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Module 102 > Interactive classes - MK and CC > Flashcards

Interactive classes - MK and CC Flashcards

1
Q

What type of epithelium is the epidermis?

A

Keratinizing stratified squamous epithelium.

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2
Q

Are eccrine sweat glands exocrine or endocrine glands?

A

Exocrine glands because they have a duct.

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3
Q

What functions does the skin perform and which structures contribute? - UV protection

A

Melanocytes

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4
Q

What functions does the skin perform and which structures contribute? - Temperature regulation

A

Vascular plexus, sweat glands, hair

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5
Q

What functions does the skin perform and which structures contribute? - Immune surveillance

A

Langerhans cells, keratinocytes

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6
Q

What functions does the skin perform and which structures contribute? - Waterproofing

A

Stratum corneum, sebum

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7
Q

What functions does the skin perform and which structures contribute? - Psychosexual/social function

A

Hair, pigmentation, apocrine glands

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8
Q

What functions does the skin perform and which structures contribute? - Mechanical barrier

A

Epidermis, dermis, subcutis

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9
Q

What functions does the skin perform and which structures contribute? - Insulation

A

Subcutaneous fat

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10
Q

What functions does the skin perform and which structures contribute? - Calorie storage

A

Subcutaneous fat

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11
Q

What functions does the skin perform and which structures contribute? - Sensory system

A

Merkel cells, free nerve endings, sensory organs and fibres

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12
Q

What vascular and cellular processes have resulted in the accumulation of neutrophils at the site of inflammation?

A

Vasodilatation

Increased vascular permeability and oedema

Emigration of neutrophils and macrophages

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13
Q

How does granulation tissue form?

A

Angiogenesis (vascular proliferation)

Fibroblast proliferation, controlled by macrophages

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14
Q

Which cells are responsible for production of collagen in the healing wound?

A

Fibroblasts produce collagen, controlled by macrophages

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15
Q

How does the scar differ from the adjacent dermis?

A

More cellular (fibroblasts)

Thin collagen

No pilosebaceous units or eccrine sweat glands

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16
Q

How does the overlying epidermis differ from the adjacent epidermis?

A

Hyperplastic epidermis = pseudoepitheliomatous hyperplasia

This will resolve over time

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17
Q

Describe the shapes of the 3 types of epithelial cells

A
  • Squamous = thin and flat
  • Columnar = almost oblong shaped
  • Cuboidal = all sides equal
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18
Q

What is the Most common type of epithelium?

A

Stratified Squamous Epithelium

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19
Q

Describe the Stratified Squamous Epithelium

A

Stratified = cells pile on top of each other

Stratification is necessary at sites of friction with the risk of mechanical damage

Squamous = cells are flat

Squamous epithelium in internal organs appears white on naked eye examination

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20
Q

Stratified Squamous Epithelium could be…

A

keratinised or non-keratinised

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21
Q

What is keratin?

A

Keratin is the protein present in skin cells produced by keratinocytes

Keratin makes the skin impervious

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22
Q

What is the most superficial part of the skin?

A

consists of dead keratinised cells which makes the skin waterproof

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23
Q

The oesophagus is joined to the stomach at the…

A

oesophago-gastric junction (OGJ)

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24
Q

What does oesophagus and stomach mucosa look like?

A

White and Pink

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25
Q

List Some of the organs
lined by squamous epithelium

A

Skin
Mouth and tongue
Oesophagus
Anal canal
Vagina
Cervix

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26
Q

What does Columnar epithelium appears as on naked eye examination?

A

pink/red

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27
Q

Where can I find columnar epithelium?

A
  • Respiratory tract = trachea & bronchi
  • Gastrointestinal tract = stomach, small & large intestines
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28
Q

What is the function of mucus secreted by columnar epithelium?

A

Protects the lining - in the stomach

Traps dust particle - respiratory tract

Acts as lubricant - large bowel and female genital tract

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29
Q

Columnar epithelium of the large intestine consists of test tube like structures termed…

A

crypts

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30
Q

The Upper Respiratory Tract: part of the larynx, trachea & bronchi are lined by …

A

pseudo-stratified columnar epithelium

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31
Q

Why is it called Pseudostratified Ciliated Columnar Epithelium?

