Integumentary System Overview and Burns Classifications

This research paper will address the integumentary system by describing the layers and the cells that are in each layer. The integumentary system is defined as the skin along with all its derivatives (hair, nails, glands) which cover the exterior body surface. The integumentary system has the functions of; protection from external biologic and chemical assailants, waterproofing the skin, hormone production, immunity, excretion, absorption, sensation, and thermoregulation and is continous with the mucous membranes lining all the body surfaces (Kanitakis,2002). The integumentary system is composed of four types of tissues that are arranged into several layers. This paper will also cover how burns are classified, and provide a description of three dermatologic diseases associated with the skin.

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Integumentary System Layers

The integumentary system is the biological term for skin and the structures derived from it. The skin is a complex arrangement of structures with a range of different, but important functions. The skin is made up of three main layers being epidermis, dermis and the subcutaneous layer. The thickness of the layers is determined by the location in the body with the epidermis having the highest degree of thickness in the soles and palms and the dermis being particulary thick in the back where it is 20-40 times the thickness of the dermis.The epidermis is composed of keratinized stratified squamous epithelium made up of keratinocytes, which contain keratin, a protein component of skin that makes it tough. Keratinocytes continuously differentiate as new cells move closer to the surface and replace older ones. These zones of differentiation are the; stratum germinativum which is the site of mitosis that facilitates the formulation of the cells of the outer layers, stratum spinosum, stratum granulosum which consists of flattened cells are responsible for the synthesis and modification of the proteins involved in keratinization, stratum corneum, stratum malpighii and rete malpighii. The two later layers are the living layers of the epidermis.

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 There are different types of cells associated with the epidermis; keratinocytes which are involved in the production of keratin, a protein that makes the skin tough, melanocytes are the pigment-producing cells that make a dark pigment known as melanin that adds a protective factor in response to UV light, Merkel cells which provide sensitivity to touch and clear dendritic cells known as Langerhans cells that help fight infection. Some cells that do not make up the layers of the dermis include the living connective tissue made of odontoblasts that makes up the teeth, the keratinized cells that make up the nails, the cells that make up the structure of the accessory structures of the skin such as salivarly glands, hair follicles, apocrine glands, sweat glands and lacrimal glands.

The dermis layer is made up of connective tissue containing fibroblasts, macrophages, a few white blood cells mast cells, blood vessels, lymphatic vessels, nerves, and the integumentary derivatives like hair, nails, and glands. The dermis layer is composed of two connective tissue structures; papillary layer, and reticular layer. The papillary layer is loose areolar connective tissue, which engages with epidermal ridges to interlock the dermis and epidermis. Now the reticular layer is a dense irregular connective tissue that pretty much provides strength.

The subcutaneous tissue consists of fat cells that are separated from the overlying dermis by thick fibrous septa made up of large blood vessels and collagen tissue. This layer of skin provides buoyancy to the body and its lipocytes undergo stimulation by the hypothalamus to produce the hormone leptin which regulates body weight (James et al, 2006).

Burns Classifications     

There are three major types of burns, classified on the basis of the agent involved in causality. Chemical burns comprise acid and alkali burns. Alkali burns cause liquefication necrosis which is much more severe as compared to the coagulation necrosis caused by acid burns. Most chemical burns have a good prognosis except in the event the burn resulted from ingesting or inhaling these chemicals. In this case, the prognosis is poor and often results in long term morbidity and or mortality. Electrical burns typically present with small external damage but the possibility of extensive internal organ damage should not be excluded as this may prolong recovery. Thermal burns are by far the most common type of burn, they are mostly superficial but can vary in degree of severity (Eyvas et al, 2015).

First Degree burns are small burns that have damaged the epidermis of the skin. The typical example for First Degree burns is a sunburn, the redness is a sign called erythema that results from inflammation of sun-damaged tissue. Second Degree burns are classified when both the epidermal and upper dermis have been damaged leading to the appearance of blisters. The accessory structures such as hair follicles and glands are generally not affected. The healing for a second-degree burn typically takes 1 to 2 weeks with the possibility of forming scar tissue. The grey shaded areas in these burns represent the depth of the damaged skin. A third-degree burn presents when the entire thickness of skin gets damaged, which means both the epidermis and dermis are destroyed and this damage has extended to the subcutaneous layer. Despite the presence of swelling caused by these burns, there is little to no pain because the innervation of the skin is destroyed as well.

The third degree is the most severe type of burn and often necessitates invasive medical interventions such as skin grafts are because it is not possible for the skin to repair itself due to the inability to form Granulation tissue and consequently, epithelial cells are unable to cover the injury. The typical treatments for burns include: removal of damaged skin, antibiotics, temporary covering, and skin grafts.

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