63
Skin Kristine Krafts, M.D.

Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

  • Upload
    others

  • View
    0

  • Download
    0

Embed Size (px)

Citation preview

Page 1: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

SkinKristine Krafts, M.D.

Page 2: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Skin Lecture Objectives• Describe the functions of skin.

• Describe the structure, location and function of the cell types found in epidermis: keratinocytes, melanocytes, Langerhans cells, and Merkel cells.

• Describe the five layers of the epidermis.

• Describe the structure and contents of the papillary dermis, reticular dermis, and hypodermis.

• Describe the structure and function of sebaceous glands, eccrine sweat glands, and apocrine sweat glands.

2

Page 3: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Skin Lecture Outline

• Introduction

• Epidermis

• Dermis

Page 4: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Skin Lecture Outline

• Introduction

Page 5: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Functions of Skin

• Serves as a barrier protecting against physical and chemical injury and infection.

• Prevents water entry and loss.

• Helps regulate body temperature.

• Receptor organ for sensory stimuli.

• Involved in synthesis of vitamin D3 from precursors in skin.

• Excretion of substances produced by glands.

Page 6: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Embryologic Origins of Skin

• Epidermis (the surface layer of skin) arises from ectoderm.

• Dermis (the connective tissue component of skin) arises from somites of the paraxial mesoderm.

Page 7: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Cranial nervesBones and connective tissue of head

Pharyngeal arches

Neural crest

NeuroectodermCentral nervous system

Intermediate plate mesoderm

Urogenital system

Lateral plate mesodermParaxial mesoderm

HeartHematopoietic system

Pharyngeal archesConnective tissue

Bones of most of the body (everything except the head)

Muscles of the body and headPharyngeal archesConnective tissue

Dermis

Endoderm

Lining of GI tract

Surface ectoderm

Epidermis

Page 8: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Skin is composed of:

• Epidermis: a surface of keratinized stratified squamous epithelium

• Dermis: connective tissue

• Skin appendages: Merocrine (eccrine) sweat glands, apocrine sweat glands, sebaceous glands, hair follicles, nails.

Page 9: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Layers of the skin

Page 10: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

10

Hair shaft

Meissner corpuscle

Sebaceous gland

Arrector pili muscle

Hair follicle

Pacinian corpuscle

Appendages of the skin

Page 11: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

More Appendages of the Skin

Page 12: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Subcutaneous tissue

• Also called hypodermis

• NOT considered part of the skin!

• Consists of loose connective tissue and adipose tissue

• Function: loosely binds the skin to underlying structures

12

Page 13: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Skin Lecture Outline

• Introduction

• Epidermis• Layers of the epidermis• Cells of the epidermis

Page 14: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Skin Lecture Outline

• Introduction

• Epidermis• Layers of the epidermis

Page 15: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

The Five Layers of Epidermis

• Corneum

• Lucidum

• Granulosum

• Spinosum

• Basale

Page 16: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Five layers of epidermis

corneum

lucidumgranulosum

spinosum

basale

Page 17: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Stratum Basale (Basalis)

• Bottom layer; just above basal lamina.

• Cuboidal to columnar keratinocytes one layer thick.

• Cells attached to each other by spot desmosomes and to basal lamina by hemidesmosomes.

• Mitoses renew epidermis every 15-30 days.

• Contains melanocytes and Merkel cells.

Page 18: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Stratum basale

Page 19: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Stratum Spinosum

• Between stratum granulosum and basale.

• Spot desmosomes connect cells.

• Cells shrink during processing but remain attached at desmosomes, and look “spiny” or prickly.

• Areas of skin subject to more mechanical pressure have more spot desmosomes.

Page 20: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Stratum spinosum

Page 21: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Keratinocytes in stratum

spinosum are attached by spot

desmosomes.

Cells retract during fixation

and appear to be connected by

spines.

Page 22: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Spot desmosomes

Cytokeratinfilaments

Stratum spinosum cells

Page 23: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Stratum Granulosum

• Just above stratum spinosum.

• Cells contain two types of granules.

• Keratohyaline granules: large, basophilic; bind cytokeratin molecules together to make keratin.

• Lamellar granules: small; contain lipid that is released into intercellular spaces (acts as a cement to prevent penetration of water and other materials).

Page 24: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Stratum granulosum

Page 25: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Stratum Lucidum

• Under stratum corneum.

• Keratinocytes have lost nuclei and organelles and appear as homogeneous, translucent cells.

• Cells contain keratin.

• Present only in very thick skin.

Page 26: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Stratum lucidum

Page 27: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Stratum Corneum

• Most superficial layer.

• Consists of flat, dead cells – basically keratin scales - that are continuously shed.

• Keratin is composed of cytokeratin filaments (long intertwined protein chains) and keratohyalin (a substance that helps hold cytokeratin filaments together).

Page 28: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Stratum corneum

Page 29: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Thick vs. Thin Skin

Refers to thickness of epidermis and keratin layer

Thick skin is present on palms and soles• Epidermis has five cell layers + thick keratin layer.• Hair follicles and sebaceous glands are NOT

present.

Thin skin is found everywhere else. • Epidermis has no stratum lucidum, and the

stratum granulosum and corneum are much thinner.

• May contain hair follicles and sebaceous glands.

