Ap 1 - Ch 05 - Integumentary System

Front 1

Layer that is deep to the dermis but not part of the skin consisting of areolar & adipose tissue. Dermis anchors to this layer which in turn attaches to underlying fascia.

Back 1

Subcutaneous layer (hypodermis)

Front 2

What is the function of the subcutaneous layer?

Back 2

Stores fat & contains blood vessels supplying skin.

Front 3

Type of nerve ending found in the subcutaneous layer (& sometimes dermis) sensitive to pressure.

Back 3

Pacinian (lamellated) corpuscles

Front 4

What type of tissue composes the epidermis? (3 adjectives)

Back 4

Keratinized stratified squamous epithelium

Front 5

What are the 6 functions of the integumentary system?

Back 5

Regulates body temperature, stores blood, protects body from external environment, detects skin sensations, excretes/absorbs substances, synthesizes vitamin D

Front 6

What is the significance of the skin in relation to other organs?

Back 6

It's the largest organ by surface area & weight.

Front 7

Type of cell that makes up 90% of epidermal cells, arranged in 4-5 layers & produces keratin & lamellar granules.

Back 7

Keratinocytes

Front 8

Tough, fibrous protein that helps protect skin & underlying tissues from heat, microbes, & chemicals.

Back 8

Keratin

Front 9

A water-repellant sealant that decreases water entry/loss & stops entry of foreign materials. What type of cell produces it?

Back 9

Lamellar granules produced by keratinocytes.

Front 10

Type of cell making up 8% of epidermal cells & produces pigment melanin. Transfers melanin granules to keratinocytes. What layer is it found in?

Back 10

Melanocytes. Found in deepest epidermal layer (basale).

Front 11

What is the function of melanin?

Back 11

It protects keratinocytes from UV light & contributes to skin colour.

Front 12

Type of white blood cell found in epidermis that arises from red bone marrow & is involved in immune responses. Easily damaged by UV light. Monocyte (in blood) give rise to macrophage (WBC in tissue) which functions as phagocyte. What layer is it found in?

Back 12

Langerhan cell. Found in stratum spinosum.

Front 13

Least numerous type of epidermal cell. Connected to tactile disc (neuron) to detect touch sensations. What layer is it found in?

Back 13

Merkel cell. Found in basale layer while projections found in stratum spinosum.

Front 14

How many layers does the epidermis have in thin skin vs. thick skin?

Back 14

Thin - 4 layers. Thick - 5 layers.

Front 15

Name the 5 epidermal layers from superficial to deep.

Back 15

Stratum: Corneum, lucidum, granulosum, spinosum, basale (germinativum)

Front 16

Epidermal layer composed of simple cuboidal/columnar keratinocytes. Includes mitotic stem cells. Intermediate filaments called ___ make up the cytoskeleton of cells in this layer.

Back 16

Stratum basale. Tonofilaments.

Front 17

What is the function of tonofilaments in keratinocytes?

Back 17

Attach to desmosomes of cells in basale & spinosum layer to bind them together. Also attaches to hemidesmosomes which bind the cell to basement membrane.

Front 18

Transfer of a healthy patch of skin taken from a donor site to cover wound.

Back 18

Skin graft

Front 19

Procedure where small amount of patient's epidermis is removed & grown in lab to produce thin sheet of skin & transplanted back.

Back 19

Autologous skin transplantation

Front 20

Epidermal layer arranged in 8-10 layers of keratinocytes providing strength & flexibility to skin. Superficial to stratum basale.

Back 20

Stratum spinosum

Front 21

Epidermal layer made of 3-5 layers of flattened keratinocytes undergoing apoptosis. Keratohyalin converts tonofilaments into keratin. Lamellar granules secrete oily, water-repellant sealant.

Back 21

Stratum granulosum

Front 22

Epidermal layer present only in thick skin such as fingertips, palms, soles. Consists of 3-5 layers of dead keratinocytes w/ large amount of keratin & thickened plasma membrane.

