Download The Integumentary System

Chapter 5 - The Integumentary System
Choose the single best answer to each of the following questions.
1) All of the following are part of the integumentary system EXCEPT the
A) epidermis
B) dermis
C) subcutaneous layer
D) hair and nails
E) sebaceous and sweat glands
Answer: C
Reference: Page 145, Structure of the Skin
Level of Difficulty: Medium
2) The epidermis
A) is the deepest layer of the cutaneous membrane.
B) is composed of stratified squamous epithelium.
C) has four or five layers of cells.
D) is highly vascular.
E) contains adipocytes and collagen fibers.
Answer: B
Reference: Page 145, Structure of the Skin
Level of Difficulty: Medium
3) Keratinocytes are the predominant cells in the:
A) epidermis.
B) papillary region of the dermis.
C) reticular region of the dermis.
D) subcutaneous layer.
E) All of the above are correct.
Answer: A
Reference: Page 145, Structure of the Skin
Level of Difficulty: Medium
4) The function of keratin is to:
A) make skin hard and brittle.
B) make skin tough and waterproof.
C) protect skin from ultraviolet light.
D) provided added pigment.
E) store vitamin A.
Answer: B
Reference: Page 145, Structure of the Skin
Level of Difficulty: Medium
5) A student leaves her anatomy and physiology text at school and is forced to study from an
older text in the public library. That book describes the deepest layer of the epidermis as
containing actively dividing stem cells but calls that layer the stratum germinativum. The book
lists the other cells in the stratum germinativum as melanocytes, Langerhans cells and Merkel
cells. The student then realizes that the stratum germinativum is the same as the stratum
A) corneum.
B) lucidum.
C) granulosum.
D) spinosum.
E) basale.
Answer: E
Reference: Page 145, Structure of the Skin
Level of Difficulty: Medium
6) A student knows that the epidermis is composed of avascular stratified squamous epithelial
tissue. As he studies the diagram of a section of skin in the anatomy and physiology text., he
realizes that nourishment to cells in the epidermis must be provided by diffusion of materials from
A) blood vessels in the stratum basale.
B) blood vessels in the subcutaneous region.
C) blood vessels in the dermal papillae.
D) blood vessels in the dermal reticulum.
E) A and C are correct.
Answer: C
Reference: Page 148, The Structure of Skin
Level of Difficulty: Hard
7) Arrange the layers of the epidermis in order from most superficial to deepest.
1. stratum spinosum
2. stratum granulosum
3. stratum corneum
4. stratum basale
5. stratum lucidum
A) 4, 1, 2, 5, 3
B) 3, 5, 1, 2, 4
C) 4, 1, 5, 3, 2
D) 3, 5, 2, 1, 4
E) 4, 3, 2, 5, 1
Answer: D
Reference: Page 145, Structure of the Skin
Level of Difficulty: Medium
8) Which layer of the epidermis consists of 25-30 layers of dead, flattened keratinocytes?
A) stratum corneum.
B) stratum lucidum.
C) stratum granulosum.
D) stratum spinosum.
E) stratum basale.
Answer: A
Reference: Page 145, Structure of the Skin
Level of Difficulty: Medium
9) Which of the following is present in thick skin but not in thin skin?
A) stratum germinativum
B) stratum lucidum
C) stratum corneum
D) stratum granulosum
E) dermal papillae
Answer: B
Reference: Page 145, Structure of the Skin
Level of Difficulty: Medium
10) Skin grafts
A) are required when the remaining stratum basale cannot repair the damaged area.
B) are most successful when the donated skin comes from an uninjured part of the patient.
C) may use skin replacement products grown from donated foreskins.
D) A and B are correct.
E) A, B and C are correct.
Answer: E
Reference: Page 145, Structure of the Skin
Level of Difficulty: Medium
11) Place the following events of keratinization and epidermal growth in order of occurrence:
1. new cell push toward surface
2. stratum basale cells divide
3. dead cells are shed
4. cells reach stratum granulosum and undergo apoptosis
5. tonofilaments converted to keratin by keratohyalin
A) 2, 1, 5, 4, 3
B) 2, 1, 3, 4, 5
C) 2, 1, 4, 5, 3
D) 3, 4, 5, 1, 2
E) 1, 2, 3, 4, 5
Answer: C
Reference: Page 145, Structure of the Skin
Level of Difficulty: Hard
12) The average length of time for a cell to be produced by the stratum basale, rise to the
surface, become keratinized, and slough off is about how long?
