Phase 1 week 1 Flashcards
What are the three main functions of skin?
Physical and immunological barrier, physiological regulation, Sensation
In what ways does the skin act as a barrier?
Protects against; mechanical impacts, pressure, variations in temperature, micro-organisms (Lymphocytes), radiation
How is the skin involved in physiological regulation of the body?
Body temperature via sweat and hair, changes in peripheral circulation, fluid balance via sweat, synthesis of vitamin D
Describe sensation in the skin
Network of nerve cells detect and relay changes in the environment (heat, cold, touch, pain)
Itch is a unique feature of the skin
Describe vitamin D synthesis in the skin
During exposure to UV light, UVB photons are absorbed by 7-dehyrocholesterol in the skin and converted to provitamin D(3) Provitamin D(3) undergoes transformation within the plasma membrane of cells to active vitamin D(3)
What are the layers of the epidermis?
Stratum corneum Stratum lucidum Stratum granulosum Stratum spinosum Stratum basale
Describe Eccrine glands
Everywhere on skin apart from nail bed and lips
secrete sweat
most abundant on palms, soles and axillae
Describe apocrine glands
Scent glands, role unclear
Axillae and genitals
Describe sebaceous glands
Present everywhere except palms and soles
Enlarge greatly at puberty in response to androgens (acne)
Main function is to provide lipids which lubricate the hair shaft
What is the main type of cell found in the epidermis and what proportion does it make up?
keratinocyte - 95%
What types of cell are found in the epithelium?
keratinocytes
dendritic cells - langerhans cells
melanocytes
what are the properties of keratinocytes?
They form keratinised squamous epithelium
waterproof
protection against friction, microbial invasion and desiccation
Held together by desmosomes - intermediate filaments and cadherins
Describe melanocytes
Found in the basal layer of the epidermis
Melanin is transferred to keratinocytes via their dendritic processes
Describe normal skin regeneration
Some cells in the stratum basale are stem cells
These can divide to form new stem cells or undergo terminal differentiation as they migrate towards the surface of the skin
It takes 1 month for epidermal turnover
2 weeks from granular layer to stratum corner
2 weeks for the corneocyte to surface the stratum corneum and to be shed to the environment
The epidermis is made up at keratinocytes at different stages of development
What is a wound?
The breakdown in the protective function of the skin
What types of wounds are there?
Erosion - only epidermis lost
Ulceration - structures deep to epidermis
Partial thickness - epidermis and some dermis
Full thickness - epidermis and all of dermis and deeper structures
What are the 3 phases of wound healing?
Inflammation - platelets and WBCs gather
tissue proliferation - epithelialisation and granulation tissue formation
Tissue remodelling
Describe phase 1 of wound healing
Platelets arrive first and initiate haemostats and release growth factors
GFs attract other cells to fight infection
New cells migrating to the area cause characteristic signs of inflammation
Neutrophils and macrophages kill microorganisms and secrete more GFs
What are the two part in phase 2 of wound healing?
re-epithelialisation and neovascularisation
Describe re-epithelialisation
Within 1-2 days of the wound, keratinocytes move from the skin appendages and near the edge of the wound
the cells adapt - they lose their adhesion properties and become flatter
Re-epithelialisation occurs either by the “leap frog” method or the “train method”
Describe neovascularisation
Chemotactic factors cause cells to migrate and proliferate
Fibroblasts multiply and lay down collagen in a haphazard way to form a fibrous network that supports new capillary loops
This tissue formed is called granulation tissue
Fibroblasts contract to pull the edges of the wound together
Describe phase 3 of wound healing
The collagen is organised into thick bundles and extensively cross-linked to form a mature scar
What factors affect wound healing?
size of wound blood supply to area presence of microorganisms age and health of the patient Drugs patient takes nutritional status of the patient