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Kerri's Part 1 Biomed Slides > 10.1 Integumentary System - COMPLETE > Flashcards

10.1 Integumentary System - COMPLETE Flashcards

1
Q

What are the names of the three main layers of the skin and are they inner, outer or middle

A

Epidermis - Inner
Dermis - Middle
Subcutaneous Layer - Outer

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2
Q

Epidermis:

Name the three types of cells in the epidermis

A

Keratinocytes – 90%
Melanocytes – 8%
Langerhans - 2 %

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3
Q

Epidermis:

Describe the structure and function of keratinocytes in the epidermis

A

Epidermal cells that accumulate keratin on the way to the surface

Structure: TOUGH FIBROUS PROTEIN

Function:
Keeps out - water, microbes, dirt, chemical
Keeps in - moisture
Protects from heat

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4
Q

Epidermis:

Describe the structure and function of melanocytes.

A
  • Structure: Surround the nuclei of keratinocytes on the side towards the skin surface.
  • Two types
    o EUMELANIN – Brown/Black
    o PHEOMELANIN – Reddish/Yellow
  • Function: Cells responsible for making the pigments that gives skin its colour and protecting keratinocytes from UV light by absorbing it. Melanin accumulates in the keratinocytes sitting like an umbrella over the top of the nucleus acting like a physical barrier between the nucleus and the UV rays.
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5
Q

In relation to the epidermis, indicate if the following statements are true or false:

a. It is drained by lymph

b. Contains blood vessels and nerve endings

c. It has the same thickness over the whole body

d. Intracellular fluid (interstitial fluid) provides oxygen and nutrients to cells

A

In relation to the epidermis, indicate if the following statements are true or false:

a. It is drained by lymph - TRUE

b. Contains blood vessels and nerve endings – FALSE
There are no blood vessels and no nerve endings.

c. It has the same thickness over the whole body - FALSE. It varies over the body

d. Intracellular fluid (interstitial fluid) provides oxygen and nutrients to cells and removes waste TRUE

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6
Q

Describe the layers of the epidermis from outer to inner

A

Stratum CORNEUM
25-30 layers of flattened dead keratinocytes. They are shed.

Stratum LUCIDIUM
(IN thick skin only) : 3-5 layers of dead cells

Stratum GRANULOSUM
3-5 layers of cells undergoing apoptosis

Stratum SPINOSUM
8-10 layers of new keratinocytes

E. Stratum BASALE
A single row dividing to form new keratinocytes. The cell factory.

Come Let’s Get Sun Burnt

Corneum Lucidium Granulosum Spinosum Basale

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7
Q

How many days does it take to replace the epidermis?

A

40 days.

Thats what it takes for cells at the Stratum Basale layer to get to the top Stratum Corneum

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8
Q

Name the most superficial layer of epidermis

A

Stratum Corneum which is 25-30 layers of dead flattened keratinocytes

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9
Q

Explain WHY an individual may display the following skin colours?

a. Pink

b. Natural Yellow

A

a. Pink
Due to the level of blood circulation and oxyhaemoglobin which is red in colour

b. Natural yellow
Caused by Carotenes which is the pigment that gives egg yolk and carrots their colour. May be due to diet or a build-up of bilirubin.

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10
Q

Describe the function of the following components of the dermis:

a. Collagen fibres
b. Elastic fibres

A

a. Collagen fibres – give tensile strength for expansion

b. Elastic fibres – allow the skin to stretch and recoil

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11
Q

List 5 of the components are located within the dermis?

A
  • Lymph vessels
  • Sweat glands
  • Sensory nerve endings
  • Hairs
  • Sebaceous glands
  • Arterioles and veins – Arterioles and capillaries for thermoregulation
  • Fibroblasts and immune cells
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12
Q

Name TWO body locations that contain numerous sweat glands.

A

Palms
Sole of the feet
Groin
Armpit

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13
Q

Describe specifically what contributes to ‘sweat odour’.

A

Bacteria breaking down substances present in sweat such as fatty acids.

