Exam 2 Flashcards
(229 cards)
1
Q
What is the largest organ in the body?
A
*integumentary system
2
Q
What means to cover?
A
*integumentary
3
Q
Why is skin called an organ?
A
*it has many components
4
Q
What are the regions of the skin?
A
*epidermis, dermis, and hypodermic
5
Q
Which layer is the deepest?
A
*dermis
6
Q
Which layer is the most superficial?
A
*epidermis
7
Q
Which layer cushions and isolates (fat)?
A
*hypodermis
8
Q
What does the skin do?
A
- communication
- site of waste secretion (sweat)
- protection
- body temperature regulation
- metabolic functions
9
Q
How does the skin regulate body temperature?
A
- hot (by sending hot blood to extremities)
- cold
- baby fat (brown fat)
10
Q
How does the skin do metabolic functions?
A
*skin influences bone health via vit D
11
Q
What is the most active form of vitamin D?
A
*calcitriol which is for bone health
12
Q
What does the hypodermis do?
A
- movement
- shock
- insulation
- not present everywhere
13
Q
Why are injections given in the hypodermis and not the dermis or epidermis?
A
*hypodermis is vascularized, and we can increase the rate of absorption
14
Q
How many types of skin are there in the epidermis?
A
*two
15
Q
What are the types of skin in the epidermis?
A
- thin
* thick
16
Q
What is thin skin?
A
- missing lucidium layer
- most parts of the body
- four layers
17
Q
What is thick skin and where is it found?
A
- palms and soles
* five layers
18
Q
What are the layers of the epidermis (from deep to superficial)?
A
- stratum basale
- stratum spinosum
- stratum granulosum
- stratum lucidum
- stratum corneum
19
Q
Which layer is closest to blood supply and has a regenerative layer?
A
*stratum basale
20
Q
Which layer has Keratinocytes, Melanocytes, and Merkel discs?
A
*stratum basale
21
Q
What are keratinocytes?
A
- produces keratin (hydrophobic protein)
* gives strength to skin, and protects
22
Q
What are Melanocytes?
A
- produces melane (brown colored protein)
* natural UV sunblock
23
Q
What are Merkel discs?
A
*discs sensitive to pressure
24
Q
What layer had dendritic cells and still some division?
A
*stratum spinosum
25
What are dendritic cells for?
*immune cells
26
What layer has granules, is 3-5 cells thick, and the organelles disintegrate?
*stratum granulosum
27
What happens when the organelles disintegrate?
* they are packaged in vesicles and you recycle those (to get an armor)
* happens every 6 weeks
28
What layer is only present in thick skin, is the first layer of dead skin, and has eleidin?
*stratum lucidum
29
what is the lightest layer?
*stratum lucidum (lucidum means light)
30
What is eleidin
*precursor to keratin, and made at stratum lucidum layer
31
Which layer is dense packed keratin, has exfoliation, and is 30 layers of dead cells?
* stratum corneum
| * cells renewed every 6-8 weeks
32
What is exfoliation?
*slough off dead cells about a pound every year
33
What are the characteristics of the dermis?
* strong, flexible
* mostly dense irregular connective tissue
* cells and molecules
* highly vascularized
* many sensory receptors
34
What is the purpose of the dermis?
* blood supply
* sensory perception
* structural integrity
35
Layers of the dermis?
* papillary layer
| * reticular layer
36
What is the reticular layer made up of?
*dense irregular connective tissue
37
What is the papillary layer made up of?
* areolar CT
| * dermal papillae (& rete pegs)
38
What else is found in the dermis?
* hair follicle
* sweat glands
* blood vessels
* nerves
* arrectorpili
39
When the epidermis dips down?
*hair follicle
40
Where does sweat come from?
*blood
41
What is the arrectorpili muscle?
*muscles that control the hair
42
What are some examples of skin derivatives?
* hair, hair follicles
* sebaceous glands
* sweat glands
* nails
43
What are the three types of hair?
* lanugo
* vellus
* terminal
44
What type of hair is fine, unpigmented fetal hair?
*lanugo
45
What type of hair is unpigmented?
*velllus
46
What type of hair is coarse, long, pigmented hair or the scalp?
*terminal
47
What are the three zones of keratinized cells?
* bulb
* root
* shaft
48
What are the three layers to the hair?
* medulla
* cortex
* cuticle
49
Which layer of the hair is loosely arranged cells?
