The Skin 1 Flashcards

1
Q

What is Dermatology?

A

Dermatology is the study of the skin. It is a branch of internal medicine concerned with interpretation of symptoms, diagnosis, treatment of diseases of the skin.

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2
Q

Skin is the body’s?

A

Thinnest organ and largest organ.

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3
Q

Where is skin the thinnest and where is it the thickest?

A

Skin is thinnest on the eyelids (0.1 mm) and thickest on the soles of feet and palms of hands (0.6-0.8 mm). (stratum corneum)

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4
Q

What is skin composed of?

A

Skin is composed of soft keratin.

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5
Q

The skin is composed of three layers. What are they?

A

Epidermis
Dermis
Subcutaneous (Superficial Fascia)

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6
Q

The epidermis is much thinner than most people would guess, what areas of the skin are thicker and the exception to this?

A

Exceptions are areas chronically exposed to pressure or friction such as soles of feet and palms of hands.

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7
Q

What is the epidermis made up of?

A

The epidermis is made entirely of epithelial cells with no blood vessels.

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8
Q

What are the 5 layers of the epidermis? (from outer layer to inner layer)

A

Stratum Corneum, Stratum Lucidum, Stratum Granulosum, Stratum Spinosum, Stratum Germinativum

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9
Q

What is the stratum corneum made up of?

A

Stratum corneum is made up of flattened keratinized cells that have no nuclei.

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10
Q

How does the stratum corneum provide protection for the rest of the skin?

A

Its toughness and durability provide protection for the rest of the skin. Its ability to thicken in response to injury, forming callous adds to its protective function.

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11
Q

How long does it take a cell to move up to the stratum corneum, and how long before they are shed from the body?

A

It typically takes 15 to 30 days for a cell to move from the stratum germinativum to the stratum corneum, and they generally remain for an additional two weeks before they are shed or washed away.

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12
Q

What does exfoliation of the skin do to the stratum corneum?

A

Exfoliation techniques removes the superficial layers of the stratum corneum, leaving a thinner layer of protective keratinized cells, leaving the skin looking pinker, softer , and more flexible.

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13
Q

Is the stratum corneum waterproof?

A

The stratum corneum is waterproof in the sense that it keeps water out of the body.

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14
Q

What is insensible perspiration? How much water do you lose from insensible perspiration?

A

Water from interstitial fluid slowly penetrates the surface, to be evaporated into the surrounding air, this process is called insensible perspiration. You lose roughly 500ml of water through insensible perspiration.

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15
Q

What can happen if damage breaks connections between superficial layers and deeper layers of the epidermis?

A

If damage breaks connections between superficial and deeper layers of the epidermis, fluid will accumulate in pockets, or blisters within the epidermis.

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16
Q

Why is the second layer of the epidermis called stratum lucidum?

A

It was named this because its closely packed cells (a few layers of shapeless cells with flattened degenerated nuclei) contains a translucent compound (eleidin) from which keratin forms. However most skin on the body, the so-called thin skin, has no stratum lucidum.

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17
Q

What is accelerated in the stratum lucidum?

A

Keratinization is accelerated in this layer.

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18
Q

Why is the third layer of the epidermis called the stratum granulosum?

A

The third layer of the epidermis is called the stratum granulosum because granules are visible in the cytoplasm of cells.

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19
Q

What is the stratum granulosum?

A

The stratum granulosum is the outermost of the living layers of the epidermis, consisting of 3-5 layers. By the time cells reach this layer they have stopped dividing, and produce large amounts of keratin. This layer is composed of living and dead cells and the nuclei and other organelles disintegrate and cells die.

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20
Q

What is the function of skin crucial too?

A

Skin functions are crucial to survival.

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21
Q

What is the stratum spinosum?

A

The stratum spinosum is the largest layer of the epidermis and it contains alive cells with spine like projections that are joined together by connective fibres and consisting of 8-10 layers. The cells begin to mature and synthesize keratin.

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22
Q

What else does the stratum spinosum contain and what are they responsible for?

A

The stratum spinosum contains langerhans cells, which are participants in the immune response. Langerhans cells serve to fix and process cutaneous antigens.

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23
Q

What is the stratum germinativum?

A

The stratum germinativum is the basal cell layer and it contains cells that undergo mitosis. It is very thin, only one cell deep. Cells push outward from stratum germinativum into each successive layer of the epidermis, die, and become keratinized and eventually flake off, as do their predecessors.

