HO CHAPTER 2 Flashcards
parts of the skin
- epidermis
- cells
- tissue
- layers - dermis
- cells
- tissue
- layers - subcutaneous layer
- cells
- tissue
- ________: superficial, thinner
- ________: thicker, stretch, and recoil
- ________: not a part of the skin
- epidermis
- dermis
- subcutaneous layer
epidermis
cells
- keratinocytes
- melanocytes
- langerhans cells
- merkel cells
tissue
- epithelial tissue
layers
- stratum basale, stratum spinosum, stratum granulosum, stratum lucidum (absent in thin skin), stratum corneum
dermis
cells
- fibroblasts
- macrophages
- some adipocytes (with collagen and elastic fibers)
tissue
- dense irregular connective tissue
layers
- papillary region
- reticular region
subcutaneous layer
aka hypodermis
cell
- adipocytes
tissue
- adipose tissue
accessory structures
- hair
- skin glands
- nails
hair growth
a. growth stage (anagen stage)
b. regression stage (catagen stage)
c. resting stage (telogen)
a. _______: cells of hair matrix divide, pushed upward and die
b. _______: cells of hair matrix stop dividing, atrophy of hair follicle, hair stops growing
c. _______: a new growth cycle begins
- _________: dissolves CHON in hair shaft (ex. Veet® Hair Removal Cream)
a. growth stage
b. regression stage
c. resting stage
- Depilatory agent
types of hair
- lanugo hair
- vellus hair
- terminal hair
a. ________: fine, non-pigmented hair covering a fetus
b. ________: short, fine, pale hair covering most of the body
c. ________: long, coarse, heavily pigmented hair in eyebrows, eyelashes, and scalp
a. lanugo hair
b. vellus hair
c. terminal hair
skin glands
a. sebaceous gland (oil gland)
b. sudoriferous gland (sweat gland)
c. cerumenous gland (ear wax)
- branched acinar glands mostly connected to hair follicles
- absent in palms and soles
- excretory duct opens in hair follicle
sebaceous gland (oil gland)
- coiled tubular glands
- divided into eccrine and apocrine glands
sudoriferous gland (sweat gland)
- opens into epidermis
- throughout the skin (EXCEPT:lip margin, nail bed, penis, clitoris, labia minora and eardrums)
- perspiration
- soon after birth
- emotional stress
- thermoregulation
eccrine
- opens into hair follicle
- Axilla, groin, areola, beard region, clitoris, labia minora
- perspiration + lipids and CHON
- puberty
- emotional stress and sexual excitement
- X thermoregulation
apocrine
- excretes cerumen
- aka earwax
- excretory duct opens in ear canal or ducts of sebaceous glands
cerumenous gland
nails
- lunula
- hangnail
– white part of nail
- vascular tissue underneath this is not visible due to thickened epithelium
lunula
- small torn piece of skin at the sides of a nail usually caused by dryness of epithelium
hangnail
Physiology of the Integumentary System
- thermoregulation
- blood reservoir
- protection
- cutaneous sensation
- excretion and absorption
- synthesis of vitamin D
- storage
- maintains homeostasis by mechanism of heat production or heat loss
HEAT PRODUCTION (6)
HEAT LOSS (4)
- thermoregulation
HEAT PRODUCTION
- basal rate of metabolism
- muscle activity
- hormone effect
- sympathetic stimulation
- cellular temperature
- effect of food
HEAT LOSS
- radiation
- conduction
- convection
- evaporation
- dermis houses an extensive network of blood vessels that carry 8-10% of total blood flow
- blood reservoir
- protection
- keratin
- lamellar granules
- langerhans cells
- macrophages
- melanin
- sebum
- acidic pH
mechanical protection from microbes, abrasion, heat and chemicals
keratin
PROTECTION
Lipids retard entry and exit of water across skin surface
lamellar granules
PROTECTION
recognize and process harmful microbial invaders
langerhans cell
PROTECTION
_______: phagocytosis
_______: shield against UV rays
- macrophages
- melanin
PROTECTION
