chapter 5- the epidermis Flashcards

1
Q

what does the integumentary system consist of?

A

the skin and accessory structures such as hair, nail, and glands

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2
Q

what are the functions of the integumentary system?

A

protection (from UV damage and MOs)
acts as a barrier
prevents water loss
sensation (hot vs cold, touch, pressure, pain, temp regulation via blood flow and sweat glands)
vitamin D protection
calcium homeostasis role
excretion of waste products through skin and glands

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3
Q

what does the epitheleal tissue consist of?

A

20-25 layers of stratified squamous cells

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4
Q

what are the layers of the skin?

A

epidermis
dermis
hypodermis (not true skin)

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5
Q

epidermis

A

upper layer, stratified squamous epithelial tissue
avascular, keratin, rapid cell division

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6
Q

dermis

A

lower layer, dense irregular CT (stronger)
true skin
vascular, glands, elasticity that decreases with age

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7
Q

hypodermis

A

NOT SKIN
subcutaneous tissue, adipose tissue (loose CT)

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8
Q

what are the four types of epidermal cells?

A

keratinocytes
melanocytes
langerhans cells
merkel cells

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9
Q

keratinocytes

A

most cells
WATERPROOFER
get sloughed off
undergo mitosis
keratin protein
resists friction and water loss
*psoriasis

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10
Q

melanocytes

A

produces melanin pigment
contributes to skin color, protects from UV damage and UV light
25% of the skin’s last layer

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11
Q

langerhans cells

A

macrophages, immune system- stays stationary until phagocytosis

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12
Q

merkel cells

A

specialized cells with nerve ending, light touch and surface pressure
deepest layer of the epidermis
(bug touching your arm)

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13
Q

what are the 5 epidermal layers ?

A

stratum corneum
stratum lucidum
stratum granulosum
stratum spinosum
stratum basale

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14
Q

stratum corneum

A

superficial layer, 25+ layers thick, slough, horny cells (dead keratinocytes)

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15
Q

stratum lucidum

A

thin clear zone, found in THICK skin, missing in thin skin.
palms and feet

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16
Q

stratum granulosum

A

up to 5 layers of flat and granulated cells
granules and dye appearance
alternative color and small amount of protection

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17
Q

stratum spinosum

A

8-10 layers, appears spiny
(was known as the stratum muosum)

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18
Q

stratum basale

A

stratum germinativum (everything from epidermis arises from this layer)
single base layer that anchors to the basement membrane (hemidesmosomes)
mitosis, merkel cells and melanocytes are 1/4 of this layer

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19
Q

thick skin

A

5 layers, seen in areas of increased friction
palms, soles, fingertips

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20
Q

thin skin

A

4 layers, missing stratum lucidum, seen in rest of the body
overall more flexible

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21
Q

what is a callus ?

A

stratum corner increases in thickness, more layers for added protection where there is more mechanical stress

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22
Q

what is a corn?

A

seen in bony prominence areas
apex area deep in epidermis
pain due to pressure

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23
Q

melanin

A

found in skin, hair, eye color
melanin protects DNA from UV damage
keratin and hemoglobin also contribute to color
removes free radicals and boosts antioxidants
ancestors determine melanin

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24
Q

what are the steps of melanin production?

A
  1. melanocytes are produced, package into vesicles (melanosomes)
  2. melanosomes move into cell processes of melanocytes
  3. tips of melanocyte cell processes are phagocytized by keratinocytes (acquire melanosomes)
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25
Q

tyrosine amino acid

A

melanin (polymer that provides pigmentation for skin)
pigments can be brown, yellow, or red
genetic factors determine the types
degree of melanin production is influenced by light exposure and hormones

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26
Q

true or false, all humans are born with the same amount of melanocytes

A

true

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27
Q

what is tanning?

