Baker - Tissue Repair Flashcards
What is primary intention?
Wound edges joined by fibrin plug
Regrowth of basal layer of epidermis
Lysis of fibrin and re-epithelializaiton
Restoration of intact skin
(Happens in an incision or laceration)
What is secondary intention healing?
Large defect filled by fibrin clot
New blood vessels and fibroblasts grow FROM THE DERMIS into fibrin
Collagen laid down by granulation tissue fibroblasts to restore integrity
MATURATION OF COLLAGEN achieves structural integrity and allows regrowth of epidermis
(Happens in a burn)
Tell me about repair.
Complete repair
Forms a scar at inflammation site
Forms a cavity - like in the brain or lung
What are some problems during tissue repair?
Slow process
- up to 10% strength of normal tissue in about a week
- up to 75% strength at most
- Scarring
Too much repair (secondary intention)
- Hypertrophic scar
- Keloid - beyond site of injury
- Desmoid/fibromatosis - benign neoplasm
Too little repair
- Wound dehiscence
- Ulcer
What are vocal nodules?
Growths on the vocal folds
Benign, not cancerous
Due to vocal abuse
What is a keloid?
Type of scar composed of type III or type I collagen
Overgrowth of granulation tissue
What is a desmoid/fibromatosis?
Most desmoid tumors is unknown and thus they are called sporadic
Mutation of beta catenin
What is a pyogenic granuloma?
Gingiva, skin, nasal septum
Vascular lesion from irritation, trauma, or hormones
Who is at risk for gangrene?
Diabetics
Cardiovascular challenged
________ _________ can result in rupture and death.
Ventricular (Ususally left) aneursym
Fibrosis, hypertrophy, loss of small blood vessels is characteristic of what?
Chronic ischemia
What is an acute kidney injury?
Sudden episode of kidney failure
Build up of waste in blood
Common in hospitals, ICUs, and elderly
What is the most common cause of kidney acute interstitial nephritis?
Adverse rxn to drug
Also due to bacterial infections
*Chronic can also occur
What can be causes of poor wound healing?
Diffuse glomerulosclerosis
Kidney interstitial nephritis -chronic and acute
Chronic ischemia
Specific organs with issues
Cryptogenic organizing pneumonia (COP) - Masson plugs the airway
What is the main cause of gastric antral ulcers?
H. Pylori
What happens after an ulcer in the stomach?
Infection
Poor circulation
What factors are associated with bed sores?
Sedentary positions
Extended hospital stays
T/F - Cystic fibrosis can present nasal polyps.
TRUE
T/F - Wound healing is associated with a true and chronic inflammation.
TRUE
Tell me the phases of tissue healing at these time intervals:
Hours
Days
Weeks to months
Hours -Coagulation —Fibrin plug formation —Release of growth factors —Cytokines —Hypoxia
In b/t hours and days: Inflammation
-Cell recruitment and chemotaxis, wound debridement
Days
-Migration/proliferation
—Fibroplasia, ECM deposition
Weeks to months
-Remodelling
—Scar formation and revision
What are the main cell types associated with coagulation?
Platelets
What are the main cell types associated with inflammation?
PMNs, monocytes
Macrophages
What are the main cell types in migration/proliferation and remodeling?
Keratinocytes
Fibroblasts
Endothelial cells
Myofibroblasts
