Intro to derm Questions Flashcards
What are the basic components of the skin?
Epidermis (upper layer)
Dermis (below the epidermis)
Sweat glands, oil glands, hair, and nails (appendages found in dermis)
Subcutaneous fat (found under all of this!)
What are the layers of the epidermis? (in ascending order)
Basal layer (think b=basement/bottom)
Stratum Spinosum
Stratum Granusolum
Stratum Corneum - what you can see (think, you can see CORNS on the skin very easily)
(the stratum layers ascend alphabetically, think C at the top/first in alphabet, G in the middle, S last because later in alphabet )
What is the function of the epidermal basal cell layer?
PROLIFERATION! Cells are undifferentiated here (B=baby cells) and then rise upward where they become more specific/acquire keratin/shed! ***this is important for how fast medication will work - takes 4-6 weeks for the baby cells to travel, so the medicine may take 4-6 weeks to show any effect before old/affected cells will be shed and new ones are presented
What is the function of the epidermal stratum spinosum layer?
KERATIN! Keratinocytes produce keratin in this layer for cells from the basal layer
What is the function of the epidermal stratum granulosum layer?
DIFFERENTIATION! Cells will differentiate and gain more keratin here, become more flat, cemented together (inflammation usually occurs in this level)
What is the function of the epidermal stratum corneum layer?
STACKING AND SHEDDING! Cells are large, flat, and full of keratin and will stack together in layers, outer layers shed off (dry skin falling off in socks is stratum corneum)
Less layers= thinner skin like eyelids
More layers= thicker skin like back/palms/soles
What are melanocytes/where are they found?
Cells that produce pigment, found in basal layer of epidermis (pigment depends on how large these cells are and how fast/how much melanin they produce to protect from things like UV radiation/sunburn)
What are langerhans cells/where are they found?
Cells that provide immunologic function (present antigens to lymphocytes), found in epidermis
What components are found in the dermis?
Nerves, blood vessels, collagen/elastic fibers and appendages like: eccrine/apocrine sweat glands, hair follicles, sebaceous glands (i.e. pilosebaceous unit: hair follicle, hair shaft, sebaceous glands that produce oil) , and nails
What glands regulate sweat based on temperature/emotional stimuli? How do they travel from the dermis to epidermis?
Eccrine sweat glands, travel through a sweat duct that creates a path from the dermis to epidermis (they help with temp regulation)
What glands have no useful purpose/become more active at puberty/cause odor? Where are they found?
Apocrine sweat glands, usually in armpits (axillae) and anogenital areas, found deep in the dermis and travel along the hair follicle
What is the purpose of hair follicles?
Both protective (from the cold, sun, etc.), and decorative
What is short, fine, light colored hair classified as?
Vellus (think peach fuzz)
All of US have FUZZ (memory trick)
What is thick, coarse, dark colored hair classified as?
Terminal (hair on head, pubic hair)
What are the hair growth cycles?
ACT
Anagen (A=ACTIVE) growth phase!
Catagen (C=CALM) transition phase, hair stops growing
Telogen (T=TUMBLE) resting phase, hair will often shed /fall out
What is the purpose of sebaceous glands?
Produce sebum (oily substance), they are found anywhere hair follicles are except the palms and soles, primarily on face/scalp
REACH FULL SIZE AT PUBERTY= ACNE
What are nails made out of?
Keratin formed from dividing epidermal cells
What is the proximal nail fold and what does it protect?
Skin that sits over/protects the nail matrix or center of growth (contains cuticle)
What is the nail matrix?
Area where nails start to grow
Where is subcutaneous fat and what is it’s purpose?
Under the dermis, and before the fascia
provides insulation, cushion, and energy reserve
What does the nail plate adhere to?
Nail bed, if lifted: technically inflammation/infection/psoriasis in nail bed
What is a macule?
FLAT skin lesion, no texture, different color than surrounding skin (ex. freckle)
(Think MACk TRUCK ran over it, FLAT)
What is a papule?
Small and raised skin lesions (ex. mole, pimple)
What is alopecia?
partial or complete hair loss to a certain degree
Does not tell you WHAT is causing it, just a general term
Can scar or be non-scarring
What is a comedone?
Specific to acne
Open: Whitehead (hard to pop-not like pustule, skin over top)
Blackheads: Closed (dirt and debris in pore)
What is a vesicle?
Blister filled with clear fluid
Diameter less than 0.5 cm
*determined by size of blister
V= very tiny :)
What is a bullae?
