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Derm anatomy Flashcards

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Dermatology Board Prep flashcards
1
Q

Where is thick skin found on the body?

A

Palms of hands, bottoms of feet, fingers, toes

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2
Q

Stratum corneum

A

Most superficial layer (20-30 cell layers thick in thick skin). All keratinocytes in this layer are dead. Layer deep to stratum is the stratum lucidum (thick skin only) or stratum granulosum

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3
Q

Layers of epidermis that are dead

A

Stratum corneum, stratum lucidum, and stratum granulosum (beginning to die)

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4
Q

Stratum lucidum

A

Thick skin only! 5-10 cell layers thick, SF: s. Corneum; D: s. Granulosum. Keratinocytes are dead in this layer

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5
Q

Stratum granulosum

A

5-10 cell layers thick. Keratinocytes are beginning to die. SF: s. Lucidum (thick skin only) or s. Corneum; D: s. Spinosum

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6
Q

Stratum spinosum

A

10-20 cell layers thick. Cells are alive but beginning to produce precursor protein for cell death in more superficial layers. SF: s. Granulosum; D: s. Basale

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7
Q

Stratum basale

A

Deepest later of the epidermis; 1-2 cell layers thick; site of cell division for SF layers of epidermis; contains melanocytes and Merkel cells. SF: s. Spinosum; D: basement membrane (separates epidermis from dermis)

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8
Q

Melanocyte

A

Present in stratum basale layer of epidermis. Produce pigment that determine skin color

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9
Q

Merkel Cell

A

Oval shaped mechanoreceptors that specialize in light/fine touch stimuli. Present in stratum basale layer of epidermis.

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10
Q

Layers of epidermis

A

(Stratum) corneum (10-20 layers thick for thick skin, less otherwise), lucidum (thick skin only, 5-10 cell layers), granulosum (5-10 layers), spinosum (10-20 cell layers), basale (1-2 cell layers). All layers are composed of stratified squamous epithelial tissue.

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11
Q

Papillary layer

A

Most superficial dermis layer. Made up of areolar connective tissue and is highly vascularized. Plays a role in temperature control with dilation/constriction of papillary loops. Papilla increase surface area with epidermis and contain meissner’s corpuscles and nociceptors. SF: basement membrane; D: d. Reticulum

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12
Q

Meissner’s Corpuscle

A

Nerve ending present in dermal papilla. Transmit sensations of fine, discriminative touch and vibration.

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13
Q

Dermis reticulum

A

Made of up dense, fibrous, irregular connective tissue; well vascularized; contains nocireceptors. SF: d. Papilla; D: adipose layer/subcutaneous layer of the hypodermis

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14
Q

Nociceptor

A

Free nerve endings that initiate sensation of pain. Present in d. Reticulum and d. Papilar (entire dermis).

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15
Q

Types of sweat glands

A

Eccrine and Merocrine

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16
Q

Merocrine/eccrine glands

A

Abundant throughout the entire body. Produces watery sweat and excretes it into tubules that connect to s. Corneum. Stimulated by sympathetic nervous system and is involved in temperature regulation (evaporative cooling).

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17
Q

Layers of Dermis

A

Papillary, reticulum.

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18
Q

Hypodermis

A

Made up of adipose/subcutaneous connective tissue. Contains pacinian corpuscles

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19
Q

Pacinian corpuscles

A

Mechanoreceptors found in hypodermis. Deep touch, pressure, vibrations.

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20
Q

Types of mechanoreceptors

A

Pacinian corpuscles, meissner’s corpuscles, Merkel’s disks, and Ruffini’s corpuscles

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21
Q

Apocrine gland

A

Produce a fluid that is secreted onto the superficial stratum lucidum. Contains proteins and lipids that are broken down by bacteria and creates body odor. Found only in axillary and anogenital region.

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22
Q

Hair follicle

A

Contains shaft, bulb, and root. Connected to arrector pili muscle (autonomic control). Next to sebaceous gland Not present in thick skin.

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23
Q

Sebaceous gland

A

Surrounds hair follicle shafts in the dermis. Produces lubricating oil (sebum) into the hair follicles to lubricate the skin and hair and kill certain types of bacteria.

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24
Q

Components of the integumentary system

A

Skin, subcutaneous tissue, appendages

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25
Q

What are the appendages of the integumentary system?

A

Sweat glands, sebaceous/oil glands, hair, hair follicles, nails

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26
Q

what proportion of the body’s total body mass is skin?

A

8%

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27
Q

Follow the skin regions from most deep to superficial

A

reticular dermis, papillary dermis, stratum basale, stratum spinosum, stratum granulosum, stratum lucidum*, stratum corneum.

The subcutaneous adipose layer is not technically part of the skin

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28
Q

What are the tissue types in the epithelium vs dermis

A

stratified sq. epithelium in the epidermis, connective tissue in dermis

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29
Q

cell types in the epithelium

A

Keratinocytes (90%), Melanocytes (10-25% of cells in basal layer), Langerhans cells, Merkel cells

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30
Q

What proteins are produced by cells in the epidermis

A

Keratin (fibrous), Filaggrin (water retention)

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31
Q

How many rows of cells are present in the stratum basale

A

1 single row of stem cells (rapid division)

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32
Q

Source of keratinocytes in epithelium and lifespan

A

Cell division in s. basale followed by migration superficially before being sloughed off at the s. corneum. The cells are largely dead upon reaching the s. granulosum. It takes 25-24 days to migrate to s. corneum

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33
Q

What epidermal layer are langerhans cells found in?

A

s. spinosum

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34
Q

What do the granules in the s. granulosum contain and what is this layer’s function?

A
  1. Lipid-rich secretion 2. filaggrin. These act as a water sealant (lipids) and also retain water inside the dying keratinocytes (filaggrin)
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35
Q

What kind of skin has a s. lucidum

A

thick only

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36
Q

Functions of the s. corneum

A

dead, flat, keratinized membranous sacs account for 3/4 of the epidermal thickness and continuously slough off. They provide protection from abrasion and penetration, give the skin its waterproof property, and act as a barrier against biological/chemical/physical assaults

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37
Q

Bullous pemphigoid

A

Autoimmune blistering disease typically affecting older patients. autoantibodies bind to antigens directly beneath the s. basale. Presentation involves tense bullae on an erythematous base

38
Q

Pemphigus Vulgaris

A

Autoimmune disease typicall affecting yound adults. autoantibodies bind antigens in intercellular spaces, causing decreased adhesions between cells (skin breaks off)

39
Q

Psoriasis

A

epidermal turnover is increased. Not enough time (25-45 days) for differentiation. Presents with scale (secondary lesion)

40
Q

Atopic dermatitis

A

Caused by mutations in filaggrin (water retention protein in keratinocytes). May be associated with other atopic diseases such as asthma

41
Q

Melanocyte nevi

A

(Moles), benign collections of melanocytes

42
Q

Melanoma

A

Malignancy of melanocytes

43
Q

Basal cell Carcinoma

A

proliferation of basal keratinocytes. Presents with pearly, erythematous papules/plaques with rolled borders and telangectasias in photodistributed areas.

44
Q

Tissue contents of Dermis

A

connective tissue, blood vessels, lymph vessels, nerves. All supply skin, sweat glands, and hair follicles

45
Q

Layers of dermis from most deep to superficial

A

Reticular, papillary

46
Q

Functions of the papillary dermis

A

Mechanical anchorage of epidermis, metabolic support of epidermis

47
Q

Contents of dermal papillae

A

Capillary loops, meissner’s corpusle, pacinian corpuscle, Free nerve endings

48
Q

Name the receptors present in all skin layers and what they detect

A

Merkel Cells (light/fine touch), Pacinian corp (pressure/vibration), meissner’s corp (light touch), free nerve endings (pain)

49
Q

Fibers present in areolar connective tissues of papillary dermis

A

Elastic and collagen fibers

50
Q

Function of reticular dermis

A

thick collagen fibers provide strength and reiliency

51
Q

Cells present in the dermis

A

Fibroplasts (fiber production), Macrophages, some mast cells/WBCs

52
Q

Factors that can influence Fibroblast activity

A

Steroid hormones, dietary content, mechanical stresses. Vitamin C deficiency impairs collagen formation

53
Q

Keloid

A

Abnormal scars resulting from uncontrolled synthesis and excessive deposition of collagen (fibroblasts!) at sites of prior injury and wound repair. results in a prominent scar that extends beyond the wound. Genetics play a role

54
Q

Hypertrophied scar

A

prominent/raised scar that is localized to the wound (compare to keloid)

55
Q

Mast cells

A

Defensive cells; contain granules of histamine (and other chemicals) that activate inflammation. Filopodia extend outward from membrane. They are numerous around blood vessels.

56
Q

types of inflammatory response

A

localized (urticaria) or generalized (anaphylactic shock)

57
Q

Friction ridges

A

dermal papillary ridges push up on the epidermis to create epidermal ridges.

58
Q

Cleavage lines

A

tension lines of collagen fibers arranged in bundles. Healing is more rapid when incisions are made parallel to cleavage lines

59
Q

pigments that contribute to skin color

A

Melanin (dark skin), Carotene (yellow/orange; palms/soles), hemoglobin (pink)

60
Q

Hypodermis contents

A

loose connective tissue, adipose component

61
Q

Function of hypodermis

A

thermal insulation, shock absorber, metabolic energy store

62
Q

Lipoma

A

benign tumor of fat. Mobile, slow growing, painless (unless angiolipoma). Most common soft tissue tumor of adulthood. Multiple lipomas suggest presence of rare autosomal dominant syndromes

63
Q

Erythema nodosum

A

inflammation of hypodermis. Could be from infection reaction, medication, or Autoimmune disease

64
Q

2 types of sweat glands

A

Eccrine (merocrine); thermoregualtion, Apocrine; BO

65
Q

Where are different types of swear glands found?

A

Eccrine (abundant on palms, soles, forehead), Apocrine (axilla, perianal region, areolae, and periumbilical skin)

66
Q

Contents and purpose of sweat

A

99% H2O, evaporative cooling, sexual scent? (apocrine)

67
Q

Other types of apocrine glands

A

Ceruminous glands (ear wax), mammary gland

68
Q

functions of hair

A

Defense (alert to insect presence), protection (physical trauma, heat loss, sunlight

69
Q

Which part of the hair follicle is necessary for hair growth?

A

hair bulb

70
Q

Cycles of hair growth

A

Anagen/growing phase, Catagen/involuting phase: hair growth ceases and follicle shrinks, telogen/resting phase: inferior segment of the follicle is absent, exogen/shedding phase

71
Q

Acne Vulgaris

A

disorder of Pilo Seb unit. Caused by 4 things: 1. abnormal keratinization plugs the hair follicle.
2. propionibacterium acnes in the hair follicle. Causes inflammation
3. Hormones (androgens)
4. sebaceous gland activity (increased in presence of androgens)

72
Q

Structure of a nail

A

Free edge, nail body, lunula, eponychium (cuticle), nail root (contains proliferating nail matrix)

73
Q

Parts of a nail

A

Nail plate: keratin, nail bed: specialized skin (same 4 layers of epiderm), eponychium (cuticle): thickened skin surrounding nail

74
Q

Vascular supply of the skin

A

Direct cutaneous system (capillary loops in papillae), musculocutaneous system, fasciocutaneous system

75
Q

Innervation of the skin

A

somatic and autonomic components (sensory and thermoregulatory properties)

76
Q

Age-related skin changes

A

chronological, environmental (photo-ageing)

77
Q

Protective barriers the skin provides

A

Chemical (acidic secretions and defensins), physical (keratin and glycolipids block water and water-soluble substances, melanin protects agains UV rad), Biological (langerhans cells, macrophages

78
Q

How does the skin aid in temp regulation

A

Elevated Temperature: dermal vessel dilation, increased eccrine gland activity
Decreased Temperature: dermal vessel constriction

79
Q

Describe the sensory properties of skin

A

Temperature, touch, and pain

80
Q

Accessory skin functions

A

Metabolic functions (Vit D and collagenase), Blood reservoir (5%), Excretion (sweat), social communication

81
Q

Cardinal signs of inflammation

A

Rubor (red), Calor (heat), Tumor (swelling), dolor (pain), functio laesa (phys function has changed)

82
Q

Cell involved in short-term inflammatory resoonse

A

Neutrophils

83
Q

Components of acute inflammation

A

hemodynamic changes, neutrophil involvement, chemical mediators

84
Q

Hemodynamic changes during acute inflammation

A
  1. transient vasoconstriction
  2. massive vasodilation mediated by histamine, bradykinin, and prostaglandins
  3. increased vascular permeability
  4. blood flow slows due to increased viscosity, allows neutrophils to migrate
85
Q

Neutrophil involvement in acute inflammation

A

Margination & adhesion to capillary wall, emigration out of capillary, chemotaxis toward chemical released by mast cells, phagocytosis and degranulation, intracellular killing.

86
Q

Chemical mediators involved in acute inflammation

A

Vasoactive amines, products of the kinin system, arachidonic acid products, products of the lipoxygenase pathway, complement system, and cytokines

87
Q

Possible outcomes of acute inflammation

A
  1. Resolution of damage/infection with regeneration of damaged tissue.
  2. Resolution with scarring
  3. Abscess formation
  4. Transition to chronic inflammation
88
Q

Characteristics of chronic inflammation

A

prolonged duration (weeks to years). Infiltration of inflamed area with mononuclear cells (macrophages, lymphocytes, and plasma cells), tissue destruction induced by inflammatory products, repair (new vessel proliferation and fibrosis)

89
Q

5 Rs of inflammation

A
  1. Recognition of injurious agent
  2. Recruitment of leukocytes
  3. Removal of agent
  4. Regulation of response (control)
  5. Resolution (repair)
90
Q

Different regenerative capacities of different cell types

A

Labile (regenerate throughout life), Stable (low level replication), permanent (no replication and is replaced by fibrous scar tissue)

91
Q

2 types of tissue repair

A
  1. primary union
  2. secondary union (residual scarring)

Derm (13 decks)

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