How does insensible perspiration slow down transepidermal water loss and prevent bacterial growth/invasion?It mixes with sebaceous gland secretions to produce a slightly acidic (pH 4-6) film over the surface of the epidermisWhat is sensible perspiration?Visible sweatingWhere the blood goes in the skin, ___ goesHeatWhat does the body do when it is hot to dissipate heat?Vasodilation in the dermis to allow more blood and heat into it, sweat glands release fluid onto surface of the skin, heat from blood dissipates into the sweat, evaporation coolsWhat does the body do when it needs to conserve heat?Vasoconstriction in the dermis to reduce blood flow to the skin, blood and its accompanying heat are shunted into deeper body tissuesWhat is the important of metabolic regulation in the integument in reference to Vitamin D3? How does this work?It promotes calcium and phosphorus absorption from ingested material in the small intestine. Keratinocytes produce cholecalciferol when exposed to UV light, cholecalciferol is transformed into calcitrol in the kidneys. Calcitrol is the active form of vit D3 which promotes the absorption mentioned aboveWhat can vitamin d deficiency be associated with?Depression, cardiac dz, immune system malfunctionThe epidermis contains a population of fixed/resident macrophages calledEpidermal dendritic cells or Langerhans cellsWhat role do langerhans cells playin in the immune response?They initiate it in the skin and phagocytize pathogens that enter the skin, also fight against epidermal cancer cellsSweating is considered an ____ functionExcretoryWhat waste products are excreted onto the skin and may be in sweat?Water, salts, urea, sebumWhy does the epidermis have to get its nutrients through diffusion from the underlying dermis?Its avascularWhat are the epidermal strata from most deep to most superficialStratum basal, spinosum, granulosum, lucidum, corneumThe deepest layer, the stratum basal/germanitivum/basal layer, of the epidermis is composed of three types of living cells:Keratinocytes, melanocytes, tactile cellsHow is the stratum basal attached to the basement membrane?HemidesmosomesWhat is the most abundant cell type in the epidermis that is seen in all layers?KeratinocytesWhat layer of the epidermis are keratinocyte stem cells found and what are they doing?Stratum basal, constantly dividing to replace stem cells and create keratinocytesWhat makes the skin tough and almost waterproof?Keratin, a family of fibrous structural proteins that are durable and insolubleKeratin proteins form a _______, a major constituent of the cytoskeletonHelical intermediate filamentKeratin proteins in keratinocytes are called?CytokeratinsWhat are scattered amongst the keratinocytes of the stratum basal that produce and store the pigment melanin in response to UV exposure?MelanocytesMelanin is transported in membrane bound vesicles calledMelanosomesDescribe the process of melanosomes being transferred into keratinocytes of the stratum basal and spinosumMelanocytes have long branching cytoplasmic processes exocyte melanosomes that are then phagocyted (im making up these words) and then accumulate around superficial nucleus to shield from UV radiationTactile cells are also known asMerkel cellsWhere are tactile cells found and what do they do?Few scattered throughout stratum basal. Sensitive to touch and compressionTactile/merkel cells contain _________ membrane bound vesicles that are released into synaptic junction of sensory nerve endings in dermisNeuroendocrine typeWhat elicits action potentials?Endocrine secretionsThe _____ is the spiny layer of the epidermis and composed of several layers of living _______Stratum spinosum, polygonal keratinocytesHow do keratinocytes in the stratum spinosum attach to their neighbors?DesmosomesWhy do you see spiny bridges between cells in the stratum spinosum after preparing a slide?Cytoplasm shrinks but desmosomes remain intactWhat are the fourth type of epidermal cells found in the stratum spinosum?Epidermal dendritic/langerhansThe stratum granulosum also known as the granular layer contains3-5 layers of living keratinocytes which have granules (secretory vesicles)Where does keratinization begin?Stratum granulosumWhat are the two types of intracellular granules in the stratum granulosum?Keratohyalin and lamellar_______ granules in the stratum