*medulla
50
Which layer of the hair is densely packed cells?
*cortex
51
What layer of the hair is a single layer of scaly cells?
*cuticle
52
Hair is modified epidermis but grey hair is?
*loss of pigment due to melanin deficit
53
What are nails?
*modified epidermis
54
What are the three parts to the nail?
* root (in skin)
* body
* free edge
* cyanosis
55
What types of glands are in the integument?
* sweat
| * sebaceous
56
What are sweat gland also known as?
*suderiforous glands (water loss that isn't beneficial)
57
What are the types of insensible sweat?
* merocrine
* apocrine
* modified
58
What are merocrin sweat glands?
* aka eccrine
* most common in palms, soles of feet, forehead
* exocytosis
59
What are apocrine sweat glands?
* secretes sweat, and fatty acids (which makes you smelly)
* found in armpits, groins, anus, areola
* larger, empty beard to hair follicles
60
What are sweat glands?
* modified mammary
| * modified ceruminous
61
What releases milk?
*mammary glands
62
What releases ear wax?
*ceruminous glands
63
What are sebaceous glands?
* holocrineglands
* excrete broken down cells
* release sebum, push out oil
* waterproof skin/hair
* on scalp moslly
64
What is Erythema?
*redness of the skin
65
What is jaundice?
* yellowing of skin caused by liver not functioning
| * bilirubin builds up in blood stream
66
What is pallor?
*pale color of skin due to reduced oxyhemoglobin
67
What is albinism?
*partial/complete absence of pigment on skin or hair
68
What is hematoma?
*a collection of blood outside blood stream, bruise
69
What is hamangiomas?
*abnormal vessel develop under skin in dermis
70
What are the types of skin cancer?
* basal cell carcinoma
* squamous cell carcinoma
* malignant melanoma
* use ABCD rule
71
What cells are affected in basal cell carcinoma?
*straum cell basale
72
What is the 2nd most common, upper most layer of skin cancer?
*squamous cell carcinoma
73
What is the rarest, most lethal, affects melanocytes, darker color skin cancer?
*malignant
74
Tattoos are inject into the?
*dermis
75
What are the types of burns?
* first-degree
* second-degree
* third-degree
76
What burn affects the epidermis only?
*first-degree
77
What burn effects the epidermis and dermis?
*second-degree
78
What burn causes blistering hair follicles, eglands regenerate where you need to clean out dead tissues?
*second-degree
79
What burn completely effects the epidermis and dermis, and uses skin grafts?
*third-degree
80
What are the treatments for burns?
*infection control, IV nutrition (no dehydration)
81
What are the two repair processes?
* regeneration
| * fibrosis
82
What repair process causes tissue regenerates and maintains original function?
*regeneration
83
What repair process causes scaring, scalp incision, function does not return?
*fibrosis
84
What makes up the skeletal system?
* bones
* cartilage
* ligaments
85
What is an embryonic framework for bones?
*cartilage
86
What do bones do?
* support
* protection
* movement
* electrolyte balance
* acid-base balance
* blood formation
87
What is electrolyte balance?
*store Calcium and phosphate ions
88
What acid-base balance?
*bone buffers against pH fluctuations, alkaline-phosphatate produced
89
What is blood formation?
*bone marrow, hematopoietic tissue
90
How are bones classified?
* long bones
* short bones
* flat bones
* irregular
* sesamoid
91
What bones are longer than they are wide?
*long bones
92
What bones are equal in length typically as width?
*short bones
93
What bones are very thin?
*very thin
94
What bones are an unsual shape, and vertebrae?
*irregular
95
What bones develop between ligaments and vessels, ex patella?
*sesamoid
96
What bone categories by location?
* axial skeleton
| * appendicular skeleton
97
What are the types of bone tissue?
* cancellous
| * osseous
98
What type of bone is at the ends of long bone, and is also known as spongy bone?
*cancellous
99
What type of bone is 1/4 or all bone, and has a diploe?
*cancellous
100
What has a spongy middle layer, and outer harden bone?
*diploe of cancellous bone
101
What type of bone is compact bone, and has a medullary cavity?
*osseous
102
What is a hollow area you can put marrow in?
*medullary cavity
103
What are some bone features?
* diaphysis
* epiphysis
* periosteum
* endosteum
* epiphyseal plate
104
What is the middle portion of bones?
*diaphysis
105
What is the sheath that covers the outside of the bone?
*periosteum
106
What is periosteum?
