Structure and Function Flashcards

1
Q

Roughly how many skin diseases are known?

A

> 2000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the difference between the EPIDERMIS and the DERMIS

A

Epidermis = outer layer of stratified squamous epithelium

Dermis = below epidermis, made of connective tissue, often described as “leather”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In terms of embryology, where does the epidermis come from?

A

the ectoderm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

In terms of embryology, where does the dermis come from?

A

The mesoderm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What part of the embryo do melanocytes (pigment cells) come from?

A

The neural crest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What layers of the skin are present at week 4 of foetal development?

A

Periderm
Basal Layer
Dermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What layers of the skin are present at week 16 of foetal development?

A
Keratin Layer
Granular Layer
Prickle Cell Layer
Basal Layer
Dermis

melanocytes also migrate from neural crest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What layers of the skin are present at week 26 of foetal development?

A
Epidermis
Appendages
Dermo-epidermal junction 
Dermis
Subcutis (Fat)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Name the appendages found in the epidermis and dermis of the skin

A

melanocytes
sebaceous gland
hair follicle
arector pili muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the function of the arector pili muscle in animals?

A

Controls temperature

Muscle contraction allows animal to stand its fur on end to decrease temp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are Blaschko’s Lines?

A

growth patterns of skin that do not follow nerves/vasculature/lymphatics

e.g if a rash were to start at the nipple and progress down the inner arm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If a patient displays a rash in a developmental pattern, what can be assumed about their condition?

A

It was acquired pre-natally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

During what week of foetal development could a mutation occur which causes all cells in a specific section to be affected?

A

Week 11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What type of epithelium is found at the epidermis and how thick is it?

A

Stratified squamous epithelium

~ 1.5 mm thick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What type of cell predominantly makes up the epidermis?

A

95% epidermis = keratinocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name 3 other types of cell found in the epidermis

A

Melanocytes
Langerhans cells
Merkel cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the function of the thick layer of keratin on the surface of the epidermis?

A

Thick layer of keratin = dead skin cells from proliferation

Stops water and bacteria penetrating the skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describe the epidermal variation between the scalp, the armpit and the palms of hands/sole of the foot

A
Scalp = hair, normal amount of sweat glands
Armpit = hair, extra apocrine sweat gland adjacent to hair follicle (produces smell)
Hands/feet = no hair , but extra sweat glands
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Give an example of “mechanical trauma” that would cause calluses to develop on the hands

A

playing guitar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe the ratio of epidermis to dermis in the skin of the abdomen

A

EPIDERMIS = thin

DERMIS - thick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What 3 factors regulate skin growth?

A

Growth Factors
Cell Death
Hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Name conditions where the predominant feature is a loss of control of skin growth

A

Cancer

Psoriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What produces the thick scabs in psoriasis?

A

Cells multiply too quickly and skin grows too fast
layer of keratin on surface is larger and does not fall off
=> leaving behind scabs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Where do keratinocytes come from?

