Exam 1: Healing and Repair Flashcards
What is the definition of healing?
The process of restoration to normal structure and function
What is the definition of repair?
To remedy, replace or heal as in a wound or a fracture
In what two ways does the healing and repair process progress?
- Total reconstruction
- Partial reconstruction
What important structure is the universal repair tissue?
Fiber our connective tissue scar
What is the most abundant type of regenerative cell
labile
Which type of cell has the poorest regenerative capacity
permenant
What are the 4 phases of repair by connective tissue
- angiogenesis
- fibroblast activity
- deposition
- remodeling
What occurs during angiogenesis
endothelial cell from damaged blood vessels migrate and proliferate
What occurs during fibroblast activity
fibroblasts migrate to damaged area and proliferate
What occurs during deposition
deposition of the extra cellular matrix in the damaged area
What occurs during remodeling
remodeling of connective tissue results in shrinkage of the damaged area
What is granulation tissue made of
proliferation of small capillaries, fibroblasts, extracellular fluid and macrophage infiltration
Without ___ tissue, healing cannot occur
granulation
What are the phases of tissue healing
Phase 1: homeostasis
Phase 2: inflammation
Phase 3: proliferation or granulation
Phase 4: remodeling or maturation
What occurs during Phase 1= homeostasis
day 1-3, stop bleeding
What occurs during Phase 2 = inflammation
day 3-20, new framework for blood vessel growth
What occurs during Phase 3 = proliferation/granulation
week 1-6, pulls the wound close
What occurs during Phase 4 = remodeling/maturation
week 6-2 years, final proper tissue
What are the characteristics of first degree intention healing
small defect size, small granulation tissue, rapid healing, small scar, and rarely has complications
What are the characteristics of second degree intention healing
large defect size, large granulation tissue, slow healing, large scar, can have keloid or proud flesh complications
True or False
Diabetes mellitus is a local factor to wound healing
False, it is a systematic factor causing damage to the microvascular circulation
What vitamin is needed for healing and collagen synthesis
vitamin C
- needed for hydroxylation of protein and lysine in collagen synthesis
What are the 4 complications in wound healing
- proud flesh
- keloid formation
- wound dehiscence
- contracture
What is proud flesh
excessive granulation tissue, bleeds easily
What is keloid formation
genetic, more common in dark skinned people
What is wound dehiscence
mechanical stress, postoperative coughing
What is contracture
excessive wound contracture, 3rd degree burns
What type of complication occurs when a wound has burst open due to sneezing
wound deshiscence
What type of complication of wound healing occurs with a severe burn
contracture
Open/ compound fracture
bone breaks and bony fragments have pierced the overlying skin or a wound exposes the bone
Closed/simple fracture
bone breaks, but skin over fractured bone is still intact
Complete fracture
bone breaks all the way through, skin penetration
Incomplete fracture
bone is fractured but not fully separated
Transverse fracture
break is straight across or runs directly across the short axis of the bone
Oblique fracture
fracture line passes obliquely through the long axis of the bone at an angle
Spiral fracture
a rotational force is applied through the long axis of the bone
Comminuted fracture
bone breaks in more than 2 pieces
Impacted fracture
ends are driven into each other
Avulsion fracture
bony fragments pulled off by a tendon or ligament
Pathological fracture
caused by disease
What are the 4 phases of bone healing
- reactive
- reparative 1
- reparative 2
- remodeling
What is phase1= Reactive
hematoma is formed and thus is replaced by granulation tissue
What is phase 2=Reparative1
deposition of cartilaginous tissue by migrating chondroblasts, which form hyaline cartilage
What is phase 3= Reparative2
the cartilaginous callus is infiltrated by osteoblasts and bony callus is formed
What is phase 4= Remodeling
remodeling by osteoblasts, removal of excess bony tissue in the bony callus by phagocytic multi-nucleated giant osteoblasts
In which stage of fracture healing is a cartilaginous callus formed
reparative2
Which specific cells are involved in the remodeling phase of bone fracture healing
osteoblasts
What are local factors of bone healing
blood supply, type of fracture, infection and immobilization
What are systemic factors of bone healing
age, nutrition, hormones, diseases
True or False
A highly vascularized bone has a better chance at healing than a poorly vascularized one
True
- a well vascularized bone heals more effectively
True or False
An 81 year old diabetic who has a fracture at the femoral head of the hip has a good chance of fracture healing within a reasonable time
False
- age and diabetics will make the healing process longer
How does a malfunction of a fracture occur
when a fracture heals in an abnormal position leading to misalignment
What is the normal healing time for most fractures
6-8 weeks but the time can vary depending on the bone and individual health
Which type of fracture complication may result in cystic degeneration
avascular necrosis
- leads to cystic degeneration
- particularly in fractures with poor blood supply such as those of the femoral head
