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Pathophysiology > Exam 1: Ch 4 > Flashcards

Exam 1: Ch 4 Flashcards

1
Q

proliferation

A

increase in cell number by mitotic division

endothelial cells & fibroblasts proliferate during tissue repair

driven by growth factos

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2
Q

differentiation

A

when stem cells specialize in structure & function

multiple orderly steps driven by expression of a tissue-specific set of genes

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3
Q

many tissues retain ______ cells that are….

A

progenitor cells

able to replace cells for that tissue only

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4
Q

interphase

A

G1: RNA & protein synthesis

S: DNA replication

G2: protein synthesis

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5
Q

mitosis

A

2 cells form from 1

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6
Q

cell cycle checkpoints

A

allow opportunity for repair

no progression from G1 –> S if DNA is damaged

no progression from G2 —> M if DNA wasn’t duplicated

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7
Q

cell cycle regulation

A

cyclins control cell cycle by activating protein kinases (CDK)

CDKs phosphorylate target proteins to activate them

causes progression through cell cycle

progression through specific checkpoints controlled by specific cyclins

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8
Q

proliferative capacity

A

labile cells like intestinal endothelium cycle continuously

other cells become stable and stop cycling

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9
Q

stable cells and G0

A

stop cycling = G0

stable cells can re-enter cycle with proper stimulation

some stable cells stop cycling permanently – nerve, skeletal/cardiac muscle

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10
Q

stem cells

A

cells that remain incompletely differentiated throughout life

divide to: replace cells that died from apoptosis, or to produce another stem cell

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11
Q

properties of stem cells

A

self renewal: one cell form each mitotic division remains a stem cell (undifferentiated)

asymmetric replication: 2 cells from mitotic division are not identical – one differentiates, the other does not

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12
Q

types of stem cell potency

A

stem cells have different differentiation potential

totipotent

pleuripotent

multipotent

unipotent

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13
Q

totipotent stem cells

A

can produce all tissue types and placenta

cells generated by the first few divisions of fertilized ovum

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14
Q

pleuripotent stem cells

A

can produce all embryonic tissue types

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15
Q

multipotent stem cells

A

can produce a few related cell types

ex. hemocytoblasts

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16
Q

unipotent stem cells

A

can produce 1 cell type only

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17
Q

embryonic vs. adult (somatic) stem cells

A

embryonic are pleuripotent

adult may have less capacity

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18
Q

growth factos

A

small hormone-like proteins that are chemical triggers for cellular proliferation

contribute to tissue regeneration & wound healing

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19
Q

how are growth factors named

A

for tissue of origin

EGF: epidermal growth factor

TGF: transforming growth factor

VEGF: vascular endothelial cell growth factor

20
Q

mechanism of growth factors

A

bind to surface receptors, activate 2nd messenger systems, increase expression of specific genes –> cellular division

21
Q

ECM includes

A

basement membrane (borders epithelial tissue)

interstitial matrix (between cells of connective tissue)

22
Q

ECM contains

A

protein fibers: collagen & elastin

water-hydrated gels: proteoglycans & hyaluronic acid

adhesion glycoproteins: fibronectin & laminin

23
Q

cells have integrins that…

A

bind to adhesion molecules

24
Q

fibroblasts produce…

A

collagen fibers

25
Q

functions of ECM

A

provides turgor to soft tissue (structure of proteins is different between old/young skin b/c of H2O loss)

regulates cell movement & differentiation

scaffold for tissue renewal after injury

26
Q

primary goal of healing by conn. tissue repair

A

fill gap created by injury and restore structure of neighboring tissues

27
Q

regeneration

A

restoration of injured tissue to a normal state

28
Q

scar formation

A

replacement of injured tissue with fibrous connective tissue

29
Q

phases of tissue repair

A

angiogenesis & ingrowth of granulation tissue

emigration of fibroblasts and deposition of ECM

maturation and remodeling of fibrous tissue

30
Q

angiogenesis

A

phase 1 of tissue repair

growth of new blood vessels stimulated by VEGF & FGF

new vessels are initially leaky –> wound edema persisting after inflammation

31
Q

ingrowth of granulation tissue

A

phase 1 of tissue repair

granulation tissue: conn. tissue that fills injured area while necrotic debris is removed

requires new blood vessels

32
Q

emigration of fibroblasts and deposition of ECM

A

fibroblasts migrate to wound and proliferate

deposit ECM including collagen

stimulated by FGF & TGF-beta

33
Q

maturation and remodeling of fibrous tissue

A

transition from granulation tissue to scar tissue

ECM remodeled by metaloproteases

34
Q

healing of skin wounds

A

involves both epithelium & conn. tissue

primary intent

secondary intent

35
Q

primary intent

A

sutured surgical incision – only for clean wounds

36
Q

secondary intent

A

wound left open and irrigated

for larger wounds with tissue loss & contaminated wounds

37
Q

phases of wound healing

A

inflammatory

proliferative

remodeling

38
Q

inflammatory phase (phase 1 of wound healing)

A

starts at time of injury

blood clotting and vasoconstriction stop bleeding

vessels dilate to bring inflammatory cells to the wound

neutrophils/macrophages phagocitize bacteria and release growth factors

GF stimulate angiogenesis & attract fibroblasts

39
Q

proliferative phase (phase 2 of wound healing)

A

starts 2-3 days post-injury

fibroblasts secrete collagen and produce GF

endothelial cells proliferate and migrate to close wound edges

granulation tissue forms

collagen synthesis continues

40
Q

remodeling phase (phase 3 of wound healing)

A

starts at ~3 weeks post-injury

collagen is remodeled and epithelium reestablished

the wound contracts – limits scar size but can also limit joint movement

41
Q

keloid

A

excess scar tissue production

42
Q

factors affecting wound healing

A

nutritional status

blood flow

impaired inflammatory response

infection, wound separation, foreign bodies

43
Q

nutritional status

A

wound healing requires adquate protein, carbohydrates, & vitamins

44
Q

blood flow for wound healing

A

O2 needed for collagen synthesis and phagocytosis

ischemic tissue heals slowly

45
Q

impaired inflammatory response

A

disorders that impair action of phagocytes slow wound healing

46
Q

infection, wound separation, foreign bodies

A

uncontaminated wounds with no foreign bodies and approximated edges heal the fastest

Pathophysiology (24 decks)

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