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Pathology > Healing > Flashcards

Healing Flashcards

1
Q

Define healing

A

Body tissue replacement

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2
Q

Describe this tissue (2 points)

A

Destroyed

Lost

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3
Q

What is the destroyed lost tissue replaced by?

A

Living tissue

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4
Q

What are the 2 processes of healing?

A

Regeneration

Repair

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5
Q

Which tissues replace the destroyed lost tissue in Regeneration?

A

Similar

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6
Q

What are these tissues similar in?

A

Type

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7
Q

Which tissue replaces the destroyed lost tissue in Repair?

A

Granulation

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8
Q

What happens to this Granulation tissue?

A

Matures

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9
Q

What tissue does this Granuloma tissue mature into?

A

Scar

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10
Q

What is this process known as?

A

Scarring

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11
Q

What is healing done by in regeneration?

A

Fibrosis

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12
Q

When is healing by Fibrosis becomes inevitable?

A

When cells lack proliferative capacity

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13
Q

Which cells do not have the capacity to proliferate?

A

Surrounding cells

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14
Q

Describe these cells

A

Specialized

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15
Q

What are the 2 factors that determine which healing process of the destroyed lost tissue is used?

A

Cell type

Destruction/Intactness

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16
Q

Which organ’s cell type determines the healing process of the destroyed lost tissue used?

A

Damaged

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17
Q

The destruction/intactness of which organ’s structure determines the healing process of the destroyed lost tissue used?

A

Stromal frame work

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18
Q

According to what are cells classified?

A

Proliferative capacity

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19
Q

What are the 3 types of cells?

A

Liable
Stable
Permanent

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20
Q

Describe the chances of Regeneration of Liable cells

A

Excellent

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21
Q

What are Liable cells characterized by?

A

Continuous turn over

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22
Q

Describe the division of Liable cells

A

Programmed

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23
Q

Where are the liable cells found in? (3 points)

A

GIT
Urinary tract
Skin

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24
Q

What are the liable cells which are found in these 3 sites?

A

Surface epithelium

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25
Q

What are other 2 examples of Liable cells?

A

Lymphoid system

Haemopoietic system

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26
Q

Which cell that divide is an example of liable cells?

A

Stem

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27
Q

Describe the chances of Regeneration of Stable cells

A

Good

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28
Q

Describe the level of replication of Stable cells compared to Liable cells

A

Lower

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29
Q

Describe the division of Stable cells

A

Rapid

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30
Q

What do these Stable cells respond to in order to divide rapidly?

A

Injury

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31
Q

Describe the number of stem cells which are an example of Stable cells

A

Few

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32
Q

What is an example of a stable cell which can proliferate?

A

Mesenchymal cell

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33
Q

What are the 4 examples of Mesenchymal cell?

A

Smooth muscle cells
Endothelial cells
Fibroblasts
Osteoblasts

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34
Q

What are examples of organs in which their stable cells can regenerate? (3 points)

A

Liver
Endocrine glands
Renal tubular epithelium

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35
Q

Describe Permanent cells

A

Non-dividing

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36
Q

What cannot happen to Permanent cells if they are lost?

A

Replacement

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37
Q

What do Permanent cells lack so that they cannot be replaced if lost?

A

Proliferative capacity

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38
Q

What are examples of Permanent cells?

3 points

A

Adult neurons
Striated muscle cells
Lens cells

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39
Q

What is Angiogenesis known as?

A

Neovascularization

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40
Q

Define Angiogenesis

A

New blood vessels formation

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41
Q

Where are these new blood vessels formed in?

A

Adult

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42
Q

What are the new blood vessels formed from? (2 points)

A

Pre-existing ones

Endothelial precursor cells

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43
Q

What is the type of these blood vessels?

A

Capillaries

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44
Q

When does Angiogenesis occur in?

6 points

A 
Wound healing
Infarction healing
Chronic inflammation
Serofibrinous inflammation 
Thrombus
Abscess
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45
Q

Describe the capillary surface

A

Granular

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46
Q

What is the color of the capillary surface?

A

Red

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47
Q

What happens to the capillary when touched?

A

Bleeds easily

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48
Q

How does the capillary feels like when touched?

A

Moist

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49
Q

What will also be newly formed alongside the capillaries?

A

Fibroblasts

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50
Q

What are the functions of Fibroblasts?

4 points

A

Migration
Proliferation
Deposition of extracellular matrix
Tissue remolding

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51
Q

What are the 2 fates of Angiogenesis?

A

Fibrosis

Scar

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52
Q

What are used to control Angiogenesis? (4 points)

A

Growth factors
Receptors
ECM proteins
Inhibitors

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53
Q

What are the ECM proteins considered as for Angiogenesis?

A

Regulators

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54
Q

What is skin wound healing an example of?

A

Regeneration and Repair Combination

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55
Q

What are the 2 types of skin wound healing?

A

First Intention

Second Intention

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56
Q

What is the First Intention known as?

A

Primary Union

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57
Q

Describe the wound in First Intention type?

