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MBChB Glasgow Year 1 Phase 1 > PBL 1 > Flashcards

PBL 1 Flashcards

1
Q

What are the three layers of skin?

A

Epidermis, Dermis, Subcutis

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2
Q

Where are the epidermal cells found?

A

On top of the dermis and subcutis

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3
Q

What is the thin layer of extracellular proteins on the bottom called?

A

Basement membrane

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4
Q

What comes after the Basement membrane?

A

Stratum basale

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5
Q

What is the stratum basale?

A

a thin layer of mitotically active cells

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6
Q

What type of junction connects the stratum basale to the basement membrane?

A

Hemidesmosomes

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7
Q

What are hemidesmosomes (desmosomes)?

A

strong junctions

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8
Q

What comes on top of the stratum basale?

A

stratum spinosum

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9
Q

What is the stratum spinosum?

A

A layer of keratinocytes

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10
Q

What are keratinocytes?

A

keratin producing cells

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11
Q

what are the functions of keratin?

A

Waterproofing skin

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12
Q

What holds the stratum spinosum (keratinocytes) together?

A

Desmosomes

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13
Q

what is on top of the stratum spinosum?

A

Stratum granulosum

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14
Q

What happens in the stratum granulosum?

A

Cells become flattened and are starting to lose nuclei and cytoplasm

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15
Q

What is the top layer of the epidermis?

A

Stratum corneum

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16
Q

What is the stratum corneum?

A

Large plate - like envelopes filled with keratin and are all linked together. It also contains some lipids

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17
Q

What are the layers of the epidermis?

A

Basement membrane, Stratum basale, Stratum spinosum, Stratum granulosum and the Stratum corneum.

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18
Q

what happens as cells move up the epidermis?

A

They become keratinised and begin to die as they can’t get enough nutrients

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19
Q

Is the epidermis vascular or avascular?

A

Avascular

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20
Q

How many layers of keratin are there?

A

20-30 layers

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21
Q

How does the epidermis get its nutrients?

A

Supplied by the dermis

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22
Q

What are the layers of the dermis?

A

The papillary and the reticular layer

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23
Q

Where is the papillary layer?

A

The upper portion of the epidermis

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24
Q

What is in the papillary layer?

A

Connective tissue

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25
Q

What is connective tissue?

A

Tissue that connects, supports, binds or separates other tissues or organs

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26
Q

Where is the reticular layer found?

A

The lower portion of the dermis

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27
Q

What is the reticular layer made of?

A

Highly dense connective tissue

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28
Q

What is the connective tissue in the reticular layer made up of?

A

Collagen type 1 and elastin fibers

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29
Q

What property does collagen give the skin?

A

Strength

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30
Q

What property does elastin give the skin?

A

Stretchiness

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31
Q

What are some additional feature of the dermis?

A

Blood vessels, Glands, Hair follicles, receptors and muscles.

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32
Q

Where is the subcutis?

A

Below the dermis and the epidermis. It is the lowest layer of the skin.

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33
Q

What does the subcutis contain?

A

Cells such as macrophages and fat cells and a network of protein fibers.

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34
Q

What are some functions of skin?

A

Protection - the skin forms a barrier
Thermoregulation - 80% of body heat is lost through the skin
Cutaneous sensation - including touch and pressure
Excretion - metabolic waste products can be released in the sweat
Absorption - lipid - soluble substances enter the body via the skin
Vit. D synthesis - starts in the skin triggered by uv light

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35
Q

Where are keratinocytes found?

A

In the epidermis - Aprox. 90% of epidermal cells are keratinocytes

36
Q

What is keratin?

A

A tough fibrous protein

37
Q

What else (apart from keratin) do keratinocytes produce?

A

Lamellar granules

38
Q

What is the function of Lamellar granules?

A

To help waterproof the skin

39
Q

Where are melanocytes found?

A

In the epidermis - Aprox. 8% of epidermal cells are melanocytes

40
Q

What do melanocytes produce?

A

Melanin granules

41
Q

What is the function of melanin?

A

To absorb UV radiation so protects the skin from sun damage

It is also partly responsible for skin colour

42
Q

What are Langerhans cells?

A

They are part of the immune system that originate in the bone marrow and move to the epidermis

43
Q

What are the functions of Langerhans cells?

A

To recognise foreign microbes and engulf them.

They can then present antigens to the immune system for further action.

44
Q

Where are merkel cells found?

A

At the border of the epidermis

45
Q

What feature do merkel cells possess?

A

Small dendrites that pass in between nearby keratinocytes

46
Q

What is each merkel cell associated with?

A

A nerve ending called a merkel disc.

47
Q

What does the combination of the merkel disc and the merkel cell function as?

