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Pathology > Chapter 4 - Repair: Recovery from Injury > Flashcards

Chapter 4 - Repair: Recovery from Injury Flashcards

1
Q

Healing = repair

A

Can occur by either regeneration or scarring; usually both processes occur in any given injury

  • Regeneration
  • Scarring
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2
Q

Regeneration

A

Complete or nearly complete restoration of normal anatomy and function my regrowth of formal functional tissue (parenchyma) and supporting tissue (stroma)

  • Labile cells
  • Stable cell
  • Permanent cells
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3
Q

Labile cell

A

Short-lived cells with stem cells that easily and continuously regenerate

  • Epithelium: epidermis, G.I. lining, respiratory whining
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4
Q

Stable cell

A

Long-lived styles with stem cells that highly regenerate after injury

  • Glandular organ: liver, kidney
  • Fibrous connective tissue
  • Bone and cartilage
  • Blood vessels
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5
Q

Permanent cells

A
  • Long live cells
  • Essentially no stem cells, do not regenerate
  • They are for healing and repair is by scarring only
  • Neurons, cardiac muscle, skeletal muscle
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6
Q

Scarring

A

Fibrous repair (replacement by fibrous connective tissue)

  • Granulation tissue
  • Collagen accumulation
  • Injury
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7
Q

Granulation tissue

A

Early stage, as early as 24 hours after injury

  • Consist of migrating and proliferating myofibroblasts and small blood vessel’s
    • Fibroblasts produce collagen
    • Blood vessels provide nutrients for the new tissue
  • Organization
  • Angiogenesis
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8
Q

Organization

A

Process of replacing necrotic material, blood caught or exudate with fibrous tissue

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9
Q

Angiogenesis

A

(Neovascularization) The growth of new blood vessels into organizing tissue

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10
Q

Collagen accumulation

A

Later stage

  • Collagen is a long fibrillar protein; gives strength to the healing wound
  • Cicatrix: mature scar
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11
Q

Injury

A
  • Mild injury: regeneration and no scarring
  • Extensive injury: regeneration and scarring
  • Permanent injury: scarring only
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12
Q

Healing by first intention

A
  • Healing of a clean wound, smooth edges that are close together
  • Heals quickly, leaving a small scar
  • Example: surgical wound with closed sutures
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13
Q

Healing by second intention

A
  • Healing of gaping wind or one complicated by infection or foreign material
  • Healing: slow, leaving a more extensive scar
  • Example: large laceration in a motor accident
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14
Q

Aberrant healing

A

Wound repair creates a problem rather than solving one

  • Keloids
  • Pyogenic granuloma
  • Adhesion
  • Contracture, stenosis, constrictions
  • Dehiscence
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15
Q

Keloids

A

Abnormally large bulging scars – it over heals

  • Common around face and upper body
  • Genetic predisposition: African heritage
  • Tend to recur when removed
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16
Q

Pyogenic granuloma

A

Persistent granulation tissue – repair process halted in most vascular stage

  • Example: healing umbilicus in newborns appear as a flashy bleeding nodule
17
Q

Adhesions

A

Scar tissue on surfaces of body cavities due to myofibroblasts

  • Abdominal adhesions between loops of bowel – term for non-viscera too
  • Pleural adhesions between lung and chest wall
18
Q

Contractures, stenosis, constrictions

A

Scar tends to contract as it matures due to myofibroblasts

  • Extensive contraction of scar tissue may interfere with normal function:
    • Joint and muscle immobility
    • Narrowing of hollow organs
19
Q

Dehiscense

A

Previously closed when that bursts open

  • Occurs and partially healed wound
  • Maybe associated with:
    • Poor collagen production (poor nutrition/blood supply; congenital)
    • Delayed wound healing due to infection or foreign bodies
20
Q

Factors that help inflammatory responses and wound healing

A
  • Nutrition
  • Good blood supply
  • Primary union
21
Q

Good nutrition

A

Very important

  • High protein diet: rapid healing
  • Adequate vitamin C: needed for good collagen formation
22
Q

Good blood supply

A

Necessary for inflammation and repair

23
Q

Primary union

A

Clean, smooth surgical wound edges; decreased scarring (first intention)

24
Q

Factors that hinder inflammatory responses and wound healing

A
  • Secondary union
  • Wound infection
  • Foreign bodies
  • Leukopenia
  • Blood in tissue
  • Metabolic derangement
  • Corticosteroid
25
Q

Secondary union

A

Ragged wound edges; heal slower, increased scarring (second intention)

26
Q

Wound infection

A

Bacteria slows healing stage

27
Q

Foreign bodies

A

Interfere with healing

28
Q

Leukopenia

A

Decreased number of leukocytes;

  • Decreased inflammatory response
  • More susceptible to infection
29
Q

Blood in tissue

A

Encourages bacterial growth; slows repair process

30
Q

Metabolic derangements

A

Diabetes interfere with proper function of inflammatory and reparative cells

31
Q

Corticosteroids

A

Cortisone

  • Decreased inflammation: good
  • Slow healing: bad

Pathology (6 decks)

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