Integument

Question 1

Characteristics of the Epidermis

Answer 1

• Tough, leathery outer surface of skin
• .05-.15 mm in thickness (up to 1.4 in thick skin)
• 5 layers
• Fairly avascular

Question 2

how often does the epidermis regenerate?

Answer 2

every 14-21 days

Question 3

Cell components of the epidermis

Answer 3

Keratinocytes, Eosinophils, Melanocytes, Lymphocytes, Langerhans cells, Merkel and Basal Cells

Question 4

Layers of the epidermis

Answer 4

• Stratum Basale
• Stratum Spinosum
• Stratum Granulosum
• Stratum Lucidum
• Stratum Corneum

Question 5

Stratum Basale

Answer 5

• Single row of keratinocytes (produce keratin)
• Deepest layer
• Attached to dermis via basement membrane (extra-cellular) and basal cells
• Diffusion through the basement membrane is how the epidermis receives its nutrition
• Concentration of Merkel cells

Question 6

Stratum Spinosum

Answer 6

• Several rows of mature, slightly flattened keratinocytes called tonofibrils
• Melanocytes appear between stratum basale and stratum spinosum
• Appear “spiny” due to kearatin filaments
• Where most Langerhans cells are found

Question 7

Stratum Granulosum

Answer 7

• 3-5 rows of flattened cells
• increased keratin concentration

Question 8

Stratum Lucidum

Answer 8

• Few layers of flattened cells, densely packed
• Mostly flattened eosinophils
• Dead keratinocytes

Question 9

Stratum Corneum

Answer 9

• Outermost layer
• 15-20 cells thick (dead keratinized cells)
• 3/4 of the thickness of epidermis

Question 10

Melanocytes

Answer 10

produce the pigment melanin

Question 11

Merkle Cells

Answer 11

specialized mechanoreceptors for light touch

Question 12

Langerhan’s Cells

Answer 12

• found in deeper layers
• help to fight infection

Question 13

What do keratinocyte (living and dead) provide?

Answer 13

mechanical strength

Question 14

Non-cellular components of the epidermis

Answer 14

a. Basement membrane – binds dermis to epidermis
b. Desmosomes – between epithelial cells; bond them together
c. Hemidesmosomes – bind basal cells to basement membrane
d. Tonofibrils – protects skin from friction and pressure
e. Hair follicles
f. Sudoriferous Glands

Question 15

What are Sudoriferous Glands

Answer 15

• Present everywhere except the lips and ears
• Secrete sweat in to ducts
• Helps to decrease the growth of bacteria

Question 16

Characteristics of the Dermis

Answer 16

2-4 mm thick
layers are less defined than in epidermis

Question 17

Papillary Dermis

Answer 17

• Superficial layer
• Contain FIBROBLASTS, mast cells and macrophages
• Loosely woven fibers with ground substance
• Ridges and valleys conform to the contours of the
  __________________ layer of the epidermis and
  creates an anchor
• Where blisters occur

Question 18

Reticular Dermis

Answer 18

• Dense, irregular CT
• Primarily type I collagen
• Has elastin fibers
• Location of nerve endings, glands and hair follicle plexus
• Deepest layer
• Gives structural support

Question 19

Cell Types in the Dermis

Answer 19

Fibroblasts
Macrophages
Mast Cells

Question 20

Fibroblasts in Dermis

Answer 20

Produce blank and blank fibers

Question 21

Macrophages in the Dermis

Answer 21

Fight infection by releasing destructive enzymes

Question 22

Mast Cells in the Dermis

Answer 22

• Secretory cells
• Produce ____________ which is important in initiating an inflammatory response

Question 23

Non-Cellular Components in the Dermis

Answer 23

• Root hair plexus
• Each hair has a sebaceous gland that secretes sebum
• Ruffini Corpuscles
• Meissner and Pacinian Corpuscles

Question 24

Root Hair Plexus

Answer 24

• Soft keratin
• Found everywhere except ___________ &
  ____________
• Help regulate body temperature by trapping air between
  hair and skin surface

Question 25

Ruffini Corpuscles

Answer 25

detect deep touch/pressure and vibration

Question 26

Meissner and Pacinian Corpuscles

Answer 26

More tactile corpuscles

Question 27

2 Components of Subcutaneous Tissue/Hypodermis

Answer 27

Adipose tissue Fascia

Question 28

Adipose Tissue

Answer 28

- Highly vascular loose connective tissue - Stores fat to provide energy, cushion bones and provide insulation

Question 29

Fascia

Answer 29

- Highly fibrous connective tissue - Lymph vessels located at this level

Question 30

Vascular Supply

Answer 30

- Arterioles and venules are in the reticular layer and terminate into the papillary layer as capillary loops. - Lymphatic terminal vessels are interspaced between the capillary loops

Question 31

What occurs when nerves cross the dermal/epidermal junction?

Answer 31

They lose Schwann cells and become free nerve endings

Question 32

Integument Functions

Answer 32

- Provide protection from the environment - Provide sensation (free nerve ending, Merkel cells, Meissner corpuscle, Pacinian corpuscle, Krause bulb, Ruffini corpuscle, root hair plexus - Prevent fluid loss – hygroscopy - Contribute to immunity (Langerhans cells) - Thermoregulation - Protection from UV rays - Synthesis and storage of vitamin D

Question 33

Erosion/ Superficial Lesion

Answer 33

- Abrasion - wound only involves the epidermis

Question 34

Partial Thickness Skin Involvement

Answer 34

- Wound involves the entire epidermis and part of the dermal layer - Will bleed d/t microvascular compromise - Stage II pressure ulcer; skin tears; deeper abrasions, superficial and partial thickness burns - Forms scar to heal

Question 35

Full Thickness Skin Involvement

Answer 35

- Wound through epidermis and entire dermis; may also include fascia or other deep tissues (tendon, bone etc.) - Stage III & IV pressure ulcers, full thickness burns, traumatic wounds, surgical wounds - Repair occurs primarily through secondary intention (see below)

Question 36

Suspected Deep Tissue Injury

Answer 36

- Purple or maroon areas of intact skin or blood-filled blisters caused by damage to the underlying soft tissues. - Represent a serious form of pressure wound - Deep tissue injuries are also known to deteriorate quickly even under optimal care

Question 37

Types of Wound Healing/ Healing Response

Answer 37

Category 1/ Primary Intention Category 2/ Delayed Primary Intention Category 3/ Secondary Intention Category 4

Question 38

Inflammation/Inflammatory Stage =

Answer 38

Hemostasis Inflammation

Question 39

Proliferation =

Answer 39

- Angiogenesis - Fibroplasia - Matrix Deposition - Re-epithelialization

Question 40

Maturation =

Answer 40

Maturation Remodeling

Question 41

Hemostasis (clot formation)

Question 42

Inflammation

Question 43

Angiogenesis

Question 44

Fibroplasia

Question 45

Matrix Deposit

Question 46

Re-Epithelialization

Question 47

Maturation Phase