3 points

A

Clean
Uninfected
Surgically incised

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58
Q

What are the edges/margins of the wound approximated by?

A

Surgical sutures

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59
Q

What are lost in the wound of the First Intention type? (2 points)

A

Cells

Tissues

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60
Q

Describe this loss in the First Intention type

A

Not much

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61
Q

What are the sequence of events of skin wound healing of the First type?
(4 points)

A

Initial Hemorrhage
Acute Inflammatory response
Epithelial changes
Organization

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62
Q

Describe the healing in the First Intention type

A

Rapid

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63
Q

What does this healing result in?

A

Scar

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64
Q

Describe this Scar (2 points)

A

Neat

Linear

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65
Q

What is the healing in the form of?

A

Granulation Tissue

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66
Q

Describe this Granulation tissue

A

Scanty

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67
Q

Describe the wound where this scanty granulation tissue is formed at

A

Incised

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68
Q

What is the wound filled with in initial hemorrhage?

A

Blood

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69
Q

What happens to the blood?

A

Clots

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70
Q

What do the blood clots do to the wound?

A

Seal it

71
Q

What do the blood clots prevent when sealing the wound? (2 points)

A

Dehydration

Infection

72
Q

Which cells are firstly involved in the Acute Inflammatory Response?

A

Polymorphs

73
Q

Which cells replace the Polymorphs?

A

Macrophages

74
Q

Which day do the Macrophages replace the Polymorphs in?

A

3rd

75
Q

What also happens to the wound area in the 3rd day?

A

Invaded

76
Q

Which cells invade the wound area?

A

Fibroblasts

77
Q

What is the wound covered by?

A

Epithelium layer

78
Q

Which day is when the wound become covered by Epithelium layer?

A

2nd

79
Q

Which epithelium layer is where epithelial changes occur in?

A

Epidermis

80
Q

Which epidermal cells are where epithelial changes occur in?

A

Basal cells

81
Q

What are the changes of the epidermal basal cells? (3 points)

A

Proliferation
Migration
Separation

82
Q

Where do the epidermal basal cells migrate towards?

A

Incisional space

83
Q

What do the Epidermal cells separate?

A

Underlaying viable dermis

84
Q

What do the Epidermal cells separate the underlaying viable dermis from?

A

Overlaying necrotic material

85
Q

What does this separation results in forming?

A

Scab

86
Q

What will then start to form?

A

New Collagen Fibrils

87
Q

Which day are the new collagen fibrils formed in?

A

5th

88
Q

Until when will the new collagen fibrils dominate?

A

Healing completion

89
Q

What will then be formed later on?

A

Scar tissue

90
Q

What will be formed with the scar tissue?

A

Elements

91
Q

Which 2 elements will be formed later on?

A

Cellular

Vascular

92
Q

Describe the cellular element

A

Scanty

93
Q

When will the scanty cellular and vascular elements be formed in?

A

4 weeks

94
Q

What are the complications of the First Intention type?

A

Epidermal inclusion cyst formation

95
Q

Describe the formation of the Epidermal inclusion cyst

A

Infrequent

96
Q

What is the Second Intention known as?

A

Secondary union

97
Q

Describe the wound in Second Intention type?

5 points

A 
Unclean
Sometimes Infected
Open
Contracted
Irregular
98
Q

What is involved in this wound compared to the wound of the primary intention?

A

Larger tissue defect

99
Q

What has to be done with this large tissue defect?

A

Bridging

100
Q

What are the edges/margins of the wound not approximated by?

A

Surgical sutures

101
Q

Describe the edges/margins of the wound

A

Irregular

102
Q

What are lost in the wound of the First Intention type? (2 points)

A

Cells

Tissues

103
Q

Describe this loss in the Second Intention type

A

Extensive

104
Q

What does this healing result in?

A

Scar

105
Q

Describe this scar (2 points)

A

Large

Ugly

106
Q

What happens to this scar with time?

A

Mature

107
Q

Describe the color of this Scar on maturation

A

Pale

108
Q

What is the color of this Scar on maturation?

A

White

109
Q

Describe the 2 factors that made this Scar pale and white on maturation

A

Increased collagen

Decreased vascularity

110
Q

What are the sequence of events of skin wound healing of the First type?
(3 points)

A

Initial Hemorrhage
Acute Inflammatory Response
Epithelial changes

111
Q

Describe the healing in the Second Intention type

A

Slow

112
Q

What is the healing in the form of? (2 points)

A

Granulation tissue

Suture tracks

113
Q

Describe the Granulation tissue

A

Exuberant

114
Q

Where exactly does the healing occur from the Granulation tissue?

A

In its gap

115
Q

Where exactly does the healing occur from the Suture tracks?

A

Along them

116
Q

What do the granulation tissue and the suture tracks do?

A

Fill the gap

117
Q

What will occur more in the Second Intention type? (3 points)

A

Inflammation
Granulation tissue formation
Scarring

118
Q

What is the main bulk of the secondary healing by?

A

Granulation

119
Q

What will not be replaced in the Second Infection type?

A

Specialized skin structures

120
Q

What are the 2 specialized skin structures that are not replaced in the Second Infection type?

A

Hair follicles

Sweat glands

121
Q

What is absent in the First Intention type but present in the Second Intention type?

A

Wound contraction

122
Q

What causes wound contraction?

A

Myofibroblasts action

123
Q

What size does the wound contract into?

A

One-third to One-fourth

124
Q

Which size does the wound contract into One-third to One-fourth of it?

A

Original

125
Q

What delays the healing process?

A

Bacterial contamination

126
Q

What is released by the bacteria in case of bacterial contamination delaying the healing process?

A

Toxins

127
Q

What do the bacterial toxins provoke?

3 points

A

Necrosis
Suppuration
Thrombosis

128
Q

What does the release of bacterial toxins indicate?

A

Infection

129
Q

What helps in healing?

A

Debridement

130
Q

Define Debridement

A

Surgical removal of dead and necrotic tissue

131
Q

Where does wound strengthened occur in?

A

Extracellular matrix

132
Q

What is the wound strengthened by?

2 points

A

Proliferation of:

Fibroblasts and Myofibroblasts

133
Q

What are the Fibroblasts and Myofibroblasts provided with?

A

Structural support

134
Q

What provides structural support to the Fibroblasts and Myofibroblasts?

A

ECM

135
Q

What does ECM directs? (4 points)

A

Cell migration
Attachment
Differentiation
Organization

136
Q

What are the 5 main components of the ECM?

A 
Collagen
Adhesive glycoproteins
Basement membrane
Elastic fibers
Proteoglycans
137
Q

What is the complication of healing in the Second Intention type?

A

Suppuration

138
Q

What may the suppuration require?

A

Debridement

139
Q

What are the 2 types of factors that affect wound healing?

A

Systemic

Local

140
Q

What features of healing are altered due to these factors?

2 points

A

Rate

Efficiency

141
Q

What are the systemic factors that affect wound healing? (7 points)

A 
Age
Anemia
Nutritional deficiency 
Glucocorticoid therapy
Cytotoxic drugs
Diabetes mellitus 
Malignancy 
Uremia
142
Q

What nutrients ,if deficient, affect the wound healing? (3 points)

A

Protein
Vitamins
Minerals

143
Q

What features of Diabetes mellitus affect wound healing? (2 points)

A

Infection

Bad Vascularity

144
Q

What are the local factors that affect wound healing? (6 points)

A 
Infection
Cell type damage
Tissue damage
Blood supply
Venous drainage
Mechanical factors 
Foreign body
145
Q

What are the 3 type of cell in which the damaged cell could be classified as?

A

Liable
Stable
Permanent

146
Q

Describe the 2 forms of tissue damage which affect the wound healing

A

Sever

Mild

147
Q

What is an example of a mechanical factor which affect the wound healing?

A

Blood vessels compression

148
Q

What are the complications of wound healing? (8 points)

A 
Wound Infection
Implantation cyst
Ulceration
Pigmentation
Incisional hernia 
Keloid
Excessive contraction
Neoplasia
149
Q

What does wound infection does to the healing?

A

Delays it

150
Q

Describe the implantation cyst

A

Epidermal

151
Q

Which cells flow into the healing wound?

A

Epithelial cells

152
Q

What do these Epithelial cells sometimes do later on? (2 points)

A

Persist

Proliferate

153
Q

What do these Epithelial cells form after their proliferation?

A

Epidermoid cyst

154
Q

What color does the pigment looks like?

A

Rust

155
Q

What gives the rust-like color of the pigment?

A

Hemosiderin

156
Q

Describe Incisional hernia

A

A Defect

157
Q

What is this defect caused by?

A

Poor wound healing following surgery

158
Q

Which organ will be affected by this poor wound healing?

A

Intestine

159
Q

What happens to the intestine?

A

Protrude

160
Q

Where does the Incisional hernia usually occur in?

A

Abdominal wall

161
Q

Describe Keloid

A

Scar tissue area

162
Q

Describe the area of this Scar tissue

A

Raised

163
Q

Describe the Scar (3 points)

A

Excessive
Ugly
Painful

164
Q

What results in a Keloid?

A

Collagenous tissue formation

165
Q

Describe the formation of this Collagenous tissue

A

Excessive

166
Q

What does the Excessive contraction result in?

A

Decrease in wound size

167
Q

What does the decrease in wound size depend on? (3 points)

A

Myofibroblasts
Cell-cell contacts development
Sustained cell contraction

168
Q

What are the 3 processes together known as?

A

Cicatrisation

169
Q

What is the exaggeration of these 3 processes known as?

A

Contracture

170
Q

What does the contracture result in?

A

Severe deformity

171
Q

Which cell becomes neoplastic?

A

Squamous cell

172
Q

What does this Squamous cell form?

A

Carcinoma

173
Q

Where is this Carcinoma formed in?

A

Marjolin’s Ulcer

Pathology (11 decks)

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