BL L21 Flashcards
Structure of skin
Three ‘main’ layers:
- Epidermis
- Dermis
- Hypodermis
4 ot 5 layers:
5 layers - only palms and soles of feet
Epidermis layers: Come to in more depth later
- St. Corneum (corny layer)
- St. Lucidum
- St. Granulosum (granular layer)
- St. Spinosum (Spiney layer)
- St. Basale (Basal layer)
No St. Lucidum in all other places
Hypodermis - thickness
The thickness of the hypodermis varies in different regions of the body and can vary considerably between different people
Thickness plays an important role in distinguishing between males and females:
- In men-hypodermis is thickest in the abdomen and shoulders
- In women-thickest in the hips, thighs, and buttocks
- Also relatively thick on the palms of the hands –both sexes
Hypodermis - location
- Lowest layer of skin
- Also known as sub-cutaneous layer (so sometimes not considered to be part of the skin)
Hypodermis - structure
- Mainly contains adipose tissue (some neurovascular bundles(nerves and blood vessels)/lymphatics)
- Loose connective tissue –fibroblasts/ macrophages/fibres
Hypodermis - Function
• Provides energy store –generate heat (lots of adipose) this layer passes this energy store to underlying skeletal muscles, these then use it as a fuel and to generate heat)
• Insulator for underlying muscle heat generation
• Shock absorber –cushions impacts/protection for underlying structures
e.g. think about fat on the buttocks when sitting (protects us from damage)
• Connects skin to underlying muscle and bones
• Makes hormones, e.g. leptin to control eating habits (adipose controls hormones like leptin, usually when leptin is low = fat is high)
What happens to the hypodermis as you age?
Thinning of this layer during ageing is responsible for skin wrinkling and hypothermia in old age
Dermis - location
- Between epidermis and hypodermis
- Also known as the corium AND with epidermis -cutis
Dermis - Structure
• Two layers
Papillary -upper (P on pic)
Reticular -lower (R on pic)
Dermal papillae - interdigitating (indignations with the epithelial tissue above - with the epilthelial pegs (E on pic)
• Variable thickness 0.6 mm on eyelid; 3 mm on hands/feet
- Epithelial pegs - holds to eperdmis close to the dermis. These are epidermis extensions. Dermal papilla - projections of the corium or dermis that interlock with the overlaying epidermis.
Epidermis - Location
Outermost layer made of epithelial cells (keratinocytes)
Epidermis - Structure
- Four layers of cells (thin skin)
- Five layers (thick skin)
- Held together (laterally) by adherensjunctions
- Held together (vertically) by desmosomes
- Some terminal nerve endings (up to the bottom basal layer)
- NO blood vessels (no blood vessels in the epithelial tissues)
Epidermis - Functions
- Prevents water loss
- Prevents entry to bacteria and parasites
- Special cells that present pathogens to immune cells (langerhans cells)
- Synthesis of keratin
- Prevents underlying tissue loss due to abrasion (keratin’s function)
- Allows gaseous exchange (skin doesn’t have blood vessels, but epidermis is exposed to the air, this means skin cells in the epidermis can exchange some gas with the otuside of the body (e.g. will absorb some oxygen if needed, and will expel CO2), can’t absorb enough O2 through the skin though !!
Cells of epidermis
- Keratinocytes: Almost 90% of the epidermis is made of cells known as keratinocytes. Keratinocytes develop from stem cells at the base of the epidermis and begin to produce and store the protein keratin. Keratin makes the keratinocytes very tough, scaly and water-resistant.
- Melanocytes: At about 8% of epidermal cells, melanocytes form the second most numerous cell type in the epidermis. Melanocytes produce the pigment melanin to protect the skin from ultraviolet radiation and sunburn.
- Langerhans cells: These are the third most common cells (just over 1% of all epidermal cells). These are star shaped cells dispersed singly throughout the upper part of stratum spinosum. Langerhans cells’ role is to detect and fight pathogens that attempt to enter the body through the skin. Thus they are components of cell mediated immunity.
