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NRS 250: Exam 3 Derm > Anatomy > Flashcards

Anatomy Flashcards

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Dermatology Board Prep flashcards
1
Q

Function of the Integumentary System

A
  1. protection
  2. waste excretion
  3. body temp
  4. production of melanin
  5. production of keratin
  6. synthesis of Vitamin D3
  7. fat storage
  8. sensation
  9. Immune response: innate, inflammation
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2
Q

Layers of the Skin

A
  • Epidermis
    • stratum basale
    • stratum spinosum
    • stratum granulosum
    • stratum lucidum
    • stratum corneum
  • Dermis
    • papillary layer
    • reticular layer
  • Subcutaneous/Hypodermis
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3
Q

Epidermis general

A
  • keratizined stratified squamous epithelium
    • keratin and related proteins are tough, fibrous, and waterproof
  • glycoproteins: are waterproof, are a film of lipids
  • is avascular → receives all of its nutrients via diffusion from the underlying connective tissue
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4
Q

Keratinocytes

A
  • majority (99.9%) of skin cells
  • keratin = water resistant, tough, fibrous protein related to intermediate filament protein
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5
Q

Langerhans Cells

A
  • antigen presenting cells (immune cells) located in the epidermis
  • engulf pathogens and cellular debris
    • present antigens in skin to T-cells
    • can migrate to nearest lymph nodes
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6
Q

Melanocytes

A
  • pigment producing cells located near basal layer of epidermis
    • they reach out into the upper layers
  • melanin: absorbs UV radiation, which helps to prevent DNA and tissue damage
    • also determines skin color
      • eumelanin: brown-black
      • pheomelanin: red-yellow
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7
Q
A
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8
Q

Skin Color

A
  • Melanin:
    • eumelanin: brown-black
    • pheomelanin: yellow-red
  • Bilirubin levels: yellow/jaundiced
  • carotene (dietary): orange-yellow
  • blood flow:
    • increased circulation = pink/red
    • decreased circulation = pale/white
    • lack of oxygen = cyanotic
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9
Q

Thick Skin vs Thin Skin

A
  • Thick skin:
    • has all 5 layers including the stratum lucidum
    • thicker layer of stratum corneum
    • location: palms of hands and feet
    • epidermal ridge: finger print
  • Thin Skin:
    • only 4 layers
    • location: everywhere else on the body
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10
Q

Dermis General

A
  • strong, elastic, flexible layer filled with blood vessels and sensory receptors
  • 1-4mm thick
  • made up of connective tissue, blood vessels, lymphatics, sensory cells and nerves
  • 2 layers:
    • papillary layer
    • reticular layer
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11
Q

Papillary Layer

A
  • part of dermis
  • areolar connective tissue
  • dermal papillae–form epidermal ridges (rete pegs)
  • blood vessels, lymphatic vessels, nerves, sensory cells
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12
Q

Reticular Layer

A
  • deepest layer of the dermis
  • dense irregular connective tissue
  • contains: blood vessels, lymphatic vessels, nerves, sensory cells, base of hair follicles and glands
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13
Q

Cells found in the dermis

A
  1. Fibroblasts
  2. Mast Cells
  3. Macrophages
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14
Q

Fibroblasts

A
  • located in the dermis
  • secrete connective tissue matrix throughout the dermis
  • primary cells in the dermis
  • surrounding by matrix (made of collagen and elastin)
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15
Q

Mast Cells

A
  • immune cells located in the dermis
  • contain granules of histamine and heparin
  • vasoactive and pro-inflammatory mediators
  • coated with IgE → allergy and anaphylaxis reactions
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16
Q

Dermal Blood Flow

A
  • blood supply is only in the dermis
  • under the control of alpha-adrenergic receptors
    • activation of the sympathetic nervous system will cause vasoconstriction of these blood vessels
  • Vasodilation = release heat
  • vasoconstriction = conserve heat
17
Q

Subcutaneous Layer of the Skin

A
  • deep to the dermis
  • contains adipose and some aerolar connective tissue
    • anchors skin to underlying muscle
    • allows skin to slide with relative ease
    • energy reserve, insulation, shock absorber
18
Q
A
19
Q