A

brownish black pigment, increased melanin produced

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28
Q

racial variation with melanin

A

due to : type of melanin, amount, size, number, and distribution of melanosomes

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29
Q

eumelanin

A

true melanin
brown and black skin, eyes, hair (blonde, brown, black)

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30
Q

pheomelanin

A

found in lips, nipples, pink parts of body

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31
Q

albino

A

lack tyrosinase (can’t go from tyrosine to melanin)
does not produce melanin, no skin pigment
white hair, blue eyes, pinkish skin
risk vision loss and skin damage, high risk of skin cancer

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32
Q

carotene

A

yellow pigment found in plants- carrots
yellow tinted skin found with increased consumption

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33
Q

hemoglobin

A

pinkish hue due to oxygenated pigment in RBCs, which circulate through dermal capillaries
lack= pallor, stress, low BP and anemia

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34
Q

cyanosis

A

bluish discoloration due to lack of oxygen

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35
Q

erythema

A

increase from sunburn, infection, rash, hot flash, allergic reactions

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36
Q

bruise

A

change color from red, to blue, to purple, to yellow
damage to BV

37
Q

what type of fibers are most prevalent in connective tissues?

A

connective tissues

38
Q

what type of cells are in the dermis?

A

fibroblasts, adipocytes, and macrophages

39
Q

besides the cells, what else makes up the dermis?

A

blood vessels, nerve endings, hair follicles, glands, lymph vessel,s smooth muscle

40
Q

papillary dermis

A

thin, upper loose CT; meissner’s corpuscles (touch receptors)
epidermal ridges (fingerprints for grip)

41
Q

reticular dermis

A

deep and dense irregular CT; Pacinian Corpuscles (Collagen & Elastic)
Cleavage Lines (Tension) Incision - Parallel with the tension = Less gap/scar
Stretch Marks (Striae) – areas of rapid growth (Pregnant, Rapid muscle growth)

42
Q

subcutaneous tissue (hypodermis)

A

area of attachment from skin to underlying bone and muscle
provides skin with blood vessels and nerves

43
Q

what is subcutaneous tissue made up of ?

A

loose CT with collagen and elastic fibers

44
Q

what does subcutaneous tissue do ?

A

insulates and pads, acts as an energy source

45
Q

subcutaneous tissue factors

A

age, sex, diet all have an impact
women have more in their thighs, breast, and butt

46
Q

subcutaneous tissue cells

A

fibroblasts, adipocytes (for protection, insulation. and an alternative energy source), and macrophages

47
Q

what are injections used for?

A

to inject certain substances into the body via a skin puncture (medication and vaccines)

48
Q

what are the 3 types of injections

A

intradermal
subcutaneous
intramuscular

49
Q

intradermal injection

A

in the dermis
for local anesthetics, sensitivity- allergy and tb skin test
uses a shallow angle

50
Q

subcutaneous injection

A

in subcutaneous tissue
for insulin, opioids, and allergy meds
uses a short needle

51
Q

intramuscular

A

in the muscle
90 degree angle, long needle
used for vaccines , DTaP, rabies, herpes zoster

52
Q

what are examples of accessory structures?

A

hair, nails, glands

53
Q

hair (pili)

A

flexible dead protein strands.
3 layers: medulla, cortex, and cuticle
hair papilla - has BVs

54
Q

where is hair found on the body?

A

everywhere except for the palms, soles, lips, nipples, external genitalia, distal fingers and toes.

55
Q

what does the arrector pili do?

A

smooth muscle that contracts to lift the hair in response to cold

56
Q

nails

A

clear coated region on he doral distal portion of the digits
aids in grasping and itching
has a free edge and body
anchored under the skin

57
Q

what are the two types of sweat glands?

A

eccrine and apocrine

58
Q

eccrine glands

A

sweat- cools the body
palms, soles, axillae

59
Q

apocrine glands

A

in axilaes and anogenital region
has no odor

60
Q

what are the 4 types of glands?

