9.21 Injury, Inflammation, Healing 9

Question 1

Proliferation and migration phase occurs when?

Answer 1

between 2-20 days

Question 2

What occurs during proliferation and migration?

Answer 2

• neovascularization/angiogenesis
• tissue gaps filled
• fibroblasts synthesize collagen, elastin, and proteoglycan cross-links

Question 3

angiogenesis process

Answer 3

• endothelial cells at edge proliferate and establish network
• grounded in connective tissue matrix

Question 4

What causes tissue gaps to be filled in?

Answer 4

• cell migration
• proliferation
• formation of new capillaries

Question 5

newly healing tissue

Answer 5

granulation tissue

Question 6

Type III collagen

Answer 6

initially weak and thin

Question 7

sequence of events with fibroplasia/collagen production

Answer 7

• granulation tissue formed
• Type III collagen
• scar formation
• Type I collagen

Question 8

scar is formed by these

Answer 8

• glycosaminoglycan (GAG)

- collagen

Question 9

Type I collagen forms by day

Answer 9

12

Question 10

Type I collagen

Answer 10

• more mature

- stronger than type III

Question 11

When does the remodeling and maturation phase occur?

Answer 11

Day 9 - 2 years

Question 12

During the remodeling phase, what happens to scar tissue?

Answer 12

• reduced

- remodeled

Question 13

contracture

Answer 13

tissue contracts to pull edges of the wound together

Question 14

Where can excess scar tissue be problematic?

Answer 14

• skin
• joints
• internal organs

Question 15

Why is the usefulness of joint manipulation questionable?

Answer 15

because the “break” takes place at the weakest link

Question 16

How will you know tissue maturation occurs?

Answer 16

• variable

- visible scar will change from vascularized red/pink tissue to less visible skin tone or white

Question 17

There is always the potential to heal any time

Answer 17

a new scar is pink

Question 18

Within just a few hours after skin injury, epithelial cells do this

Answer 18

• flatten out to cover a bare area

- divide and migrate across extracellular matrix to begin regeneration

Question 19

primary intention

Answer 19

• close approximation of tissues

- using sutures

Question 20

secondary intention

Answer 20

indirect union

Question 21

tertiary intention

Answer 21

• contaminated wound
• granulation tissue fills large gap
• slower growth