Essentials of Human Anatomy and Physiology, 11e (Marieb)
Chapter 4 Skin and Body Membranes
4.1 Multiple Choice Part I Questions
Using Figure 4.1, identify the following:
1) The hypodermis, or subcutaneous tissue, is represented by ________.
A) Label A
B) Label B
C) Label C
D) Label D
E) Label E
F) Label F
Answer: D
Page Ref: 113, 114
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2) The hair follicle is indicated by ________.
A) Label A
B) Label B
C) Label C
D) Label D
E) Label E
F) Label F
Answer: F
Page Ref: 114, 121
Bloom's: 1) Knowledge
3) The layer responsible for whorled ridges on the epidermal surfaces is indicated by ________.
A) Label A
B) Label B
C) Label C
D) Label D
E) Label E
F) Label F
Answer: A
Page Ref: 114, 116
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4) The arrector pili muscle is represented by ________.
A) Label A
B) Label B
C) Label C
D) Label D
E) Label E
F) Label F
Answer: B
Page Ref: 114, 123
Bloom's: 1) Knowledge
5) The gland that produces a mixture of oily substances and fragmented cells is indicated by
________.
A) Label A
B) Label B
C) Label C
D) Label D
E) Label E
F) Label F
Answer: C
Page Ref: 114, 119
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6) The gland that produces sweat is indicated by ________.
A) Label A
B) Label B
C) Label C
D) Label D
E) Label E
F) Label F
Answer: E
Page Ref: 114, 121
Bloom's: 1) Knowledge
7) The pleura and pericardium are examples of ________ membranes that cover organs in a body
cavity closed to the exterior.
A) mucous
B) serous
C) cutaneous
D) synovial
Answer: B
Page Ref: 110
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8) The ________ membrane lines the fibrous capsule surrounding joints.
A) synovial
B) serous
C) mucous
D) cutaneous
Answer: A
Page Ref: 110
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9) The part of a hair that projects from the surface of the scalp or skin is called the ________.
A) follicle
B) root
C) cuticle
D) shaft
Answer: D
Page Ref: 121
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10) The outermost layer of the epidermis is keratinized and known as stratum ________.
A) basale
B) granulosum
C) corneum
D) spinosum
Answer: C
Page Ref: 115-116
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11) The three pigments that contribute to skin color are ________, ________, and ________.
A) collagen; elastic; keratin
B) melanin; jaundice; erythema
C) sebum; sweat; urea
D) melanin; carotene; hemoglobin
Answer: D
Page Ref: 119
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12) The sebaceous and sweat glands associated with the skin are classified as ________ glands
because they release secretions to the skin's surface via ducts.
A) exocrine
B) endocrine
C) serous
D) mucous
Answer: A
Page Ref: 119
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13) "Goosebumps" are caused by contractions of the ________.
A) eccrine glands
B) synovial membranes
C) arrector pili muscles
D) apocrine glands
Answer: C
Page Ref: 123
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14) The type of burn that involves injury to the epidermis and the upper region of the dermis and
is red, blistered, and painful is termed as a ________-degree burn.
A) first
B) second
C) third
D) fourth
Answer: B
Page Ref: 124
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15) The white, cheesy-looking substance that is produced by the sebaceous glands and protects a
baby's skin while it is floating in its water-filled sac inside the mother is called ________.
A) lanugo
B) vernix caseosa
C) milia
D) vellus
Answer: B
Page Ref: 128
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16) Hair color is due to a pigment known as ________.
A) hemoglobin
B) carotene
C) keratin
D) melanin
Answer: D
Page Ref: 121
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17) The white crescent area located over the nail matrix is called the ________.
A) lunule
B) cuticle
C) matrix
D) bed
Answer: A
Page Ref: 124
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18) The layer of the serous membrane that covers an organ is known as the ________ layer.
