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60 Cards in this Set
- Front
- Back
Skin Anatomy
The skin is an organ that forms a protective barrier against germs (and other organisms) and keeps the inside of your body inside your body, and keeps what's outside of your body outside. Skin also helps maintain a _______________. Human skin is only about __________ thick. On average, an adult has from 18-20 square feet (about 2 square meters) of skin, which weighs about 6 pounds (2.7 kg). |
constant body temperature
0.07 inches (2 mm) |
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The outer layer is called the ___________; it is a tough protective layer that contains __________(which protects against the rays of the sun and gives the skin its color).
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epidermis
melanin |
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The second layer (located under the epidermis) is called the ________; it contains nerve endings, sweat glands, oil glands, and hair follicles.
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dermis
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Under these two skin layers is a fatty layer of subcutaneous tissue (the word subcutaneous means "under the skin"). This is also known as the ____________
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Hypodermis
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________- a tube-shaped sheath that surrounds the part of the hair that is under the skin. It is located in the epidermis and the dermis. The hair is nourished by the follicle at its base (this is also where the hair grows).
________- The part of the hair that is above the skin. _____________- a muscle is connected to each hair follicle and the skin - it contracts (in response to cold, fear, etc.), resulting in an erect hair and a "goosebump" on the skin. |
hair follicle
hair shaft hair erector muscle |
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_____________- a cell in the epidermis that produces melanin (a dark-colored pigment that protects the skin from sunlight).
_____________- nerve receptors that respond to pressure and vibration; they are oval capsules of sensory nerve fibers located in the subcutaneous fatty tissue _____________- a small, sack-shaped gland that releases oily (fatty) liquids onto the hair follicle (the oil lubricated and softens the skin). These glands are located in the dermis, usually next to hair follicles. ____________- (also called sudoriferous gland) a tube-shaped gland that produces perspiration (sweat). The gland is located in the epidermis; it releases sweat onto the skin. |
melanocyte
Pacinian corpuscle sebaceous gland sweat gland |
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Skin Function
Sensation (largest sensory organ in the body) Protection Prevents dehydration Prevents infection Physical barrier to injury Protects against ultraviolet light injury (__________) ______________ Insulation (hair and adipose tissue) Heat dissipation Sweat evaporation Increased blood flow Metabolic Energy storage of )______________in adipose tissue ____________ synthesis |
Melanin
Thermoregulation Triglycerides Vitamin D |
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Epidermis
Epidermis is the outermost layer of the skin. It forms the waterproof, protective wrap over the body's surface and is made up of stratified squamous ___________with an underlying _____________. It contains no ____________, and is nourished by _____________from the ________. The main type of cells which make up the epidermis are keratinocytes, melanocytes, __________ cells and _______________cells. |
epithelium
basal lamina blood vessels diffusion dermis Langerhans and Merkels |
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Epidermal Layers
Epidermis is divided into several layers where cells are formed through _________at the innermost layers. They move up the strata changing shape and composition as they differentiate and become filled with ____________. They eventually reach the top layer called stratum corneum and become sloughed off, or desquamated. This process is called ___________and takes place within weeks. The outermost layer of Epidermis consists of 25 to 30 layers of dead cells. |
mitosis
keratin keratinization |
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Epidermis is divided into the following 5 sublayers or strata:
Mneumonic: "Before sex, get latex condoms" (from deep to superficial) |
Stratum corneum
Stratum lucidum Stratum granulosum Stratum spinosum or mucosum Stratum germinativum (also called "stratum basale") |
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Stratum corneum (“horny layer”)
It is composed mainly of dead cells that lack ________. As these dead cells slough off, they are continuously replaced by new cells from the _______________ |
nuclei
stratum germinativum |
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Cells of the stratum corneum contain _________, a protein that helps keep the skin hydrated by preventing ___________ and absorbing water, further aiding in hydration and explaining why humans and other animals experience _________of the skin on the fingers and toes when immersed in water for prolonged periods.
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keratin
water evaporation wrinkling |
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The thickness of the stratum corneum varies according to the amount of protection and/or grip required by a region of the body. In general, the stratum corneum contains _________layers of dead cells.
