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Dermatology > Pathophys/Path > Flashcards

Pathophys/Path Flashcards

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Dermatology Board Prep flashcards
1
Q

Layers of skin?

A
  • Epidermis
  • Dermis
  • Subcutis
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2
Q

Cells in Epidermis?

A

Keratinocytes
Melanocytes
Langerhans cells
Markel cells

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3
Q

Cells in Dermis?

A 
Fibroblasts
Collagen
Elastic
Blood Vessels
Nerve Endings
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4
Q

Cells in Subcutis?

A

Fat
Blood Vessels
Fibrous Septae

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5
Q

Epidermis

A
  • Primarily barrier function, protection, wound healing
  • Barrier-structure and organization
  • Wound healing-must be able to “fix” itself
  • Self-renewing, sheds every 28 days
  • Cells grow from stem cells in basal layer and terminally differentiate as the move up
  • Apoptosis normally low in epidermis (can increase)
  • 4 Layers
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6
Q

4 layers of Epidermis?`

A

1) basal
2) spinous
3) granular
4) stratum

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7
Q

Basal Layer

A
  • In epidermis
  • Source of stem cells
  • Division starts here
  • Basal cells adhear to dermis (BM zone) through HEMIDESMOSOMES
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8
Q

Spinous Layer

A
  • In epidermis
  • Cells stop dividing/start terminal differentiation
  • Develop lipid (lamellar granules) important to barrier function
  • “spiny” due to visible DESMOSOMES with which one KC adheres to another
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9
Q

Granular Cell Layer

A
  • In epidermis
  • Intracellular keratohyline granules synthesized (including profilaggrin)
  • Lipids in lamellar granules secreted into intercellular space to form water barrier to keep water in skin
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10
Q

Stratum Corneum

A
  • In epidermis
  • Nuclei and organelles degenerate, cells flatten
  • Profilaggrin processed into filaggrin (help keep water in cells)
  • Keratins (structural cytoskeletal proteins) combine with filaggrin into macrofibrils that help create protective layer
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11
Q

Brick and mortar?

A

Stratum corneum
Brick- flattened keratinocytes filled with keratin and filaggrin
Mortar- lipid mixture surrounding keratinocytes providing water barrier

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12
Q

Keratins

A
  • In epidermis
    -major fibrous structural proteins in hair/nails
    -over 40+
    -combine to form INTERMEDIATE FILAMENTS
    (pairs differ by location in body)
    -mechanically stabilize cell against physical stress
    -have large amounts of sulfur-containing amino acid cysteine
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13
Q

Melanocytes

A
  • In epidermis
  • Pigment-producing cells
  • Derived from neural crest; migrate during embryonic development
  • “live” along basal cell with about 1 per 10 keratinocytes
  • transfer pigment to surrounding keratinocytes
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14
Q

Langerhans Cells

A
  • Dendritic cells in mid-epidermis
  • Major immune players in skin
  • Recognize abnormal antigen: take up, process, present to lymphocytes in regional lymph nodes
  • Important in allergic rxns, tumor surveillance
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15
Q

Merkel Cells

A
  • In epidermis (basal layer)
  • touch sensation
  • develop in malignant tumors
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16
Q

Dermis

A
  • Support Layer
  • Thickness Varies by site (1-4mm)
  • Blood vessels/lymphatics, nerves, sweat/oil glands, hair follicles
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17
Q

Fibroblasts

A
  • In Dermis (main cell)
  • Mesenchymal origin
  • Responsible for synthesis and degradation of connective tissue proteins (collagen, elastin, glycosminoglycans)
  • Injury to skin triggers mitosis of fibroblasts
  • Responsible for wound healing/scar formatin
18
Q

Mast Cells

A
  • In Dermis
  • Part of immune system
  • Specialized tissue cells rich in histamine and heparin granules
  • Release their granules when triggered by injury or when bind to IgE Ab during allergic rxn
  • Histamine and other mediators important in allergic rxns and wound healing “wheal & flare”
19
Q

Hair Follicle

A
  • Extend through dermis into subcutis

- Each has associated sebaceous (oil) glands

20
Q

Pilosebaceous unit

A
  • Hair follicle
  • Sebaceous (oil) gland
  • Apocrine sweat glands (in axilla and anogenital skin)
  • Arrector pili muscle (goose bumps)
21
Q

Eccrine Sweat Glands

A
  • “true”
  • present throughout body
  • open directly on skin (no hair follicle)
  • function to regulate temp by evaporative cooling of sweat
22
Q

Subcutis

A

Fat layer that separates dermis from underlying fascia, muscle, organ
Serves as: Insulation, Energy, Protection from injury

23
Q

Sun Damage

A

Hurts Keratinocytes, failure to “delete” (apoptosis)

damaged cells can result in skin cancer

24
Q

Filaggrin Defect

A

Atopic dermatitis (barrier defects)

25
Q

Epidermolysis Bullosa Simplex

A

Genetic mutations in Keratin 5/14

-blister

26
Q

Melanocytic Tumors

A

1) Nevus: benign

2) Melanoma: malignant

27
Q

Functions of Skin

A

1) barrier
2) immune recognition/surveillance
3) damage repair
4) thermoregulation
5) photoprotection
6) communication

28
Q

Barrier Function

A

-regulate water loss, protection from mechanical/chemical/microbial insults
If defective: dehydration, infection, injury of skin (ulcers), inflammation

29
Q

Immune Regulation of Skin

A

Innate and adaptive
-can be involved and injured by immune function
Defective: infection, cancer, autoimmune/inflammation, allergic rxns

30
Q

Autoimmune Bullous Diseases

A
  • disorders of epidermal adhesion or cohesion mediated by autoantibodies to skin adhesion molecules
  • characterized by erosions or blisters in skin (mucosa)
31
Q

Pemphigus Vulgaris Ab?

A

Anti-Desmosome Abs

32
Q

Bullous Pemphigoid Ab?

A

Anti-Hemidesmosome Abs

33
Q

Repair Injury

A

Wound healing, repair DNA or apoptosis

Defective: chronic skin ulcers, infection, cancer

34
Q

Xeroderma Pigmentosa

A

skin cancer in childhood

35
Q

Thermoregulation

A

-constant temp, insulation from fat and hair, control heat loss through sweat/changes in dense microvasculature
Defection: bad for health/confort, hypo/hyperthermia

36
Q

Hypohiseoric Ectodermal Dysplasia

A

Genetic mutation in EDAR gene (ectodyplasin A receptor)

  • protein critical for proper interaction b/w developing ectoderm and mesoderm
  • abnormal hair follicels, sweat glands, teeth
  • can’t regulate temp: over heat
37
Q

Raynauds’ Phenomenon

A
  • Chronic episodic attacks of digital ischemia
  • Provoked by cold
  • Painful, can ulcerate
  • Can be associated with underlying autoimmune disease
38
Q

Circulation Abnormalities

A

-diseases that injure blood vessels
-results in cutaneous necrosis/ulveration
Ex: Small vessel vasculitis

39
Q

Skin Communication

A

touch, hot/cold, mechanoreceptors
Dysfunction: itch, dysesthetic pain/burning, hyperesthesia (sensitive skin), pain
Ex: Neuropathic ulcers, Trigeminal Trophic Syndrome

40
Q

Photoprotection of skin

A

-epidermis has dark pigment (melanin), helps prevent against UV radiation
Dysfunction: cancer, burning
Ex: albinism

Dermatology (9 decks)

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