A) bursa
B) visceral
C) lamina propria
D) parietal
Answer: B
Page Ref: 110
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19) The Staphylococcus infection of the skin that causes pink, water-filled, raised lesions is
known as ________.
A) impetigo
B) cold sores
C) psoriasis
D) contact dermatitis
Answer: A
Page Ref: 126
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20) The type of gland responsible for body temperature regulation is the ________ gland.
A) sebaceous
B) eccrine (sweat or sudoriferous)
C) apocrine (sweat or sudoriferous)
D) oil
Answer: B
Page Ref: 121
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21) Which of the following letters in the ABCD rule for recognizing melanomas is incorrect?
A) A stands for asymmetry
B) B stands for border irregularity
C) C stands for color
D) D stands for diagnosis
Answer: D
Page Ref: 127
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4.2 Multiple Choice Part II Questions
1) Which membrane is constructed of a visceral and parietal layer?
A) synovial
B) cutaneous
C) mucous
D) serous
E) peritoneum
Answer: D
Page Ref: 110
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2) The deepest layer of the serous membrane covering the outer surface of the heart is the
________.
A) parietal pericardium
B) visceral pleura
C) synovial layer
D) visceral pericardium
E) peritoneum
Answer: D
Page Ref: 110
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3) Synovial fluid reduces friction ________.
A) in movable joints such as the knee
B) between the visceral and parietal layers of serous membranes
C) inside the lungs
D) as the heart beats
E) around the brain
Answer: A
Page Ref: 110
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4) Which of the following is a connective tissue membrane?
A) synovial membrane
B) cutaneous membrane
C) mucous membrane
D) serous membrane
E) pleural membrane
Answer: A
Page Ref: 110
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5) The only dry membrane is the ________.
A) synovial membrane
B) cutaneous membrane
C) mucous membrane
D) serous membrane
E) basement membrane
Answer: B
Page Ref: 110
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6) Where are mucous membranes found?
A) lining joint cavities
B) covering the heart
C) lining the inside of the stomach
D) covering the brain
E) lining the abdominal cavity wall
Answer: C
Page Ref: 110
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7) The skin and its derivatives (nails, glands, and hairs) form the ________.
A) skeletal system
B) integumentary system
C) endocrine system
D) immune system
E) lymphatic system
Answer: B
Page Ref: 112
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8) Which of the following is a vital function of the skin?
A) It converts modified epidermal cholesterol to vitamin D.
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.
E) It aids in desiccation.
Answer: A
Page Ref: 112-113
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9) Although you get wet while swimming, a tough protein within the skin prevents it from
soaking up moisture like a sponge. This substance is ________.
A) serous fluid
B) melanin
C) mucus
D) carotene
E) keratin
Answer: E
Page Ref: 112
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10) The epidermis is composed of ________.
A) simple columnar epithelium
B) stratified squamous epithelium
C) adipose tissue
D) areolar tissue
E) dense fibrous connective tissue
Answer: B
Page Ref: 113
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11) Jan got her microscope slides mixed up in lab as they were unlabeled. The slide with
abundant adipose tissue should be labeled as the ________.
A) epidermis
B) papillary layer of the dermis
C) subcutaneous tissue
D) reticular layer of the dermis
E) stratum corneum
Answer: C
Page Ref: 113
Bloom's: 4) Analysis
12) The two main layers of skin are ________.
A) papillary layer and reticular layer
B) stratum basale and dermis
C) epidermis and dermis
D) stratum corneum and dermis
E) epidermis and hypodermis
Answer: C
Page Ref: 113
Bloom's: 1) Knowledge
13) A needle pierces through the epidermal layers of the forearm in the following order:
1. stratum basale
2. stratum corneum
3. stratum granulosum
4. stratum lucidum
5. stratum spinosum
A) 2, 3, 5, 1, 4
B) 1, 5, 3, 4, 2
C) 2, 4, 3, 5, 1
D) 1, 3, 5, 2, 4
E) 2, 3, 4, 1, 5
Answer: A
Page Ref: 114-115
Bloom's: 3) Application
14) Which of the following homeostatic imbalances is caused by a herpes simplex infection?