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14
Q

Name the three sensory nerve endings of the skin

A

Meissner Corpuscle nerve ending
Pacinian nerve
Free nerve ending

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15
Q

What do Meissner’s corpuscles detect in the skin?

A

Nerve endings are very close to the surface. They are used to detect light pressure.

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16
Q

Name the sensitivity for each of the three sensory nerve endings of the skin

A

Meissner corpuscle: Sensitive to light pressure and located near the surface of the skin

Pacinian: Sensitive to deep pressure and much further down in the dermis so have to press quite hard to activate it

Free nerve ending: Sensitive to pain and temperature – 1cm sq has 200 pain receptors
Often extend up into the epidermis and are exposed so have a low threshold for pain or temperature

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17
Q

What do Free Nerve Endings detect in the skin?

A

Sensitive to pain and temperature – 1cm sq has 200 pain receptors
Often extend up into the epidermis and are exposed so have a low threshold for pain or temperature

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18
Q

What do Pacinian nerve endings detect in the skin?

A

Sensitive to deep pressure and much further down in the dermis so have to press quite hard to activate it

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19
Q

Describe the function of the arrector pili muscle.

A

Each and every hair has its own piece of smooth muscle called arrector pili that connects it to the dermis.

Being smooth muscle it is involuntary and its contraction causes the hairs to stand on end known colloquially as goose bumps. Cold weather and fear are usually the drivers.

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20
Q

Dermis:

Name the smooth muscles that attached hair follicles to the dermis

A

Erector Pilli

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21
Q

Explain how age can affect sebaceous gland activity.

A

ACTIVITY INCREASES IN PUBERTY and decreases with age.

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22
Q

Describe the role of Sebum

A

A beneficial oily substance secreted from the sebaceous gland.

Sebum
- keeps hair and skinsoft,
- provides waterproofing for the skin and,
- is anti-microbial inhibitung bacterial growthI

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23
Q

Name THREE body locations containing sebaceous glands.

A

They are all over the body but more concentrated in these locations.

Face, lips, eyelids
Scalp
Nipples
Labial folds
Glans penis (the tip of the penis)

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24
Q

Explain specifically how sebum can act as an anti-microbial.

A

It helps to stop bad bacteria growing on the skins surface.
It is the fatty acids in sebum that inhibit bacterial growth

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25
Q

List FOUR functions of the skin.

A

Protection
Temperature control
Vitamin D production
Sensation
Absorption
Secretion

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26
Q

Describe THREE ways in which the skin provides protection.

A

In general it provides protection against dehydration and external factors such as toxins, chemicals, microbes, light and trauma.

  1. Physical barrier due to the closely packed keratinised cells and melanin

Microbe control
2. Sebum – contains fatty acids that inhibit microbial growth
3. Sweat – contains lysozomes, which are enzymes that break down bacteria
4. Desquamation – shedding of skin cells helps removes microbes

  1. Nerve sensors - warn of danger
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27
Q

What is the normal body temperature?

A

36.5⁰ to 37.5⁰

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28
Q

Describe the main difference between ‘hypothermia’ and ‘hyperthermia’.

A

Hypothermia – when core body Temp drops below 35 ⁰

Hyperthermia – when core body Temp rises above 38.5 ⁰

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29
Q

Name TWO temperature control centres.

A

(i) Hypothalamus
(ii) Medulla Oblongata (Brain stem)

30
Q

Name the nervous system that controls both sweat gland and blood vessels in thermoregulation.

A

Autonomic Nervous System

31
Q

Describe the role of the skin in thermoregulation

A

Direct blood to the skin or away from the skin to regulate heat.

eg: Blood vessels dilate and bring heat to the surface of the skin. Sweat on the surface of the skin leads to the loss of heat energy through evaporation

32
Q

Which body organ is responsible for producing active vitamin D?

