Online Learning Module: Skin Exam, Basic Science of Skin, Morphology, Dermatologic Therapies

What are the functions of the skin? immunologic barrier temperature regulation protection from radiation nerve sensation injury repair apperance/quality of life Which 3 layers make up the skin? epidermis dermis subcutis Brainpower Read More This is the topmost layer of the skin. It consists primarily of keratinocytes. epidermis This lies below the epidermis. It primarily consists of fibroblasts, collagen, and elastic fibers. It provides a flexible but thought support structure. it is between 1-4 mm thick, making it much thicker than the epidermis. It contains the blood and lymphatic vessels and nerves which supply the skin, as well as sweat glands and hair follicles. dermis This lies below the dermis and is composed of fat. It is also called the panniculus or hypodermis. It separates the dermis from deeper underlying structures such as fascia and muscles. It insulates the body, serves as an energy supply, cushions and protects the skin, and allows for its mobility over underlying structures. subcutis What are the four major layers of the epidermis? stratum corneum stratum granulosum (granular cell layer) stratum spinosum (spinous layer) stratum basale (basal layer) The order in which epidermal cells mature over their two-week life cycle is from the _______ to the _______. They are then shed for the following two weeks, meaning that the cells have a 28 day life cycle. basal layer; stratum corneum This is the source of epidermal stem cells. Cell division occurs here. Keratinocytes start here in this layer basal layer This layer is in the center of the epidermis. It has a spiny appearance secondary o desmosomal junctions, which hold the keratinocytes together. spinous layer Lipids produced by keratinocytes in this layer of the epidermis are secreted into the extracellular space between the keratinocytes. It forms a water barrier that keeps water in the skin. granular cell layer This layer of the epidermis is made up of desquamating keratinocytes. There is a thick outer layer of flattened keratinized non-nucleated cells which provide a barrier against trauma and infection. stratum corneum This is a protein found in the granular cell layer of the epidermis that retains water within the keratinocytes. Mutations in this can result in atopic dermatitis and asthma. filaggrin This is an autoimmune blistering disease, typically affecting older patients. Autoantibodies form to antigens directly beneath the basal cell layer of epidermis. It clinically presents as tense bullae on an erythematous base. bullous pemphigoid In this the rate of epidermal turnover is accelerated and does not allow for adequate time for differentiation, which is recognized as a scale. psoriasis This is the most common form of skin cancer. It is composed of cells that resemble basal keratinocytes. It most commonly presents as pearly, erythematous papules or plaques with rolled borders and telangectasis in sun-exposed areas. basal cell carcinoma Which three main types of cells make up the epidermis? keratinocytes melanocytes langerhans cells These epidermal cells are the majority. They are held together by macromolecular structures called desmosomes. keratinocytes These epidermal cells are staggered along the basal layer. They are pigment producing cells, and transfer their pigment (melanin) to the keratinocytes in the basal layer. melanocytes These are benign collections of melanocytes. melanotic nevi (moles) This is a malignancy of melanocytes. melanoma These are dendritic cells found in the mid epidermis. Their main function is in the afferent limb of the immune response by providing for the recognition, uptake, and presentation of antigens to sensitized T-lymphocytes, and are important in the induction of delayed type hypersensitivity. They play a prominent role in contact dermatitis. langerhans cells What are the two layers of the dermis? papillary dermis reticular dermis Which cells are in the dermis? mast cells and fibroblasts These dermal cells are responsible for the synthesis and degradation of CT proteins. They are instrumental in wound healing and scarring. fibroblasts These are specialized derma cells that are responsible for immediate-type hypersensitive reactions in the skin. It is the major effector cell in urticaria, which is a vascular reaction of the skin characterized by wheals surrounded by a red halo or flare. mast cells This is an example of panniculiits. It clinically appears as deep-seated erythematous nodules, typically on the shins. it may be idiopathic or a reaction to infections, medication, or an underlying autoimmune disease. erythema nodosum What are the adnexal structures of the skin? pilosebaceous unit and eccrine gland This adnexal structure consists of a hair follicle, sebaceous glands, apocrine sweat glands, and an arrestor pili muscle. pilosebaceous unit This adnexal structure does not involve the hair follicle. It opens directly onto the skin surface and is present throughout the body. It helps to regulate body temperature by excreting sweat onto the skin surface. These are sometimes genetically absent. eccrine glands This is a disorder of the pilosebaceous unit. It is caused by plugging of the hair follicle, P. acnes (bacteria) in the hair follicle, presence of hormones, and sebaceous gland activity. acne vulgaris Which of the following is true regarding respecting patient modesty during skin exams? a. adult diapers in wheelchair/bedbound patients should stay on to preserve modesty b. chaperones should only be offered if the patient appears litigious c. doctors should ask permission before moving the gown to examine the next body part d. medical providers should not touch their patients skin during full body exam e. patients should just lift up their clothing to show you spots they are worried about Doctors should ask permission before moving the gown to examine the next body part Which of the following is an indication for a total body exam? a. new patient with acne on her forehead b. new patient with a sister who has melanoma c. new patient with a mole on his chin that he's had since childhood without change d. new patient with a paternal aunt with a hx of melanoma e. new patient with a wart on her R index finger new patient with a sister who has melanoma Which of the following is true regarding the order in which you perform a skin exam? a. Start with the head and then move to the face, neck, chest, abdomen, arms, etc. b. Try to use a different order each time you examine the skin c. You may use any order you want, but it's better to do it in the same order each time d. You must have the patient start sitting up, then have them stand e. You must lay the patient down, then have them flip over You may use any order you want, but it's better to do it in the same order each time