Integumentary System

Question 1

List some important functions of the skin

Answer 1

Abrasion prevention, dessication/infection prevention, body temperature regulation, absoprtion of UV for vitamin D synthesis, reception of external stimuli

Question 1

What specialized cells are present in the stratum basale?

Answer 1

Melanocytes, Merkel cells

Question 2

Cells of the upper stratum spinosum possess (x) which, when released, produce a (y) effect

Answer 2

Keratohyalin granules (x), waterproofing (y)

Question 3

Describe contact inhibition in epidermal wound healing

Answer 3

Basal cells enlarge and migrate across wound until they meet each other where cells stimulate stem cells to divide and replace lost cells

Question 4

Describe the basic pathways in effect during the different phases of deep wound healing: inflammatory? migratory? proliferative? maturation?

Answer 4

Inflammatory: peripheral blood clot, vasodilation, leukocyte infiltration; Migratory: epithelial cells bridge the wound, fibroblasts synthesize collagen/glycoprotein; Proliferative: epithelial growth, angiogensis; Maturation: scab sloughs off, epidermis normal thickness, fibroblasts decrease, scar = fibrosis

Question 5

Melanocytes produce (x) (via the enzyme (y)) which serve to (z)

Answer 5

Melanin (x), tyrosinase (y), shield genetic material from harmful UV radiation (z)

Question 6

What are the phases of deep wound healing?

Answer 6

Inflammatory, migratory, proliferative, maturation

Question 7

What condition is characerized by hyperkeratosis and parakeratosis?

Answer 7

Psoriasis

Question 8

Which cellular apparatuses are effected in the following pathologies: bullous pemphigoid? pempighus vulgaris?

Answer 8

Hemidesmosomes (BP), desmosomes (PV)

Question 9

Describe the histopathogenesis of squamous cell carcinoma

Answer 9

Malignant tumor of keratinocytes, usually due to inactivation of p53 gene, characterized by hyperkeratosis and parkeratosis

Question 10

Keratohyalin granules are composed of (x) and (y) rich proteins that appear to bind (z)

Answer 10

Histidine (x), cysteine (y), kertain filaments (z)

Question 11

The (x) layer does not possess nuclei or organelles, but contains (y) which is believed to be produced from keratohyalin

Answer 11

Stratum lucidum (x), eledin (y)

Question 12

(x) are derived from the bone marrow, reside in the stratum spinosum, contain (y) and function as (z)

Answer 12

Langerhans cells (x), Birbeck granules (y), APCs (z)

Question 13

(x) are present in the stratum basale, contain (y) and receive afferent nerve sensation believed to be important in (z)

Answer 13

Merkel cells (x), small dense-cored granules (y), sensory mechano-receptors (z)

Question 14

What are the three primary parts of hair?

Answer 14

Cuticle, cortex, medulla

Question 15

What structures comprise the internal root sheath of a hair follicle?

Answer 15

Henle’s layer, Huxley’s layer, cuticle

Question 16

What structures comprise the external root sheath of a hair follicle?

Answer 16

Continuation of stratum malpighii

Question 17

What structures are external to the outer root sheath of a hair follicle?

Answer 17

Glassy (basement) membrane, CT sheath (dermis)

Question 18

Eccrine glands are tubular coiled glands comprised of what cell types?

Answer 18

Dark cells, clear cells, myoepitheal cells

Question 19

How are apocrine and eccrine glands similar? different?

Answer 19

Similar: secrete sweat, large coiled secretory portion eveloped by myoepithelial cells, not always associated w/ hair follicles; Different: age of onset, location (apocrine: axilla, nipple areola, circumanal region)

Question 20

Compare eccrine and apocrine integument glands on the following characteristics: size? location? innervation? consistency?

Answer 20

Eccrine: small, all skin, cholinergic, watery; Apocrine: large, certain areas, adrenergic, viscous

Question 21

Where are mitotic cells of sebaceous glands located?

Answer 21

Near ducts

Question 22

Name the strata of the epithelium from deep to apical

Answer 22

Strata basale, spinosum, granulosum, lucidum, corneum

Question 23

What is the other name given for the combined stratum basale/spinosum layers?