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24
Q

What are Merkel cells?

A

Merkel cells are scattered among the cells of the stratum germinativum. They are cells that are sensitive to touch; when compressed they release chemicals that stimulate sensory nerve endings.

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25
Q

What are melanocytes and where are they located?

A

Melanocytes are located deep in the stratum germminativum, and manufacture the pigment melanin from molecules of the amino acid tyrosine. The melanin is packaged in intracellular vesicles called melanosomes, which are transferred into keratinocytes. Melanin is deposited in skin cells.

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26
Q

What is melanin?

A

Melanin is pigment that gives human skin its colour. The more melanin the deeper the brown.

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27
Q

What is the function of melanin?

A

Melanin serves a protective function. Largely baring penetration of ultraviolet rays and thereby prevents them from injuring dermis and underlying tissues.

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28
Q

How often does epidermis change?

A

The epidermis completely changes about once a month and varies based on age.

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29
Q

Define Keratin

A

Keratin is a water repellant protein. It can be soft as in skin or hard as in hair and/or nails. The protein is present in, and forming the main components of epidermal structures such as hair, nails, horns, feathers, and skin. It thickens and protects the skin and makes up hair and nails.

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30
Q

What is keratinization?

A

It is the formation of keratin or horny layers.

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31
Q

What is the dermis?

A

The dermis is the inner, thicker layer of dense, fibrous, connective tissue. The cellular components of the dermis consist of fibroblasts, mast cells, and macrophages. It is composed of two layers, the papillary layer and the reticular layer.

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32
Q

What does the papillary layer contain?

A

The papillary layer contains cone shaped projections of elastic tissue that point upward into the epidermis. These projections are papillae, which form ridges on surface of the skin. Epidermal ridges, are especially well defined on the finger tips and toes. Fingerprints and toe prints are unique for each individual.

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33
Q

What do papillae contain?

A

Looped capillaries or nerve fibre endings called tactile corpuscles.

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34
Q

What is the reticular layer?

A

The reticular layer is the innermost layer of the dermis. It is also the thickest layer. It is called the reticular layer because it consists of caliginous fibres which gives toughness to the skin.

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35
Q

What other type of fibre is present in the reticular layer?

A

Elastic fibres are also present in the reticular layer.

36
Q

How are fibres supported in the reticular layer?

A

The fibres are supported in an amorphous gel-like material called the ground substance. This material is comprised mostly of mucopolysaccharides, particularly hyaluronic acid, which helps retain water and hold cells together.

37
Q

Why does a needle going into the dermis hurt and bleed?

A

The dermis contains an abundant supply of blood vessels and nerve endings which is why a needle that penetrates the dermis will hurt and bleed, and why a needle that just penetrates the epidermis does not bleed and hurt.

38
Q

What does the reticular layer contain?

A

Fat cells, blood vessels, lymph vessels, oil glands, sweat glands, hair follicles, arrestor pili muscles, and nerves.

39
Q

What is the subcutaneous?

A

It is the layer of connective tissue under the dermis. Bundles of caliginous fibres extend from dermis into superficial fascia thereby attaching the two structures firmly together. There is no clear boundary between the dermis and subcutaneous layer.

40
Q

What are the two types of tissue that compose the subcutaneous layer?

A

Areolar and adipose

41
Q

What is areolar tissue?

A

Areolar tissue is also called loose ordinary connective tissue. Stretchy and has lots of collagen.

42
Q

What is adipose tissue?

A

Adipose tissue is fat. It may be almost entirely missing in extreme lean or thin people, and it may be several inches thick in obese people. In other words, this layer varies in thickness depending on the amount of fat that is present.

43
Q

What does the amount of fat on the body depend on?

A

Age, sex (females more than males), general health, diet, heredity.

44
Q

What are the functions of the subcutaneous layer or fat?

A
  • Gives smoothness and contour to the body
  • Stores energy
  • Acts as a protective cushion for outer skin and inner organs.
  • Maintains body warmth
  • Circulation maintained by blood vessels and lymphatic
45
Q

What are the two pigments that give skin its colour?

A

Carotene and melanin.

46
Q

What is carotene?

A

Carotene is the orange pigment that normally accumulates in the epidermal cells. It is mostly apparent in the stratum corneum of light skinned individuals, but also accumulates in fatty tissues in the dermis.

