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126 Cards in this Set

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Epidermis (Top Skin)
- Top most skin
- Has no blood supply

- Thickness varies

- Eyelids epidermis is 0.05mm (thin skin)

- Palms and Soles epidermis ia 1-5 mm (thick skin)
Four different kinds of cell in Epidermis?
- Keratinocytes – Keratin – main cells

- Melonocytes – Melanin

- Langerhans cells – immune response

- Merkel cells – sensory cells
In Epidermis- what is Stratum corneum?
Dead cells, constant shedding
The Dermis
- Immediately below epidermis

- Thicker than epidermis, thickness varies

- In Eyelids – 0.6mm

- In Palms and Soles – 3mm or more
The Dermis Has 2 different kinds of fibers??
- Collagen – 70%, Gives strength and toughness to skin

- Elastin – provides elasticity to skin
All part of the dermis include?
- Has blood supply/lymph vessels
Sweat Glands

- Sebaceous glands

- Hair follicles

- Nerves/Sensory receptors

- Defense cells
The Hypodermis
Also called the subcutaneous layer
Deepest layer in the skin
Not present in all parts of body
Missing on the eyelids
Up to 3 cm thick on the abdomen
Provides with smoothness to the body.
Function of the skin - - Protective barrier
- Prevents dehydration

- Prevents infection

- Physical barrier to injury

- Protects against UV injury
Function of the skin -- Temperature regulator
-- Heat conservation
** Insulation (hair and fat)
** Decreased blood flow

--Heat loss
** Sweating
** Increase blood flow
Function of the skin -Waste disposal system
--Excretes urine like wastes
** Water
** Salt
** Some urea
Function of the skin -- Sensation mediator
Largest sensory organ in the body
Function of the skin - Metabolic Function
- Energy storage of triglycerides in fat

- Vitamin D production
List characteristics of Eccrine Glands
1. True Sweat Glands

2. Found all over the body

3. 2 – 5 million present

4. Function from birth

5. Excrete water,salt urea

6. Odorless

7. Thermal & CNS control
List characteristics of Apocrine Glands
1. Special Sweat Glands

2. Found in armpits, pubic region

3. 2000 present

4. Function from puberty

5. Excrete milky, organic material

6. Body Odor

7. CNS control
Where does the body odor come from?
A. Chemical Oxidation
Fats ----> Fatty Acid ----> Volatile
organic acids

Protein -----> Ammonia + Hydrogen sulfide
Where does the body odor come from?
B. Microbial Oxidation
Sweat ---->Oxidation (--Oxygen --Bacteria) ----> Odoriferous Substances
List characteristics of Deodorants
--Do not prevent sweating.

-- Mask smell by Fragrance and Bacteriostatic agents
List characteristics of Antiperspirants
Reduce sweating by Blocking pores --> (Aluminum, Zirconium) AND Contracting pores ---> (Aluminum, Zirconium
(Astringent))
Bacteriostatic Agents: What is Triclosan
Active against gram + and gram – bacteria.

Present in body washes, soaps, toothpastes
Bacteriostatic Agents: What is Triclocarban (TCC)
Active against gram + bacteria.

Found in soaps
List characteristics of Astringents
Aluminum salts:
Aluminum chlorohydrate
Aluminum sesquichlorohydrate
Aluminum chloride, Aluminum sulfate

Zirconium salt (combination):
Aluminum Zirconium trichlorohydrex
Blackheads
Non Inflammatory Acne with Open Comedone
Whiteheads
Non Inflammatory Acne with Closed Comedones
Inflammatory Acne
Papules
(5 mm),

red solid lesions

longer to resolve

mild scarring
Inflammatory Acne
Pustule
pus,

resolves in days

moderate scarring
Inflammatory Acne
Nodules
5-10 mm

most severe form

severe scarring
Factors Involving acne?
Hormone changes

Bacteria (Propionibacterium acnes)

