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Dermatology > Skin Structure and Function > Flashcards

Skin Structure and Function Flashcards

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Dermatology Board Prep flashcards
1
Q

What type of epithelium is in the epidermis

A

stratified squamous epithelium

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2
Q

Which germ layer does epidermis come from

A

ectoderm

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3
Q

Which germ layer does dermis come from

A

mesoderm

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4
Q

Where do melanocytes originate from

A

neural crest

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5
Q

Foetal skin development by 4 weeks

A

Periderm, basal layer, dermis

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6
Q

Foetal skin development by 16 weeks

A

Keratin layer, granular layer, prickle cell layer, basal layer, dermis

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7
Q

Foetal skin development by 26 weeks

A

Keratin layer, granular layer, prickle cell layer, basal layer, dermis, sebaceous glands, arrector pili, hair follicles, melanocytes

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8
Q

Layers of epidermis superficial to deep

A

Keratin layer (stratum corneum), granular layer (stratum granulosum), prickle cell layer (stratum spinosum), basal layer (stratum basale)

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9
Q

what is the extra layer of the epidermis in thick skin like palms and soles of feet called?

A

stratum lucidum

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10
Q

Developmental growth pattern of skin

A

Blaschko’s lines

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11
Q

Sub-cutis is predominantly ____

A

fat

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12
Q

How thick is the epidermis

A

1.5mm

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13
Q

What type of cell makes up 95% of the epidermis

A

keratinocytes

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14
Q

Where do keratinocytes originate

A

basement membrane

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15
Q

Palm and sole of foot histology features

A

thick keratin layer, no hair follicles

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16
Q

How long do keratinocytes take to go from basement membrane up to top

A

28 days

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17
Q

basal cell shape

A

cuboidal

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18
Q

how thick is the basal layer usually

A

one cell thick

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19
Q

how many layers of cells does the granular layer have

A

2-3

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20
Q

which epidermal layer has lots of larger polyhedral cells and desmosomes

A

prickle cell layer

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21
Q

which epithelial layer contains large keratohyalin granules?

A

granular layer

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22
Q

what do large keratohyalin granules contain?

A

structural filaggrin and involucrin proteins

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23
Q

which epithelial layer contains odland/lamellar bodies

A

granular layer

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24
Q

the granular layer has a high lipid content, true or false

A

true

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25
Q

which epidermal layer is the origin of the “cornified envelope”

A

granular layer

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26
Q

in which skin layer are cell nuclei lost

A

granular layer

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27
Q

what makes up most of the keratin layer

A

keratinocytes

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28
Q

what is the insoluble cornified envelope

A

a highly insoluble and tough structure formed beneath the cell membrane during terminal differentiation of keratinocytes.

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29
Q

what does HPV infection of keratinocytes cause

A

warts

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30
Q

3 types of oral mucosa

A

masticatory, lining, specialised

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31
Q

masticatory mucosa

A

keratinised stratified squamous epithelium to deal with friction/pressure

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32
Q

lining mucosa

A

non-keratinised stratified squamous epithelium

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33
Q

specialised mucosa

A

tongue papillae, taste

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34
Q

ocular mucosa

A

lacrimal glands, eyelashes, sebaceous glands

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35
Q

main epidermal cells

A

keratinocytes, melanocytes, langerhans, merkel

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36
Q

where is melanin produced

A

melanosomes within the melanocytes

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37
Q

are melanocytes dendritic cells?

A

yes

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38
Q

what is the function of melanin caps?

A

protect the nuclear DNA in basal cells

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39
Q

what is the result of melanocytes clumping together?

A

freckles!

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40
Q

what are the two types of melanin?

A

eumelanin (brown/black pigment), pheomelanin (red/yellow pigment)

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41
Q

what happens in vitiligo?

A

autoimmune loss of melanocytes

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42
Q

vitiligo is an autoimmune disease, true or false

A

true

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43
Q

what happens in albinism?

A

genetic partial loss of pigment production

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44
Q

what happens in Nelson’s syndrome?

A

melanin stimulating hormone (MSH) is produced in excess by the pituitary
(as well as other hormones).

