The Big Picture
The integumentary system includes your skin, hair, nails, sweat glands, and oil glands. Skin covers the body and is the largest organ by mass.
Skin does much more than cover the body. It protects the body, senses different kinds of stimulation, helps control body temperature, and removes some waste.
Changes in a client’s skin and nails can also give information about the client’s physical condition.
Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.
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Start Here If You’re Overwhelmed
Focus on these core ideas:
- The integumentary system includes skin, hair, nails, sweat glands, and oil glands.
- Skin has two layers, the epidermis on the outside and the dermis underneath.
- Skin protects the body, senses stimulation, helps regulate temperature, and removes some waste.
- Blood vessels widen when the body needs to release heat and narrow when the body needs to retain heat.
- Hair and nails have protective functions.
- Sweat glands and oil glands produce different substances and perform different functions.
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Course Notes: Key Ideas You Need to Know
What Is the Integumentary System?
The integumentary system consists of the skin and its appendages. These appendages include hair, nails, sweat glands, and oil glands.
The word integument means covering. Skin forms the body’s natural covering.
A gland is a group of cells that produces and releases a substance. Skin glands produce and release sweat or oil.
This release of a substance is called secretion. Secretion means releasing a substance into or out of the body as part of normal body functions.
Skin is considered the largest organ of the body by mass.
An organ is a structure made of different tissues arranged to perform a specialized function. Skin contains all four types of tissue working together.
A tissue is a group of similar cells that share a common function. A cell is the basic functional unit of body structure and function.
The Two Layers of Skin
Skin has two main layers:
- the epidermis
- the dermis
Epidermis
The epidermis is the outer layer of skin.
It contains living and dead cells arranged in specific layers. Cells divide and create new cells. Older cells move toward the skin surface, eventually die, and constantly flake away.
Living cells replace the dead cells.
Living epidermal cells contain pigment, which gives skin its colour.
The epidermis does not contain blood vessels. It depends on blood vessels in the dermis for oxygen and nutrients.
The epidermis does contain sensory cells and a few nerve endings. These help detect sensations such as pain and pressure.
Dermis
The dermis is the inner layer of skin. It is made of connective tissue.
The dermis contains:
- blood vessels
- nerves
- sweat glands
- oil glands
- hair roots
Skin Function 1: Protection
Skin forms a protective covering around the body.
It helps:
- prevent bacteria and other substances from entering the body
- prevent excessive water loss from the body
- protect organs from injury
Skin glands also produce and release substances that provide chemical protection against bacteria, viruses, and other potentially dangerous substances.
Skin Function 2: Sensation
Nerve endings throughout the skin detect different types of stimulation.
They sense:
- heat
- cold
- pain
- touch
- pressure
These nerve endings occur over the entire body. They detect both pleasant and unpleasant stimulation.
Skin Function 3: Temperature Regulation
Skin helps regulate body temperature by changing blood flow near the skin and through sweating.
When the Body Needs to Release Heat
Blood vessels dilate, which means they widen, when the temperature outside the body is high or when the temperature inside the body is high.
For example, blood vessels dilate during a fever. They also dilate during exercise.
Wider blood vessels bring more blood toward the skin surface. Sweat evaporation helps cool this blood and the body.
When the Body Needs to Retain Heat
When the body is cold and its temperature is in danger of dropping, blood vessels constrict.
Constrict means narrow.
Less blood reaches the skin when the vessels narrow. This helps the body retain heat.
Skin Function 4: Elimination
Skin also acts as an organ of elimination.
Perspiration removes some waste produced through metabolism. Metabolism refers to the chemical processes in body cells that create and use energy and produce cellular waste.
The waste removed in perspiration includes urea and other unwanted chemicals that have collected in the perspiration.
What Skin Changes Can Show
Observing a client’s skin can provide information about the client’s physical condition.
For example:
- A bluish or grey-blue colour in the skin or nails could indicate a circulation condition.
- Very dry skin could indicate dehydration.
These observations do not all mean the same thing. Pay attention to the specific change described.
Nova Scotia CCA Note
Sorrentino’s Canadian Textbook for the Support Worker, 5th Edition explains that changes in skin and nails can give information about a client’s physical condition. In current Nova Scotia CCA practice, observing skin integrity is also part of the CCA’s ongoing observational point-of-care assessment. A CCA observes the person in care and recognizes when a change needs to be escalated to a supervisor. (novascotiacca.ca)
This observational role is not a nursing assessment. Nova Scotia’s current standards limit the CCA to observational assessments used to support the care plan and recognize changes that require escalation. The CCA does not perform the comprehensive evaluation used to make care-planning decisions. (novascotiacca.ca)
Why this matters in Nova Scotia: Know the difference between observing skin integrity and performing a nursing assessment. The CCA observes and escalates changes while staying within the care plan and the CCA role. (novascotiacca.ca)
Official source: Continuing Care Assistant Occupational Standards of Practice Official PDF
Last checked: September 25, 2026
Hair
Hair covers almost the entire body.
The exceptions are:
- the palms of the hands
- the soles of the feet
Hair in the nose, eyes, and ears protects these areas from dust, insects, and other foreign objects.
Hair also helps the body retain heat. This effect is greater in areas with more hair, such as the head.
Nails
Nails protect the tips of the fingers and toes.
Fingernails also help the fingers pick up and handle small objects.
The condition of the nails can reflect a client’s general health and nutritional status.
Nail beds are generally pink. A bluish colour in the nail beds can indicate poor oxygenation.
Oxygenation means the amount of oxygen in tissues.
Clubbing of the Fingernails
Clubbing describes enlarged fingertips with nails that curve downward.
Clubbing can be caused by:
- chronic lung disease
- heart disease
Sweat Glands
Sweat glands help regulate body temperature.
Sweat contains:
- water
- salt
- a small amount of waste
Sweat travels through pores in the skin. As the sweat evaporates, it cools the body.
Oil Glands
Oil glands lie near hair shafts.
They release an oily substance into the space near the hair shaft. The oil then travels to the skin surface.
This oil helps keep the skin and hair soft and shiny. It also inhibits the growth of bacteria on the skin surface.
Fast Review
The integumentary system has several parts and functions. Focus first on the two skin layers and the four major jobs of the skin.
- The integumentary system includes skin, hair, nails, sweat glands, and oil glands.
- The epidermis is the outer skin layer. The dermis is the inner skin layer.
- The epidermis has no blood vessels and depends on blood vessels in the dermis for oxygen and nutrients.
- Skin protects the body, senses stimulation, regulates temperature, and removes some waste.
- Blood vessels dilate, or widen, when more heat needs to leave the body.
- Blood vessels constrict, or narrow, when the body needs to retain heat.
- Bluish or grey-blue skin or nails could indicate a circulation condition. Very dry skin could indicate dehydration.
- Hair protects some body areas from foreign objects and helps retain heat.
- Nails protect fingertips and toes. Bluish nail beds can indicate poor oxygenation.
- Clubbing means enlarged fingertips with downward-curving nails and can be caused by chronic lung disease or heart disease.
- Sweat helps cool the body as it evaporates.
- Oil from oil glands keeps the skin and hair soft and shiny and inhibits bacterial growth on the skin surface.
Final Pep Talk
There are several parts and functions to remember here, so group them instead of trying to memorize everything at once. Start with epidermis versus dermis, then learn the four skin functions, and add hair, nails, sweat glands, and oil glands as separate pieces.