10. Integumentary and Lymphatic System Flashcards
Skin Structure
- The skin forms the integumentary system.
- It is the largest organ of the human body.
- 2 square metres (men), 0.5mm-4mm thickness.
- Covers external body and continuous with mucous membranes internally.
- An epithelial membrane -cutaneous membrane.
- Contains accessory structures: glands, hair and nails.
Skin layers
Epidermis: The superficial layer of skin, formed of epithelial tissue (tightly packed cells).
Dermis: The middle layer of skin, formed of connective tissue. Also contains accessory structures such as sweat glands, hairs and sebaceous glands.
Subcutaneous / adipose layer:
Epidermis
• The epidermis is the superficial layer of skin.
• Formed of ‘keratinised epithelium’ (protective and waterproofing).
• The epidermis varies in thickness over the body.
• Interstitial fluid (situated in between cells) provides oxygen & nutrients to cells.
• The epidermis is drained by lymph.
• No blood vessels (avascular) and no nerve endings.
Complete replacement of epidermis occurs in approximately 40 days.
Epidermis Cells
90% of epidermal cells are Keratinocytes:
• Keratin is a tough fibrous protein that protects from heat, microbes & chemicals.
8% of epidermal cells are Melanocytes:
• Melanin is a pigment that contributes to skin colour and absorbs UV light.
• Melanin surrounds the nuclei of keratinocytes on the side towards skin surface.
• Two types of melanin in skin = Eumelanin(brown/black) & Pheomelanin(reddish/yellow).
2% of epidermal cells are Langerhans cells:
• Immune cells that are in involved in skin ‘surveillance’.
Epidermis Layers
5 Layers Stratum corneum Stratum lucidum Stratum granulosum Stratum spinosum Stratum basale
Stratum Corneum
25-30 layers of flattened dead keratinocytes.
•Cytoplasm replaced by keratin.
•Are shed (desquamated).
Stratum Lucidum
- 3-5 layers of dead cells.
* Only present in thick skin.
Stratum Granulosum
• 3-5 layers of cells undergoing apoptosis
Stratum Spinosum
• 8-10 layers of new keratinocytes
Stratum Basale
•Single row dividing to form new keratinocytes.
Dermis
The thickest layer in skin, formed of connective tissue. The dermis contains a matrix of collagen and elastic fibres.
• Collagen fibres give tensile strength and elastic fibres allow skin to stretch & recoil.
The dermis also contains:
• Arterioles & capillaries (thermoregulation).
• Lymph vessels &sensory nerve endings.
• Sweat glands (and ducts), hairs& arrector pili muscles, sebaceous glands.
• Fibroblasts and immune cells –macrophages & mast cells.
Sweat (Sudoriferous) Glands
- Most numerous in the palms, soles of feet, axillae & groin.
- Consists of a gland, duct & pore. Located next to a capillary (receive secretions).
- Excretion of urea (waste). Excessive sweating leads to dehydration and sodium (Na+) depletion.
- Smell created by action of bacteria breaking down substances present in sweat such as fatty acids.
- Body heat used to evaporate sweat –help regulate body temperature.
Sensory Nerve Endings
- Meissner’s corpuscle: Sensitive to light pressure.
- Pacinian corpuscle: Sensitive to deep pressure.
- Free nerve ending: Sensitive to pain & temperature. 1cm square skin = 200 pain receptors
Dermis: Hairs
- Hairs are concentric columns of dead keratinised cells bonded together by proteins.
- Hair colour is genetically determined. Hormones influence distribution. Hair contains melanin pigments (more = darker).
- A microscopic band of smooth muscle called ‘arrector pili’ connect the hair follicle to the dermis.
- When the hair is erect, it traps a layer of air next to the skin (part of thermoregulation).
Dermis: Sebaceous Glands
- Sebaceous glands secrete sebum which keeps hair soft, provides water-proofing for the skin and is anti-microbial.
- Mostly located on the face, scalp, lip, eye lid, nipples, labial folds, glans penis.
- Activity increases in puberty, decreasing with age.
- The fatty acids in sebum inhibit bacterial growth.
Skin Functions
- Protection
- Thermoregulation (body temperature)
- Vitamin D production
- Sensation
- Absorption
- Excretion
Skin Functions: Protection
• Protection against dehydrationand external factors such as chemicals, toxins, trauma, light and microbes.
- Physical barrier -closely packed keratinised cells and melanin.
- Sebum-contains fatty acids which inhibit microbial growth.