A

because all nuclei do not reach the surface

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32
Q

Where are Cuboidal Cells found?

A

Found in glands which secrete specialised fluids, i.e.

  • Salivary glands
  • Sweat glands
  • Endocrine glands secrete hormones
  • Breast produces milk
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33
Q

What does fibrous tissue look like on the breast?

A

White firm appearance

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34
Q

What does fibrous tissue look like underneath a microscope?

A

Pink

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35
Q

Describe the composition of a single breast gland

A

A single breast gland is lined by cuboidal cells (more round than a cube); the lumen contains milk.

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36
Q

What are the Three types of muscle found in the body?

A

Skeletal muscle – Most common muscle: limbs, chest wall, abdominal wall

Smooth muscle – Most internal organs: stomach, small & large intestines, blood vessels, uterus

Cardiac muscle – Only in the heart

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37
Q

Why are Striations important in skeletal muscles?

A

for the contractile function of the muscle cells

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38
Q

What is the name of the thick muscle in the uterus? why is it so thick?

A

myometrium = smooth muscle fibres with cigar-shaped nuclei; no striations

endure the pressure during pregnancy

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39
Q

What is lipofuschin?

A

= Brown pigment is end product of break down of the muscle (wear and tear)

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40
Q

What is mesentery?

A

Fat as connective tissue of the small bowel

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41
Q

What is adipose tissue/cells

A

Fat cells

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42
Q

Why does adipose tissue/cells look honeycomb shaped under a microscope but when to the naked eye it is yellow?

A

processing in different chemicals the fat leaches out

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43
Q

Why is fibrous tissue important?

A

Important connective tissue due to its strength e.g. tendons

Important in healing of wounds to form scars

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44
Q

What does fibrous tissue consists of?

A

Consists of long fibres containing collagen

Fibroblasts produce the protein collagen

In healed wounds, scar tissue and fibrous tissue are used interchangeably

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45
Q

What produces elongated fibres in fibrous tissue?

A

fibroblasts

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46
Q

Give an example of scarring?

A

When the myocardium dies the muscle is replaced by scar tissue

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47
Q

What surrounds arteries and veins?

A

fat as the connective tissue

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48
Q

What type of muscle is in all nerves not in the heart?

A

smooth muscle

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49
Q

What do nerve cells look like under the microscope?

A

wavy/serpentine

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50
Q

The oesophagus is lined by:

A

Non-keratinised stratified squamous epithelium

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51
Q

Which organ contains intercalated discs?

A

The heart

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52
Q

Define normal skin and where can you find it?

A

Baseline - epidermis + dermis

Limbs and chest

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53
Q

What does Individual keratinised squamous epithelial cells appear as under the microscope?

A

pink

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54
Q

Squamous epithelium is held together by intercellular structures termed …

A

desmosomes

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55
Q

Skin from the head/scalp has numerous…

A

hairfollicles that can go deep in subcutaneous fat

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56
Q

What is responsible for dandruff?

A

sebaceous glands

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57
Q

What does skin the face contain?

A

hair follicles and sebaceous glands

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58
Q

Describe how acne can be caused

A

Sebaceous glands are controlled by sex hormones

Secretions are rich in lipid

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59
Q

Describe skin from the back

A

thin epidermis but thick dermis; no hairs

60
Q

Describe the skin from the palms of hand or soles of the foot

A

thick cornified layer of the epidermis (thick skin)

61
Q

What are the 5 layers of the epidermis?

Extensively

A

Stratum cornium; cornified layer

Stratum lucidium; only found in thick skin; it’s the pink thin layer of uniform tissue which separates the SC from SG

SG: Stratum granulosum; granular layer

SS: Stratum spinosum; spinous or prickle cell layer; desmosomes are present in this layer

SB: Stratum basalis; basal layer or germinative layer

62
Q

When irritated from scratching as in eczema what happens to the epidermis?

