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Integ > Acute/Chronic Healing > Flashcards

Acute/Chronic Healing Flashcards

1
Q

cascade of acute wound healing

A

hemostasis
inflammation
proliferation
maturation

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2
Q

what is a characteristic of hemostasis

A

platelet aggregation and clot formation
- allows for movement of cells in and out of the wound space

fibrinolysis

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3
Q

timeline of inflammatory phase

A

begin immediately and continues for upto 25 days

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4
Q

what capillary changes occur in the inflammatory phase

A

dilation and become permeable

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5
Q

role of cytokines in the inflammation phase

A

draw neutrophils and macrophages to the wound

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6
Q

macrophages attract which types of cells?

A

cytokines
growth factors
bioactive lipids
proteolytic enzymes

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7
Q

how are cytokines characterized in the healing process

A

additive
synergistic
inhibitory

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8
Q

what do cytokines regulate

A

cell proliferation
cell migration
cell matrix synthesis
cell deposition and degradation
inflammatory response

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9
Q

what to cytokines come from

A

platelets
fibroblasts
monocytes
macrophages
endothelial cells

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10
Q

timeline of proliferative phase

A

within 3 days of injury and lasts a few weeks

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11
Q

what is the proliferative phase characterized by

A

granulation tissue formation

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12
Q

what cell types assists in the formation of granulation tissue

A

fibrin
fibronectin
collagen
proteoglycans
glycosaminoglycans
glycoproteins

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13
Q

when does fibroblast proliferation peak

A

a week post injury

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14
Q

role of fibroblast in proliferation

A

synthesize and deposit extracellular proteins

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15
Q

how does fibroblast proliferation occur

A

growth and angiogenic factors cause granulation to occur

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16
Q

what is a risk in the proliferative phase

A

dehiscence and evisceration

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17
Q

what is dehiscence

A

wound separation after being closed

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18
Q

what is evisceration

A

when organs protrude through a wound

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19
Q

what is epithelization

A

marginal basal cells detaching from the dermis and migrating across the provisional matrix on each side of a wound.

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20
Q

when do fibroblasts enter the wound

A

within 3 days
peak levels at 7 days

21
Q

what do fibroblasts do

A

proliferation and synthetic activity to produce
extracellular proteins
growth factors
angiogenic factors

22
Q

what is the result of fibroblasts entering the wound

A

granulation tissue
new capillaries embedded in loose ECM

23
Q

what is the resultant ECM composed of as fibroblasts enter the wound

A

collagen
fibronectin
proteoglycans
glycosaminoglycans

24
Q

cells of the wound bed

A

proteins
polysaccharides

25
Q

what types of proteins are in the ECM

A

matrix - collagen
adhesive - elastin, laminin, fibronectin

26
Q

what does elastin allow

A

elasticity and resilience

27
Q

what does laminin/fibronectin allow for

A

structural and metabolic support
mediation of tissue remodeling

28
Q

what forms the ground substance

A

proteoglycans
glycosaminoglycans

29
Q

what cells arise at the beginning of angiogenesis? where at? what is their job?

A

vascular endothelial cells

edges of the wound from damaged vessels and capillaries

penetrate the matrix and form a vascular bud

30
Q

vascular buds grow until

A

they reach another capillary
– connect and form a vascular loop

31
Q

when does epithelization occur

A

few hours post injury

32
Q

what is contact inhibition related to? what does it form?

A

epithelization
rolled edges on a wound

33
Q

where may epithelial cells come from to complete epithelization

A

epidermis basement layer
sweat glands
oil glands
hair follicles

34
Q

where do epithelial cells come from for shallow wounds

A

epidermal basement membrane

35
Q

where do epithelial cells come from for medium depth wounds

A

glands and hair follicles
- form tiny circles of skin

36
Q

where do epithelial cells come from for deeper wounds

A

no epithelial cells available
instead granulation tissue forms and fills the base and the epithelial cells come from epidermal layer

37
Q

when does epithelization occur in deep wounds

A

will not until the wound is nearly level with normal undamaged tissue

38
Q

when does wound contraction occur

A

5 days after wound occurs

39
Q

how does wound contraction occur

A

fibroblasts and myofibroblasts rearrange themselves to share the ECM

40
Q

what is the myofibroblast theory

A

myofibroblasts attach to collagen in ECM and bring it across the wound via actin

each time the collagen is brought across the wound, the wound bed shrinks

41
Q

what is the traction theory

A

many fibroblasts exert traction forces on ECM fibers without coordinated contraction to shorten occurring

42
Q

when does the maturation phase occur

A

week out from injury up until a year or more after

43
Q

what occurs in the maturation phase

A

fibronectin ECM fills the wound
collagen is laid and forms bundles that provide stiffness and tensile strength

44
Q

chronic wound healing definition

A

one that deviates from expected sequence of repair in terms of time, appearance, and response to appropriate treatment

45
Q

factors that affect wound healing

A

comorbidities
medications/antibiotic resistance
circulation
nutrition/hydration
lifestyle
age gender race

46
Q

what is biofilm

A

microbial colony incased in a matrix that attaches to a wound surface

47
Q

what is a danger of biofilm

A

production of destructive enzymes and toxins that promote a chronic inflammatory state in the wound

48
Q

what is the pneumonic used for wound bed prep

A

T - tissue assessment
I - infeCtion assessment
M - moisture imbalance
E - edge assessment

49
Q

what symptoms/symptom clusters can occur from a wound

A

pain
cognitive changes
fatigue
depression
anxiety

Integ (12 decks)

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