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Medical Histology > Integumentary System > Flashcards

Integumentary System Flashcards

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USMLE® Step 1 flashcards
1
Q

List some important functions of the skin

A

Abrasion prevention, dessication/infection prevention, body temperature regulation, absoprtion of UV for vitamin D synthesis, reception of external stimuli

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1
Q

What specialized cells are present in the stratum basale?

A

Melanocytes, Merkel cells

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2
Q

Cells of the upper stratum spinosum possess (x) which, when released, produce a (y) effect

A

Keratohyalin granules (x), waterproofing (y)

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3
Q

Describe contact inhibition in epidermal wound healing

A

Basal cells enlarge and migrate across wound until they meet each other where cells stimulate stem cells to divide and replace lost cells

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4
Q

Describe the basic pathways in effect during the different phases of deep wound healing: inflammatory? migratory? proliferative? maturation?

A

Inflammatory: peripheral blood clot, vasodilation, leukocyte infiltration; Migratory: epithelial cells bridge the wound, fibroblasts synthesize collagen/glycoprotein; Proliferative: epithelial growth, angiogensis; Maturation: scab sloughs off, epidermis normal thickness, fibroblasts decrease, scar = fibrosis

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5
Q

Melanocytes produce (x) (via the enzyme (y)) which serve to (z)

A

Melanin (x), tyrosinase (y), shield genetic material from harmful UV radiation (z)

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6
Q

What are the phases of deep wound healing?

A

Inflammatory, migratory, proliferative, maturation

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7
Q

What condition is characerized by hyperkeratosis and parakeratosis?

A

Psoriasis

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8
Q

Which cellular apparatuses are effected in the following pathologies: bullous pemphigoid? pempighus vulgaris?

A

Hemidesmosomes (BP), desmosomes (PV)

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9
Q

Describe the histopathogenesis of squamous cell carcinoma

A

Malignant tumor of keratinocytes, usually due to inactivation of p53 gene, characterized by hyperkeratosis and parkeratosis

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10
Q

Keratohyalin granules are composed of (x) and (y) rich proteins that appear to bind (z)

A

Histidine (x), cysteine (y), kertain filaments (z)

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11
Q

The (x) layer does not possess nuclei or organelles, but contains (y) which is believed to be produced from keratohyalin

A

Stratum lucidum (x), eledin (y)

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12
Q

(x) are derived from the bone marrow, reside in the stratum spinosum, contain (y) and function as (z)

A

Langerhans cells (x), Birbeck granules (y), APCs (z)

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13
Q

(x) are present in the stratum basale, contain (y) and receive afferent nerve sensation believed to be important in (z)

A

Merkel cells (x), small dense-cored granules (y), sensory mechano-receptors (z)

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14
Q

What are the three primary parts of hair?

A

Cuticle, cortex, medulla

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15
Q

What structures comprise the internal root sheath of a hair follicle?

A

Henle’s layer, Huxley’s layer, cuticle

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16
Q

What structures comprise the external root sheath of a hair follicle?

A

Continuation of stratum malpighii

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17
Q

What structures are external to the outer root sheath of a hair follicle?

A

Glassy (basement) membrane, CT sheath (dermis)

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18
Q

Eccrine glands are tubular coiled glands comprised of what cell types?

A

Dark cells, clear cells, myoepitheal cells

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19
Q

How are apocrine and eccrine glands similar? different?

A

Similar: secrete sweat, large coiled secretory portion eveloped by myoepithelial cells, not always associated w/ hair follicles; Different: age of onset, location (apocrine: axilla, nipple areola, circumanal region)

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20
Q

Compare eccrine and apocrine integument glands on the following characteristics: size? location? innervation? consistency?

A

Eccrine: small, all skin, cholinergic, watery; Apocrine: large, certain areas, adrenergic, viscous

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21
Q

Where are mitotic cells of sebaceous glands located?

A

Near ducts

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22
Q

Name the strata of the epithelium from deep to apical

A

Strata basale, spinosum, granulosum, lucidum, corneum

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23
Q

What is the other name given for the combined stratum basale/spinosum layers?

