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Dermatology 1 Flashcards

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1
Q

What is Dermatology?

A

the study of the integument (skin, hair, nails, and mucus membranes)

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2
Q

What are the 8 functions of the skin?

A
  1. protects against microbial and foreign substances and minor physical trauma
  2. mechanical barrier against fluid loss
  3. regulates body temp
  4. provides sensory perception
  5. produce vitamin D form precursors in skin
  6. contributes to BP regulation
  7. Excretion of metabolites
  8. expression of emotions
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3
Q

Epidermis

A

thin, outermost portion of the skin, avascular- 5 layers

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4
Q

Stratum Corneum

A

contains cornified cell- tightly packed dead squamous cells, contains keratin

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5
Q

How long does it take to replace the stratum corneum?

A

3-4 weeks

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6
Q

What is keratin?

A

the warterproofing protein

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7
Q

Is there keratin or a granular layer in mucus membranes?

A

No

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8
Q

Stratum lucidum

A

Lucid layer (2nd from top)

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9
Q

Stratum granulosum

A

granular layer, with granular cells (3rd from the top)

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10
Q

Stratum spinosum

A

spinous layer- prickle or spinous cells, also has dermotomes, which attach the cells

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11
Q

Stratum Basale

A

Basal layer contains the keratinocytes and melanocytes

only layer that has mitosis occuring

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12
Q

Melanocytes

A

in contact with granulocytes, packages granularly

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13
Q

basement membrane

A

connects the epidermis to the dermis

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14
Q

Dermis

A

Richly vascular, provides nutrition for the epidermis by means of penetrating papillae

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15
Q

What 5 structures are located in the dermis?

A
  1. connective tissue (elastin, collagen, reticulin fibers)
  2. sebaceous glands
  3. blood vessels
  4. sensory nerve fibers
  5. autonomic motor neurons
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16
Q

What do the AMN innervate?

A

blood vessels, sweat glands, and pilo erection

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17
Q

Hypodermis

A

AKA subcutaneous layer
loose connective tissue filled with fatty cells
sweat glands
deeper hair follicles

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18
Q

Eccrine sweat glands

A 
distributed over most of the body
open directly to the surface of the skin
regulate body temp through water secretion
primary stimulus= heat
regulated via the hypothal.
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19
Q

Apocrine sweat glands

A

inactive until puberty
larger and deeper and Ecc
found in the axillae, anogenital region, aerola, nipple, eyelids and external ear
secretion is stimulated by emotional stress (odorless white fluid)

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20
Q

What causes the odor?

A

bacterial decomposition

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21
Q

sebaceous glands

A

stimulated by sex hormones
secrete lipid rich sebum to keep skin an hair lubricated (continuos outflow) via the follicle
None on palms or soles

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22
Q

Hair follicles

A

invagination of epidermal cells into the dermis
consists of a root, shaft, and follicle
nutrients provided by the papilla

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23
Q

Melanin
carotene
oxyhemoglobin
deoxyhemoglobin

A

brown
golden-yellow/ orange- seen on palms, soles
bright red
dark blue

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24
Q

What light is best for skin inspection? second best?