A) 24 to 48 hours
B) two weeks
C) one month
D) one year
E) Once cells are keratinized, they never slough off.
Answer: C
Reference: Page 145, Structure of the Skin
Level of Difficulty: Medium
13) Psoriasis
A) is a rare skin cancer.
B) occurs when keratinocytes reproduce too quickly.
C) forms irregular, black tarry scabs on the skin.
D) usually occurs on the shoulders, hips and ankles.
E) is treated by stimulating cell division.
Answer: B
Reference: Page 145, Structure of the Skin
Level of Difficulty: Medium
14) The dermis
A) is superficial to the epidermis.
B) is deep to the subcutaneous layer.
C) contains fibroblasts, macrophages, and a few adipocytes.
D) is avascular and poorly innervated.
E) is divided into aerolar and dense regular layers.
Answer: C
Reference: Page 145, Structure of the Skin
Level of Difficulty: Medium
15) The superficial portion of the dermis
A) is called the papillary region.
B) includes touch receptors called Meissner’s corpuscles.
C) has decreased surface area due to the presence of dermal papillae.
D) A and B are correct.
E) A, B and C are correct.
Answer: D
Reference: Page 145, Structure of the Skin
Level of Difficulty: Easy
16) The reticular region of the dermis
A) is called the reticular region.
B) consists of primarily of adipose tissue.
C) contains collagen fibers and elastic fibers.
D) A and B are correct.
E) A and C are correct.
Answer: E
Reference: Page 145, Structure of the Skin
Level of Difficulty: Medium
17) Fingerprints
A) appear during the 3rd and 4th week of fetal development.
B) are formed as the dermis conforms to the underlying subcutaneous layer.
C) are unique to each individual and maintain a constant pattern throughout life.
D) decrease friction between the skin and smooth surfaces.
E) are studied by a field of science called dermatology.
Answer: C
Reference: Page 145, Structure of the Skin
Level of Difficulty: Medium
18) A woman who had in vitro fertilization treatment is 7 months pregnant with six fetuses. Her
abdomen is dramatically increasing in size and dark red lines that have begun to appear there.
Those lines run obliquely from her sides toward her pubis; most are 3-4 inches long and have
irregular margins. What are these lines and why are they occurring?
A) The lines are called striae; they appear because of small tears in the dermis occur when skin
is stretched beyond its elastic limit.
B) The lines are called striae; they appear because the epidermis tears when the dermis grows
too quickly.
C) The lines are called linea nigra; they appear because melanocytes become more active during
pregnancy.
D) The lines are called cleavage lines; they indicate the predominant direction of the underlying
collagen fibers.
E) The lines are called dermatoglyphs; they result from tears in the underlying cartilage.
Answer: A
Reference: Page 145, Structure of the Skin
Level of Difficulty: Hard
19) Which of the following is a benign, localized overgrowth of melanocytes that usually appears
during childhood or adolescence?
A) a lentigo (age spot)
B) a freckle
C) a melanoma
D) a nevus (mole)
E) either C or D
Answer: D
Reference: Page 145, Structure of the Skin
Level of Difficulty: Medium
20) A patient with liver disease has elevated level of bilirubin in his blood. How may the presence
of bilirubin affect his skin color?
A) He may have erythema (reddened skin).
B) He may have jaundiced (or yellowed) skin.
C) He may have pallor (or very pale) skin.
D) He may have cyanotic (or blue-tinted) skin.
E) He may have vitiligo (or irregular white spots) on his skin.
Answer: B
Reference: Page 145, Structure of Skin
Level of Difficulty: Medium
21) An obstetrician has just delivered a baby boy and is concerned because he is cyanotic. Which
of the following statements explains the term cyanotic and why the doctor is concerned?
A) Cyanotic means that the skin and mucous membranes have an abnormal bluish tint.
B) Cyanotic means that the skin has an abnormal yellowish tint.
C) Cyanotic skin and mucous membranes reflect a lack of adequate oxygen circulation.
D) A and C are correct.
E) A and B are correct.
Answer: D
Reference: Page 145, Structure of the Skin
Level of Difficulty: Medium
22) An individual born without the ability to make the enzyme tyrosinase has which of the
following conditions?
A) vitiligo
B) albinism
C) jaundice
D) cyanosis
E) erythema
Answer: B
Reference: Page 145, Structure of the Skin
Level of Difficulty: Medium
23) Tattooing
A) is the coloring the skin by applying natural dyes to the epidermis.
B) inserts ink particles into the dermis.
