# A nurse is assessing a patient's skin integrity. Which layer of the skin contains blood vessels, nerve endings, and hair follicles?

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> subject: Adult Health

## 문제

A nurse is assessing a patient's skin integrity. Which layer of the skin contains blood vessels, nerve endings, and hair follicles?

## 보기

1. Epidermis
2. Stratum corneum
3. Dermis **✔ 정답**
4. Subcutaneous tissue

**정답: 3**

## 해설

The dermis contains blood vessels, nerve endings, and hair follicles, which are essential for skin function and sensation. Other layers like epidermis, stratum corneum, and subcutaneous tissue lack these structures.

## 심화 해설

Understanding the Skin's Functional Layers

To answer this question, you must distinguish between the structural layers of the skin and their specific components. The skin is composed of two primary layers, the epidermis and the dermis, with a supportive subcutaneous layer beneath. The question asks for the specific layer that houses blood vessels, nerve endings, and hair follicles.

The epidermis, the outermost layer, is an avascular stratified squamous epithelium. This means it does not contain blood vessels; it relies on the underlying dermis for nutrient and oxygen delivery via diffusion. While the epidermis contains nerve endings that extend into its lower layers, it does not house the main nerve networks or hair follicles. The stratum corneum is the most superficial, dead layer of the epidermis, providing a protective barrier, and contains none of the listed structures. The subcutaneous tissue (hypodermis) is primarily composed of adipose and connective tissue, serving as insulation and cushioning, and while it contains larger blood vessels and nerves, the hair follicle originates in the layer above it.

The dermis is the correct answer. It is a thick, vascular connective tissue layer that provides structural and nutritional support to the epidermis. It is rich with blood vessels, which are essential for thermoregulation and wound healing. It contains a dense network of sensory nerve endings that allow for the perception of touch, pressure, pain, and temperature. The role of nerve fibers in skin is so significant that their 3D morphology and distribution are now being studied in conditions like psoriasis to understand neurogenic inflammation [1]. Furthermore, hair follicles are intradermal structures; their roots are embedded deep within the dermis. The dermis is therefore the functional core where these three components—vasculature, innervation, and adnexal structures—are anatomically integrated.

References (research sources)

- [1]Nerve Fibres in Psoriatic Skin and Their Relation to Vasculature and Clinical Parameters.Research articleDoppegieter M, van der Beek N, Aalders MCG, Bakker ENTP, Neumann M, van Leeuwen TG. (2025) · DOI: 10.1111/exd.70166

## 임상 시나리오

Skin Layer AssessmentIdentifying structures within the dermis
The dermis is the functional core of the skin, located between the epidermis and subcutaneous tissue. It contains blood vessels for thermoregulation, nerve endings for sensation, and hair follicles.

A wound that bleeds or causes pain indicates that the injury has penetrated the epidermis and reached the dermis. Healing in this layer involves inflammation, granulation tissue formation, and potential scarring due to collagen deposition.

CautionStage 1 pressure injuries are characterized by non-blanchable erythema of intact skin, indicating damage is limited to the epidermis. Do not confuse this with a Stage 2 injury, which involves partial-thickness loss of dermis.

## 핵심 개념

- **Dermis** — The thick, vascular middle layer of skin containing connective tissue, blood vessels, nerve endings, hair follicles, and glands.
- **Epidermis** — The outermost avascular layer of skin composed of stratified squamous epithelium, relying on the dermis for nutrients.
- **Stratum Corneum** — The most superficial layer of the epidermis, consisting of dead, keratinized cells that form a protective barrier.
- **Subcutaneous Tissue** — The innermost layer beneath the dermis, composed mainly of adipose and connective tissue for insulation and cushioning.

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