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Intro & Anatomy Flashcards

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Dermatology Board Prep flashcards
1
Q

what are the the g_eneral, major functions_ of the skin?

A
  • serves as physical barrier - against water loss & mechanical/chemical insults
  • immunological control - prevents infection, inflammation & cancer
  • temperature regulation
  • protection from radiation
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2
Q

atopic dermatitis arises from disruption of what major skin function?

A

barrier dysfunction

prevents water loss & mechanical/chemical insults

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3
Q

molluscum contagiosum arises from disruption of what major skin function

A

immunological dysfunction

(prevents infection, inflammation, allergy, cancer)

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4
Q

disruption of the “temperature regulation” function of the skin can lead to…?

A

hyper or hypothermia

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5
Q

what is Reynaud’s syndrome?

what is due to?

A

chronic episodic attacks of digital ischemia provoked by cold exposure

d/t disruption of the temperature regulation function of skin

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6
Q

what skin component facilitates the “protection from radiation” function of the skin?

A

melanin

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7
Q

what are the layers of the skin & what does each consist primarily of?

A
  • epidermis: primarily of keratinocytes
  • dermis: primary of fibroblasts / collagen / elastic fibers
  • subcutis (panniculus / hypodermis): adipose
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8
Q

where on the body is epidermis the

  • thinnest?
  • thickest?
A
  • thinnest - eyelid
  • thickest - palms & soles
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9
Q

what are the layers of the skin from superficial to deep?

A
  • stratum corneum
  • stratum lucidum
  • stratum granulosum
  • stratum spinosum
  • stratum germinativum (stratum basal)
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10
Q

the stratum basal (germinivatum)

  • has what major function (s)?
  • is composed of what major cell types?
  • is organized how?
A
  • major function: source of epidermal stem cells - i.e., dividing keratinocytes that migrate upwards to replace keratinocytes in other layers
  • cell types:
    • dividing keratinocytes (90%)
    • melanocytes
    • merkel cells
  • organization: tonofibrils connect the cells to the basement membrane (BMZ)
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11
Q

the stratum spinosum

  • has what major function (s)?
  • is composed of what major cell types?
  • is organized how?
A

i.e., the “prickle cell layer”

  • major function: immune function, serves as supportive mesh
  • cell types
    • keratinocytes
    • Langerhans cells
  • organization: polyhedral shape (“mesh like network”) d/t desmosomes joining basal cells from stratum basal
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12
Q

stratum granulosum

  • has what major function(s)?
  • is composed of what major cell types?
  • is organized how?
A
  • major function: production of water-trapping barrier via secretion of lipids into ECF
  • cell types: keratohyalin granule containing keratinocytes
  • structure: cells are
    • flattened
    • anucleated
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13
Q

stratum cornuem

  • has what major function(s)?
  • is composed of what major cell types?
  • is organized how?
A
  • major function: keratinocyte desquamation - “end result of keratinization”
  • cell types: keratinocytes
  • structure: keratinocytes surrounded by lipid mixture (from stratum granulosum) - “brick and mortar”
    • keratinocytes are
      • flattened
      • overlapping
      • filled with: keratin + filaggrin
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14
Q

where is the stratum corneum the thickest?

A

on the palms & soles

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15
Q

what epidermal layer contains melanocytes?

A

the stratum basale (germinivatum)

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16
Q

what epidermal layer contains merkel cells?

A

the stratum basale (germinivatum)

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17
Q

what epidermal cells contain keratohyalin granules?

A

the stratum granulosum (within keratinocyte cytoplasm)

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18
Q

what epidermal layer contains langerhans cells?

A

the stratum spinosum

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19
Q

what epidermal layer contains dividing keratinocytes?

A

the stratum basale (germivatum)

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20
Q

in which epidermal layer does desquamation occur?

A

the stratum corneum

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21
Q

which epidermal layer produces the lipids?

which epidermal layer is filled with these lipids?

A
  • stratum granulosum - produces lipids
  • stratum corneum - made of flattened keratinocytes surrounded by lipids
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22
Q

which epidermal layer contains filaggrin?

A

the stratum corneum - found in the cytoplasm of keratinocytes

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23
Q

keritinocytes in the stratum corneum are filled with..?

A
  • keratin
  • filaggrin
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24
Q

briefly describe the organization of each epidermal layer?

A
  • corneum: overlapping, flattened, keratin & filaggrin filled keratinocytes surrounded by lipids
  • granulosum: flattened, anucleated keratinocytes w/ keratohyalin granules
  • spinosum: in polyhedral shape (“mesh like”) maintained by desmosomes
  • basale: attached to basement membrane (BMZ) by desmosomes
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25
Q

in which epidermal layer do keratinocytes become flattened & anucleate?

A

the stratum granulosum

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26
Q

which epidermal layer is shown here and how do you know?