C) inserts ink particles into the subcutaneous region.
D) can only be removed by cutting away the tattooed skin.
E) can be removed by repetitive washing with soap and water.
Answer: B
Reference: Page 145, Structure of the Skin
Level of Difficulty: Medium
24) Body piercing
A) is the insertion of jewelry through an artificial opening.
B) may take up to a year for complete healing to occur.
C) may result in cartilage deformation or nerve damage.
D) may interfere with medical procedures.
E) All of the above are correct.
Answer: E
Reference: Page 145, Structure of the Skin
Level of Difficulty: Medium
25) Which of the following is NOT considered an accessory structure of the skin?
A) hair
B) sweat glands
C) sebaceous glands
D) nails
E) Merkel’s disc
Answer: E
Reference: Page 151, Accessory Structures of the Skin
Level of Difficulty: Easy
26) Which of the following is NOT true of hair?
A) It is not found on the palmar surfaces of the manus or digits.
B) It is found in the eyebrows and on the scalp.
C) It is found in the axillae and around the external genitalia.
D) It is composed of rows of living cells bonded together by intracellular proteins.
E) Its distribution is controlled by genetic and endocrine factors.
Answer: D
Reference: Page 151, Accessory Structures of the Skin
Level of Difficulty: Medium
27) What is the function of hair?
A) protect the scalp from UV radiation and heat loss
B) help detect light touch
C) protect the nostrils, ear canals and eyes from foreign particles
D) A and B are correct.
E) A, B and C are correct.
Answer: E
Reference: Page 151, Accessory Structures of the Skin
Level of Difficulty: Medium
28) Which of the following structures associated with hairs is correctly paired to it function?
A) sebaceous gland: produce perspiration to cool the skin
B) arrector pili muscle: raise hair in response to cold or emotional stress
C) hair root plexus: provide blood to the hair shaft so it can grow
D) A and B are correct.
E) A, B and C are correct.
Answer: B
Reference: Page 151, Accessory Structures of the Skin
Level of Difficulty: Medium
29) Which of the following is true of hair growth?
A) Scalp hair grows for 2 to 6 months before resting for 3 years.
B) At any given time, 85% of the scalp hairs are resting.
C) Normal hair loss in the adult is around 100 hairs a day.
D) Hair growth and replacement cycles are unaffected by stress and diet.
E) Hair shafts contain living cells.
Answer: C
Reference: Page 151, Accessory Structures of the Skin
Level of Difficulty: Medium
30) All of the following are true EXCEPT:
A) A fetus miscarried at 15 weeks will not have lanugo.
B) Hair follicles develop between nine and twelve days after conception.
C) Vellus, or “peach-fuzz” hairs are found on much of a young child’s body.
D) Terminal hairs develop at puberty.
E) Terminal hairs include the hairs on the scalp, eyebrows, and eyelashes as well as whiskers.
Answer: B
Reference: Page 151, Accessory Structures of the Skin
Level of Difficulty: Medium
31) Which person is most likely to have white hair?
A) an albino, because no melanin is produced
B) a person who has air bubbles accumulating in the hair shafts
C) a person who only makes pheomelanin
D) A and B are correct.
E) A, B and C are correct.
Answer: D
Reference: Page 151, Accessory Structures of the Skin
Level of Difficulty: Medium
32) Sebum
A) is a watery secretion used to cool the body.
B) is a waxy substance produced by glands in the ear canal.
C) is produced by sebaceous glands that are, in most cases, attached to hair follicles.
D) contains primarily carbohydrates and salts.
E) promotes evaporation of water from the skin.
Answer: C
Reference: Page 151, Accessory Structures of the Skin
Level of Difficulty: Medium
33) Acne
A) is an inflammation of sebaceous glands.
B) is caused by viruses attacking the cells of the sebaceous glands.
C) is more commonly associated with the elderly.
D) is usually found in sebaceous glands inhibited by androgen hormones.
E) is never associated with permanent scarring of the epidermis.
Answer: A
Reference: Page 151, Accessory Structures of the Skin
Level of Difficulty: Easy
34) Which of the following is true of eccrine sudoriferous glands?
A) They are less numerous than apocrine sudoriferous glands.
B) Their primary function is to assist in regulation of body temperature.
C) They are found on the glans penis, glans clitoris, nail beds and the margins of the lips.
D) They produce perspiration that contains mostly lipids.
E) They play a major role in eliminating nitrogenous wastes such as urea, uric acid and ammonia.