Genetic
Provocative Factors for acne include?
Diet and drugs

Cosmetics – Oil based Products

Tight Clothes – Headbands

Hot & Humid Climate = Acne
Therapeutic treatment of Acne?
Benzociane - Local Anesthetic which relieves soreness and burning
Therapeutic treatment of Acne to Hide or conceal?
Cosmetics to cover up blemishes
Zinc oxide, titanium dioxide
Therapeutic treatment of Acne to control?
Remove excess sebum
Soap and water – 3 times a day
Detergents
Alcohol (10-60%)
Characteristics of Irritant Contact Dermatitis?
1. Non-Immunological

2. Immediate contact

3. Chemicals, Soaps, detergents, latex

4. Can occur on first exposure

5. Reaction occurs at site of contact

6. 80% patients
Characteristics of Allergic Contact Dermatitis?
1. Immunological

2. Develops 24-48 hours

3. Poison ivy, nickel, fragrances, cosmetics, hair dyes

4. Prior sensitization

5. Reaction can occur anywhere

6. 20% patients
Photosensitivity Reactions - Phototoxicity
-- Common

Chemical from sun absorbed to skin creates Irritant Contact Dermatitis
Photosensitivity Reactions - Photoallergy
-- Uncommon

Chemical + proteins from sun absorbed to skin creates Allergic Contact Dermatitis
Characteristics of Dandruff
- Accelerated keratinization process

- Relatively stable

- Localized

- Role of FUNGUS
Characteristics of seborrhea (VS dandruff)
- Extends beyond scalp

- Accelerated keratinization

- Inflammatory condition
Characteristics of psoriasis
- Scaling of scalp, elbows, knees,
fingernails, lower back, genitoanal (silvery scales with underlying lesions)

- Genetic predisposition / immune system
What are Cytostatic agents?
reduce the rate of cell growth – decrease the rate of keratinization

Chemical name: Selenium Sulfide
AND Pyrithione Zinc
What are Keratolytic Agents?
Remove Keratin

Chemical name: Sulfur AND Salicylic Acid
What is Surface Active Agent? and 3 different kinds?
breaks down the surface tension allowing Oil to dissolve in the Water

Anionic - (negative)
Cationic - (positive)
Amphoteric - (positive & negative)
Characteristics of Intrinsic Aging
- Normal, genes involved, can not control

- Young skin – epidermis translucent, retains water

- Old Skin –epidermis less translucent, does not retain water

- Old Skin – dermis thickness decreases, number of sweat and sebaceous glands reduced, fat reduced
Characteristics of Extrinsic Aging
- We have control over this

- Sun – Damages the skin
Acute and Chronic conditions?
Sunburn is Acute condition and Actinic/Solar Keratosis is Chronic condition.
Skin Cancer is Chronic condition
Different types of Skin Cancer (Chronic condition)
Basal Cell Carcinoma

Squamous Cell Carcinoma (Raised pink opaque patches)


Malignant melanoma (Black mole cancer)
types of Skin Cancer – Risk Factors
Fair Skin

UV radiation Sun/tanning booths

Location
Characteristics of UVA Radiation
Relatively low energy

Deep penetration into dermis

Darkening of pigment in skin

Photosensitivity

Photoaging

DISEASE: Basal cell carcinoma

**Dangerous in high doses**
Characteristics of UVB Radiation
- High energy

- Penetration into epidermis

- Leads to melanogenesis

- Stimulates Vitamin D production

- Associated with skin burn

- DISEASE: malignant melanomas
Characteristics of UVC Radiation
- Very high energy (fatal)

- Reacts with chemicals in the Stratosphere (Ozone)
Factors affecting amount of UV radiation reaching the earth surface on a given day
Latitude

Altitude

Transmission/reflection

Clouds

Sun Elevation

Ozone
Reflecting sunscreen (Physical sunscreen)
Zinc oxide
Titanium dioxide
List of UVB Absorbent Sunscreens
Esters of Para-aminobenzoic acid
Octylparadimethylaminobenzoate (λmax 310)

Esters of Cinnamic acid
Octyl paramethoxycinnamate (λmax 308-310) (Ethylhexyl p-methoxycinnamate)

Benzophenones
Oxybenzone (λmax 290)

Esters of Salicylic acid
Octylsalicylate (Octisalate) (λmax 306)
Homomenthylsalicylate (Homosalate)
List of UVA Absorbent Sunscreens
- Dibenzoylmethane
** Avobenzone (λ max = 360 nM)
(Usually combined with: Padimate, Oxybenzone, Methoxy cinnamate)
What is SPF?
Sun Protection Factor (SPF) Measures UVB effectiveness.

