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EMS - MoD > 8. Repair and Regeneration > Flashcards

8. Repair and Regeneration Flashcards

1
Q

Regenration occurs when?

A

After acute inflammation, if the cells can regrow

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2
Q

Repair occurs when?

A

After acute inflammation, if the cells cannot regrow

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3
Q

After regeneration, are the tissues normal or scarred?

A

Damaged cells replaced by like

Tissue returns to normal

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4
Q

After repair, are the tissues normal or scarred?

A

Damaged cells cannot be replaced by like

Fibrosis and scarring

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5
Q

After regeneration, do the tissues still have specialised function?

A

Yes, tissue restores specialised function

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6
Q

After repair, do the tissues still have specialised function?

A

No, loss of specialised function

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7
Q

Name 3 types of kinetic cell populations

A
  • liable
  • stable
  • permanent
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8
Q

What are the main characteristics of labile cell populations?

A
  • high normal turnover
  • active stem cell population
  • excellent regenerative capacity
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9
Q

Give an example of a labile cell population

A

Epithelia

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10
Q

What does ‘high turnover rate’ mean in terms of tissues?

A

Constantly producing and shredding off old cells. Do this to maintain integrity

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11
Q

In which zone of the tissue do active stem cells sit?

A

In the basal zone

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12
Q

What does ‘regenerative capacity’ mean?

A

Capacity to heal by regeneration

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13
Q

What are the main characteristics of stable (quiescent) cell populations?

A
  • low physiological turnover
  • turnover can massively increase if needed
  • good regenerative capacity
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14
Q

Give examples of stable (quiescent) cell populations

A
  • liver

- renal tubules

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15
Q

What are the main characteristics of permanent cell populations?

A
  • no physiological turnover
  • long life cells
  • no regenerative capacity
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16
Q

Give examples of permanent cell populations

A
  • neurons

- muscle cells

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17
Q

Cell types which are very specialised eg. neurones tend to be which type of cell population? (kinetics)

A

Permanent cell populations

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18
Q

Which cell populations are at the end of the differentiation capacity and have lost the ability to divide?

A

Permanent cell populations

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19
Q

Which type of cell population is good at switching on turnover when the need arises?

A

Stable (quiescent)

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20
Q

Which type of cell population constantly goes round the cell cycle?

A

Labile

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21
Q

Stable cell populations can come and go out of the cell cycle. At which stage do the go back in?

A

G1

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22
Q

Why does a cirrhotic liver consist of regenerative nodules divided by fibrous septa?

A

There is a collapse of the reticulin (connective tissue) framework of the liver so that the regeneration of liver cells cannot repopulate the normal architecture

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23
Q

What noxious agents may cause long term persistent long term damage to the liver (cirrhosis)?

A
  • alcohol
  • some hepatitis viruses
  • autoimmune damage
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24
Q

What are the stages from stem cells to terminal differentiation?

A
  • stem cell compartment
  • amplifying cell compartment
  • differentiating compartment
  • terminal differentiation
25
Q

Name some features of stem cells

A
  • prolonged self-renewal
  • asymmetric replication
  • reservoirs present in many adult tissues
  • when a stem cell divides, it produces another stem cell as well as a cell that goes up in the diagram
26
Q

What is crucial for regeneration to be able to take place?

A

Survival of stem cells

27
Q

What can damage stem cells?

A
  • full thickness burn

- radiation

28
Q

What controls regeneration?

A
  • proliferation of stem cell/amplifying cell compartments
  • covering of defect
  • contact inhibition
  • complex control by growth factors, cell-cell and cell-matrix interactions
29
Q

Why might a cell population be incapable of cell renewal?

A
  • may be a permanent cell population

- may be loss of stem cells

30
Q

What may a white area on heart muscle tissue be?

A

Fibrous scar tissue (as heart cells are a permanent cell population) - a result of healing of a myocardial infarct by repair

31
Q

What are the 3 main components of granulation tissue?

A
  • new capillary loops (due to proliferation of endothelial cells from surrounding vessels)
  • phagocytic cells (neutrophils, macrophages) from acute inflammatory reaction, role is to remove dead tissue
  • myofibroblasts (lay down matrix components, collagen etc.) normal components of fibrous connective tissue
32
Q

What is the process of new blood vessels forming in granulation tissue?

A
  • endothelial cell proliferation
  • buds
  • canalisation
  • new vessels
33
Q

How does a wound contract?

A

Fibroblasts acquire myofibrils and become myofibroblasts and therefore gain contractile ability - this allows wound contraction = reduces area

34
Q

Myofibroblasts causes wounds to contract. What problems may arise from this?

A
  • contractures after burns

- oesophageal peptic strictures (narrowing)

35
Q

What happens as granulation tissue matures?

A
  • vascularity decreases
  • cellularity decreases
  • collagen and ECM wound strength increases
36
Q

Maturation of the granulation tissue is necessary in complete repair. About how long does this normally take?

A

3 months

37
Q

Which drug generates catabolic state and impairs healing?

A

Steroids such as prednisolone

Breaks down proteins and therefore interferes with the healing process

38
Q

How does malnourishment impair healing?

A

Lack of proteins which are required for healing by repair

39
Q

How does anaemia impair healing?

A

Affects oxygen supply

40
Q

What are two types of healing?

A
  • healing by first (primary) intention

- healing by second (secondary) intention

41
Q

In what circumstances would healing by first/primary intention occur?

A
  • clean, uninfected surgical wound
  • good homeostasis
  • edges apposed eg. with sutures or staples
42
Q

What would the end result of healing by first intention be?

A

A neat scar

43
Q

Under what circumstances would healing by second intention occur?

A
  • wound edges not apposed
  • extensive loss of tissue
  • apposition not physically possible
  • large haematoma
  • infection
  • foreign body
44
Q

What is different in healing by secondary intention compared to healing by first intention?

A
  • more florid granulation tissue reaction

- more extensive scarring

45
Q

How strong is a wound when sutures are taken out?

A

10% wound strength

day 7

46
Q

What are the general stages in fracture healing?

A
  • normal bone fractures
  • haematoma at fracture site
  • callus at fracture site
  • lamellar bone replaces woven
  • remodelled to make normal bone
47
Q

What do osteoblasts do?

A

Lay down woven bone (=callus)

48
Q

What is a callus?

A

The bony healing tissue which forms around the ends of broken bone

49
Q

A fractured bone remodels according to what?

A

Mechanical stress

50
Q

The callus formed in a fracture is replaced by what?

A

Lamellar bone

51
Q

What causes non-union of fractures?

A
  • misalignment
  • movement
  • infection
  • interposed soft tissue
  • pre-existing bone pathology
    = pathological fracture
52
Q

A pathological fracture is when there is non-union of fractures due to pre-existing bone pathology. Give an example of this

A

Tumour metastasis causing weakening of bone

53
Q

To what degree are neurones differentiated?

A

Neurons are terminally differentiated

54
Q

What is the supporting tissue int the brain?

A

Glial cells

rather than collagen and fibroblasts etc

55
Q

What are glial cells

A

They are cells that provide support and protection for neurons (the supporting tissue in the brain)

56
Q

How does healing occur in the brain?

A

Damaged tissue is removed, leaving a cyst

The cyst will be surrounded by reactive gliosis (gliosis rather than scarring)

57
Q

What is gliosis?

A

Alternative to scarring, happens during healing in the brain

It is a change in glial cells in response to damage to the CNS

Involved the proliferation of glial cells (astrocytes etc)

58
Q

In general, how is healing controlled?

A

Tightly controlled by complex networks of cytokines etc.

EMS - MoD (17 decks)

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