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StatPearls . Sweetheart Island (FL): StatPearls Publishing; 2021 Jan-.


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Introduction

The integumentary system is the biggest organ that the body that forms a physical obstacle between the external environment and the internal setting that it serves to protect and maintain. The integumentary system consists of the epidermis, dermis, hypodermis, connected glands, hair, and also nails. In enhancement to its barrier function, this system performs plenty of intricate attributes such together body temperature regulation, cell fluid maintenance, synthetic of Vitamin D, and detection of stimuli. The various components of this device work in associate to lug out these functions—for example, human body temperature regulation occurs with thermoreceptors that lead to the adjustment of peripheral blood flow, level of perspiration, and body hair.


Organ solution Involved

Components the the Integumentary System

Skin: The skin is made up of two layers—the superficial epidermis and also the depths dermis.

The epidermis is the challenging outer layer that acts as the an initial line that defense versus the exterior environment. That is written of stratified squamous epithelial cells that further malfunction into four to five layers. From superficial to deep, the main layers space the stratum corneum, stratum granulosum, stratum spinosum, and stratum basale. In the palms and soles, where the skin is thicker, over there is secondary layer of skin between the stratum corneum and also stratum granulosum called the stratum lucidum. The epidermis regenerates indigenous stem cells situated in the basal layer that grow up towards the corneum. The epidermis itself is devoid of blood supply and also derives that nutrition native the basic dermis.

The dermis is the basic connective tissue frame that support the epidermis. It more subdivides right into two layers—the superficial papillary dermis and also the deep reticular layer. The papillary layer develops finger-like projections into the epidermis, well-known as dermal papillae, and also consists of extremely vascularized, loose connective tissue. The reticular class has dense connective organization that forms a strong network.<1> The dermis as a whole includes blood and also lymph vessels, nerves, sweat glands, hair follicles, and various various other structures embedded within the connective tissue. 

Hypodermis: The hypodermis lies between the dermis and underlying organs. The is frequently referred to together subcutaneous tissue and also is created of loose areolar tissue and adipose tissue. This great provides additional cushion and insulation through its fat storage function and connect the skin to underlying structures such as muscle. 

Hair: Hair is obtained from the epidermis however grows its root deep into the dermis. Its framework divides right into the externally visible hair shaft and the hair follicle in ~ the skin. The hair follicle has actually an complex structure that has the hair pear that actively divides to expand the hair obelisk vertically.<2> Hair generally categorizes right into hormone-dependent, more thickness terminal hairs in regions such together the axilla, pubic areas, scalp, chest, etc., and also androgen-independent vellus hairs that cover the rest of the areas.<2> Hair expansion has many phases referred to as anagen (growth phase), catagen (nonproliferative phase), and also telogen (resting phase) that cycles depending upon hormones and nutrients.<3> Hair consist of the bulk of the body with the few exceptions that the palms, soles, lips, and portions of external genitalia. Hair serves as mechanical defense for the skin, boosts sensory function, and also aids in regulating human body temperature. Arrector pili muscles located in the dermis attach to hair follicles, help the tower to stand and trap wait close to the epidermis for temperature control.

Nails: Nails form as class of keratin and appear in ~ the dorsal tips of the fingers and also toes.<4> The pond growth starts at the pond matrix the creates new cells and pushes old cells the end distally. The visible portion of the nail is the nail plate spanning the pond bed, whereby it adheres come the finger. Nails function to safeguard the fingers and toes while enhancing the precision the movements and also enhancing sensation.

Associated Glands: There are four types of exocrine glands within human skin—sudoriferous, sebaceous, ceruminous, and mammary glands.

Sudoriferous glands, also known as sweat glands, are further separated into eccrine and apocrine glands. Eccrine glands are dispersed throughout the body and primarily develop serous liquid to manage body temperature.<5> Apocrine glands are current in the axilla and pubic area and also produce milky protein-rich sweat.<5> These glands are responsible for odor together bacteria malfunction the secreted organic substances.

