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MOD (Semester 2) > Cellular Repair > Flashcards

Cellular Repair Flashcards

1
Q

What are the three processes which occur during wound healing?

A

Haemostasis, inflammation and regeneration & repair

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2
Q

What is regeneration?

A

This is where there is growth of cells to replace structures lost during injury.

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3
Q

What two things are needed for regeneration?

A

Intact stem cells to give rise to the new cells and a connects tissue scaffold.

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4
Q

When is regeneration not possible?

A

When there has been extensive connective tissue damage, or when there are not sufficient intact stem cells.

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5
Q

What is the name given to the tissue type where cells proliferate throughout life to replace destroyed cells?

A

Labile

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6
Q

What is a stable tissue?

A

This is a tissue where there is normally a low level of cell proliferation but can respond to a stimuli to repair the tissue.

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7
Q

Give examples of a permanent tissues

A

Cardiac muscle, neurones,

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8
Q

What features do cells in a permanent tissue have?

A

They have left the cell cycle and are unable to proliferate to repair the tissue.

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9
Q

What can be said about most cells in the body and their ability to divide?

A

Most cells in the body are terminally differentiated and this means that they cannot divide.

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10
Q

What type of replication do stem cells display?

A

Asymmetrical replication in which one daughter cell is produced which remains a stem cell and the other becomes terminally differentiated.

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11
Q

Why in adults, are stem cells called multi potent?

A

They are lineage specific and so can only give rise to a small number of different cell types.

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12
Q

What type of cells are involved in proliferation in stable tissues?

A

Both mature and stem cells. In this type of tissue stem cells replicate slowly.

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13
Q

What is a complication which is associated with fibrous repair?

A

If the tissue is supposed to be able to stretch then it may rupture.

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14
Q

When does fibrous repair occur?

A

This occurs when the collagen network has been destroyed and so is replaced by fibrosis ulnar connective tissue.

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15
Q

What is the initial stage of fibrous repair?

A

Necrotic tissue debris are phagocytosed and then endothelial cells proliferate and small capillaries grow.

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16
Q

What cell types proliferate during fibrous repair?

A

Fibroblasts and myofibroblasts. These secrete granulation tissue which looses its vascularity and matures into a fibrous scar which shrinks as myofibroblast fibres contract.

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17
Q

What is scurvy? What is the link between this and poor healing?

A

This is vitamin C deficiency which means that pro collagen cannot be hydroxylated and so patients are unable to heal and bleeding occurs.

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18
Q

What are patients with ehlers-danlos syndrome predisposed to?

A

Predisposed to joint dislocation and large vessel rupture. It is a condition in which collagen lacks strength and so their healing is poor.

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19
Q

What is Alport syndrome?

A

This is a condition which affects type IV collagen and patients suffer from haematouria which lads to chronic renal failure.

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20
Q

How do cells communicate to produce a fibro-proliferative response?

A

Local mediators (growth factors), hormones and direct contact.

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21
Q

What is the action of growth factors on a cell?

A

They bind and stimulate specific transcription of genes which regulate entry into the cell cycle.

22
Q

Over what distance do growth factors work?

A

They work over short distances locally.

23
Q

What cell types does epidermal growth factor stimulate proliferation of?

A

Epithelial cells, hepatocytes and fibroblasts.

24
Q

What is the function of vascular endothelial growth factor?

A

It induces vasculogenesis and angiogenesis in tumours, chronic inflammation and wound healing.

25
Q

What growth factor leads to proliferation of smooth muscle cells and monocytes?

A

Platelet derived growth factor.

26
Q

What is the function of tumour necrosis factor?

A

It induces fibroblast migration, proliferation and collagenase secretion.

27
Q

What is a Cadherin?

A

This is an adhesion molecule which allows cells to adhere to one and other.

28
Q

What is an integrin?

A

These allow cells to bind to Extracellular matrix.

29
Q

What does contact inhibition mean?

A

This is where when a cell becomes isolated it will proliferate until it comes into contact with more cells and adheres to them.

30
Q

What type of wounds heal by primary intention?

A

Incisional closed wounds (like from surgery). Healing occurs through all layers of skin at the same time.

31
Q

What is a seroma?

A

This is a fluid filled pocket under the skin that forms with primary intention healing.

32
Q

What happens first in primary intention healing?

A

Haemostasis, and contraction of the severed blood vessels.

33
Q

Why does inflammation occur with sterile wounds?

A

Neutrophils migrate to the edges of the wounds to ward off bacteria, and this leads to automatic triggering of inflammation.

34
Q

What function do macrophages have in primary intention healing?

A

They scavenge dead cells to phagocytose, and they secrete cytokines which leads to migration of other cells to the wound site such as fibroblasts.

35
Q

What processes occur during regeneration in primary intention healing?

A

Angiogenesis continues. As the epithelial cells thicken the scab falls off. Fibroblasts synthesise collagen.

36
Q

What is the difference between scar tissue and normal skin?

A

Skin appendages such as hair do not form.

37
Q

What happens during scar maturation?

A

If the scar has few elastic fibres then there is little recoil. Capillaries disappear and so over time the scar becomes more white.

38
Q

What type of wound will undergo secondary intention healing?

A

Wounds where the two sides are not aligned and the edges are separated.

39
Q

What happens to an open wound at the beginning of healing?

A

It fills with granulation tissue and this grows from the wound margins. A large clot also forms.

40
Q

Name two ways in which wound contraction occurs with secondary intention healing.

A

Myofibroblasts contract and pull the edges of the wound together and also the scab shrinks as it dries and this pulls the wound edges together also.

41
Q

What systemic factors can affect wound healing?

A

Age, sex, ethnicity, obesity, malignancy, anaemia, hypoxia, hypovolaemia, genetic disorders, diabetes, vitamin deficiencies and malnutrition and drugs.

42
Q

What local factors can affect wound healing?

A

Infection, mechanical stress, haematouria, blood supply, foreign bodies, necrotic tissues denervation, size and location of wound, protection (dressings) and surgical techniques

43
Q

What is a keloid scar?

A

This is when there is over production of collagen and this leads to an enlarged scar.

44
Q

What is the problem with loss of architecture in a tissue?

A

This leads to complex tissue relationships being disrupted.

45
Q

Name some complications of fibrous repair:

A

Fibrous adhesion formation which compromises organ function or can block tubes. Extensive scar contraction which can also block tubes. Loss of function due to scar tissue.

46
Q

Describe healing in cardiac muscle.

A

Cardiac muscle has a very limited regeneration ability and so scar formation occurs, this impairs the function of the heart.

47
Q

What is notable about healing in the liver?

A

The liver has an amazing ability to regenerate and so if part is removed compensatory growth can replace it.

48
Q

Can peripheral nerves regenerate?

A

Yes, but very slowly. Upon damage, a stump forms and the distal axon degenerates. Axons sprout and are guided by schwann cells.

49
Q

Why can’t cartilage heal well?

A

It is avascular, does not have a nerve supply and lacks lymphatic drainage.

50
Q

What happens in the CNS when there is tissue damage?

A

This neural tissue is permanent and so the space becomes filled with glial cells.

MOD (Semester 2) (12 decks)

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