Inflammatory Response & Wound Healing

Question 1

Three Overlapping Phases of Wound Healing

Answer 1

Inflammation, Proliferation (Epithelialization), & Remodeling

Question 2

Inflammatory Phase

Answer 2

Essential for healing. 2-5 days

Question 3

Repair Phase

Answer 3

2 days - 3 weeks

Question 4

Remodeling Phase

Answer 4

3 weeks - 2 years

Question 5

Inflammation

Answer 5

Initial healing, remove foreign agents, vascular/cellular/homeostatic immune responses

Question 6

4 Cardinal Signs of Inflammation

Answer 6

Redness, Swelling, Pain, & Warmth

Question 7

Q 10 Effect

Answer 7

For every 1 deg Celsius rise in body temperature = 10-13 times increase in metabolic activity

Question 8

Loss of Function

Answer 8

Due to: pain causing reflex guarding, increased swelling, restricted motion, & increased pressure

Question 9

Tissue Hypoxia

Answer 9

Damaged vessels less effective in oxygen delivery

Question 10

Chemotaxis

Answer 10

Attraction of WBCs to area

Question 11

Margination

Answer 11

WBCs adhere to capillary wall

Question 12

Diapedesis

Answer 12

Passage of WBCs through cell membrane wall

Question 13

Defense against Microorganisms

Answer 13

Epithelium, Neutrophils & Macrophages, & T & B Cells

Question 14

First Line of Defense

Answer 14

Skin and Mucous Membranes (Mechanical & Chemical Barriers). Forming protective wall & immune mechanisms.

Question 15

Neutrophils

Answer 15

First line of defense 7-12 hours, attract mesenchymal cells which are precursors to fibroblasts (lay down collagen). Most phagocytic of WBCS along with macrophages. Primary responsible for cleansing wound.

Question 16

Fibroblasts

Answer 16

Put down new collagen

Question 17

Macrophages

Answer 17

Second line of defense, form lysosomes which further the phagocytosis; pus is the end result

Question 18

B-Cells

Answer 18

Do not attack pathogens, produce antibodies that attack pathogens

Question 19

T-Cells

Answer 19

Attack pathogens more directly

Question 20

Contraction

Answer 20

Wound edges pull together

Question 21

Granulation

Answer 21

Fibroblast lay down new collagen, defects filled and new capillaries are formed. Pink buds.

Question 22

Hypogranulation

Answer 22

Absence of a successful proliferation phase. Insufficient granulation tissue to fill wound defect.

Question 23

Hypergranulation

Answer 23

Granulation continues after the wound defect has been filled.

Question 24

Hypertrophic Scarring

Answer 24

Over production of immature collagen.

Question 25

Keloids

Answer 25

Result from excessive immature collagen synthesis

Question 26

Dehiscence

Answer 26

Separation of wound margins due to insufficient collagen production or tensile strength

Question 27

Wolfe’s Law

Answer 27

Tissue respond to stresses placed on it. BONE

Question 28

Davie’s Law

Answer 28

Tissues respond to stresses placed upon it. SOFT TISSUE

Question 29

Transudate

Answer 29

Normal passage of fluid in the body

Question 30

Exudate

Answer 30

Abnormal fluid passage or build up. Example: Pus.

Question 31

Serous

Answer 31

Clear, watery. Example: Blister

Question 32

Sanguineous

Answer 32

Tinge of Red, Thin

Question 33

Purulent

Answer 33

Creamy, Thick

Question 34

Primary Intention

Answer 34

Occurs in wounds whose edges are closely related or whose edges have been approximated by sutures or staples. Tend to heals longer time period, scar formation. Preferred and most effective method of healing.

Question 35

Redness (Rubor)

Answer 35

Dilatory response caused by release of chemical mediators.

Question 36

Vasodilation

Answer 36

Is to allow WBCs to enter injured area.

Question 37

Swelling

Answer 37

Cell permeability changes, interstitial osmotic pressures increases.

Question 38

Pain

Answer 38

Nerve ending irritation, lowers threshold of nococeptors.

Question 39

Cell anoxia

Answer 39

Cells dying due to lack of oxygen.

Question 40

Warmth

Answer 40

Increased blood flow, increased chemical and metabolic activity.

Question 41

Sebum

Answer 41

Oil skin & hair. Pathogen inhibiting agents.

Question 42

Mucus

Answer 42

Pathogens may stick and be swept away. Viscosity inhibits microbe movements.

Question 43

Enzymes

Answer 43

Tears. May hydrolysis pathogens.

Question 44

Hydrochlorid Acid

Answer 44

Stomach acid. May destroy pathogens.

Question 45

Sweat, tears, saliva

Answer 45

Dilution and washing action. Inhibit microbial growth.

Question 46

Proliferation Phase

Answer 46

Contraction, Granulation, Epitheiliazation

Question 47

Epithelialization

Answer 47

Epithelial cell migration towards the center of the wound from edges. Contact inhibition stops migration.

Question 48

Remodeling

Answer 48

Blends with repair phase. New collagen forms which increases wound strength.

Question 49

Closed

Answer 49

The epithelial integrity has been restored

Question 50

Healed

Answer 50

After it has been resurfaced and tissue strength approaches normal.

Question 51

Contracture

Answer 51

Shortening of scar tissue resulting in deformity. Likely to occur in wounds crossing a joint (burns).

Question 52

Second Intention

Answer 52

Occurs in wounds with large surface areas, distracted edges, or large amount of tissue loss. Heal by gradual filling of the wound with granulation material. Infected more easily. Extended healing time, excessive scar formation.