A

stratum spinosum

has “spiny” appearance d/t desmosome junctions holding keratinocytes in mesh-like form

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27
Q

in what “direction” through the epidermis do basal cells move?

A

from deep to superficial: basal → spinosum → granulosum → corneum

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28
Q

the increased thickness of the epidermis at the soles & palms is mostly due to what layer?

A

the stratum corneum

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29
Q

melanocytes are

  • are found in which skin layer & and with what prevalence?
  • have what role?
  • are associated with what skin conditions?
A
  • stratum basal
  • 1:10 ratio of melanocytes: keratinocytes
  • role:
    • contain melanosomes that produce pigment in response to sun exposure that is
      • delivered to stratum spinosum via dendrites
      • protects against UV damage
  • associated with:
    • vitiligo: destruction of melanocytes
    • albinism: defective enzymes w/ in melanocytes (but normal melanocyte #)
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30
Q

Langerhans cells

  • are found in what skin layer?
  • have what role?
  • are associated with what skin conditions?
A
  • stratum spinosum
  • role induce delayed type (type IV) hypersensitivity recognizing, uptaking & presenting antigens to sensitized T-cells
  • associated with: contact dermatitis - - commonly triggered by poison oak
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31
Q

identify the features in the slide

A

bierbeck granules

langerhans cells (in stratum spinosum)

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32
Q

filaggrin

  • is found in what skin layer?
  • has what role?
  • is associated with what skin conditions?
A
  • stratum granulosum (in keratinocytes_
  • role: retains water w/in keratinocytes
  • associated with: atopic dermatitis - filaggrin mutation can can lead to asthma, ect.
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33
Q

merkel cells

  • are found in what skin layer?
  • have what role?
  • are associated with what skin conditions?
A
  • stratum basal, as well as
    • oral mucosa
    • hair follicles
  • role: serves as a rudimentary touch receptor
  • associated with: merkel cell carcinoma
34
Q

from which tissue are merkel cells derived?

what unique features do they have?

A
  • derived from neural crest cells / ectoderm
  • contain a perinuclear dot
    • stained with CK20
35
Q

what are the major disease associated with epidermal dysfunction?

A
  • bullous phemphigoid
  • psorasis
36
Q

bullous pemphigoid

  • cause?
  • presentation?
A

epidermal dysfunction

  • cause: autoimmune - Abs against basement membrane (just below basal layer), causing fluid build-up between epidermis & dermis
  • presentation: urticaria (red, itchy) precedes a tense bullae on an erythematous base
37
Q

psorasis

  • cause
  • presentation
A

epidermal dysfunction

  • cause - inc rate of epidermal turnover (thickening)
  • presentation - scales
38
Q
A

vitilgo - destruction of melanocytes

39
Q
A

albinism - normal # of melanocytes but defective enzymes

40
Q
A

contact dermatitis - mediated by langerhans cells

41
Q
A

bullous pemphigoid - epidermal dysfunction: (autoimmune). tense bullae on erythematous base

42
Q
A

psorasis - epidermal dysfunction: inc turnover of cells. scaly appearance

43
Q

what are rete ridges and their importance?

A

are ridges that form junctions between the epidermis & dermis

44
Q

the dermis is divided into what two major sections?

A
  • papillary
  • reticular
45
Q

what are the key components that comprise the dermis?

A
  • cells
    • fibroblasts
    • mast cells
    • macrophages
    • dendrites
  • ECM
    • collagen
    • elastic fibers
    • ground substance
  • vasculature
  • adnexal structures - sebaceous, eccrine & apocrine glands
  • meissner’s corpuscles
46
Q

what are the major cells types that comprise the dermis?

A
  • fibroblasts
  • mast cells
  • macrophages
  • dendritic cells
47
Q

why is the role of fibroblasts and why is it important?

A

produces collagen (CT).

this is key in skin wound healing & scarring

48
Q

which skin cells are most instrumental in wound healing?

A
  • fibroblasts
  • mast cells

dermal cell

49
Q

what are keloids & what are they caused by?

A
  • are abnormal scars
  • made by uncontrolled synthesis/excessive deposition of collagen at sites of prior injury by fibroblasts
50
Q

describe & compare the vasculature found in the dermis

A
  • arteries: made of 3 layers
    • tunica intima - endothelial cell layer
    • tunica media - 2+ muscle cell layers
    • tunica adventitia
  • veins:
    • thinner
    • NO smooth muscle
    • NO internal elastic membrane
51
Q
A

dermal artery

52
Q

what are the adnexae of the dermis?

A
  • hair follicles
  • sebaceous glands
  • eccrine glands
  • apocrine glands
53
Q

sebaceous glands

  • are found where?
  • serve what purpose?
  • note other characteristics.
A
  • found everywhere except palms & soles
  • most often found in association with other hair follicles
54
Q

sebaceous glands are found in associated with hair follicles with the exception of which locations?