Answer 23

Stratum malpighii

Question 24

The resident macrophage of the skin is the (x) and is usually located in the (y) layer

Answer 24

Langerhands cell (x), stratum spinosum (y)

Question 25

Cells of the (x) layer possess intercellular bridges between each other, namely made of (y)

Answer 25

Stratum spinosum (x), desmosomes (y)

Question 26

The underlying dermis possesses layers made of what type of tissue?

Answer 26

Papillary (loose CT), reticular (dense irregular CT)

Question 27

Which stratum/a are generally not seen in thin skin?

Answer 27

Stratum granulosum, lucidum

Question 28

Denote the epithelium of the following eccrine sweat gland parts: duct system? secretory portion?

Answer 28

Stratified cuboidal (duct), simple cuboidal + myoepithelial cells (secretory)

Question 29

Describe the mechanism of sebaceous cell secretion

Answer 29

Daughter cells migrate to alveolus, produce secretory product, break down, producing sebum

Question 30

Which two layers of the epithelium possess mitotic capabilities?

Answer 30

Strata basale, spinosum

Question 31

What condition is characterized by the increased proliferation rate of mitotic cells leading to thickened epidermis?

Answer 31

Psoriasis

Question 32

What is the most apical strata where nuclei are present?

Answer 32

Stratum granulosum

Question 33

How may medication/substances be delivered through the skin?

Answer 33

Transdermal patches (nicotine, steroid, sea sickness, nitroglycerine, menopause)

Question 34

What are the two general types of wound healing?

Answer 34

Epidermal, deep (dermal)

Question 35

Are blood vessels needed/repaired in either epidermal or deep wound healing?

Answer 35

No (epidermal), Yes (deep)

Question 36

When a scar is raised but in the normal boundary, it is said to be (x), when it extends its boundary it is said to be (y)

Answer 36

Hypertrophic (x), keloid (y)

Question 37

What is the condition termed where hyperplasia occurs in the horny (corneum) layer of the skin?

Answer 37

Hyperkeratosis

Question 38

What is the condition termed if nuclei are retained in the stratum corneum?

Answer 38

Parakeratosis

Question 39

What is a condition termed if the body produces an immune response against its own tissues?

Answer 39

Autoimmune

Question 40

What is the condition termed where there is a loss of intercellular connections (e.g. keratinocytes)?

Answer 40

Acantholysis

Question 41

What is the condition termed if epidermal hyperplasia is present in the stratum spinosum?

Answer 41

Acanthosis

Question 42

What is the system termed that present effects lysis effects on cells and Ab-Ag complexes (inclusive of cytokine release)

Answer 42

Complement system

Question 43

What system can be described as having a substance being produced from one cell to have the actions of another take effect?

Answer 43

Complement system

Question 44

Describe the histopathogenesis of psoriasis

Answer 44

Autoimmune T-cells migrate to dermis and secrete cytokines to signal marked epidermal growth, leads to increased epidermal (s. corneum) thickening

Question 45

List some etiologies of psoriasis

Answer 45

Stress, bacteria, alcohol, temperature change, tattoo, medication (lithium/hormones), smoking, cuts/bruises

Question 46

What condition is characterized by chronic autoimmune blistering of the skin?

Answer 46

Bullous pemphigoid

Question 47

Describe the histopathogenesis of bullous phemphigoid

Answer 47

Autoantibodies (IgG) bind to basement membrane, stimulate leukocytic infiltration, eosiniphils degrade hemidesmosomes

Question 48

What condition is characterized by an autoimmune separation of epidermal cells and atrophy of the prickle layer?

Answer 48

Pempighus vulgaris

Question 49

Describe the histopathogenesis of pempighus vulgaris

Answer 49

Autoimmune disorder producing antibodies against cadherins/desmoplakins leading to the disruption of desmosomes

Question 50

In which stratum are the effects of pempighus vulgaris most often noticed?

Answer 50

Stratum spinosum

Question 51

Where may lesions associated with pempighus vulgaris be viewed?

Answer 51

Back, mouth

Question 52

What condition is characterized by a loss of pigmentation of the skin, hair and eyes?

Answer 52

Albinism

Question 53

Describe the histopathogenesis of albinism

Answer 53

Gene mutation that regulates melanin synthesis, inability of cell to pick up tyrosine, tyrosinase inactivity

Question 54

List some long term implications of individuals with albinism

Answer 54

Skin cancers, reduced visual acuity, photophobia, social stigma

Question 55

What condition is characterized by an autoimmune destruction of melanocytes producing a depigmentation disorder?

