Anatomy and Physiology Test Bank Ch 5
Anatomy and Physiology Test Bank Ch 5 Biol 2301
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Human Anatomy & Physiology, 8e (Marieb/Hoehn) Chapter 5 The Integumentary System Matching Questions Figure 5.1 Using Figure 5.1, match the following: 1) Site of the dermal ridges that produce epidermal ridges on the epidermal surfaces of the fingers. Answer: E Diff: 1 Page Ref: 152; Fig. 5.1 2) Responsible for shock absorption and located in the hypodermis. Answer: B Diff: 1 Page Ref: 149; Fig. 5.1 3) Pulls the hair follicle into an upright position. Answer: A Diff: 1 Page Ref: 157; Fig. 5.1 1 Copyright © 2010 Pearson Education, Inc. 4) Sudoriferous gland. Answer: C Diff: 1 Page Ref: 155; Fig. 5.1 5) Dense irregular connective tissue. Answer: D Diff: 1 Page Ref: 152; Fig. 5.1 6) Region that thickens markedly when one gains weight. Answer: B Diff: 1 Page Ref: 149: Fig. 5.1 7) Pain receptors are found here. Answer: E Diff: 1 Page Ref: 152; Fig. 5.1 Match the following: A) Keratin B) Merkel disc C) Cornified keratinocytes D) Keratinocytes E) Epidermal dendritic cells 8) The most abundant cells of the epidermis. Diff: 1 Page Ref: 150 9) The protein found in the epidermis that is responsible for toughening the skin. Diff: 1 Page Ref: 150, 152 10) Cells plus a disclike sensory nerve ending that functions as a sensory receptor for touch. Diff: 1 Page Ref: 150 11) Skin macrophages that help activate the immune system. Diff: 1 Page Ref: 150 12) Cell remnants of the stratum corneum. Diff: 1 Page Ref: 150, 152 Answers: 8) D 9) A 10) B 11) E 12) C 2 Copyright © 2010 Pearson Education, Inc. Match the following: A) Stratum basale B) Sudoriferous glands C) Stratum corneum D) Vellus 13) The layer of the epidermis where the cells are considered protective but nonviable. Diff: 1 Page Ref: 152 14) The glands that serve an important function in thermoregulation. Diff: 1 Page Ref: 155 15) The layer that contains the mitotic viable cells of the epidermis. Diff: 2 Page Ref: 150 16) Hair that lacks pigment and is often called "immature hair." Diff: 1 Page Ref: 159 Answers: 13) C 14) B 15) A 16) D Match the following: A) Erythemia B) Jaundice C) Addison’s disease D) Pallor E) Cyanosis 17) May indicate embarrassment, fever, hypertension, inflammation, or allergy. Diff: 2 Page Ref: 155 18) May indicate fear, anger, anemia, or low blood pressure. Diff: 2 Page Ref: 155 19) Usually indicates a liver disorder. Diff: 2 Page Ref: 155 20) Appearance of a permanent tan; bronzing. Diff: 2 Page Ref: 155 21) A bluish color in lightskinned individuals. Diff: 2 Page Ref: 155 Answers: 17) A 18) D 19) B 20) C 21) E 3 Copyright © 2010 Pearson Education, Inc. True/False Questions 1) The apocrine sweat glands are fairly unimportant in thermoregulation. Answer: TRUE Diff: 3 Page Ref: 156 2) Skin surface markings that reflect points of tight dermal attachment to underlying tissues are called epidermal ridges. Answer: FALSE Diff: 1 Page Ref: 152 3) The dense fibrous connective tissue portion of the skin is located in the reticular region of the dermis. Answer: TRUE Diff: 1 Page Ref: 152 4) The outermost sheath of a hair follicle is the connective tissue root sheath. Answer: TRUE Diff: 1 Page Ref: 157 5) The protein found in large amounts in the outermost layer of epidermal cells is collagen. Answer: FALSE Diff: 2 Page Ref: 150 6) 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 thirddegree burn. Answer: FALSE Diff: 2 Page Ref: 164 7) Destruction of the matrix of the hair bulb would result in its inability to produce oil. Answer: FALSE Diff: 2 Page Ref: 156157 8) The hyponychium is commonly called the cuticle. Answer: FALSE Diff: 1 Page Ref: 160 9) The reason that the nail bed appears pink is the presence of a large number of melanocytes in the underlying dermis. Answer: FALSE Diff: 2 Page Ref: 160 10) During the resting phase of hair growth, the matrix is inactive and the follicle atrophies. 