* out fibrous collagen layer
* inner osteogenic layer
* nutrient foramina
107
Where do you give rise to new bone?
*inner osteogenic layer
108
What is the main blood vessel that feeds bone, and is dependent on length of bone?
*nutrient foramina
109
What inner portion of bone?
*endosteum
110
what type of tissue is endosteum made of?
* reticular CT
* osteoclasts
* osteoblasts
111
What breaks down bone, and is constantly turnover?
*osteoclasts
112
What build bones, and is constantly turnedover to deal with stress, and electrolyte balance?
*osteoblasts
113
What is an active turnover of new bone, and is the growth plate at end of long bones?
*epiphyseal plate
114
What is the point of elongation, and has hyaline cartilage that turns into bone?
*epiphyseal plate
115
What transforms to the epiphyseal line?
* epiphyseal plate
| * when growing is done, late teens early 20s
116
What makes up CT?
* matrix
* cells (blast, and cytes)
* bone (matrix, cells)
117
What are the four types of bone cells?
* osteogenic cells
* osteoblasts
* osteocytes
* osteoclasts
118
What type of bone cell has an endosteum and a periosteum?
*osteogenic cells
119
What type of bone cell is non-mitotic has an endosteum, periosteum, and secretes collagen?
*osteoblasts
120
What is collagen?
*fibrous protein that gives strength and is encrusts with hydroxyapatite
121
What type of bone cell is a mature bone cell, trapped in matrix, and has canaliculi that connects cells?
*osteocytes
122
What type of bone cell is multinucleated, from bone marrow cells, has cellular fusion, and resorption bays?
*osteoclasts
123
What do osteoclasts secrete?
* acid phosphatase
| * HCl
124
What enzyme digest collagen?
*acid phosphatase
125
What digest minerals?
*HCl
126
What is in the bone matrix?
*1/3 organic, 2/3 inorganic matter
127
What is in the organic part of the matrix?
* collagen, glycoproteins, proteoglycans
| * resists tension and bending
128
What is the inorganic part of the matrix for?
* resists compression
| * 85% hydroxyapatite
129
What are the parts of osseous tissue?
* lamellae
* Haversian canal
* osteon
* Volkmann (perforating) canal
130
How is lamellae connect?
*connected to other lamella via conaliculi
131
What is also known as the central canal?
*Haversian canal
132
What are the parts of cancellous tissue?
* trabeculae
* spaces
* advantage of osseous tissue (strong)
133
What are the spaces of cancellous tissue filled with?
*bone marrow
134
What develops along lines of stress?
*trabeculae
135
What is bone marrow?
* soft tissue
* red bone marrow
* yellow bone marrow
136
Where is soft tissue of bone marrow?
* between trabeculae
| * medullary cavities
137
What is red bone marrow?
* hemopoietic tissue and myloid tissue
| * found in children in many places and found in adults only in hips, shoulder, and proximal ends of humerus and femur
138
What does red bone marrow give rise to?
*platelets, red blood cells, and white blood cells
139
What is yellow bone marrow?
* mostly adipocytes
* replaces red bone marrow
* can revert to hemopoietic
* old age-> gelatinour bone marrow (high in HIV patients, and anorexia)
140
What would happen to a patient whose bone marrow became compromised from disease?
*have clotting issues, become anemic
141
How do bones form and develop?
* ossification (AKA osteogenesis- bone beginning)
* two types
- intramembranous ossification
- endochondral ossification
142
What is intramembranous ossification?
*formation of flat bones (week 8 of development)
143
What is step one of intramembranous ossification?
*ossification centers form (Mesenchymal cells differentiate into osteoblasts)
144
What cells build bone?
*osteoblasts
145
What is step two of intramembranous ossification?
* osteoblasts create trabeculae
- secrete soft matrix
- calcium phosphate deposited
- forming trabeculae becomes spongy bone (dipole)
- osteoblasts -> osteocytes
146
What is step three of intramembranous ossification?
* formation of compact bone
- outermost trabeculae calcify
- compact bone and periosteum form
147
How does the skull change after birth?
* flat bones in skull fuse (via sutures)
- a fibrous CT joint between skull bones
- fontanels
148
What allows the brain to grow, and makes birth delivery easier?
*a fibrous CT joint between skull bones
149
What are soft spots?
*fontanels
150
When do fontanels disappear?
* Frontal (anterior) fontanels
| * others close within the first year
151
What other fontanels close within the first year?
