Cell remnants of the stratum corneum.

Cornified keratinocytes

May indicate embarrassment, fever, hypertension, inflammation, or allergy

Erythema

Cells plus a disc-like sensory nerve ending that functions as a sensory receptor for touch.

Merkel disc

Name the four kinds of sudoriferous glands and give their locations.

^Answer:

^{1. eccrine ------ found in most of the body, especially the palms, soles, and forehead}

^{2. apocrine -------- axillary and anogenital regions}

^{3. ceruminous ------ lining of the external ear canal}

^{4. mammary -----breasts}

What are six of the functions of the epidermis?

Answer:

^{1. Protection against abrasion.}

^{2. Protection from the sun's radiation.}

^{3. First line of immune system defense.}

^{4. Protection from water loss. 5. Protection from heat loss.}

^{6. Covers the body; interfaces with the outside.}

^{7. Sensory perception.}

^{8. Protection against rapid chemical penetration.}

Which type of skin cancer appears as a scaly reddened papule and tends to grow rapidly and metastasize?

A)Adenoma

B)Squamous cell carcinoma

C)Basal cell carcinoma

D)Melanoma

Answer: B

Which of the following cells and their functions are correctly matched?

• ^{A)Melanocytes — protects cells in the stratum corneum from damaging effects of sun's rays}
• ^{B)Dendritic cells — activate the immune system}
• ^{C)Tactile cells — protection D)Keratinocytes — provide sense of touch and pressure}

^{Answer: B}

The glands that serve an important function in thermoregulation.

Sudoriferous glands

The most abundant cells of the epidermis.

Keratinocytes

The glands that serve an important function in thermoregulation.

Sudoriferous glands

The layer of the epidermis where the cells are considered protective but nonviable.

Stratum corneum

The only place you will find stratum ________ is in the skin that covers the palms, fingertips, and soles of the feet.

^{Answer: lucidum}

________ is an inherited condition that affects the heme pathway; it leaves the skin scarred and gums degenerated, and may have led to the folklore about vampires.

A)Porphyria

B)Impetigo

C)Decubitus ulcer

D)Rosacea

Answer: A

The protein found in the epidermis that is responsible for toughening the skin.

Keratin

Hair that lacks pigment and is often called "immature hair."

Vellus

A dendritic or Langerhan cell is a specialized ________.

A)squamous epithelial cell

B)nerve cell

C)melanocyte

D)phagocytic cell

Answer: D

Melanocytes and keratinocytes work together in protecting the skin from UV damage when keratinocytes ________.

^{A)accumulate the melanin granules on their superficial portion, forming a UV-blocking pigment layer}

^{B)maintain the appropriate pH in order for the melanocyte to synthesize melanin granules}

^{C)maintain the appropriate temperature so the product of the melanocyte will not denature D)provide the melanocyte with nutrients necessary for melanin synthesis}

^{Answer: A}

^{Answer: A}

The dermis is a strong, flexible connective tissue layer. Which of the following cell types are likely to be found in the dermis?

^{A)osteoblasts, osteoclasts, and epithelial cells}

^{B)fibroblasts, macrophages, and mast cells}

^{C)goblet cells, parietal cells, and chondrocytes}

^{D)monocytes, reticulocytes, and osteocytes}

^{Answer: B}

The ________ are the small muscles located in the dermis that cause goose bumps.

^{Answer: arrector pili}

What are the functions of the papillary layer of the skin?

Answer:

^{1. Feed and oxygenate the epidermis.}

^{2. Provide touch and pain receptors.}

^{3. Form the underlying foundation for ridges of the hands and toes.}

^{4. Keep the epidermis from sliding sideways}

The epidermis consists of five layers of cells, each layer with a distinct role to play in the health, well-being, and functioning of the skin. Which of the following layers is responsible for cell division and replacement?

^{A)stratum basale}

^{B)stratum granulosum}

^{C)stratum lucidum}

^{D)stratum corneum}

^{Answer: A}

Water loss through the epidermis could cause a serious threat to health and well-being. Which of the following protects us against excessive water loss through the skin?

^{A)cells found in the stratum spinosum}

^{B)keratinocytes, because they are so versatile}

^{C)tactile cells}

^{D)macrophages called dendritic cells (Langerhans Cell)}

^{Answer: D}

The dermis has two major layers. Which layer constitutes 80% of the dermis and is responsible for the tension lines in the skin?

A)the reticular layer

B)the papillary layer

C)the subcutaneous layer

D)the hypodermal layer

Answer: A

The reason the hypodermis acts as a shock absorber is that ________.