A

sweat, mammary, sebaceous, and ceruminosas

61
Q

sebaceous glands

A

oil (sebum in hair), softens and lubricates skin
kills bacteria

62
Q

mammary glands

A

women, lactation

63
Q

ceruminosas glands

A

earwax
an insect repellent

64
Q

what is a burn?

A

tissue damage due to excess heat, electricity, radiation, or chemicals

65
Q

what happens to the body when there is a burn?

A

lose boyd fluids, dehydration, electrolyte imbalance, renal shutdown, circulatory shock

66
Q

what is the rule of 9s?

A

determines amount of loss
11 areas with parallel areas (each 9%), genitals= 1%

67
Q

what % body surface area is the entire head and neck?

A

9%

68
Q

what % body surface area is the entire arm?

A

9%

69
Q

what % body surface area is the trunk?

A

36%

70
Q

what % body surface area is the groin?

A

1%

71
Q

what % body surface area is the entire leg?

A

18%

72
Q

what degree burns are partial thickness burns?

A

1st and 2nd degree

73
Q

1st degree burns

A

only in the epidermis
local redness, swollen, pain
heals in 2-3 days
sunburn

74
Q

2nd degree burn

A

epidermis and upper dermis
red, pain, edema, blisters
heals in 3-4 weeks
minimal scarring

75
Q

what are considered full thickness burns?

A

3rd and 4th degree

76
Q

3rd degree burn

A

epidermis/ dermis and into hypodermis
blanched, cherry red, or black
no pain
skin graft usually needed
remove eschar by debridement
need abx and synthetic membrane
and healthy skin transplant
risk of rejection

77
Q

4th degree burn

A

very severe
deeper than subQ
tendons, muscles, and bones affected
may require amputation

78
Q

what is the burn treatment for a 1st degree burn ?

A

aloe, topical analgesics, NSAID, ice, moisturizer

79
Q

what is the burn treatment for a 2nd degree burn ?

A

rinse with cold water until the pain stops, pat dry do not rub, clean burn
use ointment to keep moist, use a nonstick bandage

80
Q

what is the burn treatment for a 3rd degree burn ?

A

high calorie and protein diet
go to the hospital, clean and debride,
IV fluids and abx, silvadene cream
skin graft

81
Q

what is the burn treatment for a 4th degree burn ?

A

high calorie and protein diet
go to the hospital
surgery or skin graft
possible amputation and lengthy rehab
high risk of infection

82
Q

what is the most common cause of skin cancer?

A

20% of skin cancer is from exposure to UV rays from the sun and tanning beds
chemicals, X-rays, and immune system compromise can also cause it

83
Q

what are the three types of skin cancer?

A

basal cell carcinoma
squamous cell carcinoma
malignant melanoma

84
Q

basal cell carcinoma

A

least malignant, very common (80%)
grows slow
stratum basale is altered, proliferates into dermis and hypodermis
on face - shiny with a central ulcer with a pearly edge.
99% cured with surgery

85
Q

squamous cell carcinoma

A

second most common, grows fast, metastasizes
stratum spinosum keratinocytes
scaly, red, raised papule- may be open and bleed
found on head and hands
treat with surgery/ radiation

86
Q

malignant melanoma

A

least common, 40% develop from preexisting moles
highly metastatic, resist chemo
melanocytes become cancerous
5 year survival rate (5%), reoccurrence is deadly
77% of skin cancer deaths in the US
spreading brown-black pigment patch
metastasize to lymph and BVs
require wide excision surgery

87
Q

what is the ABCDE rule

A

early detection of melanoma
A- asymmetry (uneven appearance)
B- boarder irregularity (blurry edges)
C- color- pigment varies (blues)
D- diameter (>6 mm)
E- evolving/ elevation- changes in size, shape, color, elevation, bleeding, itchiness, crusty

88
Q

how can you prevent skin cancer?

A

UV protective eyewear and clothes, SPF 15+, no tanning beds.