Time for erythema with the product DIVIDE BY Time for erythema without the product
Macronutrients consist of?
Carbohydrates (45-60%)

Proteins (10-30%)

Fats (20-30%)
Micronutrients consist of?
Vitamins

Minerals
Monosaccharides
Absorption - Exogenous
Monosaccharides
Storage - Endogenous
What are the various energy needs for the body
Carbohydrates (top priority)

Fats (2nd Priority)

Protein (3rd Priority)
what factors decide your basal metabolic rate
Weight in kg ( 1 kg = 2.2 lbs)

Height in cm ( 1 in = 2.54 cm)

Age in years
What is abdominal obesity?
Excessive fat in the abdomen is an independent predictor of risk and morbidity (related to diabetes, hypertension, CVD, and dyslipidemia).
How to calculate BMI?
703 X Patients Wt(lbs) DIVIDE BY (Height in inches)^2
Over the counter drugs for Obesity
Orlistat (Alli)
One half strength of prescription drug Xenical
Surgery for Obesity?
Vertical Banded Gastroplasty
AND
Roux-en-Y Gastric Bypass
Anorexia nervosa – Eating Disorders
Usually affects female.

Anorexics – starves them self

Anorexia affects the whole body

Brain – can’t think right, mood swings

Heart – low blood pressure

Intestines – constipation

Hormones - Amenorrhea
Bulimia nervosa – Eating Disorders
Serious physical consequences

Vomiting, diarrhea – electrolyte imbalances – abnormal heart rhythm.

Vomiting – erosion of the food pipe, teeth damage – dental caries
recommended food intake - GRAINS
6 Ounces of grains

1 ounce = 1 slice of bread

At least 3 ounces from whole grains – brown bread, brown rice

Look for the “whole” before the grain of the ingredients
recommended food intake - VEGETABLES
2.5 Cups a day

Add color in your diet

Eat more dark green veggies, orange veggies, dry beans & peas
recommended food intake - FRUITS
2 Cups a day

Add variety

fresh, frozen or dried
recommended food intake - OILS
5-6 tea spoons /day

Most from fish, nuts, vegetable oils

Some oils –good source of fatty acids
recommended food intake - MILK, YOGURT AND CHEESE
3 cups /day
Go low fat or fat free
Calcium rich food
recommended food intake - MEATS AND BEANS
5 ½ oz

Choose low fat or lean meats and poultry

Bake it, broil it, grill it
Discretionary Calories
2000 calorie based diet – 267 calories – discretionary calories

“Luxury calories”

Inactive people – NO luxury calories
Empty Calories
Empty Calories = High Calories Low Nutrition

Candy, Soft drinks

White bread, white rice

French fries, fried chicken

Beer, wine and alcoholic beverages
characteristics of simple Carbohydrates
-- Monosaccharide:
** Glucose
** Fructose
** Galactose

-- Disaccharide:
** Maltose (glucose + glucose)
** Sucrose (glucose + fructose)
** Lactose (glucose + galactose)
characteristics of Complex Carbohydrates
Polysaccharides (3 – zillion sugar units)
Such as Starch AND Glycogen
characteristics of Dietary Fiber
Is a polysaccharide
Can not be digested by the body
No calories

Insoluble fiber : Whole grains, fruits, veggies, Laxative

Soluble fiber: Apples, Oats
Lowers Cholesterol
Dietary recommended for Carbohydrates
Daily recommendations ( 45-60%)
Minimum of 100 - 150 g/day
What is GRAS List?
Chemicals that are Generally Recognized As Safe
What is Delaney clause?
found in the 1958 FD&C Act

"No additive shall be deemed safe if it is found, after tests which are appropriate for the evaluation of food additives, to induce cancer in man or animals."
Characteristics of Saccharin
300X sucrose in sweetness

Zero calories

Bitter after-taste

Unstable to heat

Safety? (Bladder cancer in mice)
Characteristics of Aspartame (Equal, NutraSweet)
(Aspartic acid + Phenylalanine)

200X sucrose in sweetness

0.1 Cal/dose

Unstable on prolonged heating

Potential problem for PKU patients
Characteristics of Acesulfame (Sunette)
200X sucrose in sweetness

Heat stable

Inexpensive to manufacture
Characteristics of Sucralose (Splenda)
320 - 1000X sucrose in sweetness

No after-taste

No calories

It is absorbed but not metabolized

Stable to heat-used in cooking and baking
Characteristics of Neotame
10,000X sucrose in sweetness

Stable to heat-used in cooking and baking
Unintentional food additive Acrylamide
- appears in food which are prepared by frying.
** Neurotoxin
** Rat carcinogen (possible human carcinogen)

come from high temperature frying of starchy foods
(i.e. French fries)
1. Different forms of fats and role of fats.
triglycerides, phospholipids, cholesterol

Energy source

-Insulation

-Carbon source for synthesis of cholesterol & other steroids, absorption of fat soluble vitamins
Source of essential fatty acids
linoleic & linolenic acids
characteristics of saturated fats, unsaturated fats (poly and mono) and trans fats,
Polyunsaturated fats (corn oil)
Monounsaturated fats (olive oil). Poly and mono = unsaturated

Saturated fats (lard, butter, animal fat, coconut oil, palm oil)

Trans fats (Cookies, margarine, cakes crackers and bread)
What is LDL
Bad cholesterol
Keep low
What is HDL
Good cholesterol
Keep high
What are different fat substitutes
Skimmed milk - ~0 g fat; 34 Cal
(Cow’s milk: 3.7 g fat; 64 Cal)
(Ice cream: Fat 19 gm; 97 mg cholesterol; 274 Cal)

Olestra - 0 g fat; Low calorie content: 70 Cal (Potato chips: Fat 10 gm; 160 Cal)

Z-Trim (Z = zero Cal): Hulls of seeds forms a gel similar to vegetable oil

Oatrim: soluble oat fiber
Olestra
Looks and tastes like fat

Zero calories (can not be digested)

Heat stable

Toxicology – loose stools, removes fat soluble nutrients
Fat Soluble vitamins?
Vitamin A (Retinol, Retinal, Carotene)

Vitamin D (Sunshine Vitamin)

Vitamin E (Tocopherols)

Vitamin K
Water Soluble vitamins?
B Complex

Vitamin C (Ascorbic Acid)
Primary deficiencies:
Inadequate diet because of lack of food

Inadequate diet because of poor use of food (Ex. Food faddism, dieting**)
Secondary deficiencies:
Poor health/chronic disease

“Abnormal” body demand

Use of drugs
Vitamin A characteristics
Preformed Vitamin A (retinoids):
Animal sources – liver, milk, eggs, butter

Pro Vitamin A (Carotenoids):
Vegetable sources dark green, bright yellow fruits/vegetables

Health of rods.

Health of cornea

Deficiency – Night blindness – rods
Blindness (xerophthalmia) – cornea and rods
Vitamin D Characteristics
Deficiency- Rickets (child) AND Osteomalacia (adults)

Found in egg yolks, dairy products, & fish

Function: Absorption/Mobilization of Calcium
Vitamin E Characteristics
- Found in cereals, nuts, unsaturated oils, leafy green and yellow vegetables, milk, meats, butter.

Function: Unknown!!

Claims: Wound healing without scarring. Slow down aging. Protect against cancer. Increase physical performance. Prevent heart disease
Vitamin B1/Thiamine Characteristics
Sources – whole grains, pork.

Function: Energy metabolism
Nerve and Muscle cells

Deficiency: “Beriberi” – damage to nervous system, as well as to heart and other muscles
Vitamin B3/Niacin Characteristics
Sources – foods high in protein

Function: Energy metabolism,
For healthy skin, nerves, GI tract

Deficiency: “Pellagra” – diarrhea, dermatitis, dementia (three D’s) -> leads to death
Vitamin B6/Pyridoxine Characteristics
Sources – meats, fish, potatoes, fruits, vegetables

Function: Amino acid metabolism, production of serotonin

Deficiency: Low serotonin - depression
Folate/Folic Acid Characteristics
Sources – dark green vegetables.