Hair Follicles and Hair Definition

A
  • Hair Follicle:
    • tiny hair producing organ that extend into the deep dermis and even into the subcutaneous layers
  • Hair:
    • non-living keratinized structure
    • function:
      • insulate the skull
      • keep out foreign particles
      • are sensory receptors
20
Q

Arrector Pili

A
  • muscle that causes goose bumps
  • involuntary, smooth muscle that attaches to the hair follicle
    • when it contracts, it pulls on the follicle and raises the hair up
21
Q

Sebacious Gland

A
  • secrete sebum into the hair follicle
  • secrete oil onto the skin surface
  • stimulated by androgens,
    • get bigger during puberty
  • keep hair and skin supple
  • kill bacteria
  • location: face, chest, and back
    • some modified glands on eyelids, lips, nipple, glans penis, prepuce
22
Q

Suderiferous Glands

A
  • aka sweat glands
  • eccrine/merocrine glands:
    • coiled tubular gland, duct opens to the skin surface
    • watery secretion →perspiration (cooling effect)
    • location:
      • widely distributed especially on hands, feet, and face
  • apocrine glands: ducts that empty into hair follicles
    • location:
      • axillary and genital regions
      • produce milky sweat: water with lipids and proteins
23
Q

Location of Hyponychium, Eponychium, Paronychium

A
24
Q

Nail Structure

A
  • Nail Plate:
    • free edge, nail body (lunula = thickened white)
    • nail root
  • nail bed: under the nail body
  • nail fold: over the nail root
  • eponychium: (cuticle) margin of the nail fold
  • hyponychium: under free edge
  • paronychium: near sides of the nail plate
25
Q

Functions of Vitamin D

A
  • calcium and phosphate homeostasis:
    • vitamin D = increased calcium and phosphate absorption from small intestine
    • with the help of parathyroid hormone
      • increases renal reabsorption of calcium
      • increases renal excretion of phosphate
      • enhances bone calcification, bone growth, bone remodeling
  • Other functions:
    • cell growth
    • immune function
    • neurologic function
    • reduction of inflammation
26
Q

Ergocalciferol

A
  • vitamin D2
  • inactive precursor
  • can be given as a supplement
27
Q

Cholecalciferol

A
  • vitamin D3
  • inactive precursor
  • can be given as a supplement
  • made in the skin
  • hydroxilated by the liver where it becomes calcifediol 25(OH)-vitamin D3
28
Q

Calcifediol

A
  • 25 (OH)- vitamin D3
  • an intermediate form with a long half life
    • travels the the blood stream where it can travel to the kidneys to get hydroxilated and transformed into active form
    • what we test for in lab tests
29
Q

calcitriol

A
  • 1,25-dihydroxy-vitamin D3
  • active form of vitamin D
30
Q

To end up with 1,25(OH) Vitamin D3

A
  • requires:
      1. sunlight OR supplementation of ergocalciferol or cholecalciferol
    • AND functional activation of the liver AND Kidneys
31
Q

What can cause Vitamin D deficiency

A
  • liver disease
  • kidney disease
  • intestinal malabsorption (Celiac’s diseasem crohn’s disease)
  • Lack of UV (B) exposure
    • we require 15-30 minutes/day
32
Q

Rickets

A
  • in children (called osteomalacia in adults)
  • caused by:
    • lack of Vitamin D due to sunlight, dietary insufficiency AND/OR lack of calcium or phosphate
    • → demineralization of bone
  • Clinical presentation:
    • bone: tenderness, deformity, joint pain, increased risk of fracture
      • in children: growth problems, varus deformity (leg bowing), “rickety rosary” (costochondral swelling), lumbar lordosis, greenstick fractures
    • muscle: weakness/spasms or tetany
    • neurological: seizures
    • cardiovascular: cardiomyopathy
    • other: enlarged spleen and liver
33
Q

Dietary Sources of Vitamin D

A
  • fatty fish and fish oil
  • beef liver, cheese, egg yolks
  • mushrooms
  • fortified foods
  • NOTE: all infant formula contains vitamin D → breastfed infants need to be supplemented
34
Q

Normal Serum Levels of Vitamin D

A
  • >/= 50nmol
35
Q

Recommended amount of Vitamin D

A

NRS 250: Exam 3 Derm (14 decks)

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