Chapter 3

Question 1

Pathologic findings in congestive heart faliure include microscopic signs of coagulative necrosis ___ hrs after the onset of vascular occlusion (–MI). Polymorphonuclear leukocytes and macrophages predominate in the next __-___ days. @ the end of the first ____, the infarct is invaded by capillary-rich granulation tissue. Ultimatley, the necrotic myocardium is replaced by _____ rich scar tissue.

Answer 1

Pathologic findings in congestive heart faliure include microscopic signs of coagulative necrosis 24 hrs after the onset of vascular occlusion (–MI). Polymorphonuclear leukocytes and macrophages predominate in the next 2 - 5 days. @ the end of the first week, the infarct is invaded by capillary-rich granulation tissue. Ultimatley, the necrotic myocardium is replaced by collagen rich scar tissue.

Question 2

Vascular congestion and edema are features of ____ inflammation.

Answer 2

Vascular congestion and edema are features of acute inflammation.

Question 3

The initial phase of the repair rection, which typically begins with hemmorrhage, involves the formation of a ____ clot that fills the gap created by the wound. A thrombus (clot), referred to as a scab after drying out, forms on the wounded skin to protect against _____ & prevent the loss of plasma & tissue fluid.

Formed primarily from plasma fibrin, the thrombus is rich in ____. The thrombus also contains contracting platelets, which are an initial source of _____ factors. Much later, the thrombus undergoes _____ (Proteolysis is the breakdown of proteins into smaller polypeptides or amino acids), after which it is penetrated by regenerating epithelium. The scab then detaches.

Answer 3

The initial phase of the repair rection, which typically begins with hemmorrhage, involves the formation of a fibrin clot that fills the gap created by the wound. A thrombus (clot), referred to as a scab after drying out, forms on the wounded skin to protect against microorganisms & prevent the loss of plasma & tissue fluid.

Formed primarily from plasma fibrin, the thrombus is rich in fibronectin. The thrombus also contains contracting platelets, which are an initial source of growth factors. Much later, the thrombus undergoes proteolysis (Proteolysis is the breakdown of proteins into smaller polypeptides or amino acids), after which it is penetrated by regenerating epithelium. The scab then detaches.

Question 4

Mature scar is composed of type _ collagen. Early grnulation tissue however contains type _ collagen.

Answer 4

Mature scar is composed of type 1 collagen. Early grnulation tissue however contains type 3 collagen.

Question 5

The ______ is the cell responsible for wound contraction as the deforming pathologic process of wound contracture.

Answer 5

The myofibroblast is the cell responsible for wound contraction as the deforming pathologic process of wound contracture.

Question 6

Vitamin _ is a powerful reducing agent necessary for the hydroxylation of proline residues in collagen. Vitamin _ deficiencies like scurvy are caused by the formation of abnormal collagen that lacks tensile strength; hence, vitamin _ deficiency results in poor wound healing.

Answer 6

Vitamin C is a powerful reducing agent necessary for the hydroxylation of proline residues in collagen. Vitamin C deficiencies like scurvy are caused by the formation of abnormal collagen that lacks tensile strength; hence, vitamin C deficiency results in poor wound healing.

Question 7

**Granulation tissue has 2 major components: ____ and proliferating _____ (angiogenisis). The cells are fibroblasts, myofibroblasts, and macrophages. Macrophages are a major source of ____ factors. Granulation tissue is fluid laden, and its cellular constituents supply antibacterial antibodies and growth factors. Once repair is acheived there is a pale avascular scar.

Answer 7

Granulation tissue has 2 major components: cells and proliferating capillaries (angiogenisis). The cells are fibroblasts, myofibroblasts, and macrophages. Macrophages are a major source of growth factors. Granulation tissue is fluid laden, and its cellular constituents supply antibacterial antibodies and growth factors. Once repair is acheived there is a pale avascular scar.

Question 8

Matrix ____ are major components in wound healing because they enable cells to migrate by degrading matrix proteins. ____ are inhibited by a1-antitrypsin & a2-macroglobulin.

Answer 8

Matrix metalloproteinases are major components in wound healing because they enable cells to migrate by degrading matrix proteins. Metalloproteinases are inhibited by a1-antitrypsin & a2-macroglobulin.

Question 9

A large infarct of the kidney will heal by _____ (scar formation). Since repair and regeneration is incomplete due to destruction of the extracellular matrix, repair and regeneration is incomplete, which results in a scar.

Answer 9

A large infarct of the kidney will heal by fibrosis (scar formation). Since repair and regeneration is incomplete due to destruction of the extracellular matrix, repair and regeneration is incomplete, which results in a scar.