A

A slow adapting touch receptor

48
Q

What are the functions of fibroblasts?

A

To synthesise collagen, elastin and other extracellular components.
They also play a critical role in wound healing as a connective tissue.

49
Q

Where can most of the lymphocytes in the skin be found?

A

The dermis

50
Q

What are the functions of the lymphocytes?

A

Part of the immune response

Carry out immuno-surveillance

51
Q

What are the functions of mast cells?

A

Producing substances that cause inflammation e.g. histamine

52
Q

How often does the skin renew?

A

Every 24hrs the skin sheds a layer of dead cells with the skin renewing completely every 28 days

53
Q

How does renewal of the skin benefit the immune system?

A

It removes any potentially harmful pathogens from the surface of the skin

54
Q

What happens as epidermal skin cells move up towards the surface of the epidermis?

A

They become keratinised - becoming flatter and gradually losing their nucleus and cytoplasm. They eventually die

55
Q

What is another reason for the death of cells as they move towards the surface?

A

There is a lack of nutrients and oxygen they receive as they get higher up since the epidermis is receiving its nutrients from the dermis

56
Q

What are the three overlapping stages of wound healing?

A

Inflammatory, proliferative, and remodelling

57
Q

How are clots formed?

A

Fibrin and platelets combine to seal the wound from the external environment

58
Q

What is the formation of the clot known as?

A

Haemostasis

59
Q

What is inflammation triggered by?

A

The changes in microvasculature.

60
Q

when does inflammation resolve?

A

after the neutrophils have finished clearing out the dead tissue

61
Q

What are the main purposes of inflammation?

A
  • expel any foreign bodies
  • isolate the damaged area
  • mobilise cells and molecules
  • promote healing and tissue repair
62
Q

What happens during the proliferative phase?

A

A lot of cell proliferation and the movement of epithelial cells to the injury site

63
Q

How do fibroblasts move to the injury site?

A

Along fibrin threads

64
Q

How do the fibroblasts contribute to clotting?

A

They secrete collagen which strengthens the clot

65
Q

What is granulation tissue?

A

Delicate tissue that grows under the scab

66
Q

How is the collagen deposited?

A

In a random arrangement

67
Q

What is the change in type of collagen in the remodelling phase?

A

Type 3 to Type 1

68
Q

What happens when the collagen changes?

A

The granulation tissue becomes scar tissue

69
Q

What does the amount of scarring depend on?

A

The severity/depth of the wound.

70
Q

Does scar tissue or normal tissue have more collagen fibers?

A

Scar tissue

71
Q

Does scar tissue or normal tissue have reduced elasticity/stretchiness?

A

Scar tissue

72
Q

Why are scars sometimes a lighter colour than normal tissue?

A

The way blood vessels arrange themselves

73
Q

What is an incised wound?

A

Caused by a clean cut from a sharp edged object.

74
Q

What treatment is required for an incised wound?

A

If the wound is deep, stitches may be required.

They may be healed by primary intention as there is usually little or no tissue loss

75
Q

What is a laceration?

A

These wounds occur when there is a blunt/ripping force
They may bleed less but there is likely to be more tissue damage
It is also more susceptible to infection due to the increased surface area

76
Q

What treatment is required for an laceration?

A

These wounds require a lot of cleaning.

Even if they are repaired very neatly by primary intention they often leave a lot of scarring

77
Q

What is an abrasion (graze)?

A

A superficial wound in which the topmost layers of skin are scraped off. They can often contain lots of foreign particles meaning a high risk of infection

78
Q

What is a contusion (bruise)?

A

A blunt blow can cause the rupture of capillaries below the skin

79
Q

What is a puncture wound?

A

A deep wound with a small entry site

80
Q

How should a puncture wound be treated?

A

It’s often best to leave this type of wound open so that if there is any infection the wound can drain.

81
Q

What is healing by primary intention?

A
  • A clean, uninfected wound
  • not much loss of tissue/cells
  • The edges of the wound are approximated by sutures
82
Q

What is healing by secondary intention?

A
  • a wound with large tissue defects
  • potentially infected
  • the wound would not be approximated but is left open
83
Q

At what age is a young person presumed to have capacity?

A

16

84
Q

What are the laws in Scotland for 16/17 year olds who do not have capacity?

A

They are treated as an adult who doesn’t have capacity and treatment may be given where required.

85
Q

What is the law in Scotland to do with parents overriding consent?

A

In Scotland parents cannot override the competent consent of a young person to treatment that the doctor believes is in the patients best interests

86
Q

What is the law in Scotland to do with parents authorising treatment a young person has refused?

A

Parents cannot authorise treatment that a competent young person has refused

MBChB Glasgow Year 1 Phase 1 (10 decks)

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