Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CMOD- Block1 > Path: Repair > Flashcards

Path: Repair Flashcards

1
Q

Name the two forms of repair.

A

Regenerating and scarring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the regenerating form of repair.

A

Repair with the growth of fully functional tissue to replace injured or dead tissue.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Total pure regeneration of injured tissue is rare. Explain why.

A

It requires an intact connective tissue scaffold or only superficial injury (epidermal or epithelial layer only).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Explain the process of scarring repair.

A

It replaces the injured or dead tissue with fibrous tissue lacking the specialized function of the tissue it replaces.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Name the one organ capable of regeneration to replace the function of excised tissue.

A

Liver. Amazing. The liver is Amazing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

T/F: erosions heal by regeneration.

A

True.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

T/F: ulcers heal by regeneration.

A

False. Erosions are too deep to heal by regeneration alone and thus, they scar.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe……an adhesion!

A

An abnormal connection between any two things in the body. Like your nose to your elbow. That may be an adhesion secondary to PKU.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the character of an early adhesion.

A

Early on, adhesions are composed primarily of fibrin and are referred to as fibrinous.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the character of a late adhesion. Ready, GO!

A

Later, fibroblasts deposit collagen within them and they become fibrinous, requiring a scalpel or scissors or a broad sword to separate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a fistula again?

A

An abnormal opening between two places in the body. Like your PP fossa to your elbow. Might be secondary to PKU as well.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What differentiates a fistula from an anastamosis?

A

An anastamosis is a surgically formed fistula. It belongs there. Unlike PKU.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

WHO (cell type) IS RESPONSIBLE FOR ALL THIS SCAR TISSUE??

A

Wretched fibroblasts! Who hired those clowns? Was it you mesenchyme? You’re fired. You have until the afternoon to pack all your things. No, leave the ficus, that belongs to the office.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Who are the key players in repair?

A

Fibroblasts.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why is the cytoplasm of fibroblasts so basophilic?

A

Has lots of RNA.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Let’s say a fibroblast is capable of contracting. Then what is it called? Also, why is this relevant to scars?

A

Myofibroblast. In the process of healing with scar, myofibroblasts contract and tighten up the evolving scar. As a result, scars are smaller than whatever they replace.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When their job is done, fibroblasts go into reserve mode or retire (with a great pension). What are these fibroblasts called?

A

fibrocytes. (kind of like osteocytes after osteoblasts are done laying down bone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Regeneration requires the proliferation and differentiation of _____ cells.

A

Stem cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the process of asymmetric replication and what cells undergo such a fascinating thing.

A

Stem cells undergo asymmetric replication: in every cell division, one daughter cell retains self-renewing capacity and the other enters a differentiation pathway to a mature cell (it will no longer be a stem cell).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe the 3 type of stem cells.

A

Embryonic: can give rise to any tissue (pluripotent)

Adult: can only give rise to a limited # of tissues

Induced pluripotent: derived from patient cells with embryonic stem cell lines introduced. The hope is to grow a pt’s own cells into replacement tissue/organs for any pt who needs replacement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Tissues can be categorized as _______, ________ or _________ based on the replicative capacity of their cells.

A

labile, stable or permanent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe the replicative capacity of labile tissues. Give 3 examples of such tissue.

A

Labile tissues continuously lose and replace cells by proliferation of mature cells and replacement of mature cells by stem cell proliferation.
ex: GI tract, bladder, vagina, cervix, uterus, fallopian tubes, exocrine gland ducts, bone marrow.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe the replicative capacity of stable tissues. Give two examples.

A

Composed of quiescent cells capable of proliferation, but not normally called on to proliferate.
ex: Liver, kidney, pancreas, smooth muscle tissues, blood vessel linings, fibroblasts.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Describe the replicative capacity of permanent cells and give two examples.

A

Do not proliferate except under extraordinary circumstances.
ex: parenchymal cells of brain and heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which of the 3 tissue types is most vulnerable to radiation injury?