granulosum are involved in the keratinization processKeratohyalin_______ granules in the stratum granulosum fuse with the PM and release their lipid contents into the extracellular space, aid in the prevention of water loss and protectionLamellarWhat is keratinization?The process by which keratinocytes fill up with keratin protein. Keratin filaments begin to develop and the cells become thinner and flatter, plasma membrane becomes thicker and less permeableWhat happens to the nucleus and organelles during keratinization?They disintegrate and the cells begin to dieThe _______ or the clear layer of the epidermis is only found in palmar and plantar surfaces and is composed of2-3 layers of dead keratinocytes filled with the protein eleidin (intermediate product in keratin maturation process)The most superficial layer of the epidermis, the ________ is what you see and is composed ofStratum corneum, 20-30 layers of dead, anucleate, scaly, interlocking keratinized cells called corneocytesHow long does migration from the stratum basal to stratum corneum take?~2 weeksWhat is the basket weave pattern seen microscopically in the stratum corneum called?OrthokeratosisWhat layer of the skin is dye injected into to tattoo?The dermis because it doesnt have rapid cell turnover like the epidermisSkin is classified as thick or thin based on the number of strata in the epidermis and its relative thickness. How many layer do you have to have thick?5 layers of epidermis is thick, 4 is thinWhere is thick skin found? What does it contain?Palms of hands and soles of feet, sweat glands but no hair follicles or sebaceous glandsWhere is thin skin found? What does it lack? What does it contain?Covering most of the body, lacks stratum lucidum, contains hair follicles, sweat glands, sebaceous glandsWhat does non-pathological skin color result from?Hemoglobin, melanin, caroteneWhat is hemoglobin and what color does it give the dermis?Oxygen binding protein in RBCs, bright red when bound to oxygenMelanin is synthesized from what? What enzyme does it require for production?Amino acid tyrosine, tyrosinaseWhat are the two types of melanin?Eumelanin, pheomelaninWhat is the difference between dark and pale skinned individuals?Production/activity of melanocytes, NOT number of themWhat does exposure to UV radiation do to melanocytes/melanin?Darkens melanin, stimulates melanocytes to produce more_____ is a yellow-orange pigment that is acquired by eating vegetables of the same colorCaroteneWhere does carotene normally accumulate?SQ fat, keratinocytes of stratum corneumWhat is carotene converted to in the body? What is this important for?Vitamin A, vision, is also an antioxidant and can reduce number of free radicals produced in normal metabolic activity_____ is when the hair is white, skin is pale, irises of eyes are pinkAlbinismWhat are causes of albinism?Lack of melanin production, inherited recessive condition where enzyme to produce melanin is nonfunctional_____ is where the skin appears golden=brown/copper/bronzeBronzingWhat are causes of bronzing?Glucocorticoid hormon deficiency in the adrenal cortex, addisons dz_____ is when the skin appears blue as a result of oxygen deficiency in circulating bloodCyanosisWhat are causes of cyanosis?Airway obstruction, emphysema, apnea, exposure to cold weather, cardiac arrest w/ slow blood flow_____ is where the skin is abnormally redErythemaWhat can cause erythema?Exercise, sunburn, excess heat, emotions, all resulting in increased blood flow to dermal vasculatureA _____ is a bruise/pool of clotted blood visible through the skinHematomaWhat are hematomas caused by?Usually trauma, may be indicative of hemophilia or nutritional/metabolic disorder_____ is where the skin and sclera appear yellowJaundiceWhat can cause jaundice?Hyperbilirubinemia, usually when liver dz is present____ is when the skin is ashen, pale due to white collagen fibers housed within the dermisPallorWhat can cause pallor?Decreased blood flow to skin, can be a result of hypotension, hypothermia, emotional stress, severe anemiaA ____ is a mole aka a harmless localized overgrowth of melanocytesNevusA nevus may become malignant as a result ofExcess UV light exposureFreckles may also be called ______ and areEphelis, localized areas of excessive melanocyte activity, not an increase in melanocyte numbersWhat is the most