A
  1. natural light

2. combo of incandescent and fluorescent

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25
Acrocyanosis
blueness in palms and soles of feet | common*
26
peripheral cyanosis
blueness in arms and legs
27
central cyanosis
blueness in tongue and mouth
28
vellus hair
short, fine, soft, inconspicuous nonpigmented | all over the body
29
terminal hair
conspicuous, thicker course, usually pigmented from melanocytes
30
Life cycle of hair
1. anagen growth- 80-90% of hair 2. catagen atrophy-5% 3. telogen rest- 10-15% 4. shed
31
Trickogram
pluck 50 hairs to diagnose alopecia
32
How many mm per day does scalp hair grow?
0.33 mm/day
33
how long does it take for a fingernail to grow back? toenail?
grows 0.1 mm/day 3 mo for finger 6 mo for toe
34
Changing levels of androgens in adolescents stimulate?
increased terminal hairs on the face appearance of axillary hair increased truncal and body hair (males> females)
35
other skin changes in teens?
1. apocrine glands enlarge and become active causing axillary sweating and body odor 2. sebaceous glands increase sebum production causing oily skin and acne
36
Name 6 elderly skin changes?
1. decreased turgor (wrinkles) 2. decreased vascularity of the dermis 3. skin thins and is more fragile 4. furrowing and thickening of the skin (sun) 5. nails loose luster and yellow 6. hair thins and looses pigment (d/t decrease functioning melanocytes)
37
Primary skin lesion
lesions that occur as the initial spontaneous manifestation of an underlying pathologic process
38
Secondary skin lesion
lesion that results from a later evolution of or external trauma to a primary lesion (from scratching or infection)
39
Diagnostics for skin lesions: (5)
1. fungal scrapings with KOH prep 2. fungal culture 3. Tzanck smear (neonatal herpes) 4. scabies preparation 5. Allergy skin testing (patch or prick)
40
Macule
flat, circumscribed lesion, less than 1 cm in diameter, distinguished by coloration examples: freckles, flat moles, petechiae measles
41
patch
flat, irregular in shape, macule that is > 1 cm in diameter | examples: vitiligo, congenital melanocytic nevus, port wine marks
42
Papule
elevates, palpable firm, circumscribed, less than 1 cm in diameter brown, red, pink, tan, or bluish red in color examples: warts, malignant melonoma, lichen planus, pigmented nevi
43
Plaque
elevated, flat topped, firm, rough superficial plaque > 1 cm | examples- psoriasis, suborrheic and actinic keratosis
44
wheal
elevated and irregular-shaped area of skin edema, solid transient and changing, variable diameter: pale pink and lighter in the center examples- urticaria and insect bites
45
Nodule
elevated, firm, circumscribed, palpable, deeper in the dermis than papule 1-2 cm ex- lipomas, kaposi's sarcoma
46
Tumor
elevated, solid, may or may not be demarcated | greater than 2 cm, may or may not vary from skin color
47
Vesicle
elevated, circumscribed, superficial, filler with serious fluid, < 1 cm diameter examples- blister, varicella, eczema, hepes zoster
48
bulla
vesicle >1 cm | ex- blister, pemphigus vulgaris
49
pustule
elevated, superficial, like a vesicle, but filled w/ puss | ex- imetigo, acne, folliculitis
50
cyst
encaspsulated, elevated, filled with liquid or semisolid material ex- epidermoid cyst
51
scale (2)
heaped-up keratinized cells, flakey exfoliation, | ex- psoriasis, exfoliative dermatitis
52
crust (2)
dried serum, blood, purulent exudate, varies in color | ex- scab, impetigo, eczema
53
Lichenification (2)
- rough, thickened epidermis, accentuated skin markings caused by rubbing or irritation - involves flexor surfaces - ex chronic dermatitis
54
scar (2)
thick to thin fibris tissue replacing injured dermis pink red or white ex- healed wound or surgical excision
55
Keloid (2)
irregularly shaped, elevated progressively growing scar, grows beyond boundaries of the scar caused by excessive collagen formation during healing (from ear piercing or burn)
56
excoriation (2)
loss of epidermis, linear or hollowed out crusted area, dermis is exposed ex- abrasion, scratch
57
Fissure (2)
linear crack or break from epidermis to the dermis small, deep, red ex- athletes foot, cheilosis
58
Erosion (2)
loss of all or part of the dermis, depressed, moist, glistening, follows rupture of bulla ex- pemphigus vulgaris
59
Ulcer (2)
loss of epidermis and dermis, concave, varies in size, exudative, red or reddish blue ex- stasis or radiation ulcers
60
Atrophy (2)
thinning of skin surface and loss of skin markings- skin is translucent and paperlike ex- striae, aged skin
61
Ecchymoses
red-purple nonblanchable discoloriazation of variable size | causes- vascular wall destruction, trauma, vasculitis (aka bruise)
62
capillary hemangioma
(nevus flammeus) red irregular macular patches | cause- dilation of dermal capillaries
63
Telangiectasia
fine. irregular line caused by dilation of the capillaries
64
venus star
bluish spider, linear or irregularly shaped; does not blanch with pressure caused by increased pressure in superficial veins
65
spider angioma
red central body with radiating spiderlike legs that blanch with pressure to the central body caused by liver disease, vit b def. and idiopathic
66
Prednisolone
double bond between C1-C2 and has increased anti-inflammatory properties
67
MOA of steroid
penetrates cell membrane, attaches to receptors in cytoplasm, which reacts with DNA synthesis resulting in modified RNA protein synthesis
68
Effects of steroids?
``` anti- inflammatory immunosuppression vasoconstriction anti-mitotic mineralcorticoid activity glucocorticoid activity antimetabolic effects ```
69
Drying agents for weepy dermatitis
``` Water is the best aluminum salts colloidal oatmeal (aveeno) shake lotions powder ```
70
what should you not use antipuritis with?
"canes"
71
What does SPF protect against?
UBV
72
Topical Abx
``` bacitracin noemycin (most potential for sensitivity/ allergy) polymyxin sulfa preparations bactroban ```
73
common size of tubes
15, 30, 45,60, 120, 480 grams
74
ointments cover how much more than creams?
5-10%
75
do children or adults absorb more?
children 3X more than adults
76
1 lb = ___ oz = ____ grams
16, 454
77
30 grams=
1 oz
78
shave biopsy
partial thickness | use scalpel or scissors and nitrate sticks to stop bleeding
79
punch biopsy
full thickness remove a small piece of the mature lesion no normal tissue
80
elliptical excision biopsy
includes borders of normal skin | usually for mole excision
81
curettage
for benign cutaneous lesions (wart)
82
electrodessication
dehydrates and destroys the cells
83
electroangulation
produces more destruction, boils tissue and coagulates the lesions, good for vascular lesions (usually do a biopsy first to determine what you have)
84
cryosurgery
(liquid nitrogen)- application of cold to the skin, used for warts

Dermatology Intro (3 decks)

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