- Sweat-contains lysozymes, which are enzymes that break down bacteria.
- Desquamation-shedding of skin cells helps remove microbes.
- Nerve sensors -induce protective reflexes.
Skin Functions: Thermoregulation
• Normal body temperature is 36.5 –37.5°C (98–100°F).
• Changes in the evening, during ovulation & exercise.
• Temperature control centres are the hypothalamus & medulla oblongata (brain stem).
Temperature regulation by the skin occurs via:
1. Activity of sweat glands (water evaporates off skin).
2. Activity of blood vessels (vasodilatation/vasoconstriction).
High body temperature -> vasodilation of peripheral blood vessels to promote heat loss
Low body temperature -> vasoconstriction of peripheral blood vessels to prevent heat loss
Hypothermia
<35oC
When core temperature drops below that required for normal metabolism & body functions
Death usually below 25oC
Hyperthermia
> 38.5°C
When core temperature elevatesabove 38.5oC
40oC -life threatening. 41oC -brain death. 45oC –death.
Vitamin D Formation
- UV light activates a vitamin D precursor in the skin.
- The kidneys convert the precursor to calcitriol.
- Calcitriol acts as a hormone to increase uptake of calcium and phosphorus from food into blood, thus, ultimately supporting bone density.
- Vitamin D is stored in the liver.
Absorption
Lipid-soluble molecules: • VitA, D, E, K. • Some medications. • Essential oils. • O2 and CO2. Toxins: • Acetone, carbon tetrachloride, lead and mercury, arsenic, poison oak and ivy
Excretion
- Salt (sodium chloride).
- Water.
- Urea.
- Ammonia.
Superficial Wound Healing
- Includes abrasions and burns.
- Basal cells move across the gap until contact inhibition occurs.
- Epidermal growth factor causes multiplication of the basal cells until space is filled.
Deep Wound Healing
Deep wound: affects dermis and subcutaneous layer. Phases: Inflammatory Phase Proliferative Phase Remodelling Phase
Inflammatory Phase
- Migration of leukocytes to clean up any microbes & foreign tissue.
- Blood clot forms & becomes a scab. Epithelial cells migrate to repair the basement membrane.
Proliferative Phase
- Granulation tissue is formed with the laying of collagen & blood vessels.
- Extensive growth & repair of epithelial cells.
Remodelling Phase
- Can take 3 weeks to 6 months.
* Scab sloughs off and scar tissue remains (fibrosis).
Scar Tissue
- A mark left on the skin or other body tissues where a wound, burn or sore has not healed completely and fibrous connective tissue has developed.
- Contains denser collagen fibres, fewer hairs, glands, nerve endings and blood vessels (hence whiter).
Types of Scar Tissue
Hypertrophic
Keloid
Hypertrophic Scar
Stays within in the boundary of the wound
Keloid Scar
Takes up a larger space than the wound (normally raised)
The Lymphatic System
- The lymphatic system is closely allied to the cardiovascular & immune system.
- The lymphatic system consists of thin-walled vessels that transport fluid throughout the body, resembling veins.
- Lymph travels from lymphatic capillaries, which unite to form larger lymphatic vessels.
- Lymphatic vessels ultimately drain into the thoracic duct or the right lymphatic duct.
The Lymphatic System: Functions
- Return proteins, lipids and water from the interstitial fluid to the blood.
- Immunity against harmful organisms.
The Lymphatic System: Components
- Lymph fluid (lymph)
- Lymph vessels
- Lymph nodes
- Lymph organs (spleen & thymus)
- Lymphoid tissue (e.g. tonsils)
- Bone marrow
Lymph
- Lymph is a watery fluid similar to blood plasma but with less plasma proteins.
- Same composition as interstitial fluid, which is found between cells & lymph is in lymphatic vessels, tissues & between organs
Lymph Components
- Water.
- Leukocytes.
- Plasma proteins (seeped out of capillaries).
- Fats absorbed from the small intestine.
- Bacteria and cell debris from damaged tissue.
Lymphatic Vessels
CAPILLARIES: • Located in spaces between cells. • Blind end tubes -one way structure. • Recall: lacteal is a blind ended lymph vessel in the small intestine. LARGER LYMPH VESSELS: • Have 3 layers like veins. • Numerous cup shaped valves. • Vessels unite to form lymph trunks.
Lymphatic vs. Cardiovascular System
- The cardiovascular system is a circular and closed system in which the fluid (blood) leaves from and returns to the heart.