common tumor of infancy and is a benign tumor of blood vessels?HemangiomaWhat is the most common type of hemangioma that occurs in the skin, SQ tissue, and mucous membranes?Capillary hemangiomasWhat type of hemangiomas are referred to as strawberry colored birthmarks, are bright red/purple nodules, and typically fade by age 1-3 and disappear by 7 in most cases?Juvenile hemangiomaWhat kind of hemangioma are composed of large, dilated vascular channels that frequently involve deep structures and do not regress spontaneously?Cavernous hemangiomaCavernous hemangiomas are one component of what disease? Where are they found?von Hippel-Lindau, cerebellum, brain stem, retina, pancreas, liverFinger prints may also be called ______ and are formed from large folds of the dermis and epidermisFriction ridgesThe epidermal down-growths that extend into the superficial dermis are calledRete ridgesThe dermal upgrowths that extend into the deep epidermis and interdigitate with rete ridges are calledDermal papillaeWhere are rete ridges and dermal papillae most developed?Where exposure to shearing forces are almost constant ie. soles and palmsThe dermis is composed ofCells of CT proper (fibroblasts) and primarily collagen fibers, elastic and reticular also presentWhat are the two types of connective tissue present in the dermis?Areolar and dense irregularWhat are the two major regions of the dermis?Papillary (superificial) and reticular (deep) layerWhat layer of the dermis forms the dermal papillae?Papillary layerThe papillary layer is composed of what kind of connective tissue and why?Areolar, to facilitate diffusion from capillaries to supply the stratum basal of the epidermisThe papillary layer of the dermis houses ______ of the epidermisSensory receptorsThe reticular layer of the dermis is made of what kind of fibers primarily?Collagen (dense irregular CT)Why do the large bundles of collagen fibers in the reticular layer of the dermis project in all directions?To be able to withstand stress, surround structures of the dermis (vessels, sweat glands, hair follicles), also extend into the underlying SQ layerThe majority of collagen and elastic fibers in the skin are oriented in parallel bundles at specific body locations. why?Alignment of fiber bundles is a result of the direction of applied stress during routine movementWhat is a line of cleavage?The predominant orientation of collagen fiber bundles in a given area of the bodyWhy are lines of cleavage clinically significant?A cut perpendicular to a cleavage line will have a hard time healing as it will be pulled open with recoil of cut fibers, a cut parallel to a cleavage line can remain closed and heal quicker and with less scarringWhat are striae, or stretch marks, a result of?When skin is stretch beyond its elastic capacity causing collagen fibers to tear, usually due to excessive weight gain or pregnancyWhy does skin become wrinkled or saggy?UV light exposure and aging damaging the flexibility and decreasing the thickness of the skinWhat function does the extensive innervation to the skin have?Monitoring sensory receptors in dermis and epidermis, control blood flood and gland secretion, allows you to be very aware of surroundingsThe largest blood vessels that supply the skin are found where?Within the border of the reticular layer of the dermis and the SQ layer______ supply hair follicles, sebaceous glands, etc with bloodSmall arteries_______ occurs in the vasculature of the skin when the body is coldVasoconstriction______ occurs in the vasculature of the skin when the body is hotVasodilationThe _____ is not technically skin/integument and is deep to reticular layer of the dermisSubcutaneous layer/hypodermisWhat is the SQ layer/hypodermis comprised of?Areolar and adipose CT, called subcutaneous fat when adipose dominatesWhat fibers of the reticular dermis are extensively interwoven within the subcutaneous layer to bind it in place?Reticular fibersWhat is the function of the subcutaneous layer?Pads and protects the body, stores energy, provides thermal insulationWhy are drugs often injected into the subcutaneous layer?It has an extensive vascular networkNails, hair, and exocrine glands of the skin are all derived from the and are known as what?Epidermal epithelium, appendages of the integumentWhat do the appendages of the integument originate