Lecture 3 skin physiology Flashcards

1
Q

Touch receptors of the skin

A
Free nerve endings 
Tactile discs 
Tactile (Meissner) corpuscles 
Lamellar (Pacinian) corpuscles 
Bulbous (Ruffini) corpuscles
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2
Q

Free nerve endings

A

Most common receptor in the skin

Commonly quite superficial

Mostly unmyelinated small diameter fibres (impulses are conducted slowly like the achy pain of a burn after the initial pain) but also some small diameter myelinated fibres (faster pain like the initial burn pain)

Usually small swellings at distal ends = sensory terminals. Sensory terminals have receptors that function as cation channels which causes depolarisation which therefore causes action potentials

Respond mainly to temperature (hot and cold), painful stimuli, some movement and pressure, some to itch (i.e. in response to histamine), some wrap around hair follicles (peritrichial endings) acting as light touch receptors which detect the bending of hairs (like when a mosquito lands on your skin).

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3
Q

Tactile (merkel) discs

A

Free nerve endings located in the deepest layer of the epidermis

Associated with large disk shaped epidermal (merkel) cells - communication between the tactile epithelial cell and nerve ending possibly via serotonin (5HT) (neurotransmitter, found in the brain) - Merkel cells are cells that actually senses the stimuli that is then transducer and converted into a chemical signal that then depolarises the sensory nerve terminal and that information can be transmitted to the somatosensory cortex.

Abundant in fingertips and very small receptive fields therefore they are good for two point discrimination

Sensitive to an objects physical features - texture, shape, and edges and fine touch and light pressure (because they are quite superficial)

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4
Q

Tactile (meissner) corpuscles

A

Located in papillary layer of dermis, especially in hairless skin e.g. finger pads, lips, eye lids, external genitalia, soles of feet, nipples

Encapsulated - spiralling/branching unmyelinated sensory terminals surrounded by modified Schwann cells (schwann cells here are specialised so these cells are not producing myelin) and then by a thin oval fibrous connective tissue capsule. Deformation of capsule triggers entry of Na+ ions into nerve terminal (depolarise the nerve terminal and get an action potential up to the somatosensory cortex) which leads to an action potential.

Sense…
Delicate ‘fine’ or discriminative touch - sensitive to shape and textural changes in exploratory touch such as reading a braille text. Also movement of objects over the surfaces of the skin.
Light pressure
Low frequency vibration (2 to 80 Hz)

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5
Q

Lamellar (pacinian) corpuscles

A

Scattered deep in dermis and hypodermis

Single dendrite lying within concentric layers of collagen fibres and specialised fibroblasts (central dendrite is surrounded by many layers of collagen - looks like an onion if you cut it in half)

Layers separated by gelatinous interstitial fluid

Dendrite essentially isolated from stimuli other than deep pressure

Deformation of capsule opens pressure sensitive Na+ channels in sensory axon - inner layers covering axon terminal ‘relax’ quickly so action potentials discontinued (rapidly adapting) - when they are deformed they can depolarise but then these layers can resume their normal pressure very quickly and respond to another stimulus in a very short period of time.

Stimulated by deep pressure (when first applied). Also vibration because rapidly adapting ( optimal stimulation frequency is around 250 Hz which is similar to frequency range of generated upon fingertips by textures comprising features <1 micron

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6
Q

Bulbous corpuscles (Ruffini’s endings)

A

Located in dermis and subcutaneous tissue

Network of nerve endings intertwined with a core of collagen fibres that are continuous with those of the surrounding dermis. Capsule surrounds entire structure (whenever you stretch the dermis you stretch the collagen which is continuous with the collagen in the receptor)

Sensitive to sustained deep pressure and stretching or distortion of the skin. Important for signalling continuous states of deformation of the tissues such as heavy prolonged touch and pressure signals.

