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Skin Flashcards

1
Q

In dermal papillae for touch

A

Meissner corpuscle

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2
Q

In hypodermis near sides of fingers & palms for sensing vibration 🐡

A

Pacinian corpuscles

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3
Q

In dermis and respond to shearing stress

A

Ruffini endings

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4
Q

5% of CO
-arteries in subcutaneous plexus in hypodermis

A

Vascular supply

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5
Q

-Vascularizes upper portion of dermis & epidermis
-gives rise to capillary loop in each dermal papillae (house lymphatic vessels)

A

Subpapillary

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6
Q

Vascularizes the hypodermis & deeper portion of dermis

A

Cutaneous plexus

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7
Q

Where growth of hair bulb occurs

A

Matrix

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8
Q

Growth 2-7 years

A

Anagen

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9
Q

-regression
-interruption of blood 🩸 supply
-follicle shrinks
-last 2-3 weeks

A

Catagen

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10
Q

-Single layer of cuboidal cells
-mitotic layer where keratinocytes start a cycle of proliferation & maturation
-Melanocytes & Merkel cells present here
-Vitamin D

A

Stratum basale

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11
Q

-Layers of prickle (interdigitated) cells
-many cytoplasmic processes (spines)
-prominent nucleoli that’s basophilic due to keratin synthesis, vitamin D
-high filament count in upper layer synthesizing keratohyalin granules
-2-5% Langerhans cells & lymphocytes

A

Stratum spinosum

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12
Q

-numerous basophilic keratohyalin granules (overfill & rupture cells)
-release hydrophobic glycophospholipids to waterproof skin
-2-5 cells thick

A

Stratum granulosum

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13
Q

-in thick skin only
-acidophilic staining of few dead cells

A

Stratum lucidum

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14
Q

-25-50 day turnover
-no nuclei
-filled with soft keratin
-desquamation in outer layer as desmosomes break down

A

Stratum corneum

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15
Q

-clear area around nucleus in H&E stain
-by long cytoplasmic process melanin is transferred in melanosomes in stratum basale & spinosum
-attached by hemidesmosomes

A

Melanocytes

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16
Q

-APC cell (present antigen t-lymphocyte)
-spider-like cells in stratum spinosum
-no desmosomes
Pathogenesis: type IV hypersensitivity
-poison ivy, dermatitis
-Reaction to 2nd exposure due to t-cell memory

A

Langerhan cells

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17
Q

-in stratum basale
-connected to keratinocytes by desmosomes
-mechanorecptor cell (unmyelinated nerve part)
-in fingertips is discriminative touch

A

Merkel cells

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18
Q

Contains:
-vascular supply, sweat glands 💦
-nerves, macrophages, mast cells
-papillary & reticular layer, lymph
-fibroblasts, arrector pili, sebaceous
Dense irregular connective tissue of collagen & elastic fiber

A

Dermis

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19
Q

-beneath basement membrane
-contains papillary loop & is for O2, and fingers to increase healing & strength
-interdigitate with epidermal pegs (rete pegs)
-typeIII collagen randomly aligned
-many fibroblasts

A

Papillary layer

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20
Q

-below papillary dermis and has thicker collagen fibers (type 1)
-Langer’s lines is a special orientation of collagen important for surgical incisions
-perpendicular to long axis

A

Reticular layer

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21
Q

Contains: Deep fascia is under it
-Adipose & loose connective tissue
-sweat glands
-hair follicles
Dense in scalp, palms, & soles ✋🦶
Aponeuroses (full thickness wound here)

A

Hypodermis

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22
Q

-Skin on upper back is the thickest
-keratinized stratum corneum
-arteriovenous anastomosis- shunts for temp regulation

A

Non-acral skin (thin)

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23
Q

-terminal portion of the nerve fiber surrounded by connective capsule
-somatosensory nerve fibers
-skin to spinal cord to brain

A

Encapsulated nerve ending

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24
Q

-free nerve endings
-automatic nerve fibers
-smooth muscle to skin
-only postganglionic sympathetic fibers

