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Dermatology 1 > Physiology > Flashcards

Physiology Flashcards

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Dermatology Board Prep flashcards
1
Q

3 ways the integumentary system protects the body

A
  1. chemical barrier
  2. mechanical barrier
  3. biological barrier
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2
Q

How is integument a chemical barrier

A
  • low pH

- antibacterial secretions (defensin) destroy bacterial cells

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3
Q

How is integument a mechanical barrier

A

keratinized surface and glycolipids waterproof skin

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4
Q

How is integument a biological barrier

A

immune cells such as Langerhan’s cells (phagocytes stationed in epidermis)

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5
Q

What else is a part of the integumentary system that helps provide protection

A

normal flora - 1000 species of resident bacteria

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6
Q

How does integument system provide body temp regulation

A
  • endotherms: body temp regulated internally
  • Sweat allows for evaporative cooling, heat release
  • Arrector pili muscles generate heat at skin surface
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7
Q

Overview of integument role in cutaneous sensation

A
  • skin receptors sense the environment
  • Meissner’s corpuscles and Merkel discs sense light touch
  • Pacinian corpuscles in dermis and hypodermic sense pressure
  • hair movement senses wind
  • raw nerve endings sense cold, heat, pain
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8
Q

Integument role in Vitamins

A
  • modified cholesterol molecules circulate through dermal blood vessels
  • converted via solar energy into vitamin D precursor
  • liver and kidneys finish activation
  • Vitamin D aids in ca absorption
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9
Q

How is the integument system related to CVS?

A

blood reservoir

  • dermal blood holds about 5% of total body volume
  • blood vessels can constrict to shunt blood flow as needed (will cool skin surface)
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10
Q

What is the role the integument system plays in excretion

A
  • small amt nitrogen-containing waste from protein metab are eliminated via the skin
  • eliminate electrolytes in sweat
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11
Q

Keratinocytes

  • location
  • function
A
  • outer layer of stratified squamous epithelium
  • most abundant epidermal cell
  • produce keratin, a fibrous protein
  • cell differentiation occurs as progress from deep to outer layers of epidermis “keratinization”
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12
Q

List the four layers of keratinocytes in the epidermis that are always present

A

deepest to outermost

  1. Stratum basale
  2. Stratum spinousum
  3. Stratum granulosum
  4. Stratum corneum
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13
Q

Stratum Basale

A
  • deepest layer
  • single row of cuboidal/columnar cells
  • epidermal stem cells that become stem cells or keratinocytes
  • keratinocytes start to express keratin which form intermediate filaments
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14
Q

What are two types of cell connections found in stratum basale

A
  • hemidesmosomes attach cells to basal lamina

- desmosomes attach cells to each other

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15
Q

Stratum spinosum

A
  • several cell layers thick
  • active keratin production
  • full of weblike keratin filaments: provides strength in many directions
  • tonofibrils give spiky appearance (protein filaments that lock keratin fibers together, esp around desmosome connections)
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16
Q

Stratum granulosum

A
  • 2-5 layers of cells
  • cells in terminal differentiation
  • Keratin granules: dehydration of the cell and cross-linking of keratin fibers
  • laminated granules: layers of membrane (from golgi), spaces filled with lipids and glycolipids. Exocytosis creates a lipid-rich waterproof layer around keratinocytes
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17
Q

Stratum corneum

A
  • horny layer (tough)
  • 20-30 cells thick, outermost layer
  • keratinized: masses of keratin fibrils and protein aggregates
  • keratinocytes have lost nuclei and organelles, are dead, dry, flat
  • waterproof outer surface
  • desmosomes degrade, cells slough off
    (keratinocyte processes take 15-30 days)
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18
Q

Thick skin

  • location
  • what is special about the epidermis
A
  • palms and soles

- additional layer: Stratum lucidum

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19
Q

Stratum lucidum

A
  • under stratum corneum
  • flattened, differentiated layers of keratinocytes
  • held together by desmosomes
  • appears clear
  • 2-3 layers of cells
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20
Q

Melanocytes

A
  • specialized epidermal cell
  • in stratum basale and hair follicles
  • attached to basal lamina by hemidesmosomes, not attached to neighboring cells
  • cytoplasmic extensions reach through basal and spiny layers
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21
Q

What does sun exposure of skin do to melanocytes

A
  • darkens existing melanin
  • stimulates keratinocyte paracrines
  • stimulates melanin production in melanocytes
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22
Q

Melanin production from tyrosine

A
  • melanin is aggregated to structural proteins
  • accumulates in melanosomes
  • melanosomes are transported to termini of cellular extensions
  • keratinocytes phagocytize tips of extensions
  • granules are transported to keratinocyte nuclei
  • shields nucleus from UV radiation
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23
Q

Langerhans cells

A
  • monocytes derived from cells in epidermis
  • most abundant in spiny layer
  • phagocytize foreign particles, enter circulation, present antigen to lymphocytes in lymph nodes
  • immune defense and surveillance role
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24
Q

Describe the dermis

A
  • CT layer deep to epidermis
  • cells and matrix (ECF embedded with fibers)
  • rich with nerve fibers, blood vessels, lymphatic vessels (NOT in the epidermis)
  • contains most hair follicles and glands
  • form dermal papillae
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25
Q

Dermal papillae

A
  • extensions or interdigitations of dermis into epidermis

- fingerprints!