A

Stratum malpighii

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24
Q

The resident macrophage of the skin is the (x) and is usually located in the (y) layer

A

Langerhands cell (x), stratum spinosum (y)

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25
Q

Cells of the (x) layer possess intercellular bridges between each other, namely made of (y)

A

Stratum spinosum (x), desmosomes (y)

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26
Q

The underlying dermis possesses layers made of what type of tissue?

A

Papillary (loose CT), reticular (dense irregular CT)

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27
Q

Which stratum/a are generally not seen in thin skin?

A

Stratum granulosum, lucidum

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28
Q

Denote the epithelium of the following eccrine sweat gland parts: duct system? secretory portion?

A

Stratified cuboidal (duct), simple cuboidal + myoepithelial cells (secretory)

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29
Q

Describe the mechanism of sebaceous cell secretion

A

Daughter cells migrate to alveolus, produce secretory product, break down, producing sebum

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30
Q

Which two layers of the epithelium possess mitotic capabilities?

A

Strata basale, spinosum

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31
Q

What condition is characterized by the increased proliferation rate of mitotic cells leading to thickened epidermis?

A

Psoriasis

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32
Q

What is the most apical strata where nuclei are present?

A

Stratum granulosum

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33
Q

How may medication/substances be delivered through the skin?

A

Transdermal patches (nicotine, steroid, sea sickness, nitroglycerine, menopause)

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34
Q

What are the two general types of wound healing?

A

Epidermal, deep (dermal)

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35
Q

Are blood vessels needed/repaired in either epidermal or deep wound healing?

A

No (epidermal), Yes (deep)

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36
Q

When a scar is raised but in the normal boundary, it is said to be (x), when it extends its boundary it is said to be (y)

A

Hypertrophic (x), keloid (y)

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37
Q

What is the condition termed where hyperplasia occurs in the horny (corneum) layer of the skin?

A

Hyperkeratosis

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38
Q

What is the condition termed if nuclei are retained in the stratum corneum?

A

Parakeratosis

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39
Q

What is a condition termed if the body produces an immune response against its own tissues?

A

Autoimmune

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40
Q

What is the condition termed where there is a loss of intercellular connections (e.g. keratinocytes)?

A

Acantholysis

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41
Q

What is the condition termed if epidermal hyperplasia is present in the stratum spinosum?

A

Acanthosis

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42
Q

What is the system termed that present effects lysis effects on cells and Ab-Ag complexes (inclusive of cytokine release)

A

Complement system

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43
Q

What system can be described as having a substance being produced from one cell to have the actions of another take effect?

A

Complement system

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44
Q

Describe the histopathogenesis of psoriasis

A

Autoimmune T-cells migrate to dermis and secrete cytokines to signal marked epidermal growth, leads to increased epidermal (s. corneum) thickening

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45
Q

List some etiologies of psoriasis

A

Stress, bacteria, alcohol, temperature change, tattoo, medication (lithium/hormones), smoking, cuts/bruises

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46
Q

What condition is characterized by chronic autoimmune blistering of the skin?

A

Bullous pemphigoid

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47
Q

Describe the histopathogenesis of bullous phemphigoid

A

Autoantibodies (IgG) bind to basement membrane, stimulate leukocytic infiltration, eosiniphils degrade hemidesmosomes

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48
Q

What condition is characterized by an autoimmune separation of epidermal cells and atrophy of the prickle layer?

A

Pempighus vulgaris

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49
Q

Describe the histopathogenesis of pempighus vulgaris

A

Autoimmune disorder producing antibodies against cadherins/desmoplakins leading to the disruption of desmosomes

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50
Q

In which stratum are the effects of pempighus vulgaris most often noticed?

A

Stratum spinosum

51
Q

Where may lesions associated with pempighus vulgaris be viewed?

A

Back, mouth

52
Q

What condition is characterized by a loss of pigmentation of the skin, hair and eyes?

A

Albinism

53
Q

Describe the histopathogenesis of albinism

A

Gene mutation that regulates melanin synthesis, inability of cell to pick up tyrosine, tyrosinase inactivity

54
Q

List some long term implications of individuals with albinism

A

Skin cancers, reduced visual acuity, photophobia, social stigma

55
Q

What condition is characterized by an autoimmune destruction of melanocytes producing a depigmentation disorder?

