Chapter 46: Structure, Function, and Disorders of the Integument
MULTIPLE CHOICE
1. Which component of the epidermis initiates immune responses and provides a defense against
environmental antigens?
a. Langerhans cells c. Keratinocytes
b. Merkel cells d. Melanocytes
ANS: A
Langerhans cells (a type of dendritic cell) and dermal dendritic cells initiate an immune re-
sponse by presenting processed antigen to T cells, thus providing a defense against environ-
mental antigens. This function is not true of the other options.
PTS: 1 REF: Page 1617
2. Which cells of the dermis release histamine and play a role in the hypersensitivity reactions of
the skin?
a. Histiocytes c. Mast cells
b. Fibroblasts d. Macrophages
ANS: C
Only mast cells release histamine and play a role in hypersensitivity reactions in the skin.
PTS: 1 REF: Page 1618
3. Which cells of the dermis secrete connective tissue matrix?
a. Macrophages c. Fibroblasts
b. Mast cells d. Histiocytes
ANS: C
Only fibroblasts secrete the connective tissue matrix and collagen.
PTS: 1 REF: Page 1618
4. Which gland releases secretions that are important in thermoregulation and cooling of the
body through evaporation?
a. Sebaceous c. Eccrine
b. Apocrine d. Exocrine
ANS: C
The eccrine sweat glands are distributed over the body, with the greatest numbers in the palms
of the hands, soles of the feet, and forehead. These secretions are important in thermoregula-
tion and cooling of the body through evaporation. This function is not true for the other op-
tions.
PTS: 1 REF: Page 1618
5. Which receptors of the sympathetic nervous system regulate heat loss through the skin?
a. Cholinergic c. a-Adrenergic
b. §-Adrenergic d. Anticholinergic
, ANS: C
Heat loss can be regulated by varying blood flow through the skin by opening and closing the
arteriovenous anastomoses in conjunction with evaporative heat loss of sweat. The sympa-
thetic nervous system regulates vasoconstriction and vasodilation through a-adrenergic recep-
tors only.
PTS: 1 REF: Page 1619
6. What is the first change in the skin that indicates a pressure ulcer?
a. Blanchable erythema of intact skin
b. Nonblanchable erythema of intact skin
c. Blister at the site of pressure
d. Reddish-purple discoloration
ANS: B
Nonblanchable erythema of intact skin, usually over bony prominences, characterizes stage 1
pressure ulcers. This selection is the only option that accurately identifies the initial skin
change indicative of a pressure ulcer.
PTS: 1 REF: Page 1625
7. Which type of dressings should be applied to pressure ulcers?
a. Flat and dry c. Bulky and dry
b. Flat and moist d. Bulky and moist
ANS: B
Superficial pressure ulcers should be covered with flat, nonbulky dressings that cannot wrin-
kle or cause increased pressure or friction. Spontaneous healing will occur more quickly if the
ulcer is kept moist with an occlusive dressing.
PTS: 1 REF: Page 1626
8. What term is used to identify skin lesions that are elevated, rounded, and firm with irregular
clawlike margins that extend beyond the original site of injury?
a. Psoriasis c. Acne
b. Dermatitis d. Keloid
ANS: D
Of the options available, only keloids typically send out clawlike prolongations.
PTS: 1 REF: Page 1626
9. Keloids are sharply elevated, irregularly shaped, progressively enlarging scars caused by ex-
cessive amounts of which substance in the corneum during connective tissue repair?
a. Elastin c. Stroma
b. Collagen d. Reticular fibers
ANS: B
Abnormal wound healing with excessive fibroblast activity and collagen formation during
dermal connective tissue repair cause keloids. The other options are not associated with keloid
formation.
MULTIPLE CHOICE
1. Which component of the epidermis initiates immune responses and provides a defense against
environmental antigens?
a. Langerhans cells c. Keratinocytes
b. Merkel cells d. Melanocytes
ANS: A
Langerhans cells (a type of dendritic cell) and dermal dendritic cells initiate an immune re-
sponse by presenting processed antigen to T cells, thus providing a defense against environ-
mental antigens. This function is not true of the other options.
PTS: 1 REF: Page 1617
2. Which cells of the dermis release histamine and play a role in the hypersensitivity reactions of
the skin?
a. Histiocytes c. Mast cells
b. Fibroblasts d. Macrophages
ANS: C
Only mast cells release histamine and play a role in hypersensitivity reactions in the skin.
PTS: 1 REF: Page 1618
3. Which cells of the dermis secrete connective tissue matrix?
a. Macrophages c. Fibroblasts
b. Mast cells d. Histiocytes
ANS: C
Only fibroblasts secrete the connective tissue matrix and collagen.
PTS: 1 REF: Page 1618
4. Which gland releases secretions that are important in thermoregulation and cooling of the
body through evaporation?
a. Sebaceous c. Eccrine
b. Apocrine d. Exocrine
ANS: C
The eccrine sweat glands are distributed over the body, with the greatest numbers in the palms
of the hands, soles of the feet, and forehead. These secretions are important in thermoregula-
tion and cooling of the body through evaporation. This function is not true for the other op-
tions.
PTS: 1 REF: Page 1618
5. Which receptors of the sympathetic nervous system regulate heat loss through the skin?
a. Cholinergic c. a-Adrenergic
b. §-Adrenergic d. Anticholinergic
, ANS: C
Heat loss can be regulated by varying blood flow through the skin by opening and closing the
arteriovenous anastomoses in conjunction with evaporative heat loss of sweat. The sympa-
thetic nervous system regulates vasoconstriction and vasodilation through a-adrenergic recep-
tors only.
PTS: 1 REF: Page 1619
6. What is the first change in the skin that indicates a pressure ulcer?
a. Blanchable erythema of intact skin
b. Nonblanchable erythema of intact skin
c. Blister at the site of pressure
d. Reddish-purple discoloration
ANS: B
Nonblanchable erythema of intact skin, usually over bony prominences, characterizes stage 1
pressure ulcers. This selection is the only option that accurately identifies the initial skin
change indicative of a pressure ulcer.
PTS: 1 REF: Page 1625
7. Which type of dressings should be applied to pressure ulcers?
a. Flat and dry c. Bulky and dry
b. Flat and moist d. Bulky and moist
ANS: B
Superficial pressure ulcers should be covered with flat, nonbulky dressings that cannot wrin-
kle or cause increased pressure or friction. Spontaneous healing will occur more quickly if the
ulcer is kept moist with an occlusive dressing.
PTS: 1 REF: Page 1626
8. What term is used to identify skin lesions that are elevated, rounded, and firm with irregular
clawlike margins that extend beyond the original site of injury?
a. Psoriasis c. Acne
b. Dermatitis d. Keloid
ANS: D
Of the options available, only keloids typically send out clawlike prolongations.
PTS: 1 REF: Page 1626
9. Keloids are sharply elevated, irregularly shaped, progressively enlarging scars caused by ex-
cessive amounts of which substance in the corneum during connective tissue repair?
a. Elastin c. Stroma
b. Collagen d. Reticular fibers
ANS: B
Abnormal wound healing with excessive fibroblast activity and collagen formation during
dermal connective tissue repair cause keloids. The other options are not associated with keloid
formation.
