Physiology Flashcards
Embryologically the epidermis comes from the ____derm
Ectoderm
Embryologically the dermis comes from the ____derm
Mesoderm
Embryologically melanocytes comes from ______
Neural crest cells
The skin is fully developed at wk __ gestation
Week 26
At 4wks gestation the components of the skin are :
Periderm, basal layer, dermis (corium)
At 16wks gestation the ____ migrate from ____ and the layers of the skin =
Melanocytes migrate from the neural crest
Keratin, granular, prickle cell, basal and dermis
The epidermis is ________ epithelium.
Stratified squamous
____ make up 95% of the epidermis
Keratinocytes
The prickles in the prickle cell layer are _____
Lots of desmosomes
The basal cell layer is ____ for rigidity
Undulating
Takes keratinocytes ____ to get from basement membrane until they are shed from the keratin layer
28 days normally
Basal cell layer : usually ____ thick
Shape of cells = ________
Contains lots of _______
1 cell thick
Small cuboidal cells
Lots of Intermediate filaments (keratin)
Prickle cell layer: shape of cells =
Lots of _____ connecting to _____
Larger polyhedral cells
Lots of desmosomes connecting to intermediate filaments
Granular layer: ____ layers of cells = thin/thick layer
Shape of cells =
Contain ___ granules which contain ___ + _____
____ secreted from keratinocytes release _____ => high ____ content
Origin of ____ and _____ are lost here
2-3 layers - thin layer
Flattened cells
Keratinohyalin granules contains structural filaggrin and involucrin proteins
Lamellar/Odland bodies release lipids => high lipid content
Cornified envelope origin, cell nuclei lost
Keratin layer- composed of ____ that overlap and have no ____
Other name =
80% ____+____
___ from ____ glues keratin together
Corneocytes with no nuclei
Cornified envelope
80% keratin and filaggrin
Lamellar bodies produce FAs
The cells that make up the epidermis =
Keratinocytes (95%) melanocytes ( basal and suprabasal) langerhans (suprabasal) merkel cells (basal)
Melanocytes are present in _____ layers
Basal layer and above
Melanocytes are ____ cells that produce _____
Dendritic cells
UV protection pigment
Melanocytes - organelle that is transferred via dendrites to adjacent keratinocytes, synthesise store and transport _____
Melanosomes
Melanin
Melanocytes convert ____ to _____
Tyrosine to melanin
Melanin comes in two forms ____ and ____ (give the colour of pigmentation they each give to skin)
Eu (brown/black)
Phaeo ( yellow/red)
Melanin forms a cap over the nucleus to protect ___ in the ____ cells and stopping it ___
Protects DNA in basal cells and stops it crosslinking
Langerhans originate from ____
Mesenchyme - from bone marrow
Langerhans cells are found in the ___ layer, ___ and ____
Prickle cell layer, dermis and lymph nodes
Function of Langerhans cells in the skin
APCs - take antigens from skin to lymph nodes- dendritic cells
Only cells to contain birbeck granules (racquet shaped)
Langerhans cells
Lamellar bodies are ___ shaped
Racquet
Merkel cells are found in ____ layer between ___ and _____
Function =
Basal cell layer between keratinocytes and nerve fibres
Mechanoreceptors
Pigmentation in pilosebaceous is due to ____ above the ____
Melanocytes above dermal papilla
90% of hairs are in this phase of growth
It takes ____
Anagen - growing phase
3-7 years
10% of hairs are in this phase of growth
Takes _____
Catagen - involuting
3-4 wks
<1% of hairs are in this phase of growth
Occurs in____ hairs per day
Telogen
Resting/ shedding - 50-100 hairs a day
Hair and nails are both composed of ____
Specialised keratin
Underneath nail plate lies ___ proximally and _____ distally
Nail matrix proximally ( similar to hair bulb) Nail bed (CT)
Functions of DEJ
Epithelial-mesenchymal interactions - support, anchorage, adhesion, growth and differentiation of epidermal cells
Semi permeable membrane
Contents of the dermis
Collagen, elastin, ground substance, blood vessels, lymphatics, nerves, cells
Cells found in the dermis
Mostly fibroblasts (=>collagen) macrophages, mast cells, lymphocytes, Langerhans
Ground substance in dermis is composed of
Mucopolysaccharides and glycosaminoglycans
Blood vessels in dermis - supply is > than metabolic needs
Organised in ______ that ____and don’t/do enter the epidermis
Supply > metabolic needs
Horizontal plexuses branch up and stop at DEJ along with lymphatics
Pressure sensors deep in dermis
Pacinian corpuscles
Very sensitive vibration sensors in superficial dermis
Meissners corpuscles
3 types of skin glands
Sebaceous
Apocrine sweat
Eccrine sweat
Skin glands that are hormone sensitive and cause acne if blocked
Sebaceous
Sebaceous glands are _____ distributed. Largest are found on __,___+___
Widely distributed
Face back chest
Function of sebaceous glands
Control moisture loss
Bacterial and fungal infection protection
Skin glands that produce sebum and mainly open up onto hair follicles
Sebaceous
Components of sebum
Squalene, wax esters, triglycerides, FFAs
Skin glands that are part of the pilosebaceous unit and found in axils and perineum
Apocrine sweat glands
Androgen dependent glands that secrete oily fluid (odorous after bacterial decomposition)
Apocrine sweat gland
Locations of eccrine sweat glands
Whole skin surface - especially palms, soles and axillae
Eccrine sweat glands have a ___ nerve supply
Stimulated by __,___+___
Sympathetic cholinergic
Mental, thermal and gustatory stimulation