Question 10

Keloid is an exuberant _____ that progresses beyond the site of initial injury. Dark-skinned people are more affected. Keloids are abundant in type _ collagen suggesting a maturation arrest in the healing process since type 1 collagen was not deposited.

The pathogenisis of keloids is the maturation ____ of collagen assembly.

Answer 10

Keloid is an exuberant scar that progresses beyond the site of initial injury. Dark-skinned people are more affected. Keloids are abundant in type 3 collagen suggesting a maturation arrest in the healing process since type 1 collagen was not deposited.

The pathogenisis of keloids is the maturation arrest of collagen assembly.

Question 11

______ inflammation is a subtype of chronic inflammation, which develops when acute inflammatory cells are unable to digest injurious agents. Fusion of macrophages within the lesion results in the formation of a _____ giant cell.

Answer 11

Granulomatos inflammation is a subtype of chronic inflammation, which develops when acute inflammatory cells are unable to digest injurious agents. Fusion of macrophages within the lesion results in the formation of a multinucleated giant cell.

Question 12

Chronic liver injury like chronic viral hepatitis is associated with the development of broad collagenous scars within the hepatic parenchyma. This is termed _____. Hepatocytes form regenerative nodules that _____ central veins and expand to obstruct blood vessels and bile flow.

Answer 12

Chronic liver injury like chronic viral hepatitis is associated with the development of broad collagenous scars within the hepatic parenchyma. This is termed cirrhosis. Hepatocytes form regenerative nodules that lack central veins and expand to obstruct blood vessels and bile flow.

Question 13

Superficial abrasions of the skin heal via _____. It is mediated by stem cells or stabile cells that are able to progress through the cell cycle and fully restore normal tissue organization and function. Cellular migration is the prominent means by which the wound surface is reepithelialized.

Answer 13

Superficial abrasions of the skin heal via regeneration. It is mediated by stem cells or stabile cells that are able to progress through the cell cycle and fully restore normal tissue organization and function. Cellular migration is the prominent means by which the wound surface is reepithelialized.

Question 14

____ is abberant healing with deposition of collagen-rich scar tissue.

Answer 14

Fibrosis is abberant healing with deposition of collagen-rich scar tissue.

Question 15

_____ tissue forms during the repair of deep wounds.

The principal cellular components of granulation tissue are _____ blasts and _____ thelial cells.

Answer 15

Granulation tissue forms during the repair of deep wounds.

The principal cellular components of granulation tissue are fibroblasts and endothelial cells.

Question 16

Maturation of the epidermis requires an intact layer of basal cells that are in ____ contact with one another. If this contact is disrupted, basal epithelial cells at the wound margin become activated & reestablish _____ with other basal cells through extensive cell migration and mitosis. When epithelial continuity is reestablished, migration and cell division caese, and the epidermis resumes its normal cycle of maturation and shedding. This process of epithelial growth regulation is called ______.

Answer 16

Maturation of the epidermis requires an intact layer of basal cells that are in direct contact with one another. If this contact is disrupted, basal epithelial cells at the wound margin become activated & reestablish contact with other basal cells through extensive cell migration and mitosis. When epithelial continuity is reestablished, migration and cell division caese, and the epidermis resumes its normal cycle of maturation and shedding. This process of epithelial growth regulation is called contact inhibition of growth and motility.

Question 17

_____ are adhesive glycoproteins and are deposited at the site of tissue injury. In the initial phase of healing, _____ in the extravasted (leaked) plasma is cross-linked to fibrin, collagen, and other extracellular matrix components by transglutaminases. This cross-linking provides a provisional stabilization matrix of the wound during the first several hours. Fibronectin, cell debris, and bacterial products are chemoattractants for a variety of cells that are recruited to the wound over the next several days.

Answer 17

Fibronectins are adhesive glycoproteins and are deposited at the site of tissue injury. In the initial phase of healing, fibronectin in the extravasted (leaked) plasma is cross-linked to fibrin, collagen, and other extracellular matrix components by transglutaminases. This cross-linking provides a provisional stabilization matrix of the wound during the first several hours. Fibronectin, cell debris, and bacterial products are chemoattractants for a variety of cells that are recruited to the wound over the next several days.

Question 18

The locomotion of leukocytes is powered by membrane extensions called lamellipodia. Slower moving cells like fibroblasts extend fingerlike protrusions called filopodia. The leading edge of the cell membrane adheres to the extracellular matrix through the transmembrane adhesion receptors called _____.

