SKIN – INTEGUMENT (INTEGUMENTUM COMMUNE, CUTIS) AREA: 1.6 – 2.2 m2 THICKNESS: 1.5 – 4 mm Head and neck = 9% Upper limbs = 18% Trunk = 36% Lower limbs = 36% Genitoanal region = 1% Barrier against damage, thermoregulation, sensory function, biochemical functions, vitamin D, emotional states, state of health, age, pathological states (cyanosis, rash) hairless (glabrous) hairy (hirsute) EPIDERMIS (0.03 – 0.1 mm) Str. basale Str. spinosum Str. granulosum Str. lucidum Str. corneum Keratinocytes Keratin 4 weeks Melanocytes - melanosomes - melanin Melanocyte stimulating hormone gwyneth-paltrow Lucy Liu Photos martha-jones.jpg 7-dehydrocholesterole ® vitaminD3 (cholecalciferole) Melanocytic naevi (moles) Melanoma melanoma.jpg albino11 Albinism albina2 albina3 killing-albinos-tanzania-albinism_1 DERMIS (CORIUM) (0.5 – 3 mm) stratum reticulare stratum papillare Mm. arrectores pilorum Cristae cutis Areae cutaneae Lineae flexionis: Linea oppositionis pollicis Linea manus clausae Linea oclusionis digitorum trium ulnarium Linea axialis manus Linea rasceta - MCJ Linea restricta Whorl Loop Arch Cristae cutis Sulci cutis Pori sudoriferi Toruli tactiles PAPILLARY RIDGES Eminentia thenaris Eminentia hypothenaris Imprint of a right hand Toruli tactiles Dermatoglyphics Striae distensae - striae gravidarum Cleavage lines Langer’s lines Kraissl’s lines TELA SUBCUTANEA (HYPODERMIS) Retinacula cutis Bursae synoviales subcutaneae Panniculus adiposus BLOOD VESSELS Plexus reticularis Plexus subpapillaris LYMPH VESSELS Rete cutaneum spf. Rete cutaneum prof. NERVES Free nerve endings Meissner’s corpuscles Pacinian corpuscles Merkel endings Aging spots Changes in skin with age 2008_09_skinaging490X327 SKIN AGING hair_root PILUS 60 – 600/cm2 Scapus pili Radix pili Folliculus pili Bulbus pili Papilla pili Medulla pili Cortex pili Cuticula pili GROWTH OF THE HAIR 1.5 – 2.2 mm a week Anagen Catagen Telogen Alopecia M. arrector pili - piloerection Primary hair – lanugo Flumina pilorum Vortices pilorum Hypertrichosis lanuginosa Secondary hair Pili Capilli Cilia Supercilium 5989_f260 445taidjin Tertiary hair Hirci Pubes Barbae Tragi Vibrisae Sinus hairs Hypertrichosis vera phalanx dist. corpus unguis radix unguis vallum unguis eponychium matrix unguis germinativa hyponychium * * lectulus unguis UNGUIS (ONYX) 0.5 – 1 mm lunula unguis GLANDULAE SEBACEAE Sebum Meibomian glands Holocrine type of gland Comedo – acne GLANDULAE SUDORIFERAE Eccrine – sudor - pH 5.5 – 6 Apocrine glands – scent glands - gll. s. axillares - gll. circumanales - gll. ceruminosae – cerumen - gll. s. nasales - gll. ciliares (Moll) - gll. areolares - gl. mammae MAMMA sinus mammarum MAMMA FEMININA Areola mammae Glandulae areolares (Montgomery) Papilla mammae Area cribriformis papillae Ductus lactiferi Fascia pectoralis spf. Tela adiposa premammaria Tela adiposa retromammaria Lig. suspensorium Cooperi – retinacula cutis GLANDULA MAMMARIA Processus axillaris Colostrum 15 – 20 lobi mammae – lobuli mammae – alveoli Lactation Ductus lactifer Prolactin ARTERIES: A. thoracica int. – rr. perforantes A. thoracica lat. Aa. Intercostales VEINS: Circulus venosus Halleri - v. thoracica int., lat., - vv. intercostales NERVES: Nn. intercostales Nn. supraclaviculares Lymphatic drainage of the breast - nll. axillares - nll. parasternales - nll. supraclaviculares - nll. intercostales - nll. mediastinales ant. Fig. 789 Lymphatic drainage of the mammary gland and location of the regional lymph nodes. Note the connections between the lymphatic vessels of both sides and the lymphatic drainage into the intrathoracic lymph nodes. Fig. 789 Lymphatic drainage of the mammary gland and location of the regional lymph nodes. Note the connections between the lymphatic vessels of both sides and the lymphatic drainage into the intrathoracic lymph nodes. MAMMOGRAPHY