- Merkel cells: Finally, Merkel cells make up less than 1% of all epidermal cells but have the important function of sensing touch as mechanoreceptors. Merkel cells form a disk along the deepest edge of the epidermis where they connect to nerve endings in the dermis to sense light touch.
Layers in the epidermis and a discription of each
In most of the body, the epidermis is arranged into 4 distinct layers. In the palmar surface of the hands and plantar surface of the feet, the skin is thicker than in the rest of the body and there is a fifth layer of epidermis.
- Stratum basale or stratum germinativum: The deepest region of the epidermis is the stratum basale or stratum germinativum, which contains the stem cells that undergo mitotic activity to form all of the other cells of the epidermis. The cells gradually form all other layers of epidermis. The cells of the stratum basale include cuboidal keratinocytes, melanocytes, and Merkel cells.
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Stratum spinosum:
Superficial to stratum basale is the stratum spinosum layer where Langerhans cells are found along with many rows of spiny keratinocytes. The spines found here are cellular projections called desmosomes that form between keratinocytes to hold them together and resist friction. -
Stratum granulosum:
Just superficial to the stratum spinosum is the stratum granulosum, where keratinocytes begin to produce waxy lamellar granules to waterproof the skin. The layer is so named because of the granules present in the cell cytoplasm. The keratinocytes in the stratum granulosum are so far removed from the dermis that they begin to die from lack of nutrients. -
Stratum lucidum:
In the thick skin of the hands and feet, there is a layer of skin superficial to the stratum granulosum known as the stratum lucidum. It is made of several rows of clear, dead keratinocytes that protect the underlying layers. -
Stratum corneum:
The outermost layer of skin is the stratum corneum. The stratum corneum is made of many rows of flattened, dead keratinocytes that protect the underlying layers. Dead keratinocytes are constantly being shed from the surface of the stratum corneum and being replaced by cells arriving from the deeper layers.
Epidermis layers - how they are held together
The squames are held together by desmosomes (between the different layers). These desmosomes and the tonofibirls which are between the squames layers act as the water barrier.
pH:
Going up the squames layer the pH changes from pH 6.8-7.5 to 4.5-5.3 (more acidic). As the tonofilbirls and desmosomes are subject to the change of pH, the filaggrin proteins that are holding the desmosomes together are destroyed by proteases. As they do this, they break the filaggrin protein down and release the squames. This is why we are constantly losing the top layer of the skin.
Dust – squames from skin.
Layers in the epidermis
Keratin synthesis
- Basal lamina has the basal cells attached. These basal cells divide, they divide to produce a spinous cell
- Spinous cells produce lamina bodies, which is where the keratin forming factory is. (Tonofilaments are already made, they are sitting in the cytoplasm of the basal cell.)
- The lamellar body starts to package the keratin filaments together. It does this on RER.
- The spinous cells then develop into a granular cell. The granular cell has lots of golgi apparatus which starts to package the keratin and keratin hyaline into granules. Kertain hyaline is a clear substance (can’t see it in H+E staining).
- Keratin and keratin hyaline is released outside of the granular cell (this granular layer of filaments becomes clear). This is why the stratum lucidum is clear.
- As it does this, the granular cell loses it’s nucleus. This causes the cell to ‘die off’ and turn into the squames. At the granular cell level, the cells start to die off.
What are keratins also the main constituent in?
- Hair, nails and animal horns
What is the normal transit time of a keratinocyte from basal layer to stratum cornuem?
28-40 days
What is the transit time of a keratinocyte from basal layer to stratum cornuem for someone with psoriasis?
2-4 days
Psoriasis the transit time is reduced, such that stratum corneum is producedin abundance as silvery scales every 2-3 days (due to low pH)
What is hyperkeratosis?
Too much keratin put on the surface of skin (especially on the hands and feet)