It’s a disorder characterized by abnormal hormone secretion, enlargement of the pituitary gland, and the development of adenomas

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45
Q

For healthy skin you need:

A

intact physical barrier, functioning immune system, adequate supply and drainage of blood, functioning venous return and lymphatic system, means of temperature regulation (capillary dilation/constriction, functioning sweat glands), normal sensory nerve function to warn us about injury, adequate nutrition.

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46
Q

what type of healing is there in surgical wounds

A

primary intention

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47
Q

which skin layer are odland bodies found in?

A

granular layer

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48
Q

where are Langerhans cells formed?

A

bone marrow

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49
Q

which skin layer are langerhans cells most prominent in?

A

prickle cell layer (but are found in all layers)

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50
Q

what do langerhans cells do?

A

pick up antigen in skin and circulate it to lymph nodes via lymphatic system

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51
Q

what are birbeck granules?

A

rod-shaped or “tennis racket” cytoplasmic organelles in epidermal langerhans cells

52
Q

langerhans cells are antigen-presenting dendritic cells, true or false

A

true

53
Q

where are merkel cells located

A

basal layer (amongst keratinocytes and nerve fibres)

54
Q

Acute intermittent porphyria is due to impaired function of what

A

porphobilinogen deaminase

55
Q

what type of mechanoreceptors are merkel cells

A

type 1

56
Q

merkel cells are touch sensitive cells, true or false

A

true

57
Q

merkel cell cancer is common, true or false

A

false, it is rare

58
Q

3 phases of hair growth

A

anagen, catagen, telogen

59
Q

Anagen phase of hair growth

A

growing

60
Q

What happens in the catagen phase of hair growth

A

hair stops growing and becomes detached from the base of the follicle
club hairs form

61
Q

Catagen phase of hair growth

A

involuting

62
Q

Telogen phase of hair growth

A

resting.
falling out.

63
Q

what is lanugo hair

A

in utero - soft, fine, covers foetus in womb

64
Q

what is vellus hair

A

peach fuzz on face, arms, stomach, legs

65
Q

what is terminal hair

A

hair on scalp, eyebrows, eyelashes. after puberty - beard, armpits, pubic hair, chest

66
Q

where are langerhans cells formed

A

bone marrow

67
Q

where are hemi-desmosomes found

A

dermo-epidermal junction

68
Q

what is telogen effluvium

A

hair loss characterised by hair thinning or increases in hair shedding.
A change in hormone levels means all the hairs go into telogen at the same time

69
Q

who might typically have telogen effluvium

A
  • women
  • postpartum
  • can also happen in illness
70
Q

what is virilisation

A

female develops male characteristics

71
Q

causes of virilisation

A
  • androgen-secreting tumours
  • could just be bad luck
72
Q

autoimmune hair loss

A

alopecia areata

73
Q

who is more likely to get alopecia areata

A

people with certain autoimmune diseases such as psoriasis, thyroid disease, vitiligo, SLE

74
Q

circular patches of hair loss

A

alopecia areata

75
Q

what is subungual hyperkeratosis

A

build-up of keratin under nail

76
Q

what condition is subungual hyperkeratosis associated with

A

psoriasis

77
Q

what are the layers of the dermoepidermal junction

A
  • lamina lucida
  • lamina densa
  • sub-lamina densa zone
78
Q

main cells in the dermis

A
  • FIBROBLASTS
  • macrophages
  • mast cells

also lymphocytes and langerhans cells

79
Q

what fibres are in the dermis

A

collagen and elastin

80
Q

what makes collagen and elastin

A

fibroblasts

81
Q

ethnic differences in the dermis

A

dark skin - thicker dermis and more fibroblasts and more macrophages

82
Q

what is photoaging caused by

A

exposure to UV radiation

83
Q

where are horizontal plexuses (formed by blood vessels) found

A

in the dermis

84
Q

does an angioma need treated? what can it be treated with?