A

Vitiligo

56
Q

What types of vitiligo are possible?

A

Focal, segmental, generalized

57
Q

What treatments are available for vitligo?

A

Topical steroid therapy, psolaren photochemotherapy, depigmentation, autologous skin graft, micropigmentation, melanocyte transplants

58
Q

In burn victims, what method is used for approximating the amount of body burned?

A

Rule of nines

59
Q

Differentiate between a first, second and third degree burn in terms of skin damaged

A

First: epidermis only, Second: epidermis and dermis (BVs, blebs), Third: epidermis/dermis vacant

60
Q

Differentiate between first/second/third degree burns in terms of pain felt

A

First/Second: pain present (meissner’s corpuscles present), Third: meissner’s corpuscles burned away

61
Q

T/F: Malignant cells demonstrate pleomorphic variations

A

True

62
Q

List some common risk factors for squamous cell carcinoma

A

Age (older), fair skin, disposition to sunlight exposure, carcinogen exposure

63
Q

What are the general types of squamous cell carcinoma?

A

Superficial, infiltrative

64
Q

Describe infiltrative squamous cell carcinoma

A

Dermis infiltrated by malignant squamous cells, islands resemble basal cells, visually have formation of squamous pearls of swirls

65
Q

List a risk factor for basal cell carcinoma

A

UV light exposure

66
Q

Describe the appearance of basal cell tumors

A

Surrounded by a single layer of basal cells (cuboidal), palisade arrangement

67
Q

The malignant transformation of a melanocyte leads to (x) and is the (y) of skin cancer-related deaths in the U.S.

A

Malignant melanoma (x), leading cause (y)

68
Q

List a risk factor for malignant melanoma

A

Caucasian/Australian/S. African races, UV exposure

69
Q

T/F: Melanocytes which are malignant present similarly when compared to normal cells

A

False

70
Q

Explain the A-B-C-D-Es associated with clinical diagnosing of skin carcinomas

A

Asymmetry, border irregulatiry, color variation, diameter, elevation

71
Q

Areas with increased sebaceous glands are prone to (x) a disorder common in (y)

A

Acne (x), adolescents (y)

72
Q

Which areas of the body are prone to fungal infection?

A

Hair

73
Q

What conditions may arise from fungus origins?

A

Dermatophytosis, tinea vericolor, tinea corporis (ringworm), infections

74
Q

What condition is characterized by benign neurofibromas located all over the body and which is congenital (chr 17)?

A

Neurofibromatosis (Von Recklinghausens disease)

75
Q

What are the major components of the skin?

A

Epidermis, dermis

76
Q

List some appendages of the skin

A

Sweat glands, hair follicles, sebaceous glands, nails

77
Q

How many layers are present in the stratum basale?

A

One

78
Q

Which type of granules found in the stratum granulosum stain darkly with H&E?

A

Keratohyalin (basophilic)

79
Q

The most apical layer of the epidermis is known as (x) but can also be called (y) if cells are found to be flaking off

A

Stratum corneum (x), stratum disjunctum (y)

80
Q

Melanocytes possess (x) which aid in transferring melanosomes to which strata?

A

Cytoplasmic extensions (x), stratum basale & stratum spinosum

81
Q

The transfer of melanosomes from one cell to another is an example of what?

A

Cytocrine secretion

82
Q

What shape do Birbeck granules look like?

A

Barbells

83
Q

What structures are present in the upper papillary layer of the dermis and what is their function?

A

Meissner’s corpuscles, fine touch receptors

84
Q

What structures can be found in the deeper regions of the dermis and what is their function?

A

Pacinian corpuscles (pressure receptors), Krause’s end bulbs (cold/pressure receptors)

85
Q

Where do arrector pili muscles attach and insert?

A

Attach to hair follicles in dermis, insert into papillary layer of dermis

86
Q

Where is the bulb of a hair follicle located?