Blister filled with clear fluid
diameter greater than 0.5 cm
*determined by size of blister
B= bigger!
What is a pustule?
Raised and fluid filled lesion
(cloudy fluid)
*things you want to pop! p= pop p=pustule
What is a nodule?
Raised, marble like with hard texture
Diameter and depth greater than 0.5 cm
What is an ulcer?
Erosion of epidermis and part of dermis
What is lichenification?
epidermal thickening, visible and palpable (can see and feel a difference), usually the result of constant trauma or irritation. Ex. skin will thicken itself from constant itching of exema
What is a polyp?
Soft, fleshy raised growth (polyp)
Mushy and stalk like (can roll it between your fingers)
What is a fissure?
Line or linear tear in epidermis, cracked and scaly (like chapped lips/cracks)
What is scale?
Visibly thickened stratum corneum
Dry appearance or scaliness
What is crust?
Any dried liquid on surface of the skin
(blood-scab, serum, pus)
What is atrophy?
Loss of tissue
Appearance in epidermal or upper layer will be thin/shiny
appearance in dermal or lower layer will be sucked in/depressed
What is a plaque?
Elevated yet LARGE (greater than 0.5cm) and lacks depth (ex. psoriasis)
What is telangectasia?
Enlarged superficial blood vessels
(broken blood vessels)
Can be in terms of basal skin cancer or can be in aging/fair skinned individuals from sun damage or things like excessively blowing the nose
What is depigmentation?
COMPLETE loss of pigment like in vitiligo (very obvious difference in pigment)
What is hypopigmentation?
Partial loss of pigment (can happen from topical serums, etc.) more subtle than depigmentation
What is hyperpigmentation?
Excess pigment
(can happen from diseased states, procedures, etc.)
What is pruritis?
The sensation of itching (NOT scratching, the action)
What are langer’s lines? Why are they useful?
Skin tension lines, helps determine which direction the skin is going
Useful in scenarios of procedures (when making a cut, it will be the easiest to bring back together, reducing tension and having a better outcome/less chance of wound damage)
What is a wheal?
Lesion of dermal (in DERMIS, DEEP) edema, “speed bump”, subtle elevation and less defined (ex. hives)
**deeper than a plaque
What is excoriation?
The action of picking or scratching
What are dermatomes?
The area of skin supplied by branches coming from a single sensory spinal nerve root (skin sensation in certain areas transmit sensation by these nerve branches)
***importance in the distribution of shingles (herpes zoster)
What are the 5 dermatome gorups?
Cervical (7), Thoracic (12), Lumbar (5), Sacral (5), Coccygeal (1)
What are the Cervical Dermatomes?
C2/C3- head and neck
C4/C5- neck
C6- thumb
C7- middle finger
C8- little finger
What are the Thoracic Dermatomes?
T1- inner forearm
T2- upper inner arm
T3- middle of back (dorsal
T4- level of nipples
T5- mid chest and back
T6- chest/rib area
T7- upper section between xiphoid process/naval
T8- halfway down from level of xiphoid to level of naval
T9- middle section of the xiphoid process and naval
T10- level of naval
T11- between level of naval and groin
T12- midpoint of groin
What are the Lumbar Dermatomes?
L1- hip and groin area
L2- inside of thigh
L3- knee
L4- inside part of ankle bone
L5- bottom of foot and toes 1-3
What are the Sacral Dermatomes?
S1- toes 4&5, outside of ankle bone
S2- outer side of heel bone
S3- middle portion of buttocks, perineal area, genitals
S4- skin over perineal area, perineal areas, genitals
S5- skin over perineal area, skin immediately at/next to anus
What is the Coccygeal Dermatome?
Originates at the spinal cord and emerges at level of the tail bone (coccyx)
What is Fitzpatrick Classification, and what is it dependent on?
Classification of skin related to the reaction of sunlight exposure, dependent on the amount of melanin produced by melanocytes
What is Fitzpatrick skin type I?
Pale white skin, blue/green eyes, blonde/red hair
**always burns and does not tan
What is Fitzpatrick skin type II?
Fair skin, blue eyes
**burns easily, tans poorly
What is Fitzpatrick skin type III?
Darker white skin
**tans after initial burn
What is Fitzpatrick skin type IV?
Light brown skin
**burns minimally, tans easily
What is Fitzpatrick skin type V?
Brown skin
**rarely burns, tans darkly easily
What is Fitzpatrick skin type VI?
Dark brown or black skin
**never burns, always tans darkly
Can you be Fitzpatrick type VI and still get skin cancer?
YES