Answer: B
Reference: Page 151, Accessory Structures of the Skin
Level of Difficulty: Medium
35) Apocrine sudoriferous glands
A) are really holocrine glands.
B) are most active before puberty.
C) are least active during emotional stress or sexual excitement.
D) are found in the axillae, inguinal areas, areolae and the bearded regions of the face.
E) produce a less viscous and less salty secretion than eccrine sweat glands.
Answer: D
Reference: Page 151, Accessory Structures of the Skin
Level of Difficulty: Medium
36) Ceruminous glands
A) produce ear wax.
B) produce milk.
C) produce sweat.
D) produce sebum.
E) produce ear wax and sebum.
Answer: A
Reference: Page 151, Accessory Structures of the Skin
Level of Difficulty: Easy
37) Which of the following is NOT true of nails?
A) They consist of a free edge, a nail body and a nail root.
B) They are plates of lightly packed, Hard, nonkeratinized dermal cells.
C) Their thick lunula appears white because it obscures the underlying vasculature.
D) Their growth occurs from the nail matrix deep to the nail root.
E) They help us grasp and manipulate objects.
Answer: B
Reference: Page 151, Accessory Structures of the Skin
Level of Difficulty: Medium
38) A nervous student has been chewing his nails. He no longer has any white tips at the distal
ends of his nails, and one of the nails is inflamed and bloody at the distal end. Which of the
following is true?
A) The student has no white tips because he has bitten off the nail matrices.
B) The student has damaged the eponychium of his nails.
C) The student has damaged the hyponychium and underlying epidermis on one nail.
D) The student has no white tips because he damaged the lunula of his nails.
E) The student has a bloody distal end because he damaged his nail root on that digit.
Answer: C
Reference: Page 151, Accessory Structures of the Skin
Level of Difficulty: Hard
39) How does thin skin compare to thick skin?
A) Thin skin has a thicker stratum lucidum than thick skin.
B) Thin skin has higher, narrower, and more dermal papillae than thick skin.
C) Thin skin has more sweat glands than thick skin.
D) Thin skin has fewer sensory receptors than thick skin.
E) Thin skin has covers fewer parts of the body than thick skin.
Answer: D
Reference: Page 156, Types of Skin
Level of Difficulty: Medium
40) Which of the following is NOT a function of the skin?
A) regulates body temperature
B) participates in synthesis of vitamin A
C) serves as the first and foremost barrier to disease
D) excretes some waste products
E) house sensory receptors
Answer: B
Reference: Page 157, Functions of the Skin
Level of Difficulty: Medium
41) How does skin contribute to regulation of body temperature?
A) releasing perspiration, which evaporates and carries away heat
B) altering blood flow to the dermis, which adjusts how much heat will radiate from the body
C) shivering, which produces heat
D) A and B are correct.
E) A, B, and C are correct.
Answer: D
Reference: Page 157, Functions of the Skin
Level of Difficulty: Medium
42) Epinephrine and norepinephrine are regulatory substances that cause peripheral
vasoconstriction, which means that they cause the blood vessels in the skin to narrow. Why is it
important for the body to be able to narrow blood vessels in the skin?
A) Narrowing those blood vessels may divert blood from the skin to tissues that need it more.
B) Narrowing those blood vessels may prevent heat loss from the skin.
C) Narrowing those blood vessels may reduce blood loss from an injury.
D) A and B are correct.
E) A, B and C are correct.
Answer: E
Reference: Page 157, Functions of the Skin
Level of Difficulty: Hard
43) Each of the following is a protection provided by the skin EXCEPT:
A) It promotes dehydration.
B) It protects underlying tissues from abrasions and chemicals.
C) It prevents UV radiation from reaching underlying tissues.
D) It secretes substances that kill microbes.
E) It contains cells that trigger immune responses to microbes.
Answer: A
Reference: Page 157, Functions of the Skin
Level of Difficulty: Medium
44) Which of the following is true of cutaneous sensations?
A) They arise beneath the skin.
B) They include touch, pressure, itch, and tickle.
C) They cannot warn the body of possible injury.
D) They exclude tactile discs, corpuscles of touch and hair root plexuses.
E) All of these statements are true.
Answer: B
Reference: Page 157, Functions of the Skin
Level of Difficulty: Medium
45) What does the skin excrete?
A) heat
B) water
C) salt
D) urea and ammonia
E) All of these are excreted by the skin.
