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MHD 1 > L4 Healing and Repair > Flashcards

L4 Healing and Repair Flashcards

1
Q

In addition to adaptation and death, what is another possible outcome of cell injury?

A

Repair (healing)

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2
Q

When is the repair of injured cells initiated?

A

When inflammation begins

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3
Q

What are the two forms of healing/repair?

A
  1. Regeneration

2. Scar formation

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4
Q

What is regeneration?

A

The replacement of damaged cells by replicating cells of the same type

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5
Q

What is scar formation?

A

Replacement of damaged cells by connective tissue

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6
Q

True or false - regeneration and scar formation are mutually exclusive.

A

False - they may occur simultaneously

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7
Q

In regeneration, the ___ of the tissue remains intact.

A

Extracellular matrix

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8
Q

What are the three cell types with respect to division capacity?

A
  1. Labile (always regenerating)
  2. Stable (regenerate when stimulated)
  3. Permanent (cannot regenerate)
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9
Q

What is the extracellular matrix?

A

A network of interstitial proteins that comprises a significant portion of most tissues

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10
Q

What are the 4 major functions of the ECM?

A
  1. Mechanical support
  2. Control of cell proliferation via growth factors
  3. Scaffold for regeneration
  4. Boundary between epithelium and underlying connective tissue
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11
Q

What are the two forms of ECM?

A
  1. Interstitial matrix

2. Basement membrane

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12
Q

What are the 3 major components of the ECM?

A
  1. Fibrous structural proteins (collagen and elastin)
  2. Water hydrated gels (proteoglycans and hyaluronan)
  3. Adhesive glycoproteins
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13
Q

___ attach the epithelium to the basement membrane.

A

Integrins

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14
Q

What are some examples of labile tissues?

A
  1. HSC of bone marrow
  2. Squamous epithelium of skin, oral cavity, cervix, vagina
  3. Columnar epithelium of GI tract
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15
Q

What is the classic example of stable tissue (and a few others)?

A
  1. Liver
  2. Kidney, pancreas
  3. Smooth muscle cells, fibroblasts, endothelial cells
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16
Q

___ cells line the blood vessel walls.

A

Endothelial

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17
Q

What are three examples of permanent tissue?

A
  1. Neurons (brain)
  2. Myocytes (heart)
  3. Skeletal muscle (mostly)
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18
Q

Regeneration depends on what two major factors?

A
  1. Growth factors

2. Integrity of ECM

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19
Q

What is another major source of growth factors in addition to the ECM?

A

Macrophages

20
Q

What are the two main reasons scars form?

A
  1. Injured tissues are incapable of regeneration

2. ECM severely damaged/stem cells lost

21
Q

What are the two major components of connective tissue?

A
  1. Dense bands of collagen

2. Fibroblasts

22
Q

What are the pros and cons of scar formation?

A

Pro: scar usually provides enough structural stability for injured tissue to continue to function

Con: connective tissue cannot perform function of lost parenchymal cells

23
Q

What are the 4 steps in scar formation?

A
  1. Tissue injury
  2. Inflammation (macrophages)
  3. Formation of granulation tissue
  4. Scar formation (remodeling)
24
Q

What is angiogenesis?

A

New blood vessel development from existing vessels

25
Q

What are pericytes?

A

Cells with contractile properties

26
Q

Angiogenesis is often seen in what three situations?

A
  1. Healing
  2. Development of collaterals at sites of ischemia
  3. Tumor growth
27
Q

What is an important mediator of angiogenesis?

A

VEGF (vascular endothelial growth factor)

28
Q

What is an important inducer of VEGF?

A

Hypoxia

29
Q

___ synthesize connective tissue proteins. Recruitment and activation of this cell is driven by what three growth factors?

A

Fibroblasts

PDGF, FGF, TGF-beta

30
Q

What is specialized tissue that fills in defects in organs when non-regenerative cells and/or connective tissue framework is destroyed?

A

Granulation tissue

31
Q

What are the components of granulation tissue?

A

Proliferating fibroblasts laying down type III collagen (immature connective tissue) and proliferating new blood vessels

32
Q

What is the process of transforming granulation tissue into a scar? What type of connective tissue is seen here?

A

Remodeling; type I collagen

33
Q

What type of stain makes mature collagen blue?

A

Trichrome stain

34
Q

What do myofibroblasts do?

A

Contract the wound

35
Q

What is involved in healing by first intention?

A
  • Clean, uninfected surgical incision approximated by sutures
  • Epithelial regeneration principle mechanism of repair
  • Small scar
  • Minimal contraction of wound
36
Q

What is involved in healing by second intention?

A
  • Large skin wound, extensive destruction, edges not approximated
  • Large clot, more intense inflammation
  • Wound granulates in without closing gap with sutures
  • Healing process is the same but takes longer
  • Wound contraction by myofibroblasts
37
Q

What are some factors which impair repair?

A
  1. Infection
  2. Nutrition deficiencies
  3. Glucocorticoids
  4. Poor perfusion
  5. Diabetes mellitus
  6. Foreign bodies
  7. Type of tissue
  8. Extent of injury
  9. Location of injury
38
Q

What three nutritional components are important in wound healing?

A
  1. Vitamin C
  2. Zinc
  3. Copper
39
Q

What is the function of Vitamin C in wound healing?

A

Cofactor for hydroxylation reactions (cross-linking of lysine and proline in collagen synthesis)

40
Q

What is the function of zinc in wound healing?

A

Cofactor for metalloenzymes (collagenase)

41
Q

What is the function of copper in wound healing?

A

Cofactor for lysyl oxidase (cross links lysine and hydroxylysine)

42
Q

What is an accumulation of an exuberant amount of collagen that presents with raised scars and grow beyond the wound boundaries?

A

Keloid

43
Q

What is a hypertrophic scar?

A

Excess production of scar tissue localized to the wound

44
Q

What is excessive deposition of collagen and other ECM components in a tissue/organ?

A

Fibrosis

45
Q

What is contracture?

A

Excessive myofibroblast activity in a wound causing constriction of the skin

46
Q

What is dehiscence?

A

Opening of a healing or partially healed wound with separation of its edge

MHD 1 (58 decks)

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