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Integmentary Patho > Quiz 1 > Flashcards

Quiz 1 Flashcards

1
Q

Define “Integumentary System”

A
  • Skin, appendages, hair/hair follicles, nails, glands (apocrine sweat glands, eccrine sweat glands, sebaceous glands)
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2
Q

What are the 5 layers of the Epidermis and their functions?

A
  1. Stratum Corneum - (dead keratinocytes)
  2. Stratum Lucidum - only present in thick skin (i.e. palms and soles of the feet)
  3. Stratum Granulosum
  4. Stratum Spinosum
  5. Stratum Basale - host keratinocytes, Langerhans’ cells (immune), melanocytes (produce melanin), and Merkel cells (mechanoreceptors – light touch)
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3
Q

What are the GENERAL functions of the skin?

A
  • First barrier against infection & foreign substances
  • Retains moisture
  • Provides light touch sensation
  • Assists with thermoregulation (i.e. sweat & goose bumps)
  • Assists with excretion (sweat)
  • Assists with vitamin D production
  • Contributes to cosmesis/appearance/identity
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4
Q

What is the Basement Membrane Zone? Purpose?

A
  • Where the epidermis meets the dermis

- Purpose: increases surface area and reduces shear forces

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5
Q

About how many days does it take keratinocytes to travel from the basale layer to the lucidum layer?

A

28 days

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6
Q

What are the 2 layers of the Dermis?

A
  • Papillary Dermis (highly vascularized)

- Reticular Dermis (Deep layer that contains appendages; 80% of dermis)

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7
Q

Protein fibers in the dermis contain what?

A
  • Collagen, Elastin and Reticular
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8
Q

What are the functions of the Dermis?

A 
•	Supports and nourishes epidermis
•	Assists with infection control
-       Houses mast cells and macrophages
•	Assists with thermoregulation
•	Houses skin appendages
•	Provides sensation
•	Temperature regulation
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9
Q

What does the subcutaneous layer consist of?

A
  • Adipose tissue, loose CT and fascia, fibrous CT

- Contains blood vessels, lymphatics, nerves, mechanoreceptors (Ruffini endings, Pacinian corpuscles)

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10
Q

What are the functions of the subcutaneous layer?

A
  • Thermal insulation
  • Energy/stores calories
  • Cushioning
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11
Q

What are the stages of wound healing?

A
  1. Hemostasis
  2. Inflammation
  3. Repair
  4. Remodel
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12
Q

During hemostasis, what is the platelet plug?

A

Retraction and sealing off of blood vessels

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13
Q

During hemostasis, what is the fibrin clot?

A

A stable matrix of fibrinogen that serves as a structure for other cells during the wound healing process (platelets are reabsorbed into bloodstream)

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14
Q

What are the 5 cardinal signs of inflammation?

A
  • Pain
  • Erythema
  • Swelling
  • Calor (increased temperature)
  • Loss of function
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15
Q

How long does the inflammation stage last?

A

4-6 days

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16
Q

What cells are present during the inflammation stage?

A
  • Mast cells (histamine)
  • Neutrophils – “fight infection”
  • Macrophages – converted from monoctyes; perform phagocytosis
  • Lymphoctyes
17
Q

What happens during the repair stage?

A

Granulation
Wound Contraction (around day 4)
Epithelialization

18
Q

When does the remodeling stage occur?

A

Day 8 through 1 year

19
Q

Identify the positive or negative LOCAL factors that affect healing

A 
	pH (incontinence  potential acidity)
	Local ischemia
	Moisture
	Repeated trauma
	Infection
20
Q

Identify SYSTEMIC factors that affect healing

A

 Age
 Comorbidities
 Medications
• Steroids, anticoagulants, immunosuppression
 Blood flow (perfusion & oxygenation)  bad for smokers!
 Infection
 Nutrition – need protein, vitamin C (critical for collagen cross-linkage & tensile strength), zinc, and iron
 Stress

21
Q

Describe the following anatomy of the normal artery: trilaminar structures, tunica intima, media and adventitia

A

o Tri-laminar structures
o Tunica intima – endothelial cells, which maintain blood in liquid state
o Tunica media – contribute to structural integrity
o Tunica adventitia – outermost layer, which contains collagen fibrils that contribute to the strength of an artery

22
Q

Discuss the physiology of large, medium and small arteries

A

This is an objective, but no relevant answer persists in the slideshow

23
Q

Discuss the pathophysiology of atherosclerosis

A

o Proliferative disease affecting cells that make up the intima
o Associated with LDLs and thrombi
o Occurs in large/midsize arteries at certain points in the arterial tree
o Now thought of as a series of progressive acute events
o Smooth muscle proliferation

24
Q

What are the risk factors for PAD?

A 
o	Cigarette smoking
o	DM
o	Hypertension
o	Hypercholesterolemia
o	Hyperhomocysteinemia
o	Chronic kidney disease
o	Insulin resistance
o	C-reactive protein
o	More prevalent in men than in women
25
Q

Intermittent claudication is the cardinal sign of what?

A

PAD

26
Q

A patient with critical leg ischemia will tell you what during Hx?

A
  • Leg pain worsens with elevation
  • Paresthesia
  • Sleeps with legs over the side of the bed
27
Q

How do you document pulse?

A 
0 = absent
1+ = faint
2+ = diminished
3+ = normal
4+ = bounding
28
Q

An ABI below what number is indicative of MODERATE arterial disease?

A

0.8

29
Q

Where do venous skin ulcers most commonly occur?

A
  • malleolar area
30
Q

What are some useful imaging techniques for PAD?

A

o Bilateral Lower Extremity Duplex Ultrasound

o MRI Angiography

31
Q

What is the #1 suggestion for management of PAD?

A

Stop smoking, you asshole

32
Q

Define DM Type 1 and 2

A

o Type I = typically juvenile onset; you do not produce insulin thus you HAVE to take insulin
o Type II = insulin-resistance à you MAKE insulin but you’re body doesn’t use it. NOT due to a lack of insulin

33
Q

What are some prevention strategies for Typed 2 diabetes?

A 
Physical activity
Nutrition/ Diet
Weight Management
Control Stress
AVOID USING TOBACCO (causes insulin resistance)
34
Q

5 most common meds for DM

A 
	Biguanides (Metformin)
	Insulin secretagogues
	Thiazolidinediones
	DPPIV inhibitors
	α-Glucosidase inhibitors
35
Q

For diagnosis of diabetes, a fasting glucose level has to be …

A

≥ 7.0 mM (126 mg/dL)

36
Q

Describe complications of DM including: nephropathy, retinopathy & neuropathy

A

o Nephropathy - Renal dysfunction/renal failure
o Retinopathy - Impaired/absent vision
o Neuropathy - Impaired/absent sensation

37
Q

Outline factors leading to the development of diabetic/neuropathic ulcers

A

o Poor sensation/neuropathy

o Poor wound healing

38
Q

Discuss how exercise impacts insulin action/blood glucose concentrations

A

o Increases insulin sensitivity

o Stimulates glucose uptake in skeletal muscle

39
Q

Discuss the interplay of mood/mental health and diabetic incidence and outcomes

A 
Mood spectrum disorders are associated with serious endocrine/metabolic co-morbidities such as
	Bipolar disorder
	Schizophrenia
	Depression
	PTSD
	Anxiety

Integmentary Patho (2 decks)

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