healing and repair

Question 1

—– is the replacement of destroyed or lost tissue by viable tissue

Answer 1

healing

Question 2

1.the initial response of a damaged tissue is —-
2. other tissue responses to injury :

Answer 2

1.acute inflammation
2. resolution , regeneration , repair by fibrosis

Question 3

-no tissue destruction
-damaging agent and cell debris are removed
- tissue returned to its pre injury state as: mild heat injury
are all under —-

Answer 3

resolution

Question 4

—- the replacement of list tissue by the tissue of the same type
—- the replacement of the destroyed tissue by a fibrous scar

Answer 4

• regeneration
• repair

Question 5

factors affecting the healing process :

Answer 5

• The ability to remove the causative agent
• The ability to clear the inflammatory debris
• The degree of architectural damage
• The ability of cell to proliferate
• The extent of extra-cellular matrix damage

Question 6

tissue proliferative activity includes 3 types of cells which are:

Answer 6

• labile cells
• stable cells
• permanent cells

Question 7

—– are cells that continuously divide and are derived from stem cells

Answer 7

labile cells as:
Epidermis, mucosal epithelium, GI tract epithelium

Question 8

labile cells are —- healed by —– if the supporting storma is —–

Answer 8

• easily
• regeneration
• intact

Question 9

—- are cells that have low levels of replication and can be stimulated to divide and they are healed by regeneration if the supportive storm and regenerative stem cells are intact

Answer 9

stable cells

Question 10

Hepatocytes, renal tubular epithelium, pancreatic acini are —- cells

Answer 10

stable cells

Question 11

—– are non dividing cells and replaced by connective tissue

Answer 11

permentant cells

Question 12

Neurons, cardiac myocytes, skeletal muscle are —– cells

Answer 12

permanent cells

Question 13

true or false:
-permanent cells have no regeneration
- polypeptide growth factors are the most important affecting cell growth

Answer 13

true , true

Question 14

polypeptide growth factors are present in —- or produced —-
-Exert pleiotropic effects; proliferation, cell migration,
differentiation, tissue remodeling
-Regulate growth of cells by controlling expression of
genes that regulate cell proliferation

Answer 14

• serum or locally

Question 15

the storm includes:

Answer 15

• extracellular matrix w” interstitial matrix and basement membranes
• mesenchymal cells
• vessels

Question 16

its not just a scaffold for cells to grow on , it regulates cell growth , motility m and differentiation
this is ——

Answer 16

extracellular matrix which consists of:
▪ Fibrous structural proteins
▪ Collagens
▪ Elastin
▪ Adhesive glycoproteins that link ECM component
to one another and to cells
▪ Proteoglycans

Question 17

the cell-cell interactions include:

Answer 17

• growth factors as: EGF, PDGF, FGF, VEGF, TGFβ
• cytokines
• growth inhibitors

Question 18

cell matrix interactions include

Answer 18

• Integrins
  ▪ Cell surface receptors that mediate cellular attachment
  to the extracellular matrix
  ▪ Transduction of signals from ECM to cells

Question 19

the replacement of lost cells by cells of the same type through cell division by which the supporting framework is intact is known as —-

Answer 19

regeneration

Question 20

the regeneration process is controlled by —- and — factors and interactions between —- and —-

Answer 20

• controlled by inhibitory and stimulatory factors
• cells and extracellular matrix

Question 21

healing by fibrosis is healing by —- tissue and it occurs when :
- destruction of —–
- the death of —-
- organisation of —-

Answer 21

• connective tissue
• parenchymal cells and stromal framework
• permanent tissue
• inflammation

Question 22

repair by connective tissue involves the production of —- tissue
1. involves angiogenesis - new vessels budding from old
2. fibrosis - consisting of emigration and proliferation of fibroblast and disposition of ECM type iii collagen
3. scar remodelling type iii collagen replaced by type I collagen ( collagenase - requires zinc )

Answer 22

• granulation tissue ( which is fibroblast + capillary buds and myofibroblast )

Question 23

wound healing phases are:

Answer 23

1* Inflammatory phase
2* Proliferative phase
▪ Epidermal re-growth
▪ Dermal repair
3* Remodelling phase
▪ Restoration of elasticity

Question 24

—- phase is the induction of acute inflammatory response by an initial injury which involves :

Answer 24

• inflammatory phase
• heamtoma formation , infiltration by neutrophils and infiltration by macrophages

Question 25

the proliferative phase refers to:
—- proliferation
- formation of—-
-
-

Answer 25

• epithelial cells proliferation
• formation of new vessels
• granulation tissue
• proliferation of fibroblast ( sythesis of ecm proteins )

Question 26

the replacement of granulation tissue by fibrous tissue is —- phase

Answer 26

remodelling phase which involves :
1- remodelling of parenchymal elements to restore tissue function
2- remodelling of connective tissue to achieve wound strength
3- degradation of excessive extracellular matrix ( metalloproteinase )

Question 27

the types of wound healing are:

Answer 27

• primary intention
• secondary intention

Question 28

stages of wound healing by primary intention :
day 1:
- wound is filled w —-
- —- surrounding tissue
- proliferation of —–
day 2:
- —-
- —- covers the surface
day 3:
- —– formation
day 5:
—- deposition
day 7:
—- removed

Answer 28

• blood clot
• acute inflammation
• epithelial cells
• macrophages
• epithelial cells
• granulation tissue
• collagen
• sutured

Question 29

wound strength :
after suture are removed at – week , wound strenghth is only — of unwounded skin ( walkers law )
- by 3-4 months the wound strength is about —- of the unwounded skin ( walkers law)

Answer 29

• one week
• 10%
• 80%

Question 30

wound healing secondary intention:
1. the process is similar to healing by —-
2. the edges are —- and — fills the gaps
3. is it slow/fast ?
4. the inflammatory reaction is more —-
5. wound —-
6. more —

Answer 30

• primary intention
• not approximate
• granulation tissue
• slower
• more intense
• contraction ( myofibroblast )
• more scarring

Question 31

pathologic aspect of wound healing:
1. dififcent scar formation as:
2. excessive scar formation as:
3. contracture defromity
4. —— transformation which are extremely —

Answer 31

• wound rupture
• keloid type iii collagen and genetic predisposition
• malignant
• extremely rare

Question 32

mucosal surfaces :
erosions are healed by —
ulceration by ——

Answer 32

• regernation
• regeneration and fibrosis

Question 33

liver:
- single short lived injury is healed by —
chronic injury by —

Answer 33

• regeneration
• cirrhosis

Question 34

nervous system :
- CNS :
- preferial nerves:

Answer 34

• gliosis
• regernation

Question 35

muscle :
- cardiac muscle :
- skeletal muscle

Answer 35

both by fibrosis

Question 36

factors that influence healing are:

Answer 36

local and systemic effect
1. local effect :
* Poor vascular supply
* Infection
* Foreign material
* Excessive movement
* Poor approximation
* Size, site and type of injury
2. systemic effect:
SYSTEMIC FACTORS
* Age
* Nutrition (proteins, Vitamin C- collagen formation,
copper- cross linking of collagen, Zinc- conversion of
type III to type I collagen)
* Metabolic status (DM)
* Hormones (steroids)
* Malignancy
* Chemotherapy
* Radiotherapy