A)it is located just below the epidermis and protects the dermis from shock

B)the major part of its makeup is adipose, which serves as an effective shock absorber

C)the cells that make up the hypodermis secrete a protective mucus

D)it has no delicate nerve endings and can therefore absorb more shock

Answer: B

The integumentary system is protected by the action of cells that arise from bone marrow and migrate to the epidermis. Which of the following cells serve this function?

^{A)cells found in the stratum spinosum}

^{B)keratinocytes, because they are so versatile}

^{C)tactile cells}

^{D)macrophages called dendritic cells (Langerhans Cell)}

^{Answer: D}

Usually indicates a liver disorder.

Jaundice

May indicate fear, anger, anemia, or low blood pressure.

Pallor

A splinter penetrated into the skin of the sole of the foot, almost to the papillary region of the dermis. Which layer of the epidermis would be the final layer injured?

^A)spinosum

^B)granulosum

^C)basale

^D)lucidum

^{Answer: C}

Appearance of a permanent tan; bronzing.

Addison's disease

A summertime golden bronze tan may not be a tan at all; especially if the skin appears almost metallic bronze, it may be the result of ________ disease.

^{Answer: Addison's}

Sudoriferous (sweat) glands are categorized as two distinct types. Which of the following are the two types of sweat glands?

A)sebaceous and merocrine

B)eccrine and apocrine

C)mammary and ceruminous

D)holocrine and mammary

^{Answer: B}

A bluish color in light-skinned individuals.

Cyanosis

What are the most important factors influencing hair growth?

^{A)nutrition and hormones}

^{B)sex and hormones}

^{C)age and glandular products}

^{D)the size and number of hair follicles}

^{Answer: A}

Burns that result in injury to the epidermis and the upper regions of the dermis is called a ________ burn.

Answer: Second-degree

The sebaceous glands are simple alveolar glands that secrete a substance known as sebum. The secretion of sebum is stimulated ________.

^{A)when the air temperature drops}

^{B)as a protective coating when one is swimming}

^{C)by hormones, especially androgens}

^{D)by high temperatures}

^{Answer: C}

The layer of the epidermis immediately under the stratum lucidum in thick skin is the stratum ________.

^{Answer: granulosum}

Pigment-producing cells in the epidermis are ________.

Answer: Melanocytes

Changes in the color of skin are often an indication of a homeostatic imbalance. Which of the following changes would suggest that a patient is suffering from Addison's disease?

^{A)Black-and-blue marks become evident for no apparent cause.}

^{B)The skin appears to have an abnormal, yellowish tint.}

^{C)The skin takes on a bronze or metallic appearance.}

^{D)It is impossible to suggest Addison's disease from an inspection of a person's skin.}

^{Answer: C}

^{Answer: C}

What is the first threat to life from a massive third-degree burn?

^A)infection

^{B)loss of immune function}

^{C)unbearable pain}

^{D)catastrophic fluid loss}

^{Answer: D}

When an individual is exposed to extremely low air temperatures, the dermal blood vessels will dilate so that blood and heat will be dissipated.

FLASE

The single most important risk for skin cancer is ________

^{A)overexposure to UV radiation}

^B)race

^C)genetics

^{D)use of farm chemicals}

^{Answer: A}

Apocrine glands, which begin to function at puberty under hormonal influence, seem to play little role in thermoregulation. Where would we find these glands in the human body?

^{A)beneath the flexure lines in the body}

^{B)in the palms of the hands and soles of the feet}

^{C)in the axillary and anogenital area}

^{D)in all body regions and buried deep in the dermis}

^{Answer: C}

The most dangerous skin cancer is cancer of the melanocytes.

TRUE

The composition of the secretions of the eccrine glands is ________.

^{A)primarily uric acid}

^{B)metabolic wastes}

^{C)fatty substances, proteins, antibodies, and trace amounts of minerals and vitamins}

^{D)99% water, sodium chloride, trace amounts of wastes, and vitamin C}

^{Answer: D}

Eyebrow hairs are always shorter than hairs on your head because ________.

^{A)the vascular supply of the eyebrow follicle is one-tenth that of the head hair follicle}

^{B)eyebrow follicles are only active for a few months}

^{C)hormones in the eyebrow follicle switch the growth off after it has reached a predetermined length}

^{D)they grow much slower}

^{Answer: B}

The papillary layer of the dermis is connective tissue heavily invested with blood vessels. The superficial surface has structures called:

^{A)dermal papillae.}

^{B)hair follicles.}

^{C)reticular papillae.}

^{D)ceruminous glands.}

^{Answer: A}

The white crescent portion of the nail is called the ________.

^{Answer: lunula}

Burns are devastating and debilitating because of loss of fluids and electrolytes from the body. How do physicians estimate the extent of burn damage associated with such dangerous fluid loss?

^{A)by observing the tissues that are usually moist}

^{B)by measuring urinary output and fluid intake}

^{C)through blood analysis}

^{D)by using the "rule of nines"}

^{Answer: D}

The skin is not able to receive stimuli because the cells of the epidermis are not living and therefore there are no sensory receptors in the skin.

FLASE

Ceruminous glands are modified merocrine glands.

FLASE

The hyponychium is commonly called the cuticle.

FLASE

In addition to protection (physical and chemical barrier), the skin serves other functions. Which of the following is another vital function of the skin?

^{A)It aids in the transport of materials throughout the body.}

^{B)It absorbs vitamin C so that the skin will not be subject to diseases.}

^{C)The cells of the epidermis store glucose as glycogen for energy.}

^{D)It converts modified epidermal cholesterol to a vitamin D precursor important to calcium metabolism.}

^{Answer: D}

The coarse hair of the eyebrows and scalp is called ________ hair.

^{Answer: terminal}

Despite its apparent durability, the dermis is subject to tearing. How might a person know that the dermis has been previously stretched and/or torn?

^{A)The stretching causes the tension lines to disappear.}

^{B)There is an episode of acute pain due to the large number of tactile corpuscles.}

^{C)The appearance of visible, silvery-white scars is an indication of stretching of the dermis. D)The blood vessels in the dermis rupture and the blood passes through the tissue, causing permanent "black-and-blue marks."}

^{Answer: C}

Joe just burned himself on a hot pot. A blister forms and the burn is painful. Joe's burn would best be described as a third-degree burn.

FALSE

List the layers of the dermis and describe the functions of the tissue that makes up each layer.

^{Answer: The papillary layer is composed of areolar connective tissue that allows phagocytes and other defensive cells to serve as a second line of defense against microbial invasion. The reticular layer is composed of dense irregular connective tissue that gives the skin strength and resiliency, maintains hydration, and provides elasticity to the skin.}

The stratum corneum (outermost layer of skin) is a zone of approximately four layers of viable cells that are able to synthesize proteins that keep the outer layer of skin smooth and soft.

FLASE

Skin surface markings that reflect points of tight dermal attachment to underlying tissues are called epidermal ridges

FALSE

What is the most important role of the arrector pili muscles in humans?

^{A)Cause the hair follicle to stand erect}

^B)Defense

^{C)Force sebum out of the hair follicle to the skin surface}

^{D)Help retain heat}

^{Answer: C}

What are vellus hairs?

^{Answer: pale, fine body hair associated with newborn children, women, bald men, and "peach fuzz" on all people.}

Sweat glands continuously produce small amounts of sweat, even in cooler temperatures.

TRUE

The dermis is rich in blood vessels and nerve fibers.

TRUE

Which of the following cutaneous receptors is specialized for the reception of touch or light pressure?

^{A)Krause's end bulbs}

^{B)Pacinian corpuscles}

^{C)Meissner's corpuscles}

^{D)free nerve endings}

^{Answer: C}

Which glands produce ear wax?

^{A)Ceruminous glands}

^{B)Eccrine Glands}

^{C)Merocrine glands}

^{D)Apocrine glands}

^{Answer: A}

The major regions of a hair shaft include all of the following except ________.

^A)medulla

^{B)external root sheath}

^C)cuticle

^D)cortex

^{Answer: B}

The pinkish hue of individuals with fair skin is the result of the crimson color of oxygenated hemoglobin (contained in red blood cells) circulating in the dermal capillaries and reflecting through the epidermis.

TRUE

There are several reasons other than genetics for hair loss. Identify some of these other factors.

^{Answer: Stressors such as acutely high fever, surgery, severe emotional trauma; drugs such as antidepressants and chemotherapy drugs; burns and radiation; lack of adequate nutrition due to poor skin circulation; and a protein-deficient diet can cause hair loss or thinning.}

The outermost sheath of a hair follicle is the connective tissue root sheath.

TRUE

Which of the following is a skin sensory receptor for touch?

^{A)free nerve ending}

^{B)Ruffini body}

^{C)Pacinian corpuscle}

^{D)tactile corpuscle}

^{Answer: D}

Acne is a disorder associated with ________.

^{A)sebaceous glands}

^{B)Meibomian glands}

^{C)sweat glands}

^{D)ceruminous glands}

^{Answer: A}

The function of the root hair plexus is to ________.

^{A)sebaceous glands}

^{B)Meibomian glands}

^{C)sweat glands}

^{D)ceruminous glands}

^{Answer: C}

Although the integument is a covering, it is by no means simple, and some of its functions include ________.

^{A)resident macrophage-like cells whose function is to ingest antigenic invaders and present them to the immune system}

^{B)cooling the body by increasing the action of sebaceous glands during high-temperature conditions}

^{C)epidermal blood vessels serving as a blood reservoir}

^{D)the dermis providing the major mechanical barrier to chemicals, water, and other external substances}

^{Answer: A}

Cradle cap in infants is called ________.

^{Answer: seborrhea}

Why is skin not considered an absolute heat barrier for the body?

^{Answer: The skin proper must retain flexibility to give up excess body heat, so it must not function as a heat barrier. The hypodermis contains adipose tissue that acts as an insulator. With this setup, extra blood (and heat) can be shunted above the hypodermis when heat loss is desirable.}

When a patient is said to have "third-degree burns," this indicates that the patient has burns that cover approximately one-third or more of the body.

FALSE

Hair growth and density are influenced by hormones, nutrition, and, in some cases, lifestyle.

TRUE

The dense fibrous connective tissue portion of the skin is located in the reticular region of the dermis.

TRUE

Which statement correctly explains why hair appears the way it does?

^{A)Air bubbles in the hair shaft cause straight hair.}

^{B)Kinky hair has flat, ribbonlike hair shafts.}

^{C)Gray hair is the result of hormonal action altering the chemical composition of melanin.}

^{D)Perfectly round hair shafts result in wavy hair.}

^{Answer: B}

Vernix caseosa is a ________.

^{A)coat of fine, downy hair on the heads of balding men}

^{B)cheesy-looking sudoriferous secretion on the skin of newborns}

^{C)whitish material produced by fetal sebaceous glands}

^{D)substance contributing to acne during adolescence}

^{Answer: C}

Which of the following statements indicates the way in which the body's natural defenses protect the skin from the effects of UV damage?

^{A)The skin is protected by the synthesis of three pigments that contribute to the skin's color. B)Prolonged exposure to the sun induces melanin dispersion, which in turn acts as a natural sunscreen.}

^{C)Carotene, which accumulates in the stratum corneum and hypodermal adipose tissue, is synthesized in large amounts in the presence of sunlight.}

^{D)The skin is protected by increasing the number of epidermal dendritic cells, which help to activate the immune system.}

^{Answer: B}

Regardless of race, all human beings have about the same number of melanocytes.

TRUE

The design of a person's epidermal ridges is determined by the manner in which the papillae rest upon the dermal ridges to produce the specific pattern known as handprints, footprints, and fingerprints. Which of the following statements is true regarding these prints or ridges?

^{A)Because we are constantly shedding epithelial cells, these ridges are changing daily.}

^{B)They are genetically determined, therefore unique to each person.}

^{C)Every human being has the same pattern of ridges.}

^{D)Identical twins do not have the same pattern of ridges.}

^{Answer: B}

A physician is often able to detect homeostatic imbalances in the body by observing changes in the skin color.

TRUE

The apocrine sweat glands are fairly unimportant in thermoregulation.

TRUE

During the regressive phase of hair growth, the matrix is inactive and the follicle atrophies.

FLASE

Why is profuse sweating on a hot day good, and yet a potential problem?

^{Answer: Good because the sweat and evaporating of the sweat causes cooling of the body. Bad because excessive water and salt loss may occur. Fluid and electrolyte imbalances may follow.}

illions of consumer dollars are spent for deodorants and antiperspirants each year. Explain the production of body odors frequently associated with axillary skin.

^{Answer: Sweat is mostly an odorless watery secretion produced by eccrine and apocrine glands. The odor usually arises when bacteria break down lipids and proteins in the surface secretions.}

What complications might be anticipated from the loss of large areas of skin surfaces?

^{Answer: Large losses of skin, as with severe burn injuries, allow excessive fluid loss and infection. Skin grafting or "synthetic skin" applications are usually necessary.}

Balding men have tried all kinds of remedies, including hair transplants, to restore their lost locks. Explain the cause of male pattern baldness.

^{Answer: It appears to be genetically determined and sex-linked, and is possibly caused by a delayed-action gene that responds to DHT and alters normal metabolism.}

The reason that the nail bed appears pink is the presence of a large number of melanocytes in the underlying dermis.

FLASE

How are burns commonly classified? Give an example.

^{Answer: Burns are classified according to their severity or depth. For example, in first-degree burns, only the epidermis is damaged; in second degree burns, the epidermis and upper dermis are damaged; in third degree burns, there is widespread damage of epidermis and dermis.}