Function: Production and maintenance of new cells

Deficiency: In pregnancy – neural birth defects
Sodium Characteristics
Sources: Salt (table, kosher, sea) Processed food

Function: Helps maintain the right balance of fluid
Transmits nerve impulse
Muscle contraction and relaxation

Excess sodium: Increase blood pressure AND DAMAGED KIDNEYS
Define Nutraceuticals
a dietary supplement, food, or medical food that possess health benefits and is safe for human consumption.
Define Functional foods
products that are conveyed in a conventional food format and have health benefits
Define Organic foods
USDA certified organic - food with at least 95% organic content.

Made with organic ingredients - foods with 50-95% organic content.
What is Nutrition Labeling and
Education Act of 1990 (NLEA)
Allows for the approval of health claims which link a food or food component to a reduced risk of a specific disease.
Characteristics of Polyphenols and flavonoids
Sources: Fruits, vegetables, nuts, tea, wine – antioxidant activity

Prevent oxidation of LDL

“French Paradox”

French consume – 105 g fat/ day. Americans consume – 72 g fat/day
Characteristics of Nuts
Mainly fats – but the good fats.

Two important role
1. Reduce LDL (Bad cholesterol)
2. Antioxidant

Reduces risk of coronary heart disease
Characteristics of Soy isoflavones
Protein from soy bean and its products – soy milk, tofu.

25 g / day – reduces chances of heart disease (FDA approved)

May reduce chances of breast and prostate cancer (not FDA approved)
Characteristics of Carotenoids
Responsible for giving plants colors.

Two important role
1. Vitamin A
2. Antioxidant

Protection against cancer, cataracts, macular degeneration
Characteristics of Probiotics
Found in fermented milk products (live bacteria). (GOOD BACTERIA)

Important role – health of intestines

Protection against bad bacteria, help in absorption of nutrients
What is Dietary supplemental Health & Education Act 1994 (DSHEA)
Allows companies to introduce dietary supplements (herbs
& phytomedicinals) without FDA approval provided that "there is a history of use or other evidence establishing safety".

Make "general" claims but NOT "specific" claims
What is The Animal Disease Risk Assessment, Prevention and Control Act of 2001
Legislation to deal with animal products.
Protect food and feed supplies which ultimately may become products such as dietary supplements.
Info about Sam-e (S-Adenosylmethionine):
Claims: Relieve depression
Relieve arthritis
Fight liver problems

Might cause strokes & heart attacks
Info about Glucosamine+chondroitin
Claim:
Helps rebuild joints damaged by osteoarthritis (OA)

Concern:
Standards of purity of the chondroitin and glucosamine!
info about St. John's Wort
obtained from the dried flower

Physiological effect: Antidepressant (0.9 mg hypericin)

Side effects: GI irritation
Allergic reaction (Photodermatitis)
Possible drug-herb interactions
Info about Ginkgo
Physiological effect: Increased peripheral and cerebral blood flow (vasodilation)

Claimed effects: Improved memory and attention
Improved cognitive functions

Side effects: GI irritation
Allergic reaction
Info about Ginseng
Claimed effects: Aphrodisiac and tonic effect
Combat fatigue (improves stamina)

Side effects: Hypertension
Nervousness
Info about Garlic
Physiological effects: Antibacterial
Blocks the liver from making too much cholesterol

Side effects: GI discomfort
Allergic reactions
Info about Echinacea
Physiological effects: Stimulate immune system

Claimed effects: Treat and prevent the common cold
Decrease the severity and duration of the cold

Side effects: Allergic reactions
Info about Saw Palmetto
Physiological effects: Antiandrogenic (antitestosterone) effects

Claimed effects: Treat Benign Prostatic Hyperplasia (BPH)

Side effects: GI complains
Not seeking medical attention!!!!!
Homeopathy Principles
Law of Similars- the medication used should produce symptoms similar to what the patient suffers from.

Law of Infinitesimals- the more diluted the medication the stronger the action.

Process of Succession- rubbing or shaking medication releases
or potentates the medication - "Release healing forces"
Modern medicine VS. Homeopathy
Modern medicine:
Dose response curve
Controlled scientific studies

Homeopathy:
Opposite effect
No scientific studies