DEBRIDEMENT: ANATOMY and PHYSIOLOGY. Professor Donald G. MacLellan Executive Director Health Education & Management Innovations

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1 DEBRIDEMENT: ANATOMY and PHYSIOLOGY Professor Donald G. MacLellan Executive Director Health Education & Management Innovations

2 ANATOMY and PHYSIOLOGY Epidermal Layers ECM Structure Dermis Structure Skin Functions Vascular System Nervous System

3 Structures of the Skin

4 Epidermal Layers

5 EPIDERMIS 4 MAIN CELL TYPES: Keratinocytes - main cell type; arranged in 5 layers; perpetually being generated Melanocytes - melanin production; brown skin colour Merkel Cells - mechanoreceptor function Langerhan s cells immune function

6 Stratum Germinativum Deepest layer, in contact with dermis Single layer of cells Only layer of epidermis capable of cell division Contain melanocytes

7 Melanocytes Capable of producing the brown pigment, melanin Melanin can absorb energy from ultraviolet (UV) light UV light contains high energy photons that can damage DNA mutations Melanin can prevent damage to DNA, helps to prevent skin cancer

8 Melanocytes

9 Stratum Spinosum

10 Stratum Spinosum Several layers thick Cells of this layer begin to produce keratin Keratin is a water-insoluble protein that protects the body from water

11 Stratum Granulosum Multilayer and cells become compressed Keratin crystallizes into granules within the cytoplasm Cells are metabolically dead

12 Stratum Lucidum Clear layer of cells Only present in thick skin Cells nothing more than a bag of keratin

13 Stratum Corneum Multiple layers of flattened, dead cells Number of layers depends on region of the body & amount of friction Lose thousand cells per minute 15% is water; <10% = dry scaly skin

14 Dermis: Structure and Function

15 ANATOMY and PHYSIOLOGY Epidermal Layers ECM Structure Dermis Structure Skin Functions Vascular System Nervous System

16 EXTRACELLULAR MATRIX ECM: the largest component of normal skin gives the skin its elasticity, tensile strength & compressibility on a weight basis, the tensile (breaking) strength of normal skin approaches that of steel

17 ECM THREE main classes of ECM molecules: 1. Fibrous structural proteins - collagens and elastin (ECM strength and resilience)

18 ECM- Fibrous Structural Proteins COLLAGENS ( scaffolding ): largest class of fibrous ECM molecules is the collagen family at least 16 different types of collagen in the dermal matrix is composed primarily of type I (80 85%) and type III (8 11%) collagens, tensile strength of skin is due predominately to these fibrillar collagen molecules

19 ECM- Fibrous Structural Proteins ELASTIN ( elastic ): many tissues, such as skin, lung and blood vessels, need strength and elasticity to function network of elastic fibres in the ECM gives the resilience to recoil after stretching main component of elastic fibres is the elastin molecule the core of elastic fibres and are covered by fibrillin, a large glycoprotein that binds to elastin and is essential for the integrity of elastic fibres

20

21

22 ECM THREE main classes of ECM molecules: 1. Fibrous structural proteins - collagens and elastin (ECM strength and resilience) 2. Adhesive Glycoproteins - laminin and fibronectin (ECM glue & IT server )

23 ECM- Adhesive Glycoproteins LAMININ (cell-bm glue ): large protein made up of three polypeptide chains that form a cross-shaped molecule ends of the cross bind to type IV collagen, heparan sulphate proteoglycan and integrin receptors forms a sheet-like structure known as the basement membrane (basal lamina) to which epidermal cells attach this enables laminin to act as a multi-adhesive matrix protein by forming bridges between cells and the basement membrane.

24 ECM Adhesive Glycoproteins FIBRONECTIN ( IT server ): glycoprotein present in both plasma and tissue. fibronectin links together many different types of ECM molecules it also contains an important cell-binding domain made up of the three amino acids specific integrin receptors on cells bind to this site stimulates signalling pathways that promote cell attachment, migration and differentiation these characteristics enable fibronectin to play an important role in cell adhesion and to communicate signals between cells and components of the ECM

25 ECM THREE main classes of ECM molecules: 1. Fibrous structural proteins - collagens and elastin (ECM strength and resilience) 2. Adhesive Glycoproteins - laminin and fibronectin (ECM glue & IT server ) 3. Proteoglycans - multiple glycosaminoglycan chains (formed from repeating disaccharide units) branch from a linear protein core eg. dermatan sulfate and hyaluronan - extracellular proteoglycans are highly hydrated molecules; large volume of matrix (ECM tissue cushioning)

26 ECM - Proteoglycans GLYCOSAMINOGLYCANS ( gel ): GAGs composed of polysaccharide chains, strongly hydrophilic. GAGs attract large amounts of water to be drawn into their structure GAGs form gels at very low concentrations the hydrophilic nature of GAGs causes a turgor, enables the ECM to withstand compression forces cartilage matrix lining the knee joint, for example, can support pressures of hundreds of atmospheres because of its high GAG content. Hyaluronic acid (HA), a chief component of the ECM, is a large GAG that attracts water and is found in increased amounts in damaged or growing tissues. HA stimulates cytokine production by macrophages, thereby promoting angiogenesis.

27 ECM - Proteoglycans PROTEOGLYCANS: proteoglycans GAGs plus protein core retain water and form a gel-like substance through which ions, hormones and nutrients can move freely. proteoglycans may play a key role in selectively filtering molecules that pass through the basement membrane beneath the epidermal cells. proteoglycans also appear to have an important role in regulating signalling between cells.

28

29 ANATOMY and PHYSIOLOGY Epidermal Layers ECM Structure Dermis Structure Skin Functions Vascular System Nervous System

30 Dermis Papillary layer: 1/5 of dermis loose areolar connective tissue Highly vascular Dermal papillae - fingerprints

31 DERMIS PAPILLARY DERMIS RETICULAR DERMIS

32 Reticular layer: Dermis Dense irregular connective tissue Sebaceous (oil) glands Hair follicles Ducts of sudoriferous (sweat) glands Meissner s and Pacinian corpuscles

33 ANATOMY and PHYSIOLOGY Epidermal Layers ECM Structure Dermis Structure Skin Functions Vascular System Nervous System

34 1.

35 2. Protection - physical abrasion - dehydration - ultraviolet radiation 3. Sensation - touch - vibration - pain - temperature

36 4. Excretion 5. Immunity/ Resistance 6. Blood Reservoir - 8 to10 % in a resting adult 7. Synthesis of vitamin D - UV light - aids absorption of calcium

37 Physiology of Aged Skin Functional Decrement: - Epidermal turnover - Barrier function/ chemical clearance - Inflammatory response - Mechanical protection

38 ANATOMY and PHYSIOLOGY Epidermal Layers ECM Structure Dermis Structure Skin Functions Vascular System Nervous System

39

40

41 ANATOMY and PHYSIOLOGY Epidermal Layers ECM Structure Dermis Structure Skin Functions Vascular System Nervous System

42

43

44 A Dermatome is an area of skin associated with a pair of dorsal roots from the spine Nervous System

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46 L4

47 L5

48 S1

49 L5

50 S3

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