Sebaceous glands are component of the pilosebaceous unit, consisting of the hair, hair follicle, and also arrector pili muscle.<6> It secretes an oily substance called sebum, a mixture that lipids that develops a thin film ~ above the skin. This layer adds a protective layer, stays clear of fluid loss, and additionally plays one antimicrobial role.<7><8> 


Function

Physical protection: provided that the integumentary is the spanning of the person body, its most apparent role is physical protection. The skin itself is a strictly knit network that cells, through each great contributing to its strength. The epidermis has an outermost layer created by layers of dead keratin that deserve to withstand wear and also tear that the outer environment, when the dermis gives the epidermis through blood supply and also has nerves that bring danger to attention among other functions. The hypodermis offers physical cushioning to any mechanical trauma through adipose storage, and also the glands secrete protective films throughout the body. The nails protect the digits, which room prone to repetitive trauma by creating a difficult covering, and hairs throughout the human body filter harmful corpuscle from beginning the eyes, ears, nose, etc.   

Immunity: The skin is the body’s very first line the defense as it acts together the physical obstacle that avoids direct entry of pathogens. Cells are connected through junction proteins with reinforcement by keratin filaments.<9>

Antimicrobial peptides (AMPs) and also lipids on the skin also act as a biomolecular obstacle that disrupts bacter membranes. AMPs, such as defensins and cathelicidins, are produced by various cells in the skin, such as dendritic cells, macrophages, glands, etc., and also are triggered by proteolytic cleavage through stimulation. Lipids, such as sphingomyelin and glucosylceramides, room stored in lamellar bodies uncovered in the stratum corneum and display antimicrobial activity.<9>

An extr aspect of the skin’s immunity lies in the residents immune cells. Both myeloid and lymphoid cells are existing in the skin, and some, such as the Langerhans cells or dermal dendritic cells, possess the ability to take trip to the periphery and activate the better immune system.<9>

Wound healing: as soon as our human body undergoes trauma with a result injury, the integumentary device orchestrates the wound healing process through hemostasis, inflammation, proliferation, and also remodeling.<9>

Hemostasis occurs v tissue aspect located in subendothelial spaces of the skin, i beg your pardon triggers the coagulation cascade to kind a fibrin clot.

In the following inflammatory phase, immune cells such as neutrophils and also monocytes will infiltrate the injury site to assault pathogens and clear out debris.

The proliferative phase requires the multiplication that resident cells such together keratinocytes and fibroblasts that contribute to the formation of granulation tissue. With a procession of immune cells and the eventual formation of a collagen network through fibroblasts and also myofibroblasts, the new extracellular procession forms.<9>

The last remodeling phase consists of apoptosis together cells are no longer needed and excess structures are broken down in initiatives to gain back the original architecture. Macrophages secrete matrix metalloproteases that eliminate excess collagen, and also remaining immature collagen matures to finalize the extracellular matrix.<9>

Vitamin D synthesis: The main sources that vitamin D are sun exposure and oral intake. Through ultraviolet sunlight exposure, 7-dehydrocholesterol converts come vitamin D3 (cholecalciferol) in the skin. Cholecalciferol is then hydroxylated in the liver, climate kidney into its active metabolite form, 1,25-dihydroxy vitamin D (calcitriol).<10> This metabolite ultimately leads to boosted calcium absorb in the gut and is critical for bone health. 

Regulation of body temperature: The skin has actually a big surface area the is highly vascularized, which permits it to conserve and release heat through vasoconstriction and also vasodilation, respectively. Once body temperatures rise, blood vessels dilate to boost blood flow and maximize the dissipation the heat.<11> In conjunction through this method, the evaporation that sweat secreted by the skin permits for better heat loss. The hair top top the body additionally affects the regulation of body temperature together erect hair have the right to trap a great of warm close to the skin. Assorted inputs from main and skin thermoreceptors administer fine-tuning for this thermoregulatory system.   

Sensation: Skin innervation is by various sensory nerve endings that discriminate pain, temperature, touch, and also vibration. Mediation of not authorised touch in glabrous skin through four species of mechanoreceptors—Meissner corpuscle, Pacinian corpuscle, Ruffini endings, and also Merkel cells.<12> Meissner corpuscles deserve to detect movement across the skin, Pacinian corpuscles finding high-frequency vibration, Ruffini endings detect stretch, and also Merkel cells assist in spatial imaging. In hairy skin, tactile stimuli room picked increase by three types of hair follicles and their associated longitudinal and circumferential lanceolate endings.

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<12> Noxious stimuli in both glabrous and hairy skin are detectable by free nerve endings located in the epidermis.<12> Each form of receptor and nerve fiber varies in the adaptive and also conductive speeds, causing a wide range of signal that can be combined to produce an expertise of the external setting and assist the body to react appropriately.