* sphenoidal (anterior lateral)
* mastoidal (posterior lateral)
* occipital (posterior)
152
What is endochondral ossification?
* how most bones are formed (long bones)
* mesenchyme becomes hyaline cartilage (around week 6 of development)
* hyaline serves as template for ossification
153
What is step one of endochondral ossification?
* bone collar forms
- trigger is blood vessels invation of perichondrium and forming a periosteum
- osteoblasts differentiate in periosteum (form bone collar)
154
What is step two of endochondral ossification?
* chondrocytes swell (hypertrophy)
- signals mineralization of matrix
- collar cuts off circulation to chondrocytes= programed death, apoptotic (matrix deteriorates, serves as splint/support)
- primary marrow site forms
155
What is step three of endochondral ossification?
* periosteal bud forms
- cavity invaded by blood vessels, hematopoietic cells, nerves, osteoblasts, osteoclasts
- osteoblasts form primary ossification center (deposit osteoid matrix over calcified cartilage, forms spongy bone: ossification spreads towards epiphysis)
156
What is the fourth step of endochondral ossification?
*medullary cavity forms (osteoclasts, secondary ossification centers form)
157
What is used to hollow out bone and helps reshape bones?
*osteoclasts
158
What is step five of endochondral ossification?
*spongy bone develops at head (blood vessels invade head, development similar to process in bone shaft)
159
How do bones grow after birth?
* interstitial growth
| * appositional growth
160
What is interstitial growth?
* happens in short and long bones
| * cartilage organizes in zones (have epiphyseal side and diaphysis side)
161
What is the epiphyseal side for?
*where new cartilage is added
162
What is the diaphysis side for?
*osteoblasts invade and produce bones
163
What is appositional growth?
*growth in diameter, function of stress placed on bone
164
How does endochondral ossification happen?
*five zones of cartilagenous/osseous cell
165
What is zone 1?
*reserve cartilage zone
166
What is zone 2?
* proliferation zone
| - chondrocytes multiply
167
What is zone 3?
* hypertrophy zone
| - enlarge, signals bone to be laid down
168
What is zone 4?
*calcification zone
169
What is zone 5?
* deposition zone
| - osteoblasts invade, secrete osseous matrix (replaces cartilage with osteous bone)
170
What does appositional growth happen?
* balanced event
- helps maintain proper bone shape
- osteoclasts in endosteum dissolves bone (medullary cavity expands, which keeps it open for bone marrow)
- osteoblasts in periosteum produce new bone
171
What is moment of inertia?
* I=mr2
| * resistance to bending
172
The more the density of mass from the neutral axis the?
*strong the resistance to bending
173
What does endo ossification start with?
*cartilage
174
What does intramembrane ossification start with?
*mesemchymal cells
175
Does endo or intramenb ossification have a bone collar?
*endo
176
Does endo and intramemb ossification have a hypertrophy (gets larger)?
*both
177
Does endo and intramamb ossification have matrix changes?
*yes both
178
Do both ossifications have cell death?
*yes both
179
Does endo or intramamb ossification have a periosteal bud?
*endo
180
Do both ossifications result in bone formation?
*yes both
181
Do both ossifications occur in full grown adults?
*no, neither
182
This bone related event does not involve activity in/on the medullary cavity?
*intramembranous ossification
183
What controls the epiphyseal plate?
* hormones in childhood
| * sex hormones at puberty
184
What hormones control the epiphyseal plate in childhood?
* growth hormone
| * thyroid hormone
185
What stimulates osteoblasts?
*thyroid hormone
186
What hormones control the epiphyseal plate at puberty?
* estrogen/testosterone
* make bone formation out pace cartilage growth
* epiphyseal line forms
187
What stimulates chondroblasts?
*testosterone
188
When does the epiphyseal line form in women and men?
* women 18
| * men 21
189
What is Achondroplasia?
*autosomal dominant disease
190
What is the pathology of achondroplasia?
* failure in FGF receptor 3
| * failure of epiphyseal cartilage to grow (less cartilage=less bone growing)
191
What are the characteristics of achondroplasia, and treatment?
* disproportionate limbs, spinal curvature
| * no treatment
192
Are bones static in adults?
* no
* osteocytes respond to stress (wolf's law)
* osteoclasts and osteoblasts in balance=healthy bone
* out of balance=disease
193
What is wolf's law?