Also found in joint capsules where they help to signal degree of joint rotation (proprioception) - high density around fingernails so may have role monitoring slippage of objects across surface of skin - allowing for modulation of grip

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7
Q

Precapillary sphincters

A

Bands of smooth muscle at the start of capillary beds

If they constrict, they will reduce the blood flow into those capillaries and it will reduce the blood flow to the skin

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8
Q

Skin blood flow

A

Smooth muscle in walls of arteries and pre-capillary sphincters innervated by the sympathetic nervous system (SNS)

Noradrenaline acts on ⍺1 adrengenic receptors on this vascular smooth muscle in the skin

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9
Q

To reduce skin blood flow…

A

Sympathetic nerves release noradrenaline and to have an effect it must bind to some sort of receptor and on these smooth muscle walled blood vessels these receptors are called ⍺1 adrenergic receptors, not ion channels they are instead G protein coupled receptors (GPCRs) when activated, an ion channel doesn’t just open and close but rather a second messenger is produced which causes intracellular effects and in this case the increase in calcium which allows for more actin and myosin interactions which will cause contraction (vasoconstriction) which will decrease the amount of blood flow to the skin

GPCRs coupled to intracellular 2nd messengers - increased intracellular calcium - constriction = reduced skin blood flow

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10
Q

To increase skin blood flow…

A

Reducing sympathetic nervous system activity therefore causes relaxation (dilation) arteries to the skin and this increases blood flow to the skin

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11
Q

Normal human body temperature

A

36.5-37.5 ℃ is the normal range of body temperature

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12
Q

Body temperature too high…..body temperature too low

A

Too high - death, proteins denature, convulsions and cell damage
Too low - disorientation, loss of muscle control, loss of consciousness, cardiac arrest, death

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13
Q

Primary mechanisms of heat transfer

A

Radiation, evapouration, convection, conduction

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14
Q

Radiation

A

Causes heat loss in the form of infrared rays. Nay objects that are not at an absolute zero temperature will radiate such rays. For a person with no clothes on sitting inside at normal room temperature, about 60% of their total heat loss would be via radiation. As well as the body radiating heat in all directions, heat rays are also being radiated from the walls of rooms and other objects towards the body. Provided the temperature of the body is greater than that of the surroundings then more heat will be radiated from the body than to it. In very hot environments however the opposite may apply.

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15
Q

Evaporation

A

When water evaporates from the body surface the heat energy required to cause the water to evaporate is also lost. Even if a person is not sweating water will still evaporate without you noticing from the skin and the respiratory tract. Evapouration is particularly important in situations when the environment temperature is greater than body temperature. In these circumstances the body will GAIN heat by radiation and conduction/convection and so sweating becomes the only mechanism by which the body can rid itself of the heat.

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16
Q

Convection

A

Convection firstly involves the transfer of heat to air (or water) by conduction followed by the movement of the air (or water) away from the skin which maintains the gradient for heat loss from the body. A small amount of convection almost always occurs around the body because of the tendency for air adjacent to the skin to rise as it becomes heated. In windy conditions the layer of air immediately adjacent to the skin is replaced by new air much more rapidly than usual and so convective heat loss increases accordingly - wind chill factor

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17
Q

Conduction

A

Involves the transfer of heat to objects or media with which we are in contact. Normally a relatively small amount of hear is transferred to solid objects such as a chair but a significant amount is conducted into air. Once the temperature of the air adjacent to the skin becomes equal to the temperature of the skin then hear will cease to be lost in this manner. Therefore conduction of heat from the body to the air is self limited UNLESS the heated air moves away from the skin to be replaced by cooler air which allows heat loss to continue and this is called air convection

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18
Q

Heat loss to air vs water

A

Water can absorb far greater quantities of heat. Heat conductivity in water is very great in comparison with air. Consequently the body loses heat to water faster than to air and it is virtually impossible for the body to heat a thin layer of water next to the skin to form an ‘insulating zone’ as occurs in air

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19
Q

Eccrine sweat glands - how are they controlled?