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26
Q

What are the two dermis layers

A
  1. Papillary layer

2. Reticular layer

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27
Q

Papillary layer of dermis

A
  • thin
  • dermal papillae
  • fibroblasts
  • collagen fibrils: insert into basal lamina, binding dermis to epidermis
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28
Q

What two cells are found in the dermis

A
  1. Mast cells
    - skin and mucous membrane CT granulocytes (phagocytes)
    - secrete inflammatory mediators histamine, leukotriene, and prostaglandings
  2. Dendritic cells
    - derived from monocytes
    - in skin, resp. tract, GI tract
    - antigen presenting cells
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29
Q

Reticular layer of the dermis

A
  • deep to papillary layer
  • thick, dense irregular CT
  • more fiber, fewer cells
  • lots of collagen
  • rich in elastic fibers
  • elastin: produced by fibroblasts, stretch and recoil
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30
Q

Vasculature of dermis

A
  • Subpapillary plexus
  • Deep dermal plexus
  • AV anastomoses
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31
Q

Subpapillary plexus in dermis

A
  • btwn papillary and reticular dermal layers
  • extensive capillary network
  • extends to dermal papillae and subepithelaial basal lamina - provides nutrients and support to epidermal tissue
32
Q

Deep dermal plexus in dermis

A

layer of vessels near interface of dermis and subcutaneous layers

33
Q

AV anastomoses in dermis

A
  • shunts blood between subpapillary and deep dermal plexi
  • increased flow to papillary layer to vent heat
  • decreased flow to papillary layer to conserve heat
34
Q

Subcutaneous layer

A
  • hypodermis
  • deep to dermis
  • loosely anchors skin to underlying muscle
  • loose CT
  • adipocytes make it fatty
  • vascular
35
Q

Sensory receptors List (6)

A
  1. Merkel cells
  2. Free sensory nerve endings
  3. Root hair plexus
  4. Meissner corpuscle
  5. Lamellated (Pacinian corpuscle)
  6. Ruffini corpuscle
36
Q

Merkel cells

A
  • oval epidermal cells
  • stratum basal
  • associated with somatosensory nerve fiber
  • fn as sensory receptor for light sustained touch and texture
37
Q

Free sensory nerve endings

A
  • papillary and lower dermal layers

- sense pain, temp, itch

38
Q

Root hair plexus

A
  • sensory web at hair follicle base

- detects hair movement

39
Q

Meissner Corpuscle

A
  • disks perpendicular to epidermis in dermal papilla
  • stacks of flattened Schwann cells
  • single afferent nerve attached
  • highly sensitive to light touch
  • determines two point touch
  • abundant on fingertips and lips
  • rapidly adapting/phasic: action potential generated and decreased quickly, habituation
40
Q

Laminated (Pacinian) corpuscles

A
  • among adipose cells in deep dermis and subcutaneous layer
  • also in walls of bladder and rectum
  • singel afferent nerve at the core of 20-60 concentric lamellae of Schwann cells
  • sense vibration and sudden pressure
41
Q

Ruffini corpuscles

A
  • anchored firmly to CT

- sense torque and twist

42
Q

List the () types of skin gland

A
  1. Sebaceous glands
  2. Specialized sebaceous glands
  3. Sweat glands
  4. Specialized apocrine sweat glands
43
Q

Sebaceous glands

A
  • acinus gland structure (lots of cells around a duct)
  • sebocytes produce sebum
  • cells die and disintegrate, sebum is released into duct
  • Duct leads to hair or skin surface
  • Holocrine secretion
44
Q

Sebum composition

A
  • TG
  • wax esters
  • squalene
  • FFA
    (odorless, bacteria produce odor)
45
Q

two types of specialized sebaceous glands

A
  1. Meibomian glands: tear ducts, sebum mixes with tears

2. Areolar glands: lubrication and protection of nipple

46
Q

Sweat glands

A
  • aka sudoriferous glands
  • epidermal invagination into dermis
  • SNS innervation
47
Q

List the two types of sweat gland

A
  1. Eccrine

2. Apocrine

48
Q

Eccrine sweat glands

A
  • widely distributed (esp on forehead, palms, plantar foot)
  • coiled, tubular gland opens to sweat pore
  • secretes sweat which is conducted by myoepithelial cells to skin surface
  • purpose: evaporative cooling
49
Q