Back 22

Stratum lucidum

Front 23

Epidermal layer made of 25-30 layers of dead keratinized stratified squamous epithelial cells that continuously shed & are replaced by deeper cells.

Back 23

Stratum corneum

Front 24

Abnormal thickening of stratum corneum due to constant exposure of skin to friction.

Back 24

Callus

Front 25

Accumulation of keratin, occurs as cells move from deepest to surface layer, is known as ___. What is the cycle duration?

Back 25

Keratinization. 28 days.

Front 26

Excess of keratinized cells shed from scalp.

Back 26

Dandruff

Front 27

If the epidermis is avascular, where does it get its nutrients?

Back 27

Blood vessels in the dermis supply the stratum basale, which is the most active layer as it does mitosis.

Front 28

Skin disorder where keratinocytes shed prematurely in 7-10 days & make abnormal keratin. Treatment includes ointment & UV phototherapy which decreases cell division, rate of cell growth, inhibits keratinization.

Back 28

Psoriasis

Front 29

What 4 structures are found in the dermal layer that are not in the epidermis?

Back 29

Blood vessels & nerves (papillary region), glands & hair follicles (reticular region)

Front 30

Which layer (epidermis/dermis) has great tensile strength & demonstrates extensibility, elasticity?

Back 30

Dermis

Front 31

What is the predominant type of cell in the dermis?

Back 31

Fibroblast (some macrophages, adipocytes near subQ layer)

Front 32

What type of tissue makes up the papillary region?

Back 32

Loose areolar connective tissue (collagen, elastin, reticulin)

Front 33

Small fingerlike structures that project into undersurface of epidermis. Increase surface area b/w dermis & epidermis.

Back 33

Dermal papillae

Front 34

Blood vessels found in dermal papillae are called ___.

Back 34

Capillary loops

Front 35

Tactile receptors sensitive to touch found in dermal papillae are called ___. Also found are ___, dendrites with no structural specialization (detect warmth, coolness, pain, tickling, itching).

Back 35

Meissners corpuscles. Free nerve endings.

Front 36

What type of tissue makes up the reticular region?

Back 36

Dense irregular connective tissue (collagen)

Front 37

Small tears in dermis from extreme stretching visible as red or silvery white streaks on skin surface.

Back 37

Striae (stretch marks)

Front 38

"Tension lines" in skin indicating predominant direction of underlying collagen fibers. Important to plastic surgeons as incision running parallel leaves a finer scar.

Back 38

Lines of cleavage

Front 39

Series of ridges & grooves found on palms, fingers, soles & toes that form fingerprints (& footprints). What is their function?

Back 39

Epidermal ridges increase surface area which increases firmness of grip by increasing friction.

Front 40

Study of pattern of epidermal ridges.

Back 40

Dermatoglyphics

Front 41

Melanin accumulating in flat patches can be either ___ or ___.

Back 41

Freckles or age (liver) spots

Front 42

Benign localized overgrowth of melanocytes.

Back 42

Nevus (mole)

Front 43

Melanin is synthesized from the amino acid ___ & enzyme ___.

Back 43

Tyrosine (amino acid). Tyrosinase (enzyme).

Front 44

Organelle in melanocytes that synthesize melanin.

Back 44

Melanosome

Front 45

A yellow-red or brown-black pigment produced by melanocytes which absorbs UV radiation, prevents damage to cell DNA, neutralizes free radicals.

Back 45

Melanin

Front 46

Oxygen-carrying pigment in red blood cells.

Back 46

Hemoglobin

Front 47

Yellow-orange pigment found in stratum corneum, dermis, subcutaneous layer.

Back 47

Carotene

Front 48

Condition of inherited inability to produce melanin.

Back 48

Albinism

Front 49

Condition of partial or complete loss of melanocytes from patches of skin.