Answer 55

Vitiligo

Question 56

What types of vitiligo are possible?

Answer 56

Focal, segmental, generalized

Question 57

What treatments are available for vitligo?

Answer 57

Topical steroid therapy, psolaren photochemotherapy, depigmentation, autologous skin graft, micropigmentation, melanocyte transplants

Question 58

In burn victims, what method is used for approximating the amount of body burned?

Answer 58

Rule of nines

Question 59

Differentiate between a first, second and third degree burn in terms of skin damaged

Answer 59

First: epidermis only, Second: epidermis and dermis (BVs, blebs), Third: epidermis/dermis vacant

Question 60

Differentiate between first/second/third degree burns in terms of pain felt

Answer 60

First/Second: pain present (meissner's corpuscles present), Third: meissner's corpuscles burned away

Question 61

T/F: Malignant cells demonstrate pleomorphic variations

Answer 61

True

Question 62

List some common risk factors for squamous cell carcinoma

Answer 62

Age (older), fair skin, disposition to sunlight exposure, carcinogen exposure

Question 63

What are the general types of squamous cell carcinoma?

Answer 63

Superficial, infiltrative

Question 64

Describe infiltrative squamous cell carcinoma

Answer 64

Dermis infiltrated by malignant squamous cells, islands resemble basal cells, visually have formation of squamous pearls of swirls

Question 65

List a risk factor for basal cell carcinoma

Answer 65

UV light exposure

Question 66

Describe the appearance of basal cell tumors

Answer 66

Surrounded by a single layer of basal cells (cuboidal), palisade arrangement

Question 67

The malignant transformation of a melanocyte leads to (x) and is the (y) of skin cancer-related deaths in the U.S.

Answer 67

Malignant melanoma (x), leading cause (y)

Question 68

List a risk factor for malignant melanoma

Answer 68

Caucasian/Australian/S. African races, UV exposure

Question 69

T/F: Melanocytes which are malignant present similarly when compared to normal cells

Answer 69

False

Question 70

Explain the A-B-C-D-Es associated with clinical diagnosing of skin carcinomas

Answer 70

Asymmetry, border irregulatiry, color variation, diameter, elevation

Question 71

Areas with increased sebaceous glands are prone to (x) a disorder common in (y)

Answer 71

Acne (x), adolescents (y)

Question 72

Which areas of the body are prone to fungal infection?

Answer 72

Hair

Question 73

What conditions may arise from fungus origins?

Answer 73

Dermatophytosis, tinea vericolor, tinea corporis (ringworm), infections

Question 74

What condition is characterized by benign neurofibromas located all over the body and which is congenital (chr 17)?

Answer 74

Neurofibromatosis (Von Recklinghausens disease)

Question 75

What are the major components of the skin?

Answer 75

Epidermis, dermis

Question 76

List some appendages of the skin

Answer 76

Sweat glands, hair follicles, sebaceous glands, nails

Question 77

How many layers are present in the stratum basale?

Answer 77

One

Question 78

Which type of granules found in the stratum granulosum stain darkly with H&E?

Answer 78

Keratohyalin (basophilic)

Question 79

The most apical layer of the epidermis is known as (x) but can also be called (y) if cells are found to be flaking off

Answer 79

Stratum corneum (x), stratum disjunctum (y)

Question 80

Melanocytes possess (x) which aid in transferring melanosomes to which strata?

Answer 80

Cytoplasmic extensions (x), stratum basale & stratum spinosum

Question 81

The transfer of melanosomes from one cell to another is an example of what?

Answer 81

Cytocrine secretion

Question 82

What shape do Birbeck granules look like?

Answer 82

Barbells

Question 83

What structures are present in the upper papillary layer of the dermis and what is their function?

Answer 83

Meissner's corpuscles, fine touch receptors

Question 84

What structures can be found in the deeper regions of the dermis and what is their function?

Answer 84

Pacinian corpuscles (pressure receptors), Krause's end bulbs (cold/pressure receptors)

Question 85

Where do arrector pili muscles attach and insert?

Answer 85

Attach to hair follicles in dermis, insert into papillary layer of dermis

Question 86

Where is the bulb of a hair follicle located?

Answer 86

Papillary layer of dermis

Question 87

What structure overlies the crescent-shaped whitish lunula of a distal phalanx?