- In comparison, the lymphatic system is a linear system in which the lymphatic capillaries at the peripheral tissues drain lymphatic fluid.
- Lymphatic fluid contains cells, proteins and macromolecules and transports it back to the vascular system.
Lymphatic Nodes
- Lymph nodes filter lymph and remove foreign matter such as microbes, cell debris and tumour cells.
- Lymph passes through many lymph nodes before returning to the blood.
- 600 Bean shaped structures located in groups along lymph vessels throughout the body.
- Generally follow same route as veins.
- Filled with immune cells (lymphocytes & phagocytes).
Lymphatic Nodes: Process
- Lymph enters via afferent vessels.
- Foreign substances are trapped in irregular channels by reticular fibres.
- Macrophages destroy foreign substances by phagocytosis.
- Whilst lymphocytes destroy remainder by immune response.
- Filtered lymph leaves via efferent vessels.
- Many afferent vessels, very few efferent. This slows down the flow of lymph.
Lymph Nodes: Location and Function
- 5 locations contain many: Cervical, axillary, inguinal, vertebral column, mesenteric (intestinal).
- Lymph nodes develop during childhood; atrophy begins in adolescence.
- Material not filtered passes on to the next node so by the time the lymph returns to the blood it should be ‘clean’.
- During the early stages of infection, incomplete phagocytosis of microbes can cause swelling of the lymph nodes –lymphadenopathy.
Spleen
- The largest lymph organ –same size as heart.
- Between the stomach and diaphragm on the left.
- Similar in shape & structure to lymph nodes.
- Contains white pulp and red pulp:
- White pulp contains lymphocytes & macrophages.
- Red pulp contains all the components of circulating blood.
Spleen: Functions
- Haematopoesisin foetus.
- Blood reservoir.
- Phagocytosis of worn out of defective erythrocytes.
- Immunity: matures T & B lymphocytes.
Spleen Rupture
- Spleen rupture can occur following trauma.
- Damage to the thin-walled veins (sinuses) can cause significant haemorrhage and shock.
- Removal is needed to prevent death.
- Liver and red bone marrow can take over some function, however, immune function is compromised.
Thymus
- A bi-lobed organ that plays important role in immune development & antibody production in early life.
- Contains epithelial cells, T-lymphocytes and macrophages.
- Epithelial cells produce ‘thymosin’ which promotes the maturation of T-lymphocytes (produced in the red bone marrow).
- T-cells that leave the thymus via the blood migrate to lymph nodes and other lymphatic tissueswhere they colonise.
- Atrophy begins in puberty (age 12), declining throughout life –tissue is replaced by fat.
Mucosa Associated Lymphoid Tissue (MALT)
- Small aggregations of lymphoid tissue found in areas of the body exposed to the external environment –‘first line of immune defence’.
- MALT that is found in the digestive system is also called GALT(‘Gut Associated Lymphoid Tissue’).
- Some examples where MALT can be found:
- Adenoids (MALT but not GALT as found in nasal cavity not GIT).
- Tonsils.
- Small intestine and large intestine.
Lymphatic System Functions
- Tissue Drainage
- Absoption
- Immunity
Lymphatic System Functions: Tissue Drainage
- Blood arrives at the tissue at high pressure so some of the fluid & nutrients are forced out of the capillaries into the interstitial fluid.
- The remaining cells & plasma proteins in the blood create an osmotic pressure which maintains blood volume. Tissue fluid is at lower pressure.
- Interstitial fluid contributes to the nourishment of tissues. 90% returns to circulation via veins.
- The lymphatic system is responsible for draining and recirculating this extra fluid and returning it to the blood stream
- Lymphatic fluid is drained with assistance of this following:
- Mild, rhythmical contractions of the lymphatic vessels (lymphatic pump).
- Skeletal muscle pump: Movement/exercise drains fluid. Especially the calf muscles (gastrocnemius & soleus).
- Respiratory pump: During inhalation air pressure drops in the thoracic region. Lymph moves from high to low pressure.
Lymphatic System Functions: Absorption
- Lacteals absorb fat-soluble substances/nutrients from the small intestines in to the body:
- Dietary fats.
- Fat-soluble vitamins (A, D, E & K).
Lymphatic System Functions: Immunity
- Lymph organs are concerned withtheproduction and maturation of lymphocytes:
- Lymph nodes.
- Spleen.
- Thymus and Bone marrow.