Back 49

Vitiligo

Front 50

Buildup of yellow pigment bilirubin (byproduct of RBC destruction). May indicate liver condition.

Back 50

Jaundice

Front 51

Bluish skin caused by bad circulation.

Back 51

Cyanosis

Front 52

Pale skin caused by lack of hemoglobin.

Back 52

Pallor

Front 53

Redness of skin caused by engorgement of capillaries in dermis with blood due to skin injury, heat exposure, infection, inflammation, allergic reactions.

Back 53

Erythma

Front 54

Permanent coloration of skin in which a foreign pigment is deposited into dermis.

Back 54

Tattoo

Front 55

Insertion of jewelry through an artificial opening.

Back 55

Body piercing

Front 56

What is the function of hair (pili)?

Back 56

Protection (UV rays, foreign particles), decreases heat loss, senses light touch.

Front 57

Superficial portion of hair.

Back 57

Shaft

Front 58

Portion of hair deep to shaft that penetrates dermis (& sometimes subcutaneous layer)

Back 58

Root

Front 59

What are the 3 layers of cells in the hair from deep to superficial?

Back 59

Medulla, cortex, cuticle.

Front 60

In the epidermis, what 2 layers make up the hair follicle?

Back 60

External root sheath (continuation of epidermis) & internal root sheath (known together as epithelial root sheath).

Front 61

In the dermis, the dense area surrounding the hair follicle is known as ___.

Back 61

Dermal root sheath

Front 62

Structure at the base of each hair follicle & surrounding dermal rooth sheath. What does it contain?

Back 62

Bulb contains hair matrix (basale cells, melanocytes) & papilla of hair (protrusion into matrix for capillaries).

Front 63

What epidermal layer do the hair matrix cells arise from?

Back 63

Stratum basale

Front 64

Name 3 types of hair removal treatments.

Back 64

Depilatory, electrolysis, laser treatment

Front 65

Type of simple, branched acinar gland that is connected with hair follicles & secretes sebum (oil).

Back 65

Sebaceous (oil) gland

Front 66

Smooth muscle extending from dermis to dermal root sheath around side of hair follicle.

Back 66

Arrector pili

Front 67

Dendrites of neurons surrounding each hair follicle that are sensitive to touch.

Back 67

Hair root plexuses

Front 68

What are the 3 stages of the hair growth cycle?

Back 68

Growth, regression, resting stage

Front 69

Condition of partial or complete lack of hair (may result from genetic factors, aging, endocrine disorders, chemotherapy, skin disease).

Back 69

Alopecia

Front 70

Treatment of disease by means of agents that interrupt life cycle of rapidly dividing cancer cells.

Back 70

Chemotherapy

Front 71

Fine, nonpigmented hair in fetus.

Back 71

Lanugo

Front 72

Long, coarse heavily pigmented hair.

Back 72

Terminal hair

Front 73

Short, fine nonpigmented hair (peach-fuzz)

Back 73

Vellus hair

Front 74

What determines hair colour?

Back 74

Type of melanin. Dark - eumelanin. Red/blond - pheomelanin.

Front 75

Condition of excessive body hair in females or prepubertal males.

Back 75

Hirsutism

Front 76

What are 4 functions of sebum (secreted by sebaceous glands)?

Back 76

Prevents hair from drying, prevents water evaporation on skin, keeps skin soft, inhibits growth of some bacteria.

Front 77

Inflammation of sebaceous glands that usually begins at puberty when gland is colonized by bacteria is called ___. Infection that can cause a cyst to form & can permanently scar the epidermis is called ___. Treatment includes mild soap, topical/oral antibiotics, topical drugs.

Back 77

Acne. Cystic acne.

Front 78

___ glands are divided into 2 main types based on structure, location, type of secretion.

Back 78

Sudoriferous (sweat)

Front 79

Simple coiled tubular glands found mostly in dermis that excrete mostly water, salt, urea (also ammonia, amino acids, glucose, lactic acid) to regulate body temperature in process called ___. Also plays a small role in eliminating wastes. Also stimulated during emotional stress.