A) athlete's foot
B) cold sores
C) impetigo
D) contact dermatitis
E) cyanosis
Answer: B
Page Ref: 116, 126
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15) The "tanning" effect (darkening of the skin) that occurs when a person is exposed to the sun
is due to ________.
A) melanin
B) keratin
C) oil
D) Langerhans cells
E) sweat
Answer: A
Page Ref: 116
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16) The layer of the epidermis in which cells die because of their inability to get nutrients and
oxygen is the clear layer called ________.
A) stratum spinosum
B) stratum granulosum
C) stratum basale
D) stratum corneum
E) stratum lucidum
Answer: E
Page Ref: 114-115
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17) People who produce a lot of melanin have a skin tone that is ________.
A) green
B) brown
C) blue
D) pink
E) orange
Answer: B
Page Ref: 116
Bloom's: 3) Application
18) A splinter penetrates to the deepest layer of the epidermis on your foot. This layer is the
________.
A) stratum basale
B) stratum corneum
C) stratum granulosum
D) stratum lucidum
E) stratum spinosum
Answer: A
Page Ref: 114-115
Bloom's: 2) Comprehension
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19) Which of the following kills bacteria and prevents bacterial invasions of the skin?
A) sweat
B) hemoglobin
C) keratin
D) sebum
E) melanin
Answer: D
Page Ref: 119
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20) Nutrients reach the surface of the skin (epidermis) through the process of ________.
A) absorption
B) evaporation
C) filtration
D) diffusion
E) osmosis
Answer: D
Page Ref: 114
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21) Fingerprints and footprints in the epidermis are created by dermal papillae present in the
________.
A) reticular layer of the dermis
B) subcutaneous tissue
C) stratum lucidum
D) hypodermis
E) papillary layer of the dermis
Answer: E
Page Ref: 116
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22) In order to warm the body up when cold ________.
A) vitamin D is synthesized
B) sudoriferous glands release sweat
C) sebaceous glands release oil
D) the arrector pili muscles contract to stand hairs upright
E) melanin is produced
Answer: D
Page Ref: 123
Bloom's: 2) Comprehension
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23) Which vitamin is synthesized by the skin?
A) vitamin A
B) vitamin C
C) vitamin D
D) vitamin E
E) vitamin K
Answer: C
Page Ref: 112, 113
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24) Nails are composed of ________.
A) melanin
B) hemoglobin
C) keratin
D) sebum
E) carotene
Answer: C
Page Ref: 123
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25) The secretions of the eccrine glands are ________.
A) primarily uric acid
B) mostly water, sodium chloride, and trace amounts of wastes, lactic acid, and vitamin C
C) fatty substances, proteins, antibodies, and trace amounts of minerals and vitamins
D) solely metabolic wastes
E) basic
Answer: B
Page Ref: 121
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26) The secretion of sweat is stimulated ________.
A) by high temperatures
B) when the air temperature drops
C) by hormones, especially male sex hormones
D) as a protective coating when one is swimming
E) both by high temperatures and by hormones, especially male hormones
Answer: E
Page Ref: 121
Bloom's: 2) Comprehension
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27) Hairs are found associated with the ________.
A) palms of the hands
B) axillary region
C) lips
D) nipples
E) soles of the feet
Answer: B
Page Ref: 121
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28) Which of the following abnormal skin colors results from liver disorders?
A) cyanosis
B) pallor
C) erythema
D) jaundice
E) bruising
Answer: D
Page Ref: 119
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29) What skin disorder is recognized using the ABCD rule?
A) squamous cell carcinoma
B) melanoma
C) psoriasis
D) basal cell carcinoma
E) impetigo
Answer: B
Page Ref: 127
Bloom's: 2) Comprehension
30) A physician estimates the volume of fluid lost in a severely burned patient by ________.
A) measuring urinary output and fluid intake
B) observing the tissues that are usually moist
C) blood analysis
D) using the "rule of nines"
E) performing enzyme studies
Answer: D
Page Ref: 124
Bloom's: 1) Knowledge
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31) Which of the following is an indication of melanoma?
A) a symmetrical mole
B) a pigmented spot that has smooth borders
C) a spot on the skin that is smaller than the size of a pencil eraser
D) a pigmented spot that is black
E) a pigmented spot that contains areas of different colors
Answer: E
Page Ref: 127
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32) Sebum is responsible for all of the following EXCEPT ________.
A) body temperature regulation
B) makes the skin oilier during adolescence
C) kills bacteria on the skin's surface
D) keeps the skin soft and moist
E) prevents hair follicles from brittleness
Answer: A
Page Ref: 119
Bloom's: 2) Comprehension
33) A genetic switch turns on male pattern baldness in response to ________.
A) age
B) size
C) weight
D) male hormones
E) female hormones
Answer: A
Page Ref: 128
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34)
The membrane shown in Figure 4.2 is a ________.
A) cutaneous membrane
B) synovial membrane
C) pericardium, a serous membrane
D) mucous membrane
E) pleura, a serous membrane
Answer: E
Page Ref: 110, 111
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4.3 True/False Questions
1) Cutaneous membranes are the only dry membranes.
Answer: TRUE
Page Ref: 110
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2) Serous membranes line and lubricate joint cavities such as the knee.
Answer: FALSE
Page Ref: 110
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3) When an individual is exposed to extremely low air temperatures, the capillaries of the skin
will dilate so that blood will flush into skin capillary beds and heat will be dissipated.
Answer: FALSE
Page Ref: 117
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4) The dermis is composed mostly of dense connective tissue.
Answer: TRUE
Page Ref: 116
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5) The pinkish hue of healthy individuals with fair skin is the result of the crimson color of
oxygenated hemoglobin circulating in the dermal capillaries and reflecting through the dermis.
Answer: TRUE
Page Ref: 119
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6) The pattern that produces fingerprints is produced by dermal papillae in the dermis.
Answer: TRUE
Page Ref: 116
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7) The epidermis is made up of stratified squamous epithelium.
Answer: TRUE
Page Ref: 113
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8) The majority of the cells in the epidermis are keratinocytes.
Answer: TRUE
Page Ref: 114
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9) Collagen and elastic fibers are common in the epidermis of the skin.
Answer: FALSE
Page Ref: 117
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10) Sebaceous glands release sweat to help control body temperature.
Answer: FALSE
Page Ref: 121
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11) Sebaceous glands may be classified as eccrine or apocrine depending on their locations.
Answer: FALSE
Page Ref: 121
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12) Hair is produced by the hair bulb and is composed primarily of dead keratinized cells.
Answer: TRUE
Page Ref: 121
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13) Nails and hair are composed of keratin.
Answer: TRUE
Page Ref: 121, 123
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14) The reason that the nail bed appears pink is the presence of a large number of melanocytes in
the underlying dermis.
Answer: FALSE
Page Ref: 124
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15) Joe just burned his hand on a hot pot. A blister forms and the burn is painful; Joe's burn
would best be described as a third-degree, or full-thickness, burn.
Answer: FALSE
Page Ref: 124
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16) The rule of nines is used to estimate how much of the body surface is burned.
Answer: TRUE
Page Ref: 124
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17) Apocrine gland secretions are normally odorless, and may be milky or yellowish in color.
Answer: TRUE
Page Ref: 121
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18) The ABCD rule is used for classifying burns.
Answer: FALSE
Page Ref: 127
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19) Milia is most common during old age when secretions accumulate in the sebaceous glands.
Answer: FALSE
Page Ref: 128
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20) Squamous cell carcinoma arises from cells of the stratum spinosum.