A

The basement membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How long does it take for cells to migrate from the bottom to top of the epidermis (i.e. regeneration to occur)?
28 days
26
What type of epithelium does the basal membrane have and what thickness is it?
Usually one cell thick | Small cuboidal
27
Where do prickle cells arise from and what are they connected to?
Daughter cells of basal cells Connected to desmosomes these cells move upwards
28
Describe the appearance of the granular layer
2-3 layers of flatter cells
29
What proteins, released in the granules, are responsible for forming the 'cornified envelope'
structural filaggrin and involucrin proteins
30
What is the function of the 'cornified envelope'?
No water OUT (retains moisture in skin) | No bacteria IN (prevents infection)
31
How do the proteins in the granular layer retain moisture?
Large proteins are not req'd therefore they are split into small amino acids which can bind water. Without this mechanism our skin dries out
32
What is the largest component of the keratin layer?
Corneocytes | overlapping non-nucleated cell remnants
33
Why is the dermis so large in a wart?
The body attempts to proliferate the dermis to push the virus out
34
Can mucosa also be affected by skin diseases?
Yes
35
What can you deduct from the oral mucosa being white in colour?
Blood vessels are no longer visible, therefore the epidermis or dermis must have thickened.
36
What happens when skin appendages are lost?
Scarring
37
What is scarring made up of?
Collagen
38
What are melanocytes?
Pigment producing dendritic cells
39
Where are melanocytes found?
The basal layer and above
40
What organelles are found inside melanocytes and what is their function?
melanosomes Convert tyrosine to melanin pigment
41
How is melanin pigment transferred to keratinocytes?
via dendrites
42
How does the border of a melanocyte look histologically?
White halo effect | due to water depletion which causes contents of cell to shrink
43
What is the function of melanin caps?
Protect nuclear DNA of basal cells
44
What is vitiligo?
autoimmune disease with loss of melanocytes
45
What stimulates melanin production?
UV Light | Hormones
46
What is the risk of biochemically stimulating melanocytes?
Melanomas can form
47
How many people does Albinism affect in the UK?
1:20,000
48
What is albinism?
a genetic partial loss of pigment production
49
What hormone is responsible for Nelson's syndrome?
ACTH | produced in excess by pituitary in this condition
50
`Where are Langerhans cells found?
Prickle cell level in epidermis | Also found in dermis and lymph nodes
51
Where do Langerhans cells originate from?
Mesenchymal origin – bone marrow
52
What role do Langerhans cells play in the immune system?
Antigen presenting cells | They pick up antigens in skin and circulate to lymph nodes via lymphatic system
53
What organelle and granules are specific to Langerhans cells?
Racket Organelle | Birbeck granules
54
What is the function of Merkel cells?
mechanoreceptors | => can sense if something goes over you
55
Where are merkel cells found?
On the ends of myelinated nerves in the basal layer
56
What is notable of Merkel Cell cancer?
Rare Caused by viral infection High mortality
57
What is a hair follicle always accompanied by?
Adjacent sebaceous gland
58
What causes the pigment of hair?
melanocytes above dermal papilla
59
What is the side effect of retinoids given to treat acne?
They block formation of sebum => can create very dry skin
60
Name the three phases of hair growth
``` Anagen = growing Catagen = involuting Telogen = resting ```
61
How does the hair follicle develop embryologically?
Buds from the epidermis downwards
62
What hormones can influence hair growth?
Thyroxine and androgens
63
What drugs can cause a synchronous Telogen phase? (aka all hair beginning to fall out at the same time)
Chemotherapy & Radiotherapy
64
What causes alopecia areata?
Autoimmune condition where the hair follicles are attacked by T-lymphocytes
65
How much do nails grow each day?
Growth rate 0.1mm per day Fingers > toes Summer > winter
66
How are the stem cells which make up our nail, different to that which make up the rest of the skin layers?
They differentiate into keratin which is aligned into a parallel sheath
67
Which part of the nail is responsible for severe pain during trauma to the nail?
Nail matrix
68
What is the main function of the dermo-epidermal junction?
Support / anchorage / adhesion growth and differentiation of basal cells
69
What can happen if the dermo-epidermal junction is not intact?
skin can slip/blister/fail
70
What are the layers of the dermo-epidermal junction?
Lamina lucida Lamina densa Sub-Lamina densa
71
Give an example of a condition where failure of the dermo-epidermal junction causes blistering
Bullous Pemphigoid
72
If a person produces antibodies to their own dermo-epidermal junction, what test can we use to detect these/
Immunofluorescence
73
Give an example of a condition where there is a structural protein complex mutation in the dermo-epidermal junction
Epidermolysis Bullosa | (in babies)
74
What symptoms can Epidermolysis Bullosa cause?
Widespread blistered, red and crusted skin oesophageal strictures => feeding problems Nailbeds are absorbed Hands are fused (mitten deformities)
75
What cells are found in the dermis?
``` fibroblasts macrophages mast cells lymphocytes Langerhans cells ```
76
What do fibroblasts in the dermis make?
Collagen and elastin
77
What 3 things can give you fewer elastic fibres in your skin?
Ageing UV light smoking
78
Why do we have way more blood vessels in our skin that we require for only nutrition?
``` Temperature regulation (vasoconstriction/vasodilation) ```
79
How are blood vessels in the skin arranged?
Horizontal plexuses
80
What is an angioma?
a benign overgrowth of blood vessels showing through the epidermis and dermis
81
How are lymphatic vessels in the skin arranged?
Sub-epidermal horizontal plexus (like blood vessels)
82
What is cellulitis?
Bacterial infection of lymphatics
83
What specialised receptors are present in the skin
Pacinian (pressure) and Meissners (vibration) corpuscles
84
What condition can occur as a result of nerve overgrowth?
Neurofibromatosis
85
Name the three types of skin glands
Sebaceous Apocrine Eccrine
86
Where are sebaceous glands found and what is their function?
largest glands face and chest Functions: control moisture loss protection from fungal infection
87
Where are apocrine glands found and what do they produce?
Axillae and perineum Androgen dependent Produce oily fluid (odour after bacterial decomposition)
88
Where are eccrine glands found and what is their function?
Whole skin surface (palms, soles and axillae in particular) Functions: cooling by evaporation moisten palms / soles to aid grip
89
What are the main functions of the skin?
``` Barrier Metabolism & detoxification Temp. reg. Immune defence Sensory ```
90
Give 2 examples of acute skin failure
Toxic epidermal necrolysis Erythroderma `
91
What consequences are there if the skin fails and therefore doesnt work as a BARRIER?
Fluid loss => Dehydration Protein loss => Hypoalbuminaemia Infection
92
What consequences are there if the skin fails and therefore deosnt work to regulate heat?
Heat loss => Hypothermia
93
What consequences are there if the skin fails and cant function as an immune defence?
Spread of infection
94
What consequences occur if the skin fails metabolically?
Disordered thyroxine metabolism
95
What consequences can occur if the skin fails and loses its sensory function?
Pain sensation
96
What 3 categories does the skin protect us from as a BARRIER?
Physical - Friction, mechanical trauma - Ultraviolet radiation Chemical - Irritants, allergens, toxins Pathogens - Bacteria, viruses, fungi
97
How does the skin not split when you hit your hand off of a table for example?
The subcutaneous layer dissipates the energy
98
Give examples of everyday items that could be responsible for Cumulative irritant hand dermatitis
Rings | Soap/washing up liquid
99
If an ulcer were to develop following a compound fracture, what is the patient at risk of now that the compound is exposed?
Osteomyelitis | infection of the bone
100
Give 2 examples of how the skin is metabolically active
Vitamin D metabolism | Thyroid hormone metabolism
101
In what ways can our skin regulate our temperature?
Control sweating shivering Vasoconstrict/ vasodilate blood supply
102
How many scabies mites can usually be found on an average infected patient?
12
103
How many scabies mites can be found if the skin is crusting?
Millions!
104
Describe the type of inflammation and its location in Tuberculoid leprosy (Hansen's Disease)
Granulomatous inflammation to wall off an infection in the dermis
105
What percentage of patients with Chronic discoid lupus erythematosus will progress to having SLE?
10%
106
What sensory functions can the skin perform?
Touch, pressure, vibration Pain and itch Heat and cold Nerve endings and receptors in skin
107
What other condition is linked to Neuropathic ulcers(leprosy)?
Diabetes Mellitus