A

The Kidneys

Step 1: UV light activates a vitamin D precursor in the skin

Step 2: The kidneys convert the precursor to CALCITRIOL. (Calcitriol is the active form of Vitamin D)

Step 3: Calcitriol acts as a hormone to increase the uptake of CALCIUM and PHOSPHORUS from food into blood

Step 4: Vitamin D is STORED IN THE LIVER

33
Q

Name TWO minerals that vitamin D promotes the uptake from gastrointestinal tract.

A

Calcium
Phosphorous

34
Q

Name the organ where vitamin D is stored in the body.

A

The Liver

35
Q

Discuss the role of the skin with regards to Vitamin D

A

UV lights activates a Vitamin D precursor in the skin without which the kidneys cannot create calcitriol.

36
Q

With regards to skin absorption, list THREE examples for:

a. Lipid soluble molecules

b. Toxins

A

a. Lipid soluble molecules
i. Vit A, D, E, K
ii. Some medications
iii. Essential Oils
iv. O2 and CO2

b. Toxins
i. Acetone
ii. Carbon Tetrachloride
iii. Lead and Mercury
iv. Arsenic
v. Poison oak and ivy

37
Q

Name two of the substances that the skin can excrete

A

Water
Salt
Urea
Ammonia

38
Q

Describe how superficial wounds heal.

A

A superficial wound includes abrasions and burns.

Basal cells move across the gap until CONTACT INHIBITION occurs and the space if filled.

This is helped by EPIDERMAL GROWTH FACTOR causing multiplication of the basal cells until the space is filled.

39
Q

Describe specifically how deep wounds heal (HINT – think of three phases).

A

A deep wound is one that effects the dermis and subcutaneous level

Phase 1: Inflammatory Phase
i. MIGRATION OF LEUKOCYTES to clean up any microbes and foreign tissue
ii. BLOOD CLOT FORMS and becomes a scab
iii. Epithelial cells migrate to REPAIR THE BASEMENT MEMBRANE

Phase 2: Proliferative Phase
i. Granulation tissue is formed with The LAYING OF COLLAGEN AND BLOOD VESSELS
ii. Extensive growth AND REPAIR OF EPITHELIAL CELLS

Phase 3: Remodelling phase
i. Can take 3 weeks to 6 months
ii. Scab sloughs off and scar tissue (Fibrosis) remains

40
Q

Compare Hypertrophic and Keloid scar

A

They are both types of scar tissue. Defined as a mark left on the skin or other body tissue where a wound, burn or sore has not healed completely and fibrous connective tissue develops.

It contains DENSER COLLAGEN FIBRES, fewer hairs, glands, nerve endings and blood vessels (which is why it is paler).

HYPERTROPHIC SCAR stays within the boundaries of the wound and is usually flat

KELOID SCAR is caused by over proliferation of cells takes up a larger space than the wound and is usually raised.

41
Q

With regards to skin lesions, define

a. Papule
b. Lichenification
c. Pustule
d. Macule

A

Papule: A small firm elevated lesion:

Lichenification: Thick dry rough plaques of thickened skin

Pustule: Small elevated erythematous (redness) lesion containing purulent exudate

Macule: Small flat circumscribed lesion of a different colour to normal skin

42
Q

Describe the difference between an ‘open comedone’ and a ‘closed comedone’.

A

Blackheads, whiteheads or red bumps are due to excess sebum, keratin and debris forming a plug in the sebaceous duct of a hair follicle.

An open comedone is a BLACKHEAD. When oil is open to the air it will oxidise and therefore turn dark.

A closed comedone is a WHITEHEAD. It remain white if the skin has grown over the oily material.

43
Q

Using pathophysiology, describe the difference between irritant contact dermatitis and allergic contact dermatitis.

A

Contact Dermatitis is an acute inflammation of the skin caused by direct contact with an agent. There are two types.

Irritant Contact Dermatitis (ICD) represents about 80% of cases. It is an irritation to the skin that only happens when the person comes into contact with an irritant like a chemical or something we are allergic to in a contact way.

The signs and symptoms we see is ulceration, burning, prickling, soreness and quicker onset of symptoms.

