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EMS > Lecture 18: Repair and regeneration > Flashcards

Lecture 18: Repair and regeneration Flashcards

1
Q

What is regeneration?

A

Cells can regrow
Restoration of normal structure and function

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2
Q

What is repair?

A

Cells cannot regrow
Scar formation
Loss of function

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3
Q

After injury and acute inflammation, what pathways can be taken?

A

Regeneration
Repair
Chronic inflammation

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4
Q

Two most important factors determining outcome of injury?

A
  1. ability of the cells to replicate
  2. ability to rebuild complex architectural structures
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5
Q

What different cell types in the repair / regeneration of cells cycle?

A
  1. Continuously cycling labile cells
    2 Permanent Cells
  2. Quiescent stable cells
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6
Q

What different cell types in the repair / regeneration of cells cycle?

A
  1. Continuously cycling labile cells
    2 Permanent Cells
  2. Quiescent stable cells
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7
Q

What is the labile cell population and characteristics?

A

High normal turnover
Active stem cell population
Excellent regenerative capacity

Example: Epithelia

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8
Q

What is the stable quiescent cell population and characteristics?

A

Low turnover
(physiological)
Turnover can massively increase
(if needed)
Good regenerative capacity

Example: liver, renal tubules

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9
Q

What is the permanent cell population and characteristics?

A

No turnover
(physiological)
Long life cells
No regenerative capacity

Example: neurons, striated muscle cells

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10
Q

Stem cell characteristics?

A

Prolonged self-renewal
Asymmetric replication
Reservoirs in many adult tissues

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11
Q

How do Stem cells form?

A
  1. Terminal
    differentiation
    2.Differentiating
    compartment
    3.Amplifying cell
    compartment
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12
Q

What is the population of Stem cells?

A

Present in many labile and stable cell populations
Located in specific areas (basal)
Survival = crucial to regeneration

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13
Q

Give an example of the rebuild of complex architectures which is limited?

A

Glomeruli, lung

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14
Q

An example of when survival of connective tissue is essential?

A

Cirrhosis

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15
Q

How does complete restitution occur?

A

Loss of labile cell population can be completely restored
e.g minor skin abrasion
Cells at edge of defect multiply to cover defect

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16
Q

What is contact inhibition?

A

when cells cover defect proliferation stops

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17
Q

What is complex regeneration controlled by?

A

growth factors
cell-cell interactions
cell-matrix interactions

These mechanisms are lost in neoplasia

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18
Q

What does regeneration depend on?

A

tissue cell kinetics
architecture
stem cell survival

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19
Q

how does healing by regeneration affect specialised function?

A

Restitution of
specialised function

20
Q

How does healing by repair affect specialised function?

A

Loss of specialised
function

21
Q

What happens during repair of cells/tissues?

A

Normal structure cannot be replaced
Healing by non-specialised fibrous tissue (‘Scar’)
Functional consequences

22
Q

What is Organisation?

A

the repair of specialised tissue by formation of a fibrous scar

23
Q

What is an example of organisation?

A

Example = common consequence of pneumonia and infarction

24
Q

Organisation characteristics?

A

Basic stereotyped pathological process
Production of granulation tissue (often on scaffold of fibrin)
Removal of dead tissue by phagocytosis
Granulation tissue contracts and accumulates collagen
Scar forms
Organised area = firm and puckered

25
Q

What is Granulation tissue?

A

New capillary loops
Phagocytic cell (Neutrophils and Macrophages)
(Myo)fibroblasts

26
Q

What does Endothelial cell proliferation include?

A

Buds

Canalisation

New vessels

27
Q

What do phagocytes do?

A

Remove dead /
Damaged tissue

28
Q

What is included in Proliferation and migration
of myofibroblasts?

A

Synthesise collagen
and ECM

Acquire myofibrils and
contractile ability

29
Q

What decreases in maturation of granulation tissue?

A
  1. Vascularity
  2. Cellularity
30
Q

What increases in Maturation of Granulation tissue?

A

Collagen, ECM wound strength.

31
Q

What is involved in healing by first intention?

A

Clean, uninfected surgical wound
Good haemostasis
Edges apposed

32
Q

What is involved by healing by second intention?

A

Extensive loss of tissue
Wound edges not apposed
Apposition not physically possible
Large haematoma
Infection
Foreign body
More florid granulation tissue reaction
More extensive scarring

33
Q

Wound strength after a week?

A

10%

34
Q

Wound strength after week 4- week 12?

A

70 - 80%

35
Q

Local factors inhibiting healing?

A

Infection
Haematoma
Blood supply
Foreign bodies
Mechanical stress

36
Q

Systemic factors inhibiting healing?

A

Age
Drugs (eg steroids)
Anaemia
Diabetes
Malnutrition
Catabolic states
Vitamin C deficiency
Trace metal deficiency

37
Q

What is a haematoma?

A

Haemorrhage around and within the bone - haematoma

38
Q

Is haematoma organised?

A

Yes - removal of necrotic fragments

39
Q

Fracture healing pathway?

A

Osteoblasts lay down disorganised woven bone (callus)
Remodelling according to mechanical stress
Replacement by more orderly lamellar bone

40
Q

Non- union of fractures?

A

Misalignment
Movement
Infection
Interposed soft tissue
Pre-existing bone pathology
‘pathological fracture’

41
Q

How are neurons organised in the brain?

A

Terminally differentiated

42
Q

Support tissue in the brain?

A

Glial cells

43
Q

What do you get in the brain when damage tissues are removed?

A

Cysts

44
Q

What happens in the brain rather than scarring?

A

Gliosis

45
Q

For growth factor and function for control of healing:

A

Word document

EMS (54 decks)

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