A

The epidermis develops a thick cornified layer

The stratum spinosum also becomes thick, a condition termed acanthosis

63
Q

Name the organs lined by non-keratinised squamous epithelium: Top to Bottom

A

M for Mouth
E for Esophagus
A for Anal canal
C for Cervix
V for Vagina

64
Q

What does the dermis layer primarily consist of?

A

collagen and elastin fibres which are produced by the fibroblasts

65
Q

What does Excessive sun exposure do to the dermis?

A

damages the dermis to produce solar elastosis & appears featureless

66
Q

Loss of elasticity produces wrinkles as in aging. The protruding lesion is appropriately named as a…

A

cutaneous horn and consist of keratin

67
Q

Where are eccrine glands found?

A

present all over the body

68
Q

Where are apocrine glands found?

A

in the axilla, nipple and groin

69
Q

What are eccrine glands responsible for?

A

responsible for control of body temperature

70
Q

What are apocrine glands responsible for?

A

responsible for body odour

71
Q

Which type of sweat gland is larger?

A

Apocrine

72
Q

What are the 2 layers of cells eccrine glands consist of?

A

Inner secretory epithelial cells and the outer myo-epithelial cells

73
Q

What is the shape of the cells lining the glands?

A

Cuboidal epithelium

74
Q

What is the medical condition which uses the sweat test for diagnosis?

A

Cystic fibrosis

75
Q

What are the main constituents of sweat?

A

Water and
Salts/Sodium chloride

76
Q

Where is the sweat contained in apocrine sweat glands?

A

In the lumen

77
Q

Why does sweat smell?

A

bacterial fermentation

78
Q

Where do melanocytes originate?

A

neural crest - the part of the embryo which will develop into brain and nerves

78
Q

When do melanocytes migrate to the skin?

A

During embryological development

79
Q

How can congenital naevus or birth marks be made?

A

Abnormal migration and concentration of melanocytes in a single site

80
Q

What controls melanin production?

A

enzyme tyrosinase

81
Q

Where are melanocytes found?

A

found between the epithelial cells (keratinocytes) and have clear spaces around them (arrows)

82
Q

What is the concequence of congenital naevus (birthmarks)

A

Leads to staring and teasing

High risk of developing melanoma (a type of skin cancer) at a young age

83
Q

What does Lack of enzyme tyrosinase lead to?

A

albinism

84
Q

What is Vitiligo thought to be?

A

an autoimmune disease where one’s immune system attacks the melanocytes

85
Q

What are the Major Types of Skin Cancer?

A

Malignant melanoma (MM) - from melanocytes

Squamous cell carcinoma (SCC) - resembles normal skin in production of keratin

Basal cell carcinoma (BCC) - resembles cells of basal layer of the epidermis

86
Q

Which skin cancers are Non melanoma skin cancer (NMSC)?

A

Squamous cell carcinoma (SCC)

Basal cell carcinoma (BCC)

87
Q

Prognosis of all cancers is assessed using the TNM stage thus:

A

T = tumour size (diameter) or depth of invasion

N = node (whether there is lymph node metastasis or not)

M = metastasis to the liver, lung, bone etc.

88
Q

Malignant Melanoma (MM) has the Third most common cancer of the skin.

Why does it also have the worst prognosis of all skin cancers?

A

Has propensity to spread to the lymph nodes, lungs, liver and brain

89
Q

What is acral malignant melanoma?

A

Patients of African, Japanese and Asian origin tend to develop melanoma in non-sun exposed areas like the feet and hands

90
Q

Microscopically the melanin from the cancer cells is present as …

A

dispersed or collections of brown /black pigment

91
Q

Squamous cell carcinoma (SCC) is the Second most common cancer of the skin. What can it be classified as (3 classifications)?

A

well differentiated - when the cancer cells produce lots of keratin

Moderately differentiated - moderate amount of keratin

Poorly differentiated - little or no keratin
i.e. graded on how closely the cancer resemble skin

92
Q

Can SCC also spread to lymph nodes and other organs?