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15 to 20
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Stratum lucidum
a thin, clear layer of dead skin cells in the epidermis. It is found beneath the stratum corneum of thick skin The keratinocytes of the stratum lucidum do not feature distinct boundaries and are filled with _______, an intermediate form of _________. It is the waterproof layer of skin and is also called the _________of the skin |
eleidin
keratin BARRIER LAYER |
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_________________
This layer typically contains 1 to 3 rows of flattend cells with many small _________granules in their cytoplasm. These keratohyalin granules are a step in the synthesis of the waterproofing protein ________, and contain large amounts of filaggrin. Filaggrins are filament-associated _________which bind to keratin fibers This is the highest layer in the epidermis where living cells are found |
stratum granulosum
basophilic keratin proteins |
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______________
multi-layered arrangement of cuboidal cells that sits beneath the stratum granulosum. Adjacent cells are joined by ___________giving them the spiny appearance from which their name is derived. Their ________are often darkened (a condition called pyknosis), which is an early sign of cell death. Their fate is sealed because the nutrients and oxygen in interstitial fluid have become exhausted before the fluid is able to reach them by diffusion. Cells of the stratum spinosum actively synthesize intermediate filaments called _________which are composed of keratin. These intermediate filaments are anchored to the desmosomes joining adjacent cells to provide structural support, helping the skin resist abrasion. |
Stratum spinosum
desmosomes nuclei |
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Cells of the stratum spinosum actively synthesize ____________called cytokeratins which are composed of __________.
These intermediate filaments are anchored to the desmosomes joining adjacent cells to provide structural support, helping the skin resist abrasion. |
intermediate filaments
keratin |
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_____________
Stratum germinativum (also stratum basale or basal cell layer) is the layer of keratinocytes that lies at the base of the _________immediately above the dermis. It consists of a single layer of tall, simple columnar epithelial cells lying on a _____________ |
Stratum basale
epidermis basement membrane. |
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stratum basale
These cells undergo rapid cell division, ____________ to replenish the regular loss of skin by shedding from the surface. About 25% of the cells are ___________, which produce melanin which provides pigmentation for skin and hair ________________is a relatively benign form of skin cancer which arises from this layer of cells. |
mitosis
melanocytes Basal cell carcinoma |
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_______________
the major cell type of the epidermis, making up about 90% of epidermal cells. Keratinocytes originate in the basal layer. They are pushed up through the layers of the epidermis, undergoing gradual ___________until they reach the stratum corneum where they form a layer of dead, flattened, highly keratinized cells called ______________. |
Keratinocyte
differentiation squamous cells |
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Keratinocytes
This layer forms an effective barrier to the entry of foreign matter and infectious agents into the body and minimises ____________ Keratinocytes are shed and replaced continuously from the stratum corneum. The time of transit from basal layer to shedding is approximately one month although this can be accelerated in conditions of keratinocyte hyperproliferation such as __________ |
moisture loss.
psoriasis |
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___________are located as the bottom layer of the epidermis.
They produce melanin, a pigment in the ____________. There are both basal and activated levels of melanogenesis; lighter-skinned people generally have low basal levels , and exposure to UV radiation generally causes an inc. The difference in skin color between fair people and dark people is due not to the number of melanocytes in their skin, but to the melanocytes' level of activity. |
Melanocytes
skin, eyes, and hair |
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___________are immature immune cells (dendritic cells). On infection of an area of skin, the local Langerhans' cells will take up and process __________ before travelling to the draining __________and maturing to become fully-functional ____________.
Generally, Langerhans' cells are active in the capture, uptake and processing of antigens. Once they arrive in secondary lymphoid tissue however, they lose these properties while gaining the capacity to interact with naive ________. |
Langerhans' cells
microbial antigens lymph node antigen-presenting cells T-cells |
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Langerhans' cells are derived from the __________ of monocytes stimulation by ______________.
The inner surface of the foreskin, especially the downpart, contains Langerhans' cells with _____ receptors; these cells are likely to be the primary point of viral entry. |
cellular differentiation
colony stimulating factor-1 HIV |
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__________ are large oval cells found in the skin of vertebrates. They are associated with the sense of touch, and are responsible for the highly malignant skin tumor known as _____________
Most often they are associated with sensory nerve endings, when they are known as ____________ F.S. Merkel referred to them as Tastzellen or "_________", although their function has been disputed ever since. |
Merkel cells
Merkel cell carcinoma. Merkel nerve endings. touch cells |
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___________
the layer of skin beneath the epidermis that consists of -____________and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a ____________. It also harbors many nerve endings that provide the sense of touch and heat. It contains the hair follicles, ___________(3)glands and blood vessels. The blood vessels in the dermis provide nourishment and waste removal to its own cells as well as the Stratum basale of the epidermis. |
Dermis
connective tissue basement membrane sweat glands, sebaceous glands, apocrine |
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2 regions of the dermis
1. _____________ is composed of loose _______________. It is named for its fingerlike projections called ________, that extend toward the epidermis. The papillae provide the dermis with a "bumpy" surface that interdigitates with the epidermis, strengthening the connection between the two layers of skin. In the palms, fingers, soles, and toes, the influence of the papillae projecting into the epidermis forms contours in the skin's surface. These are called ________, because they help the hand or foot to grasp by increasing friction. Friction ridges occur in patterns (_________) that are genetically determined and are therefore unique to the individual, making it possible to use fingerprints or footprints as a means of identification. |
Papillary region
areolar connective tissue papillae friction ridges fingerprint |
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2. ______________
lies deep in the papillary region and is usually much thicker. It is composed of dense irregular connective tissue, and receives its name from the dense concentration of ________,_________, and reticular fibers that weave throughout it. These ________fibers give the dermis its properties of strength, extensibility, and elasticity. Located within the reticular region are also the _________, ________glands, receptors, nails, and blood vessels. Tattoo ink is injected into the dermis. Stretch marks from pregnancy are also located in the dermis. |
Reticular region
collagenous, elastic protein roots of the hair, sebaceous glands |
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__________ also called the hypoderm, subcutaneous tissue, or superficial fascia.