Answer: E
Reference: Page 157, Functions of the Skin
Level of Difficulty: Medium
46) A pharmaceutical company wants to create new medications that may be administered
transdermally. Based on your knowledge of what the skin can absorb, which of the following
products is a good candidate for transdermal delivery?
A) a water-soluble vitamin
B) a rehydration fluid
C) a lipid-soluble analgesic related to lidocaine
D) a nutrient cocktail of sugars and amino acids
E) All of these would be good product candidates.
Answer: C
Reference: Page 157, Functions of the Skin
Level of Difficulty: Medium
47) Which of the following is true of epidermal wound healing?
A) occurs following wounds that penetrate to the reticular dermis
B) exemplified by lacerations (deep cuts)
C) requires the presence and products of fibroblasts
D) requires some basal cells to detach from the basement membrane
E) is inhibited by epidermal growth factor
Answer: D
Reference: Page 158, Maintaining Homeostasis: Skin Wound Healing
Level of Difficulty: Medium
48) Place the phases required for deep wound healing in the order in which they occur:
1. maturation
2. inflammatory
3. proliferative
4. migratory
A) 2, 4, 3, 1
B) 1, 3, 4, 2
C) 2, 3, 4, 1
D) 3, 2, 4, 1
E) 1, 4, 3, 2
Answer: A
Reference: Page 158, Maintaining Homeostasis: Skin Wound Healing
Level of Difficulty: Medium
49) All of the following are true of wound healing EXCEPT:
A) Scabs fall off wounds once the underlying epidermis has healed.
B) Inflammation is a protective response that helps remove microbes from a wound.
C) Granulation tissue is associated with the migratory phase of deep wound healing.
D) Epidermal wound healing usually results in fibrosis.
E) Epidermal cells stop migrating due to a cellular response called contact inhibition.
Answer: D
Reference: Page 158, Maintaining Homeostasis: Skin Wound Healing
Level of Difficulty: Medium
50) Which of the following is true of the development of the integumentary system?
A) The epidermis begins to develop from the ectoderm about 8 weeks after conception.
B) The dermis is derived from endoderm during the 10th week after conception.
C) Nails develop from mesoderm after the 5 month of development.
D) The vernix caseosa is the layer of fine hairs that appears about 5 months after conception.
E) Lanugo is the slippery, lipid-rich substance that protects fetal skin from amniotic fluid.
Answer: A
Reference: Page 160, Development of the Integumentary System
Level of Difficulty: Medium
51) How does aging affect the integumentary system?
A) Numbers of Langerhans cells increase dramatically.
B) Numbers of functioning melanocytes increase.
C) Elasticity and extensibility decrease.
D) Dermal thickness increases.
E) Growth of hair and nails accelerates.
Answer: C
Reference: Page 160, Aging and the Integumentary System
Level of Difficulty: Medium
52) How does the integumentary system integrate with the other body systems?
A) Cutaneous sensory receptors allow the nervous system to detect changes in the environment.
B) Vitamin C activation allows the digestive system to absorb Ca+2 and the skeleton to store it.
C) Sebum, hairs, and melanocytes help the immune system defend the body against infection.
D) A and B are correct.
E) A, B and C are correct.
Answer: A
Reference: Page 163, Focus on Homeostasis: The Integumentary System
Level of Difficulty: Hard
53) All of the following are true of skin cancer EXCEPT:
A) Individuals over 50 years of age are more likely to have skin cancer than those under 30.
B) Basal cell carcinomas are least likely to metastasize.
C) Melanoma is characterized by lesions with irregular borders and abnormal colorations.
D) Squamous cell carcinoma is a nonmelanoma carcinoma.
E) Melanoma is the most common but least dangerous form of skin cancer.
Answer: E
Reference: Page 164, Disorders: Homeostatic Imbalances
Level of Difficulty: Medium
54) Which of the following is true of burns?
A) Systemic effects of burns are a greater threat to life than local effects.
B) Burn patients may go into shock due to large losses of fluids.
C) Minor burns have major effects on the urinary system.
D) A and B are correct.
E) A, B and C are correct.
Answer: D
Reference: Page 164, Disorders: Homeostatic Imbalances
Level of Difficulty: Medium
55) Which individual is most likely to develop a pressure ulcer?
A) a healthy, physically-fit individual with an active lifestyle
B) a sedentary but otherwise health person
C) an individual with poor circulation
D) an individual who is paralyzed but receives excellent care
E) an individual who is paralyzed, has poor circulation, and has little care
Answer: E
Reference: Page 164, Disorders: Homeostatic Imbalances
Level of Difficulty: Hard