A

Innervated by the sympathetic nervous system. Sympathetic cholinergic release ACh onto mAChRs (GPCRs)

Some eccrine sweat glands can also be stimulated by adrenaline (unrelated to temperature) in blood acting on beta receptors - ‘nervous sweating’ especially on palms and soles (and axilla to some degree)

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20
Q

When body temperature increases ….

A

Preoptic area of hypothalamus contains heat and cold sensitive neurons (central thermoreceptors)

If blood temperature goes ABOVE set point then the heat loss centre is activated.
Decrease in sympathetic nervous system activation of ⍺1 on skin blood vessels which causes vasodilation - relaxes the precapillary sphincters therefore more blood will go to the surface and provided the air temperature is less than our body temperature we will lose heat by conduction, convection and radiation
Increase in sympathetic nervous system cholinergic activation of mAChRs on sweat glands which causes sweating - evaporate water and lose the heat
Increase in respiratory rate - more air flowing across tongue which is wet and air flow up and down the trachea which is also going to increase evaporative losses such as dogs panting
Behavioural changes - feel hot then you move to somewhere cooler or get a cold drink for example

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21
Q

When are radiation, conduction and convection not effective heat loss mechanisms…?

A

Not effective when the environmental temperature is greater than body temperature

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22
Q

When body temperature falls…

A

Central thermoreceptors detect temperature BELOW ‘set point’ which activates the heat gain centre

Heat gain centre responds to low temperature in two ways:
Increased generation of body heat - shivering (shiver via contracting muscle which generates heat) and non shivering (start producing heat through hormones for example) thermogenesis
Conservation of body heat - Vasomotor centre decreases blood flow to the dermis and thereby reduces losses by radiation and convection.
Countercurrent exchange - beneficial to transfer heat from arteries to veins to conserve heat…warm blood in the arteries instead of going to the skin and loosing that heat to the environment it can be transferred to the veins that are bringing cold blood back to the core

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23
Q

Heat generating mechanisms

A

Shivering
Non-shivering thermogenesis
Increase in thyroxine

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24
Q

Heat generating mechanisms - shivering

A

Increased tone of skeletal muscle
When tone rises above critical level, shivering begins due to oscillatory contractions of agonist and antagonist muscles mediated by muscle spindles (stretch receptors)

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25
Q

Heat generating mechanisms -non-shivering thermogenesis

A

Increased sympathetic nerve activity and increase in the circulating adrenaline and noradrenaline from the adrenal medulla
Increased cellular metabolism e.g. increased glycogenolysis in the liver and muscle which provides some heat
‘uncoupling’ of oxidative phosphorylation i.e. heat produced instead of ATP (occurs in brown fat, particularly in infants - good blood supply and packed full of mitochondria)

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26
Q

Heat generating mechanisms - increased thyroxine

A

In response to an increase in TRH and TSH
Increases basal metabolic rate
In adults, humans may take several weeks exposure to cold before thyroid reaches new level of thyroxine secretion

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27
Q

Arrector pili muscles

A

Smooth muscles innervated by the SNS (⍺ receptors)
Attach hair follicle to the upper dermis
Contraction pulls hairs upright and dimples skin therefore you get goosebumps
Also compresses sebaceous glands which lubricates skin
If you are a hairy mammal, this traps layer of warm air around skin and makes you look bigger, scarier and more formidable. Not that useful for humans but can be a good example of physiological feedforward
In cold weather, muscle contracts, makes hair more vertical

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28
Q

What does getting goosebumps do?

A

Traps air and creates an insulating area around the body

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29
Q

Physiological feedforward

A

For example, walking out on a cold day in a singlet, you shiver straight away even though your temperature has not had time to change yet and you start to produce heat by shivering before your body temperature has even changed

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30
Q

Other than physiological responses, what other kind of response is important for maintaining homeostasis?