It is the lowermost layer of the _____________. Types of cells that are found in the hypodermis are Fibroblasts, Adipose Cells, and Macrophages. The hypodermis is used mainly for ____storage. Its physiological function includes insulation and storage of nutrients. Continuous bundles of elastic fibers connect the subcutaneous tissue with the dermis. The blood vessels that supply the skin and help _________run through the subcutaneous layer. This layer also contains nerves and nerve endings. |
Hypodermis
integumentary system fat regulate body temperature |
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Physical Exam
Dermatology has the obvious benefit of having easy access to tissue for diagnosis. _________ is generally done under bright light and preferably involves the whole body. A morphological classification of __________is important in the diagnosis of dermatological disorders. Dermatologic diagnosis is often dependent upon pattern recognition of lesions and symptoms. |
Physical examination
dermatological lesions |
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Primary lesions
________: a circumscribed change in skin color without elevation or depression. ________: a solid elevated lesion usually 0.5 cm or less in diameter. ________: a raised lesion that has a greater area as compared to its elevation above the skin surface. _________ : a rounded or flat-topped elevated lesion formed by local dermal edema. |
Macule
Papule Plaque Wheal (hive) |
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________: a palpable solid lesion of varying size, greater than 0.5 cm and less than 2 cm in diameter, which may be present in the epidermis, dermis or subcutis.
__________: a circumscribed elevated lesion which contains free fluid.;0.5 cm or less in diameter ___________: (abscess) a circumscribed elevated lesion which contains pus. An abscess is usually in the dermis or subcutis. ________: a non-blanching erythema or violaceous color due to extravasation of blood into the tissue. _________: a sac containing liquid or semisolid material usually in the dermis. |
Nodule
Vesicle Pustule Purpura Cyst |
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Macule
A ________is a change in the color of the skin. It is flat, if you were to close your eyes and run your fingers over the surface of a purely macular lesion, you could not detect it.;greater than 1 cm. may be referred to as a _________. |
macule
patch |
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_________is a solid raised lesion that has distinct borders and is less than 1 cm in diameter. May have a variety of shapes in profile (domed, flat-topped, umbilicated) and may be associated with secondary features such as ________
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Papule
crusts or scales. |
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________is a solid, raised, flat-topped lesion greater than 1 cm. in diameter. It is analogous to the geological formation, the plateau
__________is an area of edema in the upper epidermis. |
plaque
wheal Aka Hives |
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_________is a raised solid lesion more than 1 cm. and may be in the epidermis, dermis, or subcutaneous tissue.
________are raised lesions less than 1 cm. in diameter that are filled with clear fluid. |
Nodule
Vesicles |
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_________are circumscribed elevated lesions that contain pus. They are most commonly infected (as in folliculitis) but may be sterile (as in pustular psoriasis).
A ______is a harmless sac-like growth in the deeper layers of the skin, which is filled with a soft, whitish brown material that sometimes oozes onto the skin surface |
Pustules
cyst |
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________is the appearance of red or purple discolorations on the skin, caused by _________underneath the skin. Small spots are called ___________, while large spots are called __________.
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Purpura
bleeding petechiae ecchymoses |
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Secondary lesions
________: a heaping up of stratum corneum or keratin. ________: a loss of epidermis above the basal layer leaving denuded surface. ________: an accumulation of serum, blood, or purulent exudate. _________: linear crusts and erosions due to scratching. _________: a loss of epidermis and part or all of dermis leaving depressed moist lesion. ________: a thinning of epidermis or dermis. ________: a hardening or induration of skin. |
scale
Erosion Crust Excoriations Ulcer atrophy sclerosis |
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_______: fibrous tissue replacing normal skin in areas of healing.