A

Papillary layer of dermis

87
Q

What structure overlies the crescent-shaped whitish lunula of a distal phalanx?

A

Eponychium

88
Q

What structure is located beneath the free edge of a nail?

A

Hyponychium

89
Q

Where are cells located which are responsible for nail growth?

A

Cells in the nail matrix

90
Q

Describe the appearance of eccinr sweat gland myoepithelial cells

A

Lie on basal lamina, underlie dark cells, rich in mitochondria and glycogen

91
Q

Describe the cell type within the eccrine sweat gland lumen

A

Stratified cuboidal (duct), many keratin filaments prominent terminal web, rich in mitochondria

92
Q

Where do apocrine cells secrete their products?

A

Into areas superficial to duct entry from sebaceous glands

93
Q

What other glands can be accredited with being apocrine in nature?

A

Ceruminous (wax) glands

94
Q

Integument refers to the (x) and its (y)

A

Skin (x), appendages (y)

95
Q

(x) from the epidermis interdigitate with (y) from the dermis to form an irregular contour

A

Epidermal pegs (x), dermal papillae (y)

96
Q

(x) project to produce (y) which can be seen as raised protrusions (e.g. on the finger tips)

A

Dermal papillae (x), epidermal ridges (y)

97
Q

How often does skin regenerate and what time of day does mitotic acitivty usually occur?

A

2-4 weeks, night

98
Q

The (x) is the deepest layer of cells, attached directly to the basal lamina via (y)

A

Stratum basale (x), hemidesmosomes (y)

99
Q

What shape are stratum basale cells?

A

Cuboidal to columnar

100
Q

T/F: Melanocytes are able to be distinguished from LM

A

False

101
Q

T/F: Langerhans cells are considered to be APCs

A

True

102
Q

T/F: Only the cells in the stratum basale are mitotically active

A

False

103
Q

Cells in the (x) possess large amounts of membrane-coating, keratohyalin and melanosome granules

A

Stratum granulosum

104
Q

Compared to normal amounts of stratum cornuem present, how much stratum disjunctum is present in: thin skin? thick skin?

A

High percentage (thin), low percentage (apical, thick)

105
Q

Where are melanocytes derived from?

A

Neural crest

106
Q

Detection of actual melanocytes can only be possible by using what technique?

A

Electron microscopy

107
Q

T/F: The number of melanosomes is independent of race

A

True

108
Q

What types of fibers are present in the dermis?

A

Type I collagen, thick elastic fibers, Type III collagen

109
Q

T/F: Meissner’s corpuscles do not possess capsules

A

False

110
Q

Contraction of arrector pili muscles is induced by the (x) nervous system giving the appearance of (y)

A

Autonomic (x), goose bumps (y)

111
Q

T/F: The arrector pili muscle originates in the CT sheath of the hair follicle

A

True

112
Q

Describe the characteristics of thick skin

A

Thick epidermis (prominent stratum corneum), some stratum disjunctum, lacks hair follicles/sebaceous glands/arrector pili

113
Q

Where is thick skin located on the body?

A

Palms of hands, soles of feet

114
Q

Describe the characteristics of thin skin

A

Thin epidermis (minimal strtum corneum), some stratum disjunctum, contains hair follicles/sebaceous glands/arrector pili, thick dermis

115
Q

Where is thin skin located on the body?

A

Most of body surface

116
Q

What is a nail composed of?

A

Hard keratin

117
Q

What glands comprise more than 90% of sweat glands?

A

Eccrine glands

118
Q

T/F: Eccirne glands are specific to certain areas of the body

A

False

119
Q

T/F: Myoepithelial cells surround eccrine secretory duts only (within the integument system)

A

True

120
Q

Where are apocrine sweat glands located?

A

Axilla, nipple areola, circumanal region

121
Q

In what layer of the integument are apocrine glands locatd?

A

(Deep) dermis

122
Q

T/F: No part of the secretory cell becomes part of the apocrine secretion

A

False

123
Q

Where do sebaceous glands drain into?

A

Neck of hair follicle

124
Q

T/F: All of sebaceous cells are disposed of during holocrine secretion

A

True

Medical Histology (11 decks)

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