Answer 87

Eponychium

Question 88

What structure is located beneath the free edge of a nail?

Answer 88

Hyponychium

Question 89

Where are cells located which are responsible for nail growth?

Answer 89

Cells in the nail matrix

Question 90

Describe the appearance of eccinr sweat gland myoepithelial cells

Answer 90

Lie on basal lamina, underlie dark cells, rich in mitochondria and glycogen

Question 91

Describe the cell type within the eccrine sweat gland lumen

Answer 91

Stratified cuboidal (duct), many keratin filaments prominent terminal web, rich in mitochondria

Question 92

Where do apocrine cells secrete their products?

Answer 92

Into areas superficial to duct entry from sebaceous glands

Question 93

What other glands can be accredited with being apocrine in nature?

Answer 93

Ceruminous (wax) glands

Question 94

Integument refers to the (x) and its (y)

Answer 94

Skin (x), appendages (y)

Question 95

(x) from the epidermis interdigitate with (y) from the dermis to form an irregular contour

Answer 95

Epidermal pegs (x), dermal papillae (y)

Question 96

(x) project to produce (y) which can be seen as raised protrusions (e.g. on the finger tips)

Answer 96

Dermal papillae (x), epidermal ridges (y)

Question 97

How often does skin regenerate and what time of day does mitotic acitivty usually occur?

Answer 97

2-4 weeks, night

Question 98

The (x) is the deepest layer of cells, attached directly to the basal lamina via (y)

Answer 98

Stratum basale (x), hemidesmosomes (y)

Question 99

What shape are stratum basale cells?

Answer 99

Cuboidal to columnar

Question 100

T/F: Melanocytes are able to be distinguished from LM

Answer 100

False

Question 101

T/F: Langerhans cells are considered to be APCs

Answer 101

True

Question 102

T/F: Only the cells in the stratum basale are mitotically active

Answer 102

False

Question 103

Cells in the (x) possess large amounts of membrane-coating, keratohyalin and melanosome granules

Answer 103

Stratum granulosum

Question 104

Compared to normal amounts of stratum cornuem present, how much stratum disjunctum is present in: thin skin? thick skin?

Answer 104

High percentage (thin), low percentage (apical, thick)

Question 105

Where are melanocytes derived from?

Answer 105

Neural crest

Question 106

Detection of actual melanocytes can only be possible by using what technique?

Answer 106

Electron microscopy

Question 107

T/F: The number of melanosomes is independent of race

Answer 107

True

Question 108

What types of fibers are present in the dermis?

Answer 108

Type I collagen, thick elastic fibers, Type III collagen

Question 109

T/F: Meissner's corpuscles do not possess capsules

Answer 109

False

Question 110

Contraction of arrector pili muscles is induced by the (x) nervous system giving the appearance of (y)

Answer 110

Autonomic (x), goose bumps (y)

Question 111

T/F: The arrector pili muscle originates in the CT sheath of the hair follicle

Answer 111

True

Question 112

Describe the characteristics of thick skin

Answer 112

Thick epidermis (prominent stratum corneum), some stratum disjunctum, lacks hair follicles/sebaceous glands/arrector pili

Question 113

Where is thick skin located on the body?

Answer 113

Palms of hands, soles of feet

Question 114

Describe the characteristics of thin skin

Answer 114

Thin epidermis (minimal strtum corneum), some stratum disjunctum, contains hair follicles/sebaceous glands/arrector pili, thick dermis

Question 115

Where is thin skin located on the body?

Answer 115

Most of body surface

Question 116

What is a nail composed of?

Answer 116

Hard keratin

Question 117

What glands comprise more than 90% of sweat glands?

Answer 117

Eccrine glands

Question 118

T/F: Eccirne glands are specific to certain areas of the body

Answer 118

False

Question 119

T/F: Myoepithelial cells surround eccrine secretory duts only (within the integument system)

Answer 119

True

Question 120

Where are apocrine sweat glands located?

Answer 120

Axilla, nipple areola, circumanal region

Question 121

In what layer of the integument are apocrine glands locatd?

Answer 121

(Deep) dermis

Question 122

T/F: No part of the secretory cell becomes part of the apocrine secretion

Answer 122

False

Question 123

Where do sebaceous glands drain into?

Answer 123

Neck of hair follicle

Question 124

T/F: All of sebaceous cells are disposed of during holocrine secretion

Answer 124

True