Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

2025 - Intro to Surgery 737A > EXAM 1: Lecture 11 - wound healing and surgical inflammation > Flashcards

EXAM 1: Lecture 11 - wound healing and surgical inflammation Flashcards

1
Q

surgery = ____ of a wound

A

creation of a wound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what does disruption of tissue homeostasis lead to

A

inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is normal surgical inflammation

A

acute, local, short duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is abnormal surgical inflammation

A

prolonged (chronic), severe, signs of infection, or systemic signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the 3 phases of wound healing

A

inflammation, proliferation, and remodeling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

at how many days in wound healing will you see inflammation

A

4-6 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

at how many days in wound healing will you see proliferation

A

4-24 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

at how many days in wound healing will you see remodeling

A

21 days - 2 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is hemostasis

A

the body wanting to stop bleeding while maintaining perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the 2 balances of hemostasis

A

vasoconstriction and vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is endothelial cell disruption in hemostasis

A

immediate vasoconstriction, exposure of Von Willebrand factor (vWF) platelet activation and aggregation, and the coagulation cascade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what happens when endothelial cells release vasodilators

A

there is vasodilation to increase blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what mediates vasodilation

A

histamine, NO, LTs, PGs, complement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what happens when there is post-capillary venule leakiness

A

increased inflammatory cell and inflammatory mediation infiltration leading to protein leakage (edema)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what happens with protein leakage

A

decreased osmotic pressure, increased blood viscosity, and increased interstitial pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

T/F: Edema facilitates delivery of soluble factors and cells and can cause pain or loss of function

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what can cause vascular congestion

A

fluid loss to edema, hemoconcentration, and reduced velocity of blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is inflammation also called

A

debridement phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the 2 phases of inflammation

A

early and late

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what happens in the early phase of inflammation

A

neutrophil recruitment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what happens during the late phase of inflammation

A

monocyte transformation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are the functions of inflammation

A

prepares the body for next phases of wound healing and removes dead tissue/foreign material

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

___1_ of trauma = intensity of __2___ = extent of ___3___ formed

A
  1. severity
  2. inflammation
  3. scar tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what do leukocytes do with inflammation

A

they are recruited from circulation by chemoattractants and initiate rolling, activation, tight adhesion, and transmigration of cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what do neutrophils do for inflammation

A

neutrophil diapedesis is encouraged by increased capillary permeability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is diapedesis

A

passage of blood cells through intact capillary walls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

how quickly does neutrophil diapedesis happen

A

minutes and peaks 1-2 days after injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

why are neutrophils the first line of defense against contaminated wounds

A

they destroy debris and phagocytose bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

T/F: monocytes migrate from vasculature during inflammation

A

true!

30
Q

T/F: macrophages change into monocytes

A

false, monocytes turn into macrophages

31
Q

what do macrophages do for inflammation

A

pro-inflammatory functions, stimulate proliferation of dermal/endodermal/epithelial tissues and help with remodeling phase

32
Q

how do we get resolution of inflammation

A

each of the pathways need to be halted or reversed and apoptosis of cells

33
Q

what happens if there no resolution of inflammation

A

can lead to chronic, suppurative inflammation and a non healing wound OR proud flesh in horses

34
Q

how is inflammation phase modulated by clinicians

A
  1. proper surgical debridement
  2. good hemostasis
  3. adequate drainage
  4. medications like NSAIDS or steroids
35
Q

what causes proliferation of tissues

A

fibroplasia, angiogenesis, and epithelialization

36
Q

what is fibroplasia and what does it do

A

formation of granulation tissue by fibrosis

gives a temporary barrier of infection

37
Q

what are the 3 elements of granulation tissue

A
  1. macrophages
  2. fibroblasts
  3. blood vessels
38
Q

what do macrophages do to make granulation tissue

A

debride, produce cytokines/growth factors that stimulate angiogenesis and fibroplasia

39
Q

what do fibroblasts do to make granulation tissue

A

proliferate and make new extracellular matrix

40
Q

what do blood vessels do to make granulation tissue

A

carry O2 and nutrients for cell metabolism and growth

41
Q

what day in the healing process do you start to see granulation tissue

A

day 5

42
Q

T/:F fibroblasts are directed by macrophages via cytokines and growth factors

A

true

43
Q

what is angiogenesis

A

formation of new capillaries from pre-existing vessels

44
Q

what regulates angiogenesis

A

macrophages and endothelium

45
Q

_____ tissue hypoxia = _____ vessel ingrowth

A

increased tissue hypoxia = increased vessel ingrowth

46
Q

what is epithelialization

A

when epithelium covers the wound

47
Q

what is the purpose of epithelialization and how much growth is there per day

A

it reforms barrier of infection and about 0.1-0.2mm/day

48
Q

what is wound maturation

A

continued epithelialization by thickening of the epidermis

49
Q

how do wounds contract

A

fibroblasts differentiate into myofibroblasts under influence of growth factor and cytokines

50
Q

what does remodeling mean

A

conversion of granulation tissue into scar tissue

51
Q

what does MMP stand for and what is it

A

matrix metalloproteinases

it is collagenases, gelatinases, and stromelysins which is the demolition team for converting granulation in to scar

52
Q

how long does remodeling take

A

may take up 1-2 years depending on the size of the wound

53
Q

what are the 4 things that stop healing

A
  1. when wound edges meet
  2. tension surrounding skin > force of myofibroblasts
  3. reduced numbers of myofibroblasts
  4. granulation tissue is proliferative
54
Q

what is “the rude unhinging of the machinery of life”

A

shock

55
Q

what is shock

A

cascade of events that begins when cells/tissues are oxygen deprived from inadequate perfusion

56
Q

what can shock lead to

A

SIRS and MOD

57
Q

what does SIRS stand for

A

systemic inflammatory response syndrome

58
Q

is SIRS normal?

A

Yes but it is a large overreaction to the situation

59
Q

what causes SIRS

A

there are many causes leading to it. it can be infectious or non-infectious

60
Q

what are 3 things that happen with SIRS

A

cytokine storm, leukocyte dysfunction, and delayed resolution of inflammation

61
Q

what is the clinical definition of SIRS

A

must meet any 2 physiologic conditions with underlying pathologic cause

62
Q

what are the possible causes that leads to a clinical definition of SIRS

A
  1. hyperthermia or hypothermia
  2. tachycardia
  3. tachypnea
  4. leukocytosis or leukopenia
  5. depression
63
Q

what causes hyperthermia (fever)

A

IL-1, IL-6, TNF-alpha, PGE2 act on the hypothalamus

64
Q

what causes hypothermia

A

shock from hypoperfusion or central blood sequestration

65
Q

what is the cascade of tachycardia

A

vasodilation to hypotension to decreased CO to increased HR

66
Q

what changes do we see on CBC

A
  1. leukopenia (<48h)
  2. leukocytosis (>48h)
  3. left shift (variable)
66
Q

what is the cascade of tachypnea

A

hypoperfusion to anaerobic cellular metabolism to lactic acidosis to metabolic acidosis

67
Q

what causes depression

A

cytokines and eicosanoids

68
Q

what causes the stress response

A

IL-1 and TNF-alpha

69
Q

what does IL-1 and TNF-a do to cause the stress response

A

increase in adrenocorticotropic hormone to increase corticosteroids

70
Q

what do corticosteroids do to surgical healing

A

reduce it!!

2025 - Intro to Surgery 737A (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions