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Disease and Defense: Unit 3 > Dermis and Adnexal Structures > Flashcards

Dermis and Adnexal Structures Flashcards

1
Q

Does the epidermis contain blood vessels?

A

No. Only the dermis

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2
Q

What two zones make up the dermis?

Which one is more superficial?

A
  • Papillary dermis & Reticular dermis

- Papillary dermis is more superficial

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3
Q

What is the dermal matrix composed of?

A

Collagen fibers, elastic fibers and ground substance

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4
Q

What is the major function of the epidermis?

A

Protection

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5
Q

The dermoepidermal junction consists of interlocking projections. What are their names?

A

Downward projections of the epidermis = epidermal rete

Upward projections of the dermis = dermal papillae

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6
Q

What are the two functions of the dermoepidermal junction?

A
  1. Strength of adherence

2. Increases the surface area

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7
Q

Dermoepidermal junctions are responsible for what feature on the hands and feet?

A

Fingerprints

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8
Q

What is the function of collagen?

A

Provides essentially all the tensile strength of the skin

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9
Q

What is the role of Collage I?

A

Comprises >85% of adult dermis

Major component of bone

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10
Q

What is the role of Collagen III?

A

Fetal dermis- Why fetal skin doesn’t tend to scar

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11
Q

What is the role of Collagen IV?

A

Found in the basement membrane zone (present in the dermoepidermal junction)

More prominent around vessels

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12
Q

What is the role of Collagen VII?

A

Found in anchoring fibrils which are used by the body to attach the epidermis to the dermis

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13
Q

Where is procollagen synthesized?

A

INTRACELLULARLY in fibroblasts

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14
Q

What consists of three separate chains of proteins arranged in an alpha-helical structure?

A

Procollagen

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15
Q

Chains consists of three repeating chains what are they?

A

GLY-X-Y
X= Proline
Y= Hydroxyproline

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16
Q

Where is collagen assembled?

A

Extracellularly

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17
Q

Name one cofactor needed for assembly of collagen fibrils

A

Absorbic acid (Vitamin C)

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18
Q

A patient comes in with a chief complaint of:
-Inadequate wound healing
-Abnormal hair growth
-Fragile blood vessels
-Teeth falling out
What should be on you differential diagnosis?

A

Scurvy! This is caused by vitamin C deficiency&raquo_space;>abnormal collagen production

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19
Q

Name one congenital abnormality that effects collagen synthesis.

A

Ehlers-Danlow Syndrome

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20
Q

Name 4 major clinical features of Ehlers-Danlos Syndrome.

A
  1. Skin hyperextensiblity
  2. Joint hypermobility
  3. Tissue fragility
  4. Poor wound healing
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21
Q

What is the function of elastic fibers?

A

Provide resiliency

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22
Q

Are collagen fibers eosinophilic or basophilic?

A

Eosinophilic

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23
Q

What stain must you use to visualize elastic fibers?

A

Silver stain because elastic fibers are argyrophilic and appear black

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24
Q

What is one acquired disorder associated with elastin?

A

Solar elastosis- accumulates significant sunlight exposure»> degradation of elastic fibers

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25
Q

How does solar elastosis change the microscopic appearance of elastin?

A

Argyrophilic&raquo_space; Basophilic

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26
Q

What causes pseudoxanthoma elasticum (PXE)?

A

Inherited elastic disorder caused by mutation in gene encoding part of “multidrug resistance complex”

Elastic fibers become enlarged, tangled, and calcified

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27
Q

What is the role of “multidrug resistance complex”?

A

Pump compounds out of the cells (resistance to certain chemotherapy)

28
Q

A patient comes in with the skin of the flexural areas of the body having a plucked chicken appearance, hypertension and bleeding disorders. What should be on the DDX?

A

PXE

29
Q

Ground substance consists principally of two glycosaminoglycans. What are they?

A

Hyaluronic acid & Dermatan sulphate

30
Q

What are fibronectins?

A

gel-like mass functions like a sponge.

Helps facilitate nourishment

31
Q

What is the role of fibroblasts in ground substance?

What is the role of hyaluronidase in ground substance?

A

Fibroblasts- Produce ground substances

Hyaluronidase- destroys ground substances

32
Q

What two vascular structures are found in the dermis?