Allergen Contact Dermatitis (ACD) represents about 20% of cases. It is a specific reaction to an allergen which after initial exposure body will be sensitised to react to in the future. It is usually a delayed hypersensitivity of up to 72 hours.

In ACD we see an itchy rash but a slower onset of symptoms.

44
Q

Describe ONE sign / symptom more suggestive of allergic contact dermatitis.

A

Slower onset of symptoms
PRURITIS (Itchyness) is significant.

45
Q

Describe ONE sign / symptom more suggestive of Irritant contact dermatitis.

A

Quicker onset of symptoms
Ulceration, burning, prickling, soreness

46
Q

Explain how continued exposure to soap can lead to irritant contact dermatitis?

A

Hands are vulnerable due to frequent occupational exposure to soap that can abrade the lipids in the skin

47
Q

Name TWO allergens involved in allergic contact dermatitis.

A

Chemicals
Rubber
Plants
Metals

48
Q

Describe the difference between ‘phototoxic dermatitis’ and ‘photoallergic contact dermatitis’.

A

Phototoxic: Topical irritants such as perfume or ingested IRRITANTS ARE ACTIVATED by exposure to UV rays. It affects sun exposed skin only.

Photoallergic: A substance becomes allergenic only after it undergoes UNDERGOES A STRUCTURAL CHANGE triggered by UV light. For example sun screens

49
Q

List THREE food allergens which can contribute to atopic eczema.

A

Milk, eggs, soy, wheat, peanuts, fish

50
Q

List TWO airborne allergens which can contribute to atopic eczema.

A

Dust mites; moulds, pollen

51
Q

Using pathophysiology, describe the difference between ‘atopic eczema’ and ‘psoriasis’.

A

Atopic eczema is an immune mediated inflammatory disease in response to particular allergens in the environment and also genetic weakness in epidermal barrier function. Our body over releases IgE antibodies and a large dose of histamine is the result.

In 2/3 rds of cases there is a family history of atopic disorders such as asthma or allergic rhinitis, thought to be through a genetic weakness in the epidermal barrier function.

In short…
- Immune tendency to overreact to normal things in our environment
- Compromises skin barrier due to a MUTATION of the gene making FILAGGRIN which is important for helping knot our skin cells together tightly. LOSS OF FILAGGRIN may result in impaired skin barrier function and subsequent entry of foreign ENVIRONMENTAL substances that may trigger an immune response.

Psoriasis is a chronic, autoimmune and inflammatory disease. An latered immune response in the skin leads to inflammatory chemicals being released that send skin cells into production overdrive.

STRATUM BASALE IS DIVIDING TOO QUICKLY MAKING ABNORMAL KERATIN and leading to skin renewal within 7 days rather than 40.
Reduced shedding and an accumulation of the Stratum Corneum causing SILVERY SCALES AND FLAKES on the skins surface

52
Q

Explain why lichenification is a sign of atopic eczema in older children.

A

Lichenification is thick dry rough plaques of thickened skin that occurs in atopic eczema due to broken skin from scratching

53
Q

Compare location of lesions in atopic eczema and psoriasis.

A

In atopic Eczema lesions are on the cheeks and on FLEXOR SURFACES such inside the elbow, backs of the knees and folds of the armpits.

In Psoriasis it is characteristically the EXTENSOR SURFACES – wrists, elbows and knees and also the SCALP

54
Q

List TWO signs / symptoms of psoriasis.

A
  • RED SCALY PLAQUES covered with OVERLAPPING SILVERYSHINY SCALES that may blees
  • ARTHRITIS is a downstream outcome in 14% of cases
  • characteristically the EXTENSOR SURFACES – wrists, elbows and knees and also the SCALP are where you see this.
  • Possibly tiny dents in fingernails/toenails
55
Q

Name TWO trigger factors in psoriasis.

