Pt 2. Integument and Barriers to Infection

Question 1

____ thickens and forms plaques in psoriasis

Answer 1

stratum corneum

Question 2

Keratinization of new cells and desquamation is followed by _____

Answer 2

wound contraction

Question 3

occurs with
more extensive loss of tissue, where
wound edges do not approximate
(e.g., infarct, ulcer, abscess)

Answer 3

Second intention healing

Question 4

Comparing first to second intention healing: Which involves wound contraction?

Answer 4

Second

Question 5

Burn involves only epidermis

Answer 5

1st degree burn

Question 6

_____ also known as eczema, is inflammation of the skin

Answer 6

Dermatitis

Question 7

How long to fill a 1cm wide cut?

Answer 7

3 weeks

Question 8

Takes ~ 25 days for cells to mature from stratum
basale to stratum corneum => _______

Answer 8

keratinization

Question 9

What happens immediately after an incision is made?

Answer 9

It fills with blood and clots

Question 10

Name 3 common skin tumors

Answer 10

Squamous cell carcinoma
Basal cell carcinoma
Melanoma

Question 11

What happens on day 5 of wound repair?

Answer 11

incision filled with granulation
tissue

Question 12

Simultaneous proliferation/
maturation of keratinocytes behind
migrating front slowly restores
_____

Answer 12

multilayered, stratified epidermis

Question 13

Epithelial cells of _____ begin
mitosis => epithelial closure
(reapproximation) within 24—48 hrs

Answer 13

stratum basale

Question 14

Layer of dermis: Contains main blood vessels &
nerves
* Effective heat insulator, energy
storage, shock absorber
* Can contain the deepest
portion of hair follicles &
apocrine/eccrine glands

Answer 14

Hypodermis

Question 15

Comparing first to second intention healing: Which consists of more intense inflammation?

Answer 15

second (there is more necrotic debris, exudate, and fibrin to remove)

Question 16

Common skin tumors derived from melanocytes

Answer 16

melanoma

Question 17

What stage of wound repair –
continued fibroplasia & collagen
accumulation => mature granulation tissue
* Progressive ↓ in inflammation
* Presence of inflammatory cells & inflammatory cell
products => itching while healing

Answer 17

Week 2

Question 18

Skin Tumor: Specific features include consumption of the epidermis, pagetoid spread of
melanocytes, nests of melanocytes with variable size and shape (which may be
confluent and lack maturation), melanocytes within lymphovascular spaces, deep and
atypical mitoses and increased apoptosis.

Answer 18

Melanoma

Question 19

Retinoid efficacy in psoriasis is based on their antiproliferative ( slow
down skin cell growth), differentiation normalizing, and _____ effects.

Answer 19

anti-inflammatory

Question 20

3 processes: neovascularization, fibroplasia, & re-
epithelialization =>
production of _______

Answer 20

granulation tissue

Question 21

In full thickness abrasion, or third degree burns, re-
epithelialization limited by _____

Answer 21

size of wound

Question 22

What happens on day 3-7 of wound repair?

Answer 22

neutrophils begin to be replaced
by Macrophages (transition from acute to
subacute phase)

Question 23

Squamous cell carcinoma: nests of squamous epithelial cells arising from the ____
and extending into the ___

Answer 23

epidermis. dermis.

Question 24

Burn involves both epidermis &
dermis

Answer 24

2nd degree burn

Question 25

Deepest layer of dermis

Answer 25

Hypodermis (subcutis)

Question 26

Keratinization of new cells => desquamation & lifting of scab from periphery after_______

Answer 26

~ 3 wks

Question 27

________ are a useful steroid-free alternative in a wide range of skin disorders including acne photoaging, post-inflammatory hyperpigmentation, and psoriasis

Answer 27

Topical retinoids

Question 28

burn involves all three layers, epidermis, dermis & hypodermis

Answer 28

3rd degree burn (potentially destroyed capillary networks)

Question 29

Comparing first to second intention healing: Which involves larger amount of granulation tissue (larger defect)

Answer 29

second

Question 30

_____ occurs in psoriasis leading to increased blood flow to the affected areas

Answer 30

angiogenesis (formation of new blood cells)

Question 31

* Effective heat insulator, energy storage, shock absorber * Can contain the deepest portion of hair follicles & apocrine/eccrine glands

Answer 31

hypodermis

Question 32

antiproliferative

Answer 32

slowing down cell growth

Question 33

raised, thickened connective tissue scar. (what is this and what is it the result of?)

Answer 33

Keloid—excess fibroplasia (formation of fibrous tissue)

Question 34

In haired skin, migration of cells from external root sheath of hair follicles augments ___

Answer 34

re-epithelialization

Question 35

characterized by itchy, erythematous, vesicular, weeping, and crusting patches

Answer 35

eczema

Question 36

* Presence of inflammatory cells & inflammatory cell products => itching while healing OCCURS when?

Answer 36

week 2 of healing

Question 37

Wound repair: * With _____ deficiency, collagen breaks down; old scars can re-open & bleed

Answer 37

Vitamin C (not laying down as good CT)

Question 38

What is the cause of ezcema/dermatitus?

Answer 38

unclear--One possibility is a dysfunctional interplay between the immune system and skin

Question 39

What happens to a wound within 3-24 hours

Answer 39

neutrophils infiltrate clot---acute phase

Question 40

What is a common treatment of psoriasis characterized by antiproliferative effects

Answer 40

retinoids (steroid-free alternative)

Question 41

What layer of dermis is this describing? --prominent, broad bands of dense collagen & long thin elastin fibers, blood vessels, lymphatics & nerves

Answer 41

reticular layer

Question 42

What layer of dermis is this describing? ----pale-staining, less collagen & elastin but more matrix

Answer 42

papillary layer

Question 43

Following initial _______ epithelial cells of stratum basale migrate from edges of wound at ~ 0.5 mm/day

Answer 43

clot formation

Question 44

What stage of wound repair -- connective tissue scar, without inflammation, covered by intact epithelium

Answer 44

Month 2

Question 45

Psoriasis: increased inflammatory cells form _____

Answer 45

microabcesses

Question 46

Common skin tumors derived from epithelial cells

Answer 46

squamous cell carcinoma and basal cell carcinoma

Question 47

Comparing first to second intention healing: Which has the larger scab?

Answer 47

second

Question 48

Components of Dermis of Thick Skin

Answer 48

* Fibroblasts/-cytes & extracellular matrix * Collagen, elastin & reticular fibers * GAG-containing matrix * Blood vessels & nerves * Small #macrophages, lymphocytes & mast cells

Question 49

Squamous cell carcinoma: The malignant cells are often large with abundant eosinophilic cytoplasm and a _____

Answer 49

large, often vesicular, nucleus

Question 50

Burns classified according to ____

Answer 50

severity

Question 51

wound contraction is due to ______

Answer 51

myofibroblasts (trying to pull edges of wound together)

Question 52

Hypodermis is ____ tissue with fibrocollagenous septae

Answer 52

adipose

Question 53

Skin tumor: largely characterized by aggregates of cells with a small cytoplasm and large, hyperchromatic nuclei, apoptotic cells, all included in a fibromyxoid stroma, with tumor retraction spaces.

Answer 53

Basal cell carcinoma

Question 54

Grafting is common for this type of burn... what layers do this type involve..

Answer 54

3rd degree burn--epidermis, dermis, and hypodermis