Answer: TRUE
Page Ref: 127
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4.4 Matching Questions
Match the following:
A) cancer of melanocytes
B) cancer of stratum spinosum cells
C) staphylococcus bacterial infection causing water-filled lesions, commonly around the mouth
and nose
D) infection of the sebaceous gland and the formation of pimples
E) skin inflammation
F) inflammation of hair follicles and sebaceous glands
G) malignancy of the lowest epidermal layer
H) burn in which only the epidermis becomes red and swollen
I) dry, dead flakes of stratum corneum
J) virus that produces cold sores
K) full thickness burn of the skin in which the skin becomes blackened or blanched (gray-white)
1) Malignant melanoma
Page Ref: 127
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2) Dermatitis
Page Ref: 126
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3) Dandruff
Page Ref: 116
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4) Herpes simplex
Page Ref: 116, 126
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5) Basal cell carcinoma
Page Ref: 126
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6) Squamous cell carcinoma
Page Ref: 127
Bloom's: 1) Knowledge
7) First-degree burn
Page Ref: 124
Bloom's: 1) Knowledge
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8) Boils and carbuncles
Page Ref: 125
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9) Impetigo
Page Ref: 126
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10) Third-degree, or full-thickness, burn
Page Ref: 124
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11) Acne
Page Ref: 120, 128
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Answers: 1) A 2) E 3) I 4) J 5) G 6) B 7) H 8) F 9) C 10) K 11) D
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Match the following:
A) Superficial layer of the epidermis made of 20-30 cell layers of dead, keratin-filled cells
B) Cell commonly found in the epidermis that produces keratin
C) Deepest layer of the epidermis that is situated closest to the dermis
D) Upper layer of the dermis that forms dermal papillae
E) Cell that produces a pigment known as melanin
F) Hypodermis
G) Cell responsible for alerting and activating an immune response to a bacterial or viral
invasion
12) Epidermal dendritic cell
Page Ref: 116
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13) Stratum corneum
Page Ref: 115
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14) Papillary layer of dermis
Page Ref: 116
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15) Keratinocyte
Page Ref: 114
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16) Subcutaneous tissue
Page Ref: 113
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17) Melanocyte
Page Ref: 116
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18) Stratum basale
Page Ref: 114
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Answers: 12) G 13) A 14) D 15) B 16) F 17) E 18) C
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Match the following:
A) serous membrane
B) synovial membrane
C) mucous membrane
D) cutaneous membrane
19) Type of membrane that forms the skin
Page Ref: 110
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20) Type of membrane adapted for absorption or secretion
Page Ref: 110
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21) Type of membrane that secretes fluids around organs
Page Ref: 110
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22) Type of membrane that contains a visceral and a parietal layer
Page Ref: 110
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23) Type of membrane that lines the fibrous capsules surrounding joints
Page Ref: 110
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24) Type of membrane that lines open body cavities
Page Ref: 110
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25) Peritoneum, pericardium, and pleura are examples of this type of membrane
Page Ref: 110
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Answers: 19) D 20) C 21) A 22) A 23) B 24) C 25) A
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4.5 Essay Questions
1) Explain the ABCD rule.
Answer: The ABCD rule describes the appearance of the most serious form of skin cancer,
melanoma. The "A" is for asymmetry. In melanoma, the two sides of the pigmented spot or mole
do not match. The "B" is for border irregularity. In melanoma, the borders of the lesion are not
smooth but exhibit indentations. The "C" is for color. In melanoma, the pigmented spot contains
areas of different colors (blacks, browns, tans, and sometimes blues and reds). The "D" is for
diameter. In melanoma, the spot is larger than 6 mm in diameter (the size of a pencil eraser).
Page Ref: 127
Bloom's: 2) Comprehension
2) Distinguish between the locations and secretions of apocrine and eccrine sweat glands.
