Fiser ABSITE Ch. 14 Wound Healing

Question 1

What are the 3 wound healing phases?

Answer 1

Inflammation, Proliferation, Remodeling

Question 2

What is the timeframe for the inflammation phase of wound healing?

Answer 2

days 1-10

Question 3

What is the timeframe for the proliferation phase of wound healing?

Answer 3

5 days - 3 weeks

Question 4

What is the timeframe for the remodeling phase of wound healing?

Answer 4

3 weeks - 1 year

Question 5

Which phase of wound healing?:

PMNs, macrophages, epithelialization 1-2 mmday

Answer 5

Inflammation

Question 6

Which phase of wound healing?:

fibroblasts, neovascularization, production of collagen, granulation tissue

Answer 6

Proliferation

Question 7

Which phase of wound healing?:
Type III collagen replaced with type I; decreased vascularity. Net amount of collagen does not change, although significant production and degradation occur. Collagen cross-linking occurs.

Answer 7

Remodeling

Question 8

Peripheral nerves regenerate at ___ mmday

Answer 8

1

Question 9

Fibroblasts replace fibronectin-fibrin with ___

Answer 9

collagen

Question 10

Chemotactic for macrophages also anchors fibroblasts.

Answer 10

Fibronectin

Question 11

Name the predominant cell type by wound healing day:
Days 0-2 ___
Days 3-4 ___
Days 5 and on ___

Answer 11

PMNs
macrophages
fibroblasts

Question 12

Platelet plug is made of platelets and ___

Answer 12

fibrin

Question 13

Provisional matrix is made of platelets, ___ and ___

Answer 13

fibrin, fibronectin

Question 14

Accelerated wound healing is quicker healing that occurs when reopening a wound the 2nd time. Why does this occur?

Answer 14

healing cells are already present

Question 15

Which type of platelet granules contain: Platelet factor for aggregation. Beta-thrombomomdulin to bind thrombin and PDGF a chemoattractant.

Answer 15

Alpha granules

Question 16

Which type of platelet granule contains adenosine, serotonin and calcium.

Answer 16

Dense granules

Question 17

Name 3 platelet aggregation factors.

Answer 17

TXA2, thrombin, platelet factor 4

Question 18

The most important factor in healing open wounds (secondary intention).

Answer 18

epithelial integrity

Question 19

Epithelial migration occurs from what three places in wound healing?

Answer 19

wound edges, sweat glands, and hair follicles

Question 20

Unepithelialized wounds leak ___ and protein, promote bacterial

Answer 20

serum

Question 21

What is the most important factor in healing closed incisions (primary intention).

Answer 21

tensile strength

Question 22

Tensile strengh depends on what?

Answer 22

collagen deposition and cross-linking

Question 23

What is the strength layer of the bowel?

Answer 23

submucosa

Question 24

What is the weakest time point for small bowel anastomosis?

Answer 24

3-5 days

Question 25

Myofibroblasts communicate by ___

Answer 25

gap junctions

Question 26

What part of wound healing are myofibroblasts involved in?

Answer 26

wound contraction and healing by secondary intention

Question 27

What is the most common type of collagen

Answer 27

Type I

Question 28

Name the type of collagen: | skin, bone and tendons

Answer 28

I

Question 29

Name the type of collagen: Cartilage

Answer 29

II

Question 30

Name the type of collagen: increased in wound healing, also in blood vessels and skin

Answer 30

III

Question 31

Name the type of collagen: basement membranes

Answer 31

IV

Question 32

Name the type of collagen: widespread, particularly found in the cornea

Answer 32

V

Question 33

Alpha-ketoglutarate, vitamin C, oxygen and iron are required for what part of wound healing?

Answer 33

hydroxylation of proline and subsequent cross-linking of proline residues

Question 34

Collagen has ___ every 3rd amino acid; also has abundant lysine

Answer 34

proline

Question 35

Wound tensile strength is never equal to prewound, only ___%

Answer 35

80%

Question 36

What is the predominant collagen type synthesized for days 1-2?

Answer 36

Type III

Question 37

What is the predominant collagen type synthesized by days 3-4?

Answer 37

Type I

Question 38

Type III collagen is replaced by type I by ___ weeks

Answer 38

3

Question 39

At ___ weeks wound is at 80% of its final strength and 60% of its original strength.

Answer 39

6

Question 40

At ___ weeks, wound reaches maximum tensile strength, which is 80% of its original strength

Answer 40

8

Question 41

Maximum collage accumulation at ___ weeks after that -> the amount of collagen stays the same but continued cross-linking improves strength

Answer 41

2-3

Question 42

d-Penicillamine is used to treat RA, what does it do to wound healing

Answer 42

inhibits collagen cross linking

Question 43

What is the transcutaneous oxygen measurement essential for wound healing?

Answer 43

> 25 mmHg

Question 44

bacteria amount > ___ is an impediment to wound healing

Answer 44

10^5cm2

Question 45

Albumin less than ___ is a risk factor for poor wound healing

Answer 45

3

Question 46

Steroids prevent wound healing by inhibiting macrophages, PMNs and collagen synthesis by ___; decreased wound tensile strength as well.

Answer 46

fibroblasts

Question 47

What vitamin (24,000 IU qd) counteracts effects of steroids on wound healing?

Answer 47

Vitamin A

Question 48

Name the disease associated with abnormal wound healing: Type I collagen defect.

Answer 48

osteogenesis imperfecta

Question 49

Name the disease associated with abnormal wound healing: 10 types identified, all collagen disorders

Answer 49

Ehlers-Danlos syndrome

Question 50

Name the disease associated with abnormal wound healing: fibrillin (collagen) defect

Answer 50

Marfan's syndrome

Question 51

Name the disease associated with abnormal wound healing: Excessive firbroblasts. Tx: phenytoin

Answer 51

Epidermolysis bullosa

Question 52

90% of leg ulcers due to ___. Tx?

Answer 52

venous insufficiency. Unna boot, elastic wrap

Question 53

Scar revisions, wait for ___ to allow maturation; may improve with age

Answer 53

1 year

Question 54

What pts heal with little or no scarring?

Answer 54

infants

Question 55

What type of tissue contains no blood vessels

Answer 55

cartilage

Question 56

Does denervation have an effect on wound healing?

Answer 56

no

Question 57

Chemotherapy has no effect on wound healing after ___ days

Answer 57

14

Question 58

What is the inheritance for keloids?

Answer 58

autosomal dominant

Question 59

Tx for keloids?

Answer 59

XRT, steroids, silicone, pressure garments

Question 60

What is the difference between a Keloid and hypertrophic scar tissue.

Answer 60

Keloids extend beyond original scar

Question 61

Hypertrophic scar tissue often occurs in what type of wounds and what is the tx?

Answer 61

flexor surfaces of upper torso, burns or wounds that take a long time to heal; Steroids, silicone, pressure garments.