_________: (1) an accentuation of skin markings commonly associated with thickening of epidermis usually caused by scratching or rubbing. (2) marked by the presence of fine papules. ____________: a combination of atrophy, hyper and hypopigmentation and telangiectasis. ___________: dilated superficial blood vessels, especially of the upper reticular dermal plexus. |
scar
lichenification poikiloderma telangiectasia |
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Skin Biopsy
If the diagnosis is uncertain or a cutaneous _________is suspected, the dermatologic surgeon may perform a small _________(using a local anesthetic) for examination under the microscope by the dermatologist who is a trained dermatopathologist. |
malignancy
punch biopsy |
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The KOH potassium hydroxide test is the microscopic examination of a skin, nail, or hair sample for the presence of a ________that infects these structures
diagnosis of infections produced by dermatophytes and _________from other skin disorders. |
fungus
Candida albicans |
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___________are a type of fungus that invade the top layer of the skin, hair, or nails, and produce an infection commonly known as ringworm, technically known as tinea. It can appear as "jock itch" in the groin or inner thighs (tinea _______); on the feet (tinea pedis); on the scalp and hair (tinea capitis); and on the nails (tinea ________). Tinea _________appears anywhere on the skin and produces characteristic unpigmented patches. Tinea unguium affects the nails.
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Dermatophytes
cruris unguium versicolor |
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Tzank prep
The Tzanck test is a method of testing for the ________ (which causes cold sores, __________, or genital sores), or varicella-zoster virus (which causes chickenpox and "_________"). The test may help diagnose or confirm an infection with 1 of these 2 viruses. This test can not distinguish between these two viruses The sore is scraped and the scraping is put on a slide, stained, then examined under a microscope. |
herpes simplex virus
fever blister shingles |
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_________
Indications Distinguish _________from erythema (Diascopy) Technique Place glass slide over lesion border Apply direct pressure on lesion Interpretation Lesion remains red suggests Purpura Lesion blanches (loses red color) suggests erythema |
Diascopy
Purpura |
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_________is a diagnostic tool used in dermatology by which ultraviolet light is shone onto the skin of the patient
a technician then observes any subsequent ________. For example, _________— associated with some skin diseases — will fluoresce pink. Useful in diagnosing conditions such as ________ and erythrasma, both in distinguishing them from other conditions and in locating the precise boundaries of the condition. It is also helpful in diagnosing __________(Microsporum audouini), ________(Corynebacteriium minutissimum, pseudomonas), and pigmentary disorders |
Wood’s Light
fluorescence porphyrins tuberous sclerosis fungal infections bacterial infections |
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Patch test
Indications __________(Type 4 Hypersensitivity) |
Allergy test
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Interpretation of skin test
Erythema: __ Edema or Vesicles involve <50% of patch area: ____ Edema or Vesicles involve >50% of patch area: ____ |
1+
2+ 3+ |
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An _________is a benign growth that consists of small blood vessels. These tumors can be located anywhere on the body
TX: usually none (but treated with ___________, liquid nitrogen or laser) |
angioma
electrodessication |
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__________consists of small, harmless growths caused by a skin virus. They resemble pimples with a waxy, pinkish look and a small central pit.
TX: (_________or TCA acid) or liquid nitrogen |
Molluscum contagiosum
cantharone |
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Rash that develops in the spring and the fall, and seems to favor adolescents and young adults
a single, isolated oval scaly patch (the "_________") appears on the body, particularly on the trunk, upper arms, neck, or thighs. |
pityriasis rosea
herald patch |
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_____________ is a common condition of the beard area occurring in up to 60% African American men and other people with curly hair.
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Pseudofolliculitis barbae (razor bumps)
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It shows up as flaking skin, or reddish patches. Difficult to tell apart from psoriasis
TX: using shampoos containing _______ (Head and shoulders, ZNP bar), ________(Selsun blue and prescription strength Selsun) or _________(Nizoral AD and prescription strength Nizoral |
Seborrheic Dermatitis
zinc pyrithione selenium sulfide ketoconazole |
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_____________, is a common problem. Your skin needs moisture to stay smooth and supple, and retaining moisture is especially difficult in winter
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Dry skin, also called xerosis
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____________is a chronic disease of the apocrine glands (a form of sweat gland found on certain parts of the body; common in people who have had _______
tx: abx, antiinflammatory pills, birth control, injections |
Hidradenitis
acne |
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__________is a relatively common skin disease that comes in episodes lasting months to years. The onset may be gradual or quick;
appears as shiny, flat-topped bumps that often have an angular shape |
Lichen planus
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___________is the specific name given to lichen planus on the scalp that causes permanent scarring alopecia with inflammation around affected hair follicles
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Lichen Planopilaris
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___________ are benign lesions that occur on the sun-exposed areas of the body. The backs of hands and face are common areas
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Lentigines, or liver spots
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___________is a form of 'panniculitis' or inflammation of subcutaneous fat tissue. It is quite painful, especially if pressed upon. It looks like painful bruises on both of the shins; caused by meds (____) and infx (_________)
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Erythema nodosum
sulfa drugs strept throat AND TB |
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___________ is an acute, self-limiting, inflammatory skin eruption. The rash is made of spots that are red welts, sometimes with purple or blistered areas in the center. It often also affects the mouth, eyes and other moist surfaces
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Erythema multiforme (EM)
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