47
Q

What three factors does melanin production depend on?

A

Melanin production is mostly hereditary, but also depends on sunlight and hormone changes.

48
Q

How does sunlight affect melanin production?

A

Prolonged exposure to sunlight can cause melanocytes to increase melanin production and thus darken the skin.

49
Q

How can hormonal changes affect melanin production?

A

Excess secretion of ACTH (adrenocorticotrophic hormone) or MSH (melanocyte stimulating hormone) by the anterior pituitary gland.

50
Q

What might cause skin colour to change without any change in melanin?

A

Dermal circulation. Change in this case is usually temporary and stems from change in volume of blood flowing through skin capillaries.

51
Q

What happens to skin colour when blood vessels constrict or dilate?

A

If blood vessels constrict (become smaller) skin blood volume decreases and skin turns pale. If they dilate (become larger) skin blood volume increases and skin becomes pinker (blushing).

52
Q

Why are skin colour changes due to blood volume more evident in individuals with sparser pigments in their skin?

A

In general the sparser the pigments in the epidermis, the more transparent the skin is, and therefore the more vivid the change in skin colour will be with a change in skin blood volume.

53
Q

What is cyanosis?

A

Cyanosis can be caused by abnormal conditions in which skin colour changes because of an excess amount of unoxygenated haemoglobin in the skin capillary blood. More apparent in lighter skinned individuals as skin will appear bluish with lesser variation from normal. Darker skin types is less visible because they need a larger amount of unoxygenated haemoglobin before cyanosis becomes visible.

54
Q

How much of the body’s blood supply goes to the skin and what is the blood there for?

A

1/2 to 2/3rds of the body’s total blood supply goes to the skin. The blood is there to help regulate body temperature and carry nutrients and oxygen (O2) to the skin. Capillaries are numerous in the skin to facilitate this.

55
Q

What do the subcutaneous layers of the skin have networks of?

A

The subcutaneous layers have the skin have networks of arteries and lymphatic that sends smaller branches to hair papilla, hair follicles, and skin glands.

56
Q

What are the most important nutrients (vitamins, minerals and other substances) for the skin?

A

Vitamins - A, B complex, C, D, E
Minerals - iron, zinc, copper, selenium, sulphur, silica
Other important substances - EFA’s (Essential fatty acids) and collagen.

57
Q

What are the two types of vitamin A?

A

Retinol which is fat soluble and beta carotene which is water soluble.

58
Q

What is retinol?

A

Retinol is a topical application for the skin and a supplemental form of vitamin A. Sources of retinol include eggs (yolk), meat, liver, fortified milk and dairy, halibut.

59
Q

What is beta carotene?

A

Beta carotene is a water soluble co-factor from plant sources. It is a major antioxidant and protects epithelial cells/tissues and mucous membranes, eyesight. The liver converts beta carotene to vitamin A.

60
Q

What can a lack of vitamin A potentially cause?

A

A lack of vitamin A may result in acne, immune system deficiency, increased chance of infections and red scaly skin.

61
Q

What can too much vitamin A cause?

A

Too much vitamin A can result in it accumulating in the liver and causing damage.

62
Q

What is vitamin B (complex) useful for and what are some sources of vitamin B (complex)?

A

Vitamin B (complex) is useful for nerve cell formation and cellular turn over. Helps with protein/carb metabolism. Sources of vitamin B (complex) include whole grains, leafy greens, avocado, nuts and seeds.

63
Q

What are 3 types of vitamin B?

A

3 types of B vitamin are B2 (Riboflavin), B7 (Biotin), and B12 (Cobalamin).

64
Q

What are two types of vitamin C?

A

The two forms of vitamin C are ascorbic acid and calcium ascorbate.

65
Q

Why must vitamin C be derived from diet? (in humans)

A

Humans, unlike most animals cannot make their own vitamin C so it needs to be derived from diet.

66
Q

What does vitamin C do in the body and what are some sources of vitamin C?

A

Vitamin C is a water soluble (excreted regularly) antioxidant that helps form collagen, regulates synthesis of collagen and it helps to manufacture collagen and connective tissue. Sources of vitamin C include citrus fruits, berries, greens and more.

67
Q

What is vitamin C important for and what is it depleted by?

A

Vitamin C is important for collagen production in the skin and for the immune system. It is depleted by stress, smoking, medication, and infection.