Sweat formation and composition

A
  • filtrate from blood
  • hypotonic
  • 99% water with:
  • NaCl
  • bicarb
  • K+
  • glucose
  • cytokines
  • IgA
  • dermicidin
50
Q

Apocrine sweat glands

A
  • coiled gland in dermis with sweat released to hair follicle
  • sweat, FA, proteins
  • odor dt bacteria
  • mostly axillary and anogenital region
  • sex hormone control
  • granules exocytose (Merocrine release)
51
Q

List 2 types of specialized apocrine sweat gland

A
  • ceruminous glands

- Mammary gland

52
Q

ceruminous glands

A
  • subcutaneous layer in outer 1/3 of EAC
  • drain into larger ducts, drain into guard hairs in EAC
  • produce cerumen (earwax) by mixing with sebum and dead epidermal cells
  • keeps eardrum pliable, lubricates, waterproofs
  • coats guard hairs, making them sticky
53
Q

Mammary glands

A
  • milk-secreting cuboidal cells
  • surrounded by myoepithelial cells
  • join into lobules, ea has lactiferous duct that drains to openings in nipple
  • myoepithelial cells contract under oxytocin, excrete the milk
  • one complex mammary gland in each breast, each contains 10-20 simple glands
54
Q

Hair

- describe

A
  • elongated keratin structure

- color is pigment from melanocytes at base of follicle

55
Q

3 layers of keratin in hair

A
  1. cuticle: thin outer scales
  2. Cortex: inner, thickest layer
  3. Medulla: core, only in thick scalp hair
56
Q

What is the hair follicle

A

the hair producing gland

57
Q

Describe the anatomy of the hair follicle

A
  • Papilla: base of follicle, CT with capillary tuft
  • Hair bulb
  • Rooth sheath
58
Q

Hair bulb

A
  • dilated terminus of follicle during hair growth
  • houses the matrix (where hair follicle is produced)
  • keratinocytes: mitotic growth through terminal differentiation
  • melanocytes: produce melanin which is uptake by keratinocytes
59
Q

Root sheath

- two layers

A

(part of follicle extending through dermis and epidermis)

  • internal root sheath
  • external root sheath
60
Q

Internal hair root sheath

A
  • epithelial tissue surrounding root to sebaceous gland

- two layers

61
Q

External hair root sheath

A
  • CT sheath covers internal sheath

- extends all the way through the epidermis

62
Q

Three stages of hair growth

A
  1. Anagen
  2. Catagen
  3. Telogen
63
Q

Anagen phase of hair growth

A
  • 90% of active growth
  • 3-4 years on scalp
  • 30-4 days on appendages, eyelashes, eyebrows
  • begins as progenitor cells form new bulb and matrix
64
Q

Catagen phase of hair growth

A
  • growth slows

- outer sheath shrinks, attaches to hair shaft forming club hair

65
Q

Telogen phase of hair growth

A
  • hair bulb shrinks

- club hair is shed

66
Q

Arrector pili

A
  • controlled by SNS
  • smooth muscle fibers at base of hair follicle
  • contraction pulls hair vertical, goose bumps
  • heat production
67
Q

Nails

  • describe composition
  • function
  • anatomy
A
  • hard keratin plate from nail bed
  • fn: scratching, dexterity, defense
  • nail root is beneath epidermal folds
  • nail body: visible plate
  • free edge: part hangs off finger
  • Lunula: moon shape at proximal body
  • distal extent of germinal matrix of nail bed
  • dense nucleated keratinocytes (opaque)
68
Q

Nail folds

A
  • lateral
  • hyponychium: below free edge
  • Eponychium: cuticle, proximal fold over nail body
69
Q

List four types of lesion

A

abrasion
laceration
puncture
surgical

70
Q

Clotting phase of wound healing

A
  • bleeding into wound
  • platelets form platelet plug
  • clotting factors form cross-linked fibrin mesh
  • thrombus (scab)
71
Q

Inflammatory phase of wound healing

A
  • plasma and leukocytes move from blood to injured tissue

- heat, pain, redness, edema

72
Q

Proliferative phase of wound healing

A
  • mitotic activity
  • granulation: fibroblasts secrete collagen foundation, vascularization creates nutrient supply and waste removal
  • epithelialization: epidermal growth from all directions to cover site
73
Q

Maturation phase of wound healing

A
  • collage reorganization
  • granulation tissue dies
  • debris removal
  • excessive collage remains as scar
74
Q

Three wound healing categories

A
  1. Primary or first intention
  2. Second intention
  3. Tertiary intention
75
Q

Primary intention wound healing

A
  • clean wound, no tissue lost
  • closure of wound
  • heals from outside in
  • can open easily
  • infection, abscess formation
76
Q

Second intention wound healing

A
  • wound heals without closure
  • natural process of healing from inside out
  • less chance of abscess forming
77
Q

Tertiary intention wound healing

A

close wound after all evidence of inflammation has passed

Dermatology 1 (19 decks)

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