A

Superficial and deep vascular plexi

33
Q

What are the three roles of the dermal vascular supply?

A
  1. Wound healing
  2. Homeostasis
  3. Modulation of inflammation/leukocyte trafficking
34
Q

What is Sucquet-Hoyer canal?

A

Smooth muscle derived valve-like structure, blood may be directed towards skin during overheating or away during hypothermia

35
Q

What is Auspitz sign?

A

Pinpoint bleeding after the forceful removal of psoriasis plaque

36
Q

What is a verruca?

A

Benign, virally induced neoplasms that require an increased blood supply

37
Q

Leukocytoclastic vasculitis is caused by immune complexes depositing in post-capillary venules. What Gell and Coombs reaaction pattern is that?

A

Type III- immune complex mediated

38
Q

What is the pathogenesis of leukocytoclastic vasculitis?

A
  1. Immune complexes deposit in the post-capillary venule
  2. Neutrophils attach to vessel and degranulate
  3. Yielding damage and extravasation of red blood cells
39
Q

What is the manifestation of leukocytoclastic vasculitis?

A

Palpable purpura which is not blanchable

40
Q

What is the function of the nervous system in the dermis?

A

Protect and inform

41
Q

Free nerves are responsible for what two sensations?

A

Pain and itch

42
Q

What are the physical characteristic of afferent pruritus nerves?

A

Unmyelinated C fibers with a slow conduction rate

43
Q

True or False:

Itch and pain are different and independent sensory modalities.

A

True

44
Q

What is the function of Pacinian corpuscles?

A

They are onion shaped nerves involved in pressure and vibratory sensations

45
Q

What is the function of Meissner’s corpuscles?

A

They are pine-cone shaped nerves involved in fine touch and tactile discrimination

46
Q

Where is the highest concentration of Meissner’s corpuscles?

A

Distal aspects of the digits

47
Q

Mutations in the neurotrophic tyrosine recetor kinase I (NTRK1) gene results in what condition?

A

Congenital insensitivity to pain + co-existing anhidrosis (inability to sweat)

48
Q

What are the two types of hair?

A

Terminal and Vellus

49
Q

Where are terminal hairs found?

A

Scalp, a man’s beard area and possibly chest/back, and pubic area

50
Q

What is an arrector pili muscle?

A

Small, smooth-muscle which, when activated by the autonomic nervous system, brings the hair into a more erect position

51
Q

What are the three parts of the hair follicle?

A

Infundibulum- Upper third
Isthmus- Middle third
Matrical area- Lower third

52
Q

the primitive ectodermal germ (PEG) consists of three bulges. What are they and what do they encode for?

A

Lower bulge- attachment for arrector pili
Middle bulge- sebaceous gland
Upper bulge- apocrine gland

53
Q

What are the three phases of hair growth?

A

Anagen-growth phase
Telogen- resting phase
Catagen- transition phase

54
Q

What promotes alopecia?

A

The conversion of testosterone to 5-dihydrotestosterone

55
Q

What blocks the conversion of testosterone to 5-dihydrotestosterone?

A

finasterride, a 5-alpha-reductase inhibitor

56
Q

What type of gland are sebaceous glands?

A

Holocrine

57
Q

Where does a sebaceous gland release its sebum?

A

Hair follicle

58
Q

What is the function of eccrine glands?

A

Thermoregulation

59
Q

Are eccrine glands derived from primitive ectodermal germ?

A

No

60
Q

Sweating is mediated by the sympathetic portion of the autonomic nervous system, but triggered by what?

A

Acetylcholine

61
Q

Where are apocrine glands located?

A

Axillary and anogenital area

62
Q

Name three specialized variants of apocrine glands.

A
  1. Moll’s glands on the eyelids
  2. Cerumen (ear wax) glands
  3. Lactation glands of the breast
63
Q

What secretion occurs through decapitation?

A

Apocrine

64
Q

What is chromohidrosis?

A

Colored sweat

65
Q

Where are the appoeccrine glands primarity found?

A

Axilla. Cholinergic stimuli

66
Q

How can you treat hyperhidrosis?

A

Botulinum toxin A (Botox) which blocks the release of acetylcholine

Disease and Defense: Unit 3 (4 decks)

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