2a. Dermatological Principles Flashcards
What are the appendages of the skin?
Nails, Hair, Glands, Mucosae
What type of cell is the epidermis composed of?
Stratified squamous epithelium (mainly Keratinocytes)
What as the layers of the epidermis?
Basal Layer
Prickle Cell Layer
Granular Layer
Keratin Layer
What muscles allows hair to stand up?`
Arrector Pili Muscle
Describe the basal layer
Stem Cell layer One cell thick Small cuboidal cells Lots of intermediate filaments High metabolic activity
Describe the prickle cell layer
Large polyhedral cells
Lots of desmosomes with intermediate filaments
Describe the granular layer
2-3 layers of flatter cells
Large Keratohyalin granules
What do the granules in the granular layer contain?
Filaggrin
Describe the keratin layer?
Corneocytes - non-nucleated cell remnants
INSOLUBLE
What are lamellar granules?
Secretory organelles found in type ii alveolar cell sin the lungs and keratinocytes in the skin
What are the other cells in the epidermis?
Melanocytes, Lagerhans Cells, Merkel Cells
What are melanocytes?
Pigment producing dendritic cells.
Why do melanocytes have synaptic function?
They have synaptic function to release the melanin pigment.
How do melanocytes function?
Convert tyrosine to melanin pigment. Melanin absorbs lights
Why is melanin mostly at the top of the cell?
To protect DNA in the nucleus from damage
Where are langerhans cells found?
Prickle cell level in epidermis; dermis; lymph nodes
What is the function of langerhans cells?
Antigen presenting cells
What are racket organelles?
Possibly do something to do with antigen processing
Where are merkel cells found?
Basal layer - between keratinocytes and nerve fibres
What is the function of merkel cells?
Mechanoreceptors. They connect to the nerve endings and a direct connection to the CNS
What are the phases if hair growth?
Anagen - Growing
Catagen - Involuting
Telogen - Resting
What is the name of the layer of subcutaneous tissue beneath the dermis?
Hypodermis (superficial fascia)
Where do the arteries that supply the skin come from?
The dermis and the subcutaneous tissue
What is the pilosebaceous unit?
The hair follicle and all the appendages surrounding it
What is the pilosebaceous unit composed of?
Hair follicle Arrector pili muscle Sebaceous gland Hair root Apocrine sweat gland
What is the function of the sebaceous gland?
Produces sebum to lubricate the hair and connects the hair follicle
Where are the apocrine sweat glands found?
Axilla and genetalia
Where are the eccrine sweat glands found?
Skin of the forearms and legs
What is the dermo-epidermal junction?
Interface between epidermis and dermis
What is the role of the dermo-epidermal junction?
Support Anchorage Adhesion Growth Differentiation of basal cells
What is the dermis embryologically derived from?
Mesoderm
What is the function of the dermis?
A connective tissue support system for the skin
What cells are contained in the dermis?
Mainly fibroblasts Macrophages Mast cells Lymphocytes Langerhans cells Collage and elastin fibres
What cells make collagen and elastin in the dermis?
Fibroblasts
Why do people of colour have less pronounced photo ageing?
Greater UV protection due to a larger amount of melanin in skin keratinocytes
What are the two vascular plexuses in the dermis?
Superficial vascular plexus
Deep vascular plexus
Where do the lymphatics run in the dermis?
They follow the vascular plexuses
What is the immune functions of the lymphatics in the skin?
Immune surveillance by circulating lymphocytes and langerhans cells
Channelling of micro-organisms and toxins
What are the somatic sensory nerves in the dermis?
Free nerve endings in the high dermis
Special receptors
What are the pressure receptors in the dermis?
Pacinian bodies
What are the vibration receptors in the dermis?
Meissners corpuscles
What does the autonomic nerve supply in the dermis?
Blood vessels, nerves and glands
What are the 3 main segments of the hair follicle
Infundibulum - upper part
Isthmius - where sebaceous gland opens into the hair follicle and location of stem cells
Hair bulb - base of the follicle
What are the three types of glands in the dermis?
Sebaceous
Apocrine
Eccrine
What is the function of the eccrine gland?
True sweat gland - makes watery sweat for thermoregulation and filtration
What is the function of the sebaceous gland?
Attaches to the hair follicle making sticky oil to lubricate the hair follicle.
Hormone sensitive.
This controls moisture loss and protects from fungal infections.
What is the function of the apocrine gland?
Discharges into the hair follicle. Purpose unclear
At what age are sebaceous and apocrine glands activated?
During puberty
What are the functions of the skin?
Barrier function Metabolism and detoxification Thermoregulation Immune defence Communication Sensory functions
What is the metabolic activity of the skin?
Vitamin D metabloism
Thyroid hormone metabolism
Metabolism of chemicals, pollutants, drugs and sunlight
What does UBV convert to produce Vitamin D3?
7-dehydrocholesterol
Describe thyroid hormone metabolism in the skin?
Thyroxine –> Triiodothyronine
What is the named fascia of the upper libs?
Pectoral fascia
Deltoid fascia
Brachial fascia
Antebrachial fascia
What is the names fascia of the lower limb?
Fascia lata - thigh
Iliotibial tract
Crural fascia - leg
Where does the arterial supply to the upper limb begin?
Subclavian artery
What vessels does arterial blood flow through in the arm?
Subclavian –> brachial –> deep brachial –> radial (laterally) & ulnar (medially) –> deep and superficial palmar arches –> metacarpal and digital arteries
How many digital arteries are there per digit of the hand?
4
Where does the arterial supply to the lower limb begin?
External iliac artery
What vessels does arterial blood flow through in the leg?
External iliac artery –> femoral and deep femoral–> popliteal artery –> anterior and posterior tibial –> arteries of the foot
What are the arteries of the foot?
Medial and lateral plantar
Arcuate
Deep plantar arch
Metatarsal and digital
What are end arteries?
There is no collateral blood supply in an area
Where is the pulse of the bifurcation of the common carotid?
Anterior to sternocleidomastoid muscle at the level of the upper border of the thyroid cartilage
Describe superficial veins of the limbs
In superficial fascia
Variable patterns
Smaller and thinner
drain into deep
describe the deep veins of the limbs
Run deep to the deep fascia
More predictable pattern
Larger and thicker
Often occur in neurovascular bundles
What are the main superficial veins in the upper limbs?
Cephalic Vein
Basilic Vein
What is the median cubital vein?
A vein that is formed from the connection of the basilic and cephalic vein
What are the main superficial veins in the lower limbs?
Great saphenous vein
Small saphenous vein
What are vena comitantes?
Veins that surround the artery in a fascial sheath
Where do superficial lymphatic vessels of the upper limbs that follow the basilic vein drain to?
Cubital nodes then lateral axillary nodes
Where do superficial lymphatic vessels of the upper limbs that follow the cephalic vein drain to?
Apical axillary nodes
Where do the lymph vessels of the upper limb eventually drain to?
Subclavian nodes