_______: bactericidal, prevents skin and hair from drying out
_______: retards growth of microbes
- sebum
- acidic pH
PROTECTION
- cutaneous sensation
TACTILE
— touch
— pressure
— vibration
— itch
— tickle
THERMAL
— warmth
— coldness
PAIN
— nociceptors
touch
- meissner corpuscles
- hair root plexus
- merkel disc
- ruffini corpuscles
pressure
- meissner corpuscles
- merkel disc
- pacinian corpuscle
vibration
- meissner corpuscle
- pacinian corpuscle
itch & tickle
- free nerve endings
warmth
coldness
- warm receptors (32-48*C)
- cold receptors (10-40*C)
- excretion and absorption
EXCRETED
- water
- heat
- salts
- CO2
- ammonia
- urea
ABSORBED
- fat soluble vitamins
- O2
- CO2
- acetone
- CCl4
- salts of Pb, Hg, As, poison ivy, poison oak, transdermal drugs
- synthesis of vitamin D
PRECURSOR MOLECULE
—> uv rays —>
ACTIVATED PRECURSOR MOLECULE
—> liver and kidney enzymes —>
CALCITRIOL
- this is not a direct function of the skin but is related to the hypodermis, which contains the adipocytes
- adipocytes store fat in the form of triglycerides, triglycerides are broken down to glycogen and free fatty acids through lipolysis
- glycogen is broken down through glycogenolysis to produce glucose used in energy production
- storage
Skin Color as Diagnostic Clue
- cyanosis
- jaundice
- erythema
- pallor
- ________: Bluish color of skin usually due to inadequate oxygen in blood
- ________: Yellowish skin due to the build-up of bilirubin which indicates liver disease
- ________: Redness of skin due to the engorgement of capillaries in dermis
- ________: Paleness of skin due to blood conditions such as anemia or shock
- cyanosis
- jaundice
- erythema
- pallor
wound healing
- epidermal wound healing
- deep wound healing
epidermal wound healing steps
a. Basal cells enlarge and migrate across the wound.
b. When cells from opposite sides meet, they stop migrating due to contact inhibition.
c. As the basal cells migrate, epidermal growth factor stimulates cell division.
d. Basal cells divide and mature to build the next layers of the epidermis.
deep wound healing steps
a. inflammatory phase
b. migratory phase
c. proliferative phase
d. maturation phase
- blood clot forms
- mesenchymal cells form fibroblasts
- vascular response: vasodilation and increased permeability of blood vessels
- cellular response: phagocytosis, activation of inflammatory cells
a. inflammatory phase
DEEP WOUND HEALING
- clot becomes a scab
- fibroblasts migrate along fibrin threads and synthesize collagen fibers and glycoprotein
- damaged blood vessel begin to regrow
- granulation tissue fills the wound
b. migratory phase
DEEP WOUND HEALING
- extensive growth of epithelial cells
- deposition of fibroblasts and collagen fibers into random patters
- continued growth of blood vessels
c. proliferative phase
DEEP WOUND HEALING
- epidermis restored to normal thickness
- damaged blood vessels restored
- collagen fibers become slightly organized
- fibroblasts decrease in number
- scab sloughs off
d. maturation phase
DEEP WOUND HEALING
Pathophysiology of Diseases and Conditions Affecting the Integumentary System
- alopecia
- hirsutism
- stretch marks
- albinism
- vitiligo
- freckles
- acne
- impacted cerumen
- keloid
- rosacea
- skin cancer
- burns
- pressure ulcer
- psoriasis
– _________: partial or complete lack of hair due to genetic factors, aging, endocrine disorders, chemotherapy and skin disease
- _________: when male androgens inhibit hair growth in the temples and crown of hair
- _________: first drug approved to enhance hair growth, does not help people who are already bald
- alopecia
- androgenic alopecia aka male pattern baldness
- minoxidil (Rogaine)
- a condition observed in females and prepubertal males characterized by excessive body hair in areas that are usually not hairy
