Acute Inflammation and Wound Healing I Flashcards
Does this appear to be healing by first or second intention?
This is healing by primary intetion. The epithelial layer is in contact with each other, and no significant vascularization
What is the darker red object in the bottom of this picture in the dermis? What will happen to it?
This is a small hematoma in the dermis. This will eventually shrink, macrophages will begin engulfing RBCs and shrink it.
How old would you estimate this scar to be and what histopathologic features allow you to estimate this?
There is presence of neutrophils (show at 24 hours) and macrophages (show at 72 hours). So it must be around 72 hours old. Also notice the thin, pink strand composed of firbin.
What is the black arrow in this picture pointing to?
The thin pink strand are fibrin, layed down by fibroblast, which are activated by macrophages. Thus atleast 72 hours old.
What cytokines or growth factors are likely involved in proliferation of the epithelium?
Epidermal growth factor EGF
What cytokines or growth factors are likely involved in the proliferation of the dermal connective tissue underlying the epithelium?
FGF and VEGF
How old is this wound?
This is a chronic ulcer many weeks old. Notice the cotraction,
- Infection and non-union of the bone might have complicated wound healing here.
- pt will likely need an amputation, or they can take oral antibiotics for the rest of their life to avoid amputation.
- This is healing by second intent.
What is the difference between acute and chronic inflammation?
Chronic inflammation is not a vascular reaction.
Chronic inflammation can occur if the underlying cause is not removed.
The edge where the epithelium ends is indicative of what?
Point to the edge of the skin ulcer. You can see squamous epithelium above the arrow with fibrinous surface debris below. If you follow the surface you see there is no epithelium left, just fibrin and dead neutrophils.
What are the flattened cells in this picture and what is their role? What other cells are promienet in this picture?
How old is this wound?
The flattened blue cells are fibroblasts which are laying down collagen ( the pink strands). Other cells are neutropihls and macrophages
Wound is probably weeks old.
How do you think this wound is healing, by regeneration or scarring?
It is healing by scarring
What are some of the methods used to increase the healing rate in these ulcers?
Treat with antibiotics and the tissue needs to be away from low pH acid to allow healing. So use proton pump inhibitors
What is this?
This is the edge of a peptic ulcer in the duodenum. This is the edge of it right before it dives down into a pit.
What is this
A large thrombus in the duodenum
How would you describe the tisse in the base of an ulcer?
Granulation tissue. It has fibroblasts and collage. Many capillaries and will heal by scarring.