A

Yes

93
Q

What is the Histology of Well differentiated SCC of the skin with good prognosis

A

Lots of keratin production

Round base

Minimal invasion of dermis

94
Q

What is the histology of Moderately differentiated SCC of the skin; moderate prognosis?

A

Moderate amount of keratin

Irregular base

More invasive

95
Q

What must we use to identify poorly differentiated SCC and what would we observe (histology)?

A

infiltrating the stroma in a haphazard (random) manner; no keratin production

96
Q

What is the most common cancer of the skin in the western world?

A

Basal Cell Carcinoma (BCC)

97
Q

Describe the ket features of Basal Cell Carcinoma (BCC) (4)

A

Infiltrates locally, but rarely spreads to other organs

Tends to be multiple

Tends to recur

Can be disfiguring if on the face

98
Q

What do basal cells look like under the microscope?

A

BCC cells are blue

99
Q

Excision

A

the act or procedure of removing by or as if by cutting out

100
Q

In Advanced squamous cell carcinoma,
What major blood vessels are located beneath the cancer? (hint near neck and ear)

A

Carotid arteries and jugular veins

101
Q

List 4 functions of the keratinised layer of the skin

A
  1. Protects against infection
  2. Prevents dehydration
  3. Consist of dead cells
  4. Increases in thickness when irritated
101
Q

List 4 things that can occur due to Excessive sun exposure

A
  1. Increases melanin pigmentation/tanning
  2. Causes solar elastosis
  3. Causes wrinkling
  4. May lead to skin cancer
102
Q

Thick skin is: T/F

  1. Held together by desmosomes (T)
  2. Present on the back (F); has thick dermis, not epidermis
  3. Present on the sole of the foot (T)
  4. Present on the head (F)
A

True:

Held together by desmosomes (T)

Present on the sole of the foot (T)

103
Q

What are the 3 categories of inflammation?

A

Acute inflammation e.g. acute tonsillitis when the neutrophil is the dominant cell

Chronic inflammation e.g. chronic gastritis when the lymphocyte is the predominant cell

Active chronic inflammation when there is a mixture of neutrophils and lymphocytes e.g. active chronic gastritis

104
Q

What causes Breast abscess or mastitis?

A

stagnation of milk which gets infected

105
Q

What is the first cell to appear at the sight of inflammation and why?

A

Neutrophils

to ‘eat’ the bacteria or the antigen causing the inflammation

106
Q

What are the 5 theoretical cardinal signs of inflammation?

A
  1. Hot (calor)
  2. Red (rubor)
  3. Swollen/oedema (tumor)
  4. Pain (dolor)
  5. Loss of function (functio laesa)
107
Q

When does an abscess occur?

A

when inflammation causes tissue destruction to form a cavity containing lots of neutrophils and dead tissue (the pink material)

108
Q

What are the cells of chronic inflammation?

A

Lymphocytes - one nucleus and a small amount of cytoplasm

Specifically -

B lymphocytes differentiate to plasma cells to produce antibodies

T cells help in the process of inflammation

109
Q

What do antibodies make the bacteria more?

A

more palatable (opsonise) for the polymorphs

110
Q

Can you name antibodies produced by plasma cells?

A

IgM
IgG
IgA
IgE
IgD

111
Q

What do eosinophils associate with?

A

with allergic reactions such as asthma and parasitic infections

112
Q

What mediates the accumulation of Eosinophils?

A

IgE produced by plasma cells

113
Q

Describe what Eosinophils look like

A

the cytoplasm contains granules which take up the pink stain avidly

114
Q

What is a polyp?

A

A polyp is an abnormal growth protruding
growth into a cavity

115
Q

Why is the polyp pale on microscopy?

A

excess fluid called oedema

116
Q

What do Monocytes look like in a blood smear?

A

Has a single reniform (kidney – shaped) nucleus and lots of cytoplasm

117
Q

What is the function of a monocyte?