A

Labile.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Quiescent cells are in the ____ stage of the cell cycle.

A

G0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

To proliferate, quiescent cells progress through the ____ (presynthetic growth) phase, the ___ (DNA synthesis) phase, ___ (premitotic) phase and ___ (mitosis) phase of the cell cycle.

A

G1
S
G2
M

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Cell cycle progression is driven by ______ and associated ________________.

A

cyclins; cyclin-dependent kinases (CDKs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

In cell cycle progression, cyclin-dependent kinases (CKDs) ______ the various proteins needed at each phase and then cease their contribution as their associated cyclins are ________.

A

phosphorylate; degraded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

In the cell cycle, between ____ and ____ phases, there is a checkpoint where DNA is checked for imperfections before it is duplicated.

A

G1 and S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Big DNA imperfections detected between G1 and S phase of the cell cycle trigger:

A

apoptosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

In the cell cycle, between ___ and ____ phases, there is another checkpoint where the duplicated DNA is checked for defects, triggering repair for small ones and _______ for big ones.

A

G2 and M; apoptosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

The liver has a unique and amazing ability to regenerate itself with resection of up to ____% of its parenchyma.

A

90% HOLY SHIT. First round’s on me!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Regarding hepatocyte proliferation in regeneration:

There is a priming phase wherein _____ stimulates Kupffer cells to secrete ______, which primes the hepatocytes.

A

TNF; IL-6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Regarding hepatocyte proliferation in regeneration:
Following Kupffer cell secretion of IL-6 to prime hepatocytes, there is a growth phase wherein primed hepatocytes are stimulated by ______ and hepatocyte growth factor (HGF) to leave ____ (phase) and enter the _____ phase of the cell cycle.

A

TGF-alpha; G0; G1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Regarding hepatocyte proliferation in regeneration:
When regeneration is completed, there is a termination phase wherein the hepatocytes return to their _____________ state. This phase is thought to be most likely mediated by ________.

A

quiescent G0 state; TGF-beta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

When the liver is injured by inflammation or toxins like alcohol, it can regenerate from _______ cells. Some of these cells reside in the __________ where bile canaliculi connect with larger bile ducts.

A

progenitor; canals of Hering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

________ are usually present and often prominent around nodules of regenerating hepatocytes in liver repair from chronic hepatitis.

A

Proliferating bile ductules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

_______ orchestrate the migration of monocytes, fibroblasts, fibroblast proliferation, angiogenesis and collagen production, along with other shit at the site of injury for healing.

A

growth factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Name 5 of the more important growth factors involved in the process of repair.

A 
Epidermal growth factor (EGF)
Fibroblast growth factor (FGF)
Platelet-derived growth factor (PDGF)
Transforming growth factor (TGF)
Vascular endothelial growth factor (VEGF)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Describe the action of EGF to aid in the repair process of injured tissues.

A

Stimulates fibroblast migration, fibroblast proliferation and collagenase secretion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Describe the action of FGF to aid in the repair process of injured tissues.

A

stimulates fibroblast migration to repair sites and fibroblast proliferation, as well as monocyte chemotaxis and angiogenesis and collagenase secretion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Describe the action of PDGF to aid in the repair process of injured tissues.

A

Promotes fibroblast migration to repair sites, fibroblast proliferation and monocyte chemotaxis, along with collagen synthesis, but also collagenase secretion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

_______ is most prevalent early in the process of injury repair when blood vessel disruption allows platelet contact with extracellular matrix.

A

PDGF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Describe the action of VEGF to aid in the repair process of injured tissues.

A

Mediates angiogenesis. Does nothing else!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Describe the action of TGF-beta to aid in the repair process of injured tissues.