A
  • nipple: montgomery’s tubercle
  • penis/labia - tyson’s
  • vermillion border of lips - fordyce granules
  • eyelid: meibomian gland
55
Q

eccrine glands

  • are found where?
  • serve what purpose?
  • note other characteristics.
A
  • found throughout the body
  • purpose: regulate body temperature by excreting sweat onto
  • are NOT associated with hair follicles
56
Q

apocrine glands

  • are found where?
  • serve what purpose?
  • note other characteristics.
A
  • found only in a few areas:
    • anogenital region
    • external ear canal
    • eyelid
    • breast
  • purpose: scent glands
  • become functional at puberty
57
Q

loss of which dermal gland can lead to hyperthermia?

A

eccrine (produces sweat)

58
Q

which dermal glands are usually associated with a hair follicle?

A

sebaceous glands

59
Q

meissner’s corpuscles

  • what are they?
  • where are they located?
  • what is their role?
A
  • special nerve end organs
  • located in the dermal papillae: papillary section of dermis
  • role: mediate sense of touch
60
Q

subcutis layer

  • has what major function(s)?
  • is composed of what major cell types / components ?
A
  • function: serves as a fat layer that insulates the body by separating skin from underlying fascia/muscles
  • components:
    • adipocytes (major)
    • vater-pacrini corpuscles
61
Q

identify picture, note important features.

A

adipocytes - are a singlet ring cell: one large lipid droplet with eccentrically located nucleus

found in subcutis

62
Q
A

adipocytes - are a singlet ring cell: one large lipid droplet with eccentrically located nucleus

found in subcutis

63
Q

erythema nodosum

  • cause?
  • presentation?
A
  • inflammation of the subcutis (i.e., panniculitis) in response to infection, autoimmune dz, meds
  • presentation:
    • deep seated erythematous nodules - m/c on the shin
64
Q

what are the two types of special nerve end-organs and their

  • location?
  • role?
A
  • meissner corpuscle:
    • in dermal papillae
    • mediate sense of touch
  • vater-pacini corpuscles
    • in subcutis
    • mediate sense of pressure
65
Q

which type of immunity does each type of lymphocyte mediate?

A
  • B-cell: humoral
  • T-cell: cell mediated
  • NK: innate
66
Q

identify cell

A

lymphocytes

67
Q

identify cell

A

mast cell -“fried egg appearance”

68
Q

identify cell

A

neutrophil - multilobed

69
Q

identify cell

A

plasma cell - pink cytoplasm, bilobed

70
Q

identify cell

A

plasma cell - pink cytoplasm, bilobed

71
Q

identify cell

A

plasma cell - eccentric nucleus with clock phase

72
Q

mast cells

  • contents
  • role
  • associated with what skin disorder(s)?
A
  • contents:
    • histamine
    • heparin
    • leukotrienes
    • carboxypeptidase / tryptase
  • role: mediates immediate type hypersensitivity reactions
  • associated with: urticaria (type of wheel) - d/t vascular reaction
73
Q

neutrophils

  • contents
  • role
  • associated with what skin disorder(s)?
A

role: mediating acute infections

74
Q

eisonophil

  • contents
  • role
  • associated with what skin disorder(s)?
A
  • contents
    • major basic protein
    • cationic protein
    • catalase
  • role: allergies, parasites
75
Q

urticaria

  • cause
  • presentation
A
  • cause: mast cell degranulation (immediate type hypersensitivity) that leads to vascular reaction
  • presentation: wheel
76
Q

what is the pilosebaceous unit and its components?

A

pilosebaceous = hair/oil unit

  • hair follicle
  • two glands: sebaceous + apocrine
  • erector pili muscle
77
Q

label the picture

A
  • yellow - hair follicle
  • blue - sebaceous glands
  • red - epidermis
  • green - dermis
78
Q

define the following components of the hair follicle:

  • isthmus
  • infundibulum
A
  • infundibulum: length of hair follicle from epidermis to sebaceous gland insertion
  • isthmus: length of hair follicle from sebaceous gland insertion to arrector pili muscle insertion
79
Q

outline the growth phases of the hair cycle

A
  • anagen: active growth (2-6 years)
  • catagen: regression (2-3 weeks)
  • telogen: resting phase (3 months)
80
Q

acne vulgaris

  • definition
  • causes
A
  • definition: disorder of pilosebaceous unit
  • causes:
    • hair follicle plugging
    • sebaceous gland activity
    • p. acnes bacteria
    • androgens
81
Q
  • from what is melanin produced? how?
  • what is melanin’s role?
A
  • produced from tyrosine by enzyme tyrosinase → pheomelanin or eumelanin
  • UV protection
    • delivered w/in melanosomes to basal cells, then absorbs UV radiation via free-radical scavengers
82
Q

list each type of collagen and where it is found.

A
  • type I & III - dermis
    • type I - reticular dermis
    • type III - papillary dermis
  • type IV & VII - basement membrane
  • type VIII - endothelial cells

DERM (6 decks)

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