Back 79

Eccrine sweat gland. Thermoregulation.

Front 80

What's the difference between insensible & sensible perspiration?

Back 80

Insensible - evaporates before it's seen as moisture on skin. Sensible - seen as moisture on skin.

Front 81

Type of sweating that first occurs on palms, soles, axillae in response to emotional stress.

Back 81

Emotional sweating (cold sweat)

Front 82

Type of sweat gland found mostly in subcutaneous layer activated during puberty that includes lipid/protein content. Present in secondary sex regions & opens into hair follicles. Odorless until it reacts w/ bacteria on skin surface. Stimulated during emotional stress, sexual excitement.

Back 82

Apocrine sweat gland

Front 83

Type of gland found in subcutaneous layer that secretes cerumen, a waxy secretion that provides a sticky, waterproof barrier that prevents entry of foreign bodies into ear canal.

Back 83

Ceruminous gland

Front 84

What type of cells form nails?

Back 84

Tightly packed, hard, keratinized epidermal cells.

Front 85

Visible portion of nail that doesn't shed. Appears pink because of blood flow underneath.

Back 85

Nail body

Front 86

Part of nail body that extends past distal end of digit. Appears white because there are no underlying capillaries.

Back 86

Free edge

Front 87

Whitish, cresent-shaped area of proximal end of nail body. Vascular tissue doesn't show underneath due to thickened region of epithelium.

Back 87

Lunula

Front 88

Thickened region of stratum corneum beneath free edge that secures nail to fingertip.

Back 88

Hyponychium (nail bed)

Front 89

Narrow band of epidermis that occupies proximal border of nail and consists of stratum corneum.

Back 89

Eponychium (cuticle)

Front 90

Proximal portion of epithelium deep to nail root where cells divide by mitosis to produce growth.

Back 90

Nail matrix

Front 91

What factors affect the rate of nail growth?

Back 91

Age, health, nutrition, season, time, temperature.

Front 92

Dermis houses 8-10% of total blood flow in adult so it acts as a ___ ___.

Back 92

Blood reservoir.

Front 93

What volume of water evaporates through skin daily? (doesn't include sweat)

Back 93

400 mL

Front 94

What type of materials can be absorbed through the skin?

Back 94

Fat-soluble vitamins (A,D,E,K), certain drugs, gases oxygen/carbon dioxide. Toxic substances: organic solvents - acetone, carbon tetrachloride, salts of lead, mercury, arsenic, poison ivy/oak, topical steroids.

Front 95

Type of drug administration that enables drug in adhesive skin patch to pass across epidermis into blood vessels. Can be released at a controlled rate over period of several days.

Back 95

Transdermal drug administration

Front 96

Most active form of vitamin D that aids in calcium absorption. Requires 10-15mins 2x a week exposure to UV light to synthesize vitamin D.

Back 96

Calcitriol

Front 97

What are the steps in epidermal wound healing?

Back 97

1) Basal cells surrounding wound enlarge & migrate from opposite sides of wound until they meet. 2) Stop migrating due to contact inhibition. 3) Epidermal growth factor hormone stimulates basal cells to divide & replace.

Front 98

What are the 4 phases of deep wound healing in order?

Back 98

Inflammatory, migratory, proliferative, maturation.

Front 99

Deep wound healing phase where blood clot forms & inflammation occurs to eliminate microbes, foreign material, dying tissue in prep for repair. Fibroblasts, neutrophils, macrophages migrate to help repair.

Back 99

Inflammatory phase

Front 100

Deep wound healing phase where clot becomes scab & epithelial cells migrate beneath to bridge wound. Fibroblasts synthesize scar tissue & damaged blood vessels regrow. Granulation tissue fills wound.