sebaceous glands are ___ distributed and are largest on the __+__+__
widely distributed
face, back and chest
skin glands that produce sebum
they mainly open onto _____
sebaceous
hair follicle
functions of sebaceous glands
control moisture loss
bac and fungal infection protection
skin gland that is part of pilosebaceous unit and found in axillae and perineum
apocrine sweat glands
sebum components =
squalene, wax esters, triglycerides, FFAs
apocrine sweat glands are ____ dependent
they produce ___ that becomes odourous after ___
androgen dependent
oily fluid
bacterial decomposition
skin glands that cover the whole skin surface especially palms, soles and axillae
eccrine sweat glands
eccrine sweat glands have a ____ nerve supply - stimulated by ___+___+___
sympathetic cholinergic
mental, thermal ad gustatory stimulation
functions of eccrine sweat glands = (3)
ultrafiltration (NaCl-HCO3 into hypotonic fluid)
cooling by evaporation
palms and sole grip
2 metabolic functions of the skin
converts cholecalciferol to vit D3 (290-320nm UV)
T4 to T3 conversion
Immunological functions of keratinocytes in keratin layer (3) =
sense pathogens and mediate response eg. UV/allergens
produce AMPs and directly kill
produce cytokines and chemokines to recruit and reg immune cells
epidermis contains mainly ___ T cells
dermis contains ____ T cells
___ also present
epidermis = CD8+
dermis = CD4+ and 8+
NK also present
Th1 cells activate ___ and produce __+__
macrophages
IL2 and IFNgamma
Th2 cells produce ++_ and help ___ make ___
IL4+5+6
B cells make Ig
CD4+ cells ass with inflammation ___ (psoriasis) ___ (atopic dermatitis) ___ (both)
Th1
Th2
Th17
immunological cells in the epidermis
keratinocytes, langerhans, T cells
immunological cells in the dermis
dendritic cells, mast cells, macrophages, neutrophils
MHC I is present in ___ cells and present __to ___
most cells
endogenous antigens to CD8+
MHC II is present in ___ cells and present ___ to ___
APCs
exogenous antigens to CD4+
Scale that gives categories of skin tones and tanning patterns
Type __ to __
Fitzpatrick scale
I to VI
part of dermis that is thin and just below epidermis
papillary dermis
part of dermis that has thicker bundles of type I collagen with sweat glands and pilosebaceous units
reticular dermis
ECM of dermis is composed of
hyaluronic acid and chondroitin sulfate
components of the dermis
type 1+2 collagen matrix
elastic fibres
ECM
persistance of nuclei in keratin layer =
parakeratosis
parakeratosis is present in psoriasis where there is ___
high cell turnover
acanthosis =
increased thickness of epidermis
papillomatosis =
irregular epidermal thickening
spongiosis =
oedema fluid between squames appears to increase prominence of intercellular prickles
chemicals in skin that mediate itch
histamine PGE2 ACh serotonin IL2 kallikrein substance P
nerve transmission of itch in skin is by
unmyelinated C fibres
mediators in the CNS for itch
opiates (endo+exogenous)
orange naevi that if irritated causes a wheal =
mast cell naevi
something usually inflam/dryness in skin triggers itch = ___ cause of itch
eg.s (4)
pruritoceptive asteatotic eczema insect bites lichen planus (sometimes ass with hep C) psoriasis
basis of cause of itch in asteatotic eczema
direct exposure of unmyelinated C fibres in bases of microfissures and inflammatory mediators in skin released
type of eczema that is very xerototic => crazy paving/chicken wiring
eczema craquele
4 types of causes of itch
pruritoceptive
neuropathic
neurogenic
pyschogenic
basis of itch in neuropathic itch
damage of any sort to central/peripheral nerves that causes itch
basis of itch in neurogenic itch
no evident damage in CNS but caused by something affecting the CNS receptors
examples of causes of neurogenic itch
haematological, paraneoplastic, opiates, kidneys (endogenous opiates), hyperthyroid, PBC
non specific anti pruritics =
sedative antihistamines emollients antidepressants (doxepin) phototherapy opiate antagonists ondansetron anti-epileptics for some neuropathic ones
cells in the skin that metabolise vitamin D
keratinocytes
growth development of skin follows
Blaschko’s lines
maceration =
softening and break down of skin due to prolonged moisture exposure
erythropoeitic protoporphyria = lack of \_\_ leading to \_\_ build up presents at\_\_ (age) with \_\_
ferrochelatase
protoporphyrin IX
early childhood
discomfort, itch/tingling in sun
most common sweat gland on the face =
eccrine
acute intermittent porphyria is due to the reduced function of ___ leads to ___ in many tissues
porphobilinogen deaminase
acute neurotoxic reaction
Odland bodies are found in which epidermal layer
granular
it takes ___ days for cells to migrate from basal to keratin layer
28 days
Pressure sensation corpuscles
Pacinian
Vibration sensation corpuscles
Meissner’s
tuberous sclerosis mode of inheritance =
auto dom
type 1-4 HPV =
warts
type 16 + 18 HPV =
cervical cancer
type 6 and 11 HPV =
genital warts
__ more likely than ointments to cause contact sensitisation
cream
___g of ointment for overall coverage
roughly 30g
medial/lateral malleolus ulcers are likely to be __ in origin
venous
cancer that can develop on skin ulcers
squamous cell ca
Breslow thickness =
depth from granular layer to deepest melanoma cell
SCALP layers =
Skin CT Aponeurosis Loose CT Periosteum
sebaceous cyst has an obvious ___ on examination
punctum