A

Chemotactic for neutrophils, lymphocytes, macrophages, fibroblasts and smooth muscle cells. Stimulates tissue inhibitors of MMPs, stimulates karatinocyte migration, angiogenesis and fibroplasia, as well as promoting collagen synthesis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

______, is probably the most important growth factor in inflammatory fibrosis.

A

TGF-beta.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

T/F: TGF-beta promotes production of TGF-beta.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

________ activated by injury are the most important source of growth factors mediating repair.

A

Macrophages

50
Q

Monocyte chemotaxis of repair to tissue injury is mediated by what GFs?

A

PDGF
FGF
TGF-beta

51
Q

Fibroblast Migration of repair to tissue injury is mediated by what GFs?

A

PDGF
EGF
FGF
TGF-beta

52
Q

Fibroplast Proliferation of repair to tissue injury is mediated by what GFs?

A

PDGF
EGF
FGF
TGF-beta

53
Q

Angiogenesis of repair to tissue injury is mediated by what GFs?

A

FGF
VEGF
TGF-beta

54
Q

Collagen synthesis of repair to tissue injury is mediated by what GFs?

A

PDGF

TGF-beta

55
Q

Basement membranes are composed of which notable collagen type?

A

Type IV

56
Q

Name the 4 fibrillar collagens. and describe their character.

A 
I
II
III
V
Composed of 3 polypeptide chains braided into a rope-like triple helix. Strengthened by lateral cross-links.
57
Q

_______ deficiencies are collectively the most common disorders of connective tissue.

A

Collagen deficiencies

58
Q

The net result of the 4 types of osteogenesis imperfecta is:

A

fragile bones, which fracture easily with minor trauma and heal poorly.

59
Q

Ehlers-Danlos syndrome (classical form) causes defectie type _____ collagen that is weaker than normal, but this weakened collagen allows ________ joints and ______ skin.

A

type V collagen; hypermobile joints; hyperextensible skin

60
Q

The vascular type of Ehlers-Danlos syndrome causes defective type ___ collagen, which is prevalent in blood vessels and bowel wall.

A

Type III collagen.

61
Q

The kyphoscoliotic type of Ehlers-Danlos syndrome is due to deficiency of the enzyme lysyl hydroxylase, which impairs cross-linking of types ___ and ___ collagen, resulting in crooked spines.

A

types I and III collagen

62
Q

Classic and vascular types of Ehlers-Danlos have what mode of inheritance?

A

Autosomal dominant

63
Q

The kyphoscoliotic type of Ehlers-Danlos has what mode of inheritance.

A

Autosomal recessive

64
Q

_______ is a glycoprotein secreted by fibroblasts and a major component of microfibrils, which serve as scaffolding for the deposition of _______, which is an integral component of elastin, which is particularly abundant in the aorta and ligaments.

A

Fibrillin; tropoelastin

65
Q

Defects in the fibrillin gene cause ______ syndrome which features thin elongated body habitus, with abnormally long arms, fingers and legs, and weak aorta, prone to dilation and rupture.

A

Marfan syndrome

66
Q

The enzymes prolyl hydroxylase and lysyl hydroxylase catalyze the formation of the covalent bonds cross-linking fibrillar collagen and this is dependent on ________.

A

Vitamin C

67
Q

Genetic defects in structural proteins tend to have a _________ pattern of inheritance whereas genetic defects in enzymes tend to have a _________ pattern of inheritance.

A

Autosomal dominant; autosomal recessive

68
Q

________ tissue is healing tissue with residual chronic inflammatory cells (lymphocytes and macrophages), cellular debris, fibroblasts, neovascularization and new collagen.

A

Granulation tissue

69
Q

In pathology, _______ is the process of replacing injured, necrotic and inflamed tissue by healing and scar tissue.

A

Organization

70
Q

The key cellular player in the process of organization is the…

A

FIBROBLAST!

71
Q

VEGF production is mediated by two growth factors and one circumstance:

A

TGF, PDGF and hypoxia

72
Q

Describe the chronology of angiogenesis in skin wounds.

A

Begins early, peaks at day 5 (with a clean, straight wound) and rapidly dissipates (during the second week).