from?Invagination of the epidermis during embyrological developmentAppendages are located in the ___ and may project through the _____Dermis, epidermisNails and hair are primarily composed ofDead (keratinized) keratinocytesNails are modified _______ that support tips of fingers and toes and decrease mechanical stressStratum corneumThe ______ contains a free edge that is white due to lack of underlying capillary bedsNail plateThe _____ is the pink visible part due to underlying capillary beds and covers the layer of epidermis called the ____Nail body, nail bedWhat contains the only living layers of the epidermis in the nail?The nail bedThe _____ is the proximal part of the nail embedded in the skinNail rootOn the nail root, the nail bed is thickened to form a _____ which is the actively growing part of the nailNail matrixThe nail matrix forms the visible ______ which is the white half moon area of the proximal nail bedLanulaWhy is the lanula white?Thickened stratum basal obscuring the underlying capillary bedsWhat is the overlapping skin on the lateral and proximal borders of the nail called?Nail foldsThe cuticle or the _____ is the narrow band of epidermis extending from the margin of the proximal nail onto the bodyEponychiumThe ____ is the region of thickened stratum corneum over which the free nail edge projects and is technically not a nail foldHyponychiumA single hair is called aPilusThe hair grows from hair follicles that extend from where?The dermis/SQ layerDifferences in hair density are due to what?Difference in texture and pigmentation_____ is the type of hair that is fine, unpigmented, and is produced by the fetus in the second trimester. Most of it is replaced by vellus by birthLanugo_____ is the predominant form of post-fetal hair and is found on most of the bodyVellus______ is coarser, more pigmented and longer than vellus and grows on the scalp, eyebrows, and eyelashes. Also replaces vellus at puberty in the axillary and pubic regions and forms beard, arm, leg hair, and trunk hair of menTerminal hairThe ___ of a pilus is the swelling at the base of the hair and is composed of living epithelial cells. Surrounds a hair papilla that contains CT, vasculature, and nervesBulbThe ____ of a pilus is the part of the hair deep to the skin surface and is composed of dead epithelial cells?RootThe ____ of the pilus is the part of the hair that extends beyond the skin surface and is composed of dead epithelial cellsShaftWhat is the smooth muscle that extends from the dermal papillae to the mid region of the hair follicle?Arrector pilusWhat causes hair to stand upright resulting in goosebumps?Contraction of the arrector pilusHair color is a result of what?Melanin production in the matrix of the papillaeWhat are the two types of exocrine glands of the skin?Sebaceous, sweat/sudoriferousThe two types of sweat/sudoriferous glands areApocrine and merocrineWhat is the mechanism of secretion of both types of sweat glands?MerocrineMerocrine sweat glands release their nonviscous, water secretion where?Onto the surface of the epidermisApocrine sweat glands release their viscous, complex secretion (that can smell), where?Onto the root of a hair follicle, found in axillary/anal/pubic regionsWhat is a sweat pore?The opening of a merocrine sweat glands on the epidermal surfaceWhat kind of cells do sweat glands have?Myoepithelial, an epithelial cell with actin and myosin that enables it to contract and expluse contents from the glandThe most numerous and widely distributed sweat glands areMerocrine glandsSweat begins as what?A protein free filtrate of blood plasma, 99% water 1% other chemicalsThe functions of merocrine sweat glands areThermoregulation, secretion, protection (acidic pH prevents grown of bacteria, dilutes harmful chemicals on skin)Why does the viscous cloudy fluid secreted by apocrine sweat glands composed of proteins and lipids sometimes produce odor?Bacteria utilize it and produce waste making the odorSebaceous glands have a ____ method of secretion and secrete oily/waxy sebumHolocrineWhere are sebaceous glands located that secrete directly onto skin?Nipple, penis, labia minora, lipsSebaceous glands are relatively inactive during childhood, what is produced during puberty that activates them?Sex hormonesWhat are the functions of sebum?Lubricant, keeps skin and hair from becoming dry