A

Behavioural responses, not a physiological response

31
Q

First-degree burn

A

Superficial, only involves the outer layers of the epidermis
Red/pink, dry, painful - painful because the sensory receptors are still in tact and it is more painful than usual due to inflammation
Usually no blisters e.g. a mild sunburn
Skin remains a water and bacterial barrier
Usually heals 3-10 days

32
Q

Second-degree burn

A

Epidermis as well as varying amounts of the dermis
Painful, moist, red and blistered
Usually heal in approx 1-2 weeks
Need good dressings (absorptive initially) - lots of fluid is lost therefore need absorptive dressings as the lost epidermal layer is the waterproofing layer which has been entirely burnt off

Deeper second degree burns…
May include whiteish, waxy looking areas
Hair follicles, sweat glands may remain intact
Some tactile receptors may be lost
Usually heal in 1 month but may have some loss of sensation and scarring

33
Q

Third-degree burn

A

Full thickness i.e. extend into subcutaneous tissue and may involve muscle and bone
Varied colour from waxy white through to deep red or black
Hard, dry and leathery
No pain in these areas as sensory nerve endings are destrotyed
If more than a few cms may require skin grafting
Weeks to generate and scarring

Most burns are a mixture of 1st, 2nd and 3rd degree burns ….1st degree out towards the periphery and 3rd degree centrally

34
Q

How to work out fluid replacement after sustaining burns?

A
Rule of 9s 
Head 9%
Upper limb 9% each 
Trunk (front and back) 36%
Genitalia 1%
Lower limb 18% each
Child… 
Head 15% 
Trunk (front and back) 32%
Upper limb 9% each 
Genitalia 1%
Lower limb 17% each
35
Q

Potential complications of severe burns

A

Dehydration (loss of waterproofing effect of skin) and hypovolemic shock
Infection/sepsis (because skin is the first barrier)
Hypothermia (lots of 2nd and 3rd degree burns means greater evaporative function (heat loss))
These directly relate to skin function

Severe burns can also cause dysfunction in other systems such as …
Electrolyte imbalances - e.g. hyperkalaemia which is high K+, burning the cells causes K+ from the cells to be released which can be a big problem
Hypermetabolism - high caloric needs
Gastrointestinal ulceration - as a result of high cortisol or low blood pressure/volume to stomach which can cause ulcers
Renal failure - blood pressure is low and then the kidneys start to suffer, haemoglobin and myoglobin is going to start blocking up the tubules in the kidney
Respiratory dysfunction - not only if you are inhaling hot gases but also if you have lots of inflammation in your body it causes the capillaries in your lungs to become leaky and they fill up with fluid

36
Q

Some functions of skin?

A

Protection, thermoregulation, sensation (pressure, touch, pain and temperature) and metabolism

37
Q

Which basic human tissue types is the epidermis made of?

A

Epithelial tissue

38
Q

Which type of epithelium would you find in the epidermis?

A

Stratified squamous - lots of layers of thin, fat cells

39
Q

Microvilli

A

Extensions of the cell membrane that increase the surface area of the cell. This increases the ability of the cell to secrete or absorb

40
Q

Cilia

A

Hair-like projections that help to move luminal contents

Cells that have cilia are called ciliated

41
Q

Where is mucus produced?

A

Produced by special columnar cells called ‘goblet cells’. The cells make mucus for protection or for lubrication

42
Q

Stem cells in the epidermis

A

Stem cells in the deepest layers of the epidermis continuously produce keratinocytes, which allows doe the replacement of cells that are shed on the exposed surface

43
Q

Function of the epithelium of the epidermis

A

Protection from abrasion, desiccation, infection etc. as they are dead cells

44
Q

Place you will find high turnover of epithelium

A

Oral cavity and oesophagus as you need protect from food abrasion

45
Q

Outermost cells of the epidermis are …

A

dead

46
Q

What type of junction connects the epidermis to the dermis?

A

Hemidesmosomes - connects the two areas

47
Q

How are cells within the epidermis connected?

A

Desmosomes

48
Q

Epidermis layers top to bottom

A

Stratum corneum, stratum lucidum (only thick), stratum granulosum, stratum spinosium, stratum basale

49
Q

Why do you not bleed when you take off epidermis cells? Why is it not painful to do so?