73
Q

Describe the chronology of angiogenesis in myocardial infactions.

A

Angiogenesis begins simultaneously with fibroblast infiltration at the periphery of the infarcted tissue on day 4, and the new blood vessels persist for weeks into healing.

74
Q

Describe the 7 steps of angiogenesis.

A

1) Existing blood vessel dilates in response to NO. VEGF causes vessel to vasodilate and become more permeable.
2) Pericytes detatch from their blood vessel and basement membrane breaks down at site of pericyte detatchment
3) Endothelial cells migrate to site of BM breakdown.
4) Endothelial cells proliferate
5) Aggregate of proliferated endothelial cells remodeled into a capillary tube w/ lumen
6) Pericytes recruited to more fully develop new BV.
7) BM extends along new BV as further endothelial cell migration and proliferation is inhibited.

75
Q

How does the monoclonal Ab Bevacizumab treat various cancers?

A

It blocks the action of VEGF in promoting angiogenesis to expanding tumor.

76
Q

List 5 growth factors important to angiogenesis.

A

VEGF, FGFs, angiopoetins, PDGF and TGF-beta

77
Q

Regarding angiogenesis:

_____ (GF) stimulates endothelial cell proliferation.

A

FGF

78
Q

Regarding angiogenesis:

_________ (GF) recruit pericytes and smooth muscle cells (for arterial walls).

A

angiopoetins

79
Q

Regarding angiogenesis:

_______ (GF) recruits smooth muscle cells for arteries.

A

PDGF

80
Q

Regarding angiogenesis:

_______ is important for limiting the process to where it is needed at sites of injury.

A

TGF-beta

81
Q

Regarding angiogenesis:
___________ signaling regulates the sprouting and branching of new blood vessel to coordinate this with the healing needs of damaged tissue.

A

Notch pathway

82
Q

Extracellular matrix proteins interact with ________ on endothelial cells to provide the scaffolding for angiogenesis.

A

integrins

83
Q

_______ remove ECM in the way of growing blood vessels.

A

MMPs (matrix metalloproteinases)

84
Q

What metal do MMPs depend on for their action?

A

Zinc

85
Q

Name the 3 overlapping phases of cutaneous wound healing.

A

Inflammation
Proliferation (granulation tissue)
Maturation (wound contraction)

86
Q

What is healing by “first intention”?

A

Surgical incisions of the skin, when clean, uninfected and edges approximated by sutures. Heal especially quickly and well.

87
Q

What is healing by “second intention”?

A

Large wounds with commonly irregular edges, not approximated by surgical sutures.

88
Q

What happens within 24 hrs of incision in healing by first intention?

A

Incision fills with blood clot and neutrophils infiltrate the clot from the margins.

89
Q

Regarding healing by first intention:
On what day do epithelial cells proliferate and move into the clot filling the cleft, extending the cut margin of the basement membrane as they go?

A

Day 2

90
Q

Regarding healing by first intention:

What happens on day 3?

A

Macrophages infiltrate and replace neutrophils. Proliferation of epithelial cells thickens the renewing epidermis under the scab.

91
Q

Regarding healing by first intention:

What happens on day 4?

A

Fibroblasts infiltrate, proliferate and lay down collagen.

92
Q

Regarding healing by first intention:

What happens on day 5?

A

Granulation tissue fills the space created by the incision and angiogenesis reaches its peak. Collagen is now more abundant and beginning to bridge the incisional space. Epidermis reaches normal thickness, w/ keratin formation. Residual surface clot, the scab, loosens.
Mnemonic: ABC-EFG (no D)
A-angiogenesis / B-bridge of collagen / C-clot or scab loosens / E-epidermis reaches normal thickness / F-formation of keratin / G-granulation tissue

93
Q

Regarding healing by first intention, how long does it take a wound to completely heal?

A

1 month

94
Q

Regarding wound healing by second intention, what makes the end result crappy compared to healing by first intention?