68
Q

What is vitamin D and what is it important for?

A

Vitamin D is fat soluble and is called the “sunshine vitamin.” It is important for calcium absorption and mineralization of bone, and immune function. Vitamin/hormone manufactures/synthesizes from sunlight in the skin.

69
Q

What is vitamin E?

A

Vitamin E is an antioxidant (affects blood circulation) it is fat soluble (absorption is dependent upon pancreatic secretion and bile) it is an anti-inflammatory and it may be taken orally or applied to the skin. Sources of vitamin E include almonds, avocado, wheat germ, whole grains, eggs and liver.

70
Q

Taking vitamin C & E together can be helpful for what skin condition?

A

Vitamin c & e together may help in melasma (hyperpigmentation).

71
Q

What is iron helpful for and what are some sources of iron?

A

Iron helps oxygen transport to skin cells, and skin colour. Sources of iron are beans, dark leafy vegetables, meat, dried fruits.

72
Q

What can a lack of iron result in?

A

A lack of iron may result in anemia, pale skin, fatigue, blue circles under eyes (poor oxygen transport).

73
Q

What is zinc helpful for and what are some sources of zinc?

A

Zinc is helpful for wound repair, immune system function, skin healing and acne healing. Some sources of zinc include whole grains, shellfish, red meat, poultry, nuts, beans, legumes, pumpkin seeds.

74
Q

What is copper helpful for and what are some sources of copper?

A

Copper aids in development of collagen/elastin when combined with iron, it helps the body form red blood cells. Copper can be found in skin care products. Some sources of copper include spirulina, shiitake mushrooms, dark chocolate, oysters, organ meats.

75
Q

What are free radicals and what causes them?

A

Free radicals are the natural by product of everyday reactions that produce energy in the body. They are destructive molecules that may cause cells to mutate (carcinogenic reactions). Things like pollutants, smoking, processed food, or stress can be a factor in free radical production.

76
Q

What are antioxidants?

A

Antioxidants are free radical scavengers, they neutralize free radicals so body tissue isn’t damaged. They help lessen the effects of aging and reduce the risk of disease.

77
Q

What is selenium?

A

Selenium helps neutralize free radicals and it works with vitamin E to help cell membranes. Too much selenium may result in toxicity. Sources include Brazil nuts.

78
Q

What is sulphur?

A

Sulphur helps with collagen formation, body tissue formation, strengthens keratin, antibacterial effect against acne causing bacteria, drying out of excess sebum, and unclogging pores. It is helpful for cystic acne, scarring and rosacea inflammation, also helps detoxify liver. Sources include fish, eggs, cruciferous vegetables, onion and garlic.

79
Q

What is silica?

A

Silica helps make collagen in the body. Silica in foods/supplements is converted to orthosilicic acid in GI tract. The body uses this to make collagen and elastin. Sources include whole grains, beer, vegetables, supplement form.

80
Q

What are EFA’s?

A

EFA’s or omega 3 and 6 are required for moisture content of the skin, skin repair, elasticity, hormone balance, acne, anti-inflammatory (omega 3) cell growth and repair.

81
Q

What is collagen essential for and what is collagen?

A

Collagen is essential to all structures of the body (bone, tendons, skin). Collagen is the most abundant protein in the body and is also throughout the body (tendons, ligaments, blood vessels, cartilage and skin)

82
Q

What is the dermal layer of the skin composed of?

A

Dermal layer of skin is comprised of collagen and elastin (between epidermis and subcutaneous layer).

83
Q

What vitamin helps produce collagen in the body?

A

Vitamin C.

84
Q

How many types of collagen are there and what are they responsible for?

A

There are 3 types of collagen.
Type 1 is for muscles, eyes, bones, nails, hair, skin, “scaffolding” of skin. Type 1 is the most abundant collagen in the body and makes up about 80% of collagen in the skin.
Type 2 is the best for cartilage and joints.
Type 3 is mostly for intestines, muscle, blood vessels and uterus.

85
Q

What happens to collagen as we age?

A

The body makes its own collagen, however with age collagen diminishes and is noticed in skin and joints.

86
Q

What types of collagen are best for the skin?

A

Types 1 and 3.

87
Q

What are some popular sources of collagen?

A

Some popular sources of collagen are marine (type 1), bovine (cow) (type 1 & 3) and chicken sternum (type 2)