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Integ Patho (PTH 701) Quiz #1 > Layers of Skin and other stuff from Lecture #1 > Flashcards

Layers of Skin and other stuff from Lecture #1 Flashcards

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1
Q

Which layer of skin is the first barrier against infection and foreign substances?

A

Epidermis

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2
Q

Which layer of skin retains moisture?

A

Epidermis

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3
Q

Which layer of skin nourishes and supports the epidermis?

A

Dermis

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4
Q

Which layer of skin assists with infection control?

A

Dermis (Houses mast cells and macrophages)

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5
Q

Which layer of skin assists with thermoregulation?

A

Both Dermis AND Epidermis

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6
Q

Which layer of skin houses skin appendages

A

Dermis

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7
Q

Which layer of skin provides light touch sensation?

A

Epidermis for light touch, but dermis also provides sensation

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8
Q

Which layer of skin assists with excretion (sweat)

A

Epidermis

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9
Q

Which layer of skin assists with Vitamin D production?

A

Epidermis

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10
Q

Which layer of skin contributes to cosmesis (appearance and identity)?

A

Epidermis

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11
Q

What makes up the Integumentary System?

A
  • Skin
  • Appendages
  • Hair / hair follicles
  • Nails*
  • Glands
  • -Eccrine sweat glands
  • -Apocrine sweat glands
  • -Sebaceous sweat glands
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12
Q

Skin receives how much resting cardiac output?

A

1/3

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13
Q

How much % of body weight is the skin?

A

15-20%

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14
Q

What determines the color of skin?

A

How active melanin production is (Melanocytes produce the protein pigment melanin).

Also influenced by Carotene (pigment) and oxygenated hemoglobin

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15
Q

What is the pH of our skin?

A

4-6.5

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16
Q

What is another name for the Basement Membrane Zone?

A

Rete Ridges - decreases overall shearing forces

Connects epidermis and dermis

Rete bridges lost in full-thickness burn victims and the elderly

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17
Q

What is the most plentiful of all the epidermal cells?

A

Keratinocytes

  • Produce Keratin / “horny layer”
  • Migrate from s. basale to s. corneum
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18
Q

What are Langerhans’ Cells

A

Immune cells - found in s. basale

provide antigens to T-lymphocytes

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19
Q

What are Merkel Cells?

A

Mechanoreceptors - found in s. basale

The Merkel cell is located in or near the basal layer of the epidermis and is closely associated with terminal axons.

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20
Q

Which layer of skin is known as the “true skin?”

A

Dermis - primarily connective tissues to provide structure for skin

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21
Q

What protein fibers make up the dermis?

A

Collagen, elastin, and reticular

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22
Q

What are the two layers of the dermis?

A

Papillary dermis (highly vascular) and Reticular Dermis (deepest layer, contains appendages)

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23
Q

What layer of skin is “dead but waterproof?”

Study These Flashcards
A

Stratum corneum – layer of dead skin cells – contributes to thickness of skin (i.e. around the eye vs. the sole of the foot). P. 86 Sussman – “the acid mantle and stratum corneum make the skin less permeable to water & other polar compounds, and indirectly protect the skin from invasion by microorganisms.”

24
Q

What is the pH of an open wound?

