Which of the following systems is NOT affected by skin-rolling?

Skin rolling is a technique primarily used in massage and physical therapy that affects various bodily systems through mechanical manipulation of the skin and underlying tissues. The integumentary system, which includes the skin, is obviously impacted as skin rolling directly engages with the dermis and epidermis, promoting circulation and loosening muscle tension.

The musculoskeletal system is also influenced because skin rolling can help identify and alleviate muscle stiffness, tension, and the adhesions that can disrupt normal movement. It encourages better mobility by loosening connective tissues surrounding muscles and joints.

The circulatory system benefits as well, as the mechanical action increases blood flow to the area being treated, enhancing nutrient delivery and waste removal, which can promote healing and improve overall function.

However, the respiratory system is not directly affected by skin rolling. While there is an indirect relationship — such as improved general well-being through muscle relaxation — the primary focus and effects of skin rolling do not specifically involve the respiratory process or structures. This distinction highlights the correct choice in identifying which system is least impacted by skin rolling, focusing instead on the more relevant effects on the integumentary, musculoskeletal, and circulatory systems.