A

no, it’s benign and unlikely to cause any problems.
but can be treated with laser, topical beta blocker, or surgery if it’s small

85
Q

chronic lymphoedema

A

chronically enlarged lymphatic channels

86
Q

treatment for chronic lymphoedema

A
  • moisturisers
  • treat dermatitis
  • compression stockings to try move the fluid back up to the heart
87
Q

nerves in the dermis

A
  • free nerve endings (pain receptors)
  • Pacinian corpuscles and Meissner’s corpuscles
  • autonomic nerve supply
88
Q

which type of nerve looks like an onion

A

pacinian corpuscle

89
Q

what is neurofibromatosis

A

genetic condition that causes tumours to grow along your nerves (neuromas)

90
Q

3 main segments of hair follicle

A
  • infundibulum
  • isthmus
  • hair bulb
91
Q

which race has the fastest hair growth

A

asian

92
Q

which race has the lowest hair density

A

african

93
Q

which race has the most fragile hair

A

african

94
Q

what is hirsutism

A

male pattern hair growth in a woman, e.g. beard

95
Q

causes of hirsutism

A
  • could be in the family
  • polycystic ovary syndrome
  • tumour secreting a hormone causing it in older patients
96
Q

treatment of hirsutism

A

topical creams or could laser

97
Q

are sebaceous glands active pre-puberty?

A

no

98
Q

do apocrine glands form as part of the pilosebaceous unit

A

yes

99
Q

which gland is responsible for body odour

A

apocrine

100
Q

when do apocrine glands develop

A

at puberty

101
Q

where are sebaceous glands NOT present

A

palm and sole skin

102
Q

where on the body are Meissner corpuscles found

A

hairless skin (fingertips, eyelids)

103
Q

which sensory receptors detect light touch, e.g. sensation of tshirt on skin when putting it on

A

Meissner corpuscles

104
Q

where are free nerve endings located in the skin

A

basal layer of the epidermis

105
Q

which parts of hair contain:
a) ‘soft’ keratin
b) ‘hard’ keratin

A

a) central medulla
b) outer cortex and cuticle

106
Q

which region of the hair contains the keratin producing cells

A

matrix region

107
Q

which sensory receptors are responsible for detecting vibration, and sensing deep touch/pressure

A

Pacinian corpuscles

108
Q

where are eccrine glands found

A

whole body skin surface except the lips and genitals

109
Q

what condition do overactive eccrine glands cause

A

hyperhidrosis

110
Q

what is toxic epidermal necrolysis

A

life-threatening skin disorder. blistering and peeling of skin. majority are drug induced

111
Q

conditions where the physical barrier of the skin has gone wrong

A
  • steroid-sulphatase deficiency x-linked ichthyosis
  • cumulative irritant hand dermatitis
  • ulcer following compound fracture
112
Q

what is ichthyosis

A

group of skin disorders that lead to dry, itchy skin that appears scaly, rough, and red

113
Q

“fish-scale” skin

A

ichthyosis

114
Q

sources of vit D

A
  • UV light
  • fish
115
Q

tuberculoid leprosy features

A

raised edge
granulomas on histology

116
Q

what is eczema herpeticum

A

skin infection caused by the herpes simplex virus (HSV).
(mostly in people who already have atopic dermatitis (i.e., eczema)

117
Q

who is most likely to get eczema herpeticum

A
  • infants and young children
  • those with severe atopic dermatitis
118
Q

what type of disease is chronic discoid erythematosus

A

autoimmune
(it’s basically the skin version of sle, internal organs not affected)

119
Q

what is dermatitis artefacta

A

a psychocutaneous disorder in which the patients consciously create lesions in skin, hair, nail, or mucosae to satisfy a psychological need, attract attention, or evade responsibility

120
Q

what is a consequence of failure of the metabolic function of the skin

A

disordered thyroxine metabolism (because some T4 to T3 conversion happens in the skin)

121
Q

which condition can spongiosis be seen on histology

A

eczema

122
Q

what do hair follicles look like on histology

A

oval doughnut shapes

123
Q

histological features of psoriasis

A
  • thickened keratin layer
  • parakeratosis (nuclei in the keratin layer)
  • accumulation of inflammatory cells (particularly neutrophils) in the upper epidermis
  • rete pegs
124
Q

histology of sole of foot

A
  • no hair follicles
  • thick keratin layer
  • prominent granular layer
  • irregular DEJ (because more stress on feet??)
125
Q

3 stages of wound healing

A
  1. inflammation
  2. proliferation
  3. tissue remodelling
126
Q

should slough be removed from the wound

A

yes, it has inhibitory effects on the healing ability of the wound and should be removed chemically or with physical debridement. larval therapy can also be used

127
Q

which is more rapid, primary or secondary intention wound healing?

A

primary

Dermatology (6 decks)

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