A

Nonencapsulated

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25
Nonencapsulated -Mechanoreceptor cells -unmyelinated terminal of myelinated nerve fiber -respond to directional deformation of epidermis & hair (discriminative touch)
Merkel cells
26
Nonencapsulated -lower layers of epidermis - non-discriminative touch (pain, itch, temp)
Free nerve endings
27
Nonencapsulated -lower portion of hair follicle for discriminative touch & vibration
Peritrichial nerve endings (hair receptor)
28
Encapsulated nerve endings (mechanoreceptors) -located in dermal papillae for discriminative touch
Meissner’s corpuscles
29
Encapsulated nerve endings (mechanoreceptors) -located in hypodermis of fingers & palms -sensitive to vibration
Pacinian corpuscles
30
Encapsulated nerve endings (mechanoreceptors) -located in deep dermis -responds to shearing stress
Ruffini’s endings
31
-Tubular invagination of epidermis
Hair follicle
32
Lowest portion of hair follicle filled with connective tissue called the dermal hair papilla
Hair bulb
33
-inner root sheath (epidermis) -outer root sheath (epidermis) -connective root sheath (dermis)
Hair shaft
34
-resting phase -shedding -last for 10-12 weeks for 5% of follicles
Telogen
35
Cause baldness
DHT
36
Aids in expulsion of sebum
Contraction of arrector pili
37
Simple coiled tubular gland -secrete watery fluid onto skin surface -in dermis/ hypodermis - spiral duct in epidermis -merocrine secretion process -postganglionic sympathetic fibers
Eccrine sweat glands
38
-Milky & odorless but gets bacteria -in axillary, areola, & perineal -largest -postganglionic sympathetic fibers
Apocrine sweat glands
39
-High sulfur content -held down to nail bed by desmosomes
Nail plate
40
Cuticle -Covers nail root -continuous with stratum corneum -hard keratin -doesn’t desquamate -protects matrix from infection
Eponychium
41
-continuous with stratum basale & stratum spinosum -vascularized -contributes to 20% of forming nail plate
Nail bed
42
-continuous with stratum basale & stratum spinosum -vascularized -contributes to 20% of forming nail plate
Nail bed
43
-continuous with stratum basale & stratum spinosum -contributes to 80% of forming nail plate
Nail matrix
44
-continuous with stratum basale & stratum spinosum -contributes to 80% of forming nail plate
Nail matrix
45
Thickened epidermal layer beneath free edge of nail plate -continuous with stratum corneum
Hyponychium
46
-highly phagocytic APCs in the papillary & reticular dermis -derived from bone marrow -releases cytokines & initiates inflammatory skin response
Dermal dendrocytes
47
Activates: papillary dermis edema -eosinophils (parasite infection/ allergy) -histamines (vasodilation) Big for eczema, psoriasis, scleroderma -located in dermis & adipose Cause urticaria reaction & wheal
Mast cells
48
-macrophage -antimicrobial - APC to lymphocytes -secrete cytokines & growth factor
Monocytes
49
-on face, chest, back -kill lipophilic organisms Defect cause seborrheic dermatitis
Sebaceous glands
50
-in stratum corneum -depends on humidity, temp, glandular distribution -gram neg bacilli, pseudomonas, corynebacterium, staphylococcus in occluded areas -resident good, transient bad
Skin flora
51
-subcutaneous inflammation -anterior leg acute nodular eruption -hypersensitivity reaction Cause: infection, meds, autoimmune disease
Erythema nodosum
52
Skin tear without tissue loss -linear -Ia -flap -Ib
Payne & Martin category I
53
Skin tear with partial tissue loss -Scant tissue loss 25% -IIa -moderate to large tissue loss -IIb
Payne & Martin category II
54
Skin tear with complete tissue loss
Payne & Martin category III
55
Needs: -full circle blood supply -spare sensory & motor nerves -parallel to relaxed skin tension lines (little motility) -adequate target tissue exposure
Surgical incision
56
Gap open under tension -Line of maximum extensibility LME -furrows
Perpendicular incision to RSTL
57
2nd best incision -s shaped pattern
Oblique to RSTL
58
Increased allergens entering & H2O exiting due to filaggrin absence and atopic dermatitis
Ichthyosis vulgaris
59
Autoantibodies attack hemidesmosomes of basal keratinocytes and cause blistering
Bullous Pemphigoid
60
Autoantibodies attack desmosomes of basal keratinocytes and cause flaccid bullae
Pemphigus vulgaris
61
-dyshyrotic & nummular eczema -autosenitization I’d reaction -atopic dermatitis -vesicles rupture desmosomes in epidermis -contract during healing
Spongiotic dermatitis
62
-heals via stages of wound healing -below dermis tissue loss (subq) High failure & metabolic need -no secondary wound care
Full thickness wound
63
heals via re-epithelialization -above dermis tissue loss
Partial thickness wound
64
3hrs - 3days -VEGF, IGF, TGF-B, PDGF, TNF, IL-1, MMP
Hemostasis/ inflammation
65
3-21days -ECM (GAG & collagen) , fibroblasts, fibronectin, myofibroblast, keratinocytes, endothelial cells
Proliferative
66
21days-2yrs -type III to type 1 collagen -tensile strength increase
Remodeling

Skin (3 decks)

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