______** regulate the migration and differentiation of leukocytes and connective tissue cells during wound healing.

Answer 18

The locomotion of leukocytes is powered by membrane extensions called lamellipodia. Slower moving cells like fibroblasts extend fingerlike protrusions called filopodia. The leading edge of the cell membrane adheres to the extracellular matrix through the transmembrane adhesion receptors called integrins.

Integrins regulate the migration and differentiation of leukocytes and connective tissue cells during wound healing.

Question 19

Healing by _____ intention occurs in wounds with closley apposed edges & results in a small scar. Healing by _____ intention occures in a gouged wound, in which the edges are far apart and in which there is substantial tissue loss (large ugly scar forms).

Answer 19

Healing by primary intention occurs in wounds with closley apposed edges & results in a small scar. Healing by secondary intention occures in a gouged wound, in which the edges are far apart and in which there is substantial tissue loss (large ugly scar forms).

Question 20

Activated fibroblasts, myofibroblasts, and capillary sprouts are abundant in healing wounds _ to _ days following injury. Neutrophils accumulate in the wound _ to _ hrs after injury. Mature scar tissue forms _ weeks following injury.

Answer 20

Activated fibroblasts, myofibroblasts, and capillary sprouts are abundant in healing wounds 3 to 5 days following injury. Neutrophils accumulate in the wound 12 to 24 hrs after injury. Mature scar tissue forms 2 weeks following injury.

Question 21

____ arrive @ the site of injury shortly after neutrophils, but stay longer. ____ remove debris and orchestrate the formation of granulation tissue by releasing cytokines and chemoattractants.

Answer 21

Macrophages arrive @ the site of injury shortly after neutrophils, but stay longer. Macrphages remove debris and orchestrate the formation of granulation tissue by releasing cytokines and chemoattractants.

Question 22

After a laceration, secretion of type _ collagen is a forerunner to the formation of type _ collagen, which has higher tensile strength.

Answer 22

After a laceration, secretion of type 3 collagen is a forerunner to the formation of type 1 collagen, which has higher tensile strength.

Question 23

Damage to the CNS is followed by growth of capillaries and _____. _____ in the CNS is the equivalent of scar formation elsewhere. Once established, gliosis remains permanently.

Answer 23

Damage to the CNS is followed by growth of capillaries and gliosis. Gliosis in the CNS is the equivalent of scar formation elsewhere. Once established, gliosis remains permanently.

Question 24

A mechanical reduction in the size of a wound depends on the presence of myofibroblasts and sustained cell contraction. An exaggeration of these processes = _____ and results in deformity of the wound and surrounding tissues. Contractures are seen in serious burns and can even sometimes compromise the movement of joints.

Answer 24

A mechanical reduction in the size of a wound depends on the presence of myofibroblasts and sustained cell contraction. An exaggeration of these processes = contracture and results in deformity of the wound and surrounding tissues. Contractures are seen in serious burns and can even sometimes compromise the movement of joints.

Question 25

Neurons in the PNS can regenerate their axons. However, if the cut ends are not in perfect alignment or are prevented from establishing continuity by inflammation, a traumatic _____ results.

Answer 25

Neurons in the PNS can regenerate their axons. However, if the cut ends are not in perfect alignment or are prevented from establishing continuity by inflammation, a traumatic neuroma results.

Question 26

One of the earliest responses following tissue injury occurs within the microvasculature at the level of the capillary and postcapillary ____. Leukocyte rectuitment in the postcapillary venule is initiated by interaction of leukocytes with endothelial cell surface ____ molecules.

Answer 26

One of the earliest responses following tissue injury occurs within the microvasculature at the level of the capillary and postcapillary venule. Leukocyte rectuitment in the postcapillary venule is initiated by interaction of leukocytes with endothelial cell surface selectin molecules.

Question 27

______ are characterized by focal destruction of the mucosa and full thickness replacement of the muscularis with collagen-rich connective tissue.

Answer 27

Ulcers are characterized by focal destruction of the mucosa and full thickness replacement of the muscularis with collagen-rich connective tissue.

Question 28

If you scrape the palms of your hands, the primary healing mechanism of the superficial abrasion occurs by ________.

The cellular processes that help restore normal epithelial structure and function to superficial abrasions is contact ______ of epithelial cell growth and motility.

Answer 28

If you scrape the palms of your hands, the primary healing mechanism of the superficial abrasion occurs by regeneration.

The cellular processes that help restore normal epithelial structure and function to superficial abrasions is contact inhibition of epithelial cell growth and motility.

Question 29

Questions I got wrong:

Answer 29

15, 17.