A

Infection
Chemicals
Alcohol
Stress
Anti-malarials
Beta-Blockers

56
Q

Define Hives

A

An itchy red, blotchy, raised rash resulting from swelling of superficial skin

57
Q

Using pathophysiology, describe the difference between ‘acne vulgaris’ and ‘acne rosacea’.

A

Acne Vulgaris:

Blockage of the sebaceous/ hair follicle duct due to oil that normally drains to the skin surface getting blocked by excess skin cells inside the follicle. An ideal breeding ground for bacteria to grow and acne to thrive.

Acne Rosacea:

Chronic inflammation of the skin which is associated with vascular changes and result in FACIAL FLUSHING. The skin is overreactive. Blood vessels dilate very easily through a variety of triggers leading to a flushing reaction which over time leads to changes in the vasculature in the skin and the redness becomes permanent.

Gastric Helicobacter Pylori is found in 88% of patients and is thought to trigger the flushing reaction

Whilst it is often accompanied by SEBORRHOEA (excessive discharge of Sebum), it is not an inflammation of the follicles

58
Q

Name TWO body locations affected by acne vulgaris.

A

Face
Back
Chest

59
Q

Explain specifically how diet plays a role in acne vulgaris.

A

Acne Vulgaris is highly prevalent in WESTERN POPULATIONS and in some non-westernised populations it is almost completely absent, pointing to an environmental cause. One of these factors is diet.

Insulin is a big factor.

Foods that are HIGH IN GLUCOSE AND ELEVATE INSULIN LEVELS and also DAIRY foods
- promote oil production and excess skin cell production in follicles
- cause the testes and ovaries to produce excess testosterone

60
Q

What is meant by ‘inflammatory acne’?

A

This begins as closed Comedones. Distension of the follicle occurs causing inflammation. Red, swollen and sore bumps containing pus, dead skin cells and excess oil.

61
Q

Define seborrhoea.

A

Excessive discharge of Sebum. Basically oily skin

62
Q

With regards to acne rosacea, which gender is most affected?

A

Women

63
Q

List TWO causes of acne rosacea.

A
  • Exaggerated vasodilatory response to hyperthermia
  • HIGH INCIDENCE OF GASTRIC HELICOBACTER PYLORI FOUND IN 88% OF PATIENTS
  • Environmental – oil, chlorine, UV
  • Cosmetics – eg: Paraffin
  • Medication
  • Stress
64
Q

List TWO signs / symptoms more suggestive of acne rosacea.

A
  • FACIAL FLUSHING - across nose and cheeks
  • Seborrhoea with papules and pustules
65
Q

Name the virus which contributes to warts and verrucae.

A

Human Papillomavirus 2 and 4

66
Q

Describe the lesion of warts.

A

Papular lesions with a course roughened surface. Usually with a red margin.

67
Q

Name ONE endocrine pathology associated with skin tags.

A

Hyperinsulinaemia = Elevated insulin in blood

68
Q

Explain how autoimmunity can lead to vitiligo.

A

Vitiligo is due to the loss of melanocytes. It is hypothesised that increased number of Langerhans cells may inhibit the proliferation of melanocytes.

Langerhans cells, help regulate the immune system and are normally found throughout the body, especially in the skin, lymph nodes, spleen , lungs, liver , and bone marrow

69
Q

Describe the appearance of vitiligo.

A

The skin loses its pigmentation in parts of the body

70
Q

With regards to burns, which skin layer is affected by which degreee of burn?

A

Degree of burn / Skin layer affected:
1st - Epidermis
2nd - All of the epidermis and some dermis
3rd - Extends into subcutaneous tissue
4th - Extends into muscles and tendons

71
Q

Explain specifically how the following complications can arise from burns:

a. Dehydration

b. Hypothermia

c. Renal failure

A

a. Dehydration – due to loss of water and plasma through damaged skin

b. Hypothermia – due to impaired thermoregulation and heat loss

c. Renal failure – if the kidneys cannot filter waste from broken down red blood cells and damaged tissue

Kerri's Part 1 Biomed Slides (13 decks)

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