brittle and cracked, has bactericidal propertiesWhere are sebaceous glands not found? Where are they most abundant?Palms and soles, face and scalpWhat is it called when bacteria causes an infection within a sebaceous gland and produces local inflammation?FolliculitisWhat is a blocked duct in a sebaceous gland that develops into an abscess called?Furuncle/boil______ glands have a true apocrine mechanism of secretion and are located only within the external acoustic meatusCeruminousCeruminous gland secretions mix with what to produce cerumen/ear wax?Sebum and exfoliated keratinoctesCeruminous and sweat glands are what kind of glands?Simple, coiled, tubularCerumen and pili work together in the ear to do what?Trap foreign particles and keep insects from reaching the ear drumMammary glands are what kind of glands?Modified apocrine, only functional in pregnant femalesWhat are the development and production of mammary gland secretions controlled by?Gonadal and pituitary hormonesChronic overexposure to UV rays can damage the DNA of what layer of the epidermis to accelerate aging? Also potentially giving rise to the most common form of cancer, skin cancerStratum basalWhat are the three main types of skin cancer?Basal cell carcinoma, squamous cell carcinoma, malignant melanoma________ is a skin cancer that arises from keratinocytes, growth resembles the stratum basal, and is the least dangerous skin cancer because it rarely metastasizesBasal cell carcinoma______ is a skin cancer that arises from keratinocytes, whose growth resembles the stratum spinosum, may metastasize but can be treated by early detection and removalSquamous cell_____ is a skin cancer that arises from melanocytes, is the deadliest of all skin cancers because of aggressive growth and metastasis, individuals who got severe sunburns as children are more at riskMalignant melanomaWhat are the ABCDE characteristics of recognizing malignant melanoma?Asymmetry, Border (notched/blurred/ragged), Color (not uniform), Diameter (larger than 6mm, growing), Evolving (change in size, shape, color, or other symptoms ie. itchiness)With an oriented elliptical excision of skin, you should measure what?The greatest dimensions of the tissueWhat should you not when describing the superficial surface of an elliptical excision of skin?lesions, ulcerations, scars, etc. include 2-3 dimensions of each and distance to nearest marginAn _____ is a traumatic lesion breaking the epidermis and causing a raw linear areaExcoriationA _________ is thickened, rough skin, usually due to repeat rubbingLichenification/callusA ______ is a circumscribed, flat lesion distinguished from surrounding skin by color.Macule (<5mm), patch (>5mm)_____ is an elevated flat-toped lesion that is typically greater than 5mm acrossPlaqueA ____ is a discrete, pus-filled, raised lesionPustuleA ____ is a dry, horny, platelike excrescenceScaleA _____ is a fluid filled raised lesionVesicle (<5mm), bulla (>5mm), or blister for eitherA ___ is an itchy, transient elevated lesion with variable blanching and erythema formed as the result of dermal edemaWhealHow should you ink an elliptical skin excision?One half of resection margin one color and the other half anotherWhat do you do after inking an elliptical skin excision?Serially section from 12-6o'clock perpindicularlyThe most clinically useful staging system for cancer- the tumor, node, and metastasis (TNM) system is developed by who?American Joint Committee on Cancer (AJCC)How does the AJCC TNM system work?T- size and extent of primary tumor N- involvement of regional lymph nodes M- presence or absence of metastasisWhat is Breslow's Thickness?Measuring melanoma from the top of the granular layer of the epidermis (or base of ulcer if applicable) to the deepest invasive cell. Done by the pathologist at the microscope to nearest 0.1mmBreslows thickness can only be evaluated accurately in sections that are cutPerpendicular to the epidermal surfaceWhat two characteristics are required for a pathologist to correctly T stage a melanoma of the skin?Tumor thickness (depth), if the tumor is ulcerated Note both when grossing!What sections are most important to submit in a melanoma case?Those showing greatest tumor thickness and ulceration, may or may not be the same section

Integumentary System

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