- hirsutism
- aka striae
- forms when skin is over stretched disrupting the arrangement of collagen fibers and rupturing small blood vessels
- stretch marks
- inherited inability to produce melanin due to melanocytes unable to synthesize tyrosinase
- albinism
- partial or complete loss of melanocytes due to antibodies attacking these cells
- vitiligo
- accumulated patches of melanin, more visible in summertime
- freckles
- inflammation of sebaceous glands which usually begins in puberty
- _________: leaves an irreversible scar on skin
*treatment: mild soaps, topical antibiotics (______, ______), oral antibiotics (______), Isotretinoin,
Benzoyl peroxide
- acne
- cystic acne
*topical antibiotics (Clindamycin, Erythromycin)
*oral antibiotics (Minocycline)
- when cerumen accumulates in ear canal blocking soundwaves from entering the eardrum
*treatment: _________
- impacted cerumen
*ear irrigation
- a scar that extends beyond the boundaries of the original wound
- keloid
- skin condition that usually affects adults 30-60 y.o. characterized by redness, tiny pimples, and noticeable blood vessels in the central area of face
Anti-aging Treatments and Procedures:
- rosacea
a. topical products
- hydroquinone
- retinoic acid
b. microdermabrasion
c. chemical peel
d. laser resurfacing
e. dermal fillers
f. fat transplantation
g. botox
h. non-surgical facelift
i. surgical facelift
a.
- _______: bleaches skin to tone down blemishes
- _______: decreases wrinkles and roughness of skin
a. topical products
- hydroquinone
- retinoic acid
_______: use if tiny crystals to remove and vacuum dead skin cells
_______: application of mild acid to remove surface cells
- microdermabrasion
- chemical peel
_______: use of laser to clear up blood vessels near skin and decrease wrinkles
_______: injection of human collagen, hyaluronic acid, calcium hydroxylapatite or poly-L-lactic acid to make skin plump
- laser resurfacing
- dermal fillers
_______: fat from body injected to another location so smooth skin out
_______: aka botulinum toxin
- paralyze skeletal muscles which causes wrinkling
- fat transplantation
- botox
_______: uses radio frequency to tighten the deeper layers of skin
_______: invasive surgery to remove loose skin and fat
- non-surgical facelift
- surgical facelift
- due to abnormalities in epidermal cells of melanocytes
- non-melanoma skin cancers : _______________ (most common), _______________
- risk factors include: skin type, sun exposure, family history, age and immunological status
- basal cell carcinoma (most common)
- squamous cell carcinoma
- skin cancer
*preventive treatment:
_________: topical preparations that contain benzophane or its derivatives that deflect UVB rays but not UVA rays
_________: topical preparations that contain zinc oxide that deflect both UVA and UVB rays
- Sunscreens
- Sunblocks
– tissue damage caused by excessive heat, electricity, radioactivity or corrosive chemicals that denature proteins in skin
- categorized as 1st, 2nd or 3rd degree
- the ___________ describe the severity of a burn
- burns
- rule of nines
- treatment for minor burns:
- _________ (_____)
- treatment for major burns: __________, ________
- topical antimicrobial ointments (Silver sulfadiazine)
- surgery, skin grafting
– aka decubitus ulcers
- caused by constant deficiency of blood flow to tissues overlying a bony projection
- common in bedridden and diabetic patients
*preventive treatment:
- ___________
- ___________
- pressure ulcers
*preventive treatment:
- hydrocolloid patches
- antibiotics
– chronic disorder where keratinocytes divide and move more quickly thereby forming flaky, silvery scales on the surface of knees, elbows and scalp
- treatment:
- _______________
- psoriasis
- topical corticosteroid ointments
