1. After falling off his bicycle, an 8-year-old boy has a large abrasion on his posterior thigh where the epidermis in the region has been removed but the dermis is largely intact. Which of the following changes in the integumentary system would be expected in the area of his wound?
A) Profuse bleeding from removal of his epidermis
B) Fewer Merkel and Langerhans cells in the region
C) Exposure of the underlying subcutaneous tissue
D) Removal of hair follicle roots from the area of the wound bed

2. Which of the following statements best conveys an aspect of the process of keratinization?
A) Keratin cells synthesized in the dermis migrate to the surface over 20 to 30 days.
B) Mitosis that begins with the cells of the stratum granulosum results in a continual supply of new keratinocytes.
C) The stratum germinativum continuously produces new keratinocytes to replace losses.
D) The basal cells of the epidermis migrate to the skin surface at a rate that matches superficial losses of skin cells.

3. A nurse is teaching a patient about the role that skin plays in forming a barrier to environmental agents and microorganisms. The nurse would recognize that which of the following types of cellular junctions binding keratinocytes is most responsible for this function?
A) Gap junctions
B) Desmosomes
C) Adherens junctions
D) Tight junctions

4. A 40-year-old male patient has a congenital syndrome that affects the function of the Langerhans cells of his epidermis. The man’s care provider would expect which of the following manifestations of his condition?
A) Increased susceptibility to infection
B) High permeability of his epidermis to environmental materials
C) Lighter skin tone than other individuals of the same ethnicity
D) Frequent separation between the dermal and epidermal layers of his skin

5. Clinical investigation of a 40-year-old female patient with diverse dermatologic signs and symptoms has focused on the woman’s basement membrane. Which of the following skin functions would a clinician most likely attribute to a region of the integument other than the basement membrane?
A) Lack of sensory nerve impulse conduction
B) Formation of blisters on various skin surfaces
C) Lack of adhesion between the dermis and epidermis
D) Large immunoglobulin deposits

6. Which of the following components of immune function is absent in the dermis?
A) Macrophages
B) T cells
C) Lymph nodes
D) Mast cells

7. A 51-year-old woman who was born congenitally blind and deaf is able to distinguish individuals by lightly touching the individual’s face. Which of the following components of the woman’s skin innervation likely contributes the most to this ability?
A) Ruffini corpuscles
B) Meissner corpuscles
C) Pacinian corpuscles
D) Nociceptors

8. A frustrated 26-year-old female has sought a referral to a dermatologist in an effort to resolve her sweating and body odor that persists despite good hygiene. Which of the following facts would underlie the explanation that her physician provides about her problem?
A) Sebaceous secretions vary in both quantity and constituency between individuals.
B) Excess production by eccrine sweat glands, combined with bacteria, produces a characteristic odor in moist areas of the body.
C) Apocrine sweat glands produce a substance that is oilier than sweat from other sources.
D) Occlusion of sebaceous glands in the axillae and groin results in proliferation of microorganisms.

9. Which of the following structures would likely be present in a hair follicle in a man’s groin but not in a follicle on his face?
A) Arrector pili muscle
B) Sebaceous gland
C) Apocrine gland
D) Hair papilla

10. A man’s primary care physician has characterized his skin lesion as being a temporary eruption but has cautioned him against repeated rubbing or scratching to avoid lichenification. What is the most likely categorization of the man’s skin lesion?
A) A blister
B) A corn
C) A callus
D) A rash

11. Following exposure to poison oak while camping, a 20-year-old male is experiencing pruritus as a consequence of his immune response to irritants in the plant. What physiologic process best accounts for his complaint?
A) His body is communicating a low level pain response as a protective measure.
B) Free nerve endings are initiating an itch-specific signal to the somatosensory cortex.
C) Local irritation of Langerhans cells is sending signals by way of myelinated type C nerve fibers.
D) Ruffini corpuscles are transmitting the message of pruritis to the cerebral cortex.

12. An 81-year-old woman has noted a gradual decrease in the moisture of her skin over many years. Which phenomena associated with the aging process are known to contribute to her xerosis? Select all that apply.
A) Separation of the basement membrane from adjacent dermal and epidermal layers
B) Changing composition of sebaceous gland secretions
C) Flattening of the dermal rete ridges
D) Decreased moisture secretions from sweat glands
E) Decrease in skin capillaries

13. The skin is richly supplied with arteriovenous anastomoses, in which blood flows directly between an artery and a vein, bypassing the capillary circulation. What is the primary significance of these structures?
A) They regulate body temperature.
B) They process sensory information.
C) They control the formation of “goose bumps.”
D) They combat skin infections.

14. Which of the following facts accounts for the variation in skin tone that exists between individuals?
A) Someone with dark skin has more melanocytes in his or her skin layers.
B) Darker-skinned individuals have melanosomes that produce melanin faster.
C) Dark skin is associated with spherical melanosomes, which produce and “package” pigment differently.
D) Greater numbers of keratinocytes result in darker skin tone.