* bone is constantly remodeling itself based on the stressed placed on it
* resorption
* depositon
194
What is a healthy bone?
*has balanced levels of Ca and phosphate
195
What does the resorption part of wolf's law mean?
* response to decreased stress
| * osteoclasts dominate (disuse, immobilization, microgravity)
196
Explain deposition as part of wolf's law?
* response to increased stress
| * osteoblasts dominate (weight-bearing exercise)
197
How does spine shape change?
* newborn: C-shaped
* primary curvature
* secondary curvature
198
What are some secondary curvatures?
* cervical
| * lumbar
199
Explain inactivity?
* bed rest can induce a bone mass loss of 1% per week
* decreased size reduces moment of inertia=weaker strength of bone
* a 20% decrease in diameter=60% reduction in strength in torsion
200
What is demineralization?
* loss of calcium
- osteoporosis
- osteopmalacia (adults)
201
What is osteopmalacia?
* in adults
* vit D deficiency (problems with Ca absorption, leads to weaker bones/inability to mineralize these bones
* rickets (children)
202
How is bone homeostasis maintained?
* 5-7% of bone mass recycled weekly
- head of femur turns over every 5-6 mos (shaft takes longer
- use determines rate of replacement
- at both endosteal and periosteal surfaces (inside and outside remodeled)
203
What happens during remodeling?
* bone dissolved, followed by deposition
* osteoclast secrete HCl (excavate a tunnel, releasing Ca)
* osteoblasts enter tunnel and secrete matrix (matrix mineralizes)
204
What controls remodeling?
* calcium levels in blood monitored
| * hyroid and parathyroid hormones
205
What does thyroid control?
*calcitonin
206
What does parathyroid control?
*PTH
207
What happens is calcium is out of balance?
* hypocalcemia
| * hypercalcemia
208
What is hypocalcemia?
* too little
* excessive excitation of nerves
* tetanus (esp carpopedal spasm/ muscles spasms)
* laryngospasm (respiratory problems)
209
What is hypercalcemia?
* too much (rare)
* less excitable nerves, muscles
* muscles weakness, sluggish reflexes
* cardiac arrest possible
210
Arrange the zones in order, from the diaphysis to the epiphysis?
1. zone of calcification
2. zone of hypertrophy
3. zone of proliferation
4. zone of resting cartilage
211
What are the types of fractures?
* closed (simple fracture)
* compound (open, bone sticking through skin)
* spiral (twisted)
* greenstick
* comminuted
212
What is a greenstick fracture?
*fracture in kids, twist not actually fractured
213
What is a comminuted fracture?
* shattered bone
| * more common in the elderly
214
How do you treat fractures?
* closed reduction
* open reduction
* immobilize
215
What is closed reduction?
* manipulation (set bone)
| * no surgery
216
What is an open reduction?
* surgical exposure
| * screws, pins, ect
217
What is immobilize treatment of a fracture?
* can use for both closed and open fractures
| * cast or traction
218
How does the body repair fractures?
* similar to skin repair
* fibrous callus forms (scallop that hardens/ similar to granulation step)
* bony callus forms
* remodeling of spongy bone into original shape
219
What is a salter-harris fracture?
* epiphysis fractures 5 classifications
* stunt growth in involved limb
* a portion of the damaged growth plate may remain functional (open) and thus the bone and limb becomes twisted
220
Does main maintain the moment of inertia while its healing?
*yes (polar moment of inertia)
221
What is osteoporosis?
* loss of bone mass (happens globally throughout the body, happens most in hip)
- cancellous tissue
- most common in elderly women
- onset: menopause (loss of estrogen production)
222
Is osteoclast or blast higher in osteoporosis?
*osteoclast are in higher activity
223
Osteoporosis treatment and medications?
* estrogens
* SERMS
* calcium and vit D
* bisphosphonates
* calcitonin
224
Which is the most important age range for taking action to prevent osteoporosis?
*0-20 years old
225
Do men get osteoporosis?
*yes but they have denser bones to begin with
226
What is the average bone mass for men in their 80s?
*about 1300g
227
How much calcium does it take to get the RDA?
* teenagers & > 50=1200mg
* adults 20-49=1000mg
* less than 30% of calcium is actually absorbed (need vitamin D to facilitate the absorption of calcium)
228
What does caffeine have to do with bone health?
*caffeine inhibits calcium absorption
229
What is the benefit of exercise?
* impact of weight-bearing is preferred
| * window of opportunity for building BMD
