Barbiturates
Anticonvulsants and anxiolytics: Benzodiazepines
Antihistamines for allergies
Nonbenzodiazepine anticonvulsants
Opioid agonists, mixed agonist-antagonists and partial agonists
Tricyclic antidepressants
Cytokines
Inflammation
Anatomy of the abdominal viscera: Blood supply of the foregut, midgut and hindgut
Anatomy of the abdominal viscera: Esophagus and stomach
Anatomy of the abdominal viscera: Large intestine
Anatomy of the abdominal viscera: Small intestine
Anatomy of the gastrointestinal organs of the pelvis and perineum
Anatomy of the vessels of the posterior abdominal wall
Anatomy clinical correlates: Viscera of the gastrointestinal tract
Gastrointestinal bleeding: Pathology review
Anatomy of the blood supply to the brain
Anatomy of the cranial base
Anatomy of the cranial meninges and dural venous sinuses
Anatomy of the nose and paranasal sinuses
Anatomy of the suboccipital region
Anatomy of the temporomandibular joint and muscles of mastication
Anatomy of the trigeminal nerve (CN V)
Bones of the cranium
Bones of the neck
Deep structures of the neck: Prevertebral muscles
Muscles of the face and scalp
Nerves and vessels of the face and scalp
Superficial structures of the neck: Cervical plexus
Anatomy clinical correlates: Bones, fascia and muscles of the neck
Anatomy clinical correlates: Skull, face and scalp
Anatomy clinical correlates: Temporal regions, oral cavity and nose
Anatomy clinical correlates: Trigeminal nerve (CN V)
Anatomy clinical correlates: Vessels, nerves and lymphatics of the neck
Headaches: Pathology review
Anatomy of the abdominal viscera: Liver, biliary ducts and gallbladder
Anatomy of the abdominal viscera: Pancreas and spleen
Anatomy clinical correlates: Other abdominal organs
Gallbladder histology
Liver histology
Bile secretion and enterohepatic circulation
Liver anatomy and physiology
Pancreatic secretion
Jaundice: Pathology review
Anatomy of the elbow joint
Anatomy of the glenohumeral joint
Anatomy of the hip joint
Anatomy of the knee joint
Anatomy of the radioulnar joints
Anatomy of the sternoclavicular and acromioclavicular joints
Anatomy of the tibiofibular joints
Joints of the ankle and foot
Joints of the wrist and hand
Anatomy clinical correlates: Arm, elbow and forearm
Anatomy clinical correlates: Clavicle and shoulder
Anatomy clinical correlates: Knee
Anatomy clinical correlates: Leg and ankle
Anatomy clinical correlates: Wrist and hand
Gout and pseudogout: Pathology review
Rheumatoid arthritis and osteoarthritis: Pathology review
Seronegative and septic arthritis: Pathology review
Anatomy of the knee joint
Anatomy clinical correlates: Knee
Rheumatoid arthritis and osteoarthritis: Pathology review
Seronegative and septic arthritis: Pathology review
Candida
Clostridium difficile (Pseudomembranous colitis)
Enterobacter
Enterococcus
Escherichia coli
Proteus mirabilis
Pseudomonas aeruginosa
Staphylococcus aureus
Bacterial and viral skin infections: Pathology review
Skin histology
Skin anatomy and physiology
Acneiform skin disorders: Pathology review
Papulosquamous and inflammatory skin disorders: Pathology review
Pigmentation skin disorders: Pathology review
Skin cancer: Pathology review
Vesiculobullous and desquamating skin disorders: Pathology review
Anatomy of the heart
Anatomy of the vagus nerve (CN X)
Aortic dissections and aneurysms: Pathology review
Cardiomyopathies: Pathology review
Coronary artery disease: Pathology review
Heart blocks: Pathology review
Supraventricular arrhythmias: Pathology review
Valvular heart disease: Pathology review
Ventricular arrhythmias: Pathology review
Hunger and satiety
Anxiety disorders, phobias and stress-related disorders: Pathology Review
Breast cancer: Pathology review
Colorectal polyps and cancer: Pathology review
Dementia: Pathology review
Diabetes mellitus: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Heart failure: Pathology review
HIV and AIDS: Pathology review
Hyperthyroidism: Pathology review
Inflammatory bowel disease: Pathology review
Jaundice: Pathology review
Lung cancer and mesothelioma: Pathology review
Malabsorption syndromes: Pathology review
Mood disorders: Pathology review
Tuberculosis: Pathology review

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)