4 Copyright © 2010 Pearson Education, Inc. Answer: TRUE Diff: 1 Page Ref: 159 5 Copyright © 2010 Pearson Education, Inc. 11) The most dangerous skin cancer is cancer of the melanocytes. Answer: TRUE Diff: 1 Page Ref: 163 12) 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. Answer: FALSE Diff: 1 Page Ref: 161 13) The dermis is rich in blood vessels and nerve fibers. Answer: TRUE Diff: 2 Page Ref: 152 14) The hypodermis is composed of adipose and dense connective tissue. Answer: FALSE Diff: 1 Page Ref: 149 15) A physician is often able to detect homeostatic imbalances in the body by observing changes in the skin color. Answer: TRUE Diff: 3 Page Ref: 154155 16) When an individual is exposed to extremely low air temperatures, the dermal blood vessels will dilate so that blood and heat will be dissipated. Answer: FALSE Diff: 3 Page Ref: 161 17) Regardless of race, all human beings have about the same number of melanocytes. Answer: TRUE Diff: 1 Page Ref: 154 18) Ceruminous glands are modified merocrine glands. Answer: FALSE Diff: 1 Page Ref: 156 19) 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. Answer: FALSE Diff: 2 Page Ref: 152 20) 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. Answer: TRUE Diff: 2 Page Ref: 155 6 Copyright © 2010 Pearson Education, Inc. 7 Copyright © 2010 Pearson Education, Inc. 21) Hair growth and density are influenced by hormones, nutrition, and, in some cases, lifestyle. Answer: TRUE Diff: 2 Page Ref: 159 22) When a patient is said to have "thirddegree burns," this indicates that the patient has burns that cover approximately onethird of the body. Answer: FALSE Diff: 1 Page Ref: 164 23) Sweat glands continuously produce small amounts of sweat, even in cooler temperatures. Answer: TRUE Diff: 1 Page Ref: 155 MultipleChoice Questions 1) Select the most correct statement concerning skin cancer. A) Most tumors that arise on the skin are malignant. B) Squamous cell carcinomas arise from the stratum corneum. C) Basal cell carcinomas are the least common but most malignant. D) Melanomas are rare but must be removed quickly to prevent them from metastasizing. Answer: D Diff: 1 Page Ref: 162 2) ________ 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) Decubitus ulcer C) Impetigo D) Rosacea Answer: A Diff: 2 Page Ref: 168 3) A needle would pierce the epidermal layers of the forearm in which order? A) basale, spinosum, granulosum, corneum B) basale, spinosum, granulosum, lucidum, corneum C) granulosum, basale, spinosum, corneum D) corneum, granulosum, spinosum, basale Answer: D Diff: 2 Page Ref: 150; Fig. 5.2 4) The major regions of a hair shaft include all of the following except ________. A) medulla B) cortex C) external root sheath D) cuticle 8 Copyright © 2010 Pearson Education, Inc. Answer: C Diff: 2 Page Ref: 157 5) Acne is a disorder associated with ________. A) sweat glands B) sebaceous glands C) Meibomian glands D) ceruminous glands Answer: B Diff: 1 Page Ref: 157 6) The dermis ________. A) is an avascular connective tissue layer B) has two layers C) lacks sensory corpuscles and glands D) is where melanocytes are found Answer: B Diff: 1 Page Ref: 152 7) Which muscles attached to the hair follicles cause goose bumps? A) arrector integument B) arrector pili C) levator folliculi D) arrector folliculi Answer: B Diff: 1 Page Ref: 158 8) If a splinter penetrated the skin into the second epidermal layer of the sole of the foot, which cells would be damaged? A) granulosum B) basale C) lucidum D) spinosum Answer: C Diff: 2 Page Ref: 152; Fig. 5.2 9) Which of the following cutaneous receptors is specialized for the reception of touch or light pressure? A) Meissner's corpuscles B) Pacinian corpuscles C) free nerve endings D) Krause's end bulbs Answer: A Diff: 2 Page Ref: 161 9 Copyright © 2010 Pearson Education, Inc. 10) Which of the following is a skin sensory receptor for touch? A) Pacinian corpuscle B) Meissner’s corpuscle C) Ruffini body D) free nerve ending Answer: B Diff: 1 Page Ref: 161 11) Which statement correctly explains why hair appears the way it does? A) Kinky hair has flat, ribbonlike hair shafts. B) Perfectly round hair shafts result in wavy hair. C) Air bubbles in the hair shaft cause straight hair. D) Gray hair is the result of hormonal action altering the chemical composition of melanin. Answer: A Diff: 2 Page Ref: 157 12) Sudoriferous glands vary in distribution over the surface of the body. Which of the following is correct? A) Eccrine are the most numerous, being found primarily in the axillary regions. B) Apocrine glands are larger than eccrine, and empty secretions directly to the surface of the skin. C) Ceruminous glands secrete cerumen, which is thought to deter insects. D) Mammary glands are not considered a modified sweat gland. Answer: C Diff: 2 Page Ref: 155156 13) Although the integument is a covering, it is by no means simple, and some of its functions include ________. A) the dermis providing the major mechanical barrier to chemicals, water, and other external substances B) resident macrophagelike cells whose function is to ingest antigenic invaders and present them to the immune system C) cooling the body by increasing the action of sebaceous glands during hightemperature conditions D) epidermal blood vessels serving as a blood reservoir Answer: B Diff: 3 Page Ref: 161 14) The function of the root hair plexus is to ________. A) serve as a source for new epidermal cells for hair growth after the resting stage has passed B) bind the hair root to the dermis C) cause apocrine gland secretion into the hair follicle D) allow the hair to assist in touch sensation Answer: D Diff: 2 Page Ref: 157 10 Copyright © 2010 Pearson Education, Inc. 11 Copyright © 2010 Pearson Education, Inc. 15) Vernix caseosa is a ________. A) substance contributing to acne during adolescence B) whitish material produced by fetal sebaceous glands C) coat of fine, downy hair on the heads of balding men D) cheesylooking sudoriferous secretion on the skin of newborns Answer: B Diff: 2 Page Ref: 165 16) The ________ gland is a modified sudoriferous gland that secretes wax. A) eccrine B) apocrine C) ceruminous D) mammary Answer: C Diff: 1 Page Ref: 156 17) Nutrients reach the surface of the skin (epidermis) through the process of ________. A) absorbing materials applied to the surface layer of the skin B) utilizing the products of merocrine glands to nourish the epidermis C) filtration D) diffusing through the tissue fluid from blood vessels in the dermis Answer: D Diff: 2 Page Ref: 149 18) 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) it has no delicate nerve endings and can therefore absorb more shock C) the major part of its makeup is adipose, which serves as an effective shock absorber D) the cells that make up the hypodermis secrete a protective mucus Answer: C Diff: 1 Page Ref: 149150 19) Which type of skin cancer appears as a scaly reddened papule and tends to grow rapidly and metastasize? A) Melanoma B) Squamous cell carcinoma C) Basal cell carcinoma D) Adenoma Answer: B Diff: 2 Page Ref: 163 20) Keratinocytes are an important epidermal cell because they ________. A) produce a fibrous protein that gives the skin much of its protective properties B) are able to transform from living cells to plasma membranes and still function C) are able to reproduce sporadically as needed 12 Copyright © 2010 Pearson Education, Inc. D) are a powerful defense against damaging UV rays Answer: A Diff: 1 Page Ref: 150 21) Melanocytes and keratinocytes work together in protecting the skin from UV damage when keratinocytes ________. A) provide the melanocyte with a protective shield against abrasion B) accumulate the melanin granules on their superficial portion, forming a UVblocking pigment layer C) maintain the appropriate pH in order for the melanocyte to synthesize melanin granules D) maintain the appropriate temperature so the product of the melanocyte will not denature Answer: B Diff: 1 Page Ref: 150 22) The epidermis consists of five layers of cells, each layer with a distinct role to play in the health, wellbeing, and functioning of the skin. Which of the following layers is responsible for cell division and replacement? A) stratum corneum B) stratum granulosum C) stratum basale D) stratum lucidum Answer: C Diff: 2 Page Ref: 150152 23) 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) macrophages called epidermal dendritic cells C) keratinocytes, because they are so versatile D) tactile cells Answer: B Diff: 2 Page Ref: 150 24) Water loss through the epidermis could cause a serious threat to health and wellbeing. Which of the following protects us against excessive water loss through the skin? A) Lamellated granules of the cells of the stratum granulosum, a glycolipid that is secreted into extracellular spaces. B) The size and shape of the cells that make up the stratum spinosum, as well as the thick bundles of intermediate filaments. C) The dermis is the thickest portion of the skin and water cannot pass through it. D) Fat associated with skin prevents water loss. Answer: A Diff: 2 Page Ref: 150, 152 13 Copyright © 2010 Pearson Education, Inc. 25) The dermis is a strong, flexible connective tissue layer. Which of the following cell types are likely to be found in the dermis? A) goblet cells, parietal cells, and Kupffer cells B) monocytes, reticulocytes, and osteocytes C) fibroblasts, macrophages, and mast cells D) osteoblasts, osteoclasts, and epithelial cells Answer: C Diff: 1 Page Ref: 152 26) The dermis has two major layers; which of the following constitutes 80% of the dermis and is responsible for the tension lines in the skin? A) the reticular layer B) the subcutaneous layer C) the hypodermal layer D) the papillary layer Answer: A Diff: 2 Page Ref: 152153 27) Despite its apparent durability, the dermis is subject to tearing. How might a person know that the dermis has been stretched and/or torn? A) The pain is acute due to the large number of Meissner's corpuscles. B) The appearance of visible, silverywhite scars is an indication of stretching of the dermis. C) The blood vessels in the dermis rupture and the blood passes through the tissue, causing "blackandblue marks." D) The stretching causes the tension lines to disappear. Answer: B Diff: 2 Page Ref: 153 28) 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) ceruminous glands. D) reticular papillae. Answer: A Diff: 1 Page Ref: 152 29) 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) Every human being has the same pattern of ridges. B) They are genetically determined, therefore unique to each person. C) Because we are constantly shedding epithelial cells, these ridges are changing daily. D) Identical twins do not have the same pattern of ridges. Answer: B 14 Copyright © 2010 Pearson Education, Inc. Diff: 1 Page Ref: 152 15 Copyright © 2010 Pearson Education, Inc. 30) 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) Carotene, which accumulates in the stratum corneum and hypodermal adipose tissue, is synthesized in large amounts in the presence of sunlight. C) The skin is protected by increasing the number of epidermal dendritic cells, which help to activate the immune system. D) Prolonged exposure to the sun induces melanin dispersion, which in turn acts as a natural sunscreen. Answer: D Diff: 2 Page Ref: 154 31) 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) The skin takes on a bronze or metallic appearance. B) Blackandblue marks become evident for no apparent cause. C) The skin appears to have an abnormal, yellowish tint. D) It is impossible to suggest Addison's disease from an inspection of a person's skin. Answer: A Diff: 2 Page Ref: 155 32) An epidermal dendritic cell is a specialized ________. A) squamous epithelial cell B) phagocytic cell C) nerve cell D) melanocyte Answer: B Diff: 1 Page Ref: 150 33) What are the most important factors influencing hair growth? A) sex and hormones B) age and glandular products C) the size and number of hair follicles D) nutrition and hormones Answer: D Diff: 1 Page Ref: 159 34) Which of the following statements best describes what fingernails actually are? A) Fingernails are a modification of the epidermis. B) Fingernails are derived from osseous tissue. C) Fingernails are extensions of the carpal bones. D) Fingernails are a separate tissue from the skin, formed from a different embryonic layer. Answer: A Diff: 1 Page Ref: 160 16 Copyright © 2010 Pearson Education, Inc. 35) 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) mammary and ceruminous C) eccrine and apocrine D) holocrine and mammary Answer: C Diff: 1 Page Ref: 155156 36) The composition of the secretions of the eccrine glands is ________. A) primarily uric acid B) 99% water, sodium chloride, trace amounts of wastes, and vitamin C C) fatty substances, proteins, antibodies, and trace amounts of minerals and vitamins D) metabolic wastes Answer: B Diff: 1 Page Ref: 155 37) 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) in all body regions and buried deep in the dermis B) beneath the flexure lines in the body C) in the axillary and anogenital area D) in the palms of the hands and soles of the feet Answer: C Diff: 1 Page Ref: 156 38) The sebaceous glands are simple alveolar glands that secrete a substance known as sebum. The secretion of sebum is stimulated ________. A) by high temperatures B) when the air temperature drops C) by hormones, especially androgens D) as a protective coating when one is swimming Answer: C Diff: 1 Page Ref: 156 39) 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 converts modified epidermal cholesterol to a vitamin D precursor important to calcium metabolism. B) It aids in the transport of materials throughout the body. C) The cells of the epidermis store glucose as glycogen for energy. D) It absorbs vitamin C so that the skin will not be subject to diseases. Answer: A Diff: 1 Page Ref: 160163 17 Copyright © 2010 Pearson Education, Inc. 40) 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 measuring urinary output and fluid intake B) by observing the tissues that are usually moist C) through blood analysis D) by using the "rule of nines" Answer: D Diff: 1 Page Ref: 163 41) What is the first threat to life from a massive thirddegree burn? A) infection B) catastrophic fluid loss C) unbearable pain D) loss of immune function Answer: B Diff: 2 Page Ref: 163164 42) Male pattern baldness has a genetic switch that turns on in response to ________. A) age B) size C) weight D) male hormones Answer: D Diff: 1 Page Ref: 159 43) Eyebrow hairs are always shorter than hairs on your head because ________. A) they grow much slower B) eyebrow follicles are only active for a few months C) the vascular supply of the eyebrow follicle is onetenth that of the head hair follicle D) hormones in the eyebrow follicle switch the growth off after it has reached a predetermined length Answer: B Diff: 2 Page Ref: 159 18 Copyright © 2010 Pearson Education, Inc. FillintheBlank/Short Answer Questions 1) Cradle cap in infants is called ________. Answer: seborrhea Diff: 2 Page Ref: 157 2) The white crescent portion of the nail is called the ________. Answer: lunula Diff: 2 Page Ref: 160; Fig. 5.7 3) The layer of the epidermis immediately under the stratum lucidum in thick skin is the stratum ________. Answer: granulosum Diff: 1 Page Ref: 150; Fig. 5.2 4) The ________ are the small muscles located in the dermis that cause goose bumps. Answer: arrector pili Diff: 1 Page Ref: 158 5) 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 Diff: 2 Page Ref: 155 6) The coarse hair of the eyebrows and scalp is called ________ hair. Answer: terminal Diff: 1 Page Ref: 159 7) ________ burns injure the epidermis and the upper regions of the dermis. Answer: Seconddegree Diff: 1 Page Ref: 163164 8) ________ are pigmentproducing cells in the epidermis. Answer: Melanocytes Diff: 1 Page Ref: 150 9) The only place you will find stratum ________ is in the skin that covers the palms, fingertips, and soles of the feet. Answer: lucidum Diff: 1 Page Ref: 152 10) The dermis is composed of the reticular and ________ layers. Answer: papillary Diff: 1 Page Ref: 152 19 Copyright © 2010 Pearson Education, Inc. 11) 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; and a proteindeficient diet can cause hair loss or thinning. Diff: 3 Page Ref: 159 12) In addition to the synthesis of vitamin D, keratinocytes are able to carry out some other biologically important functions. Name at least two of these other functions. Answer: Keratinocyte enzymes can neutralize carcinogens that penetrate the epidermis. Keratinocytes are also able to convert topical steroid hormones to a powerful antiinflammatory drug. Diff: 3 Page Ref: 161 13) How are burns classified? Give an example. Answer: Burns are classified according to their severity or depth. For example, in firstdegree 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. Diff: 2 Page Ref: 164 14) What are vellus hairs? Answer: pale, fine body hair associated with newborn children, women, and bald men Diff: 2 Page Ref: 159 15) 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 sexlinked, and is possibly caused by a delayedaction gene that responds to DHT and alters normal metabolism. Diff: 3 Page Ref: 159 16) Billions 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 due to the metabolic activities of bacteria on the surface of the skin. Diff: 3 Page Ref: 155156 17) 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. Diff: 3 Page Ref: 163164 20 Copyright © 2010 Pearson Education, Inc. 18) 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. Diff: 3 Page Ref: 150152, 160162 19) Name the layers of the epidermis in order from the surface down. Answer: Stratum corneum, lucidum, granulosum, spinosum, and basale. Diff: 1 Page Ref: 151; Fig. 5.2 20) 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. Diff: 3 Page Ref: 152 21) Why are the apocrine sweat glands fairly unimportant in thermal regulation? Answer: They are largely confined to the axillary and anogenital regions rather than distributed on the body where heat can be more readily dissipated. Diff: 3 Page Ref: 156 22) Name the four kinds of sudoriferous glands. Answer: 1. eccrine 2. apocrine 3. ceruminous 4. mammary Diff: 1 Page Ref: 155156 23) Why is skin not considered a 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. Diff: 2 Page Ref: 161 24) 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. 21 Copyright © 2010 Pearson Education, Inc. Diff: 2 Page Ref: 161 25) Why should incisions be made parallel to cleavage lines produced by collagen fiber bundles rather than perpendicular to the lines? Answer: The skin will gape less and heal more readily when the incision is made parallel to the cleavage lines. Diff: 3 Page Ref: 152153 26) What is the function of skin dermal folds and deep skin creases? Answer: to accommodate for joint movement Diff: 3 Page Ref: 152 Clinical Questions 1) We are told that every surface we touch is teeming with bacterial cells, and bacteria are found in the pools we swim in, the water we wash with, and on the hands of friends. Why are we not inundated with bacterial infections on our skin? Answer: The low pH of the skin secretions, otherwise known as the acid mantle, retards the multiplication of bacteria on the skin. Also, in areas where sufficient sebum is produced regularly, many species of bacteria cannot exist. Beside the barrier qualities of the skin, it is also true that not all bacteria are harmful or thrive on skin. Diff: 3 Page Ref: 161 2) The temperature yesterday was an uncomfortable 98° F. You unwisely chose to play tennis at noon, counting on your body's internal defenses to protect you against heat exhaustion. How did your body respond to this distress? Answer: The thermoreceptors in the skin sense the temperature change, and the body responded by stimulating sweat glands. Their watery products evaporated at the skin surface and cooled the body. Blood vessels in the dermis also responded to neural stimulation by dilating and releasing heat to the exterior. Diff: 3 Page Ref: 161 3) Mary noticed a large, brown spot on her skin. She has been playing tennis in the sun for several years without sun protection. She reported the discovery to a friend, who told her to apply the ABCD rule to determine whether or not she had malignant melanoma. Her friend told her that if her answer was "no" to the questions that were asked by the ABCD rule, she had nothing to worry about. What is the ABCD rule and should she ignore the spot if her answers are negative? Answer: The ABCD rule refers to the following: asymmetrywhere the two sides of the spot do not match; border irregularitythe borders are not round and smooth; colorthe pigmented spot contains shades of black, brown, tan, and sometimes blues and reds; and diameterthe spot is larger than 6 mm in diameter. It is imperative that Mary have a physician examine the spot immediately. Any unusual lesion on the skin of a sun worshipper should be examined. Diff: 3 Page Ref: 162163 22 Copyright © 2010 Pearson Education, Inc. 4) The Waldorf family was caught in a fire but escaped. Unfortunately, the father and daughter suffered burns. The father had seconddegree burns on his chest, abdomen, and both arms, and thirddegree burns on his entire left lower extremity. The daughter suffered firstdegree burns on her head and neck and seconddegree burns on both lower extremities. a. What percentage of the father's body was covered by burns? b. What percentage of the daughter's body received firstdegree burns? c. What part of the daughter's body has both the dermis and epidermis involved? d. The father experiences a good deal of pain in the area of the chest and abdomen, but little pain in the leg. Why? Answer: a. 48% b. 9% c. 36% d. Normally, thirddegree burns sear nerve endings off. When the tissue regenerates, pain will return. Seconddegree burns are usually very painful because of the irritation to the nerve endings. Diff: 3 Page Ref: 163; Fig. 5.9 5) John, a younger teenager, notices that he is experiencing a lot of pimples and blackheads, which frequently become infected. What is causing this problem? Answer: Because of hormonal changes, teenagers frequently have overactive sebaceous (oil) glands, which can clog and become infected or inflamed. Scratching, squeezing, or irritating the tissue can lead to infection. Diff: 1 Page Ref: 156157 6) Albinos commonly contract skin cancer. What seems to be their problem and what is a solution? Answer: Albinos lack melanin and consequently do not have the normal defense against UV light. As a result, skin cells can be affected by UV and skin cancer can occur. Covering all body areas and avoiding bright sunlight can prevent the situation. Diff: 3 Page Ref: 154, 168 7) Melanoma is a form of skin cancer that arises from melanocytes. Melanoma is most common in Caucasians between 40 and 70 years of age. Explain why Caucasians would have a greater incidence of melanoma. Answer: Melanoma has its beginnings in melanocytes, the skin pigment cells. These cells produce the dark protective pigment called melanin. It is the melanin that is responsible for suntanned skin acting as a partial protection against the sun. Melanocytes of black and brown skinned people produce many more darker melanocytes than those of fairskinned individuals. Dark brown or black skin is not a guarantee against melanoma, but the incidence is higher in Caucasians. Diff: 2 Page Ref: 154, 162 23 Copyright © 2010 Pearson Education, Inc. 8) The 68yearold patient was admitted to the hospital medical floor with a diagnosis of chronic bronchitis. His wife asks the nurse why his skin looks blue. How would you explain cyanosis to the patient and his wife? Answer: Cyanosis is a dusky bluish or grayish discoloration of the skin and mucous membranes that occurs with reduced oxygen levels of hemoglobin. Hemoglobin carries oxygen to the tissues. Without enough oxygen getting to the tissues the skin in Caucasians appears blue. In darkskinned patients, close inspection of the conjunctiva and palms and soles may also show evidence of cyanosis. Diff: 3 Page Ref: 155 9) Explain why soap that has an alkaline base may not be healthy for some patients to use daily. Answer: The skin's acid mantle retards growth of bacteria. Soap may destroy the acid mantle of the skin, causing it to lose its protective mechanism. Some soaps contain antibacterial agents, which can change the natural flora of the skin. Diff: 3 Page Ref: 161 10) Robert, a surfer, has a mole that has changed its shape and size. His doctor, applying the ABCD(E) rule, diagnosed a melanoma. What do the letters ABCD(E) represent? Answer: A = asymmetry B = border irregularity C = color D = diameter E = elevation Diff: 2 Page Ref: 162163 24 Copyright © 2010 Pearson Education, Inc.