A

Because there is no vasculature/no blood vessels

There are no pain fibres/ free nerve endings in the outermost layers of the epidermis

50
Q

In which layer would you find the stem cells that will ultimately replace the cells which are shed?

A

Stratum basale

51
Q

Cells that contribute to pigmentation found where?

A

Melanocytes are found in the stratum basale

52
Q

Why is having melanoma more dangerous in the dermis ?

A

Dermis is not continually replaced like the epidermis and also because the dermis sits closer to the bloodstream and lymphatics

53
Q

Difference between thick and thin skin?

A

Thick skin contains a 5th stratum called the stratum lucidum

54
Q

Sensory receptors found deep in the dermis

A

Bulbous corpuscles (ruffini’s)
Lamellar (Pacinian) corpuscles
(the two above are between the dermis and the hypodermis)
Root hair plexuses

55
Q

Sensory receptors in papillary layer of the dermis

A

Tactile corpuscles

56
Q

Sensory receptors in the epidermis

A

free nerve endings and tactile discs

57
Q

Sensory receptors in the deep dermis detect

A

Sustained deep pressure and vibration
Pressure and skin stretch
Movement of hair

58
Q

Hypodermis

A

Located deep to the dermis and it connects the skin to the rest of the body. It is composed of loose connective tissue, in particular adipose tissue. The hypodermic is also the location of sensory receptors and large blood vessels that enter and leave the skin

59
Q

Role of adipose tissue in the hypodermis

A

Insulation - stores energy and provides protection

60
Q

Some functions of hair?

A

Protection and also touch sensation

61
Q

Arrector pili muscles - are they under voluntary or involuntary control? What type of muscles are they?

A

Involuntary control

Smooth muscle

62
Q

Exocrine secretion vs endocrine secretion

A

Exocrine is secretion outside of the body

Endocrine is secretion into the body, into the bloodstream

63
Q

Which basic tissue is modified to form sweat glands and sebaceous glands

A

epithelium

64
Q

Main function of sweat

A

Thermoregulation - heat loss via evaporation

65
Q

Person goes running - why do they feel hot? Does how they feel reflect a change in core body temperature?

A

Feel hot due to vasodilation bringing more blood to the skin surface

Core body temperature should not have changed. The body causes change in blood flow in peripheral areas in an attempt to maintain core body temperature. This increase in blood flow is detected by peripheral temperature receptors which register the change as an increase in temperature

66
Q

Physiolodical reponses to an increase in heat production and how do these reponses get rid of excess heat?

A

Sweating - evaporative cooling, evaporation of sweat is exothermic preocess where heat is transferred from the skin to the environment

Redness - increased blood flow to the skin surface due to vasodilation at skin surface which allows for rapid transfer of heat from the core to the periphery and increased heat loss from the body to the environment through radiation, conduction and convection

67
Q

Piloerection

A

Goosebumps - Provides a layer of insulation between the hairs thereby reducing the heat loss to the environment , more effective in animals with more body hair

68
Q

Note about shivering ….

A

Shivering does not occur in the skin but in the skeletal muscle. Shivering leads to increased metabolism (heat production) from skeletal muscle to match the increased heat loss from the environment

69
Q

Tactile discs

A

Comprised of Merkel cells and nerve terminals are key for determining the difference between rough and smooth and are very important for reading braille, as they map to deferent areas of the cortex and give an indication of the variety of sensation within the overall area of the fingertip for example

70
Q

Tactile corpuscles and lamellar corpuscles

A

Allow us to tell the difference between different rough surfaces and different smooth surfaces

71
Q

Receptors detecting temperature?

A

Peripheral temperature receptors

72
Q

When feeling with finger tips you are unlikely to be using …

A

root hair plexus

73
Q

Where does perception of shape and text occur?

A

Primary somatosensory cortex

74
Q

Control centre of cor body temperature …?

A

Hypothalamus