A

Functions as a phagocyte, but does not do this in the circulation but in the tissues where it is known as macrophage or histiocyte

118
Q

A macrophage is a cell of…

A

chronic inflammation

119
Q

When macrophages accumulate to form a collection of cells – this is known as a

A

granuloma

120
Q

What is a Horse-Shoe Shaped Giant Cell?

A

When macrophages join up together to create a single cell with multiple nuclei

121
Q

Which condition is associated with this horseshoe-shaped Langhan’s giant cell?

A

TB

122
Q

What are the causes of poor wound healing? (6)

A

Poor circulation due to atheroma

Presence of infection

Excess movement e.g. fractures

Foreign body in the wound e.g. suture material

Vitamin C deficiency

Diabetes mellitus is also associated with poor circulation

123
Q

What does Granulation Tissue consist of?

A

Oedematous fibrous tissue
New blood vessels

124
Q

When does granulation tissue occur/appear?

A

Acute and chronic inflammation

125
Q

Granulation Tissue is essential for the…

A

Is essential for the healing process
skin grafting

126
Q

What is Wound Healing by Primary Intention?

A

when the skin edges come together properly

127
Q

What happens to The material used to suture in wound healing by primary intention?

A

the wound is usually destroyed by macrophages which join up to create foreign body giant cells

128
Q

What is healing by secondary intention?

A

occurs when the wound is too large for the edges to come together or there are other factors that interfere with wound healing.

129
Q

Describe Wound Healing by Skin Graft

A

Sometimes the wound is too large even for healing by secondary intention
A skin graft from another site is applied

130
Q

What does excess accumulation of scar tissue lead to…

A

keloid formation

131
Q

What are the 4 adaptations of cells they can do in a hostile environment?

A

Metaplasia
Hypertrophy
Atrophy
Hyperplasia

132
Q

What is metaplasia?

A

Occurs when one type of mature cell differentiates to another form of mature cell

133
Q

Metaplastic epithelium is associated with high risk of…

A

developing cancer

134
Q

Examples of Metaplasia in the Oesophagus?

A

Squamous epithelium changes to columnar epithelium = Barrett’s oesophagus due to gastric contents reflux

135
Q

Examples of Metaplasia in the Bronchus

A

Pseudostratified ciliated columnar epithelium changes to squamous epithelium due to smoking

136
Q

Examples of Metaplasia in the Cervix

A

Columnar endocervical mucosa infected by HPV changes into squamous epithelium

137
Q

What is Barrett’s Oesophagus?

A

Acid reflux from the stomach into the oesophagus

This causes inflammation -> reflux oesophagitis

The squamous epithelium (white) is replaced by columnar epithelium (pink) to cope with the acidity -> gastric metaplasia or intestinal metaplasia

Barrett’s oesophagus is associated with risk of adenocarcinoma

138
Q

Describe Squamous Metaplasia in Bronchus

A

Smoking destroys the ciliated pseudo-stratified columnar epithelium which differentiates into a more resilient squamous epithelium

Squamous metaplasia has an increased risk of squamous cell carcinoma of the lung

139
Q

What is Hypertrophy?

A

Can be physiological or pathological

Hypertrophy occurs due to increase in the size of cell resulting increase in the size of the organ

140
Q

What is Atrophy? Use an example

A

Atrophy occurs when the cell decreases in size resulting in shrinkage of the organ
e.g. post menopausal atrophy of the uterus due to lack of oestrogen stimulation

141
Q

When does hyperplasia occur?

A

when there is increase in number of cells which results in increase in the size of the organ

142
Q

Give an example of hyperplasia

A

the increase in number of cells in the prostate in older men resulting in condition termed benign prostatic hyperplasia (BPH)

This causes problems with urination
Can result in urine retention

143
Q

A 32-year-old woman presented with a
breast abscess. Which are the predominant
cells in an abscess?

A

Neutrophils

144
Q

Metaplasia is associated with an increased
risk of cancer. What causes metaplasia?

A

Cells differentiate from one form of mature cells to another in the organ

Module 102 (11 decks)

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