Answer: Eccrine sweat glands are more numerous than apocrine sweat glands; they are found all
over the body. Eccrine sweat glands function in body temperature regulation. When we are too
hot, eccrine sweat glands release sweat containing water, salts, vitamin C, and metabolic wastes
on to the body's surface. Upon its evaporation, we are cooled down. The ducts of apocrine sweat
glands empty into hair follicles in the axillary and genital areas. Apocrine sweat glands activate
at puberty and produce sweat almost continuously, but their overall function is not know.
Apocrine sweat is milky or yellowish in color due to fatty acids and proteins in the secretions.
Page Ref: 121
Bloom's: 4) Analysis
3) Explain how the skin helps regulate body temperature.
Answer: The nervous system is responsible for controlling all temperature-regulating functions
of the skin. When the temperature in the external environment is high, heat loss occurs as the
nervous system activates sweat glands. Perspiration is produced, which evaporates from the skin
surface, causing heat to be dissipated. At the same time, the nervous system causes blood to be
flushed into skin capillary beds so that heat radiates from the body surface. In contrast, when the
temperature in the external environment is low, the nervous system prevents blood from entering
the skin capillary system and radiation to the body exterior is prevented so that perspiration does
not occur.
Page Ref: 117, 121
Bloom's: 2) Comprehension
4) Explain three ways in which the skin protects deeper tissues from mechanical damage.
Answer:
1. Keratinocytes are the most common cell type in the epidermis which produces a fibrous
protein known as keratin. Keratin provides a tough protective layer for the epidermis.
2. Fat cells in the subcutaneous tissue, deep to the dermis, cushions blows.
3. Pressure receptors alert the nervous system to possible damage.
Page Ref: 113, 114
Bloom's: 2) Comprehension
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5) Identify four changes that occur to the skin and subcutaneous connective tissue as a result of
aging, and state how these changes can be delayed.
Answer:
1. The amount of subcutaneous tissue below the skin decreases, leading to an intolerance to cold
in the elderly.
2. Because of decreased oil production and declining numbers of collagen fibers, the skin
becomes drier and may become itchy and bothersome.
3. Thinning of the skin makes it more susceptible to bruising and other types of injuries.
4. A decrease in elasticity of the skin, along with the loss of subcutaneous fat, allows bags to
form under the eyes and causes jowls to sag.
To delay these changes, the skin should be kept clean and shielded from the sun, and a healthy
diet with plenty of fluids should be maintained.
Page Ref: 117, 128
Bloom's: 1) Knowledge
6) List and describe the three types of epithelial membranes.
Answer:
1. Cutaneous membrane is:
a. skin
b. dry
c. composed of keratinizing stratified squamous epithelium and the underlying connective
tissue is often dense and fibrous.
2. Mucous membrane:
a. is moist
b. is found lining all body cavities that open to the exterior
c. often contains stratified squamous epithelium or simple columnar epithelium
3. Serous membrane:
a. is composed of two layers (visceral layer covers the organ in the cavity while the parietal
layer lines a specific portion of the wall of the ventral body cavity)
b. covers organs in body cavities that are closed to the exterior
c. is constructed of simple squamous epithelium overlying a thin layer of areolar connective
tissue
Page Ref: 110
Bloom's: 2) Comprehension
7) Differentiate among the roles of melanocytes and keratinocytes. Where in the skin are these
cells located?
Answer: Melanocytes are located in the stratum basale of the epidermis. These cells produce a
pigment, melanin, upon exposure to the skin. Melanin functions to protect the dermis from
damage due to UV radiation. Keratinocytes form most of the cells of the epidermis; they produce
a water-resistant, tough protein called keratin.
Page Ref: 114, 116
Bloom's: 4) Analysis
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8) Julia works in a walk-in clinic where several patients arrive with sunburns. How should she
distinguish the first-degree and second-degree burns from one another?
Answer: Although both first-degree and second-degree burns produce red and painful skin and
are partial thickness burns, only the second-degree burns produce blisters.
Page Ref: 124
Bloom's: 4) Analysis
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