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HOS Unit 1 > A 7 Wound healing > Flashcards

A 7 Wound healing Flashcards

1
Q

how long does it take for vasoconstriction to occur after a wound has occurred?

A

10-15 minutes post wounding.

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2
Q

what activates both the intrinsic and extrinsic clotting cascade?

A

collagen exposure

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3
Q

What do thromboxane A2 and Prostaglandin 2A do?

A

they are 2 important vasoconstrictors in wound healing that are released from damaged cell membranes.

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4
Q

do platelets help with vasoconstriction or vasodilatation?

A

vasoconstriction.

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5
Q

Platelets release?

A

epidermal growth factor (EGF)
fibronectin
histamine
PDGF

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6
Q

what is fibrin?

A

the primary component in the matrix of the early wound which creates a stable plug/clot.(thrombin–>fibrinogen–>fibrin)

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7
Q

besides leading to the fibrin clot, what else does thrombin do?

A

increases vascular permeability, and facilitates the migration of inflammatory cells.

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8
Q

what does histamine, prostaglandins (E1 &E2), kinins, C3a, C5a, and leukotrienes have in common?

A

they all increase vessel permeability so that cells can move out during inflammation and infection.

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9
Q

which white blood cells are the first to migrate to the wound area?

A

PMN’s or neutrophils.

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10
Q

What helps signal the white blood cell to leave the blood vessel and move into the tissue?

A

TGF-beta

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11
Q

what are the 3 stages of wound healing?

A

1) hemostasis and inflammation
2) granulation and proliferation
3) remodeling and maturation

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12
Q

lymphokines and interleukens are considered classes of?

A

cytokines

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13
Q

How do growth factors work?

A

1) GF cellular receptor
2) phosphorylation of a kinase
3) second messenger
4) nuclear transcription
5) cell proliferation

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14
Q

How long does the hemostasis/inflammatory phase generally last?

A

2-5 days post accident

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15
Q

What is the first response cell to the damaged tissue?

A

platelets

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16
Q

What is considered to be the first leukocyte (second cell type) to arrive on scene?

A

the neutrophil because the platelet releases C5a which is a chemoattractant for neutrophils.

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17
Q

What is the result when ADP leaks out from the damages tissues?

A

platelet aggragation

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18
Q

prothrombin–> thrombin, fibrinogen–> fibrin.

what do thrombin and fibrin do?

A

1) thrombin increases vascular permeability/extravascular migration
2) fibrin is the primary component of the matrix in the early wound as it strengthens the platelet aggregate.

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19
Q

which factors contribute to vessel permeability?

A 
thrombin
histamine
prostaglandins
C3a
C5a
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20
Q

what do neutrophils do?

A

phagocytosis

oxidative burst mechanisms

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21
Q

what are the third type of cells that migrate to the wound site?

A

macrophage

platelet–>neutrophil–>macrophage

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22
Q

what do macrophages release?

A

collagenases [debride the wound]
TNF [stimulate fibroblast and angiogenesis]
TGF [stimulates keratinocytes]

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23
Q

What time frame does the proliferative/granulation phase occur?

A

2 days to 3 weeks

24
Q

_________are the most important mesenchymal cells in wound healing?

A

fibroblasts.

25
Q

In order to fill in a gap produced by a wound, the cells migrate into the wound and lay down a sticky bed of proteins that consists of what?

A

laminin 5

26
Q

T/F Fibroblast migrate across fibrils in the early wound.

A

False, they migrate ALONG and not ACCROSS.

for some reason she put an emphasis on this

27
Q

What is the function of TIMP?

A

TIMP = tissue inhibitors of Metalloproteinases.

Recall that metalloproteinases break down the old matrix such as a scab to make new area)

28
Q

which type of collagen predominates in early wound healing?

which type of collagen predominates in late wound healing?

A 
early = type 3 collagen
late = type 1 collagen
29
Q

high lactate levels, low Ph, and hypoxia all stimulate what?

A

angiogenesis

30
Q

what is considered the most potent angiogenic agent?

A

VEGF

31
Q

List the order of cells that move to the wound area?

A

1) platelets
2) neutrophils
3) macrophages
4) fibroblasts

32
Q

In what time frame does remodeling/maturation phase occur?

A

3 weeks to 2 years

33
Q

collagen deposition reaches its peak in the wound by what time?
however, it is only ________% as strong?

A

1) 3 weeks

2) 15 percent

34
Q

what is considered the most potent stimulant for collagen synthesis?

A

TGF beta

35
Q

after complete renewal of the wound, the scar is only _____% as strong as the original?

A

80%

36
Q

what percentage of normal skin is made up of collagen type 1?

A

80-90 %

37
Q

T/F elastin is a major part of the wound healing process as it helps keep tension to prevent splitting?

A

False, recall that elastin is not a part of the new scar even though it is a part of normal skin.

38
Q

Name 3 enzymes used for collagen breakdown?

A

1) Matrixmetalloproteins
2) collagenase
3) gelatinase

39
Q

when does the scar reach maximum tensile strength?

A

at about 12 weeks. However, this is still only about 80% of normal.

40
Q

What is first intention surgical repair of the skin?

A

wound healing by direct approximation such as with suturing.

41
Q

what is second intention surgical repair of the skin?

A

wound left open to heal spontaneously

42
Q

what is third intention surgical repair of the skin?

A

delayed wound closure.

43
Q

Name vitamins/minerals (stuff) that affect wound healing?

A

vitamin K,A,C, zinc, protein deficiency, copper, cobalt, iron–>just trace elements…..

44
Q

how does vitamin A affect wound healing?

A

decreased collagen and increased infection rate

45
Q

how does vitamin C affect wound healing?

A

capillary fragility, unstable collagen

46
Q

how does vitamin K affect wound healing?

A

clotting cascade

47
Q

how does zinc affect wound healing?

A

decreased immune system

48
Q

what is a Keloid scar?

A

excessive accumulation of collagen on the wound and beyond.

49
Q

what is Hypertrophic scarring?

A

excessive accumulation of collagen on the wound only…

50
Q

what is hypotrophic scarring?

A

insufficient accumulation of collagen of the wound

51
Q

PDGF does what?

A

Chemotaxis
angiogenesis
wound contraction

52
Q

TGF alpha & EGF (epidermal growth factor) do what?

A

keratinocyte migration

mitogenic fibroblasts

53
Q

TGF beta does what?

A

angiogenesis

Promote collagen synthesis

54
Q

FGF’s do what?

A

fibroblast and keratinocyte migration

angiogenesis

55
Q

TNF does what?

A

activates Macrophages

angiogenesis

56
Q

T/F IL’s 1 &2 are pyrogens?

A

True

57
Q

Interferons (all)

A

activate macrophages

inhibit fibroblasts

HOS Unit 1 (13 decks)

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