A

More intense inflammation during healing.
Wound contraction by 5-10%
Scar formation
Epidermal layer is ultimately thinner than normal
Skin appendages, such as hair, sweat glands, are lost
Skin wound strength by day 7, when compared to first intention healing, is 10%.
Skin wound strength at month 3 is about 75% of normal skin and remains so for LIFE.

95
Q

What are the two most characteristic features of the proliferative phase of wound healing?

A

Angiogenesis

Fibroblast proliferation

96
Q

What is the most important GF driving angiogenesis?

A

VEGF

97
Q

Name a disease in which angiogenesis is more harmful than good (besides tumors). What mAB is injected to treat this and what does it act on?

A

Retinopathies

Bevacizumab, blocks action of VEGF

98
Q

What is the most important growth factor driving fibroblast migration, proliferation and collagen synthesis?

A

TGF-beta

99
Q

This final stage of healing features tissue remodeling.

A

Maturation (wound contraction)

100
Q

What are TIMPs?

A

Tissue inhibitors of MMPs

101
Q

Proper tissue remodeling requires a fine balance of MMPs and _______ to ensure during the wound contraction, we do not destroy ourselves.

A

TIMPs

102
Q

The influence of location on the rate of healing is largely due to the ___________________.

A

Relative blood supply to various parts of the body

103
Q

_______ is perhaps the best to regard as the most important cause of impaired wound healing, partly because it is the most common preventable cause of delayed healing.

A

Infection

104
Q

Why does diabetes mellitus delay wound healing?

A

Microangiopathy, glucose feeds infectious organisms, makes neutrophils lazy.

105
Q

Why do corticosteroids delay wound healing?

A

They inhibit TGF-beta production and result in diminished fibrosis. They inhibit protein synthesis in general and collagen synthesis in particular. They are catabolic an wound healing is an anabolic process.

106
Q

How does anemia affect wound healing?

A

Decreases O2 to site of injury, delaying healing

107
Q

What is dehiscence?

A

Rupture of a surgical wound or anastomosis.

108
Q

What is a hernia?

A

The protrusion of a body part somewhere it does not belong. Like your nose protruding into your elbow, in PKU.

109
Q

______________ is caused by excessive creation of ECM, especially of dense collagen, primarily in skin of head, neck and upper chest, primarily in young people after traumatic or thermal injury to deep dermis.

A

Hypertrophic scarring

110
Q

What are keloids?

A

Hypertrophic scars that exceed the boundaries of the wound.

111
Q

_________, also called aggressive fibromatosis, is a proliferation of fibroblasts, most common in abdominal wall surgical sites in young adult women.

A

Desmoid tumor

112
Q

What is wound contracture?

A

Abnormal excess wound contraction resulting in deformity and impaired movement.

113
Q

Where are contractures particularly common?

A

Palms (Dupuytren’s contracture)
Soles (Lederhosen disease)
Penis (Peyronie Disease)

114
Q

What is fibrosis?

A

Excessive interstitial collagen deposition, commonly replacing normal functional (parenchymal) tissue.

115
Q

_________ cause the worst fibrosis because the inciting agent is continuously present and cannot be limited or eliminated.

A

Autoimmune diseases

116
Q

Liver fibroses or scars in a unique way consisting of rounded nodules of regenerating hepatocytes surrounded by fibrous tissue and this unique form of scarring is called:

A

Cirrhosis

117
Q

What is the major cytokine in fibrosis?

A

TGF-beta

118
Q

What are cold agglutinins?

A

Immunoglobulins, predominantly IgM, typically lead to agglutination of erythrocytes below certain temperatures, causing impaired microcirculation and hemolysis.

119
Q

Cold agglutinins are associated with which microbial disease?

A

Mycoplasma pneumonia

120
Q

A mutinucleated giant cell with nuclei arranged peripherally in a horse-shoe pattern are called:

A

Langhans type. Associated with immune granulomas. Reacting to infection or autoimmune disease.

CMOD- Block1 (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions