Visual Anatomy & Physiology 3rd Ed By Martini – Test Bank

Visual Anatomy and Physiology, 3e (Martini)

Chapter 5   The Integumentary System

Multiple Choice Questions

1) Each of the following is a function of the integumentary system except

A) protection of underlying tissue.

B) excretion of salts and wastes.

C) maintenance of body temperature.

D) synthesis of vitamin C.

E) provision of sensation.

Answer:  D

Learning Outcome:  5.1

Bloom’s Taxonomy:  Remembering

2) The two components of the integumentary system are the

A) epidermis and dermis.

B) cutaneous membrane and hypodermis.

C) cutaneous membrane and accessory structures.

D) integument and hypodermis.

E) epidermis and superficial fascia.

Answer:  C

Learning Outcome:  5.1

Bloom’s Taxonomy:  Remembering

3) Accessory structures of the skin include all of the following except

A) hair follicles.

B) sebaceous glands.

C) sweat glands.

D) the epidermis.

E) lamellar corpuscles.

Answer:  D

Learning Outcome:  5.1

Bloom’s Taxonomy:  Remembering

Figure 5-1

4) An intradermal injection is administered into which layer?

A) 1

B) 2

C) 3

D) below layer 5

E) 5

Answer:  C

Learning Outcome:  5.1

Bloom’s Taxonomy:  Understanding

5) Which layer is the primary barrier against environmental hazards?

A) 1

B) 2

C) 3

D) 4

E) 5

Answer:  A

Learning Outcome:  5.1

Bloom’s Taxonomy:  Understanding

6) Which tissue is located in the region labeled “2”?

A) stratified squamous epithelium

B) areolar connective tissue

C) adipose tissue

D) cartilage and blood

E) reticular connective tissues

Answer:  B

Learning Outcome:  5.1

Bloom’s Taxonomy:  Understanding

7) Which layer contains most of the accessory organs?

A) 1

B) 2

C) 3

D) below layer 5

E) 5

Answer:  C

Learning Outcome:  5.1

Bloom’s Taxonomy:  Understanding

8) While walking barefoot on the beach, Joe stepped on a thorn that penetrated through the sole of his foot to the dermis. How many layers of epidermis did the thorn penetrate?

A) 1

B) 2

C) 3

D) 4

E) 5

Answer:  E

Learning Outcome:  5.2

Bloom’s Taxonomy:  Understanding

9) The type of most cells that form the strata in the epidermis are

A) adipocytes.

B) keratinocytes.

C) fibroblasts.

D) melanocytes.

E) dendritic cells.

Answer:  B

Learning Outcome:  5.2

Bloom’s Taxonomy:  Remembering

10) The layer of dividing cells at the base of the epidermis is the

A) stratum corneum.

B) stratum lucidum.

C) stratum basale.

D) stratum granulosum.

E) stratum spinosum.

Answer:  C

Learning Outcome:  5.2

Bloom’s Taxonomy:  Remembering

11) The tough “horny” superficial layer of the epidermis is known as the

A) stratum corneum.

B) stratum lucidum.

C) stratum basale.

D) stratum granulosum.

E) stratum spinosum.

Answer:  A

Learning Outcome:  5.2

Bloom’s Taxonomy:  Remembering

12) Insensible perspiration takes place in the

A) stratum corneum.

B) stratum lucidum.

C) stratum basale.

D) stratum granulosum.

E) stratum spinosum.

Answer:  A

Learning Outcome:  5.2

Bloom’s Taxonomy:  Remembering

13) The keratinocytes are tightly connected with each other by

A) keratin.

B) prekeratin.

C) collagen fibers.

D) elastic fibers.

E) desmosomes.

Answer:  E

Learning Outcome:  5.2

Bloom’s Taxonomy:  Remembering

14) In which layer of skin are keratinocytes produced?

A) dermis

B) subcutaneous layer

C) stratum spinosum

D) stratum corneum

E) stratum basale

Answer:  E

Learning Outcome:  5.2

Bloom’s Taxonomy:  Remembering

15) The epidermis in the thin skin contains ________ layer(s) and in the thick skin contains ________ layers.

A) 1; 2

B) 2; 3

C) 3; 4

D) 4; 5

E) 5; 6

Answer:  D

Learning Outcome:  5.2

Bloom’s Taxonomy:  Remembering

16) All of the following are characteristics of the epidermis except that it

A) is multilayered.

B) is flexible.

C) is self-repairing.

D) serves as UV radiation protection.

E) is vascularized.

Answer:  E

Learning Outcome:  5.2

Bloom’s Taxonomy:  Remembering

17) All of the following are true of epidermal ridges except that they

A) extend into the dermis.

B) contain increased numbers of free nerve endings.

C) cause ridge patterns on the surface of the skin.

D) produce patterns that are determined genetically.

E) interconnect with the dermal papillae.

Answer:  B

Learning Outcome:  5.2

Bloom’s Taxonomy:  Remembering

18) ________ are cells in the epidermis that are part of the immune system.

A) Dendritic cells

B) Basal cells

C) Merkel cells

D) Squamous cells

E) Melanocytes

Answer:  A

Learning Outcome:  5.2

Bloom’s Taxonomy:  Remembering

19) An albino individual lacks the ability to produce

A) melanin.

B) keratin.

C) carotene.

D) perspiration.

E) hemoglobin.

Answer:  A

Learning Outcome:  5.3

Bloom’s Taxonomy:  Remembering

20) All of the following are true of the pigment melanin except that it

A) decreases in concentration within cells during exposure to the sun.

B) is usually some shade of brown or black.

C) protects DNA from the damaging effects of UV radiation.

D) is released through melanosomes.

E) is produced by cells called melanocytes.

Answer:  A

Learning Outcome:  5.3

Bloom’s Taxonomy:  Remembering

21) What is the survival rate of a localized malignant melanoma that is detected and removed in the early stages of the cancer?

A) Above 95%

B) 75%

C) 60%

D) 40%

E) less than 20%

Answer:  A

Learning Outcome:  5.3

Bloom’s Taxonomy:  Understanding

22) From what layer of skin are melanosomes released?

A) stratum coneum

B) stratum basale

C) papillary layer of dermis

D) reticular layer of dermis

E) hypodermis

Answer:  B

Learning Outcome:  5.3

Bloom’s Taxonomy:  Understanding

23) The ________ in keratinocytes protects the epidermis and dermis from the harmful effects of sunlight.

A) sebum

B) hemoglobin

C) melanin

D) carotene

E) keratin

Answer:  C

Learning Outcome:  5.3

Bloom’s Taxonomy:  Remembering

24) Cyanosis signifies that a patient has

A) had too much sun.

B) been kept out of the sun.

C) an allergic reaction.

D) oxygen-starved skin.

E) been exposed to cyanide.

Answer:  D

Learning Outcome:  5.3

Bloom’s Taxonomy:  Understanding

25) ________ is a pigment found in vegetables that can make the skin appear orange or yellow.

A) Melanin

B) Chlorophyll

C) Carotene

D) Hemoglobin

E) Bilirubin

Answer:  C

Learning Outcome:  5.3

Bloom’s Taxonomy:  Remembering

26) The most dangerous type of skin cancer is termed

A) cyanosis.

B) basal cell carcinoma.

C) malignant melanoma.

D) metastasis.

E) melanosome.

Answer:  C

Learning Outcome:  5.3

Bloom’s Taxonomy:  Remembering

27) Melanin is produced by melanocytes within the stratum

A) corneum.

B) lucidum.

C) granulosum.

D) spinosum.

E) basale.

Answer:  E

Learning Outcome:  5.3

Bloom’s Taxonomy:  Remembering

28) The layer of the skin that contains bundles of collagen and elastic fibers responsible for the strength of the skin is the ________ layer.

A) papillary

B) reticular

C) epidermal

D) subcutaneous

E) hypodermal

Answer:  B

Learning Outcome:  5.4

Bloom’s Taxonomy:  Understanding

29) All of the following are true of the hypodermis except it

A) contains many blood vessels.

B) permits independent movement of deeper structures.

C) contains large amounts of adipose tissue.

D) is attached to the dermis by a basement membrane.

E) stores energy reserves.

Answer:  D

Learning Outcome:  5.4

Bloom’s Taxonomy:  Remembering

30) What is the most common type of cells in the subcutaneous layer?

A) keratinocytes

B) adipocytes

C) melanocytes

D) fibroblasts

E) fibrocytes

Answer:  B

Learning Outcome:  5.4

Bloom’s Taxonomy:  Remembering

31) Central adiposity is strongly associated with

A) liver diseases.

B) lung diseases.

C) kidney disorders.

D) cardiovascular disorders.

E) reproductive illnesses.

Answer:  D

Learning Outcome:  5.4

Bloom’s Taxonomy:  Understanding

32) Skin wrinkle and sagging is caused by

A) UV radiation.

B) hormonal changes.

C) aging.

D) all of the choices.

E) none of the choices.

Answer:  D

Learning Outcome:  5.4

Bloom’s Taxonomy:  Understanding

33) If the epidermis, dermis, and part of hypodermis are burned, it is classified as

A) first degree.

B) second degree.

C) partial thickness.

D) full thickness.

E) none of the choices.

Answer:  D

Learning Outcome:  5.5

Bloom’s Taxonomy:  Remembering

34) All of the following can be used in the management of severe burn except

A) antibiotics.

B) fluid replacement.

C) corticosteroids.

D) skin graft.

E) cell culture.

Answer:  C

Learning Outcome:  5.5

Bloom’s Taxonomy:  Understanding

35) All of the following are derived from epithelial columns except

A) hair roots.

B) hair follicles.

C) nails.

D) sebaceous glands.

E) sweat glands.

Answer:  C

Learning Outcome:  5.6

Bloom’s Taxonomy:  Remembering

36) All of the following are functions of accessory structures of integument except

A) thermoregulation.

B) protection of skull.

C) sensation of touch.

D) production of skin pigments.

E) excretion of sweat.

Answer:  D

Learning Outcome:  5.6

Bloom’s Taxonomy:  Remembering

37) ________ is a small connective tissue peg that contains nerve endings and blood vessels.

A) Hair medulla

B) Hair bulb

C) Hair papilla

D) Hair matrix

E) Hair cuticle

Answer:  C

Learning Outcome:  5.7

Bloom’s Taxonomy:  Remembering

38) When the arrector pili muscles contract,

A) “goose bumps” are formed.

B) hairs are shed.

C) sweat is released from sweat glands.

D) shivering occurs.

E) the skin changes color.

Answer:  A

Learning Outcome:  5.7

Bloom’s Taxonomy:  Understanding

39) If the papilla of a hair follicle is destroyed,

A) the hair produced by the follicle will change from terminal to vellus.

B) the color of the hair will become lighter.

C) the texture of the hair will become coarser.

D) the follicle will lose its blood supply.

E) hair production will not be affected.

Answer:  D

Learning Outcome:  5.7

Bloom’s Taxonomy:  Understanding

40) Each of the following statements concerning hair is true except

A) the medulla is the soft core of the hair.

B) the cortex of the hair is composed of hard keratin.

C) terminal hairs are heavy and more darkly pigmented than other types of hair.

D) club hair is hair that has ceased growing.

E) scalp hairs grow constantly throughout life.

Answer:  E

Learning Outcome:  5.7

Bloom’s Taxonomy:  Understanding

41) All of the following are correct regarding hair growth cycle except that

A) a hair in the scalp grows for 2 — 5 years.

B) a healthy adult with full head of hair may lose up to 100 hairs each day.

C) during the active phase, the hair grows continuously.

D) club hair is shed during follicle reactivation.

E) the hair becomes club hair during regression phase.

Answer:  E

Learning Outcome:  5.7

Bloom’s Taxonomy:  Understanding

42) ________ are fine hairs that lack pigment and cover much of the body surface.

A) Vellus hairs

B) Velvet hairs

C) Follicular hairs

D) Terminal hairs

Answer:  A

Learning Outcome:  5.7

Bloom’s Taxonomy:  Remembering

43) ________ hairs are coarse pigmented hairs.

A) Vellus

B) Dense

C) Follicular

D) Terminal

E) Keratinous

Answer:  D

Learning Outcome:  5.7

Bloom’s Taxonomy:  Remembering

44) Dandruff is a disorder that results in dry skin flakes forming in the scalp. A common cause of dandruff could be

A) inflammation around sebaceous glands.

B) lack of lamellated corpuscles.

C) overactive arrector pili muscles.

D) inactive apocrine sweat glands.

E) inactive merocrine sweat glands.

Answer:  A

Learning Outcome:  5.8

Bloom’s Taxonomy:  Understanding

45) From what structure does merocrine secretion occur?

A) ceruminous gland

B) mammary gland

C) apocrine sweat gland

D) sebaceous gland

E) eccrine sweat gland

Answer:  E

Learning Outcome:  5.8

Bloom’s Taxonomy:  Understanding

46) The substance called sebum is commonly known as

A) regular sweat.

B) earwax.

C) milk.

D) skin oil.

E) odiferous sweat.

Answer:  D

Learning Outcome:  5.8

Bloom’s Taxonomy:  Remembering

47) The ________ glands in the axilla become active at the time of puberty.

A) ceruminous

B) apocrine sweat

C) merocrine sweat

D) sebaceous

E) axillary

Answer:  B

Learning Outcome:  5.8

Bloom’s Taxonomy:  Understanding

48) Perspiration is produced by ________ glands.

A) ceruminous

B) apocrine sweat

C) merocrine sweat

D) sebaceous

E) mammary

Answer:  C

Learning Outcome:  5.8

Bloom’s Taxonomy:  Remembering

49) Milk is produced by ________ glands.

A) sebaceous

B) mammary

C) merocrine sweat

D) ceruminous

E) eccrine sweat

Answer:  D

Learning Outcome:  5.8

Bloom’s Taxonomy:  Understanding

50) The highest concentration of merocrine sweat glands is found

A) in the axillae.

B) on the chest.

C) on the palms of the hands.

D) on the upper back.

E) surrounding the genitals.

Answer:  C

Learning Outcome:  5.8

Bloom’s Taxonomy:  Remembering

51) All of the following are true of perspiration produced by merocrine sweat glands except that it

A) is very watery.

B) contains electrolytes and waste products.

C) helps cool the body when it evaporates.

D) helps prevent bacteria from colonizing the skin.

E) produces the body odor characteristic of “sweating.”

Answer:  E

Learning Outcome:  5.8

Bloom’s Taxonomy:  Remembering

52) ________ sweat glands are widely distributed across the body surface, ________ glands are located wherever hair follicles exist, and ________ sweat glands are found only in a few areas.

A) Sebaceous; merocrine; apocrine

B) Apocrine; merocrine; sebaceous

C) Merocrine; sebaceous; apocrine

D) Merocrine; apocrine; sebaceous

E) Apocrine; sebaceous; merocrine

Answer:  C

Learning Outcome:  5.8

Bloom’s Taxonomy:  Remembering

53) Which of the following is a holocrine exocrine gland?

A) sebaceous

B) apocrine

C) merocrine

D) mammary

E) ceruminous

Answer:  A

Learning Outcome:  5.8

Bloom’s Taxonomy:  Remembering

54) Merocrine sweat glands

A) are compound alveolar glands.

B) produce organic secretions that are metabolized by bacteria to produce body odor.

C) secrete a watery fluid directly onto the surface of the skin.

D) increase in number and activity with aging.

E) primarily function in lubricating the hairs.

Answer:  C

Learning Outcome:  5.8

Bloom’s Taxonomy:  Understanding

55) The nail body covers the

A) nail root.

B) nail bed.

C) lunula.

D) free edge.

E) hyponychium.

Answer:  B

Learning Outcome:  5.9

Bloom’s Taxonomy:  Remembering

56) Nail production occurs at the nail

A) body.

B) bed.

C) root.

D) cuticle.

E) hyponychium.

Answer:  C

Learning Outcome:  5.9

Bloom’s Taxonomy:  Remembering

57) At the base of a nail, keratinized skin called the cuticle is also called the

A) eponychium.

B) lunula.

C) hyponychium.

D) cerumen.

E) phalanx.

Answer:  A

Learning Outcome:  5.9

Bloom’s Taxonomy:  Remembering

58) The effects of aging on the skin include

A) a decline in the activity of sebaceous glands.

B) increased production of vitamin D.

C) thickening of the epidermis.

D) an increased blood supply to the dermis.

E) an increased number of sweat glands.

Answer:  A

Learning Outcome:  5.10

Bloom’s Taxonomy:  Remembering

59) Wrinkles in elderly individuals are the result of

A) increased production of epidermis.

B) loss of elastic filaments in the reticular layer of the dermis.

C) increased keratinization of the epidermis.

D) the loss of glands and hair follicles from the skin.

E) decreased thickness of the dermis.

Answer:  B

Learning Outcome:  5.10

Bloom’s Taxonomy:  Understanding

60) Why would an elderly person be more prone to skin infections than a younger person?

A) Skin repairs take longer in the elderly.

B) The epidermis is thinner in the elderly.

C) There are fewer dendritic cells in the skin of the elderly.

D) All of the answers are correct.

Answer:  D

Learning Outcome:  5.10

Bloom’s Taxonomy:  Understanding

61) Which of the following is not an effect of ultraviolet radiation?

A) increased activity by melanocytes

B) production of cholecalciferol within epidermal cells

C) wrinkles

D) chromosomal damage in basal cells or melanocytes

E) hair growth

Answer:  E

Learning Outcome:  5.11

Bloom’s Taxonomy:  Remembering

62) Vitamin ________ is formed in the skin when it is exposed to sunlight.

A) A

B) B

C) C

D) D

E) E

Answer:  D

Learning Outcome:  5.11

Bloom’s Taxonomy:  Remembering

63) Epidermal growth factor exerts all of the following effects on the epidermis except

A) promoting cell division.

B) stimulating keratin synthesis.

C) accelerating tissue repair.

D) speeding up glandular function.

E) stimulating melanin production.

Answer:  E

Learning Outcome:  5.11

Bloom’s Taxonomy:  Remembering

64) Vitamin D3 formed within the skin has all of these effects on other organ systems except that it

A) is essential for absorption of calcium and phosphorus by the digestive system.

B) functions as a precursor for the hormone calcitriol in the endocrine system.

C) is essential for bone maintenance.

D) functions in the activation of plasma cells by the lymphatic system.

E) is essential for bone growth.

Answer:  D

Learning Outcome:  5.11

Bloom’s Taxonomy:  Understanding

65) Rickets can be prevented by

A) adequate sunlight.

B) dietary intake of cholecalciferol.

C) avoiding sunlight.

D) adequate sunlight and dietary intake of cholecalciferol.

E) dietary intake of cholecalciferol and avoiding sunlight.

Answer:  D

Learning Outcome:  5.11

Bloom’s Taxonomy:  Understanding

66) In a penetrating wound, ________ divide to produce mobile cells that repair the dermis.

A) granulation cells

B) dendritic cells

C) macrophages

D) fibroblasts

E) muscle cells

Answer:  D

Learning Outcome:  5.12

Bloom’s Taxonomy:  Remembering

67) The repair of the epidermis after a wound begins as basal cells produce new

A) elastic fibers.

B) collagen fibers.

C) reticular fibers.

D) dense connective tissue.

E) epidermal cells.

Answer:  E

Learning Outcome:  5.12

Bloom’s Taxonomy:  Remembering

68) Skin can regenerate effectively even after considerable damage has occurred because

A) the epidermis of the skin has a rich supply of small blood vessels.

B) stem cells persist in both epithelial and connective-tissue components of the skin even after injury.

C) fibroblasts in the dermis can give rise to new germinal cells in the epidermis.

D) contraction in the area of the injury brings cells of adjacent strata together.

E) cells of the stratum basale cannot migrate to other positions in the skin.

Answer:  B

Learning Outcome:  5.12

Bloom’s Taxonomy:  Understanding

69) The following are stages in the regeneration of skin following an injury.

1. blood clot/scab formation

2. cellular migration

3. epidermis covers granulation tissue

4. epidermis covers scar tissue

Which of the following places the steps in the correct order?

A) 1, 2, 3, 4

B) 4, 3, 2, 1

C) 4, 3, 1, 2

D) 3, 4, 1, 2

E) 2, 4, 1, 3

Answer:  A

Learning Outcome:  5.12

Bloom’s Taxonomy:  Understanding

70) Scar tissue is the result of

A) large numbers of collagen fibers and relatively few blood vessels in the injured area.

B) increased numbers of epidermal layers in the area of the injury.

C) a thickened stratum basale in the area of the injury.

D) increased numbers of fibroblasts in the injured area.

E) a lack of sebaceous glands in the injured area.

Answer:  A

Learning Outcome:  5.12

Bloom’s Taxonomy:  Understanding

71) Granulation tissue is composed of

A) clotted blood.

B) an extensive capillary network.

C) fibroblasts.

D) All of the answers are correct.

Answer:  D

Learning Outcome:  5.12

Bloom’s Taxonomy:  Remembering

72) A thickened area of scar tissue that is covered by a shiny, smooth epidermal surface is called

A) a scab.

B) a keloid.

C) granulation tissue.

D) a clot.

E) a lesion.

Answer:  B

Learning Outcome:  5.12

Bloom’s Taxonomy:  Remembering

73) A fibrin clot that is formed over a skin wound is called

A) a scab.

B) a keloid.

C) granulation tissue.

D) a clot.

E) a lesion.

Answer:  A

Learning Outcome:  5.12

Bloom’s Taxonomy:  Remembering

74) The combination of fibrin clot, fibroblasts, and extensive capillary network that is formed in injured skin is called

A) a scab.

B) a keloid.

C) granulation tissue.

D) a clot.

E) a lesion.

Answer:  C

Learning Outcome:  5.12

Bloom’s Taxonomy:  Remembering

75) Identify the two major components of the cutaneous membrane. (Module 5.1A)

A) dermis and epidermis

B) dermis and subcutaneous layer

C) epidermis and subcutaneous layer

D) dermis and the cutaneous plexus

E) epidermis and the cutaneous plexus

Answer:  A

Learning Outcome:  5.1

Bloom’s Taxonomy:  Remembering

76) Compare thin skin with thick skin. (Module 5.2A)

A) Thin skin has only 1 layer and is found on lips, eyelids, and other delicate structures. Thick skin has hundreds of layers and is found all over the body except where thin skin is found.

B) Thin skin has only 1 layer and contains only the epidermis. Thick skin has 2 layers made up of the epidermis and dermis.

C) Thin skin has 4 layers and covers most of the body surfaces. Thick skin has 5 layers and covers the palms of the hands and soles of the feet.

D) Thin skin has 4 layers and covers the palms of the hands and soles of the feet. Thick skin has 4 layers and covers most of the body surfaces.

E) Thin skin contains the epidermis and dermis but not the subcutaneous layer. Thick skin contains the epidermis, dermis and subcutaneous layer.

Answer:  C

Learning Outcome:  5.2

Bloom’s Taxonomy:  Understanding

77) Identify the five layers of the epidermis (from superficial to deep). (Module 5.2B)

A) stratum basale, stratum spinosum, stratum granulosum, stratum lucidum, and stratum corneum

B) stratum basale, stratum granulosum, stratum lucidum, stratum corneum, stratum spinosum

C) stratum basale, stratum granulosum, stratum lucideum, stratum spinosum, stratum corneum

D) stratum corneum, stratum lucidum, stratum granulosum, stratum basale, stratum spinosum

E) stratum corneum, stratum lucidum, stratum granulosum, stratum spinosum, stratum basale

Answer:  E

Learning Outcome:  5.2

Bloom’s Taxonomy:  Remembering

78) Dandruff is caused by excessive shedding of cells from the outer layer of skin on the scalp. So, dandruff is composed of cells from which epidermal layer? (Module 5.2C)

A) stratum basale

B) stratum granulosum

C) stratum lucidum

D) stratum corneum

E) stratum spinosum

Answer:  D

Learning Outcome:  5.2

Bloom’s Taxonomy:  Remembering

79) A splinter that penetrates to the third layer of epidermis of the palm is lodged in which layer? (Module 5.2D)

A) stratum basale

B) stratum granulosum

C) stratum lucidum

D) stratum corneum

E) stratum spinosum

Answer:  B

Learning Outcome:  5.2

Bloom’s Taxonomy:  Remembering

80) Name the two pigments contained in the epidermis. (Module 5.3A)

A) carotene and melatonin

B) creatinine and melatonin

C) carotene and melanin

D) keratin and melanin

E) carnitine and melanoma

Answer:  C

Learning Outcome:  5.3

Bloom’s Taxonomy:  Remembering

81) Why does exposure to sunlight or sunlamps darken skin? (Module 5.3B)

A) UV radiation stimulates melanocytes to produce more melanin.

B) UV radiation stimulates melanocytes to produce more melatonin.

C) UV radiation stimulates keratinocytes to produce more carotene.

D) UV radiation stimulates keratinocytes to produce more keratin.

E) UV radiation stimulates melanocytes to produce more melanin and keratinocytes to produce more keratin.

Answer:  A

Learning Outcome:  5.3

Bloom’s Taxonomy:  Understanding

82) Why is basal cell carcinoma considered less dangerous than malignant melanoma?

(Module 5.3D)

A) Basal cell carcinoma affects the stratum basale only and will not spread to any other layer, whereas malignant melanoma affects the melanocytes which can be found throughout the epidermis.

B) Basal cell carcinoma affect the cells of the stratum basale which cannot form tumors, whereas malignant melanoma affects the melanocytes which form cancerous tumors.

C) Basal cell carcinoma only occurs in the elderly, whereas malignant melanoma occurs in children and young adults.

D) Basal cell carcinoma only occurs on the face, whereas malignant melanoma can occur anywhere on the body.

E) Basal cell carcinomas rarely become malignant and metastasize, whereas malignant melanoma cells quickly spread throughout the lymphatic system to other organs.

Answer:  E

Learning Outcome:  5.3

Bloom’s Taxonomy:  Understanding

83) Explain why a healthy 6-month-old might have yellow-orange skin. (Module 5.3E)

A) The skin of infants is very thin making it appear yellow-orange.

B) Breastmilk causes the skin to look yellow-orange.

C) The child may have been outside when it was cold causing vasoconstriction which reduces the pink coloration and makes skin look more yellow-orange.

D) The child may have eaten foods with a high amount of carotene causing the pigment to accumulate in the skin making it look yellow-orange.

E) The child may be developing adipose tissue which has a yellowish tint.

Answer:  D

Learning Outcome:  5.3

Bloom’s Taxonomy:  Applying

84) Describe the layers of the dermis. (Module 5.4A)

A) The superficial papillary layer contains areolar tissue with capillaries, lymphatic vessels, and sensory neurons. The deep reticular layer contains dense irregular connective tissue with collagen and elastic fibers.

B) The superficial reticular layer contains areolar tissue with capillaries, lymphatic vessels, and sensory neurons. The deep papillary layer contains dense irregular connective tissue with collagen and elastic fibers.

C) The superficial papillary layer contains dense irregular connective tissue with collagen and elastic fibers. The deep reticular layer contains areolar tissue with capillaries, lymphatic vessels, and sensory neurons.

D) The superficial reticular layer contains dense irregular connective tissue with collagen and elastic fibers. The deep papillary layer contains areolar tissue with capillaries, lymphatic vessels, and sensory neurons.

E) The superficial papillary layer contains stratified squamous epithelial tissue. The deep reticular layer contains areolar tissue with capillaries, lymphatic vessels, and sensory neurons.

Answer:  A

Learning Outcome:  5.4

Bloom’s Taxonomy:  Remembering

85) Predict the degree of scarring after the healing of a horizontal cut on the forehead just above the eyebrow. (Module 5.4B)

A) The scarring will be minimal because the cut follows the same direction as the tension lines.

B) The scarring will be minimal because the cut is at a right angle to the direction of the tension lines.

C) The scarring will be significant because the cut follows the same direction as the tension lines.

D) The scarring will be significant because the cut is at a right angle to the direction of the tension lines.

E) The scarring will be minimal because no tension lines run through that area of the body.

Answer:  D

Learning Outcome:  5.4

Bloom’s Taxonomy:  Applying

86) Distinguish among a first-degree, second-degree, and third-degree burn. (Module 5.5A)

A) A first-degree burn affects only the surface of the skin. A second-degree burn affects the whole epidermis and some of the dermis. A third-degree burn destroys the epidermis, the dermis, and extends into the subcutaneous layer.

B) A first-degree burn affects the whole epidermis and some of the dermis. A second-degree burn affects only the surface of the skin. A third-degree burn destroys the epidermis, the dermis, and extends into the subcutaneous layer.

C) A first-degree burn destroys the epidermis, the dermis, and extends into the subcutaneous layer. A second-degree burn affects the whole epidermis and some of the dermis. A third-degree burn affects only the surface of the skin.

D) A first-degree burn destroys the epidermis, the dermis, and extends into the subcutaneous layer. A second-degree burn affects only the surface of the skin. A third-degree burn affects the whole epidermis and some of the dermis.

E) A first-degree burn affects only the surface of the skin. A second-degree burn destroys the epidermis, the dermis, and extends into the subcutaneous layer. A third-degree burn affects the whole epidermis and some of the dermis.

Answer:  A

Learning Outcome:  5.5

Bloom’s Taxonomy:  Remembering

87) Which type of burn usually requires skin grafting? Why? (Module 5.5B)

A) First-degree burns because the epidermis is damaged.

B) First-degree burns because the tissue damage is so great that the tissue cannot repair itself.

C) Second-degree burns because the tissue damage is so great that the tissue cannot repair itself.

D) Third-degree burns because the epidermis is damaged.

E) Third-degree burns because the tissue damage is so great that the tissue cannot repair itself.

Answer:  E

Learning Outcome:  5.5

Bloom’s Taxonomy:  Applying

88) A 32-year-old woman is admitted to the hospital with third-degree burns on her entire right leg, entire right arm, and the back of her trunk. Estimate the percentage of her body surface area affected by these burns. (Module 5.5D)

A) 9%

B) 18%

C) 36%

D) 45%

E) 91%

Answer:  D

Learning Outcome:  5.5

Bloom’s Taxonomy:  Applying

89) What are epidermal derivatives? (Module 5.6A)

A) Epidermal derivatives are pigment molecules produced by the epidermis, including carotene and melanin.

B) Epidermal derivatives are the different cell types found in the epidermis, including epithelial cells and melanocytes.

C) Epidermal derivatives are chemicals produced by the epidermis, such as heparin and prostaglandins.

D) Epidermal derivatives are secretions produced by the epidermis, including sweat and sebum.

E) Epidermal derivatives are accessory structures that originate from the epidermis during embryonic development, including hair follicles, sebaceous and sweat glands, and nails.

Answer:  E

Learning Outcome:  5.6

Bloom’s Taxonomy:  Remembering

90) Which exocrine glands are in the integument? (Module 5.6B)

A) Sweat glands and salivary glands

B) Mammary glands and salivary glands

C) Sweat glands and sebaceous glands

D) Mucous glands and sebaceous glands

E) Mucous glands and sweat glands

Answer:  C

Learning Outcome:  5.6

Bloom’s Taxonomy:  Remembering

91) Describe a typical strand of hair. (Module 5.7A)

A) A keratinous strand produced by basal cells within a hair follicle.

B) A small connective tissue peg filled with blood vessels and nerves.

C) A bundle of smooth muscles attached to a hair follicle.

D) A layer of epithelial cells surrounding a deep layer of connective tissue.

E) Many layers of dead, tightly compressed cells packed with keratin.

Answer:  A

Learning Outcome:  5.7

Bloom’s Taxonomy:  Remembering

92) What happens when an arrector pili muscle contracts? (Module 5.7B)

A) The hair falls out of the hair bulb.

B) The hair grows approximately 0.33mm.

C) The sebaceous gland secretes oil onto the surface of the hair.

D) The sweat gland secretes sweat out of the pores next to the hair.

E) The hair follicle becomes erect, producing “goose bumps.”

Answer:  E

Learning Outcome:  5.7

Bloom’s Taxonomy:  Understanding

93) Identify and describe the general functions of the exocrine glands found in the skin.

(Module 5.8A)

A) Sweat glands and salivary glands; the glands help with thermoregulation and dissolve particles on the skin.

B) Mammary glands and salivary glands; the glands help with reducing bacterial colonization and dissolve particles on the skin.

C) Sweat glands and sebaceous glands; the glands help with thermoregulation, excrete wastes, and lubricate hairs and the epidermis.

D) Mucous glands and sebaceous glands; the glands help lubricate hairs and epidermis and provide waterproofing.

E) Mucous glands and sweat glands; the glands excrete wastes and provide waterproofing.

Answer:  C

Learning Outcome:  5.8

Bloom’s Taxonomy:  Remembering

94) Describe the secretory method and functions of sebum. (Module 5.8B)

A) merocrine; sebum lubricates hair and skin, protects the keratin of the hair shaft, and inhibits bacterial growth

B) holocrine; sebum lubricates hair and skin, protects the keratin of the hair shaft, and inhibits bacterial growth

C) apocrine; sebum lubricates hair and skin, protects the keratin of the hair shaft, and inhibits bacterial growth

D) merocrine; sebum is important in thermoregulation and excretion of wastes

E) endocrine; sebum is important in thermoregulation and excretion of wastes

Answer:  B

Learning Outcome:  5.8

Bloom’s Taxonomy:  Remembering

95) Deodorants are used to mask the effects of secretions from which type of skin gland? (Module 5.8C)

A) apocrine sweat glands

B) eccrine sweat glands

C) merocrine sweat glands

D) sebaceous glands

E) mucous glands

Answer:  A

Learning Outcome:  5.8

Bloom’s Taxonomy:  Remembering

96) Name the type of cell that assists the discharge of merocrine secretions, and list the glands in which such cells are present. (Module 5.8D)

A) arrector pili cell; apocrine and eccrine sweat glands

B) arrector pili cell; apocrine and eccrine sweat glands, mammary glands, lacrimal glands, and salivary glands

C) myoepithelial cell; apocrine and eccrine sweat glands

D) myoepithelial cell; apocrine and eccrine sweat glands, mammary glands, lacrimal glands, and salivary glands

E) goblet cell; apocrine and eccrine sweat glands

Answer:  D

Learning Outcome:  5.8

Bloom’s Taxonomy:  Remembering

97) Where does nail production occur? (Module 5.9A)

A) At the lunula

B) At the cuticle

C) At the eponychium

D) At the hyponychium

E) At the nail root

Answer:  E

Learning Outcome:  5.9

Bloom’s Taxonomy:  Remembering

98) Define hyponychium. (Module 5.9B)

A) A portion of the stratum corneum of the nail root that extends over the exposed nail.

B) The thickened stratum corneum underlying the free edge of the nail.

C) An epidermal fold not visible from the surface where nail production occurs.

D) An area of epidermis that is covered by the nail.

E) The visible portion of the nail.

Answer:  B

Learning Outcome:  5.9

Bloom’s Taxonomy:  Remembering

99) Why does the free edge of a nail appear white? (Module 5.9C)

A) The melanocytes are no longer living in the nail.

B) The keratinocytes have been damaged as the nail grew out.

C) There are no underlying blood vessels.

D) The epidermis is dividing faster there than at the root.

E) The nail is dryer and more brittle there than at the root.

Answer:  C

Learning Outcome:  5.9

Bloom’s Taxonomy:  Understanding

100) Why does hair turn white or gray with age? (Module 5.10A)

A) The hair is no longer producing carotene.

B) The keratinocytes have been damaged.

C) Sebaceous gland activity increases, making the hair well lubricated during growth and turning it white or gray.

D) The epidermis is dividing faster, making the hair white or gray.

E) The melanocyte activity declines, making the hair white or gray.

Answer:  E

Learning Outcome:  5.10

Bloom’s Taxonomy:  Understanding

101) List some hormones that are necessary for maintaining a healthy integument.

(Module 5.11A)

A) growth hormone, mineralocorticoids, glucocorticoids, and melatonin

B) ADH, oxytocin, and prolactin

C) aldosterone, atrial natriuretic peptide, insulin, and glucagon

D) growth hormone, sex hormones, growth factors, glucocorticoids, and thyroid hormones

E) sex hormones, mineralocorticoids, gonadocorticoids, and calcitonin

Answer:  D

Learning Outcome:  5.11

Bloom’s Taxonomy:  Remembering

102) Identify the first stage in skin repair. (Module 5.12A)

A) inflammation

B) migration

C) proliferation

D) scarring

E) keloid formation

Answer:  A

Learning Outcome:  5.12

Bloom’s Taxonomy:  Remembering

103) Describe granulation tissue. (Module 5.12B)

A) Granulation tissue is newly formed epithelial tissue.

B) Granulation tissue is a combination of blood clots, fibroblasts, and capillaries in healing tissue.

C) Granulation tissue is all three layers of the integument forming, subcutaneous, dermis, and epidermis.

D) Granulation tissue is a raised, thickened mass of scar tissue.

E) Granulation tissue is thick, non-elastic tissue dominated by collagen fibers.

Answer:  B

Learning Outcome:  5.12

Bloom’s Taxonomy:  Remembering

Essay Questions

104) Why is a subcutaneous injection with a hypodermic needle a useful method of administering drugs?

Answer:  The subcutaneous layer has a limited capillary supply and contains no vital organs; thus, the potential for tissue damage is reduced.

Learning Outcome:  5.1

Bloom’s Taxonomy:  Understanding

105) Explain why the rate of dehydration is greater when a person is immersed in seawater than when in fresh water.

Answer:  Salty ocean water is very hypertonic compared to bodily fluids, while fresh lake water is very hypotonic. Hence, in the sea, due to osmosis water will leave the body, accelerating the rate of dehydration. In fresh water, water will be gained.

Learning Outcome:  5.2

Bloom’s Taxonomy:  Analyzing

106) A new mother notices that her 6-month-old infant has a yellow-orange complexion. Fearful that the child may have jaundice, she takes him to her pediatrician. After examining the child and learning about the infant’s diet, the pediatrician declares him perfectly healthy and advises the mother to watch the child’s diet. What is likely the cause for the change in skin color?

Answer:  The infant probably has a fondness for vegetables that are high in carotene, such as sweet potatoes, squash, and carrots. It is not uncommon for parents to feed babies what they will eat best. If the child consumes large amounts of carotene, the yellow-orange pigment will be stored in the skin, producing a yellow-orange skin color.

Learning Outcome:  5.3

Bloom’s Taxonomy:  Applying

107) Many medications can be administered transdermally by applying patches that contain the medication to the surface of the skin. These patches can be attached anywhere on the skin except the palms of the hands and the soles of the feet. Why?

Answer:  Thick skin slows the rate of diffusion of the medication and thus decreases its effectiveness. In addition, excessive sweat formed on the palms of the hands and soles of the feet would make the patch fall off more readily.

Learning Outcome:  5.8

Bloom’s Taxonomy:  Applying

108) In a condition known as sunstroke, the victim appears flushed, the skin is warm and dry, and the body temperature rises dramatically. Explain these observations based on what you know concerning the role of the skin in thermoregulation.

Answer:  When the body temperature increases, more blood flow is directed to the vessels of the skin. The red cells in the blood give the skin a redder-than-usual color and account for the victim’s flushed appearance. The skin is dry because the sweat glands are not producing sweat (avoids further dehydration). Without evaporation cooling, not enough heat is dissipated from the skin, the skin is warm, and the body temperature rises. This situation represents positive feedbackoperating in a disease state.

Learning Outcome:  5.8

Bloom’s Taxonomy:  Applying

109) Vanessa’s 80-year-old grandmother sets her thermostat at 26°C (80°F) and wears a sweater on balmy spring days. When asked why, the grandmother says she feels cold. What is a possible cause for her feeling cold?

Answer:  Most elderly people have poor blood flow to the skin. Thus, their skin becomes cold. This triggers thermal receptors in the skin to signal cold skin. The brain interprets this as a cold body temperature.

Learning Outcome:  5.10

Bloom’s Taxonomy:  Applying

110) Provide one beneficial effect of exposure to ultraviolet (UV) radiation.

Answer:  It stimulates synthesis of vitamin D3.

Learning Outcome:  5.11

Bloom’s Taxonomy:  Understanding

111) Why is scab formation important in wound healing?

Answer:  Scabs temporarily restore epidermal integrity, restricting further entry of microorganisms. They also prevent the loss of fluids, maintaining internal fluid balance, and protect the delicate granulation tissue during tissue recovery.

Learning Outcome:  5.12

Bloom’s Taxonomy:  Understanding

112) What are the stages of skin regeneration after injury?

Answer:  Inflammation, migration, proliferation, and scarring

Learning Outcome:  5.12

Bloom’s Taxonomy:  Understanding

113) Identify the major functions of the integumentary system. (Module 5.1B)

Answer:  The major functions of the integumentary system are to protect underlying tissues and organs, excrete wastes by integumentary glands, maintain body temperature, produce melanin and keratin, synthesize vitamin D3, store lipids, and detect touch, pressure, pain, and temperature.

Learning Outcome:  5.1

Bloom’s Taxonomy:  Remembering

114) Why does the skin of a light-skinned person appear red during exercise in hot weather? (Module 5.3C)

Answer:  When the skin gets warm, arriving oxygenated blood is diverted to the superficial dermis (papillary layer) to eliminate heat. The oxygenated blood imparts a reddish coloration to the light skin.

Learning Outcome:  5.3

Bloom’s Taxonomy:  Understanding

115) Describe the three types of skin grafts. Which one is best? Why? (Module 5.5C)

Answer:  In an autograft, the patient’s undamaged skin is used as a graft source. An allograft uses skin from a donor, and a xenograft uses skin from an animal, such as a pig. Autografts are the best because they are not rejected by the patient’s immune system.

Learning Outcome:  5.5

Bloom’s Taxonomy:  Understanding

116) Describe the four phases of the hair growth cycle. (Module 5.7C)

Answer:  Hair follicles transition between (1) an active phase of continuous hair growth; (2) regression; (3) a resting phase, when the hair becomes a club hair; and (4) reactivation of hair growth and shedding of club hair.

Learning Outcome:  5.7

Bloom’s Taxonomy:  Remembering

117) Why is pulling a hair painful, yet cutting a hair is not? (Module 5.7D)

Answer:  Pulling a hair is painful because its root is attached deep within the hair follicle, the base of which is surrounded by a root hair plexus consisting of sensory nerves. Cutting a hair is painless because a hair shaft contains no sensory nerves.

Learning Outcome:  5.7

Bloom’s Taxonomy:  Understanding

118) Why do people tolerate summer heat less well and become more susceptible to heat-related illness when they become older? (Module 5.10B)

Answer:  As a person ages, the blood supply to the dermis decreases, and eccrine sweat glands become less active. Both changes make it more difficult for older people to cool themselves in hot weather.

Learning Outcome:  5.10

Bloom’s Taxonomy:  Applying

119) Explain the relationship between sunlight exposure and vitamin D3. (Module 5.11B)

Answer:  In the presence of UV radiation in sunlight, epidermal cells in the stratum spinosum and stratum basale convert a cholesterol-related steroid into cholecalciferol, also known as vitamin D3.

Learning Outcome:  5.11

Bloom’s Taxonomy:  Understanding

120) In some cultures, females must be covered from head to toe when they go outdoors. Explain why these women are at increased risk of developing bone problems later in life. (Module 5.11C)

Answer:  The hormone cholecalciferol (vitamin D3) is needed to form strong bones and teeth. When the body surface is covered, UV radiation cannot reach the skin to stimulate cholecalciferol (vitamin D3) production, so bones can become fragile.

Learning Outcome:  5.11

Bloom’s Taxonomy:  Applying

121) Why can skin regenerate effectively even after considerable damage? (Module 5.12C)

Answer:  Skin can regenerate effectively even after undergoing considerable damage because stem cells persist in both the epithelial and connective tissue components of skin. In response to injury, cells of the stratum basale replace epithelial cells, and mesenchymal cells replace lost dermal cells.

Learning Outcome:  5.12

Bloom’s Taxonomy:  Applying