CHAPTER 5 The Integumentary System
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.
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.
B) Decubitus ulcer
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
4) The major regions of a hair shaft include all of the following except ________.
C) external root sheath
5) Acne is a disorder associated with ________.
A) sweat glands
B) sebaceous glands
C) Meibomian glands
D) ceruminous glands
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
7) Which muscles attached to the hair follicles cause goose bumps?
A) arrector integument
B) arrector pili
C) levator folliculi
D) arrector folliculi
8) If a splinter penetrated the skin into the second epidermal layer of the sole of the foot, which
cells would be damaged?
9) Which of the following cutaneous receptors is specialized for the reception of touch or light
A) Meissnerʹs corpuscles
B) Pacinian corpuscles
C) free nerve endings
D) Krauseʹs end bulbs
10) Melanocytes ________.
A) are spidery-shaped cells in contact with cells in the stratum basale
B) are involved in the immune system
C) are involved with the nervous system
D) work their way up to the surface just like the keratinocytes
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.
12) Sudoriferous glands vary in distribution over the surface of the body. Which of the following
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
C) Ceruminous glands secrete cerumen, which is thought to deter insects.
D) Mammary glands are not considered a modified sweat gland.
13) Although the integument is a covering, it is by no means simple, and some of its functions
A) the dermis providing the major mechanical barrier to chemicals, water, and other
B) resident macrophage-like 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 high-temperature
D) epidermal blood vessels serving as a blood reservoir
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
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
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) cheesy-looking sudoriferous secretion on the skin of newborns
16) The ________ gland is a modified sudoriferous gland that secretes wax.
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
D) diffusing through the tissue fluid from blood vessels in the dermis
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
19) The epidermis is responsible for protecting the body against invasion of bacteria and other
foreign agents primarily because it is composed of ________.
A) stratified columnar epithelium
B) three layers of keratinized cells only
C) four different cell shapes found in five distinct layers, each cell shape with a special
D) a tough layer of connective tissue
20) Keratinocytes are an important epidermal cell because ________.
A) they produce a fibrous protein that gives the skin much of its protective properties
B) they are able to transform from living cells to plasma membranes and still function
C) they are able to reproduce sporadically as needed
D) they are a powerful defense against damaging UV rays
21) Melanocytes and keratinocytes work together in protecting the skin from UV damage when
A) provide the melanocyte with a protective shield against abrasion
B) accumulate the melanin granules on their superficial portion, forming a UV-blocking
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
22) The epidermis consists of five layers of cells, each layer with a distinct role to play in the health, well-being, and functioning of the skin. Which of the following layers is responsible for cell division and replacement?
A) stratum corneum
B) stratum granulosum
C) stratum basale
D) stratum lucidum
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 Langerhansʹ cells
C) keratinocytes, because they are so versatile
D) Merkel cells
24) Water loss through the epidermis could cause a serious threat to health and well-being. Which
of the following protects us against excessive water loss through the skin?
A) 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.
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
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
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) Because the pain is acute due to the large number of Meissnerʹs corpuscles.
B) The appearance of visible, silvery-white 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
ʺblack and blue marks.ʺ
D) The stretching causes the tension lines to disappear.
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.
29) The design of a personʹs 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.
30) Which of the following statements indicates the way in which the bodyʹs 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 skinʹs
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 Langerhansʹ cells, which help to
activate the immune system.
D) Prolonged exposure to the sun induces melanin dispersion, which in turn acts as a
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 Addisonʹs disease?
A) The skin takes on a bronze or metallic appearance.
B) Black-and-blue marks become evident for no apparent cause.
C) The skin appears to have an abnormal, yellowish tint.
D) It is impossible to suggest Addisonʹs disease from an inspection of a personʹs skin.
32) A Langerhansʹ cell is a ________.
A) specialized squamous epithelial cell
B) specialized phagocytic cell
C) specialized nerve cell
D) specialized melanocyte
33) The most important factors influencing hair growth are ________.
A) sex and hormones
B) age and glandular products
C) the size and number of hair follicles
D) nutrition and hormones
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.
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
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
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
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
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
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.
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
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 ʺrule of ninesʺ
41) What is the first threat to life from a massive third-degree burn?
B) catastrophic fluid loss
C) unbearable pain
D) loss of immune function
42) Male pattern baldness has a genetic switch that turns on in response to ________.
D) male hormones
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 one-tenth that of the head hair follicle
D) hormones in the eyebrow follicle switch the growth off after it has reached a
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