Page 30: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

corneum

lucidum

granulosum

spinosum

basale

Thick skin

Thin skin

Page 31: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Skin Lecture Outline

• Introduction

• Epidermis• Layers of the epidermis• Cells of the epidermis

Page 32: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Four Types of Cells in Epidermis

• Keratinocytes are stratified squamous epithelial cells. Most common cell in epidermis. Function is to produce intermediate filaments called cytokeratins. Amount of cytokeratins increases as the cells move upward.

• Melanocytes produce melanin.

• Langerhans cells process antigen.

• Merkel cells are involved in tactile sensation.

Page 33: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

melanocyte

keratinocyte

Page 34: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

More melanin is present in keratinocytes than in melanocytes.

Page 35: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

• The number of melanocytes per unit area varies from one part of the body to another but is independent of race.

• Differences in skin color are due to differing numbers of melanin granules in melanocytes!

Melanin and skin color

Page 36: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Melanin granules accumulate above keratinocyte nuclei to protect genetic material from UV damage. Smart!

Page 37: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Langerhans Cells and Merkel Cells

Langerhans cells • A type of macrophage. • Arise in bone marrow, migrate to stratum

spinosum.• Eat stuff (like bugs), present antigen to T cells.

Merkel cells • Present in stratum basale. • Function as touch receptors.

Page 38: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Skin Lecture Outline

• Introduction

• Epidermis

• Dermis• Basic structure• Specialized receptors and structures

Page 39: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Skin Lecture Outline

• Introduction

• Epidermis

• Dermis• Basic structure

Page 40: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Epidermis

Dermis

Hypodermis

Page 41: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Papillary dermis

Reticulardermis

Dermal papillae

Loose connective tissue with lots of capillary loops and thin elastic fibers

Page 42: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Papillary dermis

Reticulardermis

Dermal papillae

Dense connective tissue with thick collagen bundles and elastic fibers, larger blood vessels and glands.

Page 43: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Skin Lecture Outline

• Introduction

• Epidermis

• Dermis• Basic structure• Specialized receptors and structures

Page 44: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Meissner’s and Pacinian Corpuscles

Meissner’s corpuscle• Sensitive to light touch• Consists of an unmyelinated axon meandering

back and forth between flattened Schwann cells.

Pacinian corpuscle• Sensitive to vibration and pressure. • Consists of unmyelinated nerve terminal

surrounded by layers of fibroblasts.

Page 45: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Meissner’s corpuscle: sensitive to light touch

Page 46: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Pacinian corpuscle: sensitive to vibration, pressure

Page 47: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

The Pilosebaceous Apparatus

• Hairs: hair follicle and shaft

• Sebaceous glands and ducts: empty into hair follicle

• Arrector pili muscles: cause erection of hair shaft

• Hairs and sebaceous glands derive from ectoderm

Page 48: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Pilosebaceous apparatus and sweat gland

Page 49: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Pilosebaceous apparatus

Arrector pili muscle

Sebaceousgland

Hair follicle

Page 50: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Main parts of the hair follicle

The dermal papilla contains numerous

capillaries. It maintains the viability of the hair

follicle.

The hair follicle is a tubular invagination of

the epidermis extending deep into the dermis.

The hair bulb is basically just the base

of the hair follicle.

The hair shaftarises from the base

of the follicle.

Page 51: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Layers of the hair follicle

The cuticle and cortexmake up the hard keratin

part of the hair shaft. Some hairs have a medulla as well.

The external root sheath is continuous with the

epidermis.

The internal root sheath contains cells withclear cytoplasm.

The glassy membraneis a thickened basal

lamina that separates the hair follicle from

the surroundingconnective tissue.

Page 52: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Skin glands

• Three types: sebaceous glands, eccrine (merocrine) sweat glands, and apocrine sweat glands.

• Arise from ectoderm.

• Secretory portion of glands resides in the dermis.

• Three different types of secretion: holocrine, merocrine, and apocrine.

Page 53: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Types of secretion

Page 54: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Types of glands

Page 55: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Sebaceous glands

• Present everywhere except palms and soles.

• Secretory portion: peripheral, flattened undifferentiated cells. Central cells are large with foamy cytoplasm containing lipids.

• Cells burst, releasing sebum (holocrine secretion).

• Duct empties into hair follicle.

• Become functional at puberty.

Page 56: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Sebaceous gland

Page 57: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Sebaceous glands emptying into hair follicle

Page 58: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Eccrine (Merocrine) Sweat Glands

• Secretory portion has three cell types:• Clear cells (contain glycogen, produce a

watery substance)• Darker cells (produce a proteinaceous

substance)• Myoepithelial cells (surround gland)

• Duct is lined by simple cuboidal epithelium and opens onto skin surface.

Page 59: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Eccrine sweat glands and ducts

Page 60: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Eccrine sweat glands and ducts

Myoepithelial cells

Secretory cells

Page 61: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Apocrine Sweat Glands

• Located only in axilla, areola of breast, and anal canal.

• Have larger ducts and secretory units than eccrine sweat glands.

• Ducts open into hair follicles.

• Apocrine secretion is viscous and contains proteins, carbohydrates and lipids.

Page 62: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Apocrine sweat glands

Page 63: Skin - WordPress.com · 2019-10-03 · Skin is composed of: • Epidermis: a surface of keratinized stratified squamous epithelium • Dermis: connective tissue • Skin appendages:

Skin Lecture Outline

• Introduction

• Epidermis

• Dermis