Study These Flashcards
A

Open wound pH 6.5 – 8.5. As resurfacing occurs 5.9

25
What are the majority of epidermal cells?
Keratinocytes: majority of epidermal cells –form deepest sublayer - produce keratin – fibrous protein that is water insoluble
26
What layer of the epidermis is only found in thick skin?
Stratum lucidum – only in thick skin like palms and soles of feet. Stratum corneum – dead keratinocytes
27
What layer of skin gives you your fingerprint
Dermis - see class notes
28
I am "hairy and sweaty". What layer am I?
Epidermis?
29
How many layers comprise the epidermis of the skin on the dorsum of your hand?
Only 4. No s.l. because it's not thick
30
What are the 3 Stages of Healing
(Hemostasis) 1. Inflammation 2. Repair (granulation, epithelialization, contraction) 3. Remodeling
31
What are the 5 cardinal signs of inflammation?
``` Pain Erhythema (redness) Calor / incr. temp Swelling Loss of function ```
32
What is hemostasis?
Retraction and sealing off of blood vessels Achieved as a direct effect of formation of PLATELET plug
33
What are the cells present in the highest number shortly after wounding?
Platelets - Activated by exposed collagen in the subendothelial CT of blood vessels - Release a number of factors into the blood - -Growth factors / cytokines - -Pro-inflammatory factors (e.g. serotonin)
34
What is a fibrin clot?
A stable matrix of fibrinogen Serves as structure for other cells during wound healing process
35
How long does the inflammation stage last?
4-6 days
36
What makes up the inflammation stage?
Leukocytes: - Mast Cells - -Histamine - Neutrophils - Marcophages - Lymphocytes
37
Who do Neutrophils do?
NEUtrophils Predominate during the first 1-24 hours Purpose is to fight infection Pus is an accumulation of dead neutrophils that have phagocytized debris and bacteria May not occur in asceptic wound
38
What do monocytes do?
Convert into macrophages as they enter the wound Predominate during 24-48 hours
39
What to macrophages do?
Main role in inflammation is PHAGOCYTOSIS Initially function in hypoxic environments to promote angiogenesis and transition to repair phase through cytokine secretion
40
When does the Proliferation / Repair stage take place?
Day 4-14 (after angiogenesis) Granulation, Wound contraction, and epilethelialization
41
What is Granulation?
Granulation tissue is dependent on neovascularization / angiogenesis Tissue is rich in fibroblasts & collagen
42
When does Wound Contraction start?
Around Day 4 MYOFIBROBLASTS pull the entire wound together, thereby shrinking the defect and amount of scar tissue that will form Wound closure – skin & mm 5-8 days Tendon – lig 3-5 weeks
43
What does Epithelialization do?
Creates a barrier between wound surface and environment - Keratinocytes - To decrease risk of infection - To prevent loss of fluid / electrolytes Requires oxygen and moist environment - O2 comes from blood supply - It is best to cover wound - Different coverings available for "moisture balance" Like a train, migrates adjacent to each other?
44
When does Remodeling / Maturation take place?
From Day 8 onward up to 1 year (or more) Remodeling scar / collagen reorganization: - To fit the tissue - To fit the function - Balance between synthesis and lysis Keloid = mushrooms beyond margin of scar - similar but not hypertrophic
45
What is the difference between regeneration and repair?
Regeneration = "epithelialization or new skin formation" Repair = "wound healing that involves granulation tissue formation, wound contraction, and epithelialization
46
What are some factors that determines scarring?
- Depth of initial wound | - What was the healing environment
47
What makes a wound chronic?
Gets stuck somewhere in the normal healing process -Fail to follow normal healing Typically has one of the following: - Prolonged inflammation - Failure to progress through the proliferative phase - Failure to epithelialize
48
Which macronutrient is essential for wound healing?
PROTEIN!
49
What are some factors that influence healing?
Wound characteristics / Local Factors Systemic factors Clinician induced Local- wound environ, size-location-type of wound, infection, vascular supply, oxygen, external forces, movement Clinician induced + / - MEDS: steroids, anticoagulants, immunosupression drugs all -, nutrition – need protein, vit C, zinc, iron Systemic- age, nutrition, circulation, disease, medication, immune status VITAMIN C – critical for collagen cross-linkage & tensile strength Moffat et al. – age, nutrition, hydration, co-morbidities, immunosuppression, stress, infection, smoking
50
What are some Wound / Local Factors that influence healing?
pH -Incontinence Local ischemia, moisture, infection, repeated trauma from inapprorpiate care (e.g. pressure, dressing changes)
51
What are some Systemic Factors that influence healing?
Medications, age, comorbidities, bloodflow (perfusion and oxygenation - smokers), infection, nutrition, stress
52
What are some clinician induced factors that influence healing?
Poor management of medications, topical agents, dressing changes
53
How is the Epidermis nourished?
By diffusion from the dermis! The epidermis contains no blood vessels
54
How long does it take for Keratin to travel from the deepest layer (s. basale) to s. corneum?
28 days
55
Most common stage chronic wound is stuck in?
2. Proliferation / Repair

Integ Patho (PTH 701) Quiz #1 (8 decks)

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