Back 100

Migratory phase

Front 101

Deep wound healing phase characterized by extensive growth of epithelial cells beneath scab, fibroblast deposit collagen fibers in random patterns, continued blood vessel growth.

Back 101

Proliferative phase

Front 102

Deep wound healing phase where scab falls off, collagen fibers become more organized, fibroblast numbers decrease, blood vessels restored.

Back 102

Maturation phase

Front 103

Process of scar tissue formation.

Back 103

Fibrosis

Front 104

How is scar tissue different from normal skin?

Back 104

Collagen fibers more dense, decreased elasticity, fewer blood vessels, may have less hairs, skin glands, sensory structures.

Front 105

Why are scars usually lighter in colour than normal skin?

Back 105

Arrangement of collagen fibers & less blood vessels.

Front 106

What is the difference b/w a hypertropic vs. keloid scar?

Back 106

Hypertrophic remains in same boundaries as original wound. Keloid extends beyond boundaries into normal tissue.

Front 107

Would an epidermal wound bleed?

Back 107

No because epidermis is avascular.

Front 108

Epidermis is derived from which embryonic tissue?

Back 108

Ectoderm

Front 109

Substance that protects fetus from exposure to amniotic fluid & aids in birth because it's slippery. Composed of sebaceous glands, sloughed off peridermal cells, hairs.

Back 109

Vernix caseosa

Front 110

In the fetus, the dermis arises from ___ which gives rise to ___ that differentiate into fibroblasts.

Back 110

Mesoderm. Mesenchyme.

Front 111

Skin condition that affects mostly light skinned adults b/w 30-60. Redness, tiny pimples, noticeable blood vessels usually in central face.

Back 111

Rosacea

Front 112

(UVA/UVB) ray makes up 95% of UV radiation reaching earth. Not absorbed by ozone layer. Penetrate farthest into skin & absorbed by melanocytes. (UVA/UVB) ray partially absorbed by ozone layer, don't penetrate skin as deeply, cause sunburn, cause most tissue damage.

Back 112

UVA. UVB.

Front 113

Caused by exposure to UV radiation. A heightened reaction of skin after consumption of certain meds/contact with substances. Redness, itching, blistering, peeling, hives, shock.

Back 113

Photosensitivity

Front 114

What are 5 risk factors for skin cancer?

Back 114

Skin type, sun exposure, family history, age, immunological status.

Front 115

List 3 common type of skin cancer.

Back 115

Basal cell (78%) & squamous cell (20%) carcinoma. Malignant melanoma (2%, deadly) arise from melanocytes.

Front 116

Name 5 systemic effects of a major burn which are a greater threat to life than local effects.

Back 116

1) Large loss of water, plasma, plasma proteins will cause shock. 2) Infection. 3) Reduced blood circulation. 4) Decreased urine production. 5) Decreased immune response.

Front 117

Conditon caused by shedding of epithelium caused by constant deficiency of blood flow to tissue. Usually develop in tissues overlying bony projections subjected by pressure, such as shoulders, hips, buttocks, heels, ankles.

Back 117

Pressure ulcer

Front 118

Describe aging effects on the skin.

Back 118

Most occur in dermis. Collagen fibers decrease & disorganize. Elastic fibers lose elasticity. Fibroblasts decrease. All result in wrinkles. Langerhans cells decrease. Macrophages become less effective. Decrease sebaceous glands leads to dry, broken skin susceptible to infection. Sweat production decreases. Less melanocytes = gray hair, abnormal skin pigmentation. Larger melanocytes = age spots. Hair loss. Blood vessels thicker. SubQ adipose tissue lost. Skin heals poorly. Decrease skin thickness. Hair/nail growth decreases.

Front 119

In the rule of nines method of measuring extent of burns, what is each body part worth? Head, trunk, upper and lower limbs, perineum.

Back 119

Numbers must be doubled to account for ant vs post aspect